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Batlle C, Faron M, Deschamps F, Najafi A, Kobe A, Bonnet B, Hakimé A, Territehau C, Gouy S, Mir O, Scoazec JY, de Baere T, Honoré C, Tselikas L. Image-guided core biopsy for pelvic lesions of unknown origin. Br J Surg 2024; 111:znad351. [PMID: 37943798 DOI: 10.1093/bjs/znad351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 08/09/2023] [Accepted: 08/11/2023] [Indexed: 11/12/2023]
Affiliation(s)
- Camille Batlle
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Matthieu Faron
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France
- Oncostat U1018, INSERM, Paris-Saclay University, Labeled Ligue Contre le Cancer, Villejuif, France
| | - Frédéric Deschamps
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Arash Najafi
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Adrian Kobe
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Baptiste Bonnet
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Antoine Hakimé
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Christophe Territehau
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Sebastian Gouy
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Olivier Mir
- Département de Médecine Oncologique, Gustave Roussy, Villejuif, France
| | - Jean-Yves Scoazec
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France
- Département d'anatomopathologie, Gustave Roussy, Villejuif, France
| | - Thierry de Baere
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - Charles Honoré
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
| | - Lambros Tselikas
- Département d'Anesthésie Chirurgie Imagerie Interventionnelle, Gustave Roussy, Villejuif, France
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France
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Esfiokhi SHM, Norouzian MA, Najafi A. The Effect of Different Zinc Sources on Biochemical Parameters, Intestinal Morphology, Carcass Characteristics and Performance in Finishing Lambs. Biol Trace Elem Res 2024; 202:175-181. [PMID: 37088827 DOI: 10.1007/s12011-023-03675-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
To investigate the effect of different sources of zinc supplements on blood serum parameters, nutrient digestibility, growth performance, carcass characteristics, and intestinal morphology, 18 male Zandi lambs (with initial body weight of 31 ± 1.2 kg and 120 ± 8 days old) were divided into three groups, six animals each in a completely random design. Experimental treatments include (1) control treatment of basal diet without zinc supplementation, (2) basal diet with 40 mg/kg of zinc supplementation from zinc sulfate source, and (3) basal diet with 40 mg/kg of zinc supplementation with origin it was organic (Zn-peptide). All lambs were kept in individual pens with cemented floor and provision of individual feeding and watering. Mean daily weight gain increased with zinc supplementation (P < 0.05), but feed intake and feed conversion ratio were not affected by zinc supplementation in the diet. Zinc supplementation increased the apparent digestibility of the dry matter (P < 0.05), but the digestibility of dietary fat, neutral detergent fiber (NDF), and acid detergent fiber (ADF) were not affected by zinc supplementation. In this experiment, the addition of organic and inorganic supplements to the diet of fattening lambs had no significant effect on serum triglyceride, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and glucose concentrations, and carcass traits. The concentration of aspartate aminotransferase (AST) enzyme in the zinc sulfate group was significantly higher than the control and organic zinc groups (P < 0.05). Concentrations of blood urea nitrogen were lower in zinc fed lambs, compared to control (P ≤ 0.05). The villi width in the duodenum was higher in the zinc supplementation treatments (P < 0.05). Also, in the ileum section, the height of the villi in the treatment of zinc sulfate supplement was higher, compared to the complement and control (P < 0.05). The results of this study showed that Zn supplementation, regardless of its source, improved growth performance in fattening lambs. However, no effect was observed on feed intake and efficiency, carcass traits, and blood parameters.
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Affiliation(s)
- S H Mousavi Esfiokhi
- Department of Animal and Poultry Sciences, College of Abouraihan, University of Tehran, Tehran, Iran
| | - M A Norouzian
- Department of Animal and Poultry Sciences, College of Abouraihan, University of Tehran, Tehran, Iran.
| | - A Najafi
- Department of Animal and Poultry Sciences, College of Abouraihan, University of Tehran, Tehran, Iran
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Najafi A, Cazzato RL, Meyer BC, Pereira PL, Alberich A, López A, Ronot M, Fritz J, Maas M, Benson S, Haage P, Gomez Munoz F. CIRSE Position Paper on Artificial Intelligence in Interventional Radiology. Cardiovasc Intervent Radiol 2023; 46:1303-1307. [PMID: 37668690 DOI: 10.1007/s00270-023-03521-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 07/21/2023] [Indexed: 09/06/2023]
Abstract
Artificial intelligence (AI) has made tremendous advances in recent years and will presumably have a major impact in health care. These advancements are expected to affect different aspects of clinical medicine and lead to improvement of delivered care but also optimization of available resources. As a modern specialty that extensively relies on imaging, interventional radiology (IR) is primed to be on the forefront of this development. This is especially relevant since IR is a highly advanced specialty that heavily relies on technology and thus is naturally susceptible to disruption by new technological developments. Disruption always means opportunity and interventionalists must therefore understand AI and be a central part of decision-making when such systems are developed, trained, and implemented. Furthermore, interventional radiologist must not only embrace but lead the change that AI technology will allow. The CIRSE position paper discusses the status quo as well as current developments and challenges.
