An ultrasound system for simultaneous ultrasound hyperthermia and photon beam irradiation

International Nuclear Information System (INIS)

Straube, William L.; Moros, Eduardo G.; Low, Daniel A.; Klein, Eric E.; Willcut, Virgil M.; Myerson, Robert J.

1996-01-01

Purpose: An existing ultrasound system has been adapted for simultaneous use with external photon beam irradiation. The system is being used to investigate the potential for increased biological benefit of simultaneously combined hyperthermia and external beam irradiation with currently achievable temperature distributions. Methods and Materials: An existing clinical ultrasound system has been modified for simultaneous operation with a 60 Co teletherapy machine. The generator, thermometry system, computer, and applicators are located inside the treatment room, while the monitor and system control are located at the control console. Two approaches have been used clinically to combine the two modalities. In the first approach, an en-face setup is used in which the ultrasound beam and the photon beam travel through the same window of entry to the tumor. This is achieved by a reflecting system designed to deflect the ultrasound to the tumor while positioning the ultrasound transducer outside the radiation beam. The reflecting system consists of water and water-equivalent materials except for a 1 mm sheet of polished brass that is used as the reflector. The relative pressure fields were measured in water at the same distance from the ultrasound source using a scanning hydrophone with and without the reflector at the two operating frequencies of the device (1.0 and 3.4 MHz) for two applicators. Radiation dosimetry measurements were performed to determine the relationship between 60 Co irradiation through the reflector and absorbed dose. In the second approach the ultrasound and the radiation beam travel into the tumor from different windows of entry such that the radiation beam passes through no portion of the water bolus prior to entering the patient. We have termed this approach the orthogonal approach. For both approaches, the radiation fraction is given in the middle of an uninterrupted 60-min hyperthermia treatment. Results: The system modifications did not impair

A Diagnostic Ultrasound Imaging System

International Nuclear Information System (INIS)

Lee, Seong Woo

1999-01-01

The ability to see the internal organs of the human body in a noninvasive way is a powerful diagnostic tool of modern medicine. Among these imaging modalities such as X-ray, MRI, and ultrasound. MRI and ultrasound are presenting much less risk of undesirable damage of both patient and examiner. In fact, no deleterious effects have been reported as a result of clinical examination by using MRI and ultrasound diagnostic equipment. As a result, their market volume has been rapidly increased. MRI has a good resolution. but there are a few disadvantages such as high price. non-real-time imaging capability. and expensive diagnostic cost. On the other hand, the ultrasound imaging system has inherently poor resolution as compared with X-ray and MRI. In spite of its poor resolution, the ultrasound diagnostic equipment is lower in price and has an ability of real-time imaging as compared with the others. As a result, the ultrasound imaging system has become general and essential modality for imaging the internal organs of human body. In this review various researches and developments to enhance the resolution of the ultrasound images are explained and future trends of the ultrasound imaging technology are described

Ultrasound guided aspiration of breast abscess as an alternative to surgical incision and drainage

International Nuclear Information System (INIS)

Naper, M.A.; Shaikh, M.S.; Dholia, K.R.

2017-01-01

To evaluate the outcome and assess the success rate of ultrasound guided aspiration of breast abscess as an alternative to surgical incision and drainage. Methodology: A prospective descriptive study was carried out at Department of Surgery, Chandka Medical College Hospital, Larkana, Pakistan, from January 2015 to December 2015. A total of 111 patients of breast abscess who underwent ultrasound guided aspiration without anesthesias with oral antibiotic cover were studied. Females with breast abscess within seven days, and the abscess size was <3cm were included in the study. Males, antibioma and inflammatory carcinoma were excluded from the study. Outcome of success or failure was observed within two weeks and recorded. Results: Out of 111 patients, 68.46% were lactating and 31.53% were non-lactating women, with ages ranging from 18 to 60 years (mean 36.5 years). The successful rate with complete resolution after ultrasound guided aspiration was observed in 94.5%. 80.82% responded after single aspiration, 12.38% after two times aspiration, and 6.66% after multiple aspirations, while 5.4% of patients required incision and drainage. Conclusion: Ultrasound guided aspiration of breast abscess is an effective treatment option with a diameter of <3cm, which can be recommended as a routine outpatient procedure. (author)

Doppler ultrasound and magnetic resonance for evaluation of patients treated surgically for aortic coarctation

International Nuclear Information System (INIS)

Canteli, B.; Saez, F.; Garcia, F.; Cabrera, A.; Galdeano, J.M.; Rodriguez, O.

1994-01-01

Doppler ultrasound and magnetic resonance were performed in a series of 39 patients who had been treated surgically for aortic coarctation. The purpose was to assess the different Doppler gradients, comparing the findings with morphological data disclosed by magnetic resonance. The aortic caliber in the operative field was pathological in 7 patients (ratio between the caliber at the level of the lesion and that of descending aorta of less than 0.7). When the patients were considered as a group. Doppler ultrasound did not show satisfactory sensitivity (29%-43%), specificity (74%) or positive predictive value (17%-23%). Only the negative predictive value (85%-88%) presented more favorable results. When the Subgroup of patients without associated cardiac abnormalities or collateral circulation was studied alone, the following results were found: sensitivity, 100%; specificity, 81%-90%, positive predictive value, 33%-50%, negative predictive value, 100%, similar to those reported in the literature. Thus, we consider that Doppler ultrasound is a harmless and low cost diagnostic method that is highly suitable for follow-up of these patients, within certain limits. Magnetic resonance is the method of choice for the noninvasive assessment of aortic morphology. (Author)

Ultrasound and MRI predictors of surgical bowel resection in pediatric Crohn disease

International Nuclear Information System (INIS)

Rosenbaum, Daniel G.; Conrad, Maire A.; Kelsen, Judith R.; Biko, David M.; Anupindi, Sudha A.; Ruchelli, Eduardo D.

2017-01-01

Imaging predictors for surgery in children with Crohn disease are lacking. To identify imaging features of the terminal ileum on short-interval bowel ultrasound (US) and MR enterography (MRE) in children with Crohn disease requiring surgical bowel resection and those managed by medical therapy alone. This retrospective study evaluated patients 18 years and younger with Crohn disease undergoing short-interval bowel US and MRE (within 2 months of one another), as well as subsequent ileocecectomy or endoscopy within 3 months of imaging. Appearance of the terminal ileum on both modalities was compared between surgical patients and those managed with medical therapy, with the following parameters assessed: bowel wall thickness, mural stratification, vascularity, fibrofatty proliferation, abscess, fistula and stricture on bowel US; bowel wall thickness, T2 ratio, enhancement pattern, mesenteric edema, fibrofatty proliferation, abscess, fistula and stricture on MRE. A two-sided t-test was used to compare means, a Mann-Whitney U analysis was used for non-parametric parameter scores, and a chi-square or two-sided Fisher exact test compared categorical variables. Imaging findings in surgical patients were correlated with location-matched histopathological scores of inflammation and fibrosis using a scoring system adapted from the Simple Endoscopic Score for Crohn Disease, and a Spearman rank correlation coefficient was used to compare inflammation and fibrosis on histopathology. Twenty-two surgical patients (mean age: 16.5 years; male/female: 13/9) and 20 nonsurgical patients (mean age: 14.8; M/F: 8/12) were included in the final analysis. On US, the surgical group demonstrated significantly increased mean bowel wall thickness (6.1 mm vs. 4.7 mm for the nonsurgical group; P = 0.01), loss of mural stratification (odds ratio [OR] = 6.3; 95% confidence interval [CI]: 1.4-28.4; P = 0.02) and increased fibrofatty proliferation (P = 0.04). On MRE, the surgical group showed

Ultrasound and MRI predictors of surgical bowel resection in pediatric Crohn disease

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Rosenbaum, Daniel G. [NewYork-Presbyterian Hospital/Weill Cornell Medicine, Division of Pediatric Radiology, New York, NY (United States); Conrad, Maire A.; Kelsen, Judith R. [The Children' s Hospital of Philadelphia, Division of Gastroenterology, Hepatology and Nutrition, Philadelphia, PA (United States); Biko, David M.; Anupindi, Sudha A. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Ruchelli, Eduardo D. [The Children' s Hospital of Philadelphia, Division of Anatomic Pathology, Philadelphia, PA (United States)

2017-01-15

Imaging predictors for surgery in children with Crohn disease are lacking. To identify imaging features of the terminal ileum on short-interval bowel ultrasound (US) and MR enterography (MRE) in children with Crohn disease requiring surgical bowel resection and those managed by medical therapy alone. This retrospective study evaluated patients 18 years and younger with Crohn disease undergoing short-interval bowel US and MRE (within 2 months of one another), as well as subsequent ileocecectomy or endoscopy within 3 months of imaging. Appearance of the terminal ileum on both modalities was compared between surgical patients and those managed with medical therapy, with the following parameters assessed: bowel wall thickness, mural stratification, vascularity, fibrofatty proliferation, abscess, fistula and stricture on bowel US; bowel wall thickness, T2 ratio, enhancement pattern, mesenteric edema, fibrofatty proliferation, abscess, fistula and stricture on MRE. A two-sided t-test was used to compare means, a Mann-Whitney U analysis was used for non-parametric parameter scores, and a chi-square or two-sided Fisher exact test compared categorical variables. Imaging findings in surgical patients were correlated with location-matched histopathological scores of inflammation and fibrosis using a scoring system adapted from the Simple Endoscopic Score for Crohn Disease, and a Spearman rank correlation coefficient was used to compare inflammation and fibrosis on histopathology. Twenty-two surgical patients (mean age: 16.5 years; male/female: 13/9) and 20 nonsurgical patients (mean age: 14.8; M/F: 8/12) were included in the final analysis. On US, the surgical group demonstrated significantly increased mean bowel wall thickness (6.1 mm vs. 4.7 mm for the nonsurgical group; P = 0.01), loss of mural stratification (odds ratio [OR] = 6.3; 95% confidence interval [CI]: 1.4-28.4; P = 0.02) and increased fibrofatty proliferation (P = 0.04). On MRE, the surgical group showed

A novel ultrasound-guided shoulder arthroscopic surgery

Science.gov (United States)

Tyryshkin, K.; Mousavi, P.; Beek, M.; Chen, T.; Pichora, D.; Abolmaesumi, P.

2006-03-01

This paper presents a novel ultrasound-guided computer system for arthroscopic surgery of the shoulder joint. Intraoperatively, the system tracks and displays the surgical instruments, such as arthroscope and arthroscopic burrs, relative to the anatomy of the patient. The purpose of this system is to improve the surgeon's perception of the three-dimensional space within the anatomy of the patient in which the instruments are manipulated and to provide guidance towards the targeted anatomy. Pre-operatively, computed tomography images of the patient are acquired to construct virtual threedimensional surface models of the shoulder bone structure. Intra-operatively, live ultrasound images of pre-selected regions of the shoulder are captured using an ultrasound probe whose three-dimensional position is tracked by an optical camera. These images are used to register the surface model to the anatomy of the patient in the operating room. An initial alignment is obtained by matching at least three points manually selected on the model to their corresponding points identified on the ultrasound images. The registration is then improved with an iterative closest point or a sequential least squares estimation technique. In the present study the registration results of these techniques are compared. After the registration, surgical instruments are displayed relative to the surface model of the patient on a graphical screen visible to the surgeon. Results of laboratory experiments on a shoulder phantom indicate acceptable registration results and sufficiently fast overall system performance to be applicable in the operating room.

Machine Learning in Ultrasound Computer-Aided Diagnostic Systems: A Survey.

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Huang, Qinghua; Zhang, Fan; Li, Xuelong

2018-01-01

The ultrasound imaging is one of the most common schemes to detect diseases in the clinical practice. There are many advantages of ultrasound imaging such as safety, convenience, and low cost. However, reading ultrasound imaging is not easy. To support the diagnosis of clinicians and reduce the load of doctors, many ultrasound computer-aided diagnosis (CAD) systems are proposed. In recent years, the success of deep learning in the image classification and segmentation led to more and more scholars realizing the potential of performance improvement brought by utilizing the deep learning in the ultrasound CAD system. This paper summarized the research which focuses on the ultrasound CAD system utilizing machine learning technology in recent years. This study divided the ultrasound CAD system into two categories. One is the traditional ultrasound CAD system which employed the manmade feature and the other is the deep learning ultrasound CAD system. The major feature and the classifier employed by the traditional ultrasound CAD system are introduced. As for the deep learning ultrasound CAD, newest applications are summarized. This paper will be useful for researchers who focus on the ultrasound CAD system.

Machine Learning in Ultrasound Computer-Aided Diagnostic Systems: A Survey

Directory of Open Access Journals (Sweden)

Qinghua Huang

2018-01-01

Full Text Available The ultrasound imaging is one of the most common schemes to detect diseases in the clinical practice. There are many advantages of ultrasound imaging such as safety, convenience, and low cost. However, reading ultrasound imaging is not easy. To support the diagnosis of clinicians and reduce the load of doctors, many ultrasound computer-aided diagnosis (CAD systems are proposed. In recent years, the success of deep learning in the image classification and segmentation led to more and more scholars realizing the potential of performance improvement brought by utilizing the deep learning in the ultrasound CAD system. This paper summarized the research which focuses on the ultrasound CAD system utilizing machine learning technology in recent years. This study divided the ultrasound CAD system into two categories. One is the traditional ultrasound CAD system which employed the manmade feature and the other is the deep learning ultrasound CAD system. The major feature and the classifier employed by the traditional ultrasound CAD system are introduced. As for the deep learning ultrasound CAD, newest applications are summarized. This paper will be useful for researchers who focus on the ultrasound CAD system.

Endoscopic ultrasound-guided pancreaticobiliary intervention in patients with surgically altered anatomy and inaccessible papillae: A review of current literature

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Martin, Aaron; Kistler, Charles Andrew; Wrobel, Piotr; Yang, Juliana F.; Siddiqui, Ali A.

2016-01-01

The management of pancreaticobiliary disease in patients with surgically altered anatomy is a growing problem for gastroenterologists today. Over the years, endoscopic ultrasound (EUS) has emerged as an important diagnostic and therapeutic modality in the treatment of pancreaticobiliary disease. Patient anatomy has become increasingly complex due to advances in surgical resection of pancreaticobiliary disease and EUS has emerged as the therapy of choice when endoscopic retrograde cholangiopancreatography failed cannulation or when the papilla is inaccessible such as in gastric obstruction or duodenal obstruction. The current article gives a comprehensive review of the current literature for EUS-guided intervention of the pancreaticobiliary tract in patients with altered surgical anatomy. PMID:27386471

[Ultrasound of the urinary system].

Science.gov (United States)

Segura-Grau, A; Herzog, R; Díaz-Rodriguez, N; Segura-Cabral, J M

2016-09-01

Ultrasound techniques are able to provide a fairly complete examination of the urinary system, achieving a high sensitivity in relevant-pathology detection, especially in the kidney, bladder and prostate. Early detection of pathologies such as tumors or urinary tract obstructions, sometimes even before their clinical manifestation, has improved their management and prognosis in many cases. This, added to its low cost and harmlessness, makes ultrasound ideal for early approaches and follow-up of a wide number of urinary system pathologies. In this article, the ultrasound characteristics of the main urinary system pathologies that can be diagnosed by this technique, are reviewed. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

OSPACS: Ultrasound image management system

Directory of Open Access Journals (Sweden)

Bessant Conrad

2008-06-01

Full Text Available Abstract Background Ultrasound scanning uses the medical imaging format, DICOM, for electronically storing the images and data associated with a particular scan. Large health care facilities typically use a picture archiving and communication system (PACS for storing and retrieving such images. However, these systems are usually not suitable for managing large collections of anonymized ultrasound images gathered during a clinical screening trial. Results We have developed a system enabling the accurate archiving and management of ultrasound images gathered during a clinical screening trial. It is based upon a Windows application utilizing an open-source DICOM image viewer and a relational database. The system automates the bulk import of DICOM files from removable media by cross-validating the patient information against an external database, anonymizing the data as well as the image, and then storing the contents of the file as a field in a database record. These image records may then be retrieved from the database and presented in a tree-view control so that the user can select particular images for display in a DICOM viewer or export them to external media. Conclusion This system provides error-free automation of ultrasound image archiving and management, suitable for use in a clinical trial. An open-source project has been established to promote continued development of the system.

Actuator-Assisted Calibration of Freehand 3D Ultrasound System.

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Koo, Terry K; Silvia, Nathaniel

2018-01-01

Freehand three-dimensional (3D) ultrasound has been used independently of other technologies to analyze complex geometries or registered with other imaging modalities to aid surgical and radiotherapy planning. A fundamental requirement for all freehand 3D ultrasound systems is probe calibration. The purpose of this study was to develop an actuator-assisted approach to facilitate freehand 3D ultrasound calibration using point-based phantoms. We modified the mathematical formulation of the calibration problem to eliminate the need of imaging the point targets at different viewing angles and developed an actuator-assisted approach/setup to facilitate quick and consistent collection of point targets spanning the entire image field of view. The actuator-assisted approach was applied to a commonly used cross wire phantom as well as two custom-made point-based phantoms (original and modified), each containing 7 collinear point targets, and compared the results with the traditional freehand cross wire phantom calibration in terms of calibration reproducibility, point reconstruction precision, point reconstruction accuracy, distance reconstruction accuracy, and data acquisition time. Results demonstrated that the actuator-assisted single cross wire phantom calibration significantly improved the calibration reproducibility and offered similar point reconstruction precision, point reconstruction accuracy, distance reconstruction accuracy, and data acquisition time with respect to the freehand cross wire phantom calibration. On the other hand, the actuator-assisted modified "collinear point target" phantom calibration offered similar precision and accuracy when compared to the freehand cross wire phantom calibration, but it reduced the data acquisition time by 57%. It appears that both actuator-assisted cross wire phantom and modified collinear point target phantom calibration approaches are viable options for freehand 3D ultrasound calibration.

Ultrasound and MRI predictors of surgical bowel resection in pediatric Crohn disease.

Science.gov (United States)

Rosenbaum, Daniel G; Conrad, Maire A; Biko, David M; Ruchelli, Eduardo D; Kelsen, Judith R; Anupindi, Sudha A

2017-01-01

Imaging predictors for surgery in children with Crohn disease are lacking. To identify imaging features of the terminal ileum on short-interval bowel ultrasound (US) and MR enterography (MRE) in children with Crohn disease requiring surgical bowel resection and those managed by medical therapy alone. This retrospective study evaluated patients 18 years and younger with Crohn disease undergoing short-interval bowel US and MRE (within 2 months of one another), as well as subsequent ileocecectomy or endoscopy within 3 months of imaging. Appearance of the terminal ileum on both modalities was compared between surgical patients and those managed with medical therapy, with the following parameters assessed: bowel wall thickness, mural stratification, vascularity, fibrofatty proliferation, abscess, fistula and stricture on bowel US; bowel wall thickness, T2 ratio, enhancement pattern, mesenteric edema, fibrofatty proliferation, abscess, fistula and stricture on MRE. A two-sided t-test was used to compare means, a Mann-Whitney U analysis was used for non-parametric parameter scores, and a chi-square or two-sided Fisher exact test compared categorical variables. Imaging findings in surgical patients were correlated with location-matched histopathological scores of inflammation and fibrosis using a scoring system adapted from the Simple Endoscopic Score for Crohn Disease, and a Spearman rank correlation coefficient was used to compare inflammation and fibrosis on histopathology. Twenty-two surgical patients (mean age: 16.5 years; male/female: 13/9) and 20 nonsurgical patients (mean age: 14.8; M/F: 8/12) were included in the final analysis. On US, the surgical group demonstrated significantly increased mean bowel wall thickness (6.1 mm vs. 4.7 mm for the nonsurgical group; P = 0.01), loss of mural stratification (odds ratio [OR] = 6.3; 95% confidence interval [CI]: 1.4-28.4; P = 0.02) and increased fibrofatty proliferation (P = 0.04). On MRE, the

A Wearable Goggle Navigation System for Dual-Mode Optical and Ultrasound Localization of Suspicious Lesions: Validation Studies Using Tissue-Simulating Phantoms and an Ex Vivo Human Breast Tissue Model.

Directory of Open Access Journals (Sweden)

Zeshu Zhang

Full Text Available Surgical resection remains the primary curative treatment for many early-stage cancers, including breast cancer. The development of intraoperative guidance systems for identifying all sites of disease and improving the likelihood of complete surgical resection is an area of active ongoing research, as this can lead to a decrease in the need of subsequent additional surgical procedures. We develop a wearable goggle navigation system for dual-mode optical and ultrasound imaging of suspicious lesions. The system consists of a light source module, a monochromatic CCD camera, an ultrasound system, a Google Glass, and a host computer. It is tested in tissue-simulating phantoms and an ex vivo human breast tissue model. Our experiments demonstrate that the surgical navigation system provides useful guidance for localization and core needle biopsy of simulated tumor within the tissue-simulating phantom, as well as a core needle biopsy and subsequent excision of Indocyanine Green (ICG-fluorescing sentinel lymph nodes. Our experiments support the contention that this wearable goggle navigation system can be potentially very useful and fully integrated by the surgeon for optimizing many aspects of oncologic surgery. Further engineering optimization and additional in vivo clinical validation work is necessary before such a surgical navigation system can be fully realized in the everyday clinical setting.

Imaging of foreign bodies in the face and ultrasound guided surgical removal; Diagnostico por imagem de corpos estranhos da face e retirada cirurgica guiada por ultra-sonografia

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Lima, Claudio Marcio Amaral de Oliveira; Gambin, Moises; Ribeiro, Erica Barreiros; Amarante Junior, Jose Luiz de Medeiros [Hospital Naval Marcilio Dias, Rio de Janeiro, RJ (Brazil)]. E-mail: cmaol@br.inter.net; cmaolima@hotmail.com; Monteiro, Alexandra Maria Vieira [Pontificia Univ. Catolica do Rio de Janeiro (PUC/Rio), RJ (Brazil). Curso de Pos-Graduacao em Radiologia

2006-10-15

The identification and surgical removal of foreign bodies is a complex procedure in medical practice, principally when the involved material is radiolucent. The technological advent of the ultrasonography equipment comes enlarging the field of application of this method more and more, in medical practice. The authors describe a case of an ultrasound guided surgical removal of glass fragments from the face of a patient. The foreign bodies were previously diagnosed by ultrasound and computed tomography. The guided technic showed secure, less invasive and efficient, allowing the retreat of all the fragments. (author)

Intraoperative Ultrasound for Peripheral Nerve Applications.

Science.gov (United States)

Willsey, Matthew; Wilson, Thomas J; Henning, Phillip Troy; Yang, Lynda J-S

2017-10-01

Offering real-time, high-resolution images via intraoperative ultrasound is advantageous for a variety of peripheral nerve applications. To highlight the advantages of ultrasound, its extraoperative uses are reviewed. The current intraoperative uses, including nerve localization, real-time evaluation of peripheral nerve tumors, and implantation of leads for peripheral nerve stimulation, are reviewed. Although intraoperative peripheral nerve localization has been performed previously using guide wires and surgical dyes, the authors' approach using ultrasound-guided instrument clamps helps guide surgical dissection to the target nerve, which could lead to more timely operations and shorter incisions. Copyright © 2017 Elsevier Inc. All rights reserved.

Security of patient data when decommissioning ultrasound systems.

Science.gov (United States)

Moggridge, James

2017-02-01

Although ultrasound systems generally archive to Picture Archiving and Communication Systems (PACS), their archiving workflow typically involves storage to an internal hard disk before data are transferred onwards. Deleting records from the local system will delete entries in the database and from the file allocation table or equivalent but, as with a PC, files can be recovered. Great care is taken with disposal of media from a healthcare organisation to prevent data breaches, but ultrasound systems are routinely returned to lease companies, sold on or donated to third parties without such controls. In this project, five methods of hard disk erasure were tested on nine ultrasound systems being decommissioned: the system's own delete function; full reinstallation of system software; the manufacturer's own disk wiping service; open source disk wiping software for full and just blank space erasure. Attempts were then made to recover data using open source recovery tools. All methods deleted patient data as viewable from the ultrasound system and from browsing the disk from a PC. However, patient identifiable data (PID) could be recovered following the system's own deletion and the reinstallation methods. No PID could be recovered after using the manufacturer's wiping service or the open source wiping software. The typical method of reinstalling an ultrasound system's software may not prevent PID from being recovered. When transferring ownership, care should be taken that an ultrasound system's hard disk has been wiped to a sufficient level, particularly if the scanner is to be returned with approved parts and in a fully working state.

A passive wireless ultrasound pitch–catch system

International Nuclear Information System (INIS)

Zahedi, F; Yao, J; Huang, H

2015-01-01

This paper exploits amplitude modulation and demodulation to achieve a passive wireless ultrasound pitch–catch system consisting of a wireless interrogator and a combination of a wireless actuator and a sensor mounted on a structure. The wireless interrogator operates in two modes, i.e. the generation and sensing modes. At the generation mode, the interrogator transmits two microwave signals; one is amplitude modulated with the ultrasound excitation signal while the other is a continuous-wave carrier signal. Once received by the wireless actuator, the amplitude modulated signal is demodulated using the carrier signal to recover the ultrasound excitation signal, which is then supplied to a piezoelectric wafer actuator for ultrasound generation. Subsequently, the interrogator is switched to the sensing mode by transmitting a carrier signal with a different frequency. Once received by the wireless sensor, this carrier signal is modulated with the ultrasound sensing signal acquired by the piezoelectric wafer sensor to produce an amplitude modulated microwave signal, which can then be wirelessly transmitted and demodulated by the interrogator to recover the original ultrasound sensing signal. The principle and implementation of the wireless ultrasound pitch–catch system as well as the data processing of the wirelessly received sensing signal are described. Experiment results validating wireless ultrasound generation and sensing from a distance of 0.5 m are presented. (paper)

Transverse vs torsional ultrasound: prospective randomized contralaterally controlled study comparing two phacoemulsification-system handpieces.

Science.gov (United States)

Assil, Kerry K; Harris, Lindsay; Cecka, Jeannie

2015-01-01

To compare surgical efficiency and multiple early clinical outcome variables in eyes undergoing phacoemulsification using either transversal or torsional ultrasound systems. Assil Eye Institute, Beverly Hills, CA, USA. Prospective, randomized, clinician-masked, contralaterally controlled single-center evaluation. Patients seeking cataract removal in both eyes with implantation of multifocal intraocular lenses were randomly assigned to one of two treatment rooms for phacoemulsification with either a transverse ultrasound system or torsional handpiece system. The contralateral eye was treated at a later date with the alternate device. A total of 54 eyes of 27 patients having similar degrees of cataract, astigmatism, and visual potential were included. All operative data were collected for analysis, and patients were followed for 3 months after surgery. Similar visual acuity was reported at all postoperative visits between the two groups. Mean phacoemulsification time and total power required were both significantly lower with the transverse system than with the torsional technique (Ptransverse system vs torsional (Ptransverse vs torsional. Macular swelling was less at 1 week, 1 month, and 3 months with transverse vs torsional, although the difference did not achieve significance (P=0.1) at any single time point. Clinically detectable corneal edema was reported less frequently at all postoperative time points with the transverse system. The transverse ultrasound system was found to be possibly associated with less balanced salt-solution use, less phacoemulsification time, and less power required than the torsional phaco system. Postoperative data suggested that improved phaco efficiency may translate to a better overall safety profile for the patient.

Need for intraoperative ultrasound and surgical recommendation for partial nephrectomy: correlation with tumor imaging features and urologist practice patterns.

Science.gov (United States)

Sun, Maryellen R M; Wagner, Andrew A; San Francisco, Ignacio F; Brook, Alexander; Kavoussi, Louis; Russo, Paul; Steele, Graeme; Viterbo, Rosalia; Pedrosa, Ivan

2012-03-01

This study aimed to evaluate the need for intraoperative ultrasound (IOUS) and recommendation for surgical approach in the resection of renal tumors through a survey of practicing urologists, with correlation to tumor imaging features and urologist practice pattern. An institutional review board-approved retrospective review, compliant with the Health Insurance Portability and Accountability Act, of 44 renal tumors that underwent laparoscopic partial nephrectomy at the study institution was performed. The numeric component of the RENAL nephrometry score (radius [diameter], % exophytic, nearness [to collecting system/renal sinus], location) was calculated for each case using preoperative computed tomography/magnetic resonance imaging. Five anonymized images of each tumor were presented to 4 academic urologists with varying practice patterns. Reviewers independently scored each case for its need for IOUS, for recommendation of a surgical technique, and for the difficulty of the proposed surgery. The RENAL scores were as follows: RENAL 1 (low complexity, score 4-6; n = 19); RENAL 2 (moderate complexity, score 7-9; n = 23); RENAL 3 (high complexity, score 10-12; n = 2). The only RENAL score component significantly influencing need for IOUS was percentage exophytic (P = 0.00002). There was an inverse relationship between normalized and averaged need for IOUS and percentage exophytic (P recommendation of surgical method was the reviewer him/herself, with each reviewer's recommendations closely matching his/her practice pattern. Size and percentage exophytic represented the only tumor features significantly (P = 0.03) influencing surgical recommendation. There was a significant difference in the perceived need for IOUS and surgical recommendation when 4 academic urologists reviewed a series of renal masses requiring resection. Percentage exophytic correlated inversely with need for IOUS. Urologist's practice pattern and tumor size and percentage exophytic were most

Error analysis for determination of accuracy of an ultrasound navigation system for head and neck surgery.

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Kozak, J; Krysztoforski, K; Kroll, T; Helbig, S; Helbig, M

2009-01-01

The use of conventional CT- or MRI-based navigation systems for head and neck surgery is unsatisfactory due to tissue shift. Moreover, changes occurring during surgical procedures cannot be visualized. To overcome these drawbacks, we developed a novel ultrasound-guided navigation system for head and neck surgery. A comprehensive error analysis was undertaken to determine the accuracy of this new system. The evaluation of the system accuracy was essentially based on the method of error definition for well-established fiducial marker registration methods (point-pair matching) as used in, for example, CT- or MRI-based navigation. This method was modified in accordance with the specific requirements of ultrasound-guided navigation. The Fiducial Localization Error (FLE), Fiducial Registration Error (FRE) and Target Registration Error (TRE) were determined. In our navigation system, the real error (the TRE actually measured) did not exceed a volume of 1.58 mm(3) with a probability of 0.9. A mean value of 0.8 mm (standard deviation: 0.25 mm) was found for the FRE. The quality of the coordinate tracking system (Polaris localizer) could be defined with an FLE of 0.4 +/- 0.11 mm (mean +/- standard deviation). The quality of the coordinates of the crosshairs of the phantom was determined with a deviation of 0.5 mm (standard deviation: 0.07 mm). The results demonstrate that our newly developed ultrasound-guided navigation system shows only very small system deviations and therefore provides very accurate data for practical applications.

Ultrasound to video registration using a bi-plane transrectal probe with photoacoustic markers

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Cheng, Alexis; Kang, Hyun Jae; Zhang, Haichong K.; Taylor, Russell H.; Boctor, Emad M.

2016-03-01

Modern surgical scenarios typically provide surgeons with additional information through fusion of video and other imaging modalities. To provide this information, the tools and devices used in surgery must be registered together with interventional guidance equipment and surgical navigation systems. In this work, we focus explicitly on registering ultrasound with a stereo camera system using photoacoustic markers. Previous work has shown that photoacoustic markers can be used in this registration task to achieve target registration errors lower than the current available systems. Photoacoustic markers are defined as a set of non-collinear laser spots projected onto some surface. They can be simultaneously visualized by a stereo camera system and an ultrasound transducer because of the photoacoustic effect. In more recent work, the three-dimensional ultrasound volume was replaced by images from a single ultrasound image pose from a convex array transducer. The feasibility of this approach was demonstrated, but the accuracy was lacking due to the physical limitations of the convex array transducer. In this work, we propose the use of a bi-plane transrectal ultrasound transducer. The main advantage of using this type of transducer is that the ultrasound elements are no longer restricted to a single plane. While this development would be limited to prostate applications, liver and kidney applications are also feasible if a suitable transducer is built. This work is demonstrated in two experiments, one without photoacoustic sources and one with. The resulting target registration error for these experiments were 1.07mm±0.35mm and 1.27mm+/-0.47mm respectively, both of which are better than current available navigation systems.

PLUS: open-source toolkit for ultrasound-guided intervention systems.

Science.gov (United States)

Lasso, Andras; Heffter, Tamas; Rankin, Adam; Pinter, Csaba; Ungi, Tamas; Fichtinger, Gabor

2014-10-01

A variety of advanced image analysis methods have been under the development for ultrasound-guided interventions. Unfortunately, the transition from an image analysis algorithm to clinical feasibility trials as part of an intervention system requires integration of many components, such as imaging and tracking devices, data processing algorithms, and visualization software. The objective of our paper is to provide a freely available open-source software platform-PLUS: Public software Library for Ultrasound-to facilitate rapid prototyping of ultrasound-guided intervention systems for translational clinical research. PLUS provides a variety of methods for interventional tool pose and ultrasound image acquisition from a wide range of tracking and imaging devices, spatial and temporal calibration, volume reconstruction, simulated image generation, and recording and live streaming of the acquired data. This paper introduces PLUS, explains its functionality and architecture, and presents typical uses and performance in ultrasound-guided intervention systems. PLUS fulfills the essential requirements for the development of ultrasound-guided intervention systems and it aspires to become a widely used translational research prototyping platform. PLUS is freely available as open source software under BSD license and can be downloaded from http://www.plustoolkit.org.

Experience in the diagnostic and surgical treatment of pancreatic pseudocysts

Directory of Open Access Journals (Sweden)

N. G. Golovko

2015-10-01

Full Text Available Actuality. Problem of surgical treatment of pancreatic pseudocysts is actual and debatable. The incidence of pancreatic pseudocysts is 0.5–1 per 100 000 adults per year, and in the overall incidence it reaches 1.6% –4.5%. Aim. Surgical treatment results of 34 patients with pancreatic pseudocysts were analyzed to improve results of diagnostic and surgical management of pancreatic pseudocests. Methods and results. Ultrasound scan combined with computer tomography were used for pancreatic pseudocysts diagnostic. Pancreatic pseudocysts surgical treatment was performed by minimally invasive percutaneous techniques and laparotomic surgery. Laparotomy operations were performed in 27 patients. The structure of operations was follow: external drainage of pseudocysts - 11 patients, 2 of them by minilaparotomy access, pseudocyst jejunostomy by Roux – 9 patients, pseudocyst jejunostomy with entero-enteroanastamosis by Brown – 3 patients, pseudocyst gastrostomy and pseudocyst duodenostomy – in 2 patients. Percutaneous external drainage of pancreatic pseudocysts under ultrasound control was performed in 7 patients. Indications for external percutaneous needle drainage of pancreatic pseudocysts under ultrasound control were: presence of a secure acoustic windows, lack of communication with the pancreatic pseudocysts ductal system, pseudocyst cavity diameter greater than 60 mm with wall thickness more than 3–4 mm, presence of the severe comorbidity and high operational and anesthetic risk (III–IV class ASA. Conclusions. Analysis of early treatment results (3–6 months found that pancreatic pseudocysts minimally invasive percutaneous puncture external drainage use in combination with ultrasound control, in addition to laparotomic operation, allows to achieve excellent and good results in 91.1% of patients.

Ultrasound findings in biliary system

International Nuclear Information System (INIS)

Park, Won Sik; Lee, Yong Woo; Cheung, Hwan

1986-01-01

In the liver and biliary system ultrasound has emerged as one of the most useful imaging techniques. It is usually the first radiological procedure selected and is often sufficient alone to enable a clinical decision to be made. Good result with ultrasound depend critically on expert scanning technique coupled with an understanding of tomographic anatomy and, of course, an appreciation of the clinical significance of any findings. In addition to we'd like to stress on the ultrasonical anatomy and for the technologist and also discuss about pathological part

Surgical treatment for mediastinal abscess induced by endobronchial ultrasound-guided transbronchial needle aspiration: a case report and literature review.

Science.gov (United States)

Yokoyama, Yujiro; Nakagomi, Takahiro; Shikata, Daichi; Higuchi, Rumi; Oyama, Toshio; Goto, Taichiro

2017-07-14

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a useful and less invasive procedure for the definitive diagnosis of mediastinal and hilar lymph nodes. However, infectious complications can occur after EBUS-TBNA, although they are extremely rare. A 66-year-old man with necrotic and swollen lower paratracheal lymph nodes underwent EBUS-TBNA. A mediastinal abscess developed 9 days post-procedure. Surgical drainage and debridement of the abscess were performed along with lymph node biopsy followed by daily washing of the thoracic cavity. Surgical treatment was effective, leading to remission of the abscess. Biopsy revealed that the tumor was squamous cell carcinoma with no radiologically detected cancer elsewhere in the body. Mediastinal lung cancer was thus confirmed. Subsequent chemoradiotherapy led to the remission of the tumor. Mediastinitis after EBUS-TBNA is rare but should be considered, particularly if the target lymph nodes are necrotic. Mediastinitis can lead to serious and rapid deterioration of the patient's condition, for which surgical intervention is the treatment of choice.

Peritendinous calcinosis of calcaneus tendon associated with dermatomyositis: correlation between conventional radiograph, ultrasound, magnetic resonance imaging and gross surgical pathology

International Nuclear Information System (INIS)

Rosa, Ana Claudia Ferreira; Gomide, Lidyane Marques de Paula; Lemes, Marcella Stival

2006-01-01

Interstitial calcinosis is an uncommon condition in which there is either localized or widely disseminated deposition of calcium in the skin, subcutaneous tissues, muscles, and tendons. Calcinosis is often associated with collagen diseases, scleroderma and dermatomyositis. The authors report a case of interstitial calcinosis associated with dermatomyositis studied with conventional radiograph, ultrasound and magnetic resonance imaging, and correlate the imaging findings with the results of surgical pathology gross examination. (author)

Robot-assisted ultrasound imaging: overview and development of a parallel telerobotic system.

Science.gov (United States)

Monfaredi, Reza; Wilson, Emmanuel; Azizi Koutenaei, Bamshad; Labrecque, Brendan; Leroy, Kristen; Goldie, James; Louis, Eric; Swerdlow, Daniel; Cleary, Kevin

2015-02-01

Ultrasound imaging is frequently used in medicine. The quality of ultrasound images is often dependent on the skill of the sonographer. Several researchers have proposed robotic systems to aid in ultrasound image acquisition. In this paper we first provide a short overview of robot-assisted ultrasound imaging (US). We categorize robot-assisted US imaging systems into three approaches: autonomous US imaging, teleoperated US imaging, and human-robot cooperation. For each approach several systems are introduced and briefly discussed. We then describe a compact six degree of freedom parallel mechanism telerobotic system for ultrasound imaging developed by our research team. The long-term goal of this work is to enable remote ultrasound scanning through teleoperation. This parallel mechanism allows for both translation and rotation of an ultrasound probe mounted on the top plate along with force control. Our experimental results confirmed good mechanical system performance with a positioning error of < 1 mm. Phantom experiments by a radiologist showed promising results with good image quality.

Ultrasound elastography as an adjuvant to conventional ultrasound in the preoperative assessment of axillary lymph nodes in suspected breast cancer: A pilot study

Energy Technology Data Exchange (ETDEWEB)

Taylor, K., E-mail: kathryn.taylor@addenbrookes.nhs.uk [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); O' Keeffe, S.; Britton, P.D.; Wallis, M.G. [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom); Treece, G.M.; Housden, J. [Department of Engineering, University of Cambridge, Cambridge (United Kingdom); Parashar, D.; Bond, S. [Cambridge Cancer Trials Centre, Department of Oncology, University of Cambridge, Addenbrookes Hospital, Cambridge (United Kingdom); Cambridge Hub in Trials Methodology Research, MRC Biostatics Unit, University Forvie Site, Cambridge (United Kingdom); Sinnatamby, R. [Department of Radiology, Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge (United Kingdom)

2011-11-15

Aims: To compare the performance of ultrasound elastography with conventional ultrasound in the assessment of axillary lymph nodes in suspected breast cancer and whether ultrasound elastography as an adjunct to conventional ultrasound can increase the sensitivity of conventional ultrasound used alone. Materials and methods: Fifty symptomatic women with a sonographic suspicion for breast cancer underwent ultrasound elastography of the ipsilateral axilla concurrent with conventional ultrasound being performed as part of triple assessment. Elastograms were visually scored, strain measurements calculated and node area and perimeter measurements taken. Theoretical biopsy cut points were selected. The sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) were calculated and receiver operating characteristic (ROC) analysis was performed and compared for elastograms and conventional ultrasound images with surgical histology as the reference standard. Results: The mean age of the women was 57 years. Twenty-nine out of 50 of the nodes were histologically negative on surgical histology and 21 were positive. The sensitivity, specificity, PPV, and NPV for conventional ultrasound were 76, 78, 70, and 81%, respectively; 90, 86, 83, and 93%, respectively, for visual ultrasound elastography; and for strain scoring, 100, 48, 58 and 100%, respectively. There was no significant difference between any of the node measurements Conclusions: Initial experience with ultrasound elastography of axillary lymph nodes, showed that it is more sensitive than conventional ultrasound in detecting abnormal nodes in the axilla in cases of suspected breast cancer. The specificity remained acceptable and ultrasound elastography used as an adjunct to conventional ultrasound has the potential to improve the performance of conventional ultrasound alone.

A single FPGA-based portable ultrasound imaging system for point-of-care applications.

Science.gov (United States)

Kim, Gi-Duck; Yoon, Changhan; Kye, Sang-Bum; Lee, Youngbae; Kang, Jeeun; Yoo, Yangmo; Song, Tai-kyong

2012-07-01

We present a cost-effective portable ultrasound system based on a single field-programmable gate array (FPGA) for point-of-care applications. In the portable ultrasound system developed, all the ultrasound signal and image processing modules, including an effective 32-channel receive beamformer with pseudo-dynamic focusing, are embedded in an FPGA chip. For overall system control, a mobile processor running Linux at 667 MHz is used. The scan-converted ultrasound image data from the FPGA are directly transferred to the system controller via external direct memory access without a video processing unit. The potable ultrasound system developed can provide real-time B-mode imaging with a maximum frame rate of 30, and it has a battery life of approximately 1.5 h. These results indicate that the single FPGA-based portable ultrasound system developed is able to meet the processing requirements in medical ultrasound imaging while providing improved flexibility for adapting to emerging POC applications.

Neuronavigation for arteriovenous malformation surgery by intraoperative three-dimensional ultrasound angiography.

Science.gov (United States)

Mathiesen, Tiit; Peredo, Inti; Edner, Göran; Kihlström, Lars; Svensson, Mikael; Ulfarsson, Elfar; Andersson, Tommy

2007-04-01

Neuronavigational devices have traditionally used preoperative imaging with limited possibilities for adjustment to brain shift and intraoperative manipulation of the surgical lesions. We have used an intraoperative imaging and navigation system that uses navigation on intraoperatively acquired three-dimensional ultrasound data, as well as preoperatively acquired magnetic resonance imaging scans and magnetic resonance angiograms. The usefulness of this system for arteriovenous malformation (AVM) surgery was evaluated prospectively. Nine consecutive patients with Spetzler Grade 1 (n = 3), 2 (n = 3), 3(n = 2) or 4 (n = 1) AVMs underwent operation using this intraoperative imaging and navigation system. The system provides real-time rendering of three-dimensional angiographic data and can visualize such projections in a stereoscopic (virtual reality) manner using special glasses. The experiences with this technology were analyzed and the outcomes assessed. Angiographic reconstructions of three-dimensional images were obtained before and after resection. Conventional navigation on the basis of preoperative magnetic resonance angiography was helpful to secure positioning of the bone flap; stereoscopic visualization of the same data represented a powerful means to construct a mental three-dimensional picture of the extent of the AVM and the feeder anatomy even before skin incision. Intraoperative ultrasound corresponded well to the intraoperative findings and allowed confirmation of feeding vessels in surrounding gyri and rapid identification of the perinidal dissection planes, regardless of brain shift. The latter feature was particularly helpful because the intraoperative navigational identification of surgical planes leads to minimal exploration into the nidus or dissection at a greater distance from the malformation. Application of the system was thought to increase surgical confidence. In two patients, postresection ultrasound prompted additional nidus removal

Utility of compact ultrasound in a mass surgical selection program in Africa: experience of a sonologist at the MV Africa Mercy Hospital Ship's screening day.

Science.gov (United States)

Harris, Robert D; Parker, Gary

2015-02-01

Compact ultrasound (US) was introduced in an austere setting with no other available imaging for an annual mass surgical screening day. Compact US examinations were performed on 25 patients from more than 7000 potential patients, as deemed possibly useful by the screening surgeons. Of the 20 patients with recorded data, compact US was helpful in 14 of 20 as a decision-making tool, obviating computed tomography for preoperative planning. Compact US was helpful in most cases, saving resources (computed tomography), technologist time, and radiation risk in this select population. © 2015 by the American Institute of Ultrasound in Medicine.

Modification of Food Systems by Ultrasound

Directory of Open Access Journals (Sweden)

L. M. Carrillo-Lopez

2017-01-01

Full Text Available This review describes the mechanism, operation, and recent potential applications of ultrasound in various food systems, as well as the physical and chemical effects of ultrasound treatments on the conservation and modification of different groups of food. Acoustic energy has been recognized as an emerging technology with great potential for applications in the food industry. The phenomenon of acoustic cavitation, which modifies the physical, chemical, and functional properties of food, can be used to improve existing processes and to develop new ones. The combination of ultrasonic energy with a sanitizing agent can improve the effect of microbial reduction in foods and, thereby, their quality. Finally, it is concluded that the use of ultrasound in food is a very promising area of research; however, more research is still needed before applying this technology in a wider range of industrial sectors.

User-friendly freehand ultrasound calibration using Lego bricks and automatic registration.

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Xiao, Yiming; Yan, Charles Xiao Bo; Drouin, Simon; De Nigris, Dante; Kochanowska, Anna; Collins, D Louis

2016-09-01

As an inexpensive, noninvasive, and portable clinical imaging modality, ultrasound (US) has been widely employed in many interventional procedures for monitoring potential tissue deformation, surgical tool placement, and locating surgical targets. The application requires the spatial mapping between 2D US images and 3D coordinates of the patient. Although positions of the devices (i.e., ultrasound transducer) and the patient can be easily recorded by a motion tracking system, the spatial relationship between the US image and the tracker attached to the US transducer needs to be estimated through an US calibration procedure. Previously, various calibration techniques have been proposed, where a spatial transformation is computed to match the coordinates of corresponding features in a physical phantom and those seen in the US scans. However, most of these methods are difficult to use for novel users. We proposed an ultrasound calibration method by constructing a phantom from simple Lego bricks and applying an automated multi-slice 2D-3D registration scheme without volumetric reconstruction. The method was validated for its calibration accuracy and reproducibility. Our method yields a calibration accuracy of [Formula: see text] mm and a calibration reproducibility of 1.29 mm. We have proposed a robust, inexpensive, and easy-to-use ultrasound calibration method.

Output control of da Vinci surgical system's surgical graspers.

Science.gov (United States)

Johnson, Paul J; Schmidt, David E; Duvvuri, Umamaheswar

2014-01-01

The number of robot-assisted surgeries performed with the da Vinci surgical system has increased significantly over the past decade. The articulating movements of the robotic surgical grasper are controlled by grip controls at the master console. The user interface has been implicated as one contributing factor in surgical grasping errors. The goal of our study was to characterize and evaluate the user interface of the da Vinci surgical system in controlling surgical graspers. An angular manipulator with force sensors was used to increment the grip control angle as grasper output angles were measured. Input force at the grip control was simultaneously measured throughout the range of motion. Pressure film was used to assess the maximum grasping force achievable with the endoscopic grasping tool. The da Vinci robot's grip control angular input has a nonproportional relationship with the grasper instrument output. The grip control mechanism presents an intrinsic resistant force to the surgeon's fingertips and provides no haptic feedback. The da Vinci Maryland graspers are capable of applying up to 5.1 MPa of local pressure. The angular and force input at the grip control of the da Vinci robot's surgical graspers is nonproportional to the grasper instrument's output. Understanding the true relationship of the grip control input to grasper instrument output may help surgeons understand how to better control the surgical graspers and promote fewer grasping errors. Copyright © 2014 Elsevier Inc. All rights reserved.

Biological effects of low frequency high intensity ultrasound application on ex vivo human adipose tissue.

Science.gov (United States)

Palumbo, P; Cinque, B; Miconi, G; La Torre, C; Zoccali, G; Vrentzos, N; Vitale, A R; Leocata, P; Lombardi, D; Lorenzo, C; D'Angelo, B; Macchiarelli, G; Cimini, A; Cifone, M G; Giuliani, M

2011-01-01

In the present work the effects of a new low frequency, high intensity ultrasound technology on human adipose tissue ex vivo were studied. In particular, we investigated the effects of both external and surgical ultrasound-irradiation (10 min) by evaluating, other than sample weight loss and fat release, also histological architecture alteration as well apoptosis induction. The influence of saline buffer tissue-infiltration on the effects of ultrasound irradiation was also examined. The results suggest that, in our experimental conditions, both transcutaneous and surgical ultrasound exposure caused a significant weight loss and fat release. This effect was more relevant when the ultrasound intensity was set at 100 % (~2.5 W/cm², for external device; ~19-21 W/cm2, for surgical device) compared to 70 % (~1.8 W/cm² for external device; ~13-14 W/cm2 for surgical device). Of note, the effectiveness of ultrasound was much higher when the tissue samples were previously infiltrated with saline buffer, in accordance with the knowledge that ultrasonic waves in aqueous solution better propagate with a consequently more efficient cavitation process. Moreover, the overall effects of ultrasound irradiation did not appear immediately after treatment but persisted over time, being significantly more relevant at 18 h from the end of ultrasound irradiation. Evaluation of histological characteristics of ultrasound-irradiated samples showed a clear alteration of adipose tissue architecture as well a prominent destruction of collagen fibers which were dependent on ultrasound intensity and most relevant in saline buffer-infiltrated samples. The structural changes of collagen bundles present between the lobules of fat cells were confirmed through scanning electron microscopy (SEM) which clearly demonstrated how ultrasound exposure induced a drastic reduction in the compactness of the adipose connective tissue and an irregular arrangement of the fibers with a consequent alteration in

Remote ultrasound palpation for robotic interventions using absolute elastography.

Science.gov (United States)

Schneider, Caitlin; Baghani, Ali; Rohling, Robert; Salcudean, Septimiu

2012-01-01

Although robotic surgery has addressed many of the challenges presented by minimally invasive surgery, haptic feedback and the lack of knowledge of tissue stiffness is an unsolved problem. This paper presents a system for finding the absolute elastic properties of tissue using a freehand ultrasound scanning technique, which utilizes the da Vinci Surgical robot and a custom 2D ultrasound transducer for intraoperative use. An external exciter creates shear waves in the tissue, and a local frequency estimation method computes the shear modulus. Results are reported for both phantom and in vivo models. This system can be extended to any 6 degree-of-freedom tracking method and any 2D transducer to provide real-time absolute elastic properties of tissue.

[da Vinci surgical system].

Science.gov (United States)

Watanabe, Gou; Ishikawa, Norihiro

2014-07-01

The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

Mammography and ultrasound in the evaluation of male breast disease

Energy Technology Data Exchange (ETDEWEB)

Munoz Carrasco, Rafaela; Alvarez Benito, Marina; Raya Povedano, Jose Luis [Hospital Universitario ' Reina Sofia' , Radiology Department, Cordoba (Spain); Munoz Gomariz, Elisa [Hospital Universitario ' Reina Sofia' , Support Unit for Research, Cordoba (Spain); Martinez Paredes, Maria [University of Cordoba, Radiology and Physical Medicine Area, Cordoba (Spain)

2010-12-15

To assess clinical variables that may be useful in differentiating gynaecomastia from carcinoma and to analyse the contribution of mammography and ultrasound to the evaluation of male breast disease. All men who underwent mammography and/or ultrasound between 1993 and 2006 in our hospital were retrospectively evaluated. Clinical characteristics in patients with gynaecomastia and those with carcinoma were compared. Radiological findings were classified according to the BI-RADS (Breast Imaging Reporting and Data System) criteria. The diagnostic performance of physical examination, mammography and ultrasound was determined and compared. A total of 628 patients with 518 mammograms and 423 ultrasounds were reviewed. The final diagnoses were: 19 carcinomas, 526 gynaecomastias, 84 other benign conditions and 25 normal. There were statistically significant differences in age, bilateral involvement, clinical presentation and physical examination between patients with carcinoma and those with gynaecomastia. The diagnostic performance of physical examination was lower than that of mammography and ultrasound (p < 0.05 for specificity). Mammography was the most sensitive (94.7%) and ultrasound the most specific (95.3%) for detection of malignancy (p > 0.05). We propose an algorithm for the use of mammography and ultrasound in men. Mammography and ultrasound, with a negative predictive value close to 100%, make it possible to avoid very many unnecessary surgical procedures in men. (orig.)

SAGES TAVAC safety and effectiveness analysis: da Vinci ® Surgical System (Intuitive Surgical, Sunnyvale, CA).

Science.gov (United States)

Tsuda, Shawn; Oleynikov, Dmitry; Gould, Jon; Azagury, Dan; Sandler, Bryan; Hutter, Matthew; Ross, Sharona; Haas, Eric; Brody, Fred; Satava, Richard

2015-10-01

The da Vinci(®) Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) is a computer-assisted (robotic) surgical system designed to enable and enhance minimally invasive surgery. The Food and Drug Administration (FDA) has cleared computer-assisted surgical systems for use by trained physicians in an operating room environment for laparoscopic surgical procedures in general, cardiac, colorectal, gynecologic, head and neck, thoracic and urologic surgical procedures. There are substantial numbers of peer-reviewed papers regarding the da Vinci(®) Surgical System, and a thoughtful assessment of evidence framed by clinical opinion is warranted. The SAGES da Vinci(®) TAVAC sub-committee performed a literature review of the da Vinci(®) Surgical System regarding gastrointestinal surgery. Conclusions by the sub-committee were vetted by the SAGES TAVAC Committee and SAGES Executive Board. Following revisions, the document was evaluated by the TAVAC Committee and Executive Board again for final approval. Several conclusions were drawn based on expert opinion organized by safety, efficacy, and cost for robotic foregut, bariatric, hepatobiliary/pancreatic, colorectal surgery, and single-incision cholecystectomy. Gastrointestinal surgery with the da Vinci(®) Surgical System is safe and comparable, but not superior to standard laparoscopic approaches. Although clinically acceptable, its use may be costly for select gastrointestinal procedures. Current data are limited to the da Vinci(®) Surgical System; further analyses are needed.

Ultrasound Vector Flow Imaging: Part II: Parallel Systems

DEFF Research Database (Denmark)

Jensen, Jørgen Arendt; Nikolov, Svetoslav Ivanov; Yu, Alfred C. H.

2016-01-01

The paper gives a review of the current state-of-theart in ultrasound parallel acquisition systems for flow imaging using spherical and plane waves emissions. The imaging methods are explained along with the advantages of using these very fast and sensitive velocity estimators. These experimental...... ultrasound imaging for studying brain function in animals. The paper explains the underlying acquisition and estimation methods for fast 2-D and 3-D velocity imaging and gives a number of examples. Future challenges and the potentials of parallel acquisition systems for flow imaging are also discussed....

Intraoperative registered transrectal ultrasound guidance for robot-assisted laparoscopic radical prostatectomy.

