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Hooshangnejad H, China D, Huang Y, Zbijewski W, Uneri A, McNutt T, Lee J, Ding K. XIOSIS: An X-Ray-Based Intra-Operative Image-Guided Platform for Oncology Smart Material Delivery. IEEE TRANSACTIONS ON MEDICAL IMAGING 2024; 43:3176-3187. [PMID: 38602853 PMCID: PMC11418373 DOI: 10.1109/tmi.2024.3387830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Image-guided interventional oncology procedures can greatly enhance the outcome of cancer treatment. As an enhancing procedure, oncology smart material delivery can increase cancer therapy's quality, effectiveness, and safety. However, the effectiveness of enhancing procedures highly depends on the accuracy of smart material placement procedures. Inaccurate placement of smart materials can lead to adverse side effects and health hazards. Image guidance can considerably improve the safety and robustness of smart material delivery. In this study, we developed a novel generative deep-learning platform that highly prioritizes clinical practicality and provides the most informative intra-operative feedback for image-guided smart material delivery. XIOSIS generates a patient-specific 3D volumetric computed tomography (CT) from three intraoperative radiographs (X-ray images) acquired by a mobile C-arm during the operation. As the first of its kind, XIOSIS (i) synthesizes the CT from small field-of-view radiographs;(ii) reconstructs the intra-operative spacer distribution; (iii) is robust; and (iv) is equipped with a novel soft-contrast cost function. To demonstrate the effectiveness of XIOSIS in providing intra-operative image guidance, we applied XIOSIS to the duodenal hydrogel spacer placement procedure. We evaluated XIOSIS performance in an image-guided virtual spacer placement and actual spacer placement in two cadaver specimens. XIOSIS showed a clinically acceptable performance, reconstructed the 3D intra-operative hydrogel spacer distribution with an average structural similarity of 0.88 and Dice coefficient of 0.63 and with less than 1 cm difference in spacer location relative to the spinal cord.
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Chahine R, Zadeh C, Zeid FA, Al-Kutoubi A. Hysterosalpingography: a step up for dose reduction. Clin Radiol 2024; 79:e89-e93. [PMID: 37923624 DOI: 10.1016/j.crad.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/28/2023] [Accepted: 10/01/2023] [Indexed: 11/07/2023]
Abstract
AIM To evaluate the efficiency of last image capture in interpreting a hysterosalpingogram (HSG) when compared to conventional spot views; to confirm its validity in showing pathology; to establish its use as the preferred method; and to decrease the radiation dose to the patient. MATERIALS AND METHODS The study population consisted of women aged ≥18 years. A standard technique was performed including additional five last image capture after each spot view. Every patient had two stacks of images, one with the exposure film and one with the last image capture. The images were interpreted separately (high-dose versus low-dose) and blindly by two radiologists with different levels of training assessing for uterine abnormalities, fallopian tube abnormalities, peritoneal spillage, and incidental findings. Inter-reading variability was calculated using Kohen's kappa. RESULTS Discrepancies between exposure film and last image capture were detected in only a minority of cases for all variables. Except for the presence of strictures, there was at least substantial agreement between the readers and almost perfect agreement regarding peritoneal spillage and fallopian tube patency, both on exposure film and last image capture. CONCLUSION Reduction in radiation dose without compromising the diagnostic efficacy of HSG is mandatory. If the study is of sufficient quality and deemed negative on last image capture, conventional spot view can be avoided. If further detail is required, standard spot views can still be obtained. Using last image capture instead of spot films has the potential to reduce the overall radiation dose by up to 78%.
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Affiliation(s)
- R Chahine
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - C Zadeh
- Department of Diagnostic Radiology, University of Iowa Healthcare, Iowa City, Iowa, USA
| | - F Abou Zeid
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - A Al-Kutoubi
- Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
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Roberts A. Fallopian tube recanalization for the management of infertility. CVIR Endovasc 2023; 6:13. [PMID: 36912985 PMCID: PMC10011273 DOI: 10.1186/s42155-023-00356-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/14/2023] [Indexed: 03/14/2023] Open
Abstract
Infertility is a world-wide problem, defined as failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse. There are multiple causes for infertility involving both male and female factors. Fallopian tube occlusion is a common reason for female infertility. The initial attempts to treat proximal obstruction involved the use of a whalebone bougie positioned in the uterine cornua to dilate the proximal tube by Smith as early as 1849. Fluoroscopic fallopian tube recanalization for the treatment of infertility was first described in 1985. Since that time, there have been over 100 papers describing various methods for recanalization of occluded fallopian tubes. Fallopian tube recanalization is a minimally invasive procedure which is performed on an outpatient basis. It should be a first line therapy for patients with proximal occlusion of fallopian tubes.
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Affiliation(s)
- Anne Roberts
- University of California, San Diego, 9300 Campus Point Drive, La Jolla, CA, 92037, USA.