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Affiliation(s)
- Arash Najafi
- Department of Radiology and Nuclear Medicine, Institut für Radiologie und Nuklearmedizin, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Roberto Luigi Cazzato
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - Bernhard C Meyer
- Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Philippe L Pereira
- Center of Radiology, Minimally Invasive Therapies and Nuclear Medicine, SLK-Kliniken GmbH, Academic Hospital of Ruprecht-Karls-University, Heidelberg, Germany
- APL Prof. Faculty of Eberhards-Karls-University, Tübingen, Germany
- Faculty of Danube Private University, Krems, Austria
| | - Angel Alberich
- Quantitative Imaging Biomarkers in Medicine, Quibim SL, Valencia, Spain
| | - Antonio López
- Medical Informatics and Radiology Department, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Maxime Ronot
- Université Paris Cité, CRI, Paris, France
- Service de Radiologie, Hôpital Beaujon APHP Nord, Clichy, France
| | - Jan Fritz
- Department of Radiology, NYU Grossman School of Medicine, New York, USA
| | - Monique Maas
- Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Sean Benson
- Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Patrick Haage
- Zentrum für Radiologie, HELIOS Universitätsklinikum Wuppertal, Wuppertal, Germany
| | - Fernando Gomez Munoz
- Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, The Netherlands
- Hospital Universitari i Politecnic La Fe, Valencia, Spain
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Steffen DA, Najafi A, Binkert CA. Safety of Percutaneous Transmesenteric and Transsplenic Access for Portosystemic Shunt Creation in Patients with Portal Vein Obstruction: Single-Center Experience and Review of Literature. Cardiovasc Intervent Radiol 2023; 46:1401-1406. [PMID: 37311839 DOI: 10.1007/s00270-023-03484-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 05/26/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE To evaluate the safety of ultrasound-guided percutaneous mesenteric vein access compared to transsplenic portal vein access for portosystemic shunt placement in patients with portal vein obstruction. MATERIALS AND METHODS Eight patients underwent portosystemic shunt creation through either a transsplenic (n = 4) or transmesenteric (n = 4) approach. The superior or inferior mesenteric vein was percutaneously accessed under ultrasound guidance using a 21G needle and a 4F sheath. Hemostasis at the mesenteric access site was achieved with manual compression. For transsplenic access, sheath sizes between 6 and 8F were used and tract embolization with gelfoam was performed. RESULTS Portosystemic shunt placement was successful in all patients. While there were no bleeding complications with transmesenteric access, hemorrhagic shock requiring splenic artery embolization occurred in one patient in which the transsplenic approach was used. CONCLUSION Ultrasound-guided mesenteric vein access seems feasible and a valid alternative to the transsplenic access in case of portal vein obstruction. Level of Evidence Level 4, case series.
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Affiliation(s)
- Dominik A Steffen
- Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Arash Najafi
- Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Christoph A Binkert
- Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
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Steffen DA, Najafi A, Binkert CA. Postinterventional Patient Comfort After Uterine Artery Embolization and Superior Hypogastric Nerve Block. Cardiovasc Intervent Radiol 2023; 46:152-157. [PMID: 36352125 DOI: 10.1007/s00270-022-03290-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the duration and effect of superior hypogastric nerve block (SHNB) with ropivacaine and clonidine on postinterventional pain levels and opioid requirements in patients undergoing uterine artery embolization. MATERIALS AND METHODS Postinterventional pain levels (numeric rating scale, NRS 0-10) and opioid doses were retrospectively analyzed in 53 patients undergoing transfemoral uterine artery embolization and intraprocedural superior hypogastric nerve block during 24 h. A mixture of 150 mg of ropivacaine and 150 µg of clonidine was used for the block. RESULTS Postinterventional pain averaged between 1.4 and 2.0 during the first 9 h, after which a small but significant increase was observed (NRS 1.7 ± 1.6 vs. NRS 2.6 ± 2.2, p < 0.001). 70% of patients did not exceed a tolerable pain threshold of NRS 4 during the first 9 h after the intervention. Thirty-three patients (62%) did not require any opioid medication. Mean iv morphine dose was 3.1 ± 4.7 mg, whereas 71% of opioid doses were administered after 9 h. CONCLUSION Superior hypogastric nerve block using a mixture of ropivacaine and clonidine provides good pain relief for 9 h after uterine artery embolization requiring only very low amounts of additional opioids.