Science.gov (United States)

Mohareri, Omid; Ischia, Joseph; Black, Peter C; Schneider, Caitlin; Lobo, Julio; Goldenberg, Larry; Salcudean, Septimiu E

2015-01-01

To provide unencumbered real-time ultrasound image guidance during robot-assisted laparoscopic radical prostatectomy, we developed a robotic transrectal ultrasound system that tracks the da Vinci® Surgical System instruments. We describe our initial clinical experience with this system. After an evaluation in a canine model, 20 patients were enrolled in the study. During each procedure the transrectal ultrasound transducer was manually positioned using a brachytherapy stabilizer to provide good imaging of the prostate. Then the transrectal ultrasound was registered to the da Vinci robot by a previously validated procedure. Finally, automatic rotation of the transrectal ultrasound was enabled such that the transrectal ultrasound imaging plane safely tracked the tip of the da Vinci instrument controlled by the surgeon, while real-time transrectal ultrasound images were relayed to the surgeon at the da Vinci console. Tracking was activated during all critical stages of the surgery. The transrectal ultrasound robot was easy to set up and use, adding 7 minutes (range 5 to 14) to the procedure. It did not require an assistant or additional control devices. Qualitative feedback was acquired from the surgeons, who found transrectal ultrasound useful in identifying the urethra while passing the dorsal venous complex suture, defining the prostate-bladder interface during bladder neck dissection, identifying the seminal vesicles and their location with respect to the rectal wall, and identifying the distal prostate boundary at the apex. Real-time, registered robotic transrectal ultrasound guidance with automatic instrument tracking during robot-assisted laparoscopic radical prostatectomy is feasible and potentially useful. The results justify further studies to establish whether the approach can improve procedure outcomes. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Design and development of an ultrasound calibration phantom and system

Science.gov (United States)

Cheng, Alexis; Ackerman, Martin K.; Chirikjian, Gregory S.; Boctor, Emad M.

2014-03-01

Image-guided surgery systems are often used to provide surgeons with informational support. Due to several unique advantages such as ease of use, real-time image acquisition, and no ionizing radiation, ultrasound is a common medical imaging modality used in image-guided surgery systems. To perform advanced forms of guidance with ultrasound, such as virtual image overlays or automated robotic actuation, an ultrasound calibration process must be performed. This process recovers the rigid body transformation between a tracked marker attached to the ultrasound transducer and the ultrasound image. A phantom or model with known geometry is also required. In this work, we design and test an ultrasound calibration phantom and software. The two main considerations in this work are utilizing our knowledge of ultrasound physics to design the phantom and delivering an easy to use calibration process to the user. We explore the use of a three-dimensional printer to create the phantom in its entirety without need for user assembly. We have also developed software to automatically segment the three-dimensional printed rods from the ultrasound image by leveraging knowledge about the shape and scale of the phantom. In this work, we present preliminary results from using this phantom to perform ultrasound calibration. To test the efficacy of our method, we match the projection of the points segmented from the image to the known model and calculate a sum squared difference between each point for several combinations of motion generation and filtering methods. The best performing combination of motion and filtering techniques had an error of 1.56 mm and a standard deviation of 1.02 mm.

Verification and compensation of respiratory motion using an ultrasound imaging system

International Nuclear Information System (INIS)

Chuang, Ho-Chiao; Hsu, Hsiao-Yu; Chiu, Wei-Hung; Tien, Der-Chi; Wu, Ren-Hong; Hsu, Chung-Hsien

2015-01-01

Purpose: The purpose of this study was to determine if it is feasible to use ultrasound imaging as an aid for moving the treatment couch during diagnosis and treatment procedures associated with radiation therapy, in order to offset organ displacement caused by respiratory motion. A noninvasive ultrasound system was used to replace the C-arm device during diagnosis and treatment with the aims of reducing the x-ray radiation dose on the human body while simultaneously being able to monitor organ displacements. Methods: This study used a proposed respiratory compensating system combined with an ultrasound imaging system to monitor the compensation effect of respiratory motion. The accuracy of the compensation effect was verified by fluoroscopy, which means that fluoroscopy could be replaced so as to reduce unnecessary radiation dose on patients. A respiratory simulation system was used to simulate the respiratory motion of the human abdomen and a strain gauge (respiratory signal acquisition device) was used to capture the simulated respiratory signals. The target displacements could be detected by an ultrasound probe and used as a reference for adjusting the gain value of the respiratory signal used by the respiratory compensating system. This ensured that the amplitude of the respiratory compensation signal was a faithful representation of the target displacement. Results: The results show that performing respiratory compensation with the assistance of the ultrasound images reduced the compensation error of the respiratory compensating system to 0.81–2.92 mm, both for sine-wave input signals with amplitudes of 5, 10, and 15 mm, and human respiratory signals; this represented compensation of the respiratory motion by up to 92.48%. In addition, the respiratory signals of 10 patients were captured in clinical trials, while their diaphragm displacements were observed simultaneously using ultrasound. Using the respiratory compensating system to offset, the diaphragm

Imaging of degenerative and posttraumatic disease in the shoulder joint with ultrasound

International Nuclear Information System (INIS)

Zanetti, Marco; Hodler, Juerg

2000-01-01

This article reviews the examination technique of shoulder ultrasound, normal and abnormal ultrasound findings in acute (posttraumatic) and chronic (degenerative) lesions. Moreover, it reviews the effectiveness of ultrasound in relation to magnetic resonance (MR) imaging. Most authors report that full-thickness tears of the supraspinatus can reliably be diagnosed by ultrasound. However, the simple diagnosis of a full-thickness rotator cuff tear is no longer sufficient for surgical management. The precise localization and size of rotator cuff tears as well as the extent of muscle degeneration is important for surgical planning. For this aspect and for partial-thickness tears of the supraspinatus, for subscapularis lesions as well as for lesions of the long biceps tendons there is no consensus regarding the diagnostic value of ultrasound. To the present, ultrasound (contrary to MR imaging) has failed to demonstrate that it consistently influences the clinician's degree of confidence in the clinical diagnosis or the treatment plan. Therefore, some orthopedic surgeons prefer MR imaging to ultrasound in the evaluation of rotator cuff tears and other abnormalities of the glenohumeral joint. Moreover, MR imaging, especially when combined with arthrography, represents a one-step investigation, which not only allows for assessment of rotator cuff lesion but also of lesions of the labrum (Bankart lesions, SLAP lesions), the joint capsule and the biceps tendon. It also demonstrates muscle atrophy, which represents an important predictor of surgical outcome in rotator cuff repair

Imaging of degenerative and posttraumatic disease in the shoulder joint with ultrasound

Energy Technology Data Exchange (ETDEWEB)

Zanetti, Marco E-mail: mzanetti@balgrist.unizh.ch; Hodler, Juerg

2000-08-01

This article reviews the examination technique of shoulder ultrasound, normal and abnormal ultrasound findings in acute (posttraumatic) and chronic (degenerative) lesions. Moreover, it reviews the effectiveness of ultrasound in relation to magnetic resonance (MR) imaging. Most authors report that full-thickness tears of the supraspinatus can reliably be diagnosed by ultrasound. However, the simple diagnosis of a full-thickness rotator cuff tear is no longer sufficient for surgical management. The precise localization and size of rotator cuff tears as well as the extent of muscle degeneration is important for surgical planning. For this aspect and for partial-thickness tears of the supraspinatus, for subscapularis lesions as well as for lesions of the long biceps tendons there is no consensus regarding the diagnostic value of ultrasound. To the present, ultrasound (contrary to MR imaging) has failed to demonstrate that it consistently influences the clinician's degree of confidence in the clinical diagnosis or the treatment plan. Therefore, some orthopedic surgeons prefer MR imaging to ultrasound in the evaluation of rotator cuff tears and other abnormalities of the glenohumeral joint. Moreover, MR imaging, especially when combined with arthrography, represents a one-step investigation, which not only allows for assessment of rotator cuff lesion but also of lesions of the labrum (Bankart lesions, SLAP lesions), the joint capsule and the biceps tendon. It also demonstrates muscle atrophy, which represents an important predictor of surgical outcome in rotator cuff repair.

Low-cost Volumetric Ultrasound by Augmentation of 2D Systems: Design and Prototype.

Science.gov (United States)

Herickhoff, Carl D; Morgan, Matthew R; Broder, Joshua S; Dahl, Jeremy J

2018-01-01

Conventional two-dimensional (2D) ultrasound imaging is a powerful diagnostic tool in the hands of an experienced user, yet 2D ultrasound remains clinically underutilized and inherently incomplete, with output being very operator dependent. Volumetric ultrasound systems can more fully capture a three-dimensional (3D) region of interest, but current 3D systems require specialized transducers, are prohibitively expensive for many clinical departments, and do not register image orientation with respect to the patient; these systems are designed to provide improved workflow rather than operator independence. This work investigates whether it is possible to add volumetric 3D imaging capability to existing 2D ultrasound systems at minimal cost, providing a practical means of reducing operator dependence in ultrasound. In this paper, we present a low-cost method to make 2D ultrasound systems capable of quality volumetric image acquisition: we present the general system design and image acquisition method, including the use of a probe-mounted orientation sensor, a simple probe fixture prototype, and an offline volume reconstruction technique. We demonstrate initial results of the method, implemented using a Verasonics Vantage research scanner.

Performance Evaluation of a Synthetic Aperture Real-Time Ultrasound System

DEFF Research Database (Denmark)

Stuart, Matthias Bo; Tomov, Borislav Gueorguiev; Jensen, Jørgen Arendt

2011-01-01

This paper evaluates the signal-to-noise ratio, the time stability, and the phase difference of the sampling in the experimental ultrasound scanner SARUS: A synthetic aperture, real-time ultrasound system. SARUS has 1024 independent transmit and receive channels and is capable of handling 2D probes...... arrays (FPGAs) making it very flexible and allowing implementation of other real-time ultrasound processing methods in the future. For conventional B-mode imaging, a penetration depth around 7 cm for a 7 MHz transducer is obtained (signal-tonoise ratio of 0 dB), which is comparable to commercial...... for 3D ultrasound imaging. It samples at 12 bits per sample and has a sampling rate of 70 MHz with the possibility of decimating the sampling frequency at the input. SARUS is capable of advanced real-time computations such as synthetic aperture imaging. The system is built using fieldprogrammable gate...

Assessing the effect of different operation techniques on postoperative duplex ultrasound quality after carotid endarterectomy.

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Grambow, E; Heller, T; Wieneke, P; Weiß, C; Klar, E; Weinrich, M

2018-01-01

Duplex ultrasound is the first choice in diagnostics and surveillance of stenoses of the internal carotid arteries before and even after surgery. Therefore, the quality of duplex ultrasound is crucial to investigate these vascular pathologies. Aim of this study was the evaluation whether different surgical techniques affect the postoperative quality of duplex ultrasound. In a time period from January to May 2015 duplex ultrasound of the cervical vessels was performed in 75 patients after unilateral endarterectomy of the internal carotid artery at our department between 2006 and 2012. Thereby, the non-operated contralateral side served as a control. Study groups were defined by the surgical techniques of eversion- or thrombendarterectomy with patch plasty using different patch materials and/or a haemostatic sealant. Duplex ultrasound analysis included acoustic impedance, extinction of ultrasound, thickness of skin and individual anatomic aspects of the patients. Carotid endarterectomy itself reduced intravascular grey levels, skin thickness and increased extinction of duplex ultrasound when compared to the non-operated side of the neck. In contrast, neither the kind of chosen operative technique nor the use of different patch materials or the application of a haemostatic sealant showed an effect in this regards. Whereas carotid endarterectomy per se worsens the quality of postoperative duplex ultrasound, the different analysed surgical techniques as well as used patches and the application of a haemostatic sealant can be assumed to be equal regarding the quality of postoperative ultrasound.

Dual-modality imaging with a ultrasound-gamma device for oncology

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Polito, C.; Pellegrini, R.; Cinti, M. N.; De Vincentis, G.; Lo Meo, S.; Fabbri, A.; Bennati, P.; Cencelli, V. Orsolini; Pani, R.

2018-06-01

Recently, dual-modality systems have been developed, aimed to correlate anatomical and functional information, improving disease localization and helping oncological or surgical treatments. Moreover, due to the growing interest in handheld detectors for preclinical trials or small animal imaging, in this work a new dual modality integrated device, based on a Ultrasounds probe and a small Field of View Single Photon Emission gamma camera, is proposed.

Surgical Workflow Analysis: Ideal Application of Navigated Linear Array Ultrasound in Low-Grade Glioma Surgery.

Science.gov (United States)

Lothes, Thomas Ernst; Siekmann, Max; König, Ralph Werner; Wirtz, Christian Rainer; Coburger, Jan

2016-11-01

Background  Intraoperative imaging in low-grade glioma (LGG) surgery can facilitate residual tumor control and improve surgical outcome. The aim of the study was to evaluate the ideal application and typical interactions of intraoperative MRI (iMRI), conventional low-frequency intraoperative ultrasound (cioUS), and high-frequency linear array intraoperative ultrasound (lioUS) to optimize surgical workflow. Methods  Prospectively, we included 11 patients with an LGG. Typical procedural workflow in the iMRI suite was recorded with a compatible software. We took notes of duration, frequency of application, the surgeon's evaluation of image quality, and the respective benefit of lioUS (15 MHz), cioUS (7 MHz), and iMRI (1.5 T). With the help of the workflow software, we meticulously analyzed ∼ 55 hours of surgery. Results  During the interventions, lioUS was used more often (76.3%) than cioUS (23.7%) and showed a better mean image quality (1 = best to 6 = worst) of 2.08 versus 3.26 with cioUS. The benefit of the lioUS application was rated with an average of 2.27, whereas the cioUS probe only reached a mean value of 3.83. The most common application of lioUS was resection control (42.6%); cioUS was used mainly for orientation (63.2%). Overall, lioUS was used more often and was rated better for both the purposes just described regarding image quality and benefit. Estimated residual tumor based on lioUS alone was lower than the final residual tumor detected with iMRI (7.5% versus 14.5%). The latter technique was rated as the best imaging modality for resection control in all cases followed by lioUS. Conclusion  We provide proof of principle for workflow assessment in cranial neurosurgery. Although iMRI remains the imaging method of choice, lioUS has shown to be beneficial in a combined setup. Evaluation of lioUS was significantly superior to cioUS in most indications except for subcortical lesions. Georg Thieme Verlag KG Stuttgart · New York.

A non-disruptive technology for robust 3D tool tracking for ultrasound-guided interventions.

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Mung, Jay; Vignon, Francois; Jain, Ameet

2011-01-01

In the past decade ultrasound (US) has become the preferred modality for a number of interventional procedures, offering excellent soft tissue visualization. The main limitation however is limited visualization of surgical tools. A new method is proposed for robust 3D tracking and US image enhancement of surgical tools under US guidance. Small US sensors are mounted on existing surgical tools. As the imager emits acoustic energy, the electrical signal from the sensor is analyzed to reconstruct its 3D coordinates. These coordinates can then be used for 3D surgical navigation, similar to current day tracking systems. A system with real-time 3D tool tracking and image enhancement was implemented on a commercial ultrasound scanner and 3D probe. Extensive water tank experiments with a tracked 0.2mm sensor show robust performance in a wide range of imaging conditions and tool position/orientations. The 3D tracking accuracy was 0.36 +/- 0.16mm throughout the imaging volume of 55 degrees x 27 degrees x 150mm. Additionally, the tool was successfully tracked inside a beating heart phantom. This paper proposes an image enhancement and tool tracking technology with sub-mm accuracy for US-guided interventions. The technology is non-disruptive, both in terms of existing clinical workflow and commercial considerations, showing promise for large scale clinical impact.

Pectoralis major tears: anatomy, classification, and diagnosis with ultrasound and MR imaging

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Chiavaras, Mary M. [McMaster University, Department of Radiology, Hamilton, ON (Canada); Jacobson, Jon A. [University of Michigan, Department of Radiology, Ann Arbor, MI (United States); Smith, Jay [Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN (United States); Department of Radiology, Mayo Clinic, Rochester, MN (United States); Department of Anatomy, Mayo Clinic, Rochester, MN (United States); Dahm, Diane L. [Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN (United States)

2014-09-09

Accurate characterization of pectoralis major tears is important to guide management. Imaging evaluation with ultrasound and MR imaging can be difficult given the complex regional anatomy. In addition, recent literature has redefined the anatomy of the distal pectoralis major. The purpose of this study is to review pectoralis major injuries taking into account new anatomic descriptions using ultrasound and MR imaging, including cadaveric dissection, surgically produced pectoralis tears, and clinical pectoralis tendon tear with surgical correlation. (orig.)

Pectoralis major tears: anatomy, classification, and diagnosis with ultrasound and MR imaging

International Nuclear Information System (INIS)

Chiavaras, Mary M.; Jacobson, Jon A.; Smith, Jay; Dahm, Diane L.

2015-01-01

Accurate characterization of pectoralis major tears is important to guide management. Imaging evaluation with ultrasound and MR imaging can be difficult given the complex regional anatomy. In addition, recent literature has redefined the anatomy of the distal pectoralis major. The purpose of this study is to review pectoralis major injuries taking into account new anatomic descriptions using ultrasound and MR imaging, including cadaveric dissection, surgically produced pectoralis tears, and clinical pectoralis tendon tear with surgical correlation. (orig.)

Diagnostic Ultrasound in Colorectal Cancer

DEFF Research Database (Denmark)

Rafaelsen, Søren Rafael

2014-01-01

SUMMARYBackground and purpose Colorectal cancer is a common disease in Denmark with considerable morbidity and mortality. Although survival in recent years has improved, Denmark still has the lowest 5-year survival compared to the other Nordic countries. The treatment of patients depends on local...... the potential to contribute to the staging of colorectal cancer. The purpose of these studies was to determine the usefulness of ultrasound diagnostics in patients with colorectal cancer.The purpose of the TRUS studies was to compare staging of rectal carcinomas using digital rectal exploration...... of 295 patients with primary colorectal cancer we found a sensitivity of preoperative ultrasound, surgical exploration, and intraoperative ultrasound of 70%, 84%, and 97%, respectively, based on a patient-by-patient comparison (p

Line fiducial material and thickness considerations for ultrasound calibration

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Ameri, Golafsoun; McLeod, A. J.; Baxter, John S. H.; Chen, Elvis C. S.; Peters, Terry M.

2015-03-01

Ultrasound calibration is a necessary procedure in many image-guided interventions, relating the position of tools and anatomical structures in the ultrasound image to a common coordinate system. This is a necessary component of augmented reality environments in image-guided interventions as it allows for a 3D visualization where other surgical tools outside the imaging plane can be found. Accuracy of ultrasound calibration fundamentally affects the total accuracy of this interventional guidance system. Many ultrasound calibration procedures have been proposed based on a variety of phantom materials and geometries. These differences lead to differences in representation of the phantom on the ultrasound image which subsequently affect the ability to accurately and automatically segment the phantom. For example, taut wires are commonly used as line fiducials in ultrasound calibration. However, at large depths or oblique angles, the fiducials appear blurred and smeared in ultrasound images making it hard to localize their cross-section with the ultrasound image plane. Intuitively, larger diameter phantoms with lower echogenicity are more accurately segmented in ultrasound images in comparison to highly reflective thin phantoms. In this work, an evaluation of a variety of calibration phantoms with different geometrical and material properties for the phantomless calibration procedure was performed. The phantoms used in this study include braided wire, plastic straws, and polyvinyl alcohol cryogel tubes with different diameters. Conventional B-mode and synthetic aperture images of the phantoms at different positions were obtained. The phantoms were automatically segmented from the ultrasound images using an ellipse fitting algorithm, the centroid of which is subsequently used as a fiducial for calibration. Calibration accuracy was evaluated for these procedures based on the leave-one-out target registration error. It was shown that larger diameter phantoms with lower

Real-Time Implementation of Medical Ultrasound Strain Imaging System

International Nuclear Information System (INIS)

Jeong, Mok Kun; Kwon, Sung Jae; Bae, Moo Ho

2008-01-01

Strain imaging in a medical ultrasound imaging system can differentiate the cancer or tumor in a lesion that is stiffer than the surrounding tissue. In this paper, a strain imaging technique using quasistatic compression is implemented that estimates the displacement between pre- and postcompression ultrasound echoes and obtains strain by differentiating it in the spatial direction. Displacements are computed from the phase difference of complex baseband signals obtained using their autocorrelation, and errors associated with converting the phase difference into time or distance are compensated for by taking into the center frequency variation. Also, to reduce the effect of operator's hand motion, the displacements of all scanlines are normalized with the result that satisfactory strain image quality has been obtained. These techniques have been incorporated into implementing a medical ultrasound strain imaging system that operates in real time.

Ultrasound systems for blood velocity estimation

DEFF Research Database (Denmark)

Jensen, Jørgen Arendt

1998-01-01

Medical ultrasound scanners can be used both for displayinggray-scale images of the anatomy and for visualizing theblood flow dynamically in the body.The systems can interrogate the flow at a single position in the bodyand there find the velocity distribution over time. They can also show adynamic...

Ultrasound of the coracoclavicular ligaments in the acute phase of an acromioclavicular disjonction: Comparison of radiographic, ultrasound and MRI findings.

Science.gov (United States)

Faruch Bilfeld, Marie; Lapègue, Franck; Chiavassa Gandois, Hélène; Bayol, Marie Aurélie; Bonnevialle, Nicolas; Sans, Nicolas

2017-02-01

Acromioclavicular joint injuries are typically diagnosed by clinical and radiographic assessment with the Rockwood classification, which is crucial for treatment planning. The purpose of this study was to describe how the ultrasound findings of acromioclavicular joint injury compare with radiography and MRI findings. Forty-seven patients with suspected unilateral acromioclavicular joint injury after acute trauma were enrolled in this prospective study. All patients underwent digital radiography, ultrasound and 3T MRI. A modified Rockwood classification was used to evaluate the coracoclavicular ligaments. The classifications of acromioclavicular joint injuries diagnosed with radiography, ultrasound and MRI were compared. MRI was used as the gold standard. The agreement between the ultrasound and MRI findings was very good, with a correlation coefficient of 0.83 (95 % CI: 0.72-0.90; p acromioclavicular injury. • Ultrasound is appropriate for acute acromioclavicular trauma due to its accessibility. • Ultrasound contributes to the diagnostic work-up of acute lesions of the coracoclavicular ligaments. • Ultrasound is appropriate in patients likely to benefit from surgical treatment. • Ultrasound could be a supplement to standard radiography in acute acromioclavicular trauma.

Development and implementation of ultrasound picture archiving and communication system

Science.gov (United States)

Weinberg, Wolfram S.; Tessler, Franklin N.; Grant, Edward G.; Kangarloo, Hooshang; Huang, H. K.

1990-08-01

The Department of Radiological Sciences at the UCLA School of Medicine is developing an archiving and communication system (PACS) for digitized ultrasound images. In its final stage the system will involve the acquisition and archiving of ultrasound studies from four different locations including the Center for Health Sciences, the Department for Mental Health and the Outpatient Radiology and Endoscopy Departments with a total of 200-250 patient studies per week. The concept comprises two stages of image manipulation for each ultrasound work area. The first station is located close to the examination site and accomodates the acquisition of digital images from up to five ultrasound devices and provides for instantaneous display and primary viewing and image selection. Completed patient studies are transferred to a main workstation for secondary review, further analysis and comparison studies. The review station has an on-line storage capacity of 10,000 images with a resolution of 512x512 8 bit data to allow for immediate retrieval of active patient studies of up to two weeks. The main work stations are connected through the general network and use one central archive for long term storage and a film printer for hardcopy output. First phase development efforts concentrate on the implementation and testing of a system at one location consisting of a number of ultrasound units with video digitizer and network interfaces and a microcomputer workstation as host for the display station with two color monitors, each allowing simultaneous display of four 512x512 images. The discussion emphasizes functionality, performance and acceptance of the system in the clinical environment.

Real-time Near-infrared Virtual Intraoperative Surgical Photoacoustic Microscopy

Directory of Open Access Journals (Sweden)

Changho Lee

2015-09-01

Full Text Available We developed a near infrared (NIR virtual intraoperative surgical photoacoustic microscopy (NIR-VISPAM system that combines a conventional surgical microscope and an NIR light photoacoustic microscopy (PAM system. NIR-VISPAM can simultaneously visualize PA B-scan images at a maximum display rate of 45 Hz and display enlarged microscopic images on a surgeon's view plane through the ocular lenses of the surgical microscope as augmented reality. The use of the invisible NIR light eliminated the disturbance to the surgeon's vision caused by the visible PAM excitation laser in a previous report. Further, the maximum permissible laser pulse energy at this wavelength is approximately 5 times more than that at the visible spectral range. The use of a needle-type ultrasound transducer without any water bath for acoustic coupling can enhance convenience in an intraoperative environment. We successfully guided needle and injected carbon particles in biological tissues ex vivo and in melanoma-bearing mice in vivo.

[Endoscopic ultrasound guided rendezvous for biliary drainage].

Science.gov (United States)

Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem; Karstensen, John Gésdal

2015-04-27

Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from the stomach or duodenum to the common bile duct and from there on to the duodenum enabling ERCP. With a relatively high rate of success EUS-RV should be considered as an alternative to biliary drainage and surgical intervention.

System Architecture of an Experimental Synthetic Aperture Real-Time Ultrasound System

DEFF Research Database (Denmark)

Jensen, Jørgen Arendt; Hansen, Martin; Tomov, Borislav Gueorguiev

2007-01-01

is done using a parametric beam former. Code synthesized for a Xilinx V4FX100 speed grade 11 FPGA can operate at a maximum clock frequency of 167.8 MHz producing 1 billion I and Q samples/second sufficient for real time SA imaging. The system is currently in production, and all boards have been laid out......Synthetic Aperture (SA) ultrasound imaging has many advantages in terms of flexibility and accuracy. One of the major drawbacks is, however, that no system exists, which can implement SA imaging in real time due to the very high number of calculations amounting to roughly 1 billion complex focused...... samples per second per receive channel. Real time imaging is a key aspect in ultrasound, and to truly demonstrate the many advantages of SA imaging, a system usable in the clinic should be made. The paper describes a system capable of real time SA B-mode and vector flow imaging. The Synthetic Aperture...

[The rational application of Da Vinci surgical system in thyroidectomy].

Science.gov (United States)

He, Q Q

2017-08-01

Da Vinci surgical system is the most advanced minimally invasive surgical platform in the world, and this system has been widely used in cardiac surgery, urology surgery, gynecologic surgery and general surgery. Although the application of this system was relatively late in thyroid surgery, the number of thyroidectomy with Da Vinci surgical system is increasing quickly. Having reviewed recent studies and summarized clinical experience, compared with traditional open operation, the robotic thyroidectomy has the same surgical safety and effectiveness in selective patients with thyroid cancer. In this paper, several aspects on this novel operation were demonstrated, including surgical indications and contraindications, the approaches, surgical procedures and postoperative complications, in order to promote the rational application of Da Vinci surgical system in thyroidectomy.

Ultrasound scan in the diagnosis of neonatal renal candidiasis

International Nuclear Information System (INIS)

Muro, D.; Sanguesa, C.; Torres, D.; Berbel, O.; Andres, V.

2003-01-01

To describe the most pertinent echographic findings regarding systemic and renal candidiasis in high-risk neonates. Echographic findings and clinical histories of 40 neonates in the neonatal intensive care unit were retrospectively analyzed. Thirty-eight presented systemic candidiasis with renal participation, while two showed only renal candidiasis. Ultrasound scans were performed using 7.5 MHz probes. Alterations in renal echo structure, presence of echogenic material without acoustic shadowing in the excretory system (mycetoma), presence of lithiasis, pyonephrosis and associated renal malformations were all evaluated. Ten patients presented renal alterations in ultrasound scan. Six children had originally shown increased eye-catching in the renal parenchyma which was resolved after medical treatment. Four children presented renal mycetoma, and in two there were renal malformations. Both of these exhibited a profile for pyonephrosis. One patient with renal mycetoma without urological abnormalities developed a lithiasis. Surgical intervention was unnecessary in all cases. The most common echographic findings in immature high-risk low-weight patients with systemic and renal candidiasis were alterations in the eye-catching of renal parenchyma and the presence of mycetoma. (Author) 22 refs

Evaluation of Chest Ultrasound Integrated Teaching of Respiratory System Physiology to Medical Students

Science.gov (United States)

Paganini, Matteo; Bondì, Michela; Rubini, Alessandro

2017-01-01

Ultrasound imaging is a widely used diagnostic technique, whose integration in medical education is constantly growing. The aim of this study was to evaluate chest ultrasound usefulness in teaching respiratory system physiology, students' perception of chest ultrasound integration into a traditional lecture in human physiology, and short-term…

Ultrasound-guided versus surgical transversus abdominis plane block in obese patients following cesarean section: a prospective randomised study

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Aykut Urfalıoğlu

2017-09-01

Full Text Available Background and objectives: Ultrasound-guided transversus abdominis plane block demonstrated efficacy in providing post-operative analgesia by prolonging the time to first analgesic requirement and reducing the total analgesic consumption. The surgical transversus abdominis plane block, a novel technique, can be performed safely in obese patients in whom muscle layers cannot be sufficiently exposed. Here, we compared applicability, efficacy and complications of surgical transversus abdominis plane and ultrasound-guided transversus abdominis plane blocks in obese pregnant women following cesarean section under general anesthesia. Methods: Seventy-five pregnant women with pre- and post-pregnancy body mass index > 30 were randomized and allocated into two groups: Ultrasound-guided transversus abdominis plane block (UT group; n = 38 and surgical TAP block (ST group; n = 37. Visual analogue scale scores at post-operative 0, 2, 6, 12 and 24 hours (h, time to first analgesic requirement, total analgesic consumption amount in 24 h, post-operative side effects, complications and patient satisfaction were recorded. Results and conclusions: Age, American Society of Anesthesiologist score, operative duration, body mass index, mean time to first analgesic requirement and total analgesic consumption in 24 h were similar between groups, while significant differences in pre- and post-pregnancy body mass index were observed between groups. Block procedure durations were 7 and 10 minutes in ST and UT groups, respectively. No significant differences in visual analogue scale scores were observed between the groups at all times; itching and nausea was observed in one (UT group and four (UT and ST groups patients, respectively. Surgical transversus abdominis plane block was safe in obese pregnant patients and provided similar post-operative analgesia to ultrasound-guided transversus abdominis plane block. Resumo: Justificativa e objetivos: O bloqueio do

Preliminary Clinical Experience with a Combined Automated Breast Ultrasound and Digital Breast Tomosynthesis System.

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Larson, Eric D; Lee, Won-Mean; Roubidoux, Marilyn A; Goodsitt, Mitchell M; Lashbrook, Chris; Davis, Cynthia E; Kripfgans, Oliver D; Carson, Paul L

2018-03-01

We analyzed the performance of a mammographically configured, automated breast ultrasound (McABUS) scanner combined with a digital breast tomosynthesis (DBT) system. The GE Invenia ultrasound system was modified for integration with GE DBT systems. Ultrasound and DBT imaging were performed in the same mammographic compression. Our small preliminary study included 13 cases, six of whom had contained invasive cancers. From analysis of these cases, current limitations and corresponding potential improvements of the system were determined. A registration analysis was performed to compare the ease of McABUS to DBT registration for this system with that of two systems designed previously. It was observed that in comparison to data from an earlier study, the McABUS-to-DBT registration alignment errors for both this system and a previously built combined system were smaller than those for a previously built standalone McABUS system. Copyright © 2018 World Federation for Ultrasound in Medicine and Biology. Published by Elsevier Inc. All rights reserved.

A novel graphical user interface for ultrasound-guided shoulder arthroscopic surgery

Science.gov (United States)

Tyryshkin, K.; Mousavi, P.; Beek, M.; Pichora, D.; Abolmaesumi, P.

2007-03-01

This paper presents a novel graphical user interface developed for a navigation system for ultrasound-guided computer-assisted shoulder arthroscopic surgery. The envisioned purpose of the interface is to assist the surgeon in determining the position and orientation of the arthroscopic camera and other surgical tools within the anatomy of the patient. The user interface features real time position tracking of the arthroscopic instruments with an optical tracking system, and visualization of their graphical representations relative to a three-dimensional shoulder surface model of the patient, created from computed tomography images. In addition, the developed graphical interface facilitates fast and user-friendly intra-operative calibration of the arthroscope and the arthroscopic burr, capture and segmentation of ultrasound images, and intra-operative registration. A pilot study simulating the computer-aided shoulder arthroscopic procedure on a shoulder phantom demonstrated the speed, efficiency and ease-of-use of the system.

Prototype volumetric ultrasound tomography image guidance system for prone stereotactic partial breast irradiation: proof-of-concept

Science.gov (United States)

Chiu, Tsuicheng D.; Parsons, David; Zhang, Yue; Hrycushko, Brian; Zhao, Bo; Chopra, Rajiv; Kim, Nathan; Spangler, Ann; Rahimi, Asal; Timmerman, Robert; Jiang, Steve B.; Lu, Weiguo; Gu, Xuejun

2018-03-01

Accurate dose delivery in stereotactic partial breast irradiation (S-PBI) is challenging because of the target position uncertainty caused by breast deformation, the target volume changes caused by lumpectomy cavity shrinkage, and the target delineation uncertainty on simulation computed tomography (CT) images caused by poor soft tissue contrast. We have developed a volumetric ultrasound tomography (UST) image guidance system for prone position S-PBI. The system is composed of a novel 3D printed rotation water tank, a patient-specific resin breast immobilization cup, and a 1D array ultrasound transducer. Coronal 2D US images were acquired in 5° increments over a 360° range, and planes were acquired every 2 mm in elevation. A super-compounding technique was used to reconstruct the image volume. The image quality of UST was evaluated with a BB-1 breast phantom and BioZorb surgical marker, and the results revealed that UST offered better soft tissue contrast than CT and similar image quality to MR. In the evaluated plane, the size and location of five embedded objects were measured and compared to MR, which is considered as the ground truth. Objects’ diameters and the distances between objects in UST differ by approximately 1 to 2 mm from those in MR, which showed that UST offers the image quality required for S-PBI. In future work we will develop a robotic system that will be ultimately implemented in the clinic.

A projective surgical navigation system for cancer resection

Science.gov (United States)

Gan, Qi; Shao, Pengfei; Wang, Dong; Ye, Jian; Zhang, Zeshu; Wang, Xinrui; Xu, Ronald

2016-03-01

Near infrared (NIR) fluorescence imaging technique can provide precise and real-time information about tumor location during a cancer resection surgery. However, many intraoperative fluorescence imaging systems are based on wearable devices or stand-alone displays, leading to distraction of the surgeons and suboptimal outcome. To overcome these limitations, we design a projective fluorescence imaging system for surgical navigation. The system consists of a LED excitation light source, a monochromatic CCD camera, a host computer, a mini projector and a CMOS camera. A software program is written by C++ to call OpenCV functions for calibrating and correcting fluorescence images captured by the CCD camera upon excitation illumination of the LED source. The images are projected back to the surgical field by the mini projector. Imaging performance of this projective navigation system is characterized in a tumor simulating phantom. Image-guided surgical resection is demonstrated in an ex-vivo chicken tissue model. In all the experiments, the projected images by the projector match well with the locations of fluorescence emission. Our experimental results indicate that the proposed projective navigation system can be a powerful tool for pre-operative surgical planning, intraoperative surgical guidance, and postoperative assessment of surgical outcome. We have integrated the optoelectronic elements into a compact and miniaturized system in preparation for further clinical validation.

The role of intraoperative ultrasound in small renal mass robotic enucleation

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Roberta Gunelli

2016-12-01

Full Text Available Introduction: As a result of the growing evidence on tumor radical resection in literature, simple enucleation has become one of the best techniques associated to robotic surgery in the treatment of renal neoplasia, as it guarantees minimal invasiveness and the maximum sparing of renal tissue, facilitating the use of reduced or zero ischemia techniques during resection. The use of a robotic ultrasound probe represents a useful tool to detect and define tumor location, especially in poorly exophytic small renal mass. Materials and methods: A total of 22 robotic enucleations were performed on < 3 cm renal neoplasias (PADUA score 18 Pz 6/7 e 4 Pz 8 using a 12-5 MHz robotic ultrasound probe (BK Drop-In 8826. Results: Once kidney had been isolated from the adipose capsule at the site of the neoplasia (2, the exact position of the lesion could be easily identified in all cases (22/22, even for mostly endophytic lesions, thanks to the insertion of the ultrasound probe through the assistant port. Images were produced and visualized by the surgeon using the TilePro feature of the DaVinci surgical system for producing a picture-in-picture image on the console screen. The margins of resection were then marked with cautery, thus allowing for speedy anatomical dissection. This reduced the time of ischemia to 8 min (6-13 and facilitated the enucleation technique when performed without clamping the renal peduncle (6/22. No complications due to the use of the ultrasound probe were observed. Conclusions: The use of an intraoperative robotic ultrasound probe has allowed for easier identification of small, mostly endophytic neoplasias, better anatomical approach, shorter ischemic time, reduced risk of pseudocapsule rupture during dissection, and easier enucleation in cases performed without clamping. It is noteworthy that the use of intraoperative ultrasound probe allows mental reconstruction of the tumor through an accurate 3D vision of the hidden field during

The role of intraoperative ultrasound in small renal mass robotic enucleation.

Science.gov (United States)

Gunelli, Roberta; Fiori, Massimo; Salaris, Cristiano; Salomone, Umberto; Urbinati, Marco; Vici, Alexia; Zenico, Teo; Bertocco, Mauro

2016-12-30

As a result of the growing evidence on tumor radical resection in literature, simple enucleation has become one of the best techniques associated to robotic surgery in the treatment of renal neoplasia, as it guarantees minimal invasiveness and the maximum sparing of renal tissue, facilitating the use of reduced or zero ischemia techniques during resection. The use of a robotic ultrasound probe represents a useful tool to detect and define tumor location, especially in poorly exophytic small renal mass. A total of 22 robotic enucleations were performed on < 3 cm renal neoplasias (PADUA score 18 Pz 6/7 e 4 Pz 8) using a 12-5 MHz robotic ultrasound probe (BK Drop-In 8826). Once kidney had been isolated from the adipose capsule at the site of the neoplasia (2), the exact position of the lesion could be easily identified in all cases (22/22), even for mostly endophytic lesions, thanks to the insertion of the ultrasound probe through the assistant port. Images were produced and visualized by the surgeon using the TilePro feature of the DaVinci surgical system for producing a picture-in-picture image on the console screen. The margins of resection were then marked with cautery, thus allowing for speedy anatomical dissection. This reduced the time of ischemia to 8 min (6-13) and facilitated the enucleation technique when performed without clamping the renal peduncle (6/22). No complications due to the use of the ultrasound probe were observed. The use of an intraoperative robotic ultrasound probe has allowed for easier identification of small, mostly endophytic neoplasias, better anatomical approach, shorter ischemic time, reduced risk of pseudocapsule rupture during dissection, and easier enucleation in cases performed without clamping. It is noteworthy that the use of intraoperative ultrasound probe allows mental reconstruction of the tumor through an accurate 3D vision of the hidden field during surgical dissection.

Ultrasound signs of acute appendicitis in children - clinical application

International Nuclear Information System (INIS)

Vegar-Zubovic, S.; Lincender, L.; Dizdarevic, S.; Sefic, I.; Dalagija, F.

2005-01-01

Background. Acute appendicitis is a leading cause of the abdominal pain in children that need an urgent surgical treatment. Neither of individually clinical variables doesn't have a real discriminational nor predictive strength to be used as the only diagnostic test. A goal of this study is to define ultrasound criteria of the acute appendicitis by appointing of ultrasound parameters for this pathological condition, determine the relation between ultrasound signs and pathohistological finding, determine the connection of several ultrasound signs with a degree of the inflammation of the acute appendicitis. Methods. In the prospective study with an ultrasound method we examine 50 patients with clinical signs of the acute abdomen. In these patients, the sonographic diagnosis is confirmed by the surgical finding, in fact with a pathohistological diagnosis. A basic, positive sonograph finding of the acute appendicitis was the identification of tubular, noncompresive, aperistaltic bowel which demonstrates a connection with coecum and blind terminal. In our work we analysed the lasting of the symptoms until the hospital intervention in patients stratified according to the pathohistological finding. We used ultrasound equipment- Toshiba Sonolayer with convex 3.75 MHz and linear 8 MHz probes. Results. From 8 ultrasound signs of the acute appendicitis, only an anterior-posterior (AP) diameter of appendices, FAT (width of periappendicular fat tissue) and a peristaltic absence are positive ultrasound signs of the acute appendicitis. Appendicitis phlegmonosa is the most common pathohistological finding in our study (44%). Perforate gangrenous appendicitis and gangrenous appendicitis are represented in more than half of patients (30% + 22%), which suggests a long period of persisting symptoms until a hospital treatment. A statistic analysis shows a great possibility for using values of AP diameter, width of periapendicular fat tissue, just like the values of mural thickness in

Multi-perspective workflow modeling for online surgical situation models.

Science.gov (United States)

Franke, Stefan; Meixensberger, Jürgen; Neumuth, Thomas

2015-04-01

Surgical workflow management is expected to enable situation-aware adaptation and intelligent systems behavior in an integrated operating room (OR). The overall aim is to unburden the surgeon and OR staff from both manual maintenance and information seeking tasks. A major step toward intelligent systems behavior is a stable classification of the surgical situation from multiple perspectives based on performed low-level tasks. The present work proposes a method for the classification of surgical situations based on multi-perspective workflow modeling. A model network that interconnects different types of surgical process models is described. Various aspects of a surgical situation description were considered: low-level tasks, high-level tasks, patient status, and the use of medical devices. A study with sixty neurosurgical interventions was conducted to evaluate the performance of our approach and its robustness against incomplete workflow recognition input. A correct classification rate of over 90% was measured for high-level tasks and patient status. The device usage models for navigation and neurophysiology classified over 95% of the situations correctly, whereas the ultrasound usage was more difficult to predict. Overall, the classification rate decreased with an increasing level of input distortion. Autonomous adaptation of medical devices and intelligent systems behavior do not currently depend solely on low-level tasks. Instead, they require a more general type of understanding of the surgical condition. The integration of various surgical process models in a network provided a comprehensive representation of the interventions and allowed for the generation of extensive situation descriptions. Multi-perspective surgical workflow modeling and online situation models will be a significant pre-requisite for reliable and intelligent systems behavior. Hence, they will contribute to a cooperative OR environment. Copyright © 2015 Elsevier Inc. All rights reserved.

First clinical experience with a dedicated MRI-guided high-intensity focused ultrasound system for breast cancer ablation

Energy Technology Data Exchange (ETDEWEB)

Merckel, Laura G.; Knuttel, Floor M.; Peters, Nicky H.G.M.; Mali, Willem P.T.M.; Bosch, Maurice A.A.J. van den [University Medical Center Utrecht, Department of Radiology, HP E 01.132, Utrecht (Netherlands); Deckers, Roel; Moonen, Chrit T.W.; Bartels, Lambertus W. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Dalen, Thijs van [Diakonessenhuis Utrecht, Department of Surgery, Utrecht (Netherlands); Schubert, Gerald [Philips Healthcare, Best (Netherlands); Weits, Teun [Diakonessenhuis Utrecht, Department of Radiology, Utrecht (Netherlands); Diest, Paul J. van [University Medical Center Utrecht, Department of Pathology, Utrecht (Netherlands); Vaessen, Paul H.H.B. [University Medical Center Utrecht, Department of Anesthesiology, Utrecht (Netherlands); Gorp, Joost M.H.H. van [Diakonessenhuis Utrecht, Department of Pathology, Utrecht (Netherlands)

2016-11-15

To assess the safety and feasibility of MRI-guided high-intensity focused ultrasound (MR-HIFU) ablation in breast cancer patients using a dedicated breast platform. Patients with early-stage invasive breast cancer underwent partial tumour ablation prior to surgical resection. MR-HIFU ablation was performed using proton resonance frequency shift MR thermometry and an MR-HIFU system specifically designed for breast tumour ablation. The presence and extent of tumour necrosis was assessed by histopathological analysis of the surgical specimen. Pearson correlation coefficients were calculated to assess the relationship between sonication parameters, temperature increase and size of tumour necrosis at histopathology. Ten female patients underwent MR-HIFU treatment. No skin redness or burns were observed in any of the patients. No correlation was found between the applied energy and the temperature increase. In six patients, tumour necrosis was observed with a maximum diameter of 3-11 mm. In these patients, the number of targeted locations was equal to the number of areas with tumour necrosis. A good correlation was found between the applied energy and the size of tumour necrosis at histopathology (Pearson = 0.76, p = 0.002). Our results show that MR-HIFU ablation with the dedicated breast system is safe and results in histopathologically proven tumour necrosis. (orig.)

Surgical neuro navigator guided by preoperative magnetic resonance images, based on a magnetic position sensor

International Nuclear Information System (INIS)

Perini, Ana Paula; Siqueira, Rogerio Bulha; Carneiro, Antonio Adilton Oliveira; Oliveira, Lucas Ferrari de; Machado, Helio Rubens

2009-01-01

Image guided neurosurgery enables the neurosurgeon to navigate inside the patient's brain using pre-operative images as a guide and a tracking system, during a surgery. Following a calibration procedure, three-dimensional position and orientation of surgical instruments may be transmitted to computer. The spatial information is used to access a region of interest, in the pre-operative images, displaying them to the neurosurgeon during the surgical procedure. However, when a craniotomy is involved and the lesion is removed, movements of brain tissue can be a significant source of error in these conventional navigation systems. The architecture implemented in this work intends the development of a system to surgical planning and orientation guided by ultrasound image. For surgical orientation, the software developed allows the extraction of slices from the volume of the magnetic resonance images (MRI) with orientation supplied by a magnetic position sensor (Polhemus R ). The slices extracted with this software are important because they show the cerebral area that the neurosurgeon is observing during the surgery, and besides they can be correlated with the intra-operative ultrasound images to detect and to correct the deformation of brain tissue during the surgery. Also, a tool for per-operative navigation was developed, providing three orthogonal planes through the image volume. In the methodology used for the software implementation, the Python tm programming language and the Visualization Toolkit (VTK) graphics library were used. The program to extract slices of the MRI volume allowed the application of transformations in the volume, using coordinates supplied by the position sensor. (author)

Trends in the Surgical Correction of Gynecomastia

OpenAIRE

Brown, Rodger H.; Chang, Daniel K.; Siy, Richard; Friedman, Jeffrey

2015-01-01

Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited...

Evolution of Robot-assisted ultrasound-guided breast biopsy systems

Directory of Open Access Journals (Sweden)

Mustafa Z. Mahmoud

2018-01-01

Full Text Available Robot-assisted ultrasound-guided breast biopsy combines ultrasound (US imaging with a robotic system for medical interventions. This study was designed to provide a literature review of a robotic US-guided breast biopsy system to delineate its efficacious impact on current medical practice. In addition, the strengths and limitations of this approach were also addressed. Articles published in the English language between 2000 and 2016 were appraised in this review. A wide range of systems that bind robotics with US imaging and guided breast biopsy were examined in this article. The fundamental safety and real-time imaging capabilities of US, together with the accuracy and maneuverability of robotic devices, is clearly an effective association with unmatched capabilities. Numerous experimental systems have obvious benefits over old-fashioned techniques, and the future of robot-assisted US-guided breast biopsy will be characterized by increasing levels of automation, and they hold tremendous possibility to impact doctor achievement, patient recovery, and clinical management.

Corneal endothelial morphology and function after torsional and longitudinal ultrasound mode phacoemulsification.

Science.gov (United States)

Módis, László Jr; Szalai, Eszter; Flaskó, Zsuzsa; Németh, Gábor

2016-01-01

To study the endothelial cell morphology and corneal thickness changes after phacoemulsification by using the OZil torsional and longitudinal ultrasound techniques (Infiniti Vision System, Alcon Laboratories). Department of Ophthalmology, Clinical Center, University of Debrecen, Debrecen, Hungary. 52 patients with cataract were randomly assigned to longitudinal ultrasound and torsional mode group. All surgeries were performed through a 2.2 mm clear corneal incision, the method employed being divide and conquer. The endothelial morphometry such as cell density (ECD), mean cell area, coefficient of variation of cell area, and central corneal thickness were examined with specular microscopy (EM-1000, Tomey) preoperatively and 4, 8 weeks postoperatively. ECD values decreased significantly in both surgical groups (P .05). No significant correlation was found between the endothelial cell loss and the nucleus density. Both phacoemulsification techniques were safe and effective. The torsional handpiece performs oscillatory movements and delivers less energy into the eye than the longitudinal ultrasound technique, therefore providing more favorable energy and thermal safety profile.

Obstetrical ultrasound data-base management system by using personal computer

International Nuclear Information System (INIS)

Jeon, Hae Jeong; Park, Jeong Hee; Kim, Soo Nyung

1993-01-01

A computer program which performs obstetric calculations on Clipper Language using the data from ultrasonography was developed for personal computer. It was designed for fast assessment of fetal development, prediction of gestational age, and weight from ultrasonographic measurements which included biparietal diameter, femur length, gestational sac, occipito-frontal diameter, abdominal diameter, and etc. The Obstetrical-Ultrasound Data-Base Management System was tested for its performance. The Obstetrical-Ultrasound Data-Base Management System was very useful in patient management with its convenient data filing, easy retrieval of previous report, prompt but accurate estimation of fetal growth and skeletal anomaly and production of equation and growth curve for pregnant women

Application of da Vinci surgical robotic system in hepatobiliary surgery

Directory of Open Access Journals (Sweden)

Chen Jiahai

2018-01-01

Full Text Available The development of minimally invasive surgery has brought a revolutionary change to surgery techniques, and endoscopic surgical robots, especially Da Vinci robotic surgical system, has further broaden the scope of minimally invasive surgery, which has been applied in a variety of surgical fields including hepatobiliary surgery. Today, the application of Da Vinci surgical robot can cover most of the operations in hepatobiliary surgery which has proved to be safe and practical. What’s more, many clinical studies in recent years have showed that Da Vinci surgical system is superior to traditional laparoscopy. This paper summarize the advantage and disadvantage of Da Vinci surgical system, and outlines the current status of and future perspectives on the robot-assisted hepatobiliary surgery based on the cases reports in recent years of the application of Da Vinci surgical robot.

Ultrasound-based tumor movement compensation during navigated laparoscopic liver interventions.

Science.gov (United States)

Shahin, Osama; Beširević, Armin; Kleemann, Markus; Schlaefer, Alexander

2014-05-01

Image-guided navigation aims to provide better orientation and accuracy in laparoscopic interventions. However, the ability of the navigation system to reflect anatomical changes and maintain high accuracy during the procedure is crucial. This is particularly challenging in soft organs such as the liver, where surgical manipulation causes significant tumor movements. We propose a fast approach to obtain an accurate estimation of the tumor position throughout the procedure. Initially, a three-dimensional (3D) ultrasound image is reconstructed and the tumor is segmented. During surgery, the position of the tumor is updated based on newly acquired tracked ultrasound images. The initial segmentation of the tumor is used to automatically detect the tumor and update its position in the navigation system. Two experiments were conducted. First, a controlled phantom motion using a robot was performed to validate the tracking accuracy. Second, a needle navigation scenario based on pseudotumors injected into ex vivo porcine liver was studied. In the robot-based evaluation, the approach estimated the target location with an accuracy of 0.4 ± 0.3 mm. The mean navigation error in the needle experiment was 1.2 ± 0.6 mm, and the algorithm compensated for tumor shifts up to 38 mm in an average time of 1 s. We demonstrated a navigation approach based on tracked laparoscopic ultrasound (LUS), and focused on the neighborhood of the tumor. Our experimental results indicate that this approach can be used to quickly and accurately compensate for tumor movements caused by surgical manipulation during laparoscopic interventions. The proposed approach has the advantage of being based on the routinely used LUS; however, it upgrades its functionality to estimate the tumor position in 3D. Hence, the approach is repeatable throughout surgery, and enables high navigation accuracy to be maintained.

Ultrasound-assisted endoscopic partial plantar fascia release.

Science.gov (United States)

Ohuchi, Hiroshi; Ichikawa, Ken; Shinga, Kotaro; Hattori, Soichi; Yamada, Shin; Takahashi, Kazuhisa

2013-01-01

Various surgical treatment procedures for plantar fasciitis, such as open surgery, percutaneous release, and endoscopic surgery, exist. Skin trouble, nerve disturbance, infection, and persistent pain associated with prolonged recovery time are complications of open surgery. Endoscopic partial plantar fascia release offers the surgeon clear visualization of the anatomy at the surgical site. However, the primary medial portal and portal tract used for this technique have been shown to be in close proximity to the posterior tibial nerves and their branches, and there is always the risk of nerve damage by introducing the endoscope deep to the plantar fascia. By performing endoscopic partial plantar fascia release under ultrasound assistance, we could dynamically visualize the direction of the endoscope and instrument introduction, thus preventing nerve damage from inadvertent insertion deep to the fascia. Full-thickness release of the plantar fascia at the ideal position could also be confirmed under ultrasound imaging. We discuss the technique for this new procedure.

Investing in a Surgical Outcomes Auditing System

Science.gov (United States)

Bermudez, Luis; Trost, Kristen; Ayala, Ruben

2013-01-01

Background. Humanitarian surgical organizations consider both quantity of patients receiving care and quality of the care provided as a measure of success. However, organizational efficacy is often judged by the percent of resources spent towards direct intervention/surgery, which may discourage investment in an outcomes monitoring system. Operation Smile's established Global Standards of Care mandate minimum patient followup and quality of care. Purpose. To determine whether investment of resources in an outcomes monitoring system is necessary and effectively measures success. Methods. This paper analyzes the quantity and completeness of data collected over the past four years and compares it against changes in personnel and resources assigned to the program. Operation Smile began investing in multiple resources to obtain the missing data necessary to potentially implement a global Surgical Outcomes Auditing System. Existing personnel resources were restructured to focus on postoperative program implementation, data acquisition and compilation, and training materials used to educate local foundation and international employees. Results. An increase in the number of postoperative forms and amount of data being submitted to headquarters occurred. Conclusions. Humanitarian surgical organizations would benefit from investment in a surgical outcomes monitoring system in order to demonstrate success and to ameliorate quality of care. PMID:23401763

High-intensity ultrasound production of Maillard reaction flavor compounds in a cysteine-xylose model system.

Science.gov (United States)

Ong, Olivia X H; Seow, Yi-Xin; Ong, Peter K C; Zhou, Weibiao

2015-09-01

Application of high intensity ultrasound has shown potential in the production of Maillard reaction odor-active flavor compounds in model systems. The impact of initial pH, sonication duration, and ultrasound intensity on the production of Maillard reaction products (MRPs) by ultrasound processing in a cysteine-xylose model system were evaluated using Response Surface Methodology (RSM) with a modified mathematical model. Generation of selected MRPs, 2-methylthiophene and tetramethyl pyrazine, was optimal at an initial pH of 6.00, accompanied with 78.1 min of processing at an ultrasound intensity of 19.8 W cm(-2). However, identification of volatiles using gas chromatography-mass spectrometry (GC/MS) revealed that ultrasound-assisted Maillard reactions generated fewer sulfur-containing volatile flavor compounds as compared to conventional heat treatment of the model system. Likely reasons for this difference in flavor profile include the expulsion of H2S due to ultrasonic degassing and inefficient transmission of ultrasonic energy. Copyright © 2015 Elsevier B.V. All rights reserved.

Toward a real-time system for temporal enhanced ultrasound-guided prostate biopsy.