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J A A, M A A, M R U, C A A. Assessment of Patient Absorbed Radiation Dose during Hysterosalpingography: A Pilot Study in Southwest Nigeria. J Biomed Phys Eng 2020; 10:131-140. [PMID: 32337179 PMCID: PMC7166218 DOI: 10.31661/jbpe.v0i0.1054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 12/10/2018] [Indexed: 06/11/2023]
Abstract
BACKGROUND Hysterosalpingography (HSG) is an indispensable tool for diagnosing infertility in females. The procedure exposes female reproductive organs to ionizing radiation as the genitals are irradiated during the process. Investigating patient absorbed dose during the procedures is essential for effective radiological protection of the patient. OBJECTIVE This study aims to investigate the radiation dose received by patient during HSG examination in the study environment in order to enhance optimization of procedures and the associated dose, thereby minimizing radiation risks. MATERIAL AND METHODS The prospective pilot study, was conducted in four tertiary healthcare institutions in Southwest Nigeria. Thermoluminescence dosimeter (TLD 100) was used to determine the Entrance Surface Dose (ESD) of 80 patients presented for HSG investigation. The corresponding effective dose, ovary, uterus and urinary bladder doses were evaluated using PCXMC software. RESULTS The mean entrance surface doses (ESD) obtained from the four centers were 18.58±6.31 mGy, 15.18±2.27 mGy, 17.44±3.43 mGy and 34.24±11.98 mGy for SW1, SW2, SW3 and SW4 centers, respectively. The corresponding mean of effective doses were 1.54±0.63 mSv, 1.24±0.28 mSv, 1.41±0.30 mSv and 2.53±0.94 mSv for SW1, SW2, SW3 and SW4 centers, respectively. The resulting mean doses to the ovary, urinary bladder and uterus were also presented. CONCLUSION The results obtained in general are comparable with international standards. It was, however, recommended that study centers with high doses should conduct dose audit in order to enhance patient safety.
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Affiliation(s)
- Achuka J A
- PhD, Department of Physics, Covenant University Ota, Ogun State, Nigeria
| | - Aweda M A
- PhD, Department of Radiation Biology, Radiotherapy and Radiodiagnosis, College of Medicine, Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria
| | - Usikalu M R
- PhD, Department of Physics, Covenant University Ota, Ogun State, Nigeria
| | - Aborisade C A
- PhD, Department of Physics and Engineering Physics, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
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Ngaile J, Msaki P, Kazema R. Monte Carlo based estimation of organ and effective doses to patients undergoing hysterosalpingography and retrograde urethrography fluoroscopy procedures. Radiat Phys Chem Oxf Engl 1993 2018. [DOI: 10.1016/j.radphyschem.2017.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Alzimami K, Sulieman A, Babikir E, Alsafi K, Alkhorayef M, Omer H. Estimation of effective dose during hystrosalpingography procedures in certain hospitals in Sudan. Appl Radiat Isot 2015; 100:2-6. [PMID: 25752707 DOI: 10.1016/j.apradiso.2015.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 02/08/2015] [Accepted: 02/09/2015] [Indexed: 11/18/2022]
Abstract
The aims of this study were to measure the patients' entrance surface air kerma doses (ESAK), effective doses and to compare practices between different hospitals in Sudan. ESAK were measured for patient using calibrated thermo luminance dosimeters (TLDs, GR200A). Effective doses were estimated using National radiological Protection Board (NRPB) software. This study was conducted in five radiological departments: Two Teaching Hospitals (A and D), two private hospitals (B and C) and one University Hospital (E). The mean ESAK was 20.1mGy, 28.9mGy, 13.6mGy, 17.5mGy, 35.7mGy for hospitals A, B, C, D, and E, respectively. The mean effective dose was 2.4mSv, 3.5mSv, 1.6mSv, 2.1mSv and 4.3mSv in the same order. The study showed wide variations in the ESDs with three of the hospitals having values above the internationally reported values.
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Affiliation(s)
- K Alzimami
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P. O. Box 10219, Riyadh 11433, Saudi Arabia.