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Affiliation(s)
- Dominik A Steffen
- Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Arash Najafi
- Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Christoph A Binkert
- Department of Radiology and Nuclear Medicine, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
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Ojaghi H, Najafi A. Infectious keratitis: an update on the prevalence, risk factors, culture results, clinical features, visual outcomes, and therapeutic strategies of infectious keratitis. Eur Rev Med Pharmacol Sci 2022; 26:9021-9029. [PMID: 36524521 DOI: 10.26355/eurrev_202212_30577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study aimed to assess the prevalence, risk factors, culture results, clinical features, visual outcomes, and therapeutic strategies of infectious keratitis after surface ablation (PRK). PATIENTS AND METHODS This single-center prospective case-series review comprised 6500 eyes of 3400 patients undergoing PRK operation successively at the Ardabil Noor Surgical Center between January 1, 2003, and February 1, 2020. The incidence, risk factors, and clinical course were recorded for these samples. RESULTS Three clinical and culture-proven cases of infectious keratitis in three eyes of three patients were diagnosed during the study period. Post-operative keratitis was observed in cases 1 and 2 after 3 days and in case 3 after 112 days. The results of cultures were positive in all three cases. The isolated microorganisms were Staphylococcus species in cases 1 and 2 and Candida Albicans in case 3. The final corrected distance visual acuity was 20/25 and 20/20 in cases 1 and 2, respectively, and hand motion in case 3. All three patients had some risk factors such as well-controlled familial Mediterranean fever, mild Meibomian gland dysfunction, and the healthcare environment of the patient's wife in case 1, contact lens manipulation in case 2, and dry eye in case 3. CONCLUSIONS The prevalence of infectious keratitis after PRK was 0.046%. Infectious keratitis is one of the complications of PRK that can threaten patients' vision. Accordingly, proper preoperative clinical history taking, adequate eye exam and aggressive management can help maintain good eyesight in patients who undergo PRK surgery.
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Affiliation(s)
- H Ojaghi
- Department of Surgery, School of Medicine and Allied Medical Sciences, Imam Reza Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
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Soroush MZ, Sadeghniiat K, Najafi A, Shahmansouri N. Dream Emotion Recognition through EEG Nonlinear Analysis. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sartoretti E, Sartoretti T, Wyss M, van Smoorenburg L, Eichenberger B, van der Duim S, Cereghetti D, Binkert CA, Sartoretti-Schefer S, Najafi A. Impact of Acoustic Noise Reduction on Patient Experience in Routine Clinical Magnetic Resonance Imaging. Acad Radiol 2022; 29:269-276. [PMID: 33158702 DOI: 10.1016/j.acra.2020.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Acoustic noise emission from MRI scanners is considered a major factor of patient discomfort during routine MRI examinations. We prospectively evaluated the impact of acoustic noise reduction using software implementations in routine clinical MRI on subjective patient experience and image quality. METHODS Two-hundred consecutive patients undergoing one of four MRI examinations (brain, lumbar spine, shoulder, and knee) at a single center were prospectively randomized into two groups at a 1 to 1 ratio: standard MRI examination and MRI examination with acoustic noise reduction. After the examination, patients were asked to complete a questionnaire aimed at defining their subjective experience (primary endpoint). Two readers assessed subjective image quality of all patient studies in consensus (secondary endpoint). Nonparametric tests and logistic regression models were used for statistical analysis. RESULTS Hundred-seventy-four patients were included in the final study. Patients in the intervention group felt less discomforted by the acoustic noise (p = 0.01) and reported increased audibility of music through the headphones (p = 0.03). No significant difference in subjective image quality was found. CONCLUSION Our study indicates that the effects of acoustic noise reduction in routine clinical MRI can be translated into reduced patient discomfort from acoustic noise and improved audibility of music. Acoustic noise reduction thus significantly contributes to increased patient comfort during MRI examinations.
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Moharari R, Davani B, Pourfakhr P, Nooraie R, Khajavi M, Etezadi F, Najafi A. The effect of digital nerve block on the accuracy of hemoglobin monitoring during surgery: A randomized clinical trial. Acta Anaest Belg 2021. [DOI: 10.56126/72.4.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: The decision to transfuse blood products to patients during surgery is critical, due to the potential complications and costs of transfusion. Measuring hemoglobin level by spectrophotometry (SpHb) plays an important role in making this decision. The accuracy of SpHb depends on the finger perfusion. Since digital nerve blocks (DNB) can enhance blood circulation, we aimed at investigating DNB effects on the accuracy of SpHb.
Methods: Patients undergoing spine surgery were randomly assigned to two groups. Group A received DNB in the left hand, and group B received DNB in the right hand. In each group, the other hand was considered as the control. Rainbow adult ReSposable sensors were attached to the patients’ both hands. Before surgical incision and every 1.5 hours, the SpHb values of both hands and the perfusion index were recorded. Concomitantly, arterial blood samples were drawn and sent to the lab for hemoglobin concentration measurement. This served as the gold standard for assessing hemoglobin levels (labHb). We used a mixed-effects generalized linear model to test the effect of independent variables on the difference between SpHb and labHb at each time point.
Results: The SpHb displayed higher hemoglobin levels than those assessed by the lab. For lower labHb values, the SpHb-labHb differences were larger. A one-unit decrease in labHb increased the difference between SpHb and labHb by 0.56 g dL -1 , which was statistically significant.
DNB significantly increased the difference between SpHb and labHb by 0.42 g dL -1 . The effect of DNB on the difference between SpHb and labHb was significant up to three hours after the beginning of surgery (0.58 g dL -1 difference between blocked and non-blocked hands).
Conclusion: This study shows that, when hemoglobin levels are low, the accuracy of spectrophotometry decreases. Although DNB increases finger perfusion, it leads to an overestimation of hemoglobin levels by SpHb.