Science.gov (United States)

Azizi, Shekoofeh; Van Woudenberg, Nathan; Sojoudi, Samira; Li, Ming; Xu, Sheng; Abu Anas, Emran M; Yan, Pingkun; Tahmasebi, Amir; Kwak, Jin Tae; Turkbey, Baris; Choyke, Peter; Pinto, Peter; Wood, Bradford; Mousavi, Parvin; Abolmaesumi, Purang

2018-03-27

We have previously proposed temporal enhanced ultrasound (TeUS) as a new paradigm for tissue characterization. TeUS is based on analyzing a sequence of ultrasound data with deep learning and has been demonstrated to be successful for detection of cancer in ultrasound-guided prostate biopsy. Our aim is to enable the dissemination of this technology to the community for large-scale clinical validation. In this paper, we present a unified software framework demonstrating near-real-time analysis of ultrasound data stream using a deep learning solution. The system integrates ultrasound imaging hardware, visualization and a deep learning back-end to build an accessible, flexible and robust platform. A client-server approach is used in order to run computationally expensive algorithms in parallel. We demonstrate the efficacy of the framework using two applications as case studies. First, we show that prostate cancer detection using near-real-time analysis of RF and B-mode TeUS data and deep learning is feasible. Second, we present real-time segmentation of ultrasound prostate data using an integrated deep learning solution. The system is evaluated for cancer detection accuracy on ultrasound data obtained from a large clinical study with 255 biopsy cores from 157 subjects. It is further assessed with an independent dataset with 21 biopsy targets from six subjects. In the first study, we achieve area under the curve, sensitivity, specificity and accuracy of 0.94, 0.77, 0.94 and 0.92, respectively, for the detection of prostate cancer. In the second study, we achieve an AUC of 0.85. Our results suggest that TeUS-guided biopsy can be potentially effective for the detection of prostate cancer.

Surgical data processing for smart intraoperative assistance systems

Directory of Open Access Journals (Sweden)

Stauder Ralf

2017-09-01

Full Text Available Different components of the newly defined field of surgical data science have been under research at our groups for more than a decade now. In this paper, we describe our sensor-driven approaches to workflow recognition without the need for explicit models, and our current aim is to apply this knowledge to enable context-aware surgical assistance systems, such as a unified surgical display and robotic assistance systems. The methods we evaluated over time include dynamic time warping, hidden Markov models, random forests, and recently deep neural networks, specifically convolutional neural networks.

Clinical diagnostic ultrasound

International Nuclear Information System (INIS)

Barnett, E.; Morley, P.

1986-01-01

This textbook on diagnostic ultrasound covers the main systems, with emphasis being placed on the clinical application of diagnostic ultrasound in everyday practice. It provides not only a textbook for postgraduates (particularly FRCR candidates), but also a reference work for practitioners of clinical ultrasound and clinicians generally

Evaluation of teleoperated surgical robots in an enclosed undersea environment.

Science.gov (United States)

Doarn, Charles R; Anvari, Mehran; Low, Thomas; Broderick, Timothy J

2009-05-01

The ability to support surgical care in an extreme environment is a significant issue for both military medicine and space medicine. Telemanipulation systems, those that can be remotely operated from a distant site, have been used extensively by the National Aeronautics and Space Administration (NASA) for a number of years. These systems, often called telerobots, have successfully been applied to surgical interventions. A further extension is to operate these robotic systems over data communication networks where robotic slave and master are separated by a great distance. NASA utilizes the National Oceanographic and Atmospheric Administration (NOAA) Aquarius underwater habitat as an analog environment for research and technology evaluation missions, known as NASA Extreme Environment Mission Operations (NEEMO). Three NEEMO missions have provided an opportunity to evaluate teleoperated surgical robotics by astronauts and surgeons. Three robotic systems were deployed to the habitat for evaluation during NEEMO 7, 9, and 12. These systems were linked via a telecommunications link to various sites for remote manipulation. Researchers in the habitat conducted a variety of tests to evaluate performance and applicability in extreme environments. Over three different NEEMO missions, components of the Automated Endoscopic System for Optimal Positioning (AESOP), the M7 Surgical System, and the RAVEN were deployed and evaluated. A number of factors were evaluated, including communication latency and semiautonomous functions. The M7 was modified to permit a remote surgeon the ability to insert a needle into simulated tissue with ultrasound guidance, resulting in the world's first semi-autonomous supervisory-controlled medical task. The deployment and operation of teleoperated surgical systems and semi-autonomous, supervisory-controlled tasks were successfully conducted.

Urachal Cyst Diagnosed by Point-of-care Ultrasound

Directory of Open Access Journals (Sweden)

Vigil James

2017-10-01

Full Text Available Irreducible umbilical swelling in infants is considered a surgical emergency because a delay in surgical intervention for an incarcerated umbilical hernia can lead to bowel ischemia and necrosis. We report two patients who presented to a pediatric emergency department with history and symptoms of irreducible umbilical mass suggestive of umbilical hernia. Point-of-care ultrasound was used at the bedside to demonstrate the presence of urachal cyst remnants and accurately guided the care of these children.

Ultrasound-guided nerve block for inguinal hernia repair

DEFF Research Database (Denmark)

Bærentzen, Finn; Maschmann, Christian; Jensen, Kenneth

2012-01-01

Open inguinal hernia repair in adults is considered a minor surgical procedure but can be associated with significant pain. We aimed to evaluate acute postoperative pain management in male adults randomized to receive an ultrasound-guided ilioinguinal and iliohypogastric nerve block administered...

A novel fluoride anion modified gelatin nanogel system for ultrasound-triggered drug release.

Science.gov (United States)

Wu, Daocheng; Wan, Mingxi

2008-01-01

Controlled drug release, especially tumor-targeted drug release, remains a great challenge. Here, we prepare a novel fluoride anion-modified gelatin nanogel system and investigate its characteristics of ultrasound-triggered drug release. Adriamycin gelatin nanogel modified with fluoride anion (ADM-GNMF) was prepared by a modified co-precipitation method with fluoride anion and sodium sulfate. The loading and encapsulation efficiency of the anti-neoplastic agent adriamycin (ADM) were measured by high performance liquid chromatography (HPLC). The size and shape of ADM-GNMF were determined by electron microscopy and photo-correlation spectroscopy. The size distribution and drug release efficiency of ADM-GNMF, before and after sonication, were measured by two designed measuring devices that consisted of either a submicron particle size analyzer and an ultrasound generator as well as an ultrasound generator, automatic sampler, and HPLC. The ADM-GNMF was stable in solution with an average diameter of 46+/-12 nm; the encapsulation and loading efficiency of adriamycin were 87.2% and 6.38%, respectively. The ultrasound-triggered drug release and size change were most efficient at a frequency of 20 kHz, power density of 0.4w/cm2, and a 1~2 min duration. Under this ultrasound-triggered condition, 51.5% of drug in ADM-GNMF was released within 1~2 min, while the size of ADM-GNMF changed from 46 +/- 12 nm to 1212 +/- 35 nm within 1~2 min of sonication and restored to its previous size in 2~3 min after the ultrasound stopped. In contrast, 8.2% of drug in ADM-GNMF was released within 2~3 min without sonication, and only negligible size changes were found. The ADM-GNMF system efficiently released the encompassed drug in response to ultrasound, offering a novel and promising controlled drug release system for targeted therapy for cancer or other diseases.

Vacuum mammotomy under ultrasound guidance

International Nuclear Information System (INIS)

Luczynska, E.; Kocurek, A.; Pawlik, T.; Aniol, J.; Herman, K.; Skotnicki, P.

2007-01-01

Breast ultrasound is a non-invasive method of breast examination. You can use it also for fine needle biopsy, core needle biopsy, vacuum mammotomy and for placing the '' wire '' before open surgical biopsy. 106 patients (105 women and 1 man) aged 20-71 years (mean age 46.9) were treated in Cancer Institute in Cracow by vacuum mammotomy under ultrasound guidance. The lesions found in ultrasonography were divided into three groups: benign lesions (BI RADS II), ambiguous lesions (BI RADS 0, III and IVa), and suspicious lesions (BI RADS IV B, IV C and V). Then lesions were qualified to vacuum mammotomy. According to USG, fibroadenoma or '' fibroadenoma-like '' lesions were found in 75 women, in 6 women complicated cysts, in 6 women cyst with dense fluid (to differentiate with FA), and in 19 patients undefined lesions. Fibroadenoma was confirmed in histopathology in 74% patients among patients with fibroadenoma or '' fibroadenoma-like '' lesions in ultrasound (in others also benign lesions were found). Among lesions undefined after ultrasound examination (total 27 patients) cancer was confirmed in 6 % (DCIS and IDC). In 6 patients with complicated cysts in ultrasound examination, histopathology confirmed fibroadenoma in 4 women, an intraductal lesion in 1 woman and inflamatory process in 1 woman. Also in 6 women with a dense cyst or fibroadenoma seen in ultrasound, histopathology confirmed fibroadenoma in 3 women and fibrosclerosis in 3 women. Any breast lesions undefined or suspicious after ultrasound examination should be verified. The method of verification or kind of operation of the whole lesion (vacuum mammotomy or '' wire '') depends on many factors, for example: lesion localization; lesion size; BI RADS category. (author)

Advanced ultrasound applications in the assessment of renal transplants: contrast-enhanced ultrasound, elastography, and B-flow.

Science.gov (United States)

Morgan, Tara A; Jha, Priyanka; Poder, Liina; Weinstein, Stefanie

2018-04-09

Ultrasound is routinely used as the first imaging exam for evaluation of renal transplants and can identify most major surgical complications and evaluate vascularity with color Doppler. Ultrasound is limited, however, in the detection of parenchymal disease processes and Doppler evaluation is also prone to technical errors. Multiple new ultrasound applications have been developed and are under ongoing investigation which could add additional diagnostic capability to the routine ultrasound exam with minimal additional time, cost, and patient risk. Contrast-enhanced ultrasound (CEUS) can be used off-label in the transplant kidney, and can assist in detection of infection, trauma, and vascular complications. CEUS also can demonstrate perfusion of the transplant assessed quantitatively with generation of time-intensity curves. Future directions of CEUS include monitoring treatment response and microbubble targeted medication delivery. Elastography is an ultrasound application that can detect changes in tissue elasticity, which is useful to diagnose diffuse parenchymal disease, such as fibrosis, otherwise unrecognizable with ultrasound. Elastography has been successfully applied in other organs including the liver, thyroid, and breast; however, it is still under development for use in the transplant kidney. Unique properties of the transplant kidney including its heterogeneity, anatomic location, and other technical factors present challenges in the development of reference standard measurements. Lastly, B-flow imaging is a flow application derived from B-mode. This application can show the true lumen size of a vessel which is useful to depict vascular anatomy and bypasses some of the pitfalls of color Doppler such as demonstration of slow flow.

The utility of ultrasound and magnetic resonance imaging versus surgery for the characterization of müllerian anomalies in the pediatric and adolescent population.

Science.gov (United States)

Santos, X M; Krishnamurthy, R; Bercaw-Pratt, J L; Dietrich, J E

2012-06-01

To evaluate the utility of transabdominal ultrasound and magnetic resonance imaging in the evaluation of American Society for Reproductive Medicine (†)(ASRM)-classified müllerian anomalies compared to surgical findings in the pediatric and adolescent population. Retrospective chart review. Tertiary academic center. Thirty-eight patients with müllerian anomalies seen in our pediatric and adolescent gynecology clinic were identified both on the basis of ICD-9 codes and having magnetic resonance imaging at Texas Children's Hospital between 2004 and 2009. None. Correlation among transabdominal ultrasound and magnetic resonance imaging findings with surgical findings. Mean age was 12.2 (± 4.1) years. Twenty-eight patients underwent magnetic resonance imaging and required surgical intervention, and 88.5% demonstrated correlative consistency with surgical findings. Twenty-two patients underwent ultrasound, magnetic resonance imaging, and surgery, which revealed consistency among ultrasound and surgical findings (59.1%) and consistency among magnetic resonance imaging and surgical findings (90.9%). In ASRM diagnoses evaluated by magnetic resonance imaging, surgical findings correlated in 92% (Pearson 0.89). Overall, 55.2% of patients had a renal malformation. Magnetic resonance imaging is the gold standard imaging modality for müllerian anomalies and is an effective technique for noninvasive evaluation and accurate classification of the type of anomaly in the pediatric and adolescent population. Magnetic resonance imaging should be considered as an adjunct to transabdominal ultrasound to evaluate müllerian anomalies. Copyright © 2012 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Use of Ultrasound Elastography in the Assessment of the Musculoskeletal System

International Nuclear Information System (INIS)

Paluch, Łukasz; Nawrocka-Laskus, Ewa; Wieczorek, Janusz; Mruk, Bartosz; Frel, Małgorzata; Walecki, Jerzy

2016-01-01

This article presents possible applications of ultrasound elastography in musculoskeletal imaging based on the available literature, as well as the possibility of extending indications for the use of elastography in the future. Ultrasound elastography (EUS) is a new method that shows structural changes in tissues following application of physical stress. Elastography techniques have been widely used to assess muscles and tendons in vitro since the early parts of the twentieth century. Only recently with the advent of new technology and creation of highly specialized ultrasound devices, has elastography gained widespread use in numerous applications. The authors performed a search of the Medline/PubMed databases for original research and reviewed publications on the application of ultrasound elastography for musculoskeletal imaging. All publications demonstrate possible uses of ultrasound elastography in examinations of the musculoskeletal system. The most widely studied areas include the muscles, tendons and rheumatic diseases. There are also reports on the employment in vessel imaging. The main limitation of elastography as a technique is above all the variability of applied pressure during imaging, which is operator-dependent. It would therefore be reasonable to provide clear guidelines on the technique applied, as well as clear indications for performing the test. It is important to develop methods for creating artifact-free, closed-loop, compression-decompression cycles. The main advantages include cost-effectiveness, short duration of the study, non-invasive nature of the procedure, as well as a potentially broader clinical availability. There are no clear guidelines with regard to indications as well as examination techniques. Ultrasound elastography is a new and still poorly researched method. We conclude, however, that it can be widely used in the examinations of musculoskeletal system. Therefore, it is necessary to conduct large, multi-center studies to

Breast ultrasound in the management of gynecomastia in Peutz-Jeghers syndrome in monozygotic twins: two case reports.

Science.gov (United States)

Di Grezia, Graziella; Romano, Tiziana; De Francesco, Francesco; Somma, Francesco; Rea, Gaetano; Grassi, Roberto; Gatta, Gianluca

2014-12-18

Peutz-Jeghers syndrome is an autosomal dominant disease with incomplete penetrance and variable expression caused by germline mutation of serine threonine kinase 11/liver kinase B1; it is characterized by hamartomatous polyps in the gastrointestinal tract, mucocutaneous melanin pigmentation, and increased predisposition to neoplasms. In Peutz-Jeghers syndrome, bilateral Sertoli cell testicular tumors cause endocrine manifestations including gynecomastia and feminization. This study aimed to assess the role of breast ultrasound in the evaluation of the effectiveness of an innovative surgical approach. This report presents a pair of European 9-year-old identical male twins with Peutz-Jeghers syndrome, bilateral prepubertal gynecomastia, and testicular multifocal calcifications. Both twins were treated with anastrozole for 2 years. After finishing treatment, both underwent subcutaneous mastectomy performed by the "modified" Webster technique. Breast examination and ultrasound were performed before and after the pharmacological and surgical treatment. A breast ultrasound scan before surgery showed bilateral gynecomastia in both patients. No solid nodular or cystic formations were present on either side. After pharmacological therapy and surgical glandular removal, a breast examination showed a significant reduction in breast volume; 1 year after surgery, a breast ultrasound scan of both patients showed a total absence of glandular parenchyma, with muscle planes well represented. Breast examination and ultrasound have proved to be a valid approach in the assessment of the treatment of prepubertal gynecomastia because they allow the efficacy of the pharmacological and surgical treatment to be evaluated in a multidisciplinary approach to one of the most frequent endocrine manifestations of Peutz-Jeghers syndrome.

Accuracy and safety of ward based pleural ultrasound in the Australian healthcare system.

Science.gov (United States)

Hammerschlag, Gary; Denton, Matthew; Wallbridge, Peter; Irving, Louis; Hew, Mark; Steinfort, Daniel

2017-04-01

Ultrasound has been shown to improve the accuracy and safety of pleural procedures. Studies to date have been performed in large, specialized units, where pleural procedures are performed by a small number of highly specialized physicians. There are no studies examining the safety and accuracy of ultrasound in the Australian healthcare system where procedures are performed by junior doctors with a high staff turnover. We performed a retrospective review of the ultrasound database in the Respiratory Department at the Royal Melbourne Hospital to determine accuracy and complications associated pleural procedures. A total of 357 ultrasounds were performed between October 2010 and June 2013. Accuracy of pleural procedures was 350 of 356 (98.3%). Aspiration of pleural fluid was successful in 121 of 126 (96%) of patients. Two (0.9%) patients required chest tube insertion for management of pneumothorax. There were no recorded pleural infections, haemorrhage or viscera puncture. Ward-based ultrasound for pleural procedures is safe and accurate when performed by appropriately trained and supported junior medical officers. Our findings support this model of pleural service care in the Australian healthcare system. © 2016 Asian Pacific Society of Respirology.

Comparison of a novel real-time SonixGPS needle-tracking ultrasound technique with traditional ultrasound for vascular access in a phantom gel model.

Science.gov (United States)

Kopac, Daniel S; Chen, Jerry; Tang, Raymond; Sawka, Andrew; Vaghadia, Himat

2013-09-01

Ultrasound-guided percutaneous vascular access for endovascular procedures is well established in surgical practice. Despite this, rates of complications from venous and arterial access procedures remain a significant cause of morbidity. We hypothesized that the use of a new technique of vascular access using an ultrasound with a novel needle-guidance positioning system (GPS) would lead to improved success rates of vascular puncture for both in-plane and out-of-plane techniques compared with traditional ultrasound. A prospective, randomized crossover study of medical students from all years of medical school was conducted using a phantom gel model. Each medical student performed three ultrasound-guided punctures with each of the four modalities (in-plane no GPS, in-plane with GPS, out-of-plane no GPS, out-of-plane with GPS) for a total of 12 attempts. The success or failure was judged by the ability to aspirate a simulated blood solution from the model. The time to successful puncture was also recorded. A poststudy validated NASA Task Load Index workload questionnaire was conducted to assess the student's perceptions of the two different techniques. A total of 30 students completed the study. There was no significant difference seen in the mean times of vascular access for each of the modalities. Higher success rates for vascular access using the GPS for both the in-plane (94% vs 91%) and the out-of-plane (86% vs 70%) views were observed; however, this was not statistically significant. The students perceived the mental demand (median 12.0 vs 14.00; P = .035) and effort to be lower (mean 11.25 vs 14.00; P = .044) as well as the performance to be higher (mean 15.50 vs 14.00; P = .041) for the GPS vs the traditional ultrasound-guided technique. Students also perceived their ability to access vessels increased with the aid of the GPS (7.00 vs 6.50; P = .007). The majority of students expressed a preference for GPS (26/30, 87%) as opposed to the traditional counterpart

Routine ultrasound guided evacuation of first trimester missed abortion versus blind evacuation

OpenAIRE

Mostafa Abdulla Elsayed

2014-01-01

Background: The clinical management of miscarriage has changed little over the years and many women undergo surgical uterine evacuation. Surgical evacuation of the uterine contents in missed abortion is a challenge to the obstetrician as it is done blindly. The current study recommends the use of ultrasound guided surgical evacuation. It serves two important advantages; the first is to complete evacuation without the need of additional step. The second is to protect against uterine perforatio...

Assessment of substantia nigra echogenicity in German and Filipino populations using a portable ultrasound system.

Science.gov (United States)

Go, Criscely L; Frenzel, Antonia; Rosales, Raymond L; Lee, Lillian V; Benecke, Reiner; Dressler, Dirk; Walter, Uwe

2012-02-01

Transcranial sonography of the substantia nigra for diagnosing premotor stages of Parkinson disease has been attracting increasing interest. Standard reference values defining an abnormal increased echogenic size (hyperechogenicity) of the substantia nigra have been established in several populations using high-end stationary ultrasound systems. It is unknown whether a portable ultrasound system can be appropriately used and how the Filipino population would compare with the well-studied white population. We prospectively studied substantia nigra echogenic sizes and third ventricle widths in 71 healthy adult German participants and 30 age- and sex-matched Filipino participants using both a well-established stationary ultrasound system (in the German cohort) and a recently distributed portable ultrasound system (in both ethnic cohorts). Mean substantia nigra echogenic sizes, cutoff values defining abnormal hyperechogenicity, and intra-rater reliability were similar with both systems and in both ethnic cohorts studied. The Filipino and German participants did not differ with respect to the frequency of insufficient insonation conditions (each 3%) and substantia nigra hyperechogenicity (10% versus 9%; P = .80). However, third ventricle widths were smaller in the Filipino than the German participants (mean ± SD, 1.6 ± 1.1 versus 2.4 ± 1.0 mm; P = .004). The frequency of substantia nigra hyperechogenicity appears to be homogeneous in white and Asian populations. Screening for this feature may well be performed with a present-day portable ultrasound system.

Ultrasound techniques in the evaluation of the mediastinum, part 2

DEFF Research Database (Denmark)

Jenssen, Christian; Annema, Jouke Tabe; Clementsen, Paul

2015-01-01

and inoperable lung cancer (e.g., surgery vs. combined chemoradiation therapy). Tissue sampling is often indicated for accurate nodal staging. Recent international lung cancer staging guidelines clearly state that endosonography should be the initial tissue sampling test over surgical staging. Mediastinal nodes...... can be sampled from the airways [endobronchial ultrasound combined with transbronchial needle aspiration (EBUS-TBNA)] or the esophagus [endoscopic ultrasound fine needle aspiration (EUS-FNA)]. EBUS and EUS have a complementary diagnostic yield and in combination virtually all MLNs can be biopsied...... and mediastinal staging of lung cancer. A specific emphasis will be on learning mediastinal endosonography. Part 1 deals with an introduction into ultrasound techniques, MLN anatomy and diagnostic reach of ultrasound techniques and part 2 with the clinical work up of neoplastic and inflammatory mediastinal...

Optical surgical navigation system causes pulse oximeter malfunction.

Science.gov (United States)

Satoh, Masaaki; Hara, Tetsuhito; Tamai, Kenji; Shiba, Juntaro; Hotta, Kunihisa; Takeuchi, Mamoru; Watanabe, Eiju

2015-01-01

An optical surgical navigation system is used as a navigator to facilitate surgical approaches, and pulse oximeters provide valuable information for anesthetic management. However, saw-tooth waves on the monitor of a pulse oximeter and the inability of the pulse oximeter to accurately record the saturation of a percutaneous artery were observed when a surgeon started an optical navigation system. The current case is thought to be the first report of this navigation system interfering with pulse oximetry. The causes of pulse jamming and how to manage an optical navigation system are discussed.

Utility of ultrasound in the early diagnosis of childhood neutropenic enterocolitis

International Nuclear Information System (INIS)

Muro, D.; Sanguesa, C.; Bermudez, M.; Verdeguer, A.

1999-01-01

To determine the utility of ultrasound in the diagnosis of neutropenic enterocolitis (NEC) in children with cancer or AIDS, and to establish the differential diagnosis with respect to more common causes of acute abdomen. We studied eight patients diagnosed as having NEC over a ten-year period, gathering the clinical data and imaging studied for each. Seven of the children were cancer patients and the remaining child had AIDS. The imaging methods used were plain radiography, B-mode ultrasound and color Doppler ultrasound: in addition, one patient underwent a barium enema. All eight patients presented abdominal pain, predominantly in right iliac fossa, and fever; the neutrophil count was under 100/mm''3. The most common plain abdominal X-ray image was the absence of air in right iliac fossa and dilation of the small bowel loops. One child presented submucosal and subserosal ectopic air colon and cecum, air in the intrahepatic portal system and in peritoneum. Abdominal ultrasound revealed thickening of the cecal mucosa in every case, and color Doppler ultrasound disclosed increased vascularization of the intestinal wall. Six children received medical treatment and two underwent surgery. Three patients died, one a few hours after the surgical procedure and the other two a few days after onset of NEC and initiation of medical treatment. Abdominal ultrasound is the best imaging technique for early diagnosis of NEC and assessment of the response to medical treatment, Moreover, it can be performed at bedside, making it unnecessary to move the patient from his room. (Author) 26 refs

Systems for tracking minimally invasive surgical instruments.

Science.gov (United States)

Chmarra, M K; Grimbergen, C A; Dankelman, J

2007-01-01

Minimally invasive surgery (e.g. laparoscopy) requires special surgical skills, which should be objectively assessed. Several studies have shown that motion analysis is a valuable assessment tool of basic surgical skills in laparoscopy. However, to use motion analysis as the assessment tool, it is necessary to track and record the motions of laparoscopic instruments. This article describes the state of the art in research on tracking systems for laparoscopy. It gives an overview on existing systems, on how these systems work, their advantages, and their shortcomings. Although various approaches have been used, none of the tracking systems to date comes out as clearly superior. A great number of systems can be used in training environment only, most systems do not allow the use of real laparoscopic instruments, and only a small number of systems provide force feedback.

Ultrasound-guided wire localization of lesions detected on ...

African Journals Online (AJOL)

Background: Wire localization for planned surgical treatment in the management of breast cancer is underutilized in our environment. The objective of this study is to assess the role of ultrasound-guided wire localization of breast masses detected on screening mammography and its impact on biopsy and breast ...

In vivo demonstration of ultrasound power delivery to charge implanted medical devices via acute and survival porcine studies.

Science.gov (United States)

Radziemski, Leon; Makin, Inder Raj S

2016-01-01

Animal studies are an important step in proving the utility and safety of an ultrasound based implanted battery recharging system. To this end an Ultrasound Electrical Recharging System (USER™) was developed and tested. Experiments in vitro demonstrated power deliveries at the battery of up to 600 mW through 10-15 mm of tissue, 50 mW of power available at tissue depths of up to 50 mm, and the feasibility of using transducers bonded to titanium as used in medical implants. Acute in vivo studies in a porcine model were used to test reliability of power delivery, temperature excursions, and cooling techniques. The culminating five-week survival study involved repeated battery charging, a total of 10.5h of ultrasound exposure of the intervening living tissue, with an average RF input to electrical charging efficiency of 20%. This study was potentially the first long term cumulative living-tissue exposure using transcutaneous ultrasound power transmission to an implanted receiver in situ. Histology of the exposed tissue showed changes attributable primarily due to surgical implantation of the prototype device, and no damage due to the ultrasound exposure. The in vivo results are indicative of the potential safe delivery of ultrasound energy for a defined set of source conditions for charging batteries within implants. Copyright © 2015 Elsevier B.V. All rights reserved.

[Clinical application of Da Vinci surgical system in China].

Science.gov (United States)

Jin, Zhenyu

2014-01-01

Da Vinci robotic surgical system leads the development of minimally invasive surgical techniques. By using Da Vinci surgical robot for minimally invasive surgery, it brings a lot of advantages to the surgeons. Since 2008, Da Vinci surgeries have been performed in 14 hospitals in domestic cities such as Beijing and Shanghai. Until the end of 2012, 3 551 cases of Da Vinci robotic surgery have been performed, covering various procedures of various surgical departments including the department of general surgery, urology, cardiovascular surgery, thoracic surgery, gynecology, and etc. Robotic surgical technique has made remarkable achievements.

Interfaces for Modular Surgical Planning and Assistance Systems

OpenAIRE

Gessat, Michael

2010-01-01

Modern surgery of the 21st century relies in many aspects on computers or, in a wider sense, digital data processing. Department administration, OR scheduling, billing, and - with increasing pervasion - patient data management are performed with the aid of so called Surgical Information Systems (SIS) or, more general, Hospital Information Systems (HIS). Computer Assisted Surgery (CAS) summarizes techniques which assist a surgeon in the preparation and conduction of surgical interventions...

Efficacy of high frequency ultrasound in postoperative evaluation of carpal tunnel syndrome treatment

Directory of Open Access Journals (Sweden)

Katarzyna Kapuścińska

2016-03-01

Full Text Available Carpal tunnel syndrome (CTS is the most common entrapment neuropathy and a frequent cause of sick leave because of work-related hand overload. The main treatment is operation. Aim: The aim of the study is to assess the usefulness of high frequency ultrasound in the postoperative evaluation of CTS treatment efficacy. Material and methods: Sixty-two patients (50 women and 12 men aged 28–70, mean age 55.2 underwent surgical treatment of CTS. Ultrasound examinations of the wrist in all carpal tunnel sufferers were performed 3 months after the procedure with the use of a high frequency broadband linear array transducer (6–18 MHz, using 18 MHz band of MyLab 70/Esaote. On the basis of the collected data, the author has performed multiple analyses to confirm the usefulness of ultrasound imaging for postoperative evaluation of CTS treatment efficacy. Results: Among all 62 patients, 3 months after surgical median nerve decompression: in 40 patients, CTS symptoms subsided completely, and sonographic evaluation did not show median nerve entrapment signs; in 9 patients, CTS symptoms persisted or exacerbated, and ultrasound proved nerve compression revealing preserved flexor retinaculum fibers; in 13 patients, scar tissue symptoms occurred, and in 5 of them CTS did not subside completely (although ultrasound showed no signs of compression. Conclusions: Ultrasound imaging with the use of a high frequency transducer is a valuable diagnostic tool for postoperative assessment of CTS treatment efficacy.

Compensated Row-Column Ultrasound Imaging System Using Multilayered Edge Guided Stochastically Fully Connected Random Fields.

Science.gov (United States)

Ben Daya, Ibrahim; Chen, Albert I H; Shafiee, Mohammad Javad; Wong, Alexander; Yeow, John T W

2017-09-06

The row-column method received a lot of attention for 3-D ultrasound imaging. By reducing the number of connections required to address the 2-D array and therefore reducing the amount of data to handle, this addressing method allows for real time 3-D imaging. Row-column still has its limitations: the issues of sparsity, speckle noise inherent to ultrasound, the spatially varying point spread function, and the ghosting artifacts inherent to the row-column method must all be taken into account when building a reconstruction framework. In this research, we build on a previously published system and propose an edge-guided, compensated row-column ultrasound imaging system that incorporates multilayered edge-guided stochastically fully connected conditional random fields to address the limitations of the row-column method. Tests carried out on simulated and real row-column ultrasound images show the effectiveness of our proposed system over other published systems. Visual assessment show our proposed system's potential at preserving edges and reducing speckle. Quantitative analysis shows that our proposed system outperforms previously published systems when evaluated with metrics such as Peak Signal-to-Noise Ratio, Coefficient of Correlation, and Effective Number of Looks. These results show the potential of our proposed system as an effective tool for enhancing 3-D row-column imaging.

Surgical bedside master console for neurosurgical robotic system.

Science.gov (United States)

Arata, Jumpei; Kenmotsu, Hajime; Takagi, Motoki; Hori, Tatsuya; Miyagi, Takahiro; Fujimoto, Hideo; Kajita, Yasukazu; Hayashi, Yuichiro; Chinzei, Kiyoyuki; Hashizume, Makoto

2013-01-01

We are currently developing a neurosurgical robotic system that facilitates access to residual tumors and improves brain tumor removal surgical outcomes. The system combines conventional and robotic surgery allowing for a quick conversion between the procedures. This concept requires a new master console that can be positioned at the surgical bedside and be sterilized. The master console was developed using new technologies, such as a parallel mechanism and pneumatic sensors. The parallel mechanism is a purely passive 5-DOF (degrees of freedom) joystick based on the author's haptic research. The parallel mechanism enables motion input of conventional brain tumor removal surgery with a compact, intuitive interface that can be used in a conventional surgical environment. In addition, the pneumatic sensors implemented on the mechanism provide an intuitive interface and electrically isolate the tool parts from the mechanism so they can be easily sterilized. The 5-DOF parallel mechanism is compact (17 cm width, 19cm depth, and 15cm height), provides a 505,050 mm and 90° workspace and is highly backdrivable (0.27N of resistance force representing the surgical motion). The evaluation tests revealed that the pneumatic sensors can properly measure the suction strength, grasping force, and hand contact. In addition, an installability test showed that the master console can be used in a conventional surgical environment. The proposed master console design was shown to be feasible for operative neurosurgery based on comprehensive testing. This master console is currently being tested for master-slave control with a surgical robotic system.

A multipoint feedback control system for scanned focussed ultrasound hyperthermia

International Nuclear Information System (INIS)

Johnson, C.; Kress, R.; Roemer, R.; Hynynen, K.

1987-01-01

A multipoint feedback control system has been developed and tested for use with a scanned focussed ultrasound hyperthermia system. Extensive in-vivo tests (using a perfused organ model) have been made to evaluate the basic performance characteristics of the feedback control scheme for control of temperature in perfused media. The results of these tests are presented and compared with the predictions of a simulation routine. The control scheme was also tested in vivo using dogs' thighs and kidneys. Thigh experiments show the control scheme responds well to the affects of vasodilation and is able to maintain the targeted temperatures. In kidney experiments, where the rate of perfusion was controllable, the power adjusting algorithm successfully maintained uniform temperature distributions across regions of varying rates of perfusion. As a conclusion, the results show that this multipoint feedback controller scheme induces uniform temperature distributions when used with scanned focussed ultrasound systems

Ultrasound assessment of selected peripheral nerve pathologies. Part III: Injuries and postoperative evaluation

Directory of Open Access Journals (Sweden)

Berta Kowalska

2013-03-01

Full Text Available The previous articles of the series devoted to ultrasound diagnostics of peripheral nerves concerned the most common nerve pathologies, i.e. entrapment neuropathies. The aim of the last part of the series is to present ultrasound possibilities in the postoperative control of the peripheral nerves as well as in the diagnostics of the second most common neuropathies of peripheral nerves, i.e. posttraumatic lesions. Early diagnostics of posttraumatic changes is of fundamental importance for the course of treatment and its long-term effects. It aids surgeons in making treatment decisions (whether surgical or conservative. When surgical treatment is necessary, the surgeon, based on US findings, is able to plan a given type of operative method. In certain cases, may even abandon the corrective or reconstructive surgery of the nerve trunk (when there are extensive defects of the nerve trunks and instead, proceed with muscle transfers. Medical literature proposes a range of divisions of the kinds of peripheral nerve injuries depending on, among others, the mechanism or degree of damage. However, the most important issue in the surgeon-diagnostician communication is a detailed description of stumps of the nerve trunks, their distance and location. In the postoperative period, ultrasound is used for monitoring the operative or conservative treatment effects including the determination of the causes of a persistent or recurrent neuropathy. It facilitates decision-making concerning a repeated surgical procedure or assuming a wait-and-see attitude. It is a difficult task for a diagnostician and it requires experience, close cooperation with a clinician and knowledge concerning surgical techniques. Apart from a static assessment, a dynamic assessment of possible adhesions constitutes a crucial element of postoperative examination. This feature distinguishes ultrasound scanning from other methods used in the diagnostics of peripheral neuropathies.

Unpowered wireless transmission of ultrasound signals

International Nuclear Information System (INIS)

Huang, H; Paramo, D; Deshmukh, S

2011-01-01

This paper presents a wireless ultrasound sensing system that uses frequency conversion to convert the ultrasound signal to a microwave signal and transmit it directly without digitization. Constructed from a few passive microwave components, the sensor is able to sense, modulate, and transmit the full waveform of ultrasound signals wirelessly without requiring any local power source. The principle of operation of the unpowered wireless ultrasound sensor is described first, and this is followed by a detailed description of the implementation of the sensor and the sensor interrogation unit using commercially available antennas and microwave components. Validation of the sensing system using an ultrasound pitch–catch system and the power analysis model of the system are also presented

Dissimilar trend of nonlinearity in ultrasound transducers and systems at resonance and non-resonance frequencies

DEFF Research Database (Denmark)

Ghasemi, Negareh; Zare, Firuz; Davari, Pooya

2017-01-01

Several factors can affect performance of an ultrasound system such as quality of excitation signal and ultrasound transducer behaviour. Nonlinearity of piezoelectric ultrasound transducers is a key determinant in designing a proper driving power supply. Although, the nonlinearity of piezoelectric...... was excited at different frequencies. Different excitation signals were generated using a linear power amplifier and a multilevel converter within a range of 30–200 V. Empirical relation was developed to express the resistance of the piezoelectric transducer as a nonlinear function of both excitation voltage...... and resonance frequency. The impedance measurements revealed that at higher voltage ranges, the piezoelectric transducer can be easily saturated. Also, it was shown that for the developed ultrasound system composed of two transducers (one transmitter and one receiver), the output voltage measured across...

Ultrasound-guided needle aspiration of parotid abscess

Directory of Open Access Journals (Sweden)

André Takahashi

2012-01-01

Full Text Available Ultrasound (US has been used as a tool for parotid abscess diagnosis and treatment. The present article aimed to report a case of 72-year-old woman with parotid abscess treated by US-guided needle aspiration and conventional surgical drainage. Along with the clinical report, indications, advantages, and limitations of the method are discussed.

Development of a Cognitive Robotic System for Simple Surgical Tasks

Directory of Open Access Journals (Sweden)

Riccardo Muradore

2015-04-01

Full Text Available The introduction of robotic surgery within the operating rooms has significantly improved the quality of many surgical procedures. Recently, the research on medical robotic systems focused on increasing the level of autonomy in order to give them the possibility to carry out simple surgical actions autonomously. This paper reports on the development of technologies for introducing automation within the surgical workflow. The results have been obtained during the ongoing FP7 European funded project Intelligent Surgical Robotics (I-SUR. The main goal of the project is to demonstrate that autonomous robotic surgical systems can carry out simple surgical tasks effectively and without major intervention by surgeons. To fulfil this goal, we have developed innovative solutions (both in terms of technologies and algorithms for the following aspects: fabrication of soft organ models starting from CT images, surgical planning and execution of movement of robot arms in contact with a deformable environment, designing a surgical interface minimizing the cognitive load of the surgeon supervising the actions, intra-operative sensing and reasoning to detect normal transitions and unexpected events. All these technologies have been integrated using a component-based software architecture to control a novel robot designed to perform the surgical actions under study. In this work we provide an overview of our system and report on preliminary results of the automatic execution of needle insertion for the cryoablation of kidney tumours.

Towards Safe Robotic Surgical Systems

DEFF Research Database (Denmark)

Sloth, Christoffer; Wisniewski, Rafael

2015-01-01

a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...... from several initial conditions to demonstrate that the designed control system is safe for every admissible initial condition....

The Effects of Ultrasound on Biological Systems: Site

Science.gov (United States)

El-Karmi, Anan M.

Earlier studies (Dinno et al., Ultrasound Med. Biol. 15:461 -470; 1989) demonstrated that ultrasound at therapeutic intensities causes large increases in total conductance (G_{rm t}) of frog skin. These changes were attributed to non-thermal mechanisms, primarily, cavitation. In this study, the site(s) and mechanism(s) of action of ultrasound for the increase in G_{rm t} were examined. The reversible changes in G_{rm t } and sodium current were monitored in real time as a function of ultrasound exposure. Amiloride, a sodium channel blocker, was used to differentiate between cellular (G_{rm c}) and paracellular (G_{rm s}) pathways in the presence and absence of ultrasound. No significant changes were detected in G_ {rm c}. However, changes in G _{rm s} were significant. These results demonstrate that most of the increase in G _{rm t} due to ultrasound is taking place in the paracellular pathways. Sodium channels were not significantly affected by ultrasound. Thus, the changes in G_{rm c} are not specific. The effects of ultrasound were examined in the presence of radical scavengers and antioxidants. The increase in G_{rm t} due to ultrasound was significantly minimized in the presence of cystamine, cysteamine, and sodium ascorbate. This demonstrates that free radicals and other reactive species generated by cavitation are causing the increase in G_ {rm t}, possibly by acting from inside the cells. Radical scavengers and antioxidants are providing protection from oxidative damage but are not involved in the recovery of G_{ rm t} towards steady state values after sonication. The role of Ca^{2+} in the effects of ultrasound was examined since many of the cellular reactions involved in tissue recovery are dependent on the intracellular availability of free Ca^{2+}. The percentage increase in G_{rm t} in the presence of Ca^{2+} was larger than in its absence (140% vs. 27%). The time constant for G_{rm t} to return to steady state was longer in calcium-free solutions (122

Test characteristics of high-resolution ultrasound in the preoperative assessment of margins of basal cell and squamous cell carcinoma in patients undergoing Mohs micrographic surgery.

Science.gov (United States)

Jambusaria-Pahlajani, Anokhi; Schmults, Chrysalyne D; Miller, Christopher J; Shin, Daniel; Williams, Jennifer; Kurd, Shanu K; Gelfand, Joel M

2009-01-01

Noninvasive techniques to assess subclinical spread of nonmelanoma skin cancer (NMSC) may improve surgical precision. High-resolution ultrasound has shown promise in evaluating the extent of NMSC. To determine the accuracy of high-resolution ultrasound to assess the margins of basal cell (BCC) and squamous cell carcinomas (SCC) before Mohs micrographic surgery (MMS). We enrolled 100 patients with invasive SCC or BCC. Before the first stage of MMS, a Mohs surgeon delineated the intended surgical margin. Subsequently, a trained ultrasound technologist independently evaluated disease extent using the EPISCAN I-200 to evaluate tumor extent beyond this margin. The accuracy of high-resolution ultrasound was subsequently tested by comparison with pathology from frozen sections. The test characteristics of the high-resolution ultrasound were sensitivity=32%, specificity=88%, positive predictive value=47%, and negative predictive value=79%. Subgroup analyses demonstrated better test characteristics for tumors larger than the median (area>1.74 cm(2)). Qualitative analyses showed that high-resolution ultrasound was less likely to identify extension from tumors with subtle areas of extension, such as small foci of dermal invasion from infiltrative SCC and micronodular BCC. High-resolution ultrasound requires additional refinements to improve the preoperative determination of tumor extent before surgical treatment of NMSC.

A review of the recommendations governing quality assurance of ultrasound systems used for guidance in prostate brachytherapy.

Science.gov (United States)

Doyle, Andrea Jane; King, Deirdre M; Browne, Jacinta E

2017-12-01

Ultrasound guided brachytherapy for the treatment of prostate cancer has become a routine treatment option, due to many benefits including patient recovery and dose localisation [1]; however it is not clear whether the standards which govern the image quality for these systems are adequate. Upon review of the recommended standards for ultrasound systems used in prostate brachytherapy procedures, the recommended tests do not appear to be specific to the clinical application of ultrasound guided prostate brachytherapy. Rather they are generic and similar to those recommended for other clinical applications such as general abdominal scanning [2]. Furthermore, there is growing evidence that these tests should be specific to the clinical application [3,4] in order to gain meaningful data about the performance of the system for the application, and also to detect clinically relevant changes in quality control results. An additional problem is that there are no clinically relevant test phantom recommended for the quality assurance of ultrasound systems used in prostate brachytherapy. The image quality for this application of ultrasound needs to be monitored to ensure consistent levels of confidence in the procedure. This paper reviews the currently recommended test guidelines and test phantoms for ultrasound systems used in prostate brachytherapy from the different standard bodies and professional organisations. A critical analysis of those tests which are most reflective of the imaging and guidance tasks undertaken in an ultrasound guided prostate brachytherapy procedure will also be presented to inform the design of a TRUS quality assurance protocol. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Development of haptic system for surgical robot

Science.gov (United States)

Gang, Han Gyeol; Park, Jiong Min; Choi, Seung-Bok; Sohn, Jung Woo

2017-04-01

In this paper, a new type of haptic system for surgical robot application is proposed and its performances are evaluated experimentally. The proposed haptic system consists of an effective master device and a precision slave robot. The master device has 3-DOF rotational motion as same as human wrist motion. It has lightweight structure with a gyro sensor and three small-sized MR brakes for position measurement and repulsive torque generation, respectively. The slave robot has 3-DOF rotational motion using servomotors, five bar linkage and a torque sensor is used to measure resistive torque. It has been experimentally demonstrated that the proposed haptic system has good performances on tracking control of desired position and repulsive torque. It can be concluded that the proposed haptic system can be effectively applied to the surgical robot system in real field.

Transperineal Ultrasound as a Tool to Plan Surgical Strategies in Pediatric Urology: Back to the Future?

Science.gov (United States)

de Jesus, Lisieux Eyer; Fazecas, Tatiana; Ribeiro, Bianca G; Dekermacher, Samuel

2017-06-01

To demonstrate the usefulness and advantages of transperineal ultrasound (TPUS) on planning the surgical tactics to treat childhood pelviperineal disease (CPPD). A cohort of CPPD is reviewed to provide a pictorial review of TPUS as imaging method variety of CPPD. Other imaging methods are compared with TPUS. TPUS studies of patients showing different conditions on the spectrum of pelviperineal malformation are shown in detail (pictorial review, graphically shown-see figures in the article and as supplementary material), highlighting the advantages of the method and comparing TPUS findings with other imaging techniques. Magnetic resonance imaging, contrast genitograms, voiding cystourethrography, and genital or urologic endoscopy have some important disadvantages, especially radiation exposure, high cost, not easily available equipment, and the need of general anesthesia or deep sedation in children. TPUS is easily available, including in impoverished environments, portable, painless, reproducible, inexpensive, and capable of providing detailed and specific information about pelviperineal malformation with accuracy. Data provided by TPUS are comparable with other imaging techniques (Table 1). Its main disadvantage is the dependency on the expertise of the operator to obtain high-quality, well-interpreted images. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of ultrasound and ultrasound plus nerve stimulator guidance axillary plexus block

International Nuclear Information System (INIS)

Demirelli, G.; Baskan, S.; Karabeyoglu, I.; Aytac, I.; Omek, D.H.; Erdogmus, A.; Baydar, M.

2017-01-01

To evaluate the characteristics of axillary plexus blockade applied using ultrasound only and using ultrasound together with nerve stimulator in patients undergoing planned forearm, wrist or hand surgery. Methods: This randomised, prospective, double-blinded, single-centre study was conducted at Ankara Numune Training and Research Hospital, Ankara, Turkey, from November 2014 to August 2015, and comprised patients undergoing forearm, wrist or hand surgery. Participants were separated into 2 groups. In Group 1, the nerve roots required for the surgical site were located one by one and local anaesthetic was applied separately to each nerve for the block. In Group 2, the vascular nerve bundle was located under ultrasound guidance and a total block was achieved by administering all the local anaesthetic within the nerve sheath. In the operating room, standard monitorisation was applied. Following preparation of the skin, the axillary region nerve roots and branches and vascular structures were observed by examination with a high-frequency ultrasound probe. In both groups, a 22-gauge, 5cm block needle was entered to the axillary region with visualisation of the whole needle on ultrasound and 20ml local anaesthetic of 0.5% bupivacaine was injected. SPSS 19 was used for data analysis. Results: Of the 60 participants, there were 30(50%) in each group. The mean age was 39.1+-15 years in the group 1 which was the ultrasound nerve stimulation group, and 41.5+-14.3 years in group 2. The duration of the procedure was longer in group I than in group 2 (p<0.05). Patient satisfaction values during the procedure were higher in group 2(p<0.05). In the ulnar sensory examination, the values of the patients in group 1 were higher at 10, 15, 20 and 25 minutes (p<0.05). In the median, radial and ulnar motor examination, the values of the patients in group 1were higher at 15 and 20 minutes (p<0.05). Conclusion: Brachial plexus blockade via axillary approach guided by ultrasound offered

MO-AB-210-00: Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-On Workshop

International Nuclear Information System (INIS)

2015-01-01

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

MO-AB-210-00: Diagnostic Ultrasound Imaging Quality Control and High Intensity Focused Ultrasound Therapy Hands-On Workshop

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

Ultrasound assisted combustion synthesis of TiC in Al-Ti-C system.

Science.gov (United States)

Liu, Zhiwei; Rakita, Milan; Xu, Wilson; Wang, Xiaoming; Han, Qingyou

2015-11-01

This research investigated the effects of high-intensity ultrasound on the combustion synthesis of TiC particles in Al-Ti-C system. The process involved that high-intensity ultrasound was applied on the surface of a compacted Al-Ti-C pellet directly through a Nb probe during the thermal explosion reaction. By comparing with the sample without ultrasonic treatment, it was found that the thermal explosion reaction for synthesizing TiC phase could take place thoroughly in the ultrasonically treated sample. During the process of synthesizing TiC phase, the dissolution of solid graphite particles into the Al-Ti melt, as well as the nucleation and growth of TiC particles could be promoted effectively due to the effects of ultrasound, leading to an enhancement of the formation of TiC particles. Ultrasound assisted combustion synthesis as a simple and effective approach was proposed for synthesizing materials in this research. Copyright © 2015 Elsevier B.V. All rights reserved.

Potential and problems in ultrasound-responsive drug delivery systems

Directory of Open Access Journals (Sweden)

Zhao YZ

2013-04-01

Full Text Available Ying-Zheng Zhao,1,3 Li-Na Du,2 Cui-Tao Lu,1 Yi-Guang Jin,2 Shu-Ping Ge3 1Wenzhou Medical College, Wenzhou City, Zhejiang Province, 2Department of Pharmaceutical Sciences, Beijing Institute of Radiation Medicine, Beijing, People’s Republic of China; 3St Christopher’s Hospital for Children/Drexel University College of Medicine, Philadelphia, PA, USA Abstract: Ultrasound is an important local stimulus for triggering drug release at the target tissue. Ultrasound-responsive drug delivery systems (URDDS have become an important research focus in targeted therapy. URDDS include many different formulations, such as microbubbles, nanobubbles, nanodroplets, liposomes, emulsions, and micelles. Drugs that can be loaded into URDDS include small molecules, biomacromolecules, and inorganic substances. Fields of clinical application include anticancer therapy, treatment of ischemic myocardium, induction of an immune response, cartilage tissue engineering, transdermal drug delivery, treatment of Huntington’s disease, thrombolysis, and disruption of the blood–brain barrier. This review focuses on recent advances in URDDS, and discusses their formulations, clinical application, and problems, as well as a perspective on their potential use in the future. Keywords: ultrasound, targeted therapy, clinical application

Ultrasound study of ovarian pain in pre adolescent and adolescent girls

International Nuclear Information System (INIS)

Sanguesa, C.; Muro, D.

1999-01-01

To assess the role of ultrasound in the study of acute ovarian pain in pre adolescent and adolescent girls. B-mode ultrasound was employed to study 40 ovarian lesions in 37 girls between the age of 6 and 17 years complaining of acute pelvic pain of ovarian origin. Thirteen of the lesions were also assessed by color Doppler ultrasound. We found 25 cases of hemorrhagic cysts, 8 of simple cyst and 7 of ovarian torsion. Surgical and pathological correlation was established in 17 cases (7 cases hemorrhagic cyst, 3 of simple cysts and 7 of ovarian torsion). The remaining lesions are being followed by clinical and ultrasonographic monitoring. Simple and hemorrhagic cysts presenting the so called hematocrit effect are easily diagnosed by B-mode ultrasound. The ultrasonographic features of torsion and certain hemorrhagic cysts are similar on occasion, and surgery and histologic assessment are necessary for the definitive diagnosis. Doppler ultrasound provides no additional information to aid in the diagnosis of these lesions. (Author) 28 refs

Portable Ultrasound Imaging

DEFF Research Database (Denmark)

di Ianni, Tommaso

This PhD project investigates hardware strategies and imaging methods for hand-held ultrasound systems. The overall idea is to use a wireless ultrasound probe linked to general-purpose mobile devices for the processing and visualization. The approach has the potential to reduce the upfront costs...... beamforming strategies are simulated from a system-level perspective. The quality of the B-mode image is evaluated and the minimum specifications are derived for the design of a portable probe with integrated electronics in-handle. The system is based on a synthetic aperture sequential beamforming approach...... that allows to significantly reduce the data rate between the probe and processing unit. The second part investigates the feasibility of vector flow imaging in a hand-held ultrasound system. Vector flow imaging overcomes the limitations of conventional imaging methods in terms of flow angle compensation...

Virtual Reality Simulator Systems in Robotic Surgical Training.

Science.gov (United States)

Mangano, Alberto; Gheza, Federico; Giulianotti, Pier Cristoforo

2018-06-01

The number of robotic surgical procedures has been increasing worldwide. It is important to maximize the cost-effectiveness of robotic surgical training and safely reduce the time needed for trainees to reach proficiency. The use of preliminary lab training in robotic skills is a good strategy for the rapid acquisition of further, standardized robotic skills. Such training can be done either by using a simulator or by exercises in a dry or wet lab. While the use of an actual robotic surgical system for training may be problematic (high cost, lack of availability), virtual reality (VR) simulators can overcome many of these obstacles. However, there is still a lack of standardization. Although VR training systems have improved, they cannot yet replace experience in a wet lab. In particular, simulated scenarios are not yet close enough to a real operative experience. Indeed, there is a difference between technical skills (i.e., mechanical ability to perform a simulated task) and surgical competence (i.e., ability to perform a real surgical operation). Thus, while a VR simulator can replace a dry lab, it cannot yet replace training in a wet lab or operative training in actual patients. However, in the near future, it is expected that VR surgical simulators will be able to provide total reality simulation and replace training in a wet lab. More research is needed to produce more wide-ranging, trans-specialty robotic curricula.

Mesh three-dimensional arm orthosis with built-in ultrasound physiotherapy system

Science.gov (United States)

Kashapova, R. M.; Kashapov, R. N.; Kashapova, R. S.

2017-09-01

The possibility of using the built-in ultrasound physiotherapy system of the hand orthosis is explored in the work. The individual mesh orthosis from nylon 12 was manufactured by the 3D prototyping method on the installation of selective laser sintering SLS SPro 60HD. The applied technology of three-dimensional scanning made it possible to obtain a model of the patient’s hand and on the basis of it to build a virtual model of the mesh frame. In the course of the research, the developed system of ultrasound exposure was installed on the orthosis and its tests were carried out. As a result, the acceleration of the healing process and the reduction in the time of wearing orthosis were found.

ULTRASOUND AND COMPUTED TOMOGRAPHIC DIAGNOSIS OF OPTIC NERVE TUMORS

Directory of Open Access Journals (Sweden)

S. V. Saakyan

2012-01-01

Full Text Available A comprehensive examination was made in 93 patients, including 18 children, with tumors of the optic nerve (ON. Duplex ultrasound scanning was performed in 39 patients, of them there were 11 patients with ON gliomas and 28 with ON meningiomas. The specific computed tomographic and echographic signs of ON glioma and meningiomas were detected. The studies have shown that duplex ultrasound scanning and structural computed tomography of orbital sockets are highly informative complementary imaging procedures for ON tumors, which permits one to make their correct diagnosis, to specify surgical volume, and to plan adequate treatment.

Usefulness of color and pulsed Doppler's in the evaluation of surgical portosystemic shunts in pediatric patients

International Nuclear Information System (INIS)

Berrocal, T.; Prieto, C.; Cortes, P.; Rodriguez, R.; Pastor, I.