| | - A Sulieman
- Salman bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P.O. Box 422, Alkharj, Saudi Arabia; Basic Science Department, College of Medical Radiologic Sciences, Sudan University of Science and Technology, P.O. Box 1908, Khartoum, Sudan
| | - E Babikir
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P. O. Box 10219, Riyadh 11433, Saudi Arabia
| | - K Alsafi
- Radiology Department, School of Medicine, King Abdulaziz University, Saudi Arabia
| | - M Alkhorayef
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P. O. Box 10219, Riyadh 11433, Saudi Arabia
| | - Hiba Omer
- Faculty of Medicine, Dammam University, Dammam, Saudi Arabia
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Harvey H, Chavda A, Richenberg J. Fluoroscopic removal of ‘lost thread’ IUCD's: A novel second line technique. J OBSTET GYNAECOL 2014; 35:173-7. [DOI: 10.3109/01443615.2014.940299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Efstathopoulos E, Charalambatou P, Tsalafoutas I, Kelekis A, Antonakos I, Brountzos E, Kelekis D. Effective and ovarian dose in PA conventional and rotational 3D hysterosalpingography examinations. Phys Med 2013; 29:549-55. [DOI: 10.1016/j.ejmp.2013.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 12/27/2012] [Accepted: 01/09/2013] [Indexed: 11/28/2022] Open
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Rehani MM, Ciraj-Bjelac O, Vañó E, Miller DL, Walsh S, Giordano BD, Persliden J. ICRP Publication 117. Radiological protection in fluoroscopically guided procedures performed outside the imaging department. Ann ICRP 2012; 40:1-102. [PMID: 22732420 DOI: 10.1016/j.icrp.2012.03.001] [Citation(s) in RCA: 172] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
An increasing number of medical specialists are using fluoroscopy outside imaging departments, but there has been general neglect of radiological protection coverage of fluoroscopy machines used outside imaging departments. Lack of radiological protection training of those working with fluoroscopy outside imaging departments can increase the radiation risk to workers and patients. Procedures such as endovascular aneurysm repair, renal angioplasty, iliac angioplasty, ureteric stent placement, therapeutic endoscopic retrograde cholangio-pancreatography,and bile duct stenting and drainage have the potential to impart skin doses exceeding Gy. Although tissue reactions among patients and workers from fluoroscopy procedures have, to date, only been reported in interventional radiology and cardiology,the level of fluoroscopy use outside imaging departments creates potential for such injuries.A brief account of the health effects of ionising radiation and protection principles is presented in Section 2. Section 3 deals with general aspects of the protection of workers and patients that are common to all, whereas specific aspects are covered in Section 4 for vascular surgery, urology, orthopaedic surgery, obstetrics and gynaecology,gastroenterology and hepatobiliary system, and anaesthetics and pain management.Although sentinel lymph node biopsy involves the use of radio-isotopic methods rather than fluoroscopy, performance of this procedure in operating theatres is covered in this report as it is unlikely that this topic will be addressed in another ICRP publication in coming years. Information on radiation dose levels to patients and workers, and dose management is presented for each speciality.
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Cobellis L, Argano F, Castaldi MA, Acone G, Mele D, Signoriello G, Colacurci N. Selective salpingography: preliminary experience of an office operative option for proximal tubal recanalization. Eur J Obstet Gynecol Reprod Biol 2012; 163:62-6. [DOI: 10.1016/j.ejogrb.2012.03.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2011] [Revised: 03/08/2012] [Accepted: 03/29/2012] [Indexed: 10/28/2022]
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Bocca SM, Oehninger S, Stadtmauer L, Agard J, Duran EH, Sarhan A, Horton S, Abuhamad AZ. A study of the cost, accuracy, and benefits of 3-dimensional sonography compared with hysterosalpingography in women with uterine abnormalities. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:81-85. [PMID: 22215773 DOI: 10.7863/jum.2012.31.1.81] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVES We conducted a prospective blinded study to evaluate the costs, accuracy, risks, and benefits of 3-dimensional (3D) transvaginal sonography compared to hysterosalpingography. METHODS A total of 101 women aged 26 to 44 years with evidence of uterine anomalies were enrolled. All participants had routine hysterosalpingography as part of their infertility evaluation as well as 3D transvaginal sonography as part of the study. Surgical findings were used as the standard for final diagnosis. RESULTS A total of 6 normal uteri and 119 uterine anomalies were classified: 30 congenital uterine anomalies (3 arcuate, 1 unicornuate, 4 bicornuate, 2 didelphys, and 20 septate uteri) and 89 acquired anomalies (38 polyps, 30 fibroids, 17 synechiae, and 4 adenomyosis). Congenital anomalies were correctly identified in 30 of 30 cases by 3D sonography but from 10 to 30 of 30 cases by hysterosalpingography. The detection rates for acquired uterine anomalies were lower for both techniques: 44 to 89 of 89 cases for 3D sonography and 22 to 74 of 89 cases for hysterosalpingography. Only 7 of the 20 septi would have been surgically corrected if patients only had hysterosalpingography. On the contrary, 30 of 30 patients with congenital uterine anomalies, 2 of 4 patients with adenomyosis, and all 6 patients with normal uteri were spared from surgery with diagnoses by 3D sonography. No adverse effects were reported after sonography, and only 6 minor ones were reported after hysterosalpingography. CONCLUSIONS Three-dimensional transvaginal sonography provides visualization and evaluation of the uterine cavity with similar or better accuracy than standard hysterosalpingography in the office setting, with lower cost and morbidity.
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Affiliation(s)
- Silvina M Bocca
- Jones Institute for Reproductive Medicine, Department of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, VA 23507-1627, USA.
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