Multimodality Imaging Suite: Neo-Futuristic Diagnostic Imaging Operating Suite Marks a Significant Milestone for Innovation in Medical Technology

Neuroendocrine tumors of the urinary system: literature review

Most often, neuroendocrine carcinoma (NEC) is found in the gastrointestinal tract, broncho-pulmonary system, but they can also occur in other organs, such as the kidney, bladder, which is of most interest because of the rarity of this pathology. Until recently, there was not even a proper morphological classification for kidney NEC, and among some histological types, such as large cell neuroendocrine carcinoma of the kidney, only about 7 cases were recorded, and independent bladder carcinoids, about 15 cases. Currently, there are no clinical and morphological features of the NEC of the kidney and bladder, fundamentally distinguishing them from other neuroendocrine tumors and “classic” cancer of the same localization. This article also provides the data of the N.N. Blokhin National Medical Research Centre of Oncology on the incidence of all malignant neoplasms of the urinary system.

Treating cerebrovascular diseases in hybrid operating room equipped with a robotic angiographic fluoroscopy system: level of necessity and 5-year experiences

BACKGROUND

A hybrid operating room (OR) equipped with robotic angiographic fluoroscopy system has become prevalent in neurosurgery. The level of necessity of the hybrid OR in treating cerebrovascular diseases (CVD) is rarely discussed.

OBJECTIVE

The authors proposed a scoring and classification system to evaluate the cerebrovascular procedures according to the level of treatment necessity for CVD in a hybrid OR and shared our 5-year experiences.

METHODS

From December 2009 to January 2016, the registry of cerebrovascular procedures performed in the hybrid OR was retrieved. A scoring system was used to evaluate the importance of the surgical and interventional components of a cerebrovascular procedure performed in the hybrid OR. The score of either component ranged from 1, 1.5, to 2 (1 = no role, 1.5 = supplementary or informative, 2 = important or therapeutic). The total score of a procedure was by multiplying two individual scores. Levels of necessity were classified into level A (important), level B (beneficial), and level C (replaceable).

RESULTS

A total of 1027 cerebrovascular procedures were performed during this period: diagnostic angiography in 328, carotid artery stenting in 286, aneurysm coiling in 128, intra-operative DSA in 101, aspiration of ICH under image guidance in 79, intra-arterial thrombolysis/thrombectomy in 51, intracranial angioplasty/stenting in 30, hybrid surgery/serial procedures in 19, and rescue surgery during embolization in 5. According to the scoring system, hybrid surgery and serial procedures scored the highest points (2 × 2). The percentages distributed at each level: levels A (2.3%), B (17.5%), and C (80.2%).

CONCLUSION

This study conveys a concept of what a hybrid OR equipped with robotic angiographic fluoroscopy system is capable of and its potential. For cerebrovascular diseases, hybrid OR exerts its value via hybrid surgery or avoiding patient transportation in serial procedures (level A), via providing real-time high-quality angiography and image guidance (level B), which constituted about 20% of the cases. The subspecialty of the group using the hybrid OR directly reflects on the number of procedures categorized in each level. In a hybrid OR, innovative treatment strategies for difficult-to-treat CVD can be developed.

Novel CT-guided coil localization of peripheral pulmonary nodules prior to video-assisted thoracoscopic surgery: a pilot study

BACKGROUND

Small peripheral lung nodules detected on computed tomography (CT) scans are often difficult to find during thoracoscopic resection, and the present localizing techniques are inefficient or impractical.

PURPOSE

To evaluate a novel marking procedure for small peripheral pulmonary nodules using an embolization coil.

MATERIAL AND METHODS

Patients with small peripheral pulmonary nodules underwent preoperative CT-guided nodule localization using an embolization coil and then resection by fluoroscopically-guided video-assisted thoracoscopic surgery (VATS; group A, n = 22), or, underwent conventional VATS without prior location procedures (group B, n = 16). Comparisons were made between group A and group B concerning operative time, hospitalization, postoperative drainage, and complications. Histopathological diagnoses were made immediately after resection of pulmonary nodules.

RESULTS

All CT-guided embolization coil fixations were successful. No patient in group A and eight (50%) in group B required conversion to open thoracotomy (P < 0.0001). No severe complications occurred in either group. Compared with group B, group A had a significantly shorter mean operative time and hospitalization, and less postoperative drainage.

CONCLUSION

Preoperative localization of small peripheral pulmonary nodules using CT-guided embolization coil insertion and subsequent fluoroscopically-guided VATS resection is safer and more effective than conventional VATS.