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Najafi A, Al Ahmar M, Bonnet B, Delpla A, Kobe A, Madani K, Roux C, Deschamps F, de Baère T, Tselikas L. The PEARL Approach for CT-guided Lung Biopsy: Assessment of Complication Rate. Radiology 2021; 302:473-480. [PMID: 34726537 DOI: 10.1148/radiol.2021210360] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Percutaneous CT-guided biopsy of lung nodules is an established method with high diagnostic accuracy but a high rate of pneumothorax and chest tube insertion compared with endobronchial methods. Purpose To investigate the effect of a protocol combining patient positioning biopsy-side down, needle removal during expiration, autologous blood patch sealing, rapid rollover, and pleural patching (PEARL) on complication rate after percutaneous CT-guided lung biopsy, especially chest tube insertion. Materials and Methods In a secondary analysis of both prospectively and retrospectively acquired data from December 2019 to November 2020, consecutive participants underwent biopsy with use of the PEARL protocol (prospective data) and were compared with patients who underwent biopsy at the same tertiary cancer center according to the standard method without any additional techniques (controls, retrospective data). Patient demographics, lesion characteristics, intraprocedural data, complications, and histologic results were recorded and compared. Results One hundred patients in the control group (mean age ± standard deviation, 63 years ± 12; 61 men) and 100 participants in the PEARL group (mean age, 64 years ± 12; 48 men) were evaluated. No differences were found in patient and lesion characteristics. The emphysema rate was 47 of 100 patients (47%) in both groups. The rate of pneumothorax was 37 of 100 patients (37%) in the control group versus 16 of 100 (16%) in the PEARL group (P = .001). Of the pneumothoraxes that occurred, fewer were during the intervention in the PEARL group, with 21 of 37 onsets (57%) in the control group versus three of 16 onsets (19%) in the PEARL group (P < .001). A chest tube was inserted in 13 of 100 patients (13%) in the control group and only in one of 100 (1%) in the PEARL group (P = .002). Histologic findings were diagnostic in 94 of 100 patients (94%) in the control group and 95 of 100 (95%) in the PEARL group (P > .99). Conclusion During CT-guided percutaneous lung biopsy, a protocol of positioning biopsy-side down, needle removal during expiration, autologous blood patch sealing, rapid rollover, and pleural patching, or PEARL, reduced rates of pneumothorax and chest tube insertion. © RSNA, 2021.
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Affiliation(s)
- Arash Najafi
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Marc Al Ahmar
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Baptiste Bonnet
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Alexandre Delpla
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Adrian Kobe
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Khaled Madani
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Charles Roux
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Frédéric Deschamps
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Thierry de Baère
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
| | - Lambros Tselikas
- From the Department of Interventional Radiology, Institut Gustave Roussy, Villejuif, Île-de France, France
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Madani K, Najafi A, Boticella A, Roux C, Tselikas L, Delpla A, Al Ahmar M, de Baere T, Deschamps F. Combined local treatments for vertebral metastases with limited epidural extension. Support Care Cancer 2021; 30:337-345. [PMID: 34287688 DOI: 10.1007/s00520-021-06443-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/13/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Vertebral metastases with limited epidural extension (VMLEE) are frequently encountered in cancer patients; they can cause severe and debilitating symptoms including pain and neurological impairment and are usually treated by radiotherapy. In this study, we mainly evaluated the safety of combined local treatments (CLT), associating radiofrequency ablation (RFA) with vertebroplasty and radiotherapy (RT) to treat VMLEE. Also, we aimed to evaluate the short-term efficacy of CLT on bone metastases palliation and long-term prevention of skeletal-related events. METHODS We retrospectively reviewed treatment complications, pain palliation, and skeletal complications after combined local treatments (CLT) for vertebral metastasis with limited epidural extension (VMLEE). RESULTS Eighteen consecutive patients had CLT for 24 VMLEE, between June 2016 and January 2021. No major post-treatment complication was recorded. Nine patients had pain before the initiation of CLT. One month after CLT, only 3 patients had residual pain with a significant decrease of visual analogue scale (VAS), from 7.3 ± 2.4 to 2 ± 0 (p = .008), as well as the mean morphine milligram equivalent dose from 196.6 ± 135.7 to 38.5 ± 26, p = .008. Mean follow-up was 16.7 ± 11.5 months. Only one vertebra showed an increase of a preexisting vertebral fracture. Nine VMLEE had evidence of residual disease, including 2 which resulted in spinal cord compression (2, 11 months). CONCLUSION CLT was safe and effective for pain palliation and long-term prevention of skeletal-related events for treatment of patients with VMLEE. The effectiveness of this combined treatment on tumor control and epidural involvement on the long term needs further investigation.
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Affiliation(s)
- Khaled Madani
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France.
| | - Arash Najafi
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France
| | - Angela Boticella
- Department of Radiation Therapy, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France
| | - Charles Roux
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France
| | - Lambros Tselikas
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France
| | - Alexandre Delpla
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France
| | - Marc Al Ahmar
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France
| | - Thierry de Baere
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France
| | - Frédéric Deschamps
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, 114 Rue Édouard Vaillant, 94800, Villejuif, France.