2003-01-01

Portosystemic shunts are performed to relieve symptomatic portal hypertension symptomatic or removal pressure in hepatic vascularisation in patients with Budd-Chiari's syndrome. Most surgical portosystemic shunts can be suitably studied by means of ultrasound scan complemented by color and pulsed Dopplers, proved one understands the hemodynamics of the surgical procedures involved. This article demonstrates the usefulness and limitations of the ultrasound scan Duplex Doppler in the evaluation of portosystemic shunts performed on pediatric patients. Pulsed Doppler provides information regarding the nature and direction of blood flow. Color doppler is capable of directly revealing the shunt and, in most cases, permits the anastomosis to be located. The types of shunts that appear include proximal and distal spleno-renal, portocaval and mesocaval. Types of vascular connections are illustrated,s well as expected post-surgical blood flow direction in affected vessels. The ultrasound scanning technique is discussed, as well as the criteria for determining vascular permeability. Also highlighted are the advantages, limitations and diagnostic difficulties associated with the different forms of Doppler. (Author) 17 refs

Breast Ultrasound Examination with Video Monitor System: A Satisfaction Survey among Patients

International Nuclear Information System (INIS)

Ryu, Jung Kyu; Kim, Hyun Cheol; Yang, Dal Mo

2010-01-01

The purpose of this study is to assess the patients satisfaction with a newly established video-monitor system and the associated basic items for performing breast ultrasound exams by conducting a survey among the patients. 349 patients were invited to take the survey and they had undergone breast ultrasound examination once during the 3 months after the monitor system has been introduced. The questionnaire was composed of 8 questions, 4 of which were about the basic items such as age, gender and the reason of their taking the breast ultrasound exam, their preference for the gender of the examiner and the desired length of time for the examination. The other 4 question were about their satisfaction with the video monitor. The patients were divided into two groups according to the purposes of taking the exams, which were screening or diagnostic purposes. The results were compared between these 2 groups. The satisfaction with the video monitor system was assessed by using a scoring system that ranged from 1 to 5. For the total patients, the screening group was composed of 124 patients and the diagnostic group was composed of 225. The reasons why the patients wanted to take the examinations in the diagnostic group varied. The questionnaire about the preference of the gender of the examiner showed that 81.5% in the screening group and 79.1% in the diagnostic group preferred a woman doctor. The required, suitable time for the breast ultrasound examination was 5 to 10 minutes or 10 to 15 minutes for about 70% of the patients. The mean satisfaction score for the video monitor system was as high as 3.95 point. The portion of patients in each group who answered over 3 points for their satisfaction with the monitor system was 88.7% and 94.2%, respectively. Our study showed that patients preferred 5-15 minutes for the length of the examination time and a female examiner. We also confirmed high patient satisfaction with the video monitor system

Breast Ultrasound Examination with Video Monitor System: A Satisfaction Survey among Patients

Energy Technology Data Exchange (ETDEWEB)

Ryu, Jung Kyu; Kim, Hyun Cheol; Yang, Dal Mo [East-West Neo Medical Center, Kyung-Hee University, Seoul (Korea, Republic of)

2010-03-15

The purpose of this study is to assess the patients satisfaction with a newly established video-monitor system and the associated basic items for performing breast ultrasound exams by conducting a survey among the patients. 349 patients were invited to take the survey and they had undergone breast ultrasound examination once during the 3 months after the monitor system has been introduced. The questionnaire was composed of 8 questions, 4 of which were about the basic items such as age, gender and the reason of their taking the breast ultrasound exam, their preference for the gender of the examiner and the desired length of time for the examination. The other 4 question were about their satisfaction with the video monitor. The patients were divided into two groups according to the purposes of taking the exams, which were screening or diagnostic purposes. The results were compared between these 2 groups. The satisfaction with the video monitor system was assessed by using a scoring system that ranged from 1 to 5. For the total patients, the screening group was composed of 124 patients and the diagnostic group was composed of 225. The reasons why the patients wanted to take the examinations in the diagnostic group varied. The questionnaire about the preference of the gender of the examiner showed that 81.5% in the screening group and 79.1% in the diagnostic group preferred a woman doctor. The required, suitable time for the breast ultrasound examination was 5 to 10 minutes or 10 to 15 minutes for about 70% of the patients. The mean satisfaction score for the video monitor system was as high as 3.95 point. The portion of patients in each group who answered over 3 points for their satisfaction with the monitor system was 88.7% and 94.2%, respectively. Our study showed that patients preferred 5-15 minutes for the length of the examination time and a female examiner. We also confirmed high patient satisfaction with the video monitor system

Pediatric abdominal non-Hodgkin's lymphoma: diagnosis through surgical and non-surgical procedures.

Science.gov (United States)

Aguiar, Arthur Almeida; Lima, Luciana Cavalvanti; Araújo, Cláudia Corrêa de; Gallindo, Rodrigo Melo

2017-12-29

To describe the success rate and the complications after procedures to diagnose abdominal non-Hodgkin's lymphoma in children and adolescents. A retrospective cross-sectional study was conducted with a population consisting of children and adolescents with abdominal non-Hodgkin's lymphoma diagnosed between September 1994 and December 2012. The sample comprised of 100 patients who underwent 113 diagnostic procedures, including urgent surgery (n=21), elective surgery (n=36), and non-surgical diagnosis (n=56). The most frequent procedures were laparotomy (46.9%) and ultrasound-guided core biopsy (25.6%). The rate of diagnostic success was 95.2% for urgent surgeries; 100% for elective surgeries and 82.1% for non-surgical procedures (p<0.05). The rates of complication during the three diagnosis procedures considered were significant (p<0.001; 95.2% of the urgent surgeries, 83.8% of the elective surgeries, and 10.7% of the non-surgical procedures). The length of time before resuming a full diet and starting chemotherapy was significantly reduced for patients who underwent non-surgical procedures when compared with the other procedures (p<0.001). Non-surgical procedures for the diagnosis of pediatric abdominal non-Hodgkin's lymphoma are an effective option with low morbidity rate, allowing an earlier resumption of a full diet and chemotherapy initiation. Furthermore, non-surgical procedures should also be considered for obtaining tumor samples from patients with extensive disease. Copyright © 2017. Published by Elsevier Editora Ltda.

Ultrasound skin tightening.

Science.gov (United States)

Minkis, Kira; Alam, Murad

2014-01-01

Ultrasound skin tightening is a noninvasive, nonablative method that allows for energy deposition into the deep dermal and subcutaneous tissue while avoiding epidermal heating. Ultrasound coagulation is confined to arrays of 1-mm(3) zones that include the superficial musculoaponeurotic system and connective tissue. This technology gained approval from the Food and Drug Administration as the first energy-based skin "lifting" device, specifically for lifting lax tissue on the neck, submentum, and eyebrows. Ultrasound has the unique advantage of direct visualization of treated structures during treatment. Ultrasound is a safe and efficacious treatment for mild skin tightening and lifting. Copyright © 2014 Elsevier Inc. All rights reserved.

Medical ultrasound imaging

DEFF Research Database (Denmark)

Jensen, Jørgen Arendt

2007-01-01

The paper gives an introduction to current medical ultrasound imaging systems. The basics of anatomic and blood flow imaging are described. The properties of medical ultrasound and its focusing are described, and the various methods for two- and three-dimensional imaging of the human anatomy...

OW FREQUENCY ULTRASOUND APPLICATION IN KNEE ARTHROSCOPY

Directory of Open Access Journals (Sweden)

V. V. Pedder

2016-01-01

Full Text Available Purpose: in vitro study of ultrasound dissection devices' impact on meniscus and knee cartilage as well as comparison of outcomes with familiar arthroscopic techniques.Materials and methods. Meniscus and joint cartilage specimen obtained during total knee replacement were placed in a normal saline. All experiments were conducted no later than in 2 hours after obtaining and followed by histology of biopsy specimens. In the first series of experiment the authors performed meniscus dissection with ultrasound instrument «Scalpel», cold plasm ablator and surgical scalpel.Results. The first series of experiments demonstrated disruption of fibers orientation on meniscus rim after dissection with scalpel; necrosis depth after coblation is 0,7-0,8 mm. Ultrasound dissection devices leave necrosis depth of 0,1-0,2 mm and smooth cartilage surface. The second series of experiments proved that after shaver application cartilage surface was coarse; certain necrosis sections of 16-90 nm were observed on relatively smooth cartilage surface after coblation. Application of ultrasound «Miller» device leaves smooth cartilage surface with no fibers, no signs of cartilage thinning and necrosis not exceeding 15 nm.Conclusion. The results of experiments confirm that use of low frequency ultrasound dissection devices is advantageous as compared to mechanical and ablation cutting techniques while ensuring histologically proven atraumatic handling of biopsy specimens of meniscus and hyaline cartilage.

Surgical repair of a congenital pericardial diaphragmatic hernia

International Nuclear Information System (INIS)

Wright, R.P.; Wright, R.; Scott, R.

1987-01-01

Objective: To describe the surgical repair and pre- and postoperative management of a peritoneopericardial diaphragmatic hernia (PPDH) in a pregnant dog. Case summary: A pregnant dog was presented for vomiting, lethargy, and pale mucous membranes. Pulsus paradoxus was noted on physical examination. The dog was diagnosed with a PPDH via thoracic radiographs, abdominal ultrasound, and a n echocardiogram. The hernia was surgically repaired and the dog received supportive medical care until the puppies were old enough to be delivered via cesarean section. The mother and all puppies survived. New or unique information provided: This is the first report that describes the surgical repair and postoperative management of a PPDH in a pregnant dog

Development of a precision multimodal surgical navigation system for lung robotic segmentectomy.

Science.gov (United States)

Baste, Jean Marc; Soldea, Valentin; Lachkar, Samy; Rinieri, Philippe; Sarsam, Mathieu; Bottet, Benjamin; Peillon, Christophe

2018-04-01

Minimally invasive sublobar anatomical resection is becoming more and more popular to manage early lung lesions. Robotic-assisted thoracic surgery (RATS) is unique in comparison with other minimally invasive techniques. Indeed, RATS is able to better integrate multiple streams of information including advanced imaging techniques, in an immersive experience at the level of the robotic console. Our aim was to describe three-dimensional (3D) imaging throughout the surgical procedure from preoperative planning to intraoperative assistance and complementary investigations such as radial endobronchial ultrasound (R-EBUS) and virtual bronchoscopy for pleural dye marking. All cases were operated using the DaVinci System TM . Modelisation was provided by Visible Patient™ (Strasbourg, France). Image integration in the operative field was achieved using the Tile Pro multi display input of the DaVinci console. Our experience was based on 114 robotic segmentectomies performed between January 2012 and October 2017. The clinical value of 3D imaging integration was evaluated in 2014 in a pilot study. Progressively, we have reached the conclusion that the use of such an anatomic model improves the safety and reliability of procedures. The multimodal system including 3D imaging has been used in more than 40 patients so far and demonstrated a perfect operative anatomic accuracy. Currently, we are developing an original virtual reality experience by exploring 3D imaging models at the robotic console level. The act of operating is being transformed and the surgeon now oversees a complex system that improves decision making.

Surgical drill system and surgical drill bit to be used therein

NARCIS (Netherlands)

Margallo Balbas, E.; Wieringa, P.A.; French, P.J.; Lee, R.A.; Breedveld, P.

2007-01-01

Surgical drill system comprising a mechanical drill bit and means for imaging the vicinity of the drill bit tip, said means comprising: at least one optical fiber having a distal end and a proximal end, said distal end being located adjacent said drill bit tip, an optical processing unit, said

CT and Ultrasound Guided Stereotactic High Intensity Focused Ultrasound (HIFU)

Science.gov (United States)

Wood, Bradford J.; Yanof, J.; Frenkel, V.; Viswanathan, A.; Dromi, S.; Oh, K.; Kruecker, J.; Bauer, C.; Seip, R.; Kam, A.; Li, K. C. P.

2006-05-01

To demonstrate the feasibility of CT and B-mode Ultrasound (US) targeted HIFU, a prototype coaxial focused ultrasound transducer was registered and integrated to a CT scanner. CT and diagnostic ultrasound were used for HIFU targeting and monitoring, with the goals of both thermal ablation and non-thermal enhanced drug delivery. A 1 megahertz coaxial ultrasound transducer was custom fabricated and attached to a passive position-sensing arm and an active six degree-of-freedom robotic arm via a CT stereotactic frame. The outer therapeutic transducer with a 10 cm fixed focal zone was coaxially mounted to an inner diagnostic US transducer (2-4 megahertz, Philips Medical Systems). This coaxial US transducer was connected to a modified commercial focused ultrasound generator (Focus Surgery, Indianapolis, IN) with a maximum total acoustic power of 100 watts. This pre-clinical paradigm was tested for ability to heat tissue in phantoms with monitoring and navigation from CT and live US. The feasibility of navigation via image fusion of CT with other modalities such as PET and MRI was demonstrated. Heated water phantoms were tested for correlation between CT numbers and temperature (for ablation monitoring). The prototype transducer and integrated CT/US imaging system enabled simultaneous multimodality imaging and therapy. Pre-clinical phantom models validated the treatment paradigm and demonstrated integrated multimodality guidance and treatment monitoring. Temperature changes during phantom cooling corresponded to CT number changes. Contrast enhanced or non-enhanced CT numbers may potentially be used to monitor thermal ablation with HIFU. Integrated CT, diagnostic US, and therapeutic focused ultrasound bridges a gap between diagnosis and therapy. Preliminary results show that the multimodality system may represent a relatively inexpensive, accessible, and simple method of both targeting and monitoring HIFU effects. Small animal pre-clinical models may be translated to large

Sampling system for in vivo ultrasound images

DEFF Research Database (Denmark)

Jensen, Jorgen Arendt; Mathorne, Jan

1991-01-01

Newly developed algorithms for processing medical ultrasound images use the high frequency sampled transducer signal. This paper describes demands imposed on a sampling system suitable for acquiring such data and gives details about a prototype constructed. It acquires full clinical images...... at a sampling frequency of 20 MHz with a resolution of 12 bits. The prototype can be used for real time image processing. An example of a clinical in vivo image is shown and various aspects of the data acquisition process are discussed....

Molecular ultrasound imaging: current status and future directions

International Nuclear Information System (INIS)

Deshpande, N.; Needles, A.; Willmann, J.K.

2010-01-01

Targeted contrast-enhanced ultrasound (molecular ultrasound) is an emerging imaging strategy that combines ultrasound technology with novel molecularly-targeted ultrasound contrast agents for assessing biological processes at the molecular level. Molecular ultrasound contrast agents are nano- or micro-sized particles that are targeted to specific molecular markers by adding high-affinity binding ligands onto the surface of the particles. Following intravenous administration, these targeted ultrasound contrast agents accumulate at tissue sites overexpressing specific molecular markers, thereby enhancing the ultrasound imaging signal. High spatial and temporal resolution, real-time imaging, non-invasiveness, relatively low costs, lack of ionising irradiation and wide availability of ultrasound systems are advantages compared to other molecular imaging modalities. In this article we review current concepts and future directions of molecular ultrasound imaging, including different classes of molecular ultrasound contrast agents, ongoing technical developments of pre-clinical and clinical ultrasound systems, the potential of molecular ultrasound for imaging different diseases at the molecular level, and the translation of molecular ultrasound into the clinic.

Five-dimensional ultrasound system for soft tissue visualization.

Science.gov (United States)

Deshmukh, Nishikant P; Caban, Jesus J; Taylor, Russell H; Hager, Gregory D; Boctor, Emad M

2015-12-01

A five-dimensional ultrasound (US) system is proposed as a real-time pipeline involving fusion of 3D B-mode data with the 3D ultrasound elastography (USE) data as well as visualization of these fused data and a real-time update capability over time for each consecutive scan. 3D B-mode data assist in visualizing the anatomy of the target organ, and 3D elastography data adds strain information. We investigate the feasibility of such a system and show that an end-to-end real-time system, from acquisition to visualization, can be developed. We present a system that consists of (a) a real-time 3D elastography algorithm based on a normalized cross-correlation (NCC) computation on a GPU; (b) real-time 3D B-mode acquisition and network transfer; (c) scan conversion of 3D elastography and B-mode volumes (if acquired by 4D wobbler probe); and (d) visualization software that fuses, visualizes, and updates 3D B-mode and 3D elastography data in real time. We achieved a speed improvement of 4.45-fold for the threaded version of the NCC-based 3D USE versus the non-threaded version. The maximum speed was 79 volumes/s for 3D scan conversion. In a phantom, we validated the dimensions of a 2.2-cm-diameter sphere scan-converted to B-mode volume. Also, we validated the 5D US system visualization transfer function and detected 1- and 2-cm spherical objects (phantom lesion). Finally, we applied the system to a phantom consisting of three lesions to delineate the lesions from the surrounding background regions of the phantom. A 5D US system is achievable with real-time performance. We can distinguish between hard and soft areas in a phantom using the transfer functions.

Implementation of a versatile research data acquisition system using a commercially available medical ultrasound scanner

DEFF Research Database (Denmark)

Hemmsen, Martin Christian; Nikolov, Svetoslav Ivanov; Pedersen, Mads Møller

2012-01-01

to the clinic. The system consists of a standard PC equipped with a camera link and an ultrasound scanner equipped with a research interface. The ultrasound scanner is an easy-to-use imaging device that is capable of generating high-quality images. In addition to supporting the acquisition of multiple data...

Surgical treatment of gynecomastia: complications and outcomes.

Science.gov (United States)

Li, Chun-Chang; Fu, Ju-Peng; Chang, Shun-Cheng; Chen, Tim-Mo; Chen, Shyi-Gen

2012-11-01

Gynecomastia is defined as the benign enlargement of the male breast. Multiple surgical options have been used to improve outcomes. The aim of this study was to analyze the surgical approaches to the treatment of gynecomastia and their outcomes over a 10-year period. All patients undergoing surgical correction of gynecomastia in our department between 2000 and 2010 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and revision rate. The surgical result was evaluated with self-assessment questionnaires. A total of 41 patients with 75 operations were included. Techniques included subcutaneous mastectomy alone or with additional ultrasound-assisted liposuction (UAL) and isolated UAL. The surgical revision rate for all patients was 4.8%. The skin-sparing procedure gave good surgical results in grade IIb and grade III gynecomastia with low revision and complication rates. The self-assessment report revealed a good level of overall satisfaction and improvement in self-confidence (average scores 9.4 and 9.2, respectively, on a 10-point scale). The treatment of gynecomastia requires an individualized approach. Subcutaneous mastectomy combined with UAL could be used as the first choice for surgical treatment of grade II and III gynecomastia.

Gynecomastia Classification for Surgical Management: A Systematic Review and Novel Classification System.

Science.gov (United States)

Waltho, Daniel; Hatchell, Alexandra; Thoma, Achilleas

2017-03-01

Gynecomastia is a common deformity of the male breast, where certain cases warrant surgical management. There are several surgical options, which vary depending on the breast characteristics. To guide surgical management, several classification systems for gynecomastia have been proposed. A systematic review was performed to (1) identify all classification systems for the surgical management of gynecomastia, and (2) determine the adequacy of these classification systems to appropriately categorize the condition for surgical decision-making. The search yielded 1012 articles, and 11 articles were included in the review. Eleven classification systems in total were ascertained, and a total of 10 unique features were identified: (1) breast size, (2) skin redundancy, (3) breast ptosis, (4) tissue predominance, (5) upper abdominal laxity, (6) breast tuberosity, (7) nipple malposition, (8) chest shape, (9) absence of sternal notch, and (10) breast skin elasticity. On average, classification systems included two or three of these features. Breast size and ptosis were the most commonly included features. Based on their review of the current classification systems, the authors believe the ideal classification system should be universal and cater to all causes of gynecomastia; be surgically useful and easy to use; and should include a comprehensive set of clinically appropriate patient-related features, such as breast size, breast ptosis, tissue predominance, and skin redundancy. None of the current classification systems appears to fulfill these criteria.

Transbiliary intravascular ultrasound-guided diagnostic biopsy of an inaccessible pancreatic head mass

Directory of Open Access Journals (Sweden)

Jeffrey Forris Beecham Chick, MD, MPH, DABR

2017-06-01

Full Text Available Percutaneous image-guided biopsies of pancreatic malignancies may prove challenging and nondiagnostic due to a variety of anatomic considerations. For patients with complex post-surgical anatomy, such as a Roux-en-Y gastric bypass, diagnosis via endoscopic ultrasound with fine-needle aspiration may not be possible because of an inability to reach the proximal duodenum. This report describes the first diagnostic case of transbiliary intravascular ultrasound-guided biopsy of a pancreatic head mass in a patient with prior Roux-en-Y gastric bypass for which a diagnosis could not be achieved via percutaneous and endoscopic approaches. Transbiliary intravascular ultrasound-guided biopsy resulted in a diagnosis of pancreatic adenocarcinoma, allowing the initiation of chemotherapy.

Ultrasound Guided Needle Aspiration versus Surgical Drainage in the management of breast abscesses: a Ugandan experience

Directory of Open Access Journals (Sweden)

Chandika Alphonce B

2012-01-01

Full Text Available Abstract Background Despite breast abscess becoming less common in developed countries, it has remained one of the leading causes of morbidity in women in developing countries. A randomized controlled trial was conducted at Mulago hospital complex in Kampala Uganda to establish whether ultrasound guided needle aspiration is a feasible alternative treatment option for breast abscesses. Results A total of 65 females with breast abscess were analyzed, of these 33 patients were randomized into the ultrasound guided needle aspiration and 32 patients in the Incision and drainage arm. The mean age was 23.12, most of them were lactating (66.2%, primipararous (44.6% with peripheral abscesses (73.8% located in the upper lateral quadrant (56%.The mean breast size was 3.49 cm. The two groups were comparably in demographic characteristic and breast abscess size. Survival analysis showed no difference in breast abscess healing rate between the two groups (Log rank 0.24 df 1 and P = 0.63. Incision and drainage was found to be more costly than ultrasound guided aspiration (cost effective ratio of 2.85. Conclusion Ultrasound guided needle aspiration is therefore a feasible and cost effective treatment option for both lactating and non lactating breast abscesses with a diameter up to 5 cm by ultrasound in an immune competent patient

Ultrasound imaging in urogynecology – state of the art 2016

Directory of Open Access Journals (Sweden)

Michał Bogusiewicz

2016-11-01

Full Text Available The role of ultrasound imaging in urogynecology is not clearly defined. Despite significant developments in visualization techniques and interpretation of images, pelvic ultrasound is still more a tool for research than for clinical practice. Structures of the lower genitourinary tract and pelvic floor can be visualized from different approaches: transperineal, introital, transvaginal, abdominal or endoanal. According to contemporary guidelines and recommendations, the role of ultrasound in urogynecology is limited to the measurement of post-void residue. However, in many instances, including planning and audit of surgical procedures, management of recurrences or complications, ultrasound may be proposed as the initial examination of choice. Ultrasound may be used for assessment of bladder neck mobility before anti-incontinence procedures. On rare occasions it is helpful in recognition of pathologies mimicking vaginal prolapse such as vaginal cyst, urethral diverticula or rectal intussusception. In patients subjected to suburethral slings, causes of surgery failure or postsurgical voiding dysfunctions can be revealed by imaging. Many reports link the location of a tape close to the bladder neck to unfavorable outcomes of sling surgery. Some postoperative complications, such as urinary retention, mesh malposition, hematoma, or urinary tract injury, can be diagnosed by ultrasound. On the other hand, the clinical value of some applications of ultrasound in urogynecology, for example measurement of the bladder wall thickness as a marker of detrusor overactivity, has not been proved.

[Ultrasound in the management of non-melanoma skin cancer].

Science.gov (United States)

Hernández Ibáñez, C; Aguilar Bernier, M; de Troya Martín, M

2015-11-01

Cutaneous ultrasound plays an important role in the study and management of non-melanoma skin cancer. Among other factors, this technique contributes to the diagnosis and differential diagnosis of these tumours, the establishment of their size and relation to neighbouring structures, the delimitation of surgical margins, and the detection of subclinical and recurrent lesions. The present article analyses the role of cutaneous ultrasound in the field of non-melanoma skin cancer (basal and squamous cell carcinomas, lymphomas and dermatofibrosarcoma) through a literature review. Copyright © 2015 Academia Española de Dermatología y Venereología. Published by Elsevier España, S.L.U. All rights reserved.

Field: A Program for Simulating Ultrasound Systems

DEFF Research Database (Denmark)

Jensen, Jørgen Arendt

1997-01-01

A program for the simulation of ultrasound systems is presented.It is based on the Tupholme-Stepanishen method, and is fastbecause of the use of a far-field approximation. Any kind oftransducer geometry and excitation can be simulated, and bothpulse-echo and continuous wave fields can be calculated...... for bothtransmit and pulse-echo. Dynamic apodization and focusing arehandled through time lines, and different focusingschemes can be simulated. The versatility of the program isensured by interfacing it to Matlab. All routines are calleddirectly from Matlab, and all Matlab features can be used. Thismakes...

Ultrasound-Guided Single-Injection Infraclavicular Block Versus Ultrasound-Guided Double-Injection Axillary Block: A Noninferiority Randomized Controlled Trial.

Science.gov (United States)

Boivin, Ariane; Nadeau, Marie-Josée; Dion, Nicolas; Lévesque, Simon; Nicole, Pierre C; Turgeon, Alexis F

2016-01-01

Single-injection ultrasound-guided infraclavicular block is a simple, reliable, and effective technique. A simplified double-injection ultrasound-guided axillary block technique with a high success rate recently has been described. It has the advantage of being performed in a superficial and compressible location, with a potentially improved safety profile. However, its effectiveness in comparison with single-injection infraclavicular block has not been established. We hypothesized that the double-injection ultrasound-guided axillary block would show rates of complete sensory block at 30 minutes noninferior to the single-injection ultrasound-guided infraclavicular block. After approval by our research ethics committee and written informed consent, adults undergoing distal upper arm surgery were randomized to either group I, ultrasound-guided single-injection infraclavicular block, or group A, ultrasound-guided double-injection axillary block. In group I, 30 mL of 1.5% mepivacaine was injected posterior to the axillary artery. In group A, 25 mL of 1.5% mepivacaine was injected posteromedial to the axillary artery, after which 5 mL was injected around the musculocutaneous nerve. Primary outcome was the rate of complete sensory block at 30 minutes. Secondary outcomes were the onset of sensory and motor blocks, surgical success rates, performance times, and incidence of complications. All outcomes were assessed by a blinded investigator. The noninferiority of the double-injection ultrasound-guided axillary block was considered if the limits of the 90% confidence intervals (CIs) were within a 10% margin of the rate of complete sensory block of the infraclavicular block. At 30 minutes, the rate of complete sensory block was 79% in group A (90% CI, 71%-85%) compared with 91% in group I (90% CI, 85%-95%); the upper limit of CI of group A is thus included in the established noninferiority margin of 10%. The rate of complete sensory block was lower in group A (proportion

A novel fusion imaging system for endoscopic ultrasound

DEFF Research Database (Denmark)

Gruionu, Lucian Gheorghe; Saftoiu, Adrian; Gruionu, Gabriel

2016-01-01

BACKGROUND AND OBJECTIVE: Navigation of a flexible endoscopic ultrasound (EUS) probe inside the gastrointestinal (GI) tract is problematic due to the small window size and complex anatomy. The goal of the present study was to test the feasibility of a novel fusion imaging (FI) system which uses...... time was 24.6 ± 6.6 min, while the time to reach the clinical target was 8.7 ± 4.2 min. CONCLUSIONS: The FI system is feasible for clinical use, and can reduce the learning curve for EUS procedures and improve navigation and targeting in difficult anatomic locations....

TH-A-207B-02: QIBA Ultrasound Elasticity Imaging System Biomarker Qualification and User Testing of Systems

International Nuclear Information System (INIS)

Garra, B.

2016-01-01

Imaging of tissue elastic properties is a relatively new and powerful approach to one of the oldest and most important diagnostic tools. Imaging of shear wave speed with ultrasound is has been added to most high-end ultrasound systems. Understanding this exciting imaging mode aiding its most effective use in medicine can be a rewarding effort for medical physicists and other medical imaging and treatment professionals. Assuring consistent, quantitative measurements across the many ultrasound systems in a typical imaging department will constitute a major step toward realizing the great potential of this technique and other quantitative imaging. This session will target these two goals with two presentations. A. Basics and Current Implementations of Ultrasound Imaging of Shear Wave Speed and Elasticity - Shigao Chen, Ph.D. Learning objectives-To understand: Introduction: Importance of tissue elasticity measurement Strain vs. shear wave elastography (SWE), beneficial features of SWE The link between shear wave speed and material properties, influence of viscosity Generation of shear waves External vibration (Fibroscan) ultrasound radiation force Point push Supersonic push (Aixplorer) Comb push (GE Logiq E9) Detection of shear waves Motion detection from pulse-echo ultrasound Importance of frame rate for shear wave imaging Plane wave imaging detection How to achieve high effective frame rate using line-by-line scanners Shear wave speed calculation Time to peak Random sample consensus (RANSAC) Cross correlation Sources of bias and variation in SWE Tissue viscosity Transducer compression or internal pressure of organ Reflection of shear waves at boundaries B. Elasticity Imaging System Biomarker Qualification and User Testing of Systems – Brian Garra, M.D. Learning objectives-To understand: Goals Review the need for quantitative medical imaging Provide examples of quantitative imaging biomarkers Acquaint the participant with the purpose of the RSNA Quantitative Imaging

TH-A-207B-02: QIBA Ultrasound Elasticity Imaging System Biomarker Qualification and User Testing of Systems

Energy Technology Data Exchange (ETDEWEB)

Garra, B. [FDA, Silver Spring, MD (United States)

2016-06-15

Imaging of tissue elastic properties is a relatively new and powerful approach to one of the oldest and most important diagnostic tools. Imaging of shear wave speed with ultrasound is has been added to most high-end ultrasound systems. Understanding this exciting imaging mode aiding its most effective use in medicine can be a rewarding effort for medical physicists and other medical imaging and treatment professionals. Assuring consistent, quantitative measurements across the many ultrasound systems in a typical imaging department will constitute a major step toward realizing the great potential of this technique and other quantitative imaging. This session will target these two goals with two presentations. A. Basics and Current Implementations of Ultrasound Imaging of Shear Wave Speed and Elasticity - Shigao Chen, Ph.D. Learning objectives-To understand: Introduction: Importance of tissue elasticity measurement Strain vs. shear wave elastography (SWE), beneficial features of SWE The link between shear wave speed and material properties, influence of viscosity Generation of shear waves External vibration (Fibroscan) ultrasound radiation force Point push Supersonic push (Aixplorer) Comb push (GE Logiq E9) Detection of shear waves Motion detection from pulse-echo ultrasound Importance of frame rate for shear wave imaging Plane wave imaging detection How to achieve high effective frame rate using line-by-line scanners Shear wave speed calculation Time to peak Random sample consensus (RANSAC) Cross correlation Sources of bias and variation in SWE Tissue viscosity Transducer compression or internal pressure of organ Reflection of shear waves at boundaries B. Elasticity Imaging System Biomarker Qualification and User Testing of Systems – Brian Garra, M.D. Learning objectives-To understand: Goals Review the need for quantitative medical imaging Provide examples of quantitative imaging biomarkers Acquaint the participant with the purpose of the RSNA Quantitative Imaging

An experimental system for the study of ultrasound exposure of isolated blood vessels

International Nuclear Information System (INIS)

Tokarczyk, Anna; Rivens, Ian; Symonds-Tayler, Richard; Ter Haar, Gail; Van Bavel, E

2013-01-01

An experimental system designed for the study of the effects of diagnostic or therapeutic ultrasound exposure on isolated blood vessels in the presence or absence of intraluminal contrast agent is described. The system comprised several components. A microscope was used to monitor vessel size (and thus vessel functionality), and potential leakage of intraluminal 70 kDa FITC-dextran fluorescence marker. A vessel chamber allowed the mounting of an isolated vessel whilst maintaining its viability, with pressure regulation for the control of intraluminal pressure and induction of flow for the infusion of contrast microbubbles. A fibre-optic hydrophone sensor mounted on the vessel chamber using a micromanipulator allowed pre-exposure targeting of the vessel to within 150 µm, and monitoring of acoustic cavitation emissions during exposures. Acoustic cavitation was also detected using changes in the ultrasound drive voltage and by detection of audible emissions using a submerged microphone. The suitability of this system for studying effects in the isolated vessel model has been demonstrated using a pilot study of 6 sham exposed and 18 high intensity focused ultrasound exposed vessels, with or without intraluminal contrast agent (SonoVue) within the vessels. (paper)

Ultrasound screening for developmental dysplasia of the hip and its socioeconomic impact: Experience of tertiary care health level

Directory of Open Access Journals (Sweden)

Khaled Aly Matrawy

2014-03-01

Conclusion: Screening ultrasound is a useful tool for detection of hip dislocation and dysplasia especially among the population of infants at increased risk of developmental dysplasia of the hip. Limitation of screening ultrasound programs for those at risk only reduces the financial burden with better outcome in choosing candidates for further workup especially surgical intervention.

Analysis of achilles tendon vascularity with second-generation contrast-enhanced ultrasound.

Science.gov (United States)

Genovese, Eugenio; Ronga, Mario; Recaldini, Chiara; Fontana, Federico; Callegari, Leonardo; Maffulli, Nicola; Fugazzola, Carlo

2011-01-01

To compare morphological, power Doppler, and contrast-enhanced ultrasound (CEUS) features of the Achilles tendon between asymptomatic athletes and athletes who had undergone surgical repair of a previous rupture. Twenty-four athletes were divided in two groups (A and B). Group A included 14 patients with a median age of 32 years (range 27 to 47 years) who had undergone surgical repair for unilateral Achilles tendon rupture. Group B (control group) included 10 subjects with a median age of 34 years (range 27 to 40 years) with no previous or present history of tendinopathy. All patients were evaluated with ultrasound, power Doppler, and CEUS with second-generation contrast agent. We studied the uninjured Achilles tendon in athletes of group A and either the left or the right Achilles tendon of the athletes in group B. CEUS showed a significantly greater ability to detect a greater number of vascular spots within the uninjured tendon of group A compared to group B (power Doppler ultrasound in the uninjured contralateral Achilles tendon. CEUS is useful to evaluate vascularity not detected by other imaging techniques. Vascularity in the uninjured tendon seems to be increased in patients who had a previous rupture. Copyright © 2011 Wiley Periodicals, Inc.

Detection surgical treatment and its results in children's thyroid gland

International Nuclear Information System (INIS)

Polyakov, V.G.; Lebedev, V.I.; Belkina, B.M.; Shishkov, R.V.; Makarova, I.S.; Durnov, L.A.

1995-01-01

208 patients with thyroid gland cancer were observed in 1975-1993 . The morphological investigations point to an absolute prevalence of highly differentiated forms of thyroid gland cancer in children. The radiation diagnostic techniques included ultrasound investigations of neck organs, chest roentgenography, thyroid gland scintigraphy. It is shown that the surgical method is the basic technique of treating thyroid gland cancer in children. 5-year survival rate of patients depending on the stage of disease development and scope of surgical treatment is analysed

Biomicroscopia ultra-sônica (UBM no planejamento cirúrgico e acompanhamento pós-operatório de melanomas malignos de íris e corpo ciliar Ultrasound biomicroscopy (UBM in the surgical planning and postoperative follow-up of iris and ciliary body melanomas

Directory of Open Access Journals (Sweden)

Zélia Maria da Silva Corrêa

2003-08-01

for histopathologic study. Patients were followed-up for a minimum of 6 months when a new ultrasound biomi croscopy examination was performed. RESULTS: In this group of 5 patients, 3 were females and 2, males, age range from 32 to 64 years. All tumors were unilateral. Four patients presented an iridociliary tumor and one presented a lesion limited to the iris. In all cases ultrasound biomicroscopy was very helpful to determine surgical planning ensuring free surgical margins. Postoperative ultrasound biomicroscopy revealed no signs of tumor recurrence in all cases; 2 patients presented vitreous in the surgical wound, one with limited vitreous traction but no retinal detachment was detected. CONCLUSIONS: Ultrasound biomicroscopy seems to be a reliable ancilliary method to diagnose iris and iridociliary tumors, plan surgical treatment and postoperative follow-up.

Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: An analysis for Austria

Energy Technology Data Exchange (ETDEWEB)

Gruber, R., E-mail: renate.gruber@meduniwien.ac.a [Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Walter, E. [Institute of Pharmacoeconomic Research, Wolfengasse 4/7, A-1010 Vienna (Austria); Helbich, T.H. [Medical University of Vienna, Department of Radiology, Division of Molecular and Gender Imaging, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

2010-06-15

Purpose: To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. Materials and methods: In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Results: Overall cost savings for US-guided LCBB over OSB were Euro 977 ( Euro 2,337/ Euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were Euro 1,542 ( Euro 2,600/ Euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. Conclusion: From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be Euro 18.5 million.

Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: An analysis for Austria

International Nuclear Information System (INIS)

Gruber, R.; Walter, E.; Helbich, T.H.

2010-01-01

Purpose: To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. Materials and methods: In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Results: Overall cost savings for US-guided LCBB over OSB were Euro 977 ( Euro 2,337/ Euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were Euro 1,542 ( Euro 2,600/ Euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. Conclusion: From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be Euro 18.5 million.

The utilization of an ultrasound-guided 8-gauge vacuum-assisted breast biopsy system as an innovative approach to accomplishing complete eradication of multiple bilateral breast fibroadenomas

Directory of Open Access Journals (Sweden)

Povoski Stephen P

2007-10-01

Full Text Available Abstract Background Ultrasound-guided vacuum-assisted breast biopsy technology is extremely useful for diagnostic biopsy of suspicious breast lesions and for attempted complete excision of appropriately selected presumed benign breast lesions. Case presentation A female patient presented with 16 breast lesions (eight within each breast, documented on ultrasound and all presumed to be fibroadenomas. Over a ten and one-half month period of time, 14 of these 16 breast lesions were removed under ultrasound guidance during a total of 11 separate 8-gauge Mammotome® excision procedures performed during seven separate sessions. Additionally, two of these 16 breast lesions were removed by open surgical excision. A histopathologic diagnosis of fibroadenoma and/or fibroadenomatous changes was confirmed at all lesion excision sites. Interval follow-up ultrasound imaging revealed no evidence of a residual lesion at the site of any of the 16 original breast lesions. Conclusion This report describes an innovative approach of utilizing ultrasound-guided 8-gauge vacuum-assisted breast biopsy technology for assisting in achieving complete eradication of multiple bilateral fibroadenomas in a patient who presented with 16 documented breast lesions. As such, this innovative approach is highly recommended in similar appropriately selected patients.

Treatment of Partial Rotator Cuff Tear with Ultrasound-guided Platelet-rich Plasma

Directory of Open Access Journals (Sweden)

Vetrivel Chezian Sengodan

2017-01-01

Full Text Available Background: The treatment of symptomatic partial rotator cuff tear has presented substantial challenge to orthopaedic surgeons as it can vary from conservative to surgical repair. Researches have established the influence of platelet rich plasma in healing damaged tissue. Currently very few data are available regarding the evidence of clinical and radiological outcome of partial rotator cuff tear treated with ultrasound guided platelet rich plasma injection in English literature. Materials and Methods: 20 patients with symptomatic partial rotator cuff tears were treated with ultrasound guided platelet rich plasma injection. Before and after the injection of platelet rich plasma scoring was done with visual analogue score, Constant shoulder score, and UCLA shoulder score at 8 weeks and third month. A review ultrasound was performed 8 weeks after platelet rich plasma injection to assess the rotator cuff status. Results: Our study showed statistically significant improvements in 17 patients in VAS pain score, constant shoulder score and UCLA shoulder score. No significant changes in ROM were noted when matched to the contra-lateral side (P < 0.001 at the 3 month follow-up. The study also showed good healing on radiological evaluation with ultrasonogram 8 weeks after platelet rich plasma injection. Conclusion: Ultrasound guided platelet rich plasma injection for partial rotator cuff tears is an effective procedure that leads to significant decrease in pain, improvement in shoulder functions, much cost-effective and less problematic compared to a surgical treatment.

SU-G-JeP3-08: Robotic System for Ultrasound Tracking in Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Kuhlemann, I [University of Luebeck, Luebeck (Germany); Graduate School for Computing in Medicine and Life Sciences, University of Luebeck (Germany); Jauer, P; Schweikard, A; Ernst, F [University of Luebeck, Luebeck (Germany)

2016-06-15

Purpose: For safe and accurate real-time tracking of tumors for IGRT using 4D ultrasound, it is necessary to make use of novel, high-end force-sensitive lightweight robots designed for human-machine interaction. Such a robot will be integrated into an existing robotized ultrasound system for non-invasive 4D live tracking, using a newly developed real-time control and communication framework. Methods: The new KUKA LWR iiwa robot is used for robotized ultrasound real-time tumor tracking. Besides more precise probe contact pressure detection, this robot provides an additional 7th link, enhancing the dexterity of the kinematic and the mounted transducer. Several integrated, certified safety features create a safe environment for the patients during treatment. However, to remotely control the robot for the ultrasound application, a real-time control and communication framework has to be developed. Based on a client/server concept, client-side control commands are received and processed by a central server unit and are implemented by a client module running directly on the robot’s controller. Several special functionalities for robotized ultrasound applications are integrated and the robot can now be used for real-time control of the image quality by adjusting the transducer position, and contact pressure. The framework was evaluated looking at overall real-time capability for communication and processing of three different standard commands. Results: Due to inherent, certified safety modules, the new robot ensures a safe environment for patients during tumor tracking. Furthermore, the developed framework shows overall real-time capability with a maximum average latency of 3.6 ms (Minimum 2.5 ms; 5000 trials). Conclusion: The novel KUKA LBR iiwa robot will advance the current robotized ultrasound tracking system with important features. With the developed framework, it is now possible to remotely control this robot and use it for robotized ultrasound tracking

SU-G-JeP3-08: Robotic System for Ultrasound Tracking in Radiation Therapy

International Nuclear Information System (INIS)

Kuhlemann, I; Jauer, P; Schweikard, A; Ernst, F

2016-01-01

Purpose: For safe and accurate real-time tracking of tumors for IGRT using 4D ultrasound, it is necessary to make use of novel, high-end force-sensitive lightweight robots designed for human-machine interaction. Such a robot will be integrated into an existing robotized ultrasound system for non-invasive 4D live tracking, using a newly developed real-time control and communication framework. Methods: The new KUKA LWR iiwa robot is used for robotized ultrasound real-time tumor tracking. Besides more precise probe contact pressure detection, this robot provides an additional 7th link, enhancing the dexterity of the kinematic and the mounted transducer. Several integrated, certified safety features create a safe environment for the patients during treatment. However, to remotely control the robot for the ultrasound application, a real-time control and communication framework has to be developed. Based on a client/server concept, client-side control commands are received and processed by a central server unit and are implemented by a client module running directly on the robot’s controller. Several special functionalities for robotized ultrasound applications are integrated and the robot can now be used for real-time control of the image quality by adjusting the transducer position, and contact pressure. The framework was evaluated looking at overall real-time capability for communication and processing of three different standard commands. Results: Due to inherent, certified safety modules, the new robot ensures a safe environment for patients during tumor tracking. Furthermore, the developed framework shows overall real-time capability with a maximum average latency of 3.6 ms (Minimum 2.5 ms; 5000 trials). Conclusion: The novel KUKA LBR iiwa robot will advance the current robotized ultrasound tracking system with important features. With the developed framework, it is now possible to remotely control this robot and use it for robotized ultrasound tracking

Optimisation of Surgical Results in de-Quervain’s Disease

Directory of Open Access Journals (Sweden)

B Jagannath Kamath

2014-11-01

Full Text Available Background: De Quervain’s disease poses more problems with respect to management than the diagnosis. Surgery is resorted to when the conservative methods fail. There are known complications of the surgical intervention. Surgeon contemplating the surgery should be aware of these and make every attempt to optimize the results and avoid the above mentioned complication. Methods: Sixty symptomatic wrists in 57 individuals suffering from de Quervain’s disease who needed surgery were studied preoperatively with ultrasound. Number of tendons and the sub septae identified in the ultrasound examination preoperatively were confirmed on the table during the surgery. The release was brought about under local anesthesia, with magnification taking care to avoid injury to the cephalic vein and superficial branch of radial nerve, not to violate the anterior margin of the sheath, thus preventing complications. A negative post release finkelstein test was ensured before the wound closure. Results: All 60 patients who underwent release for de Quervain’s disease were symptom free, satisfied and fully functional. Conclusions: De-Quervain's disease not relieved by conservative methods needs surgical release under local anesthesia with a transverse incision with Preoperative ultrasound examination for the number of tendons and subseptae. Avoiding the violation of the volar aspect of the sheath, loupe magnification, tourniquet and post release Finkelstein’s test before wound closure, will ensure optimal results.

Bipolar-power-transistor-based limiter for high frequency ultrasound imaging systems.

Science.gov (United States)

Choi, Hojong; Yang, Hao-Chung; Shung, K Kirk

2014-03-01

High performance limiters are described in this paper for applications in high frequency ultrasound imaging systems. Limiters protect the ultrasound receiver from the high voltage (HV) spikes produced by the transmitter. We present a new bipolar power transistor (BPT) configuration and compare its design and performance to a diode limiter used in traditional ultrasound research and one commercially available limiter. Limiter performance depends greatly on the insertion loss (IL), total harmonic distortion (THD) and response time (RT), each of which will be evaluated in all the limiters. The results indicated that, compared with commercial limiter, BPT-based limiter had less IL (-7.7 dB), THD (-74.6 dB) and lower RT (43 ns) at 100 MHz. To evaluate the capability of these limiters, they were connected to a 100 MHz single element transducer and a two-way pulse-echo test was performed. It was found that the -6 dB bandwidth and sensitivity of the transducer using BPT-based limiter were better than those of the commercial limiter by 22% and 140%, respectively. Compared to the commercial limiter, BPT-based limiter is shown to be capable of minimizing signal attenuation, RT and THD at high frequencies and is thus suited for high frequency ultrasound applications. Copyright © 2013 Elsevier B.V. All rights reserved.

Software components for medical image visualization and surgical planning

Science.gov (United States)

Starreveld, Yves P.; Gobbi, David G.; Finnis, Kirk; Peters, Terence M.

2001-05-01

Purpose: The development of new applications in medical image visualization and surgical planning requires the completion of many common tasks such as image reading and re-sampling, segmentation, volume rendering, and surface display. Intra-operative use requires an interface to a tracking system and image registration, and the application requires basic, easy to understand user interface components. Rapid changes in computer and end-application hardware, as well as in operating systems and network environments make it desirable to have a hardware and operating system as an independent collection of reusable software components that can be assembled rapidly to prototype new applications. Methods: Using the OpenGL based Visualization Toolkit as a base, we have developed a set of components that implement the above mentioned tasks. The components are written in both C++ and Python, but all are accessible from Python, a byte compiled scripting language. The components have been used on the Red Hat Linux, Silicon Graphics Iris, Microsoft Windows, and Apple OS X platforms. Rigorous object-oriented software design methods have been applied to ensure hardware independence and a standard application programming interface (API). There are components to acquire, display, and register images from MRI, MRA, CT, Computed Rotational Angiography (CRA), Digital Subtraction Angiography (DSA), 2D and 3D ultrasound, video and physiological recordings. Interfaces to various tracking systems for intra-operative use have also been implemented. Results: The described components have been implemented and tested. To date they have been used to create image manipulation and viewing tools, a deep brain functional atlas, a 3D ultrasound acquisition and display platform, a prototype minimally invasive robotic coronary artery bypass graft planning system, a tracked neuro-endoscope guidance system and a frame-based stereotaxy neurosurgery planning tool. The frame-based stereotaxy module has been

A ferromagnetic surgical system reduces phrenic nerve injury in redo congenital cardiac surgery.

Science.gov (United States)

Shinkawa, Takeshi; Holloway, Jessica; Tang, Xinyu; Gossett, Jeffrey M; Imamura, Michiaki

2017-05-01

A ferromagnetic surgical system (FMwand®) is a new type of dissection device expected to reduce the risk of adjacent tissue damage. We reviewed 426 congenital cardiac operations with cardiopulmonary bypass through redo sternotomy to assess if this device prevented phrenic nerve injury. The ferromagnetic surgical system was used in 203 operations (47.7%) with regular electrocautery and scissors. The preoperative and operative details were similar between the operations with or without the ferromagnetic surgical system. The incidence of phrenic nerve injury was significantly lower with the ferromagnetic surgical system (0% vs 2.7%, P = 0.031). A logistic regression model showed that the use of the ferromagnetic surgical system was significantly associated with reduced odds of phrenic nerve injury (P < 0.001). © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Quantitative ultrasound imaging detects degenerative changes in articular cartilage surface and subchondral bone

International Nuclear Information System (INIS)

Saarakkala, Simo; Laasanen, Mikko S; Jurvelin, Jukka S; Toeyraes, Juha

2006-01-01

Previous studies have suggested that quantitative ultrasound imaging could sensitively diagnose degeneration of the articular surface and changes in the subchondral bone during the development of osteoarthrosis (OA). We have recently introduced a new parameter, ultrasound roughness index (URI), for the quantification of cartilage surface roughness, and successfully tested it with normal and experimentally degraded articular surfaces. In this in vitro study, the applicability of URI was tested in bovine cartilage samples with spontaneously developed tissue degeneration. Simultaneously, we studied the sensitivity of quantitative ultrasound imaging to detect degenerative changes in the cartilage-bone interface. For reference, histological degenerative grade of the cartilage samples was determined. Mechanical reference measurements were also conducted. Cartilage surface roughness (URI) was significantly (p < 0.05) higher in histologically degenerated samples with inferior mechanical properties. Ultrasound reflection at the cartilage-bone interface was also significantly (p < 0.05) increased in degenerated samples. Furthermore, it was quantitatively confirmed that ultrasound attenuation in the overlying cartilage significantly affects the measured ultrasound reflection values from the cartilage-bone interface. To conclude, the combined ultrasound measurement of the cartilage surface roughness and ultrasound reflection at the cartilage-bone interface complement each other, and may together enable more sensitive and quantitative diagnosis of early OA or follow up after surgical cartilage repair

Processing system of jaws tomograms for pathology identification and surgical guide modeling

Energy Technology Data Exchange (ETDEWEB)

Putrik, M. B., E-mail: pmb-88@mail.ru; Ivanov, V. Yu. [Ural Federal University named after the first President of Russia B.N. Yeltsin, Yekaterinburg (Russian Federation); Lavrentyeva, Yu. E. [Private dental clinic «Uraldent», Yekaterinburg (Russian Federation)

2015-11-17

The aim of the study is to create an image processing system, which allows dentists to find pathological resorption and to build surgical guide surface automatically. X-rays images of jaws from cone beam tomography or spiral computed tomography are the initial data for processing. One patient’s examination always includes up to 600 images (or tomograms), that’s why the development of processing system for fast automation search of pathologies is necessary. X-rays images can be useful not for only illness diagnostic but for treatment planning too. We have studied the case of dental implantation – for successful surgical manipulations surgical guides are used. We have created a processing system that automatically builds jaw and teeth boundaries on the x-ray image. After this step, obtained teeth boundaries used for surgical guide surface modeling and jaw boundaries limit the area for further pathologies search. Criterion for the presence of pathological resorption zones inside the limited area is based on statistical investigation. After described actions, it is possible to manufacture surgical guide using 3D printer and apply it in surgical operation.

Processing system of jaws tomograms for pathology identification and surgical guide modeling

International Nuclear Information System (INIS)

Putrik, M. B.; Ivanov, V. Yu.; Lavrentyeva, Yu. E.

2015-01-01

The aim of the study is to create an image processing system, which allows dentists to find pathological resorption and to build surgical guide surface automatically. X-rays images of jaws from cone beam tomography or spiral computed tomography are the initial data for processing. One patient’s examination always includes up to 600 images (or tomograms), that’s why the development of processing system for fast automation search of pathologies is necessary. X-rays images can be useful not for only illness diagnostic but for treatment planning too. We have studied the case of dental implantation – for successful surgical manipulations surgical guides are used. We have created a processing system that automatically builds jaw and teeth boundaries on the x-ray image. After this step, obtained teeth boundaries used for surgical guide surface modeling and jaw boundaries limit the area for further pathologies search. Criterion for the presence of pathological resorption zones inside the limited area is based on statistical investigation. After described actions, it is possible to manufacture surgical guide using 3D printer and apply it in surgical operation

Ultrasound-guided supra-acetabular pin placement in pelvic external fixation: description of a surgical technique and results.

Science.gov (United States)

Chana-Rodríguez, Francisco; Cuervas-Mons, Manuel; Rojo-Manaute, José; Mora, Félix; Arnal, Juan; Vaquero-Martín, Javier

2017-11-01

Pelvic fracture in trauma patients can lead to hemodynamic instability. External fixation is a treatment capable of stabilizing these injuries in the context of damage control surgery. Supra-acetabular pin offers the greater biomechanical stability but requires the use of intraoperative fluoroscopy. The aim of this study was to analyze our results for an ultrasound-guided supra-acetabular pinning. Cross-sectional study with cadaveric specimens. Ultrasound-guided pin placement assessed by fluoroscopy and dissection. Fourteen ultrasound-guided supra-acetabular pins were placed in seven cadaveric specimens. Excellent placement in all cases, evaluated with radiological control. Good qualitative bone fixation after dissection. One femoral cutaneous nerve was not found during anatomic dissection and was assumed injured. Ultrasound-guided supra-acetabular pin placement is a feasible and effective technique. Our study indicates that pin placement without intraoperative fluoroscopy is feasible without compromising the reliability of its placement. © 2017 Elsevier Ltd. All rights reserved.

Ultrasound-guided hydrostatic reduction of intestinal intussusception: description of three cases

Directory of Open Access Journals (Sweden)

Martha Hanemann Kim

2008-09-01

Full Text Available With the objective of reporting the technique of ultrasound-guided hydrostatic reduction of intestinal intussusception, three cases with confirmed diagnosis of the disease submitted to reduction with this technique are described. All cases had successful reductions with no complications. One patient experienced a recurrence of the invagination eight days after treatment, which was surgically corrected. The technique of hydrostatic reversal of intestinal intussusception guided by ultrasound may be used in place of the conventional barium enema, since it is a minimally invasive and safe method, with high rates of success and few complications.

Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction.

Science.gov (United States)

Rohrich, Rod J; Ha, Richard Y; Kenkel, Jeffrey M; Adams, William P

2003-02-01

Gynecomastia, or excessive male breast development, has an incidence of 32 to 65 percent in the male population. This condition has important physical and psychological impacts. Advances in elucidating the pathophysiology of gynecomastia have been made, though understanding remains limited. Recommendations for evaluation and workup have varied and are often arbitrary. A diagnostic algorithm is suggested, with emphasis on a comprehensive history, physical examination, and minimizing unnecessary diagnostic testing. Medical management has had limited success; surgical therapy, primarily through excisional techniques, has been the accepted standard. Although effective, excisional techniques subject patients to large, visible scars. Ultrasound-assisted liposuction has recently emerged as a safe and effective method for the treatment of gynecomastia. It is particularly efficient in the removal of the dense, fibrous male breast tissue while offering advantages in minimal external scarring. A new system of classification and graduated treatment is proposed, based on glandular versus fibrous hypertrophy and degree of breast ptosis (skin excess). The authors' series of 61 patients with gynecomastia from 1987 to 2000 at the University of Texas Southwestern Department of Plastic Surgery demonstrated an overall success rate of 86.9 percent using suction-assisted lipectomy (1987 to 1997) and ultrasound-assisted liposuction (1997 to 2000). The authors have found ultrasound-assisted liposuction to be effective in treating most grades of gynecomastia. Excisional techniques are reserved for severe gynecomastia with significant skin excess after attempted ultrasound-assisted liposuction.

Design and implementation of a PC-based image-guided surgical system.

