Comparison of low-dose CT with CT/CT fluoroscopy guidance in percutaneous sacral and supra-acetabular cementoplasty

Expanding the Utilization of Low-Dose Computed Tomography in Plastic and Reconstructive Surgery Based on Validated Practices Among Surgical Specialties

INTRODUCTION

As computed tomography (CT) usage increases, so have concerns over radiation-induced malignancy. To mitigate these risks, low-dose CT (LDCT) has emerged as a versatile alternative by other specialties, although its use in plastic surgery remains sparse. This study aimed to investigate validated uses of LDCT across surgical specialties and extrapolate these insights to expand its application for plastic surgeons.

METHODS

A systematic review of the literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using search terms "low dose CT" OR "low dose computed tomography" AND "surgery," where the name of each surgical specialty was substituted for word "surgery" and each specialty term was searched separately in combination with the 2 CT terms. Data on radiation dose, outcomes, and level of evidence were collected. Validated surgical applications were correlated with similar procedures and diagnostic tests performed routinely by plastic surgeons to extrapolate potential applications for plastic surgeons.

RESULTS

A total of 3505 articles were identified across surgical specialties, with 27 ultimately included. Depending on the application, use of LDCT led to a 25% to 97% reduction in radiation dose and all studies reported noninferior image quality and diagnostic capability compared with standard-dose CT. Potential identified uses included the following: evaluation of soft tissue infections, preoperative and postoperative management of facial and hand fractures, flap design, 3D modeling, and surgical planning.

DISCUSSION

Low-dose CT is a valid imaging alternative to standard-dose CT. Expanded utilization in plastic surgery should be considered to minimize the iatrogenic effects of radiation and to promote patient safety without compromising outcomes.

Computed Tomography Image Feature under Intelligent Algorithms in Diagnosing the Effect of Humanized Nursing on Neuroendocrine Hormones in Patients with Primary Liver Cancer

This study was to explore the application value of computed tomography (CT) images processed by intelligent algorithm denoising in the evaluation of humanized nursing in postoperative neuroendocrine hormone changes in patients with primary liver cancer (PLC). In this study, a simple-structured recursive residual coding and decoding (RRCD) algorithm was constructed on the basis of residual network, which can effectively remove artifacts and noise in CT images and can also restore image details and lesion features well. In addition, 60 postoperative patients with primary liver cancer were collected and divided into routine nursing control group (30 cases) and humanized nursing experimental group (30 cases). After a period of nursing, CT images based on intelligent algorithms were evaluated by determining the hormone content. The results showed that the focal necrosis rate (FNR) of the experimental group was 6%. The adrenocorticotropic hormone (ACTH) levels of 6 and 15 days after admission (T3 and T4) were 41.25 ± 3.81 pg/mL and 19.55 ± 1.72 pg/mL, respectively. The cortisol levels of days 6, 15, and 30 after admission (T3, T4, and T5) were 424.86 ± 16.82 nmol/L, 277.98 ± 14.36 nmol/L, and 241.53 ± 13.27 nmol/L, respectively. Estradiol levels were 53.48 ± 11.19 pg/mL, 41.64 ± 9.28 pg/mL, and 30.59 ± 8.16 pg/mL, respectively. Testosterone levels were 2.18 ± 1.14 ng/mL, 1.78 ± 1.03 ng/mL, and 1.42 ± 0.69 ng/mL, respectively. Self-Rating Anxiety Scale (SAS) scores were 40.24 ± 5.81 points, 36.55 ± 5.02 points, and 32.53 ± 4.8 points, respectively. There were 24 cases, 27 cases, 23 cases, and 21 patients who followed no smoking and drinking, taking medication on time, diet control, and self-monitoring. The scores of physical function, self-cognition, emotional function, and social function were 62.59 ± 6.82 points, 69.26 ± 8.14 points, 73.89 ± 6.35 points, and 66.88 ± 7.04 points, which were better than those of the control group in all aspects (P < 0.05). In short, the humanized nursing course can enhance the compliance of the patients after the surgery, improve the quality of life, and inhibit the anxiety and depression of the patients, so it showed a positive effect on the neuroendocrine hormones and the prognosis of the patients.

Image-guided Sports Medicine and Musculoskeletal Tumor Interventions: A Patient-Centered Model

The spectrum of effective musculoskeletal (MSK) interventions is broadening and rapidly evolving. Increasing demands incite a perpetual need to optimize services and interventions by maximizing the diagnostic and therapeutic yield, reducing exposure to ionizing radiation, increasing cost efficiency, as well as identifying and promoting effective procedures to excel in patient satisfaction ratings and outcomes. MSK interventions for the treatment of oncological conditions, and conditions related to sports injury can be performed with different imaging modalities; however, there is usually one optimal image guidance modality for each procedure and individual patient. We describe our patient-centered workflow as a model of care that incorporates state-of-the-art imaging techniques, up-to-date evidence, and value-based practices with the intent of optimizing procedural success and outcomes at a patient-specific level. This model contrasts interventionalist- and imaging modality-centered practices, where procedures are performed based on local preference and selective availability of imaging modality or interventionalists. We discuss rationales, benefits, and limitations of fluoroscopy, ultrasound, computed tomography, and magnetic resonance imaging procedure guidance for a broad range of image-guided MSK interventions to diagnose and treat sports and tumor-related conditions.