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Najafi A, Schadde E, Binkert CA. Combined simultaneous embolization of the portal vein and hepatic vein (double vein embolization) - a technical note about embolization sequence. CVIR Endovasc 2021; 4:43. [PMID: 34037882 PMCID: PMC8155155 DOI: 10.1186/s42155-021-00230-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Simultaneous portal vein embolization (PVE) and hepatic vein embolization (HVE) has been shown to be feasible, safe and lead to a faster growth of future liver remnant (FLR) than PVE alone. The objective of this study is to highlight different technical aspects as well as importance of embolization order. Materials and methods Seven patients were treated with simultaneous PVE and HVE. In three cases, HVE was performed first followed by PVE and in four cases the other way around. Portal vein branches were embolized using Glubran-Lipiodol mixture in all cases. Hepatic veins were embolized using Amplatzer II plugs sized 8–20 mm. Specific consideration was given to depth of glue penetration in the portal vein defined by visible branch order on the treated side. Results Six of seven patients were discharged home the same day. One patient with infected tumor necrosis died of liver failure 40 days later, otherwise there were no periprocedural clinical complications. Median glue penetration was to the 5th order (4th – 5th) when PVE was performed first and 3rd order (2nd - 4th) when PVE was performed after HVE. In one PVE first case, glue spillage was seen due to marked reduced flow in the right portal vein. There was sufficient FLR growth for subsequent surgical resection in the remaining six patients. Conclusion PVE should be performed prior to HVE because the reduced flow in the portal vein after HVE leads to less deep glue penetration with presumably increased risk of contralateral spillage.
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Affiliation(s)
- Arash Najafi
- Department of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Erik Schadde
- Department of Surgery, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Christoph A Binkert
- Department of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
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Assouline J, Tselikas L, Roux C, Yevich S, Delpla A, Najafi A, Al Ahmar M, Bijot JC, de Baère T, Deschamps F. Prophylactic Percutaneous Consolidation of Large Osteolytic Tumors of the Pelvic Ring Using Fixation by Internal Cemented Screws. Radiol Imaging Cancer 2021; 3:e200137. [PMID: 33988476 DOI: 10.1148/rycan.2021200137] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose To evaluate the efficacy, durability, and safety of percutaneous fixation by internal cemented screw (FICS) for prophylactic consolidation of impending pathologic fractures of the pelvic ring. Materials and Methods In this single-institute retrospective study, patients with large, minimally symptomatic to asymptomatic osteolytic tumors of the pelvic ring that were treated with percutaneous cone-beam CT-guided FICS procedures were included (January 2014 to May 2019). Follow-up cross-section imaging and clinical reports were reviewed for procedural complications and assessment of the long-term consolidation efficacy on the basis of the development of pathologic fracture or need for additional surgical intervention. All continuous variables were expressed as a mean with standard deviation, and dichotomous variables were expressed as frequencies and percentages. Results Fifty consecutive patients (mean age, 60 years ± 12; 27 men) underwent prophylactic FICS for consolidation of 54 osteolytic tumors (mean size, 51 mm ± 21.5; range, 30-114 mm). Local tumor destruction was performed in association with FICS in 38 patients (76%) using percutaneous thermal and/or radiation therapy. Follow-up exceeded a year in 35 patients (70%), with mean follow-up of 22 months ± 18 (range, 1-67 months). Long-term consolidation efficacy was 98% (49 of 50), with the development of a pathologic fracture in only one patient 20 months after FICS. Procedural complications were limited to two patients with self-resolving hematoma, one patient with inflammatory sciatic pain, and one patient with focal pain at the ischial tuberosity. Conclusion Percutaneous FICS provides a safe and durable minimally invasive treatment for the prevention of pathologic fractures of the pelvic ring. Keywords: Interventional-MSK, Percutaneous, Skeletal-Axial, Metastases, Oncology Supplemental material is available for this article. © RSNA, 2020.
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Affiliation(s)
- Jessica Assouline
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Lambros Tselikas
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Charles Roux
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Steven Yevich
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Alexandre Delpla
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Arash Najafi
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Marc Al Ahmar
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Jean-Charles Bijot
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Thierry de Baère
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
| | - Frédéric Deschamps
- From the Department of Interventional Radiology, Gustave Roussy-Cancer Center, 114 Rue Edouard Vaillant, 94805 Villejuif, France (J.A., L.T., C.R., S.Y., A.D., A.N., M.A.A., J.C.B., T.d.B., F.D.); Laboratory of Translational Research in Immunology (LRTI), INSERM U1015, Villejuif France (L.T.); and University Paris-Sud Le Kremlin Bicêtre, France (L.T., T.d.B., F.D.)
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Najafi A, Wildt M, Hainc N, Hohmann J. Evaluation of Cystic and Solid Renal Lesions with Contrast-Enhanced Ultrasound: A Retrospective Study. Ultrasound Int Open 2021; 7:E25-E34. [PMID: 34337312 PMCID: PMC8315990 DOI: 10.1055/a-1522-8969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/15/2021] [Indexed: 10/25/2022] Open
Abstract
Purpose Renal lesions are frequent random findings on CT, MRI, and conventional ultrasound. Since they are usually found accidentally, the respective examinations have not been performed optimally to provide a conclusive diagnosis, making additional multiphase contrast-enhanced examinations necessary. The aim of the study is to correlate CEUS findings with the final diagnosis and to determine whether it is a suitable method for the conclusive characterization of undetermined renal lesions. Materials and Methods All CEUS examinations of focal renal lesions performed at our institute between 2007 and 2014 were retrospectively examined. 437 patients with a total of 491 lesions and 543 examinations were included. 54 patients had bilateral lesions. One patient had three lesions in one kidney. Histology was available in 49 cases and follow-ups in 124 cases. The sensitivity, specificity, positive and negative predictive value as well as positive and negative likelihood ratios were calculated. Results There were 54 malignant and 437 benign lesions. The sensitivity and specificity were 0.981/0.954 overall, 1.000/0.956 for cystic lesions, 0.977/0.906 for solid lesions, and 0.971/0.071 for the histologically confirmed lesions. Bosniak classification was consistent in 289 of 301 lesions (96%). Only 12 lesions (3.9%) were falsely assessed as malignant. Conclusion CEUS is an appropriate method for the clarification of undetermined renal lesions. The characterization of cystic lesions according to Bosniak is adequately possible, especially for potentially malignant lesions (types III and IV).
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Affiliation(s)
- Arash Najafi
- Department of Radiology and Nuclear Medicine, Canton Hospital
Winterthur, Winterthur, Switzerland
| | - Michael Wildt
- Department of Radiology and Nuclear Medicine, University Hospital
Basel, Basel, Switzerland
| | - Nicolin Hainc
- Department of Medical Imaging, Division of Neuroradiology, Toronto
Western Hospital, Toronto, Canada
| | - Joachim Hohmann
- Department of Radiology and Nuclear Medicine, Canton Hospital
Winterthur, Winterthur, Switzerland
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15
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Najafi A, de Baere T, Purenne E, Bayar A, Al Ahmar M, Delpla A, Roux C, Madani K, Assouline J, Deschamps F, Tselikas L. Risk factors for local tumor progression after RFA of pulmonary metastases: a matched case-control study. Eur Radiol 2021; 31:5361-5369. [PMID: 33474569 DOI: 10.1007/s00330-020-07675-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/22/2020] [Accepted: 12/28/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Curative treatment of oligometastatic pulmonary disease aims at eradication of all metastases. Radiofrequency ablation (RFA) has been shown to be an efficient method and the frequency of local tumor progression (LTP) should be minimized. The objective of this study was to determine the morphological and treatment-related risk factors for LTP after RFA of pulmonary metastases. MATERIALS AND METHODS All patients treated with RFA for pulmonary metastases from 2002 to 2014 were reviewed. All LTPs from 2011 to 2014 were individually matched on the basis of tumor size, number, and histology. In total, 48 LTPs and 112 controls were blindly analyzed for morphological factors including vicinity of bronchus and vessels as well as treatment-related factors such as the size of the ablation zone and ablation margins. RESULTS In the simple regression analysis, the significant predictive variables were ≤ 5-mm distance to a large bronchus (OR = 4.94; p = 0.0095) or large vessel (OR = 7.09; p < 0.001), minimal ablation margin (≤ 5 mm (OR = 42.67; p < 0.001), and a central-peripheral ablation offset/ablation zone size > 0.36 (OR = 13.83; p = 0.013). In the multiple regression model, only a minimal ablation margin ≤ 5 mm remained a significant risk factor for LTP. CONCLUSION Only the minimal ablation margin remains significant in the multiple regression analysis; the other factors are presumably surrogates of an insufficient ablation margin. Improvement of lung RFA outcomes can probably be obtained by immediate post RFA evaluation of ablation margins to ensure a minimal ablation margin of at least 5 mm. KEY POINTS • A distance < 5 mm to a bronchus or vessel of over 3 mm diameter is associated with insufficient ablation margin and thus risk factors for local tumor progression after pulmonary radiofrequency ablation. • A minimal ablation margin of > 5 mm after pulmonary RFA is associated with significantly less local tumor progression and should be looked for at the end of treatment session before needle removal in order to decrease local tumor progression. • Tumor location, pleural contact, occurrence of intra-alveolar hemorrhage, pulmonary atelectasis, and pneumothorax are not associated with an increased risk of local tumor progression.