Science.gov (United States)

Stefansic, James D; Bass, W Andrew; Hartmann, Steven L; Beasley, Ryan A; Sinha, Tuhin K; Cash, David M; Herline, Alan J; Galloway, Robert L

2002-11-01

In interactive, image-guided surgery, current physical space position in the operating room is displayed on various sets of medical images used for surgical navigation. We have developed a PC-based surgical guidance system (ORION) which synchronously displays surgical position on up to four image sets and updates them in real time. There are three essential components which must be developed for this system: (1) accurately tracked instruments; (2) accurate registration techniques to map physical space to image space; and (3) methods to display and update the image sets on a computer monitor. For each of these components, we have developed a set of dynamic link libraries in MS Visual C++ 6.0 supporting various hardware tools and software techniques. Surgical instruments are tracked in physical space using an active optical tracking system. Several of the different registration algorithms were developed with a library of robust math kernel functions, and the accuracy of all registration techniques was thoroughly investigated. Our display was developed using the Win32 API for windows management and tomographic visualization, a frame grabber for live video capture, and OpenGL for visualization of surface renderings. We have begun to use this current implementation of our system for several surgical procedures, including open and minimally invasive liver surgery.

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... frequently used to evaluate the reproductive and urinary systems. Ultrasound is safe, noninvasive and does not use ... and evaluate a variety of urinary and reproductive system disorders in both sexes without x-ray exposure. ...

Combined ultrasound and MR imaging to guide focused ultrasound therapies in the brain

Science.gov (United States)

Arvanitis, Costas D.; Livingstone, Margaret S.; McDannold, Nathan

2013-07-01

Several emerging therapies with potential for use in the brain, harness effects produced by acoustic cavitation—the interaction between ultrasound and microbubbles either generated during sonication or introduced into the vasculature. Systems developed for transcranial MRI-guided focused ultrasound (MRgFUS) thermal ablation can enable their clinical translation, but methods for real-time monitoring and control are currently lacking. Acoustic emissions produced during sonication can provide information about the location, strength and type of the microbubble oscillations within the ultrasound field, and they can be mapped in real-time using passive imaging approaches. Here, we tested whether such mapping can be achieved transcranially within a clinical brain MRgFUS system. We integrated an ultrasound imaging array into the hemisphere transducer of the MRgFUS device. Passive cavitation maps were obtained during sonications combined with a circulating microbubble agent at 20 targets in the cingulate cortex in three macaques. The maps were compared with MRI-evident tissue effects. The system successfully mapped microbubble activity during both stable and inertial cavitation, which was correlated with MRI-evident transient blood-brain barrier disruption and vascular damage, respectively. The location of this activity was coincident with the resulting tissue changes within the expected resolution limits of the system. While preliminary, these data clearly demonstrate, for the first time, that it is possible to construct maps of stable and inertial cavitation transcranially, in a large animal model, and under clinically relevant conditions. Further, these results suggest that this hybrid ultrasound/MRI approach can provide comprehensive guidance for targeted drug delivery via blood-brain barrier disruption and other emerging ultrasound treatments, facilitating their clinical translation. We anticipate that it will also prove to be an important research tool that will

Combined ultrasound and MR imaging to guide focused ultrasound therapies in the brain

International Nuclear Information System (INIS)

Arvanitis, Costas D; McDannold, Nathan; Livingstone, Margaret S

2013-01-01

Several emerging therapies with potential for use in the brain, harness effects produced by acoustic cavitation—the interaction between ultrasound and microbubbles either generated during sonication or introduced into the vasculature. Systems developed for transcranial MRI-guided focused ultrasound (MRgFUS) thermal ablation can enable their clinical translation, but methods for real-time monitoring and control are currently lacking. Acoustic emissions produced during sonication can provide information about the location, strength and type of the microbubble oscillations within the ultrasound field, and they can be mapped in real-time using passive imaging approaches. Here, we tested whether such mapping can be achieved transcranially within a clinical brain MRgFUS system. We integrated an ultrasound imaging array into the hemisphere transducer of the MRgFUS device. Passive cavitation maps were obtained during sonications combined with a circulating microbubble agent at 20 targets in the cingulate cortex in three macaques. The maps were compared with MRI-evident tissue effects. The system successfully mapped microbubble activity during both stable and inertial cavitation, which was correlated with MRI-evident transient blood–brain barrier disruption and vascular damage, respectively. The location of this activity was coincident with the resulting tissue changes within the expected resolution limits of the system. While preliminary, these data clearly demonstrate, for the first time, that it is possible to construct maps of stable and inertial cavitation transcranially, in a large animal model, and under clinically relevant conditions. Further, these results suggest that this hybrid ultrasound/MRI approach can provide comprehensive guidance for targeted drug delivery via blood–brain barrier disruption and other emerging ultrasound treatments, facilitating their clinical translation. We anticipate that it will also prove to be an important research tool that

Contrast enhanced ultrasound of sentinel lymph nodes

Directory of Open Access Journals (Sweden)

XinWu Cui

2013-03-01

Full Text Available Sentinel lymph nodes are the first lymph nodes in the region that receive lymphatic drainage from a primary tumor. The detection or exclusion of sentinel lymph node micrometastases is critical in the staging of cancer, especially breast cancer and melanoma because it directly affects patient’s prognosis and surgical management. Currently, intraoperative sentinel lymph node biopsies using blue dye and radioisotopes are the method of choice for the detection of sentinel lymph node with high identification rate. In contrast, conventional ultrasound is not capable of detecting sentinel lymph nodes in most cases. Contrast enhanced ultrasound with contrast specific imaging modes has been used for the evaluation and diagnostic work-up of peripherally located suspected lymphadenopathy. The method allows for real-time analysis of all vascular phases and the visualization of intranodal focal “avascular” areas that represent necrosis or deposits of neoplastic cells. In recent years, a number of animal and human studies showed that contrast enhanced ultrasound can be also used for the detection of sentinel lymph node, and may become a potential application in clinical routine. Several contrast agents have been used in those studies, including albumin solution, hydroxyethylated starch, SonoVue®, Sonazoid® and Definity®. This review summarizes the current knowledge about the use of ultrasound techniques in detection and evaluation of sentinel lymph node.

Potential use of an ultrasound antifouling technology as a ballast water treatment system

Science.gov (United States)

Estévez-Calvar, Noelia; Gambardella, Chiara; Miraglia, Francesco; Pavanello, Giovanni; Greco, Giuliano; Faimali, Marco; Garaventa, Francesca

2018-03-01

The aim of this study was to investigate, at a laboratory scale, the potentialities of an ultrasound-based treatment initially designed to eliminate fouling, as a ballast water treatment system. Therefore, early life stages of three different zooplanktonic species (Amphibalanus amphitrite, Brachionus plicatilis and Artemia salina) were exposed to ultrasound waves (20-22 kHz). The experimental set up included static assays with variations of time exposure (30 s, 60 s and 30 s on/60 s off/30 s on), material of tanks (stainless steel, galvanized steel and plastic) and position of the ultrasound source. Results showed that the treatment efficacy increased from 30 to 60 s and no differences were registered between 60 s-continuous exposure and pulse exposure. The highest efficacy was observed in Experiment I (metal-to-metal contact assay) with a mortality value of 93-95% for B. plicatilis and A. salina. It consisted of organisms located inside stainless steel tubes that were located in direct contact with the ultrasound source and treated for 60 s. Further, we found that, generally, A. amphitrite and B. plicatilis were the most resistant species to the ultrasound treatment whereas A. salina was the most sensitive. We further discuss that US may unlikely be used for commercial vessels, but may be used to treat ballast water in smaller ballast tanks as on board of mega yachts.

Pilot Study of a New Nonradioactive Surgical Guidance Technology for Locating Nonpalpable Breast Lesions.

Science.gov (United States)

Cox, Charles E; Garcia-Henriquez, Norbert; Glancy, M Jordan; Whitworth, Pat; Cox, John M; Themar-Geck, Melissa; Prati, Ronald; Jung, Michelle; Russell, Scott; Appleton, Kristie; King, Jeff; Shivers, Steven C

2016-06-01

The current technique for locating nonpalpable breast lesions is wire localization (WL). Radioactive seed localization and intraoperative ultrasound were developed to improve difficulties with WL. The SAVI SCOUT surgical guidance system was developed to improve these methods. The SCOUT system is a non-radioactive, FDA-cleared medical device that uses electromagnetic wave technology to provide real-time guidance during excisional breast procedures. Consenting patients underwent localization and excision using an implantable electromagnetic wave reflective device (reflector) and a detector handpiece with a console. Using image guidance, the reflector was placed up to 7 days before the surgical procedure. The primary end points of the study were successful reflector placement, localization, and retrieval. The secondary end points were percentage of clear margins, reexcision rates, days of placement before excision, and physician comparison with WL. This study analyzed 50 patients. The reflectors were placed under mammographic guidance (n = 18, 36 %) or ultrasound guidance (n = 32, 64 %). Of the 50 patients, 10 (20 %) underwent excisional biopsy and 40 (80 %) had a lumpectomy. The lesion and reflector were successfully removed in all 50 patients, and no adverse events occurred. Of the 41 patients who had in situ and/or invasive carcinoma identified, 38 (93 %) had clear margins and 3 (7 %) were recommended for reexcision. These data suggest that the SCOUT system is safe and effective for guiding the excision of nonpalpable breast lesions and a viable alternative to standard localization options. A larger prospective, multi-institution trial of SCOUT currently is underway to validate these findings.

An experimental system for the study of ultrasound exposure of isolated blood vessels

NARCIS (Netherlands)

Tokarczyk, Anna; Rivens, Ian; van Bavel, E.; Symonds-Tayler, Richard; ter Haar, Gail

2013-01-01

An experimental system designed for the study of the effects of diagnostic or therapeutic ultrasound exposure on isolated blood vessels in the presence or absence of intraluminal contrast agent is described. The system comprised several components. A microscope was used to monitor vessel size (and

Ultrasound pregnancy

Science.gov (United States)

Pregnancy sonogram; Obstetric ultrasonography; Obstetric sonogram; Ultrasound - pregnancy; IUGR - ultrasound; Intrauterine growth - ultrasound; Polyhydramnios - ultrasound; Oligohydramnios - ultrasound; ...

Tracked "Pick-Up" Ultrasound for Robot-Assisted Minimally Invasive Surgery.

Science.gov (United States)

Schneider, Caitlin; Nguan, Christopher; Rohling, Robert; Salcudean, Septimiu

2016-02-01

We present a novel "pick-up" ultrasound transducer for intraabdominal robot-assisted minimally invasive surgery. Such a "pick-up" ultrasound transducer is inserted through an abdominal incision at the beginning of the procedure and remains in the abdominal cavity throughout, eliminating the need for a dedicated port or a patient bedside surgical assistant. The transducer has a handle that can be grasped in a repeatable manner using a da Vinci Prograsp tool, allowing the transducer to be accurately manipulated by the surgeon using the da Vinci Robot. This is one way to enable 3-D tracking of the transducer, and, thus, mapping of the vasculature. The 3-D vascular images can be used to register preoperative CT to intraoperative camera images. To demonstrate the feasibility of the approach, we use an ultrasound vessel phantom to register a CT surface model to extracted ultrasound vessel models. The 3-D vascular phantom images are generated by segmenting B-mode images and tracking the pick-up ultrasound transducer with the da Vinci kinematics, internal electromagnetic sensor, or visible fiducials suitable for camera tracking. Reconstruction results using da Vinci kinematics for tracking give a target registration error of 5.4 ± 1.7 mm.

MATLAB/Simulink Pulse-Echo Ultrasound System Simulator Based on Experimentally Validated Models.

Science.gov (United States)

Kim, Taehoon; Shin, Sangmin; Lee, Hyongmin; Lee, Hyunsook; Kim, Heewon; Shin, Eunhee; Kim, Suhwan

2016-02-01

A flexible clinical ultrasound system must operate with different transducers, which have characteristic impulse responses and widely varying impedances. The impulse response determines the shape of the high-voltage pulse that is transmitted and the specifications of the front-end electronics that receive the echo; the impedance determines the specification of the matching network through which the transducer is connected. System-level optimization of these subsystems requires accurate modeling of pulse-echo (two-way) response, which in turn demands a unified simulation of the ultrasonics and electronics. In this paper, this is realized by combining MATLAB/Simulink models of the high-voltage transmitter, the transmission interface, the acoustic subsystem which includes wave propagation and reflection, the receiving interface, and the front-end receiver. To demonstrate the effectiveness of our simulator, the models are experimentally validated by comparing the simulation results with the measured data from a commercial ultrasound system. This simulator could be used to quickly provide system-level feedback for an optimized tuning of electronic design parameters.

Virtual reality based surgical assistance and training system for long duration space missions.

Science.gov (United States)

Montgomery, K; Thonier, G; Stephanides, M; Schendel, S

2001-01-01

Access to medical care during long duration space missions is extremely important. Numerous unanticipated medical problems will need to be addressed promptly and efficiently. Although telemedicine provides a convenient tool for remote diagnosis and treatment, it is impractical due to the long delay between data transmission and reception to Earth. While a well-trained surgeon-internist-astronaut would be an essential addition to the crew, the vast number of potential medical problems necessitate instant access to computerized, skill-enhancing and diagnostic tools. A functional prototype of a virtual reality based surgical training and assistance tool was created at our center, using low-power, small, lightweight components that would be easy to transport on a space mission. The system consists of a tracked, head-mounted display, a computer system, and a number of tracked surgical instruments. The software provides a real-time surgical simulation system with integrated monitoring and information retrieval and a voice input/output subsystem. Initial medical content for the system has been created, comprising craniofacial, hand, inner ear, and general anatomy, as well as information on a number of surgical procedures and techniques. One surgical specialty in particular, microsurgery, was provided as a full simulation due to its long training requirements, significant impact on result due to experience, and likelihood for need. However, the system is easily adapted to realistically simulate a large number of other surgical procedures. By providing a general system for surgical simulation and assistance, the astronaut-surgeon can maintain their skills, acquire new specialty skills, and use tools for computer-based surgical planning and assistance to minimize overall crew and mission risk.

Cost comparison between ultrasound-guided 14-g large core breast biopsy and open surgical biopsy: an analysis for Austria.

Science.gov (United States)

Gruber, R; Walter, E; Helbich, T H

2010-06-01

To examine the budget impact of ultrasound-guided 14-g large core breast biopsy (US-guided LCBB) by comparing the costs of US-guided LCBB and open surgical biopsy (OSB); to calculate the cost savings attributable to US-guided LCBB; and to assess the frequency with which US-guided LCBB obviates the need for an OSB. In a retrospective study, we reviewed 399 suspicious breast lesions on which US-guided LCBB and OSB or, in cases of benign histology, clinical follow-up, were performed. Cost savings were calculated using nationally allowed flat rates (A-drg) and patient charges. Costs were measured from both, a hospital and a socioeconomic perspective. Deterministic sensitivity analyses were simulated to assess the extent of achievable cost savings. Overall cost savings for US-guided LCBB over OSB were euro 977 (euro 2,337/euro 3,314) per case from a hospital perspective, resulting in a total cost decrease of 30% for the diagnosis of suspicious breast lesions. From a socioeconomic perspective, cost savings were euro 1,542 (euro 2,600/euro 4,142) per case, resulting in a 37% reduction in biopsy cost. US-guided LCBB obviated the need for a surgical procedure in 240 (60%) of 399 women. In all four sensitivity analyses, costs of US-guided LCBB remained lower than that of OSB. From an economic perspective, US-guided LCBB is highly recommended for the diagnosis of suspicious breast lesions, as this procedure reduces the cost of diagnosis substantially. In Austria, annual cost savings would be euro 18.5 million. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Signal Processing in Medical Ultrasound B-mode Imaging

International Nuclear Information System (INIS)

Song, Tai Kyong

2000-01-01

Ultrasonic imaging is the most widely used modality among modern imaging device for medical diagnosis and the system performance has been improved dramatically since early 90's due to the rapid advances in DSP performance and VLSI technology that made it possible to employ more sophisticated algorithms. This paper describes 'main stream' digital signal processing functions along with the associated implementation considerations in modern medical ultrasound imaging systems. Topics covered include signal processing methods for resolution improvement, ultrasound imaging system architectures, roles and necessity of the applications of DSP and VLSI technology in the development of the medical ultrasound imaging systems, and array signal processing techniques for ultrasound focusing

Ultrasound imaging with a micromotor; Micromotor ni yoru choonpa imaging

Energy Technology Data Exchange (ETDEWEB)

Oshiro, O.; Salimuzzaman, M.; Matani, A.; Chihara, K. [Nara Institute of Science and Technology, Nara (Japan); Asao, M. [Osaka National Hospital, Osaka (Japan)

1998-03-01

This paper describes a new ultrasound intravascular imaging system. In this system, an ultrasound probe consists of a micromotor, an ultrasound reflecting mirror attached with the micromotor and an ultrasound transducer. Ultrasound is scanned radially by a micromotor instead of a rotation transmitting wire and the rotation of the micromotor is performed and controlled by an external magnetic field. This ultrasound imaging system with a micromotor was applied to observe the inside of blood vessels through in vitro experiments. The preliminary results suggest that this system has the sufficient ability to define the blood vessel morphology and that the simple image processing enhances signal-to-noise ratio of the reconstructed image. 12 refs., 5 figs.

Contributory factors in surgical incidents as delineated by a confidential reporting system.

Science.gov (United States)

Mushtaq, F; O'Driscoll, C; Smith, Fct; Wilkins, D; Kapur, N; Lawton, R

2018-05-01

Background Confidential reporting systems play a key role in capturing information about adverse surgical events. However, the value of these systems is limited if the reports that are generated are not subjected to systematic analysis. The aim of this study was to provide the first systematic analysis of data from a novel surgical confidential reporting system to delineate contributory factors in surgical incidents and document lessons that can be learned. Methods One-hundred and forty-five patient safety incidents submitted to the UK Confidential Reporting System for Surgery over a 10-year period were analysed using an adapted version of the empirically-grounded Yorkshire Contributory Factors Framework. Results The most common factors identified as contributing to reported surgical incidents were cognitive limitations (30.09%), communication failures (16.11%) and a lack of adherence to established policies and procedures (8.81%). The analysis also revealed that adverse events were only rarely related to an isolated, single factor (20.71%) - with the majority of cases involving multiple contributory factors (79.29% of all cases had more than one contributory factor). Examination of active failures - those closest in time and space to the adverse event - pointed to frequent coupling with latent, systems-related contributory factors. Conclusions Specific patterns of errors often underlie surgical adverse events and may therefore be amenable to targeted intervention, including particular forms of training. The findings in this paper confirm the view that surgical errors tend to be multi-factorial in nature, which also necessitates a multi-disciplinary and system-wide approach to bringing about improvements.

Superficial Ultrasound Shear Wave Speed Measurements in Soft and Hard Elasticity Phantoms: Repeatability and Reproducibility Using Two Different Ultrasound Systems

Science.gov (United States)

Dillman, Jonathan R.; Chen, Shigao; Davenport, Matthew S.; Zhao, Heng; Urban, Matthew W.; Song, Pengfei; Watcharotone, Kuanwong; Carson, Paul L.

2014-01-01

Background There is a paucity of data available regarding the repeatability and reproducibility of superficial shear wave speed (SWS) measurements at imaging depths relevant to the pediatric population. Purpose To assess the repeatability and reproducibility of superficial shear wave speed (SWS) measurements acquired from elasticity phantoms at varying imaging depths using three different imaging methods, two different ultrasound systems, and multiple operators. Methods and Materials Soft and hard elasticity phantoms manufactured by Computerized Imaging Reference Systems, Inc. (Norfolk, VA) were utilized for our investigation. Institution #1 used an Acuson S3000 ultrasound system (Siemens Medical Solutions USA, Inc.) and three different shear wave imaging method/transducer combinations, while institution #2 used an Aixplorer ultrasound system (Supersonic Imagine) and two different transducers. Ten stiffness measurements were acquired from each phantom at three depths (1.0, 2.5, and 4.0 cm) by four operators at each institution. Student’s t-test was used to compare SWS measurements between imaging techniques, while SWS measurement agreement was assessed with two-way random effects single measure intra-class correlation coefficients and coefficients of variation. Mixed model regression analysis determined the effect of predictor variables on SWS measurements. Results For the soft phantom, the average of mean SWS measurements across the various imaging methods and depths was 0.84 ± 0.04 m/s (mean ± standard deviation) for the Acuson S3000 system and 0.90 ± 0.02 m/s for the Aixplorer system (p=0.003). For the hard phantom, the average of mean SWS measurements across the various imaging methods and depths was 2.14 ± 0.08 m/s for the Acuson S3000 system and 2.07 ± 0.03 m/s Aixplorer system (p>0.05). The coefficients of variation were low (0.5–6.8%), and inter-operator agreement was near-perfect (ICCs ≥0.99). Shear wave imaging method and imaging depth

Ultrasound scan in the diagnosis of neonatal renal candidiasis; Ecografia en el diagnostico de la candidiasis renal neonatal

Energy Technology Data Exchange (ETDEWEB)

Muro, D.; Sanguesa, C.; Torres, D.; Berbel, O.; Andres, V. [Hospital Infantil La Fe. Valencia (Spain)

2003-07-01

To describe the most pertinent echographic findings regarding systemic and renal candidiasis in high-risk neonates. Echographic findings and clinical histories of 40 neonates in the neonatal intensive care unit were retrospectively analyzed. Thirty-eight presented systemic candidiasis with renal participation, while two showed only renal candidiasis. Ultrasound scans were performed using 7.5 MHz probes. Alterations in renal echo structure, presence of echogenic material without acoustic shadowing in the excretory system (mycetoma), presence of lithiasis, pyonephrosis and associated renal malformations were all evaluated. Ten patients presented renal alterations in ultrasound scan. Six children had originally shown increased eye-catching in the renal parenchyma which was resolved after medical treatment. Four children presented renal mycetoma, and in two there were renal malformations. Both of these exhibited a profile for pyonephrosis. One patient with renal mycetoma without urological abnormalities developed a lithiasis. Surgical intervention was unnecessary in all cases. The most common echographic findings in immature high-risk low-weight patients with systemic and renal candidiasis were alterations in the eye-catching of renal parenchyma and the presence of mycetoma. (Author) 22 refs.

New ultrasound stone locking system in extracorporeal lithotripsy: Decreased duration of fluoroscopy and radiation doses

International Nuclear Information System (INIS)

Abid, N.; Ravier, E.; Codas, R.; Crouzet, S.; Martin, X.

2013-01-01

Extracorporeal shock wave lithotripsy is the most common method of treatment for kidney stones. Both fluoroscopy and ultrasound imaging can be used to locate stones, but fluoroscopy is more frequently employed. Evaluation of a new stereotaxic navigational system: the stone was located using an ultrasound probe, and its 3D location was saved. The table automatically moved to position the stone at the focal point. A real-time follow-up was possible during treatment. Our objective was to demonstrate a decrease in the use of fluoroscopy to locate kidney stones for extracorporeal shock wave lithotripsy through the use of a 3D ultrasound stone locking system. Prospective analysis of the case records of the 20 patients preceding and the 20 patients succeeding the arrival of the ultrasound stone locking system Visio-Track (EDAP-TMS). We used a Student test to compare age, BMI, kidney stone size, number of shock waves and administered energy. Patient characteristics were comparable. The average age was 55 years old and the average kidney stone size was 10.7 mm. Radiation duration was 174.8 seconds in the group without Visio-Track versus 57.1 seconds in the group with it (P < 0.0001). A similar result was observed for radiation doses: 5197.25 mGy.cm 2 for the group without versus 1987.6 mGy.cm 2 for the group with Visio-Track (P ≡ 0.0033). The stone locking system Visio-Track reduced fluoroscopy in our first group of patients, which decreased the patient's individual absorbed irradiation dose. (authors)

[Endobronchial Ultrasound (EBUS) - an Update 2017].

Science.gov (United States)

Darwiche, K; Özkan, F; Wolters, C; Eisenmann, S

2017-11-01

Endobronchial Ultrasound (EBUS) with the two modalities curved and radial EBUS significantly improved the diagnostics in several pulmonary diseases. The examination and staging of mediastinal and hilar lymph nodes in patients with known or suspected lung malignancy as well as the evaluation of unknown pulmonary or mediastinal lesions can be achieved with minimal invasive means when using EBUS. More invasive surgical procedures for diagnostic purposes can be omitted. The diagnostic yield also increases when EBUS is applied in sarcoidosis or mediastinal lymph node tuberculosis but only to some extend in case of lymphoma. Samples obtained by EBUS-TBNA should be handled efficiently to allow molecular analysis in lung cancer. EBUS is a safe procedure, and complication rate is extremely low. Further advances of the EBUS technology focus on improving analysis of the information provided by the ultrasound image and a better tissue sampling by developing of new EBUS bronchoscopes and TBNA-needles. © Georg Thieme Verlag KG Stuttgart · New York.

A thermocouple thermometry system for ultrasound hyperthermia

International Nuclear Information System (INIS)

Ozarka, M.; Gharakhani, A.; Magin, R.; Cain, C.

1984-01-01

A thermometry system designed to be used in the treatment of cancer by ultrasound hyperthermia is described. The system monitors tumor temperatures using 16 type T (copper-constantan) thermocouples and is controlled by a 12 MHz Intel 8031 microcomputer. An analog circuit board contains the thermocouple amplifiers, an analog multiplexer, scaling circuitry, and an analog to digital converter. A digital board contains the Intel 8031, program memory, data memory, as well as circuitry for control and data communications. Communication with the hyperthermia system control computer is serially by RS-232 with selectable baud rate. Since the thermocouple amplifiers may have slight differences in gain and offset, a calibrated offset is added to a lookup table value to obtain the proper display temperature to within +- 0.1 0 C. The calibration routine, implemented in software, loads a nonvolatile random access memory chip with the proper offset values based on the outputs of each thermocouple channel at known temperatures which bracket a range of interest

Early clinical experience with the da Vinci Xi Surgical System in general surgery.

Science.gov (United States)

Hagen, Monika E; Jung, Minoa K; Ris, Frederic; Fakhro, Jassim; Buchs, Nicolas C; Buehler, Leo; Morel, Philippe

2017-09-01

The da Vinci Xi Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) has been released in 2014 to facilitate minimally invasive surgery. Novel features are targeted towards facilitating complex multi-quadrant procedures, but data is scarce so far. Perioperative data of patients who underwent robotic general surgery with the da Vinci Xi system within the first 6 month after installation were collected and analyzed. The gastric bypass procedures performed with the da Vinci Xi Surgical System were compared to an equal amount of the last procedures with the da Vinci Si Surgical System. Thirty-one foregut (28 Roux-en-Y gastric bypasses), 6 colorectal procedures and 1 revisional biliary procedure were performed. The mean operating room (OR) time was 221.8 (±69.0) minutes for gastric bypasses and 306.5 (±48.8) for colorectal procedures with mean docking time of 9.4 (±3.8) minutes. The gastric bypass procedure was transitioned from a hybrid to a fully robotic approach. In comparison to the last 28 gastric bypass procedures performed with the da Vinci Si Surgical System, the OR time was comparable (226.9 versus 230.6 min, p = 0.8094), but the docking time significantly longer with the da Vinci Xi Surgical System (8.5 versus 6.1 min, p = 0.0415). All colorectal procedures were performed with a single robotic docking. No intraoperative and two postoperative complications occurred. The da Vinci Xi might facilitate single-setups of totally robotic gastric bypass and colorectal surgeries. However, further comparable research is needed to clearly determine the significance of this latest version of the da Vinci Surgical System.

Implementation and utility of a daily ultrasound-based localization system with intensity-modulated radiotherapy for prostate cancer

International Nuclear Information System (INIS)

Morr, Jody; DiPetrillo, Thomas; Tsai, J.-S.; Engler, Mark; Wazer, David E. MD.

2002-01-01

Purpose: To evaluate the clinical feasibility of daily computer-assisted transabdominal ultrasonography for target position verification in the setting of intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods and Materials: Twenty-three patients with clinically localized prostate cancer were treated using a sequential tomotherapy IMRT technique (Peacock) and daily computer-assisted transabdominal ultrasonography (BAT) for target localization. Patients were instructed to maintain a full bladder and were placed in the supine position using triangulation tattoos and a leg immobilizer to minimize pelvic rotation. The BAT ultrasound system is docked to the treatment collimator and electronically imports the CT simulation target contours and isocenter. The system is able to use the machine isocenter as a reference point to overlay the corresponding CT contours onto the ultrasound images captured in the transverse and sagittal planes. A touch screen menu is used to maneuver the CT contours in three dimensions such that they match the ultrasound images. The system then displays the three-dimensional couch shifts required to produce field alignment. Data were prospectively collected to measure the frequency by which useful ultrasound images were obtained, the amount of time required for localization/setup, and the direction/magnitude of the positional adjustments. Results: Of the 23 patients, the BAT ultrasound system produced images of sufficient quality to perform the overlay of the CT contours in 19 patients such that positional verification could be reliably performed. Poor image quality was associated with patient inability to maintain a full bladder, large body habitus, or other anatomic constraints. Of the 19 assessable patients, a total of 185 treatment alignments were performed (mean 8.8/patient). For all cases, the average time required for the daily ultrasound imaging and positional adjustments was 11.9 min. After the initial 5 cases, the user

High definition ultrasound imaging for battlefield medical applications

Energy Technology Data Exchange (ETDEWEB)

Kwok, K.S.; Morimoto, A.K.; Kozlowski, D.M.; Krumm, J.C.; Dickey, F.M. [Sandia National Labs., Albuquerque, NM (United States); Rogers, B; Walsh, N. [Texas Univ. Health Science Center, San Antonio, TX (United States)

1996-06-23

A team has developed an improved resolution ultrasound system for low cost diagnostics. This paper describes the development of an ultrasound based imaging system capable of generating 3D images showing surface and subsurface tissue and bone structures. We include results of a comparative study between images obtained from X-Ray Computed Tomography (CT) and ultrasound. We found that the quality of ultrasound images compares favorably with those from CT. Volumetric and surface data extracted from these images were within 7% of the range between ultrasound and CT scans. We also include images of porcine abdominal scans from two different sets of animal trials.

Strain ratio ultrasound elastography increases the accuracy of colour-Doppler ultrasound in the evaluation of Thy-3 nodules. A bi-centre university experience.

Science.gov (United States)

Cantisani, Vito; Maceroni, Piero; D'Andrea, Vito; Patrizi, Gregorio; Di Segni, Mattia; De Vito, Corrado; Grazhdani, Hektor; Isidori, Andrea M; Giannetta, Elisa; Redler, Adriano; Frattaroli, Fabrizio; Giacomelli, Laura; Di Rocco, Giorgio; Catalano, Carlo; D'Ambrosio, Ferdinando

2016-05-01

To assess whether ultrasound elastography (USE) with strain ratio increases diagnostic accuracy of Doppler ultrasound in further characterisation of cytologically Thy3 thyroid nodules. In two different university diagnostic centres, 315 patients with indeterminate cytology (Thy3) in thyroid nodules aspirates were prospectively evaluated with Doppler ultrasound and strain ratio USE before surgery. Ultrasonographic features were analysed separately and together as ultrasound score, to assess sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Receiver operating characteristic (ROC) curves to identify optimal cut-off value of the strain ratio were also provided. Diagnosis on a surgical specimen was considered the standard of reference. Higher strain ratio values were found in malignant nodules, with an optimum strain ratio cut-off of 2.09 at ROC analysis. USE with strain ratio showed 90.6% sensitivity, 93% specificity, 82.8% PPV, 96.4% NPV, while US score yielded a sensitivity of 52.9%, specificity of 84.3%, PPV 55.6% and NPV 82.9%. The diagnostic gain with strain ratio was statistically significant as proved by ROC areas, which was 0.9182 for strain ratio and 0.6864 for US score. USE with strain ratio should be considered a useful additional tool to colour-Doppler US, since it improves characterisation of thyroid nodules with indeterminate cytology. • Strain ratio measurements improve differentiation of thyroid nodules with indeterminate cytology • Elastography with strain ratio is more reliable than ultrasound features and ultrasound score • Strain ratio may help to better select patients with Thy 3 nodules candidate for surgery.

Round Robin Test for Performance Demonstration System of Ultrasound Examination Personnel in Nuclear Power Plants

International Nuclear Information System (INIS)

Kim, Young Ho; Yang, Seung Han; Kim, Yong Sik; Yoon, Byung Sik; Lee, Hee Jong

2005-01-01

Ultrasound testing performance during in-service inspection for the main components of NPPs is strongly affected by each examination person. Therefore, ASME established a more strict qualification requirement in Sec. XI Appendix VIII for the ultrasound testing personnel in nuclear power plants. The Korean Performance Demonstration (KPD) System according to the ASME code for the ultrasonic testing personnel, equipments, and procedures to apply to the Class 1 and 2 piping ultrasound examination of nuclear power plants in Korea was established. And a round robin test was conducted in order to verify the effectiveness of PD method by comparing the examination results from the method of Performance Demonstration (PD) and a traditional ASME code dB-drop method. The round robin test shows that the reliability of the PD method is better than that of the dB-drop method. As a result, application of the PD method to the in-service inspection of the nuclear power plants will improve the performance of ultrasound testing

[Mobile hospital -real time mobile telehealthcare system with ultrasound and CT van using high-speed satellite communication-].

Science.gov (United States)

Takizawa, Masaomi; Miyashita, Toyohisa; Murase, Sumio; Kanda, Hirohito; Karaki, Yoshiaki; Yagi, Kazuo; Ohue, Toru

2003-01-01

A real-time telescreening system is developed to detect early diseases for rural area residents using two types of mobile vans with a portable satellite station. The system consists of a satellite communication system with 1.5Mbps of the JCSAT-1B satellite, a spiral CT van, an ultrasound imaging van with two video conference system, a DICOM server and a multicast communication unit. The video image and examination image data are transmitted from the van to hospitals and the university simultaneously. Physician in the hospital observes and interprets exam images from the van and watches the video images of the position of ultrasound transducer on screenee in the van. After the observation images, physician explains a results of the examination by the video conference system. Seventy lung CT screening and 203 ultrasound screening were done from March to June 2002. The trial of this real time screening suggested that rural residents are given better healthcare without visit to the hospital. And it will open the gateway to reduce the medical cost and medical divide between city area and rural area.

Prostate Ultrasound

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Full Text Available ... Physician Resources Professions Site Index A-Z Ultrasound - Prostate Ultrasound of the prostate uses sound waves to ... Ultrasound Imaging? What is Ultrasound Imaging of the Prostate? Ultrasound is safe and painless, and produces pictures ...

Ultrasound diagnosis of postoperative complications of nerve repair.

Science.gov (United States)

Fantoni, Caterina; Erra, Carmen; Fernandez Marquez, Eduardo Marcos; Ortensi, Andrea; Faiola, Andrea; Coraci, Daniele; Piccinini, Giulia; Padua, Luca

2018-05-03

Peripheral nerve injuries often undergo surgical repair, but poor postoperative functional recovery is frequently observed. We describe four cases of traumatic nerve lesions in whom postoperative recovery was prevented by complications such as detachment of nerve sutures or neuroma growth. To the best of our knowledge no similar cases have been reported in literature so far. It is important an early diagnosis of such condition because it prevents recovery and delays re-intervention, which should be performed before complete muscle denervation and atrophy. Nerve ultrasound is a valuable tool in traumatic nerve injury and has proven to be useful in postoperative follow-up, especially in diagnosing surgical complications such as detachment of nerve direct sutures. Copyright © 2018 Elsevier Inc. All rights reserved.

Audit of ultrasound and decision to operate in groin pain of unknown aetiology with ultrasound technique explained

International Nuclear Information System (INIS)

Depasquale, R.; Landes, C.; Doyle, G.

2009-01-01

Aim: To determine the ability of a groin ultrasound service to identify inguinal/femoral hernias in patients with groin pain and equivocal clinical signs, and to evaluate the number of positive cases undergoing surgery. Methods and materials: A retrospective review of 243 examinations performed during the period January 2000 to June 2004 was undertaken. The referral information, as well as details of the examination and subsequent follow-up, were obtained through our hospital/radiological information system. Results: Of 243 patients, 92 (38%) were referrals from general practitioners and 151 (62%) were hospital referrals. The examinations were performed by radiology consultants or specialist registrars, the former accounting for 228 examinations (94%). The age range of the patients was 3 months to 88 years (mean age = 48.7), with a male to female ratio of 3.2:1. One hundred and forty-three examinations were negative for hernias. Two of these patients underwent groin explorations and were found to be normal. The rest were discharged and none returned with related complaints. Ninety-four examinations (39%) were positive for hernias, as a result of which 62 patients underwent surgery. Of these, only four were found to be false-positives giving a positive predictive value of 94% in operated patients. Three scans were equivocal, and three were positive for other conditions. Conclusion: In patients with equivocal clinical signs, groin ultrasound is a useful tool for identifying hernias, and therefore, aids surgical management.

Audit of ultrasound and decision to operate in groin pain of unknown aetiology with ultrasound technique explained

Energy Technology Data Exchange (ETDEWEB)

Depasquale, R. [Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Chester, Cheshire (United Kingdom)], E-mail: ruben.depasquale@gmail.com; Landes, C.; Doyle, G. [Countess of Chester Hospital NHS Foundation Trust, Countess of Chester Health Park, Chester, Cheshire (United Kingdom)

2009-06-15

Aim: To determine the ability of a groin ultrasound service to identify inguinal/femoral hernias in patients with groin pain and equivocal clinical signs, and to evaluate the number of positive cases undergoing surgery. Methods and materials: A retrospective review of 243 examinations performed during the period January 2000 to June 2004 was undertaken. The referral information, as well as details of the examination and subsequent follow-up, were obtained through our hospital/radiological information system. Results: Of 243 patients, 92 (38%) were referrals from general practitioners and 151 (62%) were hospital referrals. The examinations were performed by radiology consultants or specialist registrars, the former accounting for 228 examinations (94%). The age range of the patients was 3 months to 88 years (mean age = 48.7), with a male to female ratio of 3.2:1. One hundred and forty-three examinations were negative for hernias. Two of these patients underwent groin explorations and were found to be normal. The rest were discharged and none returned with related complaints. Ninety-four examinations (39%) were positive for hernias, as a result of which 62 patients underwent surgery. Of these, only four were found to be false-positives giving a positive predictive value of 94% in operated patients. Three scans were equivocal, and three were positive for other conditions. Conclusion: In patients with equivocal clinical signs, groin ultrasound is a useful tool for identifying hernias, and therefore, aids surgical management.

Characterization of ultrasound elevation beamwidth artifacts for prostate brachytherapy needle insertion

International Nuclear Information System (INIS)

Peikari, Mohammad; Chen, Thomas Kuriran; Lasso, Anras; Heffter, Tamas; Fichtinger, Gabor; Burdette, Everette C.

2012-01-01

Purpose: Ultrasound elevation beamwidth leads to image artifacts and uncertainties in localizing objects (such as a surgical needle) in ultrasound images. The authors examined the clinical significance of errors caused by elevation beamwidth artifacts and imaging parameters in needle insertion procedures. Methods: Beveled prostate brachytherapy needles were inserted through all holes of a grid template under real-time transrectal ultrasound (TRUS) guidance. The needle tip position as indicated by the TRUS image was compared to their observed physical location. A new device was developed to measure the ultrasound elevation beamwidth. Results: Imaging parameters of the TRUS scanner have direct impact on the localization error ranging from 0.5 up to 4 mm. The smallest localization error was observed laterally close to the center of the grid template and axially within the beam's focal zone. Largest localization error occurs laterally around both sides of the grid template and axially within the beam's far field. The authors also found that the localization errors vary with both lateral and elevation offsets. Conclusions: The authors found properly adjusting the TRUS imaging settings to lower the ultrasound gain and power effectively minimized the appearance of elevation beamwidth artifacts and in turn reduced the localization errors of the needle tip.

Ultrasound -- Pelvis

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Full Text Available ... specific content. Related Articles and Media Sonohysterography Ultrasound - Abdomen Children's (Pediatric) Ultrasound - Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and ...

Integrated ultrasound and magnetic resonance imaging for simultaneous temperature and cavitation monitoring during focused ultrasound therapies.

Science.gov (United States)

Arvanitis, Costas D; McDannold, Nathan

2013-11-01

Ultrasound can be used to noninvasively produce different bioeffects via viscous heating, acoustic cavitation, or their combination, and these effects can be exploited to develop a wide range of therapies for cancer and other disorders. In order to accurately localize and control these different effects, imaging methods are desired that can map both temperature changes and cavitation activity. To address these needs, the authors integrated an ultrasound imaging array into an MRI-guided focused ultrasound (MRgFUS) system to simultaneously visualize thermal and mechanical effects via passive acoustic mapping (PAM) and MR temperature imaging (MRTI), respectively. The system was tested with an MRgFUS system developed for transcranial sonication for brain tumor ablation in experiments with a tissue mimicking phantom and a phantom-filled ex vivo macaque skull. In experiments on cavitation-enhanced heating, 10 s continuous wave sonications were applied at increasing power levels (30-110 W) until broadband acoustic emissions (a signature for inertial cavitation) were evident. The presence or lack of signal in the PAM, as well as its magnitude and location, were compared to the focal heating in the MRTI. Additional experiments compared PAM with standard B-mode ultrasound imaging and tested the feasibility of the system to map cavitation activity produced during low-power (5 W) burst sonications in a channel filled with a microbubble ultrasound contrast agent. When inertial cavitation was evident, localized activity was present in PAM and a marked increase in heating was observed in MRTI. The location of the cavitation activity and heating agreed on average after registration of the two imaging modalities; the distance between the maximum cavitation activity and focal heating was -3.4 ± 2.1 mm and -0.1 ± 3.3 mm in the axial and transverse ultrasound array directions, respectively. Distortions and other MRI issues introduced small uncertainties in the PAM�

Early experience using the da Vinci Surgical System for the treatment of mediastinal tumors.

Science.gov (United States)

Kajiwara, Naohiro; Taira, Masahiro; Yoshida, Koichi; Hagiwara, Masaru; Kakihana, Masatoshi; Usuda, Jitsuo; Uchida, Osamu; Ohira, Tatsuo; Kawate, Norihiko; Ikeda, Norihiko

2011-10-01

The da Vinci Surgical System has been used in only a few cases for treating mediastinal tumors in Japan. Recently, we used the da Vinci Surgical System for various types of anterior and middle mediastinal tumors in clinical practice. We report our early experience using the da Vinci Surgical System. Seven patients gave written informed consent to undergo robotic surgery for mediastinal tumor dissection using the da Vinci Surgical System. We evaluated the safety and feasibility of this system for the surgical treatment of mediastinal tumors. Two specialists in thoracic surgery who are certified to use the da Vinci S Surgical System and another specialist acted as an assistant performed the tumor dissection. We were able to access difficult-to-reach areas, such as the mediastinum, safely. All the resected tumors were classified as benign tumors histologically. The average da Vinci setting time was 14.0 min, the average working time was 55.7 min, and the average overall operating time was 125.9 min. The learning curve for the da Vinci setup and manipulation time was short. Robotic surgery enables mediastinal tumor dissection in certain cases more safely and easily than conventional video-assisted thoracoscopic surgery and less invasively than open thoracotomy.

Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging

International Nuclear Information System (INIS)

McCarthy, C.L.; Wilson, D.J.; Coltman, T.P.

2008-01-01

differentiating soft tissue from osseous impingement. Synovitic lesions in two control patients suggest that abnormal antero-lateral soft tissue does not necessarily imply the presence of symptomatic ALI. Synovitic lesions in excess of 10 mm were associated with symptoms. Ultrasound will not demonstrate osteocartilaginous lesions or stress fractures and may overlook some loose bodies. Ultrasound findings together with clinical correlation can be used to direct arthroscopic examination and surgical debridement. (orig.)

High-frequency Doppler ultrasound transducer for the peripheral circulatory system

Energy Technology Data Exchange (ETDEWEB)

Bae, Youngmin; Yang, Jeongwon; Kang, Uk; Kim, Guanghoon [Korea Electrotechnology Research Institute, Ansan (Korea, Republic of)

2011-12-15

A Doppler ultrasound transducer was designed and implemented to measure the blood flow velocity in tiny vessels near the skin of hands or feet. The geometric parameters of the transducer for defining the observation volume were derived and implemented with an acoustic window made of polystyrene. The observation volume designed in this study was located 6.5 mm from the transducer, which was comparable to the value predicted geometrically. The two-way insertion loss of the transducer was -11.3 dB on ultrasound frequency of 20 MHz, and the 3-dB bandwidth was approximately 2 MHz. In addition, the Doppler shift in the frequency measured by using a Doppler device composed of the transducer and a Doppler signal processing unit was proportional to the flow velocity generated by a homemade flowing system. Finally, we concluded that the transducer could be applied to measure the blood flow velocity in hands or feet.

High-frequency Doppler ultrasound transducer for the peripheral circulatory system

International Nuclear Information System (INIS)

Bae, Youngmin; Yang, Jeongwon; Kang, Uk; Kim, Guanghoon

2011-01-01

A Doppler ultrasound transducer was designed and implemented to measure the blood flow velocity in tiny vessels near the skin of hands or feet. The geometric parameters of the transducer for defining the observation volume were derived and implemented with an acoustic window made of polystyrene. The observation volume designed in this study was located 6.5 mm from the transducer, which was comparable to the value predicted geometrically. The two-way insertion loss of the transducer was -11.3 dB on ultrasound frequency of 20 MHz, and the 3-dB bandwidth was approximately 2 MHz. In addition, the Doppler shift in the frequency measured by using a Doppler device composed of the transducer and a Doppler signal processing unit was proportional to the flow velocity generated by a homemade flowing system. Finally, we concluded that the transducer could be applied to measure the blood flow velocity in hands or feet.

Automated flow quantification in valvular heart disease based on backscattered Doppler power analysis: implementation on matrix-array ultrasound imaging systems.

Science.gov (United States)

Buck, Thomas; Hwang, Shawn M; Plicht, Björn; Mucci, Ronald A; Hunold, Peter; Erbel, Raimund; Levine, Robert A

2008-06-01

Cardiac ultrasound imaging systems are limited in the noninvasive quantification of valvular regurgitation due to indirect measurements and inaccurate hemodynamic assumptions. We recently demonstrated that the principle of integration of backscattered acoustic Doppler power times velocity can be used for flow quantification in valvular regurgitation directly at the vena contracta of a regurgitant flow jet. We now aimed to accomplish implementation of automated Doppler power flow analysis software on a standard cardiac ultrasound system utilizing novel matrix-array transducer technology with detailed description of system requirements, components and software contributing to the system. This system based on a 3.5 MHz, matrix-array cardiac ultrasound scanner (Sonos 5500, Philips Medical Systems) was validated by means of comprehensive experimental signal generator trials, in vitro flow phantom trials and in vivo testing in 48 patients with mitral regurgitation of different severity and etiology using magnetic resonance imaging (MRI) for reference. All measurements displayed good correlation to the reference values, indicating successful implementation of automated Doppler power flow analysis on a matrix-array ultrasound imaging system. Systematic underestimation of effective regurgitant orifice areas >0.65 cm(2) and volumes >40 ml was found due to currently limited Doppler beam width that could be readily overcome by the use of new generation 2D matrix-array technology. Automated flow quantification in valvular heart disease based on backscattered Doppler power can be fully implemented on board a routinely used matrix-array ultrasound imaging systems. Such automated Doppler power flow analysis of valvular regurgitant flow directly, noninvasively, and user independent overcomes the practical limitations of current techniques.

Ultrasound-Assisted Hot Air Drying of Foods

Science.gov (United States)

Mulet, Antonio; Cárcel, Juan Andrés; García-Pérez, José Vicente; Riera, Enrique

This chapter deals with the application of power ultrasound, also named high-intensity ultrasound, in the hot air drying of foods. The aim of ultrasound-assisted drying is to overcome some of the limitations of traditional convective drying systems, especially by increasing drying rate without reducing quality attributes. The effects of ultrasound on drying rate are responsible for some of the phenomena produced in the internal and/or external resistance to mass transfer.

Surgical rehabilitation of patients with spinal neurotrophic decubitus

Directory of Open Access Journals (Sweden)

S. G. Shapovalov

2016-01-01

Full Text Available The greatest weight neurodystrophic process develops in traumatic spinal cord injury, appears as neurotrophic decubitus (bedsores. There is a high risk of wound infection in the event of pressure ulcers. Surgical repair of the skin integrity in spinal patients of 3 and 4 grade is a basic prerequisite for the further complex of the rehabilitation measures. Work objective: to develop the concept of innovative technologies of treatment of local physical impacts and to implement it in surgical system of rehabilitation of patients with spinal cord lesion with neurotrophic decubitus of 3 and 4 grade. Clinical studies subjected 49 (100% patients with spinal cord lesions and neurotrophic decubitus of 3 and 4 grade. All patients were divided into two groups: 1– (study group 1 29 patients; 2 – (control group 2 20 patients. The managed negative pressure system S042 NPWT VivanoTec (Hartmann, a method of ultrasonic cavitation (Sonoca%180, the system for the hydro surgery Versajet Smith and Nephew were used in the 1%st group. Traditional dressings for the preparation of a plastic closure of the wound defect neurotrophic decubitus of the grade 3%4 were used in the 2nd group. Statistical analysis was performed using package of Microsoft Excel%97 Statistica for Windows 6.0, SPSS 10.0 for Windows. The study showed that the use of complex methods of vacuum therapy, ultrasound cavitation and hydro surgical in the 1st group significantly reduces the duration of treatment compared with conservative methods in the 2nd group. In group 1, the mean duration of treatment was 19.9±13.9 days, in group 2 (comparison group – 40.0±28.2 days (p<0.05. The usage of physical methods (managed negative pressure system, ultrasonic processing method, hydro surgical system local treatment is a highly effective method of preparation neurotrophic decubitus grade 3 and 4 to the early recovery of the skin. Physical methods of local treatment have a positive effect on tissue

Compact teleoperated laparoendoscopic single-site robotic surgical system: Kinematics, control, and operation.

Science.gov (United States)

Isaac-Lowry, Oran Jacob; Okamoto, Steele; Pedram, Sahba Aghajani; Woo, Russell; Berkelman, Peter

2017-12-01

To date a variety of teleoperated surgical robotic systems have been developed to improve a surgeon's ability to perform demanding single-port procedures. However typical large systems are bulky, expensive, and afford limited angular motion, while smaller designs suffer complications arising from limited motion range, speed, and force generation. This work was to develop and validate a simple, compact, low cost single site teleoperated laparoendoscopic surgical robotic system, with demonstrated capability to carry out basic surgical procedures. This system builds upon previous work done at the University of Hawaii at Manoa and includes instrument and endoscope manipulators as well as compact articulated instruments designed to overcome single incision geometry complications. A robotic endoscope holder was used for the base, with an added support frame for teleoperated manipulators and instruments fabricated mostly from 3D printed parts. Kinematics and control methods were formulated for the novel manipulator configuration. Trajectory following results from an optical motion tracker and sample task performance results are presented. Results indicate that the system has successfully met the goal of basic surgical functionality while minimizing physical size, complexity, and cost. Copyright © 2017 John Wiley & Sons, Ltd.

Acute scrotal pathology in Schonlein-Henoch purpura: management by color Doppler ultrasound. A case report

International Nuclear Information System (INIS)

Jornet, J.; Cervera, J.; Marco, S.F.; Gonzalez, M.

1998-01-01

Schonlein-Henoch purpura is the most common form of purpura in children. It can affect a number of organs, but scrotal involvement is rare. We present a case of scrotal hemorrhage and epidymo-orchitis, diagnosed by color Doppler ultrasound, in which conservative treatment was employed. The differential diagnosis involves testicular torsion, which is also, although less frequently, associated with Schonlein-Henoch purpura. color Doppler ultrasound results in the correct diagnosis, ruling out testicular torsion and avoiding surgical exploration of the testicles. (Author) 8 refs

Intussusception in children: not only surgical treatment

Directory of Open Access Journals (Sweden)

Anna Maria Caruso

2017-02-01

Full Text Available Introduction: Intussusception is the commonest cause of acute in­testinal obstruction in children. Failure of timely diagnosis and treatment results in a surgical emergency leading to fatal outcome. The classic triad of symptoms is seen in less than one-third of the children affected. Aim of this study was to evaluate the comprehensive management of intussusception in children, evaluating the outcome of conservative treatment with hydrostatic ultrasound reduction and surgery.Material and methods: A retrospective analysis was conducted including pediatric patients (up to 14 years old with diagnosis of bowel intussusception. The management and treatment depended on the patients’ situation: for children in good general conditions initial hydrostatic reduction under continuous ultrasonographic monitoring was attempted; if severe dehydration and/or septic shock was observed, the conservative treatment was contraindicated and direct surgical treatment was performed.Result: A total of 44 pediatric patients were included in the study. The most frequent symptoms observed were paroxysmal abdominal pain (100% of cases and vomiting (72%; only 29% of patients presented with the classic triad of symptoms (abdominal pain, palpable mass and blood stained stools. 28 patients (64% were managed conservatively with ultrasound hydrostatic reduction. 10 patients (23% required primary surgical intervention because of clinical conditions; 6 patients (14% were operated after failure of conservative approach. The total percentage of operated patients was 36%, with lead points identified in 12 cases.Conclusion: Our data confirm that hydrostatic reduction is a simple, real time procedure, free of radiations, non invasive and safe. Age had no impact on the reducibility whereas bloody stool, a prolonged duration of symptoms and the presence of lead point were risk factors of failure.

Inguinal Hernia in Athletes: Role of Dynamic Ultrasound.

Science.gov (United States)

Vasileff, William Kelton; Nekhline, Mikhail; Kolowich, Patricia A; Talpos, Gary B; Eyler, Willam R; van Holsbeeck, Marnix

Inguinal hernia is a commonly encountered cause of pain in athletes. Because of the anatomic complexity, lack of standard imaging, and the dynamic condition, there is no unified opinion explaining its underlying pathology. Athletes with persistent groin pain would have a high prevalence of inguinal hernia with dynamic ultrasound, and herniorrhaphy would successfully return athletes to activity. Case-control study. Level 3. Forty-seven amateur and professional athletes with sports-related groin pain who underwent ultrasound were selected based on history and examination. Patients with prior groin surgery or hip pathology were excluded. Clinical and surgical documentation were correlated with imaging. The study group was compared with 41 age-matched asymptomatic athletes. Ultrasound was positive for hernia with movement of bowel, bladder, or omental tissue anterior to the inferior epigastric vessels during Valsalva maneuver. The 47-patient symptomatic study group included 41 patients with direct inguinal hernias, 1 with indirect inguinal hernia, and 5 with negative ultrasound. Of 42 patients with hernia, 39 significantly improved with herniorrhaphy, 2 failed to improve after surgery and were diagnosed with adductor longus tears, and 1 improved with physical therapy. Five patients with negative ultrasound underwent magnetic resonance imaging and were diagnosed with hip labral tear or osteitis pubis. The 41-patient asymptomatic control group included 3 patients with direct inguinal hernias, 2 with indirect inguinal hernias, and 3 with femoral hernias. Inguinal hernias are a major component of groin pain in athletes. Prevalence of direct inguinal hernia in symptomatic athletes was greater than that for controls ( P < 0.001). Surgery was successful in returning these athletes to sport: 39 of 42 (93%) athletes with groin pain and inguinal hernia became asymptomatic. Persistent groin pain in the athlete may relate to inguinal hernia, which can be diagnosed with dynamic

Comprehensive ultrasound assessment of complications post-liver transplantation.

LENUS (Irish Health Repository)

O'Brien, J

2010-04-01

Human liver transplantation for end-stage liver disease was first performed in 1963. Refinements in surgical technique and new immunosuppressive regimens have improved outcomes. Today, transplant patients have a 5-year survival rate of approximately 75%. Nevertheless, significant complications still occur. Ultrasonography (US), is the initial imaging modality of choice allowing bedside assessment for detection and follow-up of early and delayed graft complications, and facilitating interventional procedures. This review outlines the role of ultrasound in post-transplantation assessment.

Ultrasound -- Pelvis

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Full Text Available ... Ultrasound - Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to Ultrasound - Pelvis Sponsored by Please ...

Validation of American Thyroid Association Ultrasound Risk Assessment of Thyroid Nodules Selected for Ultrasound Fine-Needle Aspiration.

Science.gov (United States)

Tang, Alice L; Falciglia, Mercedes; Yang, Huaitao; Mark, Jonathan R; Steward, David L

2017-08-01

The aim of this study was to validate the American Thyroid Association (ATA) sonographic risk assessment of thyroid nodules. The ATA sonographic risk assessment was prospectively applied to 206 thyroid nodules selected for ultrasound-guided fine-needle aspiration (US-FNA), and analyzed with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC), as well as surgical pathology for the subset undergoing surgical excision. The analysis included 206 thyroid nodules averaging 2.4 cm (range 1-7 cm; standard error of the mean 0.07). Using the ATA US pattern risk assessment, nodules were classified as high (4%), intermediate (31%), low (38%), and very low (26%) risk of malignancy. Nodule size was inversely correlated with sonographic risk assessment, as lower risk nodules were larger on average (p risk estimates (high 70-90%, intermediate 10-20%, low 5-10%, and very low 3%). ATA US pattern risk assessment also appropriately predicted the proportion of nodules classified as malignant or suspicious for malignancy through TBSRTC classification-high (77%), intermediate (6%), low (1%), and very low 0%-as well as benign TBSRTC classification-high (0%), intermediate (47%), low (61%), and very low (70%) (p risk stratification (high 100%, intermediate 21%, low 17%, and very low 12%; p = 0.003). This prospective study supports the new ATA sonographic pattern risk assessment for selection of thyroid nodules for US-FNA based upon TBSRTC and surgical pathology results. In the setting of indeterminate cytopathology, nodules categorized as atypia of undetermined significance/follicular lesion of undetermined significance with ATA high-risk sonographic patterns have a high likelihood of being malignant.

[System design of small intellectualized ultrasound hyperthermia instrument in the LabVIEW environment].

Science.gov (United States)

Jiang, Feng; Bai, Jingfeng; Chen, Yazhu

2005-08-01

Small-scale intellectualized medical instrument has attracted great attention in the field of biomedical engineering, and LabVIEW (Laboratory Virtual Instrument Engineering Workbench) provides a convenient environment for this application due to its inherent advantages. The principle and system structure of the hyperthermia instrument are presented. Type T thermocouples are employed as thermotransducers, whose amplifier consists of two stages, providing built-in ice point compensation and thus improving work stability over temperature. Control signals produced by specially designed circuit drive the programmable counter/timer 8254 chip to generate PWM (Pulse width modulation) wave, which is used as ultrasound radiation energy control signal. Subroutine design topics such as inner-tissue real time feedback temperature control algorithm, water temperature control in the ultrasound applicator are also described. In the cancer tissue temperature control subroutine, the authors exert new improvments to PID (Proportional Integral Differential) algorithm according to the specific demands of the system and achieve strict temperature control to the target tissue region. The system design and PID algorithm improvement have experimentally proved to be reliable and excellent, meeting the requirements of the hyperthermia system.

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... Children's (Pediatric) Ultrasound - Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to Ultrasound - Pelvis Sponsored by Please ...

Intraocular robotic interventional surgical system (IRISS): Mechanical design, evaluation, and master-slave manipulation.

Science.gov (United States)

Wilson, Jason T; Gerber, Matthew J; Prince, Stephen W; Chen, Cheng-Wei; Schwartz, Steven D; Hubschman, Jean-Pierre; Tsao, Tsu-Chin

2018-02-01

Since the advent of robotic-assisted surgery, the value of using robotic systems to assist in surgical procedures has been repeatedly demonstrated. However, existing technologies are unable to perform complete, multi-step procedures from start to finish. Many intraocular surgical steps continue to be manually performed. An intraocular robotic interventional surgical system (IRISS) capable of performing various intraocular surgical procedures was designed, fabricated, and evaluated. Methods were developed to evaluate the performance of the remote centers of motion (RCMs) using a stereo-camera setup and to assess the accuracy and precision of positioning the tool tip using an optical coherence tomography (OCT) system. The IRISS can simultaneously manipulate multiple surgical instruments, change between mounted tools using an onboard tool-change mechanism, and visualize the otherwise invisible RCMs to facilitate alignment of the RCM to the surgical incision. The accuracy of positioning the tool tip was measured to be 0.205±0.003 mm. The IRISS was evaluated by trained surgeons in a remote surgical theatre using post-mortem pig eyes and shown to be effective in completing many key steps in a variety of intraocular surgical procedures as well as being capable of performing an entire cataract extraction from start to finish. The IRISS represents a necessary step towards fully automated intraocular surgery and demonstrated accurate and precise master-slave manipulation for cataract removal and-through visual feedback-retinal vein cannulation. Copyright © 2017 John Wiley & Sons, Ltd.

Integrated low power ultrasound sensor interfaces

OpenAIRE

Gustafsson, Martin

2005-01-01

Imagine that the technical development can take the ultrasound measurement systems from the large piece of machinery today, to a coin size system tomorrow. The factor that has reduced the size of electronic systems over time is integration and integrated circuits. In this thesis circuit simulator models of complete ultrasound systems are used to design custom integrated circuits. These circuits are optimized for low power consumption and small size. The models that are used predict the acoust...

Computer-aided diagnostic system for detection of Hashimoto thyroiditis on ultrasound images from a Polish population.

Science.gov (United States)

Acharya, U Rajendra; Sree, S Vinitha; Krishnan, M Muthu Rama; Molinari, Filippo; Zieleźnik, Witold; Bardales, Ricardo H; Witkowska, Agnieszka; Suri, Jasjit S

2014-02-01

Computer-aided diagnostic (CAD) techniques aid physicians in better diagnosis of diseases by extracting objective and accurate diagnostic information from medical data. Hashimoto thyroiditis is the most common type of inflammation of the thyroid gland. The inflammation changes the structure of the thyroid tissue, and these changes are reflected as echogenic changes on ultrasound images. In this work, we propose a novel CAD system (a class of systems called ThyroScan) that extracts textural features from a thyroid sonogram and uses them to aid in the detection of Hashimoto thyroiditis. In this paradigm, we extracted grayscale features based on stationary wavelet transform from 232 normal and 294 Hashimoto thyroiditis-affected thyroid ultrasound images obtained from a Polish population. Significant features were selected using a Student t test. The resulting feature vectors were used to build and evaluate the following 4 classifiers using a 10-fold stratified cross-validation technique: support vector machine, decision tree, fuzzy classifier, and K-nearest neighbor. Using 7 significant features that characterized the textural changes in the images, the fuzzy classifier had the highest classification accuracy of 84.6%, sensitivity of 82.8%, specificity of 87.0%, and a positive predictive value of 88.9%. The proposed ThyroScan CAD system uses novel features to noninvasively detect the presence of Hashimoto thyroiditis on ultrasound images. Compared to manual interpretations of ultrasound images, the CAD system offers a more objective interpretation of the nature of the thyroid. The preliminary results presented in this work indicate the possibility of using such a CAD system in a clinical setting after evaluating it with larger databases in multicenter clinical trials.

Virtual Ultrasound Guidance for Inexperienced Operators

Science.gov (United States)

Caine, Timothy; Martin, David

2012-01-01

Medical ultrasound or echocardiographic studies are highly operator-dependent and generally require lengthy training and internship to perfect. To obtain quality echocardiographic images in remote environments, such as on-orbit, remote guidance of studies has been employed. This technique involves minimal training for the user, coupled with remote guidance from an expert. When real-time communication or expert guidance is not available, a more autonomous system of guiding an inexperienced operator through an ultrasound study is needed. One example would be missions beyond low Earth orbit in which the time delay inherent with communication will make remote guidance impractical. The Virtual Ultrasound Guidance system is a combination of hardware and software. The hardware portion includes, but is not limited to, video glasses that allow hands-free, full-screen viewing. The glasses also allow the operator a substantial field of view below the glasses to view and operate the ultrasound system. The software is a comprehensive video program designed to guide an inexperienced operator through a detailed ultrasound or echocardiographic study without extensive training or guidance from the ground. The program contains a detailed description using video and audio to demonstrate equipment controls, ergonomics of scanning, study protocol, and scanning guidance, including recovery from sub-optimal images. The components used in the initial validation of the system include an Apple iPod Classic third-generation as the video source, and Myvue video glasses. Initially, the program prompts the operator to power-up the ultrasound and position the patient. The operator would put on the video glasses and attach them to the video source. After turning on both devices and the ultrasound system, the audio-video guidance would then instruct on patient positioning and scanning techniques. A detailed scanning protocol follows with descriptions and reference video of each view along with

Effect of high intensity ultrasound on the fermentation profile of Lactobacillus sakei in a meat model system.

Science.gov (United States)

Ojha, Kumari Shikha; Kerry, Joseph P; Alvarez, Carlos; Walsh, Des; Tiwari, Brijesh K

2016-07-01

The objective of this study was to investigate the efficacy of high intensity ultrasound on the fermentation profile of Lactobacillus sakei in a meat model system. Ultrasound power level (0-68.5 W) and sonication time (0-9 min) at 20 °C were assessed against the growth of L. sakei using a Microplate reader over a period of 24h. The L. sakei growth data showed a good fit with the Gompertz model (R(2)>0.90; SEfunctional food products can be tailored by selection of ultrasound processing parameters. Copyright © 2016 Elsevier B.V. All rights reserved.

MR-Guided Focused Ultrasound for the Treatment of Uterine Fibroids

International Nuclear Information System (INIS)

Hesley, Gina K.; Gorny, Krzysztof R.; Woodrum, David A.

2013-01-01

Magnetic resonance imaging–guided focused ultrasound (MRgFUS) ablation of uterine fibroids provides a minimally invasive outpatient technique for targeting and treating symptomatic uterine fibroids. Magnetic resonance imaging provides a guidance platform that has high temporal and spatial resolution for guiding, as well as thermal monitoring of the procedure. The high-intensity focused ultrasound provides a mechanism for delivering large amounts of energy directly into the fibroid without causing detrimental effects to the nontarget tissues. Early and intermediate follow-up of patients treated with MRgFUS provided promising results on the efficacy of the technique for providing symptom relief to patients. As more long-term follow-up data are published, the efficacy of this technique can be compared to more invasive surgical and minimally invasive catheter treatments.

Relative ultrasound energy measurement circuit

OpenAIRE

Gustafsson, E.Martin I.; Johansson, Jonny; Delsing, Jerker

2005-01-01

A relative ultrasound energy estimation circuit has been designed in a standard 0.35-μm CMOS process, to be a part of a thumb size internet connected wireless ultrasound measurement system. This circuit measures the relative energy between received ultrasound pulses, and presents an output signal that is linear to the received energy. Post-layout simulations indicate 7 bit linearity for 500 mV input signals, 5 μsec startup and stop times, 2.6 mW power consumption during active state. The acti...

Multi-Channel RF System for MRI-Guided Transurethral Ultrasound Thermal Therapy

Science.gov (United States)

Yak, Nicolas; Asselin, Matthew; Chopra, Rajiv; Bronskill, Michael

2009-04-01

MRI-guided transurethral ultrasound thermal therapy is an approach to treating localized prostate cancer which targets precise deposition of thermal energy within a confined region of the gland. This treatment requires a system incorporating a heating applicator with multiple planar ultrasound transducers and associated RF electronics to control individual elements independently in order to achieve accurate 3D treatment. We report the design, construction, and characterization of a prototype multi-channel system capable of controlling 16 independent RF signals for a 16-element heating applicator. The main components are a control computer, microcontroller, and a 16-channel signal generator with 16 amplifiers, each incorporating a low-pass filter and transmitted/reflected power detection circuit. Each channel can deliver from 0.5 to 10 W of electrical power and good linearity from 3 to 12 MHz. Harmonic RF signals near the Larmor frequency of a 1.5 T MRI were measured to be below -30 dBm and heating experiments within the 1.5 T MR system showed no significant decrease in SNR of the temperature images. The frequency and power for all 16 channels could be changed in less than 250 ms, which was sufficiently rapid for proper performance of the control algorithms. A common backplane design was chosen which enabled an inexpensive, modular approach for each channel resulting in an overall system with minimal footprint.

A multicenter prospective study of surgical audit systems.

Science.gov (United States)

Haga, Yoshio; Ikejiri, Koji; Wada, Yasuo; Takahashi, Tadateru; Ikenaga, Masakazu; Akiyama, Noriyoshi; Koike, Shoichiro; Koseki, Masato; Saitoh, Toshihiro

2011-01-01

This study was undertaken to evaluate a modified form of Estimation of Physiologic Ability and Surgical Stress (E-PASS) for surgical audit comparing with other existing models. Although several scoring systems have been devised for surgical audit, no nation-wide survey has been performed yet. We modified our previous E-PASS surgical audit system by computing the weights of 41 procedures, using data from 4925 patients who underwent elective digestive surgery, designated it as mE-PASS. Subsequently, a prospective cohort study was conducted in 43 national hospitals in Japan from April 1, 2005, to April 8, 2007. Variables for the E-PASS and American Society of Anesthesiologists (ASA) status-based model were collected for 5272 surgically treated patients. Of the 5272 patients, we also collected data for the Portsmouth modification of Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) in 3128 patients. The area under the receiver operative characteristic curve (AUC) was used to evaluate discrimination performance to detect in-hospital mortality. The ratio of observed to estimated in-hospital mortality rates (OE ratio) was defined as a measure of quality. The numbers of variables required were 10 for E-PASS, 7 for mE-PASS, 20 for P-POSSUM, and 4 for the ASA status-based model. The AUC (95% confidence interval) values were 0.86 (0.79-0.93) for E-PASS, 0.86 (0.79-0.92) for mE-PASS, 0.81 (0.75-0.88) for P-POSSUM, and 0.73 (0.63-0.83) for the ASA status-based model. The OE ratios for mE-PASS among large-volume hospitals significantly correlated with those for E-PASS (R = 0.93, N = 9, P = 0.00026), P-POSSUM (R = 0.96, N = 6, P = 0.0021), and ASA status-based model (R = 0.83, N = 9, P = 0.0051). Because of its features of easy use, accuracy, and generalizability, mE-PASS is a candidate for a nation-wide survey.

Electrical impedance tomography imaging using a priori ultrasound data

Directory of Open Access Journals (Sweden)

Soleimani Manuchehr

2006-02-01

Full Text Available Abstract Background Different imaging systems (e.g. electrical, magnetic, and ultrasound rely on a wide variety of physical properties, and the datasets obtained from such systems provide only partial information about the unknown true state. One approach is to choose complementary imaging systems, and to combine the information to achieve a better representation. Methods This paper discusses the combination of ultrasound and electrical impedance tomography (EIT information. Ultrasound reflection signals are good at locating sharp acoustic density changes associated with the boundaries of objects. Some boundaries, however, may be indeterminable due to masking from intermediate boundaries or because they are outside the ultrasound beam. Conversely, the EIT data contains relatively low-quality information, but it includes the whole region enclosed by the electrodes. Results Results are shown from a narrowband level-set method applied to 2D and 3D EIT incorporating limited angle ultrasound time of flight data. Conclusion The EIT reconstruction is shown to be faster and more accurate using the additional edge information from both one and four transducer ultrasound systems.

Carotid and femoral B-mode ultrasound intima-media thickness measurements in adult post-coarctectomy patients

NARCIS (Netherlands)

Vriend, J. J. W.; de Groot, E.; Kastelein, J. J. P.; Mulder, B. J. M.

2004-01-01

Aim. Cardiovascular and cerebrovascular morbidity and mortality in adult post-coarctectomy patients is increased even after successful surgical repair of the aorta. B-mode ultrasound intima-media thickness (IMT), a validated marker for atherosclerosis and vascular disease risk, was used to measure

Ultrasound guided percutaneous cholecystostomy in high-risk patients for surgical intervention.

Science.gov (United States)

Bakkaloglu, Huseyin; Yanar, Hakan; Guloglu, Recep; Taviloglu, Korhan; Tunca, Fatih; Aksoy, Murat; Ertekin, Cemalettin; Poyanli, Arzu

2006-11-28

To assess the efficacy and safety of ultrasound guided percutaneous cholecystostomy (PC) in the treatment of acute cholecystitis in a well-defined high risk patients under general anesthesia. The data of 27 consecutive patients who underwent percutaneous transhepatic cholecystostomy for the management of acute cholecystitis from January 1999 to June 2003 was retrospectively evaluated. All of the patients had both clinical and sonographic signs of acute cholecystitis and had comorbid diseases. Ultrasound revealed gallbladder stones in 25 patients and acalculous cholecystitis in two patients. Cholecystostomy catheters were removed 14-32 d (mean 23 d) after the procedure in cases where complete regression of all symptoms was achieved. There were statistically significant reductions in leukocytosis, (13.7 x 10(3)+/-1.3 x 10(3) microg/L vs 13 x 10(3)+/-1 x 10(3) microg/L, P extraction was performed successfully with endoscopic retrograde cholangio-pancreatography (ERCP) in three patients. After cholecystostomy, 5 (18%) patients underwent delayed cholecystectomy without any complications. Three out of 22 patients were admitted with recurrent acute cholecystitis during the follow-up and recovered with medical treatment. Catheter dislodgement occurred in three patients spontaneously, and two of them were managed by reinsertion of the catheter. As an alternative to surgery, percutaneous cholecystostomy seems to be a safe method in critically ill patients with acute cholecystitis and can be performed with low mortality and morbidity. Delayed cholecystectomy and ERCP, if needed, can be performed after the acute period has been resolved by percutaneous cholecystostomy.

Impact of ultrasound video transfer on the practice of ultrasound

Science.gov (United States)

Duerinckx, Andre J.; Hayrapetian, Alek S.; Grant, Edward G.; Valentino, Daniel J.; Rahbar, Darius; Kiszonas, Mike; Franco, Ricky; Melany, Michelle; Narin, Sherelle L.; Ragavendra, Nagesh

1996-05-01

Sonography can be highly dependent on real-time imaging and as such is highly physician intensive. Such situations arise mostly during complicated ultrasound radiology studies or echocardiology examinations. Under those circumstances it would be of benefit to transmit real-time images beyond the immediate area of the ultrasound laboratory when a physician is not on location. We undertook this study to determine if both static and dynamic image transfer to remote locations might be accomplished using an ultrafast ATM network and PACS. Image management of the local image files was performed by a commercial PACS from AGFA corporation. The local network was Ethernet based, and the global network was based on Asynchronous Transfer Mode (ATM, rates up to 100 Mbits/sec). Real-time image transfer involved two teaching hospitals, one of which had 2 separate ultrasound facilities. Radiologists consulted with technologists via telephone while the examinations were being performed. The applications of ATM network providing real time video for ultrasound imaging in a clinical environment and its potential impact on health delivery and clinical teaching. This technology increased technologist and physician productivity due to the elimination of commute time for physicians and waiting time for technologists and patients. Physician confidence in diagnosis increased compared to reviewing static images alone. This system provided instant access for radiologists to real-time scans from remote sites. Image quality and frame rate were equivalent to the original. The system increased productivity by allowing physicians to monitor studies at multiple sites simultaneously.

Comparison between transurethral ultrasound and conventional urethrography in male urethral stricture

International Nuclear Information System (INIS)

Fernandez, G. C.; Rivas, C.; Rivas, B.; Perez, M.; Peasqueira, D.; Tardaguila, F.

2001-01-01

To define the role of transurethral ultrasound in the study of male urethral structure. A prospective study was carried out in 19 consecutive patients with male urethral structure, diagnosed by means of conventional urethrography, who subsequently underwent transurethral ultrasound. The latter study consisted of the introduction of a Foley catheter (8 or 10 F) and gradual inflation of the balloon within the navicular fossa. Sterile saline solution was then slowly and continuously infused while the ultrasound was carried out by placing the transducer on the ventral aspect of the penis and in the perineal region to identify the different portions of the urethra. The location and extension of the structure were determined by both radiological techniques, and adjacent areas of fibrosis (spongiofibrosis) were detected by ultrasound. The results correlated with the pathological findings in 10 case. There was good agreement between the two techniques in the localization of the structure (kappa=0.81). However, there were statistically significant differences in the measurements of the extension (p=0.01). Transurethral ultrasound revealed areas of spongiofibrosis adjacent to the structure that presented a different echogenicity. The results of the measurement of their extension were not significantly different from those found in the pathological study. Transurethral ultrasound is more effective than conventional urethrography in the study of urethral structure since it permits the precise measurement and localization of the structure and the visualization of the zone of spongiofibrosis, a determining factor in surgical planning. (Author) 11 refs

Prehospital Ultrasound

Directory of Open Access Journals (Sweden)

Jen-Tang Sun

2014-06-01

Full Text Available Ultrasound is a commonly used diagnostic tool in clinical conditions. With recent developments in technology, use of portable ultrasound devices has become feasible in prehospital settings. Many studies also proved the feasibility and accuracy of prehospital ultrasound. In this article, we focus on the use of prehospital ultrasound, with emphasis on trauma and chest ultrasound.

Prospective validation of a surgical complications grading system in a cohort of 2114 patients.

Science.gov (United States)

Mazeh, Haggi; Cohen, Oded; Mizrahi, Ido; Hamburger, Tamar; Stojadinovic, Alexander; Abu-Wasel, Bassam; Alaiyan, Bilal; Freund, Herbert R; Eid, Ahmed; Nissan, Aviram

2014-05-01

We recently reported a grading system for surgical complications. This system proved to have a high sensitivity for recording minor but meaningful complications prolonging hospital stay in patients after colorectal surgery. We aimed to prospectively validate the complication grading system in a general surgery department over 1 year. All surgical procedures and related complications were prospectively recorded between January 1st and December 31st, 2009. Surgical complications were graded on a severity scale of 1-5. The system classifies short-term outcome by grade emphasizing intensity of therapy required for treatment of the defined complication. During the study period, 2114 patients underwent surgery. Elective and oncological surgeries were performed in 1606 (76%) and 465 (22%) patients, respectively. There were 422 surgical complications in 304 (14%) patients (Grade 1/2: 203 [67%]; Grade 3/4: 90 [29%]; Grade 5: 11 [4%]). Median length of stay correlated significantly with complication severity: 2.3 d for no complication, 6.2 and 11.8 d for Grades 1/2 and 3/4, respectively (P 2 (OR 2.07, P Grade (OR 1.85, P = 0.001), oncological (OR 2.82, P 120 min (OR 2.08, P grading surgical complications permits standardized reporting of surgical morbidity according to the severity of impact. Prospective validation of this system supports its use in a general surgery setting as a tool for surgical outcome assessment and quality assurance. Copyright © 2014 Elsevier Inc. All rights reserved.

Lens subluxation grading system: predictive value for ectopia lentis surgical outcomes

Directory of Open Access Journals (Sweden)

Mauro Waiswol

2009-03-01

Full Text Available Objective: To present a classification system to grade ectopia lentis and to assess its usefulness as a predictor for surgical outcomes. Methods: Fifty-one eyes of 28 patients with either simple (19 patients or Marfan syndrome-associated ectopia lentis (nine patients with variable degrees of subluxation were operated on. Lens subluxation intensity was graded according to the lens subluxation grading system (LSGS from grade 1 (lens on the whole pupillary area up to grade 4 (lens absent from the pupillary area. Thirty eyes underwent cataract extraction (“dry” aspiration with endocapsular ring and in-the-bag intraocular lens (IOL implantation. Twenty-one eyes underwent cataract extraction (“dry” aspiration with scleral fixation of the IOL. The predictive value of the LSGS was assessed by analyzing the post-operative outcomes, including visual acuity (VA, endothelial cell loss, and complications for each grade on the grading system. Rresults: Patients were classified into grade 1 (19.6%, grade 2 (51% and grade 3 (29.4%. Post-operative VA was lower for eyes with larger degrees of subluxation. The higher the subluxation grade, the higher the endothelial cell loss, as well as, the frequency of vitreous loss and surgical time. Higher subluxation grades prevented optimal surgical outcomes with endocapsular ring and in-the-bag IOL implantation. Cconclusions: The LSGS provides an estimate of the surgical success of ectopia lentis. Adequate standardization of lens subluxation is crucial for understanding studies dealing with the surgical correction of this disorder.

Poster - 09: A MATLAB-based Program for Automated Quality Assurance of a Prostate Brachytherapy Ultrasound System

Energy Technology Data Exchange (ETDEWEB)

Poon, Justin; Sabondjian, Eric; Sankreacha, Raxa [University of British Columbia, Dept. of Physics and Astronomy, Vancouver, BC (Canada); Trillium Health Partners – Credit Valley Hospital, Peel Regional Cancer Centre, Mississauga, ON, Trillium Health Partners – Credit Valley Hospital, Peel Regional Cancer Centre, Mississauga, ON, Trillium Health Partners – Credit Valley Hospital, Peel Regional Cancer Centre, Mississauga, ON (Canada); University of Toronto, Dept. of Radiation Oncology, Toronto, ON (Canada)

2016-08-15

Purpose: A robust Quality Assurance (QA) program is essential for prostate brachytherapy ultrasound systems due to the importance of imaging accuracy during treatment and planning. Task Group 128 of the American Association of Physicists in Medicine has recommended a set of QA tests covering grayscale visibility, depth of penetration, axial and lateral resolution, distance measurement, area measurement, volume measurement, and template/electronic grid alignment. Making manual measurements on the ultrasound system can be slow and inaccurate, so a MATLAB program was developed for automation of the described tests. Methods: Test images were acquired using a BK Medical Flex Focus 400 ultrasound scanner and 8848 transducer with the CIRS Brachytherapy QA Phantom – Model 045A. For each test, the program automatically segments the inputted image(s), makes the appropriate measurements, and indicates if the test passed or failed. The program was tested by analyzing two sets of images, where the measurements from the first set were used as baseline values. Results: The program successfully analyzed the images for each test and determined if any action limits were exceeded. All tests passed – the measurements made by the program were consistent and met the requirements outlined by Task Group 128. Conclusions: The MATLAB program we have developed can be used for automated QA of an ultrasound system for prostate brachytherapy. The GUI provides a user-friendly way to analyze images without the need for any manual measurement, potentially removing intra- and inter-user variability for more consistent results.

Poster - 09: A MATLAB-based Program for Automated Quality Assurance of a Prostate Brachytherapy Ultrasound System

International Nuclear Information System (INIS)

Poon, Justin; Sabondjian, Eric; Sankreacha, Raxa

2016-01-01

Purpose: A robust Quality Assurance (QA) program is essential for prostate brachytherapy ultrasound systems due to the importance of imaging accuracy during treatment and planning. Task Group 128 of the American Association of Physicists in Medicine has recommended a set of QA tests covering grayscale visibility, depth of penetration, axial and lateral resolution, distance measurement, area measurement, volume measurement, and template/electronic grid alignment. Making manual measurements on the ultrasound system can be slow and inaccurate, so a MATLAB program was developed for automation of the described tests. Methods: Test images were acquired using a BK Medical Flex Focus 400 ultrasound scanner and 8848 transducer with the CIRS Brachytherapy QA Phantom – Model 045A. For each test, the program automatically segments the inputted image(s), makes the appropriate measurements, and indicates if the test passed or failed. The program was tested by analyzing two sets of images, where the measurements from the first set were used as baseline values. Results: The program successfully analyzed the images for each test and determined if any action limits were exceeded. All tests passed – the measurements made by the program were consistent and met the requirements outlined by Task Group 128. Conclusions: The MATLAB program we have developed can be used for automated QA of an ultrasound system for prostate brachytherapy. The GUI provides a user-friendly way to analyze images without the need for any manual measurement, potentially removing intra- and inter-user variability for more consistent results.

Multiparametric ultrasound in the detection of prostate cancer: a systematic review.

Science.gov (United States)

Postema, Arnoud; Mischi, Massimo; de la Rosette, Jean; Wijkstra, Hessel

2015-11-01

To investigate the advances and clinical results of the different ultrasound modalities and the progress in combining them into multiparametric UltraSound (mpUS). A systematic literature search on mpUS and the different ultrasound modalities included: greyscale ultrasound, computerized transrectal ultrasound, Doppler and power Doppler techniques, dynamic contrast-enhanced ultrasound and (shear wave) elastography. Limited research available on combining ultrasound modalities has presented improvement in diagnostic performance. The data of two studies suggest that even adding a lower performing ultrasound modality to a better performing modality using crude methods can already improve the sensitivity by 13-51 %. The different modalities detect different tumours. No study has tried to combine ultrasound modalities employing a system similar to the PIRADS system used for mpMRI or more advanced classifying algorithms. Available evidence confirms that combining different ultrasound modalities significantly improves diagnostic performance.

Evaluation of a Novel Wireless Transmission System for Trauma Ultrasound Examinations From Moving Ambulances.

Science.gov (United States)

Morchel, Herman; Ogedegbe, Chinwe; Chaplin, William; Cheney, Brianna; Zakharchenko, Svetlana; Misch, David; Schwartz, Matthew; Feldman, Joseph; Kaul, Sanjeev

2018-03-01

To determine if physicians trained in ultrasound interpretation perceive a difference in image quality and usefulness between Extended Focused Assessment with Sonography ultrasound examinations performed at bedside in a hospital vs. by emergency medical technicians minimally trained in medical ultrasound on a moving ambulance and transmitted to the hospital via a novel wireless system. In particular, we sought to demonstrate that useful images could be obtained from patients in less than optimal imaging conditions; that is, while they were in transport. Emergency medical technicians performed the examinations during transport of blunt trauma patients. Upon patient arrival at the hospital, a bedside Extended Focused Assessment with Sonography examination was performed by a physician. Both examinations were recorded and later reviewed by physicians trained in ultrasound interpretation. Data were collected on 20 blunt trauma patients over a period of 13 mo. Twenty ultrasound-trained physicians blindly compared transmitted vs. bedside images using 11 Questionnaire for User Interaction Satisfaction scales. Four paired samples t-tests were conducted to assess mean differences between ratings for ambulatory and base images. Although there is a slight tendency for the average rating across all subjects and raters to be slightly higher in the base than in the ambulatory condition, none of these differences are statistically significant. These results suggest that the quality of the ambulatory images was viewed as essentially as good as the quality of the base images.

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... the ovaries. Transvaginal ultrasound also evaluates the myometrium (muscular walls of the uterus). Sonohysterography allows for a ... and evaluate a variety of urinary and reproductive system disorders in both sexes without x-ray exposure. ...

Peritendinous calcinosis of calcaneus tendon associated with dermatomyositis: correlation between conventional radiograph, ultrasound, magnetic resonance imaging and gross surgical pathology; Calcinose peritendinea do tendao calcaneo associada a dermatomiosite: correlacao entre radiografia convencional, ultra-sonografia, ressonancia magnetica e macroscopia cirurgica

Energy Technology Data Exchange (ETDEWEB)

Rosa, Ana Claudia Ferreira; Gomide, Lidyane Marques de Paula; Lemes, Marcella Stival [Universidade Federal de Goias (UFG), Goiana, GO (Brazil). Faculdade de Medicina. Hospital das Clinicas; Costa, Edegmar Nunes; Rocha, Valney Luiz da [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Ortopedia; Machado, Marcio Martins; Santos Junior, Rubens Carneiro dos; Barros, Nestor de; Cerri, Giovanni Guido [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Radiologia; Sernik, Renato Antonio [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Inst. de Radiologia; Nunes, Rodrigo Alvarenga [Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG (Brazil). Faculdade de Ciencias Medicas; Albieri, Alexandre Daher [Hospital de Acidentados de Goiania, GO (Brazil)

2006-01-15

Interstitial calcinosis is an uncommon condition in which there is either localized or widely disseminated deposition of calcium in the skin, subcutaneous tissues, muscles, and tendons. Calcinosis is often associated with collagen diseases, scleroderma and dermatomyositis. The authors report a case of interstitial calcinosis associated with dermatomyositis studied with conventional radiograph, ultrasound and magnetic resonance imaging, and correlate the imaging findings with the results of surgical pathology gross examination. (author)

Efficacy of Ablation Therapy for Secondary Hyperparathyroidism by Ultrasound Guided Percutaneous Thermoablation.

Science.gov (United States)

Zhao, Junfeng; Qian, Linxue; Zu, Yuan; Wei, Ying; Hu, Xiangdong

2016-05-01

The objective of this study was to explore the value of ultrasound-guided percutaneous microwave thermoablation to treat secondary hyperparathyroidism (SHPT). One hundred and thirty-eight parathyroid glands from 56 patients with SHPT were ablated in this study. All the parathyroid glands were evaluated by real-time contrast-enhanced ultrasound before, during and after ablation. Changes in serum parathyroid hormone (sPTH) levels were measured before treatment and at 1 h, 1 wk, 1 mo and 6 mo after thermoablation treatment. All 56 cases had a 1-mo follow-up, and 34 cases had a 6-mo follow-up. The sPTH level of the 54 cases 1 mo after ablation was significantly lower than that before (p 0.05). Ultrasound-guided percutaneous microwave thermoablation is a feasible and effective non-surgical alternative treatment for SHPT patients. Copyright © 2016. Published by Elsevier Inc.

Ultrasound -- Pelvis

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Full Text Available ... Ultrasound - Pelvis Ultrasound imaging of the pelvis uses sound waves to produce pictures of the structures and ... pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or ...

Prostate Ultrasound

Medline Plus

Full Text Available ... ultrasound or with a rectal examination, an ultrasound-guided biopsy can be performed. This procedure involves advancing ... of the Prostate) Prostate Cancer Ultrasound- and MRI-Guided Prostate Biopsy Images related to Ultrasound - Prostate Sponsored ...

MO-AB-210-02: Ultrasound Imaging and Therapy-Hands On Workshop

International Nuclear Information System (INIS)

Sammet, S.

2015-01-01

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

MO-AB-210-01: Ultrasound Imaging and Therapy-Hands On Workshop

International Nuclear Information System (INIS)

Lu, Z.

2015-01-01

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

MO-AB-210-02: Ultrasound Imaging and Therapy-Hands On Workshop

Energy Technology Data Exchange (ETDEWEB)

Sammet, S. [University of Chicago Medical Center (United States)

2015-06-15

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

MO-AB-210-01: Ultrasound Imaging and Therapy-Hands On Workshop

Energy Technology Data Exchange (ETDEWEB)

Lu, Z. [University of Chicago (United States)

2015-06-15

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

Prostate Ultrasound

Medline Plus

Full Text Available ... Z Ultrasound - Prostate Ultrasound of the prostate uses sound waves to produce pictures of a man’s prostate ... pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or ...

Ultrasound -- Pelvis

Science.gov (United States)

... endometrial polyps fibroids cancer, especially in patients with abnormal uterine bleeding Some physicians also use 3-D ultrasound or ... Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to Ultrasound - Pelvis Sponsored ...

Evaluation of an automated breast 3D-ultrasound system by comparing it with hand-held ultrasound (HHUS) and mammography.

Science.gov (United States)

Golatta, Michael; Baggs, Christina; Schweitzer-Martin, Mirjam; Domschke, Christoph; Schott, Sarah; Harcos, Aba; Scharf, Alexander; Junkermann, Hans; Rauch, Geraldine; Rom, Joachim; Sohn, Christof; Heil, Joerg

2015-04-01

Automated three-dimensional (3D) breast ultrasound (US) systems are meant to overcome the shortcomings of hand-held ultrasound (HHUS). The aim of this study is to analyze and compare clinical performance of an automated 3D-US system by comparing it with HHUS, mammography and the clinical gold standard (defined as the combination of HHUS, mammography and-if indicated-histology). Nine hundred and eighty three patients (=1,966 breasts) were enrolled in this monocentric, explorative and prospective cohort study. All examinations were analyzed blinded to the patients´ history and to the results of the routine imaging. The agreement of automated 3D-US with HHUS, mammography and the gold standard was assessed with kappa statistics. Sensitivity, specificity and positive and negative predictive value were calculated to assess the test performance. Blinded to the results of the gold standard the agreement between automated 3D-US and HHUS or mammography was fair, given by a Kappa coefficient of 0.31 (95% CI [0.26;0.36], p automated 3D-US the sensitivity improved to 84% (NPV = 99%, specificity = 85%). The results of this study let us suggest, that automated 3D-US might be a helpful new tool in breast imaging, especially in screening.

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... endometrial polyps fibroids cancer, especially in patients with abnormal uterine bleeding Some physicians also use 3-D ultrasound or ... Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding Ovarian Cancer Images related to Ultrasound - Pelvis Sponsored ...

Biomedical engineering: A platform for research and innovation in ultrasound

Science.gov (United States)

Holland, Christy K.

2004-05-01

An undergraduate or graduate degree in biomedical engineering prepares students to solve problems at the interface between engineering and medicine. Biomedical engineering encompasses evolving areas such as advanced medical imaging for diagnosis and treatment of disease, tissue engineering for designing and manufacturing biological implants for damaged or diseased tissues and organs, and bioinformatics for determining which genes play a major role in health and disease. Biomedical engineering academic programs produce graduates with the ability to pursue successful careers in the biomedical device industry or to obtain advanced degrees leading to careers in biomedical engineering research, medicine, law or business. Biomedical engineering majors take courses in biology, anatomy, physics, chemistry, engineering, mathematics and medical product design and value life-long learning. Students learn to work effectively in interdisciplinary teams comprised of individuals with diverse social, cultural and technical backgrounds. Biomedical engineering is becoming increasingly important in imaging and image-guided research. Some examples of innovative ultrasound technology under development are ultrasound devices to accelerate the dissolution of blood clots, advanced surgical instruments with ultrasound guidance and ultrasound contrast agents for targeted drug delivery. Biomedical engineering is a great career choice for technically minded individuals who endeavor to work on applied problems that are medically relevant.

GPU-Based Simulation of Ultrasound Imaging Artifacts for Cryosurgery Training

Science.gov (United States)

Keelan, Robert; Shimada, Kenji

2016-01-01

This study presents an efficient computational technique for the simulation of ultrasound imaging artifacts associated with cryosurgery based on nonlinear ray tracing. This study is part of an ongoing effort to develop computerized training tools for cryosurgery, with prostate cryosurgery as a development model. The capability of performing virtual cryosurgical procedures on a variety of test cases is essential for effective surgical training. Simulated ultrasound imaging artifacts include reverberation and reflection of the cryoprobes in the unfrozen tissue, reflections caused by the freezing front, shadowing caused by the frozen region, and tissue property changes in repeated freeze–thaw cycles procedures. The simulated artifacts appear to preserve the key features observed in a clinical setting. This study displays an example of how training may benefit from toggling between the undisturbed ultrasound image, the simulated temperature field, the simulated imaging artifacts, and an augmented hybrid presentation of the temperature field superimposed on the ultrasound image. The proposed method is demonstrated on a graphic processing unit at 100 frames per second, on a mid-range personal workstation, at two orders of magnitude faster than a typical cryoprocedure. This performance is based on computation with C++ accelerated massive parallelism and its interoperability with the DirectX-rendering application programming interface. PMID:26818026

Development and validation of a surgical-pathologic staging and scoring system for cervical cancer.

Science.gov (United States)

Li, Shuang; Li, Xiong; Zhang, Yuan; Zhou, Hang; Tang, Fangxu; Jia, Yao; Hu, Ting; Sun, Haiying; Yang, Ru; Chen, Yile; Cheng, Xiaodong; Lv, Weiguo; Wu, Li; Zhou, Jin; Wang, Shaoshuai; Huang, Kecheng; Wang, Lin; Yao, Yuan; Yang, Qifeng; Yang, Xingsheng; Zhang, Qinghua; Han, Xiaobing; Lin, Zhongqiu; Xing, Hui; Qu, Pengpeng; Cai, Hongbing; Song, Xiaojie; Tian, Xiaoyu; Shen, Jian; Xi, Ling; Li, Kezhen; Deng, Dongrui; Wang, Hui; Wang, Changyu; Wu, Mingfu; Zhu, Tao; Chen, Gang; Gao, Qinglei; Wang, Shixuan; Hu, Junbo; Kong, Beihua; Xie, Xing; Ma, Ding

2016-04-12

Most cervical cancer patients worldwide receive surgical treatments, and yet the current International Federation of Gynecology and Obstetrics (FIGO) staging system do not consider surgical-pathologic data. We propose a more comprehensive and prognostically valuable surgical-pathologic staging and scoring system (SPSs). Records from 4,220 eligible cervical cancer cases (Cohort 1) were screened for surgical-pathologic risk factors. We constructed a surgical-pathologic staging and SPSs, which was subsequently validated in a prospective study of 1,104 cervical cancer patients (Cohort 2). In Cohort 1, seven independent risk factors were associated with patient outcome: lymph node metastasis (LNM), parametrial involvement, histological type, grade, tumor size, stromal invasion, and lymph-vascular space invasion (LVSI). The FIGO staging system was revised and expanded into a surgical-pathologic staging system by including additional criteria of LNM, stromal invasion, and LVSI. LNM was subdivided into three categories based on number and location of metastases. Inclusion of all seven prognostic risk factors improves practical applicability. Patients were stratified into three SPSs risk categories: zero-, low-, and high-score with scores of 0, 1 to 3, and ≥4 (P=1.08E-45; P=6.15E-55). In Cohort 2, 5-year overall survival (OS) and disease-free survival (DFS) outcomes decreased with increased SPSs scores (P=9.04E-15; P=3.23E-16), validating the approach. Surgical-pathologic staging and SPSs show greater homogeneity and discriminatory utility than FIGO staging. Surgical-pathologic staging and SPSs improve characterization of tumor severity and disease invasion, which may more accurately predict outcome and guide postoperative therapy.

Do Robotic Surgical Systems Improve Profit Margins? A Cross-Sectional Analysis of California Hospitals.

Science.gov (United States)

Shih, Ya-Chen Tina; Shen, Chan; Hu, Jim C

2017-09-01

The aim of this study was to examine the association between ownership of robotic surgical systems and hospital profit margins. This study used hospital annual utilization data, annual financial data, and discharge data for year 2011 from the California Office of Statewide Health Planning and Development. We first performed bivariate analysis to compare mean profit margin by hospital and market characteristics and to examine whether these characteristics differed between hospitals that had one or more robotic surgical systems in 2011 and those that did not. We applied the t test and the F test to compare mean profit margin between two groups and among three or more groups, respectively. We then conducted multilevel logistic regression to determine the association between ownership of robotic surgical systems and having a positive profit margin after controlling for other hospital and market characteristics and accounting for possible correlation among hospitals located within the same market. The study sample included 167 California hospitals with valid financial information. Hospitals with robotic surgical systems tended to report more favorable profit margins. However, multilevel logistic regression showed that this relationship (an association, not causality) became only marginally significant (odds ratio [OR] = 6.2; P = 0.053) after controlling for other hospital characteristics, such as ownership type, teaching status, bed size, and surgical volumes, and market characteristics, such as total number of robotic surgical systems owned by other hospitals in the same market area. As robotic surgical systems become widely disseminated, hospital decision makers should carefully evaluate the financial and clinical implications before making a capital investment in this technology. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Surgical neuro navigator guided by preoperative magnetic resonance images, based on a magnetic position sensor;Neuronavegador cirurgico guiado por imagens de ressonancia magnetica pre-operatoria, baseado num transdutor de posicao magnetico

Energy Technology Data Exchange (ETDEWEB)

Perini, Ana Paula; Siqueira, Rogerio Bulha; Carneiro, Antonio Adilton Oliveira, E-mail: adilton@ffclrp.usp.b [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras. Dept. de Fisica e Matematica; Oliveira, Lucas Ferrari de [Universidade Federal de Pelotas (UFPel), RS (Brazil). Dept. de Informatica; Machado, Helio Rubens [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Dept. de Neurocirurgia

2009-08-15

Image guided neurosurgery enables the neurosurgeon to navigate inside the patient's brain using pre-operative images as a guide and a tracking system, during a surgery. Following a calibration procedure, three-dimensional position and orientation of surgical instruments may be transmitted to computer. The spatial information is used to access a region of interest, in the pre-operative images, displaying them to the neurosurgeon during the surgical procedure. However, when a craniotomy is involved and the lesion is removed, movements of brain tissue can be a significant source of error in these conventional navigation systems. The architecture implemented in this work intends the development of a system to surgical planning and orientation guided by ultrasound image. For surgical orientation, the software developed allows the extraction of slices from the volume of the magnetic resonance images (MRI) with orientation supplied by a magnetic position sensor (Polhemus{sup R}). The slices extracted with this software are important because they show the cerebral area that the neurosurgeon is observing during the surgery, and besides they can be correlated with the intra-operative ultrasound images to detect and to correct the deformation of brain tissue during the surgery. Also, a tool for per-operative navigation was developed, providing three orthogonal planes through the image volume. In the methodology used for the software implementation, the Python{sup tm} programming language and the Visualization Toolkit (VTK) graphics library were used. The program to extract slices of the MRI volume allowed the application of transformations in the volume, using coordinates supplied by the position sensor. (author)

Microfocused ultrasound for skin tightening.

Science.gov (United States)

MacGregor, Jennifer L; Tanzi, Elizabeth L

2013-03-01

The demand for noninvasive skin tightening procedures is increasing as patients seek safe and effective alternatives to aesthetic surgical procedures of the face, neck, and body. Over the past decade, radiofrequency and infrared laser devices have been popularized owing to their ability to deliver controlled heat to the dermis, stimulate neocollagenesis, and effect modest tissue tightening with minimal recovery. However, these less invasive approaches are historically associated with inferior efficacy so that surgery still remains the treatment of choice to address moderate to severe tissue laxity. Microfocused ultrasound was recently introduced as a novel energy modality for transcutaneous heat delivery that reaches the deeper subdermal connective tissue in tightly focused zones at consistent programmed depths. The goal is to produce a deeper wound healing response at multiple levels with robust collagen remodeling and a more durable clinical response. The Ulthera device (Ulthera, Inc, Meza, AZ), with refined microfocused ultrasound technology, has been adapted specifically for skin tightening and lifting with little recovery or risk of complications since its introduction in 2009. As clinical parameters are studied and optimized, enhanced efficacy and consistency of clinical improvement is expected.

Usefulness of Ultrasound Examinations in the Diagnostics of Necrotizing Enterocolitis

International Nuclear Information System (INIS)

Staryszak, Joanna; Stopa, Joanna; Kucharska-Miąsik, Iwona; Osuchowska, Magdalena; Guz, Wiesław; Błaż, Witold

2015-01-01

Necrotizing enterocolitis (NEC) is one of the most serious disorders of gastrointestinal tract during neonatal period. Early diagnosis and adequate treatment are essential in the presence of clinical suspicion of NEC. Plain abdominal radiography is currently the modality of choice for initial evaluation of gastrointestinal tract in neonates. However, when the diagnosis is uncertain, abdominal ultrasound with bowel assessment might be an important complementary examination. The aim of the study was to evaluate usefulness of ultrasound in the diagnosis of NEC and its value for implementation of proper treatment. The data of nine neonates diagnosed with NEC, hospitalized at the Provincial Hospital No. 2 in Rzeszow in the period from September 2009 to April 2013 was retrospectively analyzed. Apart from abdominal radiography, abdominal ultrasound with bowel assessment was performed in all nine cases. Imaging findings, epidemiological data, coexisting risk factors and disease course were assessed. Most children in the group were preterm neonates. Findings in plain abdominal radiography were normal or nonspecific. A wider spectrum of findings was demonstrated in all ultrasound examinations and intestinal pneumatosis, a pathognomonic sign for NEC, was more frequently noted than in plain abdominal x-ray. Most children were treated by surgical intervention with resection of necrotic bowel loops and in more than half of the cases location of changes identified during surgery was concordant with ultrasonographic findings. Abdominal ultrasound examination might be helpful in the diagnosis of NEC, especially when plain abdominal radiography findings do not correlate with clinical symptoms. However, abdominal radiography is still considered the modality of choice. The range of morphological changes detectable on ultrasound examination is much wider than in plain abdominal radiography. Ultrasound examination allows for more accurate assessment of changes within intestines and

Ultrasound cavitation versus cryolipolysis for non-invasive body contouring.

Science.gov (United States)

Mahmoud ELdesoky, Mohamed Taher; Mohamed Abutaleb, Enas ELsayed; Mohamed Mousa, Gihan Samir

2015-08-24

The demand for non-surgical and non-invasive devices is continuous and increasing. Such devices have gradually gained ground in the reduction of localised fat and the improvement of body contouring. The study aimed to compare the effects of ultrasound cavitation and cryolipolysis on localised abdominal fat. In total, 60 participants with a body mass index (BMI) over 30 kg/m 2 , whose age ranged between 25 and 45 years, were included. The participants were randomly assigned to three groups of 20 each, using ultrasound cavitation and diet, cryolipolysis and diet, and diet only (the control group), respectively. Measures were bodyweight, BMI, waist circumference and suprailiac skinfold were measured at the beginning of the study and 2 months later. The three groups showed significant improvements in all measured variables after 2 months. There was no statistically significant difference in bodyweight or in BMI among the groups after treatment. However, the groups using ultrasound cavitation and cryolipolysis showed better post-treatment improvement than the diet-only group in waist circumference and suprailiac skinfold. There was no statistically significant difference post-treatment between the cavitation and cryolipolysis groups in waist circumference or suprailiac skinfold. Both ultrasound cavitation and cryolipolysis are safe and effective for the reduction of abdominal fat thickness and for abdominal contouring. © 2015 The Australasian College of Dermatologists.

Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.

Science.gov (United States)

Kuo, Calvin C; Robb, William J

2013-06-01

The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE(®) database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.

Prospective utility of therapeutic ultrasound in dentistry-Review with recent comprehensive update

Directory of Open Access Journals (Sweden)

Shalu Rai

2012-01-01

Full Text Available Background: The utility of ultrasound (US for therapeutic purposes is still in its infancy. Therapeutic US (TUS has been used widely in medical field for urological application, surgical intervention, bone healing, and osteointegration in cancer and healing of full thickness excised skin lesions, and within dentistry as a prediagnostic, diagnostic and therapeutic purpose. The purpose of the paper is to review and determine the efficacy of US as one of the treatment modalities for its role in maxillofacial region to reduce pain and promote soft tissue healing. Materials and Methods: A Medline search included of the international literature published between 1976 and 2011 and was restricted to English language articles, published work of past researchers including in vitro and in vivo studies, recent additions of textbooks on surgical and therapeutic applications of US and, current articles in conference papers and reports accessed from the internet using Google search engine on therapeutic ultrasound. Results: Very few article regarding effect of therapeutic of US for its use of insonation for treatment of patient with pain and soft tissue injury are available. This review article mainly emphasizes the therapeutic utility of US in dentistry for its effectiveness to decrease joint stiffness, reduce pain and muscle spasms and improve muscle mobility. In vivo studies have shown very little clinical effects. Conclusions: Further research is warranted in this clinically important area to make the development of noninvasive, multifunctional ultrasound devices for repair, regeneration and other therapeutic utility a success.

Therapeutic Ultrasound Bypasses Canonical Syndecan-4 Signaling to Activate Rac1*S⃞

Science.gov (United States)

Mahoney, Claire M.; Morgan, Mark R.; Harrison, Andrew; Humphries, Martin J.; Bass, Mark D.

2009-01-01

The application of pulsed, low intensity ultrasound is emerging as a potent therapy for the treatment of complex bone fractures and tissue damage. Ultrasonic stimuli accelerate fracture healing by up to 40% and enhance tendon and ligament healing by promoting cell proliferation, migration, and matrix synthesis through an unresolved mechanism. Ultrasound treatment also induces closure of nonunion fractures, at a success rate (85% of cases) similar to that of surgical intervention (68-96%) while avoiding the complications associated with surgery. The regulation of cell adhesion necessary for wound healing depends on cooperative engagement of the extracellular matrix receptors, integrin and syndecan, as exemplified by the wound healing defects observed in syndecan- and integrin-knock-out mice. This report distinguishes the influence of ultrasound on signals downstream of the prototypic fibronectin receptors, α5β1 integrin and syndecan-4, which cooperate to regulate Rac1 and RhoA. Ultrasonic stimulation fails to activate integrins or induce cell spreading on poor, electrostatic ligands. By contrast, ultrasound treatment overcomes the necessity of engagement or expression of syndecan-4 during the process of focal adhesion formation, which normally requires simultaneous engagement of both receptors. Ultrasound exerts an influence downstream of syndecan-4 and PKCα to specifically activate Rac1, itself a critical regulator of tissue repair, and to a lesser extent RhoA. The ability of ultrasound to bypass syndecan-4 signaling, which is known to facilitate efficient tissue repair, explains the reduction in healing times observed in ultrasound-treated patients. By substituting for one of the key axes of adhesion-dependent signaling, ultrasound therapy has considerable potential as a clinical technique. PMID:19147498

Intraoperative ultrasound in colorectal surgery.

Science.gov (United States)

Greif, Franklin; Aranovich, David; Hananel, Nissim; Knizhnik, Mikhail; Belenky, Alexander

2009-09-01

To assess the accuracy of intraoperative ultrasound (IOUS) as a localizing technique for colorectal resections, and its impact on surgical management. Twenty-five patients (15 men and 10 women; mean age, 74.4 years) with early cancers (p T1), or polyps, not amenable to endoscopic removal were selected. IOUS was used as a sole method of intraoperative localization. Its performance was evaluated through review of preoperative colonoscopy reports, intraoperative findings, histopathology reports, and clinical follow-up. The lesions were situated in the cecum (n = 5), ascending colon (n = 3), transverse colon (n = 4), descending colon (n = 7), and rectum (n = 6). IOUS technique allowed correct localization in 24 of 25 patients, visualization of the bowel wall, and its penetration by malignant tumors. In rectal lesions, IOUS showed clearly the tumor and its margin, which facilitated performance sphincter-sparing procedure. In patients with small polyps and early cancers of colon and rectum, IOUS may be effectively used as a sole method of intraoperative localization and provide additional information that may alter decision making with regard to surgical technique. (c) 2009 Wiley Periodicals, Inc.

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... Radiation Therapy for Gynecologic Cancers Radiation Therapy for Prostate Cancer top of page This page was reviewed on ... Abdomen Children's (Pediatric) Ultrasound - Abdomen Obstetric Ultrasound Ultrasound - Prostate Kidney and Bladder Stones Abnormal Vaginal Bleeding ... Images related to Ultrasound - Pelvis Sponsored by Please ...

Point-of-care Ultrasound Detection of Endophthalmitis

Directory of Open Access Journals (Sweden)

James Tucker

2018-01-01

Full Text Available History of present illness: A 59-year-old woman presented to the emergency department (ED with right eye pain. She had a history of cataract surgery in the right eye three months prior. The patient was seen at an outside ED eight days prior and reportedly had normal vision, normal eye pressures, with a large corneal ulcer and hypopyon in the anterior chamber. She was given subconjunctival injections of antibiotics and discharged with antibiotic drops. She was seen by a retina specialist the next day and had no evidence of endophthalmitis. On her second ED presentation, she had worsening right eye pain. Workup included normal intraocular pressures bilaterally and visual acuity with only light-perception in the affected eye. An ultrasound of her right eye was performed and is shown in figures 1 and 2. Significant findings: The patient’s ultrasound revealed an attached retina and a complex network of hyperechoic, mobile, membranous material in the posterior segment. Discussion: Endophthalmitis is a bacterial or fungal infection inside the vitreous and/or aqueous humors. The classic presentation is painful vision loss in a patient with recent ophthalmologic surgical intervention, an immunocompromised patient, or a septic patient. The specific bacteria or fungus causing the infection will vary depending on the reason for infection (post-surgical vs sepsis. Ultrasound findings typically include low amplitude mobile echoes, vitreous membranes, and thickening of the retina and choroid.1 Treatment for endophthalmitis includes direct, intraocular antibiotic injections by an ophthalmologist; hence, disposition for these patients would include admission for ophthalmology consultation. If there is a blood source of infection rather than a direct ocular inoculation, IV antibiotics should be initiated. Patients should also receive tetanus vaccination if tetanus status is outdated. In this case, the patient was diagnosed with endophthalmitis of the right eye

Enhanced ultrasound for advanced diagnostics, ultrasound tomography for volume limb imaging and prosthetic fitting

Science.gov (United States)

Anthony, Brian W.

2016-04-01

Ultrasound imaging methods hold the potential to deliver low-cost, high-resolution, operator-independent and nonionizing imaging systems - such systems couple appropriate algorithms with imaging devices and techniques. The increasing demands on general practitioners motivate us to develop more usable and productive diagnostic imaging equipment. Ultrasound, specifically freehand ultrasound, is a low cost and safe medical imaging technique. It doesn't expose a patient to ionizing radiation. Its safety and versatility make it very well suited for the increasing demands on general practitioners, or for providing improved medical care in rural regions or the developing world. However it typically suffers from sonographer variability; we will discuss techniques to address user variability. We also discuss our work to combine cylindrical scanning systems with state of the art inversion algorithms to deliver ultrasound systems for imaging and quantifying limbs in 3-D in vivo. Such systems have the potential to track the progression of limb health at a low cost and without radiation exposure, as well as, improve prosthetic socket fitting. Current methods of prosthetic socket fabrication remain subjective and ineffective at creating an interface to the human body that is both comfortable and functional. Though there has been recent success using methods like magnetic resonance imaging and biomechanical modeling, a low-cost, streamlined, and quantitative process for prosthetic cup design and fabrication has not been fully demonstrated. Medical ultrasonography may inform the design process of prosthetic sockets in a more objective manner. This keynote talk presents the results of progress in this area.

Trends in the Surgical Correction of Gynecomastia.

Science.gov (United States)

Brown, Rodger H; Chang, Daniel K; Siy, Richard; Friedman, Jeffrey

2015-05-01

Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited in their inability to address significant skin excess and ptosis. For mild to moderate gynecomastia, newer techniques using arthroscopic morcellation and endoscopic techniques promise to address the fibrous component, while minimizing scar burden by utilizing liposuction incisions. Nevertheless, direct excision through periareolar incisions remains a mainstay in treatment algorithms for its simplicity and avoidance of additional instrumentation. This is particularly true for more severe cases of gynecomastia requiring skin resection. In the most severe cases with significant skin redundancy and ptosis, breast amputation with free nipple grafting remains an effective option. Surgical treatment should be individualized to each patient, combining techniques to provide adequate resection and optimize aesthetic results.

Interobserver variability of ultrasound elastography and the ultrasound BI-RADS lexicon of breast lesions.

Science.gov (United States)

Park, Chang Suk; Kim, Sung Hun; Jung, Na Young; Choi, Jae Jung; Kang, Bong Joo; Jung, Hyun Seouk

2015-03-01

Elastographpy is a newly developed noninvasive imaging technique that uses ultrasound (US) to evaluate tissue stiffness. The interpretation of the same elastographic images may be variable according to reviewers. Because breast lesions are usually reported according to American College of Radiology Breast Imaging and Data System (ACR BI-RADS) lexicons and final category, we tried to compare observer variability between lexicons and final categorization of US BI-RADS and the elasticity score of US elastography. From April 2009 to February 2010, 1356 breast lesions in 1330 patients underwent ultrasound-guided core biopsy. Among them, 63 breast lesions in 55 patients (mean age, 45.7 years; range, 21-79 years) underwent both conventional ultrasound and elastography and were included in this study. Two radiologists independently performed conventional ultrasound and elastography, and another three observers reviewed conventional ultrasound images and elastography videos. Observers independently recorded the elasticity score for a 5-point scoring system proposed by Itoh et al., BI-RADS lexicons and final category using ultrasound BI-RADS. The histopathologic results were obtained and used as the reference standard. Interobserver variability was evaluated. Of the 63 lesions, 42 (66.7 %) were benign, and 21 (33.3 %) were malignant. The highest value of concordance among all variables was achieved for the elasticity score (k = 0.59), followed by shape (k = 0.54), final category (k = 0.48), posterior acoustic features (k = 0.44), echogenecity and orientation (k = 0.43). The least concordances were margin (k = 0.26), lesion boundary (k = 0.29) and calcification (k = 0.3). Elasticity score showed a higher level of interobserver agreement for the diagnosis of breast lesions than BI-RADS lexicons and final category.

Ultrasound-Guided Drainage of Supralevator Hematoma in a Hemodynamically Stable Patient.

Science.gov (United States)

Mukhopadhyay, Debjani; Jennings, Paul E; Banerjee, Mamta; Gada, Ruta

2015-12-01

Paravaginal hematomas can be life-threatening. In patients with intact vaginal walls and perineum, they may pose a diagnostic and therapeutic challenge. Supralevator hematomas are much less common than infralevator hematomas. We present a case of puerperal hemorrhagic shock after a normal vaginal delivery in a low-risk parous woman resulting from an occult supralevator hematoma. Because the woman was hemodynamically unstable initially, she underwent a vaginal surgical drainage. A week later, the supravaginal hematoma reformed. At this time the patient was hemodynamically stable, and ultrasound-guided drainage was performed, which resulted in complete resolution of the hematoma within 10 days. In a clinically stable puerperal patient, ultrasound-guided drainage of a supralevator hematoma resulted in rapid and complete resolution of symptoms.

Development of surgical CW Nd:YAG laser with optical fiber delivery system

International Nuclear Information System (INIS)

Kim, Cheol Jung; Kim, Jeong Mook; Jung, Chin Mann; Kim, Kwang Suk; Kim, Min Suk; Cho, Jae Wan; Kim, Duk Hyun

1992-06-01

We developed a surgical CW Nd:YAG laser with optical fiber delivery system. Several commercial models have been investigated in design and performance. We improved its quality to the level of commercial Nd:YAG laser by an endurance test for each parts of laser system. The maximum power of our surgical laser was 150 W and the laser pulse width could be controlled to 99 sec continuously by 0.1 sec. Many optical parts were localized and lowered much in cost. Only few parts were imported and almost 90% in cost were localized. Also, to find out the maintenance problem of this surgical laser, it was applicated to the production line of our joint company. (Author)

Novel power MOSFET-based expander for high frequency ultrasound systems.

Science.gov (United States)

Choi, Hojong; Shung, K Kirk

2014-01-01

The function of an expander is to obstruct the noise signal transmitted by the pulser so that it does not pass into the transducer or receive electronics, where it can produce undesirable ring-down in an ultrasound imaging application. The most common type is a diode-based expander, which is essentially a simple diode-pair, is widely used in pulse-echo measurements and imaging applications because of its simple architecture. However, diode-based expanders may degrade the performance of ultrasonic transducers and electronic components on the receiving and transmitting sides of the ultrasound systems, respectively. Since they are non-linear devices, they cause excessive signal attenuation and noise at higher frequencies and voltages. In this paper, a new type of expander that utilizes power MOSFET components, which we call a power MOSFET-based expander, is introduced and evaluated for use in high frequency ultrasound imaging systems. The performance of a power MOSFET-based expander was evaluated relative to a diode-based expander by comparing the noise figure (NF), insertion loss (IL), total harmonic distortion (THD), response time (RT), electrical impedance (EI) and dynamic power consumption (DPC). The results showed that the power MOSFET-based expander provided better NF (0.76 dB), IL (-0.3 dB) and THD (-62.9 dB), and faster RT (82 ns) than did the diode-based expander (NF (2.6 dB), IL (-1.4 dB), THD (-56.0 dB) and RT (119 ns)) at 70 MHz. The -6 dB bandwidth and the peak-to-peak voltage of the echo signal received by the transducer using the power MOSFET-based expander improved by 17.4% and 240% compared to the diode-based expander, respectively. The new power MOSFET-based expander was shown to yield lower NF, IL and THD, faster RT and lower ring down than the diode-based expander at the expense of higher dynamic power consumption. Copyright © 2013 Elsevier B.V. All rights reserved.

Application of a drug delivery system using ultrasound and nano/microbubbles for anti-angiogenic therapy

International Nuclear Information System (INIS)

Horie, Sachiko; Kodama, Tetsuya; Sato, Yasushi

2017-01-01

The drug delivery system using ultrasound and nano/microbubbles is a molecular delivery approach using the mechanism of sonoporation. With sonoporation, an endothelium-derived negative-feedback regulator of angiogenesis, Vasohibin-1 (VASH1), was introduced specifically into tumor vessels. We found VASH1 in tumor vessels induce normalization of tumor vessels and inhibited tumor growth. A recent topic regarding tumor angiogenesis is vascular normalization. Tumor vessels are abnormal or immature that cause hyperpermeability and impaired blood flow. Tumor vascular normalization improves blood flow and tissue hypoxia, which increase the effectiveness of chemotherapy and radiotherapy and reduce tumor cell malignancy. In this review, application of drug delivery system using ultrasound for an anti-angiogenic therapy, a tumor vessel normalization therapy to treat cancer, is summarized. (author)

System Level Design of a Continuous-Time Delta-Sigma Modulator for Portable Ultrasound Scanners

DEFF Research Database (Denmark)

Llimos Muntal, Pere; Færch, Kjartan; Jørgensen, Ivan Harald Holger

2015-01-01

In this paper the system level design of a continuous-time ∆Σ modulator for portable ultrasound scanners is presented. The overall required signal-to-noise ratio (SNR) is derived to be 42 dB and the sampling frequency used is 320 MHz for an oversampling ratio of 16. In order to match these requir......, based on high-level VerilogA simulations, the performance of the ∆Σ modulator versus various block performance parameters is presented as trade-off curves. Based on these results, the block specifications are derived.......In this paper the system level design of a continuous-time ∆Σ modulator for portable ultrasound scanners is presented. The overall required signal-to-noise ratio (SNR) is derived to be 42 dB and the sampling frequency used is 320 MHz for an oversampling ratio of 16. In order to match...

General Ultrasound Imaging

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Full Text Available ... inserted into a man's rectum to view the prostate. Transvaginal ultrasound. The transducer is inserted into a ... Stenting Ultrasound-Guided Breast Biopsy Obstetric Ultrasound Ultrasound - Prostate Biopsies - Overview Images related to General Ultrasound Videos ...

General Ultrasound Imaging

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Full Text Available ... News Physician Resources Professions Site Index A-Z General Ultrasound Ultrasound imaging uses sound waves to produce ... the limitations of General Ultrasound Imaging? What is General Ultrasound Imaging? Ultrasound is safe and painless, and ...

Intraluminal laser atherectomy with ultrasound and electromagnetic guidance

Science.gov (United States)

Gregory, Kenton W.; Aretz, H. Thomas; Martinelli, Michael A.; LeDet, Earl G.; Hatch, G. F.; Gregg, Richard E.; Sedlacek, Tomas; Haase, Wayne C.

1991-05-01

The MagellanTM coronary laser atherectomy system is described. It uses high- resolution ultrasound imaging and electromagnetic sensing to provide real-time guidance and control of laser therapy in the coronary arteries. The system consists of a flexible catheter, an electromagnetic navigation antenna, a sensor signal processor and a computer for image processing and display. The small, flexible catheter combines an ultrasound transducer and laser delivery optics, aimed at the artery wall, and an electromagnetic receiving sensor. An extra-corporeal electromagnetic transmit antenna, in combination with catheter sensors, locates the position of the ultrasound and laser beams in the artery. Navigation and ultrasound data are processed electronically to produce real-time, transverse, and axial cross-section images of the artery wall at selected locations. By exploiting the ability of ultrasound to image beneath the surface of artery walls, it is possible to identify candidate treatment sites and perform safe radial laser debulking of atherosclerotic plaque with reduced danger of perforation. The utility of the system in plaque identification and ablation is demonstrated with imaging and experimental results.

Rotational multispectral fluorescence lifetime imaging and intravascular ultrasound: bimodal system for intravascular applications

Science.gov (United States)

Ma, Dinglong; Bec, Julien; Yankelevich, Diego R.; Gorpas, Dimitris; Fatakdawala, Hussain; Marcu, Laura

2014-01-01

Abstract. We report the development and validation of a hybrid intravascular diagnostic system combining multispectral fluorescence lifetime imaging (FLIm) and intravascular ultrasound (IVUS) for cardiovascular imaging applications. A prototype FLIm system based on fluorescence pulse sampling technique providing information on artery biochemical composition was integrated with a commercial IVUS system providing information on artery morphology. A customized 3-Fr bimodal catheter combining a rotational side-view fiberoptic and a 40-MHz IVUS transducer was constructed for sequential helical scanning (rotation and pullback) of tubular structures. Validation of this bimodal approach was conducted in pig heart coronary arteries. Spatial resolution, fluorescence detection efficiency, pulse broadening effect, and lifetime measurement variability of the FLIm system were systematically evaluated. Current results show that this system is capable of temporarily resolving the fluorescence emission simultaneously in multiple spectral channels in a single pullback sequence. Accurate measurements of fluorescence decay characteristics from arterial segments can be obtained rapidly (e.g., 20 mm in 5 s), and accurate co-registration of fluorescence and ultrasound features can be achieved. The current finding demonstrates the compatibility of FLIm instrumentation with in vivo clinical investigations and its potential to complement conventional IVUS during catheterization procedures. PMID:24898604

Optimization of surgical treatment of cataract in patients with diabetes mellitus

Directory of Open Access Journals (Sweden)

Dmitriy Valentinovich Lipatov

2010-06-01

Full Text Available Aim. To compare different methods for surgical treatment of cataract in patients with diabetes melli-tus (DM and substantiate the choice of its optimalmodality. Materials and methods. Analysis included data on 209 patients (221 eyes treated from January 2008 to December 2009 in the Department ofRetinopathy and Ophthalmosurgey, Endocrinological Research Centre. Diabetic cataract was managed using UNIVERSAL-II, LEGACY EVEREST,and INFINITI phacoemulsifiers. Parameters studied included time of ultrasound (US ex-posure, US power, and retinal characteristics in the earlypostoperative period. In addition, analysis included data on the location of lens opacity in 1047 patients (1897 eyes with diabetic cataract. Results. Relatively low corrected and uncorrected visual acuity in the early postoperative period was attributable to concomitant DM-related retinalpathology. Analysis of lenticular opacity showed that it in the first place affected collagen fibers beneath the posterior capsule. The use of torsional USin INFINITI for cataract phacoemulsification produced almost 4-fold reduction in the exposure time of ocular tissues. As a result, the postoperativeoedema was significantly smaller than in patients undergoing combined treatment (AQUALASE hydromonitoring and OZIL ultrasound system. Conclusion. Combination of ultrasound and hydromonitoring phacoemulsification for the treatment of cataract in DM patients reduces exposure timeof ocular tissues and postoperative oedema which creates prerequisites for faster recovery of visual acuity after surgery. Functional results of surgicaltreatment of diabetic cataract can be further improved by early diagnosis of lens opacity and the use of US and hydromonitoring phacoemulsificationtechniques.

Surgical scheduling categorization system (SSCS): A novel classification system to improve coordination and scheduling of operative cases in a tertiary pediatric medical system.

Science.gov (United States)

Gantwerker, Eric A; Bannos, Cassandra; Cunningham, Michael J; Rahbar, Reza

2017-01-01

To describe a surgical categorization system to create a universal nomenclature, delineating patient complexity as a first step toward developing a true risk stratification system. Retrospective database review of all otolaryngology surgical procedures performed in a tertiary pediatric hospital system over one academic year (July 2012-June 2013). All otolaryngology surgical procedures were reviewed, encompassing 8478 procedures on 5711 patients. The attending otolaryngologist assigned surgical scheduling category (SSCS) at the time of case booking based on an institution specific guidelines. The guidelines are as follow: Category I was assigned to American Society of Anesthesiologists physical status classification (ASA) I/II patients, designating them appropriate for institution's suburban ambulatory surgery centers; Category II was ASA I/II patients with social or transportation issues; Category III was ASA I/II patients who required case coordination with other medical or surgical departments; Category IV was reserved for patients of any ASA class whom the surgeon designated to be of a higher complexity. 8478 total procedures analyzed with 7198 having complete records. 48% were Category I, 13.6% were Category II, 1.9% were Category III and 36.5% were Category IV. The ASA were 34.7% ASA I, 50% ASA II, 13.39% ASA III, and 1.9% ASA IV. Although the largest proportion of patients were ASA II (50%), 39.6% of all ASA II were Category IV. Category IV was split into 54.2% ASA II and 34% ASA III and shows that peri-operative surgical concerns were not encompassed by the ASA system. This surgical categorization system streamlines surgical scheduling in a tertiary pediatric hospital system, particularly with respect to the designation of cases as ambulatory surgery center or main operating room appropriate. The case mix complexity is also readily apparent, enhancing recognition of the coordination and attention required for the perioperative management of high complexity

WE-AB-206-01: Diagnostic Ultrasound Imaging Quality Assurance

Energy Technology Data Exchange (ETDEWEB)

Zagzebski, J. [University of Wisconsin (United States)

2016-06-15

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.

WE-AB-206-01: Diagnostic Ultrasound Imaging Quality Assurance

International Nuclear Information System (INIS)

Zagzebski, J.

2016-01-01

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.

Unusual presentation of antenatal ovarian torsion: free-floating abdominal cysts. Our experience and surgical management.

Science.gov (United States)

Zampieri, Nicola; Scirè, Gabriella; Zambon, Carla; Ottolenghi, Alberto; Camoglio, Francesco Saverio

2009-04-01

Abdominal cystic formations in newborns are relatively common and often diagnostic suspicion arises before birth as a result of ultrasound scans carried out during pregnancy. Prenatal ovarian torsion is a rare condition very difficult to manage in the first days of life. We report and discuss the management of prenatal ovarian torsion with a free-floating abdominal cyst detected on prenatal ultrasound. We recorded the cases of antenatal abdominal cysts detected on ultrasound at the Department of Antenatal Diagnosis between January 2003 and January 2007. Only patients with a free-floating cyst were included in the study. Clinical and surgical findings were then recorded. Two out of 57 patients underwent surgery for a free-floating abdominal cyst during the second day of life. Postnatal ultrasound, Doppler ultrasound, and laparoscopic exploration were useful to identify an unusual presentation of antenatal ovarian torsion with a complete atresia of the Fallopian tube. The cases reported in this study suggest that a good clinical approach to all cases of abdominal cysts detected on prenatal ultrasound scans require postnatal Doppler and abdominal ultrasound with a laparoscopic exploration. Free-floating abdominal cysts are rare but, at the same time, strictly correlated with autoamputation of the ovary/Fallopian tube complex.

Making surgical missions a joint operation: NGO experiences of visiting surgical teams and the formal health care system in Guatemala.

Science.gov (United States)

Roche, Stephanie; Hall-Clifford, Rachel

2015-01-01

Each year, thousands of Guatemalans receive non-emergent surgical care from short-term medical missions (STMMs) hosted by local non-governmental organizations (NGOs) and staffed by foreign visiting medical teams (VMTs). The purpose of this study was to explore the perspectives of individuals based in NGOs involved in the coordination of surgical missions to better understand how these missions articulate with the larger Guatemalan health care system. During the summers of 2011 and 2013, in-depth interviews were conducted with 25 representatives from 11 different Guatemalan NGOs with experience with surgical missions. Transcripts were analysed for major themes using an inductive qualitative data analysis process. NGOs made use of the formal health care system but were limited by several factors, including cost, issues of trust and current ministry of health policy. Participants viewed the government health care system as a potential resource and expressed a desire for more collaboration. The current practices of STMMs are not conducive to health system strengthening. The role of STMMs must be defined and widely understood by all stakeholders in order to improve patient safety and effectively utilise health resources. Priority should be placed on aligning the work of VMTs with that of the larger health care system.

MO-AB-210-03: Workshop [Advancements in high intensity focused ultrasound

Energy Technology Data Exchange (ETDEWEB)

Lu, Z. [University of Chicago (United States)

2015-06-15

The goal of this ultrasound hands-on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound. HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well-defined regions of necrosis. This completely non-invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands-on demonstrations with on-site instructors at separate stations. The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations of the techniques. Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high-intensity focused ultrasound and in diagnostic ultrasound QC. Learning Objectives: Learn ultrasound physics and safety for HIFU applications through live demonstrations Get an overview of the state-of-the art in HIFU technologies and equipment Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools List of supporting vendors for HIFU and diagnostic ultrasound QC hands-on workshop: Philips Healthcare Alpinion Medical Systems Verasonics, Inc Zonare Medical Systems, Inc Computerized Imaging Reference Systems (CIRS), Inc. GAMMEX, Inc., Cablon Medical BV Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS

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.

Development of ClearPEM-Sonic, a multimodal mammography system for PET and Ultrasound

Science.gov (United States)

Cucciati, G.; Auffray, E.; Bugalho, R.; Cao, L.; Di Vara, N.; Farina, F.; Felix, N.; Frisch, B.; Ghezzi, A.; Juhan, V.; Jun, D.; Lasaygues, P.; Lecoq, P.; Mensah, S.; Mundler, O.; Neves, J.; Paganoni, M.; Peter, J.; Pizzichemi, M.; Siles, P.; Silva, J. C.; Silva, R.; Tavernier, S.; Tessonnier, L.; Varela, J.

2014-03-01

ClearPEM-Sonic is an innovative imaging device specifically developed for breast cancer. The possibility to work in PEM-Ultrasound multimodality allows to obtain metabolic and morphological information increasing the specificity of the exam. The ClearPEM detector is developed to maximize the sensitivity and the spatial resolution as compared to Whole-Body PET scanners. It is coupled with a 3D ultrasound system, the SuperSonic Imagine Aixplorer that improves the specificity of the exam by providing a tissue elasticity map. This work describes the ClearPEM-Sonic project focusing on the technological developments it has required, the technical merits (and limits) and the first multimodal images acquired on a dedicated phantom. It finally presents selected clinical case studies that confirm the value of PEM information.

Development of ClearPEM-Sonic, a multimodal mammography system for PET and Ultrasound

International Nuclear Information System (INIS)

Cucciati, G; Vara, N Di; Ghezzi, A; Paganoni, M; Pizzichemi, M; Auffray, E; Frisch, B; Lecoq, P; Bugalho, R; Neves, J; Cao, L; Peter, J; Farina, F; Felix, N; Juhan, V; Mundler, O; Siles, P; Jun, D; Lasaygues, P; Mensah, S

2014-01-01

ClearPEM-Sonic is an innovative imaging device specifically developed for breast cancer. The possibility to work in PEM-Ultrasound multimodality allows to obtain metabolic and morphological information increasing the specificity of the exam. The ClearPEM detector is developed to maximize the sensitivity and the spatial resolution as compared to Whole-Body PET scanners. It is coupled with a 3D ultrasound system, the SuperSonic Imagine Aixplorer that improves the specificity of the exam by providing a tissue elasticity map. This work describes the ClearPEM-Sonic project focusing on the technological developments it has required, the technical merits (and limits) and the first multimodal images acquired on a dedicated phantom. It finally presents selected clinical case studies that confirm the value of PEM information

Ultrasound mediated nanoparticle drug delivery

Science.gov (United States)

Mullin, Lee B.

Ultrasound is not only a powerful diagnostic tool, but also a promising therapeutic technology that can be used to improve localized drug delivery. Microbubble contrast agents are micron sized encapsulated gas filled bubbles that are administered intravenously. Originally developed to enhance ultrasound images, microbubbles are highly echogenic due to the gas core that provides a detectable impedance difference from the surrounding medium. The core also allows for controlled response of the microbubbles to ultrasound pulses. Microbubbles can be pushed using acoustic radiation force and ruptured using high pressures. Destruction of microbubbles can increase permeability at the cellular and vascular level, which can be advantageous for drug delivery. Advances in drug delivery methods have been seen with the introduction of nanoparticles, nanometer sized objects often carrying a drug payload. In chemotherapy, nanoparticles can deliver drugs to tumors while limiting systemic exposure due to abnormalities in tumor vasculature such large gaps between endothelial cells that allow nanoparticles to enter into the interstitial space; this is referred to as the enhanced permeability and retention (EPR) effect. However, this effect may be overestimated in many tumors. Additionally, only a small percentage of the injected dose accumulates in the tumor, which most the nanoparticles accumulating in the liver and spleen. It is hypothesized that combining the acoustic activity of an ultrasound contrast agent with the high payload and extravasation ability of a nanoparticle, localized delivery to the tumor with reduced systemic toxicity can be achieved. This method can be accomplished by either loading nanoparticles onto the shell of the microbubble or through a coadministration method of both nanoparticles and microbubbles. The work presented in this dissertation utilizes novel and commercial nanoparticle formulations, combined with microbubbles and a variety of ultrasound systems

Ultrasound -- Pelvis

Medline Plus

Full Text Available ... ultrasound exams are also used to monitor the health and development of an embryo or fetus during pregnancy. See the ... can help to identify and evaluate a variety of urinary and reproductive system disorders in both sexes without x-ray exposure. ...

Prostate Ultrasound

Medline Plus

Full Text Available ... through blood vessels. Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. Prostate ultrasound, also called transrectal ultrasound, provides ...

A multicenter hospital-based diagnosis study of automated breast ultrasound system in detecting breast cancer among Chinese women.

Science.gov (United States)

Zhang, Xi; Lin, Xi; Tan, Yanjuan; Zhu, Ying; Wang, Hui; Feng, Ruimei; Tang, Guoxue; Zhou, Xiang; Li, Anhua; Qiao, Youlin

2018-04-01

The automated breast ultrasound system (ABUS) is a potential method for breast cancer detection; however, its diagnostic performance remains unclear. We conducted a hospital-based multicenter diagnostic study to evaluate the clinical performance of the ABUS for breast cancer detection by comparing it to handheld ultrasound (HHUS) and mammography (MG). Eligible participants underwent HHUS and ABUS testing; women aged 40-69 years additionally underwent MG. Images were interpreted using the Breast Imaging Reporting and Data System (BI-RADS). Women in the BI-RADS categories 1-2 were considered negative. Women classified as BI-RADS 3 underwent magnetic resonance imaging to distinguish true- and false-negative results. Core aspiration or surgical biopsy was performed in women classified as BI-RADS 4-5, followed by a pathological diagnosis. Kappa values and agreement rates were calculated between ABUS, HHUS and MG. A total of 1,973 women were included in the final analysis. Of these, 1,353 (68.6%) and 620 (31.4%) were classified as BI-RADS categories 1-3 and 4-5, respectively. In the older age group, the agreement rate and Kappa value between the ABUS and HHUS were 94.0% and 0.860 (P<0.001), respectively; they were 89.2% and 0.735 (P<0.001) between the ABUS and MG, respectively. Regarding consistency between imaging and pathology results, 78.6% of women classified as BI-RADS 4-5 based on the ABUS were diagnosed with precancerous lesions or cancer; which was 7.2% higher than that of women based on HHUS. For BI-RADS 1-2, the false-negative rates of the ABUS and HHUS were almost identical and were much lower than those of MG. We observed a good diagnostic reliability for the ABUS. Considering its performance for breast cancer detection in women with high-density breasts and its lower operator dependence, the ABUS is a promising option for breast cancer detection in China.

Transcervical, intrauterine ultrasound-guided radiofrequency ablation of uterine fibroids with the VizAblate® System: three- and six-month endpoint results from the FAST-EU study.

Science.gov (United States)

Bongers, Marlies; Brölmann, Hans; Gupta, Janesh; Garza-Leal, José Gerardo; Toub, David

This was a prospective, longitudinal, multicenter, single-arm controlled trial, using independent core laboratory validation of MRI results, to establish the effectiveness and confirm the safety of the VizAblate® System in the treatment of symptomatic uterine fibroids. The VizAblate System is a transcervical device that ablates fibroids with radiofrequency energy, guided by a built-in intrauterine ultrasound probe. Fifty consecutive women with symptomatic uterine fibroids received treatment with the VizAblate System. Patients had a minimum Menstrual Pictogram score of 120, no desire for fertility, and met additional inclusion and exclusion criteria. The VizAblate System was inserted transcervically and individual fibroids were ablated with radiofrequency energy. An integrated intrauterine ultrasound probe was used for fibroid imaging and targeting. Anesthesia was at the discretion of each investigator. The primary study endpoint was the percentage change in perfused fibroid volume, as assessed by contrast-enhanced MRI at 3 months. Secondary endpoints, reached at 6 months, included safety, percentage reductions in the Menstrual Pictogram (MP) score and the Symptom Severity Score (SSS) subscale of the Uterine Fibroid Symptom-Quality of Life questionnaire (UFS-QOL), along with the rate of surgical reintervention for abnormal uterine bleeding and the mean number of days to return to normal activity. Additional assessments included the Health-Related Quality of Life (HRQOL) subscale of the UFS-QOL, medical reintervention for abnormal uterine bleeding, and procedure times. Fifty patients were treated, representing 92 fibroids. Perfused fibroid volumes were reduced at 3 months by an average of 68.8 ± 27.8 % ( P  abnormal uterine bleeding associated with fibroids, with appropriate safety and a low reintervention rate.

A CT-ultrasound-coregistered augmented reality enhanced image-guided surgery system and its preliminary study on brain-shift estimation

International Nuclear Information System (INIS)

Huang, C H; Hsieh, C H; Lee, J D; Huang, W C; Lee, S T; Wu, C T; Sun, Y N; Wu, Y T

2012-01-01

With the combined view on the physical space and the medical imaging data, augmented reality (AR) visualization can provide perceptive advantages during image-guided surgery (IGS). However, the imaging data are usually captured before surgery and might be different from the up-to-date one due to natural shift of soft tissues. This study presents an AR-enhanced IGS system which is capable to correct the movement of soft tissues from the pre-operative CT images by using intra-operative ultrasound images. First, with reconstructing 2-D free-hand ultrasound images to 3-D volume data, the system applies a Mutual-Information based registration algorithm to estimate the deformation between pre-operative and intra-operative ultrasound images. The estimated deformation transform describes the movement of soft tissues and is then applied to the pre-operative CT images which provide high-resolution anatomical information. As a result, the system thus displays the fusion of the corrected CT images or the real-time 2-D ultrasound images with the patient in the physical space through a head mounted display device, providing an immersive augmented-reality environment. For the performance validation of the proposed system, a brain phantom was utilized to simulate brain-shift scenario. Experimental results reveal that when the shift of an artificial tumor is from 5mm ∼ 12mm, the correction rates can be improved from 32% ∼ 45% to 87% ∼ 95% by using the proposed system.

Outcome in hyperglycemic stroke with ultrasound-augmented thrombolytic therapy.

Science.gov (United States)

Martini, S R; Hill, M D; Alexandrov, A V; Molina, C A; Kent, T A

2006-08-22

Hyperglycemia independently predicts poor outcome after acute ischemic stroke. CLOTBUST (Combined Lysis Of Thrombus in Brain ischemia using transcranial Ultrasound and Systemic tPA) demonstrated that ultrasound-augmented thrombolysis improves recanalization and 24-hour outcome in patients with acute ischemic stroke. We hypothesized that ultrasound would preferentially benefit hyperglycemic patients, and reviewed CLOTBUST with respect to admission glucose and good outcome. We found that ultrasound's benefit on 90-day outcome was primarily apparent at higher glucose levels, suggesting that ultrasound therapy may improve outcome following hyperglycemic stroke.

Factors influencing the examinations by means of ultrasounds

International Nuclear Information System (INIS)

Brocco, M.

1988-01-01

The reliability of ultrasound examination can be influenced by many variables: the pulse generator and receiver, the material under examination, size, type, position and orientation of a defect inside the material. The results of a study aiming at evaluating the amplitude of the response signals as a means to size defects are exposed. The conclusions have been drawn considering the influence that a defect and an ultrasound system have on the power absorbed. The results show that the orientation, the geometry and the band width of the ultrasound system

Introducing a Fresh Cadaver Model for Ultrasound-guided Central Venous Access Training in Undergraduate Medical Education.

Science.gov (United States)

Miller, Ryan; Ho, Hang; Ng, Vivienne; Tran, Melissa; Rappaport, Douglas; Rappaport, William J A; Dandorf, Stewart J; Dunleavy, James; Viscusi, Rebecca; Amini, Richard

2016-05-01

Over the past decade, medical students have witnessed a decline in the opportunities to perform technical skills during their clinical years. Ultrasound-guided central venous access (USG-CVA) is a critical procedure commonly performed by emergency medicine, anesthesia, and general surgery residents, often during their first month of residency. However, the acquisition of skills required to safely perform this procedure is often deficient upon graduation from medical school. To ameliorate this lack of technical proficiency, ultrasound simulation models have been introduced into undergraduate medical education to train venous access skills. Criticisms of simulation models are the innate lack of realistic tactile qualities, as well as the lack of anatomical variances when compared to living patients. The purpose of our investigation was to design and evaluate a life-like and reproducible training model for USG-CVA using a fresh cadaver. This was a cross-sectional study at an urban academic medical center. An 18-point procedural knowledge tool and an 18-point procedural skill evaluation tool were administered during a cadaver lab at the beginning and end of the surgical clerkship. During the fresh cadaver lab, procedure naïve third-year medical students were trained on how to perform ultrasound-guided central venous access of the femoral and internal jugular vessels. Preparation of the fresh cadaver model involved placement of a thin-walled latex tubing in the anatomic location of the femoral and internal jugular vein respectively. Fifty-six third-year medical students participated in this study during their surgical clerkship. The fresh cadaver model provided high quality and lifelike ultrasound images despite numerous cannulation attempts. Technical skill scores improved from an average score of 3 to 12 (pcadaver model prevented extravasation of fluid, maintained ultrasound-imaging quality, and proved to be an effective educational model allowing third-year medical

Time reversal and phase coherent music techniques for super-resolution ultrasound imaging

Science.gov (United States)

Huang, Lianjie; Labyed, Yassin

2018-05-01

Systems and methods for super-resolution ultrasound imaging using a windowed and generalized TR-MUSIC algorithm that divides the imaging region into overlapping sub-regions and applies the TR-MUSIC algorithm to the windowed backscattered ultrasound signals corresponding to each sub-region. The algorithm is also structured to account for the ultrasound attenuation in the medium and the finite-size effects of ultrasound transducer elements. A modified TR-MUSIC imaging algorithm is used to account for ultrasound scattering from both density and compressibility contrasts. The phase response of ultrasound transducer elements is accounted for in a PC-MUSIC system.

Surgical repair of large cyclodialysis clefts.

Science.gov (United States)

Gross, Jacob B; Davis, Garvin H; Bell, Nicholas P; Feldman, Robert M; Blieden, Lauren S

2017-05-11

To describe a new surgical technique to effectively close large (>180 degrees) cyclodialysis clefts. Our method involves the use of procedures commonly associated with repair of retinal detachment and complex cataract extraction: phacoemulsification with placement of a capsular tension ring followed by pars plana vitrectomy and gas tamponade with light cryotherapy. We also used anterior segment optical coherence tomography (OCT) as a noninvasive mechanism to determine the extent of the clefts and compared those results with ultrasound biomicroscopy (UBM) and gonioscopy. This technique was used to repair large cyclodialysis clefts in 4 eyes. All 4 eyes had resolution of hypotony and improvement of visual acuity. One patient had an intraocular pressure spike requiring further surgical intervention. Anterior segment OCT imaging in all 4 patients showed a more extensive cleft than UBM or gonioscopy. This technique is effective in repairing large cyclodialysis clefts. Anterior segment OCT more accurately predicted the extent of each cleft, while UBM and gonioscopy both underestimated the size of the cleft.

Left lower lobe sleeve lobectomy for lung cancer using the Da Vinci surgical system.

Science.gov (United States)

Zhao, Yandong; Jiao, Wenjie; Ren, Xiaoyang; Zhang, Liangdong; Qiu, Tong; Fu, Bo; Wang, Lei

2016-04-12

Despite the robotic surgery is widely applied, sleeve lobectomy for lung cancer using the Da Vinci surgical system is still less performed. We described a sleeve lobectomy for adenocarcinoma located at the left lower lobe using the Da Vinci surgical system. A case of 57-year old female referred to our hospital. Computed tomography scan showed an occupation located at the left lower lobe and adenocarcinoma project from the lobe bronchus was diagnosed by bronchoscope examination. A sleeve lobectomy was performed using the Da Vinci surgical system and the postoperative recovery was uneventful. Robotic thoracic surgery is feasible to perform sleeve lobectomy inspite of inadequate experience.

The OMERACT ultrasound task force--status and perspectives.

LENUS (Irish Health Repository)

Naredo, Esperanza

2011-09-01

This article reports the most recent work of the Outcome Measures in Rheumatology (OMERACT) Ultrasound Task Force, and highlights the future research priorities discussed at the OMERACT 10 meeting. Results of the following studies were presented: (1) intra- and interobserver reliability of ultrasound detecting and scoring synovitis in different joints of patients with rheumatoid arthritis (RA); (2) systematic review of previous ultrasound scoring systems of synovitis in RA; (3) enthesitis systematic review and Delphi definition exercise in spondyloarthritis enthesitis; (4) enthesitis intra- and interobserver reliability exercise; and (5) Delphi definition exercise in hand osteoarthritis, and reliability exercises. Study conclusions were discussed, and a future research agenda was approved, notably further validation of an OMERACT ultrasound global synovitis score (GLOSS) in RA, emphasizing the importance of testing feasibility, predictive value, and added value over standard clinical variables. Future research areas will include validating scoring systems for enthesitis and osteoarthritis, and testing the metric qualities of ultrasound for evaluating tenosynovitis and structural damage in RA.

The feasibility of an infrared system for real-time visualization and mapping of ultrasound fields

Energy Technology Data Exchange (ETDEWEB)

Shaw, Adam; Nunn, John, E-mail: adam.shaw@npl.co.u [National Physical Laboratory, Teddington, Middlesex, TW11 0LW (United Kingdom)

2010-06-07

In treatment planning for ultrasound therapy, it is desirable to know the 3D structure of the ultrasound field. However, mapping an ultrasound field in 3D is very slow, with even a single planar raster scan taking typically several hours. Additionally, hydrophones that are used for field mapping are expensive and can be damaged in some therapy fields. So there is value in rapid methods which enable visualization and mapping of the ultrasound field in about 1 min. In this note we explore the feasibility of mapping the intensity distribution by measuring the temperature distribution produced in a thin sheet of absorbing material. A 0.2 mm thick acetate sheet forms a window in the wall of a water tank containing the transducer. The window is oriented at 45{sup 0} to the beam axis, and the distance from the transducer to the window can be varied. The temperature distribution is measured with an infrared camera; thermal images of the inclined plane could be viewed in real time or images could be captured for later analysis and 3D field reconstruction. We conclude that infrared thermography can be used to gain qualitative information about ultrasound fields. Thermal images are easily visualized with good spatial and thermal resolutions (0.044 mm and 0.05 {sup 0}C in our system). The focus and field structure such as side lobes can be identified in real time from the direct video output. 3D maps and image planes at arbitrary orientations to the beam axis can be obtained and reconstructed within a few minutes. In this note we are primarily interested in the technique for characterization of high intensity focused ultrasound (HIFU) fields, but other applications such as physiotherapy fields are also possible. (note)

The feasibility of an infrared system for real-time visualization and mapping of ultrasound fields

International Nuclear Information System (INIS)

Shaw, Adam; Nunn, John

2010-01-01

In treatment planning for ultrasound therapy, it is desirable to know the 3D structure of the ultrasound field. However, mapping an ultrasound field in 3D is very slow, with even a single planar raster scan taking typically several hours. Additionally, hydrophones that are used for field mapping are expensive and can be damaged in some therapy fields. So there is value in rapid methods which enable visualization and mapping of the ultrasound field in about 1 min. In this note we explore the feasibility of mapping the intensity distribution by measuring the temperature distribution produced in a thin sheet of absorbing material. A 0.2 mm thick acetate sheet forms a window in the wall of a water tank containing the transducer. The window is oriented at 45 0 to the beam axis, and the distance from the transducer to the window can be varied. The temperature distribution is measured with an infrared camera; thermal images of the inclined plane could be viewed in real time or images could be captured for later analysis and 3D field reconstruction. We conclude that infrared thermography can be used to gain qualitative information about ultrasound fields. Thermal images are easily visualized with good spatial and thermal resolutions (0.044 mm and 0.05 0 C in our system). The focus and field structure such as side lobes can be identified in real time from the direct video output. 3D maps and image planes at arbitrary orientations to the beam axis can be obtained and reconstructed within a few minutes. In this note we are primarily interested in the technique for characterization of high intensity focused ultrasound (HIFU) fields, but other applications such as physiotherapy fields are also possible. (note)

Development of stereo endoscope system with its innovative master interface for continuous surgical operation.

Science.gov (United States)

Kim, Myungjoon; Lee, Chiwon; Hong, Nhayoung; Kim, Yoon Jae; Kim, Sungwan

2017-06-24

Although robotic laparoscopic surgery has various benefits when compared with conventional open surgery and minimally invasive surgery, it also has issues to overcome and one of the issues is the discontinuous surgical flow that occurs whenever control is swapped between the endoscope system and the operating robot arm system. This can lead to problems such as collision between surgical instruments, injury to patients, and increased operation time. To achieve continuous surgical operation, a wireless controllable stereo endoscope system is proposed which enables the simultaneous control of the operating robot arm system and the endoscope system. The proposed system consists of two improved novel master interfaces (iNMIs), a four-degrees of freedom (4-DOFs) endoscope control system (ECS), and a simple three-dimensional (3D) endoscope. In order to simultaneously control the proposed system and patient side manipulators of da Vinci research kit (dVRK), the iNMIs are installed to the master tool manipulators of dVRK system. The 4-DOFs ECS consists of four servo motors and employs a two-parallel link structure to provide translational and fulcrum point motion to the simple 3D endoscope. The images acquired by the endoscope undergo stereo calibration and rectification to provide a clear 3D vision to the surgeon as available in clinically used da Vinci surgical robot systems. Tests designed to verify the accuracy, data transfer time, and power consumption of the iNMIs were performed. The workspace was calculated to estimate clinical applicability and a modified peg transfer task was conducted with three novice volunteers. The iNMIs operated for 317 min and moved in accordance with the surgeon's desire with a mean latency of 5 ms. The workspace was calculated to be 20378.3 cm 3 , which exceeds the reference workspace of 549.5 cm 3 . The novice volunteers were able to successfully execute the modified peg transfer task designed to evaluate the proposed system's overall

Quantitative analysis of ultrasound B-mode images of carotid atherosclerotic plaque: correlation with visual classification and histological examination

DEFF Research Database (Denmark)

Wilhjelm, Jens E.; Grønholdt, Marie-Louise; Wiebe, Brit

1998-01-01

regions of the plaque in still ultrasound images from three orthogonal scan planes and finally a histological analysis of the surgically removed plaque. The quantitative comparison was made with the linear model and with separation of the available data into training and test sets. The comparison......This paper presents a quantitative comparison of three types of information available for 52 patients scheduled for carotid endarterectomy: subjective classification of the ultrasound images obtained during scanning before operation, first- and second-order statistical features extracted from...

Ultrasound-guided plantar fascia release technique: a retrospective study of 46 feet.

Science.gov (United States)

Vohra, Praveen K; Japour, Christopher J

2009-01-01

Ultrasound-guided plantar fascia release offers the surgeon clear visualization of anatomy at the surgical site. This technique uses small arthroscopic dissecting instruments through a 0.5-cm incision, allowing the surgeon to avoid the larger and more tissue-disruptive incision that is traditionally used for plantar heel spur resection and plantar fascia releases. Forty-one patients (46 feet) were selected for the study. The mean patient age was 47 years. Twenty-nine were considered obese with a body mass index greater than 30 kg/m(2). Patients were functionally and subjectively evaluated 4 weeks after surgery using the American Orthopedic Foot and Ankle Society Ankle and Hindfoot Rating Scale. Results from the study show a significant improvement (P = .05 confidence level) 4 weeks postoperatively for the 41 patients (46 feet), compared to their preoperative condition. The mean pretest score was 33.6 (range 10-52); this score improved to 88.0 (range 50-100), 4 weeks postoperatively. There were no postoperative infections or complications. The ultrasound-guided plantar fascia release technique is a practical surgical procedure for the relief of chronic plantar fascia pain because the surgeon is able to clearly visualize the plantar fascia by ultrasound. In addition, there is minimal disruption to surrounding tissue because small instruments are passed through a small 0.5-cm incision. The traditional open method of heel spur surgery, in contrast, uses a larger skin incision of 3 to 5 cm, followed by larger instruments to dissect to the plantar fascia.

A Portable Shoulder-Mounted Camera System for Surgical Education in Spine Surgery.

Science.gov (United States)

Pham, Martin H; Ohiorhenuan, Ifije E; Patel, Neil N; Jakoi, Andre M; Hsieh, Patrick C; Acosta, Frank L; Wang, Jeffrey C; Liu, John C

2017-02-07

The past several years have demonstrated an increased recognition of operative videos as an important adjunct for resident education. Currently lacking, however, are effective methods to record video for the purposes of illustrating the techniques of minimally invasive (MIS) and complex spine surgery. We describe here our experiences developing and using a shoulder-mounted camera system for recording surgical video. Our requirements for an effective camera system included wireless portability to allow for movement around the operating room, camera mount location for comfort and loupes/headlight usage, battery life for long operative days, and sterile control of on/off recording. With this in mind, we created a shoulder-mounted camera system utilizing a GoPro™ HERO3+, its Smart Remote (GoPro, Inc., San Mateo, California), a high-capacity external battery pack, and a commercially available shoulder-mount harness. This shoulder-mounted system was more comfortable to wear for long periods of time in comparison to existing head-mounted and loupe-mounted systems. Without requiring any wired connections, the surgeon was free to move around the room as needed. Over the past several years, we have recorded numerous MIS and complex spine surgeries for the purposes of surgical video creation for resident education. Surgical videos serve as a platform to distribute important operative nuances in rich multimedia. Effective and practical camera system setups are needed to encourage the continued creation of videos to illustrate the surgical maneuvers in minimally invasive and complex spinal surgery. We describe here a novel portable shoulder-mounted camera system setup specifically designed to be worn and used for long periods of time in the operating room.

Effect of sensory substitution on suture-manipulation forces for robotic surgical systems.

Science.gov (United States)

Kitagawa, Masaya; Dokko, Daniell; Okamura, Allison M; Yuh, David D

2005-01-01

Direct haptic (force or tactile) feedback is not yet available in commercial robotic surgical systems. Previous work by our group and others suggests that haptic feedback might significantly enhance the execution of surgical tasks requiring fine suture manipulation, specifically those encountered in cardiothoracic surgery. We studied the effects of substituting direct haptic feedback with visual and auditory cues to provide the operating surgeon with a representation of the forces he or she is applying with robotic telemanipulators. Using the robotic da Vinci surgical system (Intuitive Surgical, Inc, Sunnyvale, Calif), we compared applied forces during a standardized surgical knot-tying task under 4 different sensory-substitution scenarios: no feedback, auditory feedback, visual feedback, and combined auditory-visual feedback. The forces applied with these sensory-substitution modes more closely approximate suture tensions achieved under ideal haptic conditions (ie, hand ties) than forces applied without such sensory feedback. The consistency of applied forces during robot-assisted suture tying aided by visual feedback or combined auditory-visual feedback sensory substitution is superior to that achieved with hand ties. Robot-assisted ties aided with auditory feedback revealed levels of consistency that were generally equivalent or superior to those attained with hand ties. Visual feedback and auditory feedback improve the consistency of robotically applied forces. Sensory substitution, in the form of visual feedback, auditory feedback, or both, confers quantifiable advantages in applied force accuracy and consistency during the performance of a simple surgical task.

Immediate Emergency Department Diagnosis of Pyloric Stenosis with Point-of-care Ultrasound

Directory of Open Access Journals (Sweden)

Nicole Dorinzi

2017-11-01

Full Text Available A 15-day-old male who was born at term presented with non-bilious projectile vomiting. He was nontoxic and his abdomen was benign without masses. Point-of-care ultrasound (POCUS showed hypertrophic pyloric stenosis (HPS. Typical findings include target sign; pyloric muscle thickness greater than three millimeters (mm; channel length greater than 15–18 mm; and lack of gastric emptying. The patient was admitted; consultative ultrasound (US was negative, but repeated 48 hours later for persistent vomiting. This second US was interpreted as HPS, which was confirmed surgically. Pyloromyotomy was successful. Few reports describe POCUS by general emergency physicians to diagnose HPS. Here, we emphasize the value in repeat US for patients with persistent symptoms.

Ultrasound -- Pelvis

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Full Text Available ... three types of pelvic ultrasound: abdominal, vaginal (for women), and rectal (for men). These exams are frequently ... pelvic ultrasound: abdominal ( transabdominal ) vaginal ( transvaginal / endovaginal ) for women rectal ( transrectal ) for men A Doppler ultrasound exam ...

Ultrasound -- Pelvis

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Full Text Available ... a pelvic ultrasound examination. Doppler ultrasound , also called color Doppler ultrasonography, is a special ultrasound technique that ... and processes the sounds and creates graphs or color pictures that represent the flow of blood through ...

Ultrasound -- Pelvis

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Full Text Available ... Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions. There are ... Ultrasound page for more information . Ultrasound examinations can help diagnose symptoms experienced by women such as: pelvic ...

Ultrasound -- Pelvis

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Full Text Available ... ultrasound images are captured in real-time, they can show the structure and movement of the body's ... Obstetrical Ultrasound page for more information . Ultrasound examinations can help diagnose symptoms experienced by women such as: ...

Prostate ultrasound imaging: evaluation of a two-step scoring system in the diagnosis of prostate cancer.

Science.gov (United States)

Gao, Yong; Liao, Xin-Hong; Ma, Yan; Lu, Lu; Wei, Li-Yan; Yan, Xue

2017-12-01

This study aims to investigate the feasibility and performance of a two-step scoring system of ultrasound imaging in the diagnosis of prostate cancer. 75 patients with 888 consecutive histopathologically verified lesions were included in this study. Step 1, an initial 5-point scoring system was developed based on conventional transrectal ultrasound (TRUS). Step 2, a final scoring system was evaluated according to contrast-enhanced transrectal ultrasound (CE-TRUS). Each lesion was evaluated using the two-step scoring system (step 1 + step 2) and compared with only using conventional TRUS (step 1). 888 lesions were histologically verified: 315 of them were prostate cancer from 46 patients and 573 were benign prostatic hypertrophy (BPH) from 29 patients. According to the two-step scoring system, 284 lesions were upgraded and 130 lesions were downgraded from step 1 to step 2 (this means using step 2 to assess the results by step 1). However, 96 cases were improperly upgraded after step 2 and 48 malignant lesions were still missed after step 2 as score-1. For the two-step scoring system, the sensitivity, specificity, and accuracy were 84.7%, 83.2%, and 83.7%, respectively, versus 22.8%, 96.6%, and 70.4%, respectively, for conventional TRUS. The area under the ROC curve (AUC) for lesion diagnosis was 0.799-0.952 for the two-step scoring system, versus 0.479-0.712 for conventional TRUS. The difference in the diagnostic accuracy of the two-step scoring system and conventional TRUS was statistically significant (Pstep scoring system was straightforward to use and achieved a considerably accurate diagnostic performance for prostate cancer. The application of the two-step scoring system for prostate cancer is promising.

Pulsed radiofrequency on radial nerve under ultrasound guidance for treatment of intractable lateral epicondylitis.

Science.gov (United States)

Oh, Dae Seok; Kang, Tae Hyung; Kim, Hyae Jin

2016-06-01

Lateral epicondylitis is a painful and functionally limiting disorder. Although lateral elbow pain is generally self-limiting, in a minority of people symptoms persist for a long time. When various conservative treatments fail, surgical approach is recommended. Surgical denervation of several nerves that innervate the lateral humeral epicondyle could be considered in patients with refractory pain because it denervates the region of pain. Pulsed radiofrequency is a minimally invasive procedure that improves chronic pain when applied to various neural tissues without causing any significant destruction and painful complication. This procedure is safe, minimally invasive, and has less risk of complications relatively compared to the surgical approach. The radial nerve can be identified as a target for pulsed radiofrequency lesioning in lateral epicondylitis. This innovative method of pulsed radiofrequency applied to the radial nerve has not been reported before. We reported on two patients with intractable lateral epicondylitis suffering from elbow pain who did not respond to nonoperative treatments, but in whom the ultrasound-guided pulsed radiofrequency neuromodulation of the radial nerve induced symptom improvement. After a successful diagnostic nerve block, radiofrequency probe adjustment around the radial nerve was performed on the lateral aspect of the distal upper arm under ultrasound guidance and multiple pulsed treatments were applied. A significant reduction in pain was reported over the follow-up period of 12 weeks.

Emergency percutaneous treatment in surgical bile duct injury.

Science.gov (United States)

Carrafiello, Gianpaolo; Laganà, Domenico; Dizonno, Massimiliano; Ianniello, Andrea; Cotta, Elisa; Dionigi, Gianlorenzo; Dionigi, Renzo; Fugazzola, Carlo

2008-09-01

The aim of this study is to evaluate the efficacy of emergency percutaneous treatment in patients with surgical bile duct injury (SBDI). From May 2004 to May 2007, 11 patients (five men, six women; age range 26-80 years; mean age 58 years) with a critical clinical picture (severe jaundice, bile peritonitis, septic state) due to SBDI secondary to surgical or laparoscopic procedures were treated by percutaneous procedures. We performed four ultrasound-guided percutaneous drainages, four external-internal biliary drainages, one bilioplasty, and two plastic biliary stenting after 2 weeks of external-internal biliary drainage placement. All procedures had 100% technical success with no complications. The clinical emergencies resolved in 3-4 days in 100% of cases. All patients had a benign clinical course, and reoperation was avoided in 100% of cases. Interventional radiological procedures are effective in the emergency management of SBDI since they are minimally invasive and have a high success rate and a low incidence of complications compared to the more complex and dangerous surgical or laparoscopic options.

General Ultrasound Imaging

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Full Text Available ... What are the limitations of General Ultrasound Imaging? What is General Ultrasound Imaging? Ultrasound is safe and ... be heard with every heartbeat. top of page What are some common uses of the procedure? Ultrasound ...

General Ultrasound Imaging

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Full Text Available ... Index A-Z General Ultrasound Ultrasound imaging uses sound waves to produce pictures of the inside of ... pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or ...

General Ultrasound Imaging

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Full Text Available ... guide biopsy of breast cancer ( see the Ultrasound-Guided Breast Biopsy page . diagnose a variety of heart ... Articles and Media Angioplasty and Vascular Stenting Ultrasound-Guided Breast Biopsy Obstetric Ultrasound Ultrasound - Prostate Biopsies - Overview ...

General Ultrasound Imaging

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Full Text Available ... of an ultrasound examination. Doppler ultrasound , also called color Doppler ultrasonography, is a special ultrasound technique that ... kidneys. There are three types of Doppler ultrasound: Color Doppler uses a computer to convert Doppler measurements ...

General Ultrasound Imaging

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Full Text Available ... those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in ... ultrasound study may be part of an ultrasound examination. Doppler ultrasound , also called color Doppler ultrasonography, is ...

Experimental ultrasound system for real-time synthetic imaging

DEFF Research Database (Denmark)

Jensen, Jørgen Arendt; Holm, Ole; Jensen, Lars Joost

1999-01-01

Digital signal processing is being employed more and more in modern ultrasound scanners. This has made it possible to do dynamic receive focusing for each sample and implement other advanced imaging methods. The processing, however, has to be very fast and cost-effective at the same time. Dedicated...... for synthetic aperture imaging, 2D and 3D B-mode and velocity imaging. The system can be used with 128 element transducers and can excite 128 channels and receive and sample data from 64 channels simultaneously at 40 MHz with 12 bits precision. Data can be processed in real time using the system's 80 signal...... chips are used in order to do real time processing. This often makes it difficult to implement radically different imaging strategies on one platform and makes the scanners less accessible for research purposes. Here flexibility is the prime concern, and the storage of data from all transducer elements...

Musculoskeletal ultrasound in rheumatology in Korea: targeted ultrasound initiative survey.

Science.gov (United States)

Kang, Taeyoung; Wakefield, Richard J; Emery, Paul

2016-04-01

In collaboration with the Targeted Ultrasound Initiative (TUI), to conduct the first study in Korea to investigate current practices in ultrasound use among Korean rheumatologists. We translated the TUI Global Survey into Korean and added questions to better understand the specific challenges facing rheumatologists in Korea. To target as many rheumatologists in Korea as possible, we created an on-line version of this survey, which was conducted from March to April 2013. Rheumatologists are in charge of ultrasound in many Korean hospitals. Rheumatologists in hospitals and private clinics use ultrasound to examine between one and five patients daily; they use ultrasound for diagnosis more than monitoring and receive compensation of about US$30-50 per patient. There are marked differences in the rates of ultrasound usage between rheumatologists who work in private practice compared with tertiary hospitals. Korean rheumatologists not currently using ultrasound in their practice appear eager to do so. This survey provides important insights into the current status of ultrasound in rheumatology in Korea and highlights several priorities; specifically, greater provision of formal training, standardization of reporting and accrual of greater experience among ultrasound users. If these needs are addressed, all rheumatology departments in Korea are likely to use ultrasound or have access to it in the future. © 2014 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Application of a uniform anatomic grading system to measure disease severity in eight emergency general surgical illnesses.

Science.gov (United States)

Crandall, Marie L; Agarwal, Suresh; Muskat, Peter; Ross, Steven; Savage, Stephanie; Schuster, Kevin; Tominaga, Gail T; Shafi, Shahid

2014-11-01

Emergent general surgical diseases encompass a broad spectrum of anatomy and pathophysiology, creating challenges for outcomes assessment, research, and surgical training. The goal of this study was to measure anatomic disease severity for eight emergent general surgical diseases using the uniform grading system of the American Association for the Surgery of Trauma (AAST). The Committee on Patient Assessment and Outcomes of AAST applied the previously developed uniform grading system to eight emergent general surgical diseases using a consensus of experts. It was then reviewed and approved by the Board of Managers of AAST. Severity grades for eight commonly encountered emergent general surgical conditions were created: breast abscess, esophageal perforation, infectious colitis, pelvic inflammatory disease, perirectal abscess, pleural space infections, soft tissue infections, and surgical site infections. The range of grades from I through V, reflect progression from mild disease, limited to within the organ itself, to widespread severe disease. This article provides a uniform grading system for measuring anatomic severity of eight emergent general surgical diseases. Consistent adoption of these grades could improve standardization for quality assurance, outcomes research, and surgical training.

Development of Flexible Capacitive Ultrasound Transducers and the Use of Ultrasound for Bone Repair

Science.gov (United States)

Wentzell, Scott A.

devices have the potential to mediate both bone resorption and deposition, and also provide a new functional system for generating ultrasound on the irregular surfaces encountered in clinical settings.

WE-AB-206-02: ACR Ultrasound Accreditation: Requirements and Pitfalls

International Nuclear Information System (INIS)

Walter, J.

2016-01-01

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. The goal of this ultrasound hands-on workshop is to demonstrate quality control (QC) testing in diagnostic ultrasound and to provide updates in ACR ultrasound accreditation requirements. The first half of this workshop will include two presentations reviewing diagnostic ultrasound QA/QC and ACR ultrasound accreditation requirements. The second half of the workshop will include live demonstrations of basic QC tests. An array of ultrasound testing phantoms and ultrasound scanners will be available for attendees to learn diagnostic ultrasound QC in a hands-on environment with live demonstrations and on-site instructors. The targeted attendees are medical physicists in diagnostic imaging. Learning Objectives: Gain familiarity with common elements of a QA/QC program for diagnostic ultrasound imaging dentify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools Learn ACR ultrasound accreditation requirements Jennifer Walter is an employee of American College of Radiology on Ultrasound Accreditation.

System-Level Design of an Integrated Receiver Front End for a Wireless Ultrasound Probe

DEFF Research Database (Denmark)

di Ianni, Tommaso; Hemmsen, Martin Christian; Llimos Muntal, Pere

2016-01-01

In this paper, a system-level design is presented for an integrated receive circuit for a wireless ultrasound probe, which includes analog front ends and beamformation modules. This paper focuses on the investigation of the effects of architectural design choices on the image quality. The point...

ANALYSIS OF EFFECT AND COMPLICATION ON SURGICAL TREATMENT OF CAROTID BODY TUMORS IN 46 CASES

Institute of Scientific and Technical Information of China (English)

郑月宏; 刘暴; 李拥军; 刘昌伟; 管珩

2003-01-01

Objective. To describe the effects of surgical treatment and complications in 46 patients with carotid body tumor (CBT). Method. Retrospective study on surgical treatment and complications was carried out in 46 cases of CBT which were surgically treated with different kind of procedures. Result. All procedures performed successfully except that the CBT was not excised in 4 cases. No operative mortality was observed. There were 2 postoperative hemiplegia, 4 hypoglossal nerve impairment,2 glossopharyngeal nerve impairment, 1 vagus nerve impairment, and 1 accessory nerve impairment. One patient presented postoperative cranial nerve impairment in glossopharyngeal, vagus and hypoglossal nerves. Two patients developed local recurrence during the long-term follow-up. Conclusion. Complete surgical excision was possible in each patient if the diagnosis had been correctly made through selective preoperative angiography, vessel ultrasound Doppler and other examinations.Reasonable surgical procedure and Matas training were necessary to the successful surgical treatment and thus decrease the complicative incidence rate of carotid chemodectomas.

Thorascopic resection of an apical paraspinal schwannoma using the da Vinci surgical system.

Science.gov (United States)

Finley, David; Sherman, Jonathan H; Avila, Edward; Bilsky, Mark

2014-01-01

Posterior mediastinal neurogenic tumors have traditionally been resected via an open posterolateral thoracotomy. Video-assisted thorascopic surgery has emerged as an alternative technique allowing for improved morbidity with decreased blood loss, less postoperative pain, and a shorter recovery period, among others. The da Vinci surgical system, as first described for urologic procedures, has recently been reported for lung lobectomy. This technique provides the advantages of instrumentation with 6 degrees of freedom, stable operating arms, and improved visualization with the three-dimensional high-definition camera. We describe the technique for thorascopic resection of an apical paraspinal schwannoma of the T1 nerve root with the da Vinci surgical system. This technique used a specialized intraoperative neuromonitoring probe for free-running electromyography (EMG) and triggered EMG. We demonstrate successful resection of a posterior paraspinal schwannoma with the da Vinci surgical system while preserving neurologic function. The patient displayed stable intraoperative monitoring of the T1 nerve root and full intrinsic hand strength postoperatively. The technique described in this article introduces robotic system accuracy and precludes the need for an open thoracotomy. In addition, this approach demonstrates the ability of the da Vinci surgical system to safely dissect tumors from their neural attachments and is applicable to other such lesions of similar size and location. Georg Thieme Verlag KG Stuttgart · New York.

Ultrasound

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Ultrasound is a useful procedure for monitoring the baby's development in the uterus. Ultrasound uses inaudible sound waves to produce a two-dimensional image of the baby while inside the mother's ...

Trends in the Surgical Correction of Gynecomastia

Science.gov (United States)

Brown, Rodger H.; Chang, Daniel K.; Siy, Richard; Friedman, Jeffrey

2015-01-01

Gynecomastia refers to the enlargement of the male breast due to a proliferation of ductal, stromal, and/or fatty tissue. Although it is a common condition affecting up to 65% of men, not all cases require surgical intervention. Contemporary surgical techniques in the treatment of gynecomastia have become increasingly less invasive with the advent of liposuction and its variants, including power-assisted and ultrasound-assisted liposuction. These techniques, however, have been largely limited in their inability to address significant skin excess and ptosis. For mild to moderate gynecomastia, newer techniques using arthroscopic morcellation and endoscopic techniques promise to address the fibrous component, while minimizing scar burden by utilizing liposuction incisions. Nevertheless, direct excision through periareolar incisions remains a mainstay in treatment algorithms for its simplicity and avoidance of additional instrumentation. This is particularly true for more severe cases of gynecomastia requiring skin resection. In the most severe cases with significant skin redundancy and ptosis, breast amputation with free nipple grafting remains an effective option. Surgical treatment should be individualized to each patient, combining techniques to provide adequate resection and optimize aesthetic results. PMID:26528088

RADIOLOGICAL EVALUATION OF OBSTRUCTIVE JAUNDICE BY ULTRASOUND AND CT

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Padmalatha

2015-10-01

Full Text Available INTRODUCTION: The goals of any radiologic procedure in obstructive Jaundice are to confirm the presence of bile duct obstruction, its location, its extent & the probable cause. It should also attempt to obtain a map of the biliary tree that will help the surgeon to det ermine the best approach to each individual case. OBJECTIVES: 1. To evaluate the role of Ultrasound and CT in patients presenting with clinical features of obstructive jaundice. 2. To evaluate the causes of obstructive jaundice by Ultrasound and CT. PATIENTS AND METHODS: The study was carried with 45 patients from January 2006 to September 2007 who were attending the surgical and Gastroenterology Departments, Govt. General Hospital, Kurnool, which is an attached hospital to Kurnool Medical College, Kurnool. O BSERVATIONS AND RESULTS: In our study, there is female predominance with male: female ratio 1: 1.6.Majority of patients are in age group of 41 - 50 years. Jaundice was the commonest presentation in all patients followed by pruritis in 72% and pain abdomen in 67% of patients. Ultrasound identified the benign cause of biliary obstruction in 79.1% cases and the malignant cause in 61.9% cases. CT identified the benign cause of biliary obstruction in 91.6% of patients and the malignant cause in 80.9% cases.

Ultrasound as a Screening Tool for Central Venous Catheter Positioning and Exclusion of Pneumothorax.

Science.gov (United States)

Amir, Rabia; Knio, Ziyad O; Mahmood, Feroze; Oren-Grinberg, Achikam; Leibowitz, Akiva; Bose, Ruma; Shaefi, Shahzad; Mitchell, John D; Ahmed, Muneeb; Bardia, Amit; Talmor, Daniel; Matyal, Robina

2017-07-01

Although real-time ultrasound guidance during central venous catheter insertion has become a standard of care, postinsertion chest radiograph remains the gold standard to confirm central venous catheter tip position and rule out associated lung complications like pneumothorax. We hypothesize that a combination of transthoracic echocardiography and lung ultrasound is noninferior to chest radiograph when used to accurately assess central venous catheter positioning and screen for pneumothorax. All operating rooms and surgical and trauma ICUs at the institution. Single-center, prospective noninferiority study. Patients receiving ultrasound-guided subclavian or internal jugular central venous catheters. During ultrasound-guided central venous catheter placement, correct positioning of central venous catheter was accomplished by real-time visualization of the guide wire and positive right atrial swirl sign using the subcostal four-chamber view. After insertion, pneumothorax was ruled out by the presence of lung sliding and seashore sign on M-mode. Data analysis was done for 137 patients. Chest radiograph ruled out pneumothorax in 137 of 137 patients (100%). Lung ultrasound was performed in 123 of 137 patients and successfully screened for pneumothorax in 123 of 123 (100%). Chest radiograph approximated accurate catheter tip position in 136 of 137 patients (99.3%). Adequate subcostal four-chamber views could not be obtained in 13 patients. Accurate positioning of central venous catheter with ultrasound was then confirmed in 121 of 124 patients (97.6%) as described previously. Transthoracic echocardiography and lung ultrasound are noninferior to chest x-ray for screening of pneumothorax and accurate central venous catheter positioning. Thus, the point of care use of ultrasound can reduce central venous catheter insertion to use time, exposure to radiation, and improve patient safety.

Ultrasound -- Pelvis

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Full Text Available ... transducer sends out high-frequency sound waves (that the human ear cannot hear) into the body and then ... ultrasound , there are no known harmful effects on humans. top of page What are the limitations of Pelvic Ultrasound Imaging? Ultrasound waves are ...

Causes of discordant or negative ultrasound of parathyroid glands in treatment naïve patients with primary hyperparathyroidism

International Nuclear Information System (INIS)

Chandramohan, Anuradha; Sathyakumar, Kirthi; Irodi, Aparna; Abraham, Deepak; Paul, M.J.

2012-01-01

Objectives: To describe causes of discordant or negative parathyroid ultrasound and to assess factors influencing them. Materials and methods: Retrospective review of patients who underwent parathyroidectomy between 2000 and 2012 was done. Imaging findings were compared with operative findings and pathology to identify discrepant (n = 60; 32 negative, 28 incorrect) parathyroid ultrasounds. Results: Fifty (83.3%) patients had parathyroid adenoma, of which 10 (16.6%) were ectopic and three were double adenomas; 8 (13.3%) had multigland hyperplasia and two had parathyroid carcinoma. Discrepant reports were due to incorrect localisation in 8 (13.3%); difficulty in differentiating thyroid from parathyroid lesion in 12 (20%); large and small size in two and three patients, respectively; overcall in 5 (8.3%) and satisfaction of search in 7 (11.7%) patients. There was significant correlation between presence of multi-nodular goitre and incorrect reports (χ 2 = 4.112, p = 0.04). Experience of ultrasound operators performing initial and second look ultrasound was significantly different (p < 0.0001). Second look ultrasound was concordant with surgical findings in 39(65%) patients; 21 (66%) patients with initially negative ultrasound and four out of five extra-mediastinal ectopic lesions. Ten patients with negative initial ultrasound had elongated parathyroid lesion. Scintigraphy was concordant in 44 (73.3%) patients and nine were ectopic. Conclusion: Second look ultrasound performed by experienced operator for negative or discordant initial ultrasound of parathyroid is a useful strategy which will improve the accuracy of parathyroid ultrasound. Being able to differentiate thyroid from parathyroid lesion is a factor which will influence performance of parathyroid ultrasound.

Causes of discordant or negative ultrasound of parathyroid glands in treatment naïve patients with primary hyperparathyroidism

Energy Technology Data Exchange (ETDEWEB)

Chandramohan, Anuradha, E-mail: anuradhachandramohan@gmail.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632004 (India); Sathyakumar, Kirthi, E-mail: kirthi86s@yahoo.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632004 (India); Irodi, Aparna, E-mail: aparnashyam@gmail.com [Department of Radiology, Christian Medical College, Vellore, Tamil Nadu 632004 (India); Abraham, Deepak, E-mail: abrahamdt@gmail.com [Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu 632004 (India); Paul, M.J., E-mail: mjpaul@cmcvellore.ac.in [Department of Endocrine Surgery, Christian Medical College, Vellore, Tamil Nadu 632004 (India)

2012-12-15

Objectives: To describe causes of discordant or negative parathyroid ultrasound and to assess factors influencing them. Materials and methods: Retrospective review of patients who underwent parathyroidectomy between 2000 and 2012 was done. Imaging findings were compared with operative findings and pathology to identify discrepant (n = 60; 32 negative, 28 incorrect) parathyroid ultrasounds. Results: Fifty (83.3%) patients had parathyroid adenoma, of which 10 (16.6%) were ectopic and three were double adenomas; 8 (13.3%) had multigland hyperplasia and two had parathyroid carcinoma. Discrepant reports were due to incorrect localisation in 8 (13.3%); difficulty in differentiating thyroid from parathyroid lesion in 12 (20%); large and small size in two and three patients, respectively; overcall in 5 (8.3%) and satisfaction of search in 7 (11.7%) patients. There was significant correlation between presence of multi-nodular goitre and incorrect reports (χ{sup 2} = 4.112, p = 0.04). Experience of ultrasound operators performing initial and second look ultrasound was significantly different (p < 0.0001). Second look ultrasound was concordant with surgical findings in 39(65%) patients; 21 (66%) patients with initially negative ultrasound and four out of five extra-mediastinal ectopic lesions. Ten patients with negative initial ultrasound had elongated parathyroid lesion. Scintigraphy was concordant in 44 (73.3%) patients and nine were ectopic. Conclusion: Second look ultrasound performed by experienced operator for negative or discordant initial ultrasound of parathyroid is a useful strategy which will improve the accuracy of parathyroid ultrasound. Being able to differentiate thyroid from parathyroid lesion is a factor which will influence performance of parathyroid ultrasound.

Modelling and Experiment Based on a Navigation System for a Cranio-Maxillofacial Surgical Robot

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Xingguang Duan

2018-01-01

Full Text Available In view of the characteristics of high risk and high accuracy in cranio-maxillofacial surgery, we present a novel surgical robot system that can be used in a variety of surgeries. The surgical robot system can assist surgeons in completing biopsy of skull base lesions, radiofrequency thermocoagulation of the trigeminal ganglion, and radioactive particle implantation of skull base malignant tumors. This paper focuses on modelling and experimental analyses of the robot system based on navigation technology. Firstly, the transformation relationship between the subsystems is realized based on the quaternion and the iterative closest point registration algorithm. The hand-eye coordination model based on optical navigation is established to control the end effector of the robot moving to the target position along the planning path. The closed-loop control method, “kinematics + optics” hybrid motion control method, is presented to improve the positioning accuracy of the system. Secondly, the accuracy of the system model was tested by model experiments. And the feasibility of the closed-loop control method was verified by comparing the positioning accuracy before and after the application of the method. Finally, the skull model experiments were performed to evaluate the function of the surgical robot system. The results validate its feasibility and are consistent with the preoperative surgical planning.

Modelling and Experiment Based on a Navigation System for a Cranio-Maxillofacial Surgical Robot

Science.gov (United States)

Duan, Xingguang; Gao, Liang; Li, Jianxi; Li, Haoyuan; Guo, Yanjun

2018-01-01

In view of the characteristics of high risk and high accuracy in cranio-maxillofacial surgery, we present a novel surgical robot system that can be used in a variety of surgeries. The surgical robot system can assist surgeons in completing biopsy of skull base lesions, radiofrequency thermocoagulation of the trigeminal ganglion, and radioactive particle implantation of skull base malignant tumors. This paper focuses on modelling and experimental analyses of the robot system based on navigation technology. Firstly, the transformation relationship between the subsystems is realized based on the quaternion and the iterative closest point registration algorithm. The hand-eye coordination model based on optical navigation is established to control the end effector of the robot moving to the target position along the planning path. The closed-loop control method, “kinematics + optics” hybrid motion control method, is presented to improve the positioning accuracy of the system. Secondly, the accuracy of the system model was tested by model experiments. And the feasibility of the closed-loop control method was verified by comparing the positioning accuracy before and after the application of the method. Finally, the skull model experiments were performed to evaluate the function of the surgical robot system. The results validate its feasibility and are consistent with the preoperative surgical planning. PMID:29599948

SU-E-J-114: Towards Integrated CT and Ultrasound Guided Radiation Therapy Using A Robotic Arm with Virtual Springs

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Ding, K; Zhang, Y; Sen, H; Lediju Bell, M; Goldstein, S; Kazanzides, P; Iordachita, I; Wong, J [Johns Hopkins University, Baltimore, MD (United States)

2014-06-01

Purpose: Currently there is an urgent need in Radiation Therapy for noninvasive and nonionizing soft tissue target guidance such as localization before treatment and continuous monitoring during treatment. Ultrasound is a portable, low cost option that can be easily integrated with the LINAC room. We are developing a cooperatively controlled robot arm that has high intrafraction reproducibility with repositioning of the ultrasound probe. In this study, we introduce virtual springs (VS) to assist with interfraction probe repositioning and we compare the soft tissue deformation introduced by VS to the deformation that would exist without them. Methods: Three metal markers were surgically implanted in the kidney of one dog. The dog was anesthetized and immobilized supine in an alpha cradle. The reference ultrasound probe position and force to ideally visualize the kidney was defined by an experienced ultrasonographer using the Clarity ultrasound system and robot sensor. For each interfraction study, the dog was removed from the cradle and re-setup based on CBCT with bony anatomy alignment to mimic regular patient setup. The ultrasound probe was automatically returned to the reference position using the robot. To accommodate the soft tissue anatomy changes between each setup the operator used the VS feature to adjust the probe and obtain an ultrasound image that matched the reference image. CBCT images were acquired and each interfraction marker location was compared with the first interfraction Result. Results: Analysis of the marker positions revealed that the kidney was displaced by 18.8 ± 6.4 mm without VS and 19.9 ± 10.5 mm with VS. No statistically significant differences were found between two procedures. Conclusion: The VS feature is necessary to obtain matching ultrasound images, and they do not introduce further changes to the tissue deformation. Future work will focus on automatic VS based on ultrasound feedback. Supported in part by: NCI R01 CA161613

SU-E-J-114: Towards Integrated CT and Ultrasound Guided Radiation Therapy Using A Robotic Arm with Virtual Springs

International Nuclear Information System (INIS)

Ding, K; Zhang, Y; Sen, H; Lediju Bell, M; Goldstein, S; Kazanzides, P; Iordachita, I; Wong, J

2014-01-01

Purpose: Currently there is an urgent need in Radiation Therapy for noninvasive and nonionizing soft tissue target guidance such as localization before treatment and continuous monitoring during treatment. Ultrasound is a portable, low cost option that can be easily integrated with the LINAC room. We are developing a cooperatively controlled robot arm that has high intrafraction reproducibility with repositioning of the ultrasound probe. In this study, we introduce virtual springs (VS) to assist with interfraction probe repositioning and we compare the soft tissue deformation introduced by VS to the deformation that would exist without them. Methods: Three metal markers were surgically implanted in the kidney of one dog. The dog was anesthetized and immobilized supine in an alpha cradle. The reference ultrasound probe position and force to ideally visualize the kidney was defined by an experienced ultrasonographer using the Clarity ultrasound system and robot sensor. For each interfraction study, the dog was removed from the cradle and re-setup based on CBCT with bony anatomy alignment to mimic regular patient setup. The ultrasound probe was automatically returned to the reference position using the robot. To accommodate the soft tissue anatomy changes between each setup the operator used the VS feature to adjust the probe and obtain an ultrasound image that matched the reference image. CBCT images were acquired and each interfraction marker location was compared with the first interfraction Result. Results: Analysis of the marker positions revealed that the kidney was displaced by 18.8 ± 6.4 mm without VS and 19.9 ± 10.5 mm with VS. No statistically significant differences were found between two procedures. Conclusion: The VS feature is necessary to obtain matching ultrasound images, and they do not introduce further changes to the tissue deformation. Future work will focus on automatic VS based on ultrasound feedback. Supported in part by: NCI R01 CA161613

INITIAL EXPERIENCE WITH ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF RENAL MASSES: indications, applications and limitations

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Renata Nobre MOURA

2014-12-01

Full Text Available Context Tissue sampling of renal masses is traditionally performed via the percutaneous approach or laparoscopicaly. The utility of endoscopic ultrasound to biopsy renal lesions it remains unclear and few cases have been reported. Objectives To evaluate the feasibility and outcome of endoscopic ultrasound fine needle aspiration of renal tumors. Methods Consecutive subjects undergoing attempted endoscopic ultrasound fine needle aspiration of a kidney mass after evaluation with computerized tomography or magnetic resonance. Results Ten procedures were performed in nine male patients (median age 54.7 years on the right (n = 4 and left kidney (n = 4 and bilaterally (n = 1. Kidney masses (median diameter 55 mm ; range 13-160 mm were located in the upper pole (n = 3, the lower pole (n = 2 and the mesorenal region (n = 3. In two cases, the mass involved more than one kidney region. Surgical resection confirmed renal cell carcinoma in six patients in whom pre-operative endoscopic ultrasound fine needle aspiration demonstrated renal cell carcinoma. No complications were reported. Conclusions Endoscopic ultrasound fine needle aspiration appears as a safe and feasible procedure with good results and minimal morbidity.

Windowed time-reversal music technique for super-resolution ultrasound imaging

Science.gov (United States)

Huang, Lianjie; Labyed, Yassin

2018-05-01

Systems and methods for super-resolution ultrasound imaging using a windowed and generalized TR-MUSIC algorithm that divides the imaging region into overlapping sub-regions and applies the TR-MUSIC algorithm to the windowed backscattered ultrasound signals corresponding to each sub-region. The algorithm is also structured to account for the ultrasound attenuation in the medium and the finite-size effects of ultrasound transducer elements.

Motion Detection in Ultrasound Image-Sequences Using Tensor Voting

Science.gov (United States)

Inba, Masafumi; Yanagida, Hirotaka; Tamura, Yasutaka

2008-05-01

Motion detection in ultrasound image sequences using tensor voting is described. We have been developing an ultrasound imaging system adopting a combination of coded excitation and synthetic aperture focusing techniques. In our method, frame rate of the system at distance of 150 mm reaches 5000 frame/s. Sparse array and short duration coded ultrasound signals are used for high-speed data acquisition. However, many artifacts appear in the reconstructed image sequences because of the incompleteness of the transmitted code. To reduce the artifacts, we have examined the application of tensor voting to the imaging method which adopts both coded excitation and synthetic aperture techniques. In this study, the basis of applying tensor voting and the motion detection method to ultrasound images is derived. It was confirmed that velocity detection and feature enhancement are possible using tensor voting in the time and space of simulated ultrasound three-dimensional image sequences.

[Percutaneous ultrasound-guided drainage in the surgical treatment of acute severe pancreatitis].

Science.gov (United States)

Delattre, J-F; Levy Chazal, N; Lubrano, D; Flament, J-B

2004-11-01

To report results of percutaneous ultrasound-guided drainage, performed by a surgeon, in the treatment of complications of acute pancreatitis (AP), and to determine the role of this technique in the therapeutic armamentarium of severe AP. From 1986 to 2001, 59 patients were included in this retrospective study. All patients initially had severe necrotizing AP (mean Ranson score = 4.1 ; range : 2-7). Anatomical lesions included pancreatic abscess in 6 patients and necrosis in 53 (17 stage D and 36 stage E according to Balthazar's classification). Necrosis was infected in 42 and sterile in 11 respectively. Drainage was performed under ultrasound guidance and local anaesthesia using small-diameter drains (7-14 French). Drainage was performed on average 23 days after onset of AP. Infection was proven by fine-needle aspiration in 47 (80 %) patients (41 infected necrosis and 6 localized abscess). In one patient, culture of aspirated fluid was negative but necrosis was infected (one false negative). Culture of aspirated fluid was negative and necrosis was sterile in 11 patients. Nineteen (32%) patients healed without subsequent surgery: 7 (16%) in the infected necrosis group, 6(55%) in the sterile necrosis group, and 6 (100%) in the abscess group. Forty (68%) patients had subsequent necrosectomy including 8 (14%) who died. Twenty (34 %) digestive fistulas healed spontaneously, except one treated by diversion stomia. Of the 16 (27 %) pancreatic fistulas, 6 needed subsequent interventional treatment. In selected patients, percutaneous drainage can represent an alternative to surgery with a 14% mortality rate. The high rate of subsequent necrosectomy suggests that drains with larger diameter, possibly associated with continuous irrigation, should be used.

The OMERACT Ultrasound Group

DEFF Research Database (Denmark)

Terslev, Lene; Iagnocco, Annamaria; Bruyn, George A W

2017-01-01

OBJECTIVE: To provide an update from the Outcome Measures in Rheumatology (OMERACT) Ultrasound Working Group on the progress for defining ultrasound (US) minimal disease activity threshold at joint level in rheumatoid arthritis (RA) and for standardization of US application in juvenile idiopathic......) and power Doppler (PD). Synovial effusion (SE) was scored a binary variable. For JIA, a Delphi approach and subsequent validation in static images and patient-based exercises were used to developed preliminary definitions for synovitis and a scoring system. RESULTS: For minimal disease activity, 7% HC had...

Surgical smoke.

Science.gov (United States)

Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

2009-10-01

Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

Bedside Ultrasound for the Diagnosis of Small Bowel Obstruction

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Alexander Anshus

2017-09-01

Full Text Available History of present illness: An elderly female with no history of prior abdominal surgeries presented to the emergency department (ED with acute onset of abdominal pain and distention. Upon arrival, she began having large volume bilious emesis. While waiting for a computed tomography (CT scan of her abdomen and pelvis, a point of care ultrasound (POCUS was performed which showed evidence of a small bowel obstruction (SBO. The patient had a nasogastric tube placed that put out over two liters of bilious contents. A subsequent CT scan confirmed the diagnosis of SBO from a left inguinal hernia and the patient was admitted to the surgical service. Significant findings: The POCUS utilizing the low frequency curvilinear probe demonstrates fluid-filled, dilated bowel loops greater than 2.5cm with to-and-fro peristalsis, and thickened bowel walls greater than 3mm, concerning for SBO. Discussion: Gastrointestinal obstruction is a common diagnosis in the ED, accounting for approximately 15% of all ED visits for acute abdominal pain.1 SBO accounts for approximately 80% of all obstructions.2 In the diagnosis of SBO, studies show that abdominal x-rays have a sensitivity of 66-77% and specificity of 50-57%,3 CT scans have a sensitivity of 92% and specificity of 93%,4 and ultrasound has a sensitivity of 88% and specificity of 96%.5 While CT scan remains a widely accepted modality for diagnosing SBO, ultrasound is more cost effective, well tolerated, does not involve ionizing radiation, and can be done in a timely manner at the patient’s bedside. Ultrasound can also identify transition points as well as distinguish between functional and mechanical obstruction.6 In addition to SBO, ultrasound can be used to diagnose external hernias, intussusception, tumors, superior mesenteric artery (SMA syndrome, foreign bodies, bezoars, and ascariasis.7

A GPU Accelerated Spring Mass System for Surgical Simulation

DEFF Research Database (Denmark)

Mosegaard, Jesper; Sørensen, Thomas Sangild

2005-01-01

There is a growing demand for surgical simulators to dofast and precise calculations of tissue deformation to simulateincreasingly complex morphology in real-time. Unfortunately, evenfast spring-mass based systems have slow convergence rates for largemodels. This paper presents a method to accele...... to accelerate computation of aspring-mass system in order to simulate a complex organ such as theheart. This acceleration is achieved by taking advantage of moderngraphics processing units (GPU)....

The use of vertical constructed wetland and ultrasound in aquaponic systems.

Science.gov (United States)

Krivograd Klemenčič, A; Griessler Bulc, T

2015-01-01

Treatment performance, fish production, crop plant biomass production, water consumption, and water use efficiency of a pilot aquaponic system for small-scale land-based cyprinid fish farms were evaluated. The system consisted of a 36 m(3) Pond A with an initial carp load of 0.6 kg/m(3); of a treatment chain with a lamellar settler, a roughing filter, a vertical constructed wetland filled with expanded clay and planted with tomatoes; and of a low power ultrasound unit installed in the corner of the pond. The average circulation of the water in the system was 1.2 times per day. Pond A was compared with Pond B of the same dimensions and fish load but with no treatment chain or ultrasound. The treatment chain was efficient in mass removal of total suspended solids , biochemical oxygen demand, chemical oxygen demand, NH4-N, total nitrogen, and total phosphorous (57, 49, 35, 42, 31, and 25 %, respectively). Negative removal of NO3-N, NO2-N, and PO4-P indicated the need for the introduction of additional hydroponic beds in the system. Pond A had markedly lower nutrient concentrations compared with Pond B. Fish body weight increase and specific growth rate in Pond A were higher than in Pond B (102.6 %, 72.1 %; 0.19 %/day, 0.14 %/day, respectively) indicating better rearing conditions in Pond A. Tomato biomass production was high. Water use efficiency was higher in Pond A compared with Pond B (0.31 kg of produced fish/m(3) inflow water and 0.22 kg of produced fish/m(3) inflow water, respectively). The presented aquaponic system could be useful for semi-natural fish farming with fish loads up to 2 kg/m(3).

Clinically low-risk prostate cancer: evaluation with transrectal doppler ultrasound and functional magnetic resonance imaging

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Maria Inês Novis

2011-01-01

Full Text Available OBJECTIVES: To evaluate transrectal ultrasound, amplitude Doppler ultrasound, conventional T2-weighted magnetic resonance imaging, spectroscopy and dynamic contrast-enhanced magnetic resonance imaging in localizing and locally staging low-risk prostate cancer. INTRODUCTION: Prostate cancer has been diagnosed at earlier stages and the most accepted classification for low-risk prostate cancer is based on clinical stage T1c or T2a, Gleason score <6, and prostate-specific antigen (PSA <10 ng/ml. METHODS: From 2005 to 2006, magnetic resonance imaging was performed in 42 patients, and transrectal ultrasound in 26 of these patients. Seven patients were excluded from the study. Mean patient age was 64.94 years and mean serum PSA was 6.05 ng/ml. The examinations were analyzed for tumor identification and location in prostate sextants, detection of extracapsular extension, and seminal vesicle invasion, using surgical pathology findings as the gold standard. RESULTS: Sixteen patients (45.7% had pathologically proven organ-confined disease, 11 (31.4% had positive surgical margin, 8 (28.9% had extracapsular extension, and 3 (8.6% presented with extracapsular extension and seminal vesicle invasion. Sensitivity, specificity, positive predictive value (PPV, negative predictive value (NPV and accuracy values for localizing low-risk prostate cancer were 53.1%, 48.3%, 63.4%, 37.8% and 51.3% for transrectal ultrasound; 70.4%, 36.2%, 65.1%, 42.0% and 57.7% for amplitude Doppler ultrasound; 71.5%, 58.9%, 76.6%, 52.4% and 67.1% for magnetic resonance imaging; 70.4%, 58.7%, 78.4%, 48.2% and 66.7% for magnetic resonance spectroscopy; 67.2%, 65.7%, 79.3%, 50.6% and 66.7% for dynamic contrast-enhanced magnetic resonance imaging, respectively. Sensitivity, specificity, PPV, NPV and accuracy values for detecting extracapsular extension were 33.3%, 92%, 14.3%, 97.2% and 89.7% for transrectal ultrasound and 50.0%, 77.6%, 13.7%, 95.6% and 75.7% for magnetic resonance imaging

Histological diagnosis of ultrasound-visible breast lesions by large core needle biopsy

International Nuclear Information System (INIS)

Sanchis-Querol, E.; Valeros, O.; Collado, A.; Gimenez, J.; Yanguas, C.

1999-01-01

We present our experience in the histological diagnosis of breast lesions using ultrasound-guided large core needle biopsy (LCNB), assessing its utility as an alternative to excisional biopsy. We have studied retrospectively a series of 146 cases involving the performance of LCNB. The results were comparable with those of FNAB in 59 cases and with those of surgical aspiration biopsy in 105. Of the 113 lesions identified as malignant by percutaneous large core needle aspiration biopsy, 96 were resected. Surgical aspiration biopsy agreed with LCNB in 100% of cases. Of the 33 lesions identified as benign by LCNB, surgical biopsy detected malignancy in 5. The results obtained establish a specificity for LCNB of 100% and a sensitivity of 96%, both of which are superior to the values for FNAB. Thus, this technique can be considered valid for preoperative diagnosis. LCNB is useful in the preoperative diagnosis of breast lesions, making FNAB and surgical biopsy unnecessary. Moreover, it constitutes a significant change in the management of patients with malignant or undetermined breast lesions. (Author) 8 refs

A cable-driven soft robot surgical system for cardiothoracic endoscopic surgery: preclinical tests in animals.

Science.gov (United States)

Wang, Hesheng; Zhang, Runxi; Chen, Weidong; Wang, Xiaozhou; Pfeifer, Rolf

2017-08-01

Minimally invasive surgery attracts more and more attention because of the advantages of minimal trauma, less bleeding and pain and low complication rate. However, minimally invasive surgery for beating hearts is still a challenge. Our goal is to develop a soft robot surgical system for single-port minimally invasive surgery on a beating heart. The soft robot described in this paper is inspired by the octopus arm. Although the octopus arm is soft and has more degrees of freedom (DOFs), it can be controlled flexibly. The soft robot is driven by cables that are embedded into the soft robot manipulator and can control the direction of the end and middle of the soft robot manipulator. The forward, backward and rotation movement of the soft robot is driven by a propulsion plant. The soft robot can move freely by properly controlling the cables and the propulsion plant. The soft surgical robot system can perform different thoracic operations by changing surgical instruments. To evaluate the flexibility, controllability and reachability of the designed soft robot surgical system, some testing experiments have been conducted in vivo on a swine. Through the subxiphoid, the soft robot manipulator could enter into the thoracic cavity and pericardial cavity smoothly and perform some operations such as biopsy, ligation and ablation. The operations were performed successfully and did not cause any damage to the surrounding soft tissues. From the experiments, the flexibility, controllability and reachability of the soft robot surgical system have been verified. Also, it has been shown that this system can be used in the thoracic and pericardial cavity for different operations. Compared with other endoscopy robots, the soft robot surgical system is safer, has more DOFs and is more flexible for control. When performing operations in a beating heart, this system maybe more suitable than traditional endoscopy robots.

Ultrasound in differential diagnosis of periapical radiolucencies: A radiohistopathological study

Science.gov (United States)

Khambete, Neha; Kumar, Rahul

2015-01-01

Objectives: To evaluate the efficacy of ultrasound in differential diagnosis of periapical radiolucencies. Materials and Methods: Ten patients aged between 19 years and 40 years with periapical lesions associated with anterior maxillary or mandibular teeth were selected and consented for the study. Pre-operative periapical radiographs were obtained. Measurements and provisional diagnoses of the apical areas were made by two specialist observers on two separate occasions. Preoperative ultrasound examinations with Doppler flowmetry were then performed and the images assessed by two specialist observers for the size, contents, vascular supply and a provisional diagnosis made as to whether the lesion was a cyst or granuloma. Endodontic surgery was performed including curettage of the apical tissues to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed. Results: Total 10 lesions were identified in 10 patients. On periapical radiographs, lesions were readily identified but observers were unable to differentiate granuloma from cyst using either modality. Where sufficient buccal cortical bone had been resorbed, ultrasound imaging was simple but underestimated the size of the lesions compared with periapical radiographs. In all cases, the ultrasound diagnosis agreed with the histopathological gold standard. Conclusion: Ultrasonography (USG) can provide accurate information about the nature of intraosseous lesions of the jaws before any surgical procedure. It is proposed that USG with Doppler flowmetry can provide an additional diagnostic tool without invasive surgery, where treatment option is nonsurgical. PMID:25657525

Ultrasound diagnosis of uterine myomas and complications in pregnancy.

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Exacoustòs, C; Rosati, P

1993-07-01

To evaluate myomas for ultrasound-documented size, location, position, and relation to the placenta, and to relate these findings to complications during pregnancy, at delivery, and in the puerperium. Among 12,708 pregnant patients who had ultrasound scans, 492 had uterine myomas. Single myomas were found in 88% of cases and multiple myomas in 12%. The myomas were evaluated for size, number, position, location, relationship to the placenta, and echogenic structure, and the outcome of pregnancy was compared to that of patients in the control group. A statistically significant increased incidence of threatened abortion, threatened preterm delivery, abruptio placentae, and pelvic pain was observed in patients with uterine myomas (P abortion, preterm birth, premature rupture of membranes, and fetal growth did not seem to be affected by the presence of myomas. Thirty-two women with uterine myomas were managed surgically. Thirteen underwent myomectomy during pregnancy. Of these, eight delivered at term and five delivered preterm after the 32nd week of gestation. None of the deliveries were associated with neonatal death. The other 19 patients had surgery at delivery. Nine myomectomies were performed at cesarean delivery. Of these, three were complicated by severe hemorrhage necessitating hysterectomy. Another nine hysterectomies were performed during cesarean and one after vaginal delivery. In addition to myoma size, the ultrasound evaluation of pregnant women with myomas should include position, location, relationship to the placenta, and echogenic structure. These ultrasound findings make it possible to identify women at risk for myoma-related complications and could be useful in managing the pregnancy.

Ultrasound-based scores as predictors for nodular hyperplasia in patients with secondary hyperparathyroidism: a prospective validation study.

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Gwiasda, Jill; Kaltenborn, Alexander; Müller, Jörg A; Serttas, Michaela; Scheumann, Georg W F; Schrem, Harald; Jäger, Mark D

2017-03-01

Former studies evaluated echostructural and vascular patterns in ultrasound of the parathyroid gland to identify nodular hyperplasia in patients with secondary hyperparathyroidism due to chronic kidney disease. This prospective study aims to externally validate suggested ultrasound classifications. Parathyroid glands of 27 patients with secondary hyperparathyroidism undergoing parathyroidectomy were prospectively analyzed. Ultrasound including Doppler imaging was performed 1 day prior to surgery. Ultrasound data were available for 70 parathyroid glands. Echostructural and vascular scores according to previous studies were applied calculating the area under the receiver operating characteristic curve (AUROC). Overall correctness, sensitivity, and specificity of the investigated scores were assessed with the Youden index method. The Doppler score introduced by Vulpio and colleagues based on characteristic blood flow patterns in parathyroid glands showed an AUROC of 0.749 for the prediction of nodular hyperplasia with an overall correctness of 72.8%. Other ultrasound classifications based on blood flow patterns, as well as echostructure of the parathyroid gland displayed AUROCs of secondary hyperparathyroidism was externally validated for the first time. Other ultrasound scores fail as prognostic models in this study population. Doppler sonography of the parathyroid gland has prognostic capability to identify nodular hyperplasia as surrogate marker for patients with secondary hyperparathyroidism indicating the need for ablative or surgical treatment when failing conservative therapy.

The da vinci robot system eliminates multispecialty surgical trainees' hand dominance in open and robotic surgical settings.

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Badalato, Gina M; Shapiro, Edan; Rothberg, Michael B; Bergman, Ari; RoyChoudhury, Arindam; Korets, Ruslan; Patel, Trushar; Badani, Ketan K

2014-01-01

Handedness, or the inherent dominance of one hand's dexterity over the other's, is a factor in open surgery but has an unknown importance in robot-assisted surgery. We sought to examine whether the robotic surgery platform could eliminate the effect of inherent hand preference. Residents from the Urology and Obstetrics/Gynecology departments were enrolled. Ambidextrous and left-handed subjects were excluded. After completing a questionnaire, subjects performed three tasks modified from the Fundamentals of Laparoscopic Surgery curriculum. Tasks were performed by hand and then with the da Vinci robotic surgical system (Intuitive Surgical, Sunnyvale, California). Participants were randomized to begin with using either the left or the right hand, and then switch. Left:right ratios were calculated from scores based on time to task completion. Linear regression analysis was used to determine the significance of the impact of surgical technique on hand dominance. Ten subjects were enrolled. The mean difference in raw score performance between the right and left hands was 12.5 seconds for open tasks and 8 seconds for robotic tasks (Probot tasks, respectively (Probotic and open approaches for raw time scores (Phand, prior robotic experience, and comfort level. These findings remain to be validated in larger cohorts. The robotic technique reduces hand dominance in surgical trainees across all task domains. This finding contributes to the known advantages of robotic surgery.

Three-dimensional ultrasound image-guided robotic system for accurate microwave coagulation of malignant liver tumours.

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Xu, Jing; Jia, Zhen-zhong; Song, Zhang-jun; Yang, Xiang-dong; Chen, Ken; Liang, Ping

2010-09-01

The further application of conventional ultrasound (US) image-guided microwave (MW) ablation of liver cancer is often limited by two-dimensional (2D) imaging, inaccurate needle placement and the resulting skill requirement. The three-dimensional (3D) image-guided robotic-assisted system provides an appealing alternative option, enabling the physician to perform consistent, accurate therapy with improved treatment effectiveness. Our robotic system is constructed by integrating an imaging module, a needle-driven robot, a MW thermal field simulation module, and surgical navigation software in a practical and user-friendly manner. The robot executes precise needle placement based on the 3D model reconstructed from freehand-tracked 2D B-scans. A qualitative slice guidance method for fine registration is introduced to reduce the placement error caused by target motion. By incorporating the 3D MW specific absorption rate (SAR) model into the heat transfer equation, the MW thermal field simulation module determines the MW power level and the coagulation time for improved ablation therapy. Two types of wrists are developed for the robot: a 'remote centre of motion' (RCM) wrist and a non-RCM wrist, which is preferred in real applications. The needle placement accuracies were robot with the RCM wrist was improved to 1.6 +/- 1.0 mm when real-time 2D US feedback was used in the artificial-tissue phantom experiment. By using the slice guidance method, the robot with the non-RCM wrist achieved accuracy of 1.8 +/- 0.9 mm in the ex vivo experiment; even target motion was introduced. In the thermal field experiment, a 5.6% relative mean error was observed between the experimental coagulated neurosis volume and the simulation result. The proposed robotic system holds promise to enhance the clinical performance of percutaneous MW ablation of malignant liver tumours. Copyright 2010 John Wiley & Sons, Ltd.

Dual-Modality Imaging of the Human Finger Joint Systems by Using Combined Multispectral Photoacoustic Computed Tomography and Ultrasound Computed Tomography

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Yubin Liu

2016-01-01

Full Text Available We developed a homemade dual-modality imaging system that combines multispectral photoacoustic computed tomography and ultrasound computed tomography for reconstructing the structural and functional information of human finger joint systems. The fused multispectral photoacoustic-ultrasound computed tomography (MPAUCT system was examined by the phantom and in vivo experimental tests. The imaging results indicate that the hard tissues such as the bones and the soft tissues including the blood vessels, the tendon, the skins, and the subcutaneous tissues in the finger joints systems can be effectively recovered by using our multimodality MPAUCT system. The developed MPAUCT system is able to provide us with more comprehensive information of the human finger joints, which shows its potential for characterization and diagnosis of bone or joint diseases.

Applications of ultrasound in food and bioprocessing.

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Ashokkumar, Muthupandian

2015-07-01

Improving the quality and nutritional aspects of food is one of the key issues for healthy life of human beings. The stability during storage is an important parameter in quality assurance of food products. Various processing techniques such as high pressure, thermal, pulsed electric field and microwave have been used to prolong the shelf-life of food products. In recent years, ultrasound technology has been found to be a potential food processing technique. The passage of ultrasound in a liquid matrix generates mechanical agitation and other physical effects due to acoustic cavitation. Owing to its importance, a number of review articles and book chapters on the applications of ultrasound in food processing have been published in recent years. This article provides an overview of recent developments in ultrasonic processing of food and dairy systems with a particular focus on functionality of food and dairy ingredients. More specifically, the use of high frequency ultrasound in fat separation from milk and viscosity modification in starch systems and the use of low frequency ultrasound in generating nutritional food emulsions, viscosity modification and encapsulation of nutrients have been highlighted. The issues associated with the development of large scale ultrasonic food processing equipment have also been briefly discussed. Copyright © 2014 Elsevier B.V. All rights reserved.

Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery.

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Singla, Rohit; Edgcumbe, Philip; Pratt, Philip; Nguan, Christopher; Rohling, Robert

2017-10-01

In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

A comparison of ultrasound guided fine needle aspiration cytology and core needle biopsy in evaluation of palpable breast lesions

International Nuclear Information System (INIS)

Altaf, H.N.; Farooqui, F.

2015-01-01

Objective: To compare ultrasound guided fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in patients presenting with palpable breast lumps (PBLs), in terms of sensitivity and specificity, taking final histopathology as gold standard. Methodology: This cross-sectional study was conducted at Holy Family Hospital, Rawalpindi, Pakistan. Ultrasound guided FNAC and CNB were taken of all female patients with PBLs. The results were compared with final histopathology as gold standard. Data analysis was performed using SPSS software and chi-square test. Results: A total of 60 patients were included in the study. The mean age was 33.8 yrs. The sensitivity and specificity of ultrasound guided FNAC were 68.7% and 93.1%, respectively. The sensitivity and specificity of ultrasound guided CNB was 93.7% and 100%. The accuracy of FNAC was 86.2% and that of core needle biopsy was 98.3%. Conclusion: The ultrasound guided core needle biopsy can be used as an initial diagnostic test for the evaluation of all PBLs. Because of high negative predictive value core needle biopsy can replace surgical excision biopsy for benign lesions. (author)

Analysis of Achilles tendon vascularity with second generation Contrast-Enhanced Ultrasound (CEUS)

OpenAIRE

Genovese , Eugenio; Ronga , Mario; Recaldini , Chiara; Fontana , Federico; Callegari , Leonardo; Fugazzola , Carlo

2011-01-01

Abstract Purpose: To compare morphological and power Doppler features of the Achilles tendon and Contrast-Enhanced Ultrasound (CEUS) behaviour between asymptomatic athletes and athletes who had undergone surgery for repair of an Achilles tendon rupture. Materials and Methods: 24 athletes were divided in two groups (A and B). Group A included 14 patients with a median age of 32 years (range 27 to 47 years) who had undergone surgical repair for unilateral Achilles tendon ...

Test characteristics of high frequency ultrasound in the pre-operative assessment of margins of basal cell and squamous cell carcinoma in patients undergoing Mohs micrographic surgery

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Jambusaria-Pahlajani, Anokhi; Schmults, Chrysalyne D.; Miller, Christopher J.; Shin, Daniel; Williams, Jennifer; Kurd, Shanu K; Gelfand, Joel M.

2015-01-01

Background Non-invasive techniques to assess subclinical spread of non-melanoma skin cancer (NMSC) may improve surgical precision. High frequency ultrasound (HIFU) has shown promise to evaluate the extent of NMSC. Objective To determine the accuracy of HIFU to assess the margins of basal cell (BCC) and squamous cell carcinomas (SCC) prior to Mohs micrographic surgery (MMS). Methods We enrolled 100 patients with invasive SCC or BCC. Prior to the first stage of MMS, a Mohs surgeon delineated the intended surgical margin. Subsequently, a trained ultrasound technologist independently evaluated disease extent using the EPISCAN I-200 to evaluate tumor extent beyond this margin. The accuracy of HIFU was subsequently tested by comparison to pathology from frozen sections. Results The test characteristics of the ultrasound were sensitivity= 32%, specificity= 88%, positive predictive value= 47%, and negative predictive value=79%. Subgroup analyses demonstrated improved test characteristics for tumors larger than the median (area >1.74 cm2). Qualitative analyses showed that HIFU was less likely to identify extension from tumors with subtle areas of extension, such as small foci of dermal invasion from infiltrative SCC and micronodular BCC. Conclusions HIFU requires additional refinements to improve the preoperative determination of tumor extent prior to surgical treatment of NMSC. PMID:19018815

An optimum method for pulsed high intensity focused ultrasound treatment of large volumes using the InSightec ExAblate (registered) 2000 system

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O' Neill, B E; Karmonik, C; Li, K C P, E-mail: beoneill@tmhs.or [The Methodist Hospital Research Institute, 6565 Fannin, Houston TX 77030 (United States)

2010-11-07

Pulsed high intensity focused ultrasound (pHIFU) is a method for delivering ultrasound to tissue while avoiding high temperatures. The technique has been suggested for non-destructively enhancing local uptake of drugs. Side effects include thermal necrosis; therefore, real-time monitoring of tissue temperature is advantageous. This paper outlines a method for improving the treatment efficiency of pHIFU using the MR image-guided InSightec ExAblate (registered) 2000 system, an ultrasound system integrated into a whole body human MRI scanner with the ability to measure temperature at the treatment location in near real time. Thermal measurements obtained during treatment of a tissue phantom were used to determine appropriate heating parameters, and compared to in vivo treatment of rabbit muscle. Optimization of the treatment procedure and ultrasound transducer steering patterns was then conducted with the goal of minimizing treatment time while avoiding overheating. The optimization was performed on the basis of approximate solutions to the standard bioheat equation. The commercial system software of the Exablate (registered) system was modified to assist in this optimization. Depending on the size of the treatment volume, the presented results demonstrate that it is possible to use the technique described to cut treatment times significantly, up to one-third of that required by the current standard treatment cycle.

Application of Ultrasound in a Closed System: Optimum Condition for Antioxidants Extraction of Blackberry (Rubus fructicosus) Residues.

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Zafra-Rojas, Quinatzin Y; Cruz-Cansino, Nelly S; Quintero-Lira, Aurora; Gómez-Aldapa, Carlos A; Alanís-García, Ernesto; Cervantes-Elizarrarás, Alicia; Güemes-Vera, Norma; Ramírez-Moreno, Esther

2016-07-21

Blackberry processing generates up to 20% of residues composed mainly of peel, seeds and pulp that are abundant in flavonoids. The objective of this study was to optimize the ultrasound conditions, in a closed system, for antioxidants extraction, using the response surface methodology. Blackberry (Rubus fructicosus) residues were analyzed for total phenolics, total anthocyanins, and antioxidant activity by ABTS and DPPH. The selected independent variables were ultrasound amplitude (X₁: 80%-90%) and extraction time (X₂: 10-15 min), and results were compared with conventional extraction methods. The optimal conditions for antioxidants extraction were 91% amplitude for 15 min. The results for total phenolic content and anthocyanins and antioxidant activity by ABTS and DPPH were of 1201.23 mg gallic acid equivalent (GAE)/100 g dry weight basis (dw); 379.12 mg/100 g·dw; 6318.98 µmol Trolox equivalent (TE)/100 g·dw and 9617.22 µmol TE/100 g·dw, respectively. Compared to solvent extraction methods (water and ethanol), ultrasound achieved higher extraction of all compounds except for anthocyanins. The results obtained demonstrated that ultrasound is an alternative to improve extraction yield of antioxidants from fruit residues such as blackberry.

LED surgical lighting system with multiple free-form surfaces for highly sterile operating theater application.

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Liu, Peng; Zhang, Yaqin; Zheng, Zhenrong; Li, Haifeng; Liu, Xu

2014-06-01

Although the ventilation system is widely employed in the operating theater, a strictly sterile surgical environment still cannot be ensured because of laminar disturbance, which is mainly caused by the surgical lighting system. Abandoning traditional products, we propose an LED surgical lighting system, which can alleviate the laminar disturbance and provide an appropriate lighting condition for surgery. It contains a certain amount of LED lens units, which are embedded in the ceiling and arranged around the air supply smallpox. The LED lens unit integrated with an LED light source and a free-form lens is required to produce a uniform circular illumination with a large tolerance to the change of lighting distance. To achieve such a dedicated lens, two free-form refractive surfaces, which are converted into two ordinary differential equations by the design method presented in this paper, are used to deflect the rays. The results show that the LED surgical lighting system can provide an excellent illumination environment for surgery, and, apparently, the laminar disturbance also can be relieved.

Dermatomyositis and calcific myonecrosis in the leg: ultrasound as an aid in management

International Nuclear Information System (INIS)

Batz, Richard; Sofka, Carolyn M.; Adler, Ronald S.; Mintz, Douglas N.; DiCarlo, Edward

2006-01-01

Calcific myonecrosis, often reported in the setting of prior trauma or compartment syndrome, has traditionally been treated with surgical debridement; however, these cases are often complicated by poor wound closure and poor healing. Serial percutaneous aspirations, instead, have been proposed as an alternative treatment option. This is the first report, to our knowledge, of the use of ultrasound guidance in the aspiration of calcific myonecrosis as an aid in management. (orig.)

A Google Glass navigation system for ultrasound and fluorescence dual-mode image-guided surgery