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Affiliation(s)
- Arash Najafi
- Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland. .,Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France.
| | - Thierry de Baere
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Edouard Purenne
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Amine Bayar
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Marc Al Ahmar
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Alexandre Delpla
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Charles Roux
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Khaled Madani
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Jessica Assouline
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Frederic Deschamps
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Lambros Tselikas
- Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France
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16
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Ayaz M, Najafi A, Karami MY. Thin Split Thickness Skin Grafting on Human Acellular Dermal Matrix Scaffold for the Treatment of Deep Burn Wounds. Int J Organ Transplant Med 2021; 12:44-51. [PMID: 34987732 PMCID: PMC8717875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Use of AlloDerm™ is highly suggested for the treatment of deep burns and burn sequela reconstruction. Scar formation and contracture are recognized as long-term consequences of split-thickness skin autografting, which is applied for full-thickness burn injuries. Mature fibroblasts, in the absence of dermis, seem to secrete collagen in the reformed scar pattern. OBJECTIVE To process AlloDerm™ from fresh allograft and use it as a dermal substitute for covering deep wounds in burn patients and evaluate its effectiveness. METHODS In this case-series, 7 patients with deep burn wounds involving different locations on the body surface were exposed to combined AlloDerm™ (processed from fresh human allograft) with thin split thickness skin autograft on it. On the 5th post-operative day, wound dressings were changed to evaluate the graft survival with the human acellular dermal matrix scaffold. To determine the skin profiles, follow-ups continued for at least 6 months. RESULTS The results showed excellent graft take, good elasticity, acceptable thickness, and little contracture and scarring according to fix surgeon assessment in 6 patients. Graft rejection happened only in one patient with chronic electrical injury. CONCLUSION AlloDerm™ derived from cadaver skin and combination of it with thin split thickness skin auto grafting constitute a cost-effective and favorable option for the treatment of deep burn wounds in our center, considering the increased tendency of the population towards organ donation in the event of brain death.
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Affiliation(s)
- M. Ayaz
- Correspondence: Mehdi Ayaz, Division of Burn and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.E-mail:
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Sartoretti E, Sartoretti T, Gutzwiller A, Karrer U, Binkert C, Najafi A, Czell D, Beyeler S, Sartoretti-Schefer S. Advanced multimodality MR imaging of a cerebral nocardiosis abscess in an immunocompetent patient with a focus on Amide Proton Transfer weighted imaging. BJR Case Rep 2020; 6:20190122. [PMID: 33029379 PMCID: PMC7527004 DOI: 10.1259/bjrcr.20190122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/03/2020] [Accepted: 02/17/2020] [Indexed: 01/27/2023] Open
Abstract
Cerebral nocardiosis abscess is a very rare entity in an immunocompetent patient. In this case report multiparametric and multimodality MR imaging characteristics of a pyogenic brain abscess caused by Nocardia Farcinica are discussed with a specific focus on amide proton transfer weighted imaging as a modern non-invasive, molecular MR imaging method which detects endogenous mobile protein and peptide concentration and tissue pH changes in pathologic brain lesions. The imaging characteristics are reviewed and discussed in respect to possible differential diagnoses, especially malignant tumorous lesions.
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Affiliation(s)
- Elisabeth Sartoretti
- Institut für Radiologie, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - Thomas Sartoretti
- Institut für Radiologie, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - Annina Gutzwiller
- Klinik für Innere Medizin, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - Urs Karrer
- Klinik für Innere Medizin, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - Christoph Binkert
- Institut für Radiologie, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - Arash Najafi
- Institut für Radiologie, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
| | - David Czell
- Klinik für Innere Medizin, Zuger Kantonsspital, Landhausstrasse 11, 6340 Baar, Switzerland
| | - Simon Beyeler
- Institut für Radiologie, Kantonsspital Winterthur, Brauerstrasse 15, 8401 Winterthur, Switzerland
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Vahed M, Ramezani F, Tafakori V, Mirbagheri VS, Najafi A, Ahmadian G. Molecular dynamics simulation and experimental study of the surface-display of SPA protein via Lpp-OmpA system for screening of IgG. AMB Express 2020; 10:161. [PMID: 32880759 PMCID: PMC7471224 DOI: 10.1186/s13568-020-01097-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/26/2020] [Indexed: 11/10/2022] Open
Abstract
Staphylococcal protein A (SpA) is a major virulence factor of Staphylococcus aureus. S. aureus is able to escape detection by the immune system by the surface display of protein A. The SpA protein is broadly used to purify immunoglobulin G (IgG) antibodies. This study investigates the fusion ability of Lpp'-OmpA (46-159) to anchor and display five replicate domains of protein A with 295 residues length (SpA295) of S. aureus on the surface of Escherichia coli to develop a novel bioadsorbent. First, the binding between Lpp'-OmpA-SPA295 and IgGFc and the three-dimensional structure was investigated using molecular dynamics simulation. Then high IgG recovery from human serum by the surface-displayed system of Lpp'-OmpA-SPA295 performed experimentally. In silico analysis was demonstrated the binding potential of SPA295 to IgG after expression on LPP-OmpA surface. Surface-engineered E. coli displaying SpA protein and IgG-binding assay with SDS-PAGE analysis exhibited high potential of the expressed complex on the E. coli surface for IgG capture from human serum which is applicable to conventional immune precipitation.
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Affiliation(s)
- M. Vahed
- Department of Toxico/Pharmacology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Niayesh Highway, Valiasr Ave, Tehran, 6153-14155 Iran
- Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Niayesh Highway, Valiasr Ave, Tehran, 14155-1817 Iran
| | - F. Ramezani
- Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - V. Tafakori
- Department of Cell & Molecular Sciences, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - V. S. Mirbagheri
- PhD Student in Fisheries Products Processing Group, Faculty of Fisheries and Environmental Sciences, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | - A. Najafi
- Department of Environmental and Industrial Biotechnology, National Institute of Genetic Engineering and Biotechnology (NIGEB), P.O.BOX: 14965/161, Tehran, 1497716316 Iran
- Present Address: Department of Cell and Molecular Biology, Uppsala University, P.O. Box 256, 751 05 Uppsala, Sweden
| | - G. Ahmadian
- Department of Environmental and Industrial Biotechnology, National Institute of Genetic Engineering and Biotechnology (NIGEB), P.O.BOX: 14965/161, Tehran, 1497716316 Iran
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Abstract
Interventional oncology and the value of thermal ablation of small tumors is increasingly recognized by the oncological community. Primary lung cancers and lung metastases have been one of the most researched applications of percutaneous ablation and as interventional oncologists gain more experience and confidence, it is becoming a more effective treatment with expanding indications. Importantly, the current literature does not demonstrate major differences in survival between ablation, sublobar resection, and stereotactic body radiation. The advantages of percutaneous ablation over other local therapies like surgery or SBRT are significantly lower morbidity, mortality, and repeatability of treatments. The focus of this essay is to highlight technical and procedural aspects of lung ablation as well as management and follow-up in a practical fashion.
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Sartoretti T, Sartoretti E, Schwenk Á, van Smoorenburg L, Mannil M, Euler A, Becker AS, Alfieri A, Najafi A, Binkert CA, Wyss M, Sartoretti-Schefer S. Clinical feasibility of ultrafast intracranial vessel imaging with non-Cartesian spiral 3D time-of-flight MR angiography at 1.5T: An intra-individual comparison study. PLoS One 2020; 15:e0232372. [PMID: 32348366 PMCID: PMC7190165 DOI: 10.1371/journal.pone.0232372] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 04/13/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives Non-Cartesian Spiral readout can be implemented in 3D Time-of-flight (TOF) MR angiography (MRA) with short acquisition times. In this intra-individual comparison study we evaluated the clinical feasibility of Spiral TOF MRA in comparison with compressed sensing accelerated TOF MRA at 1.5T for intracranial vessel imaging as it has yet to be determined. Materials and methods Forty-four consecutive patients with suspected intracranial vascular disease were imaged with two Spiral 3D TOFs (Spiral, 0.82x0.82x1.2 mm3, 01:32 min; Spiral 0.8, 0.8x0.8x0.8 mm3, 02:12 min) and a Compressed SENSE accelerated 3D TOF (CS 3.5, 0.82x0.82x1.2 mm3, 03:06 min) at 1.5T. Two neuroradiologists assessed qualitative (visualization of central and peripheral vessels) and quantitative image quality (Contrast Ratio, CR) and performed lesion and variation assessment for all three TOFs in each patient. After the rating process, the readers were questioned and representative cases were reinspected in a non-blinded fashion. For statistical analysis, the Friedman and Nemenyi post-hoc test, Kendall W tests, repeated measure ANOVA and weighted Cohen's Kappa tests were used. Results The Spiral and Spiral 0.8 outperformed the CS 3.5 in terms of peripheral image quality (p<0.001) and performed equally well in terms of central image quality (p>0.05). The readers noted slight differences in the appearance of maximum intensity projection images. A good to high degree of interstudy agreement between the three TOFs was observed for lesion and variation assessment (W = 0.638, p<0.001 –W = 1, p<0.001). CR values did not differ significantly between the three TOFs (p = 0.534). Interreader agreement ranged from good (K = 0.638) to excellent (K = 1). Conclusions Compared to the CS 3.5, both the Spiral and Spiral 0.8 exhibited comparable or better image quality and comparable diagnostic performance at much shorter acquisition times.
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Affiliation(s)
- Thomas Sartoretti
- Institute of Radiology, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | | | - Árpád Schwenk
- Institute of Radiology, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | | | - Manoj Mannil
- Institute of Diagnostic and Interventional Radiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - André Euler
- Institute of Diagnostic and Interventional Radiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Anton S. Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Alex Alfieri
- Department of Neurosurgery, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | - Arash Najafi
- Institute of Radiology, Winterthur Cantonal Hospital, Winterthur, Switzerland
| | | | - Michael Wyss
- Institute of Radiology, Winterthur Cantonal Hospital, Winterthur, Switzerland
- Philips Healthsystems, Zürich, Switzerland
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Saraei M, Najafi A, Heidarbagi E, Rahimi-Golkhandan A. Evaluation of Metabolic Syndrome among Locomotive Drivers. Occup Med (Lond) 2020. [DOI: 10.18502/tkj.v11i3.2588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Screening of risk factors for metabolic syndrome among commercial and train drivers that are considered safety sensitive jobs, is an important issue in safety of transportation system. Metabolic syndrome is consisted of disturbed lipid profile, high blood pressure, and high waist circumference. It can lead to decrease the quality of life and higher health associated costs for these patients. This study aimed to assess risk factors for metabolic syndrome among train drivers.
Methods: This cross-sectional study was conducted on 281 train drivers referred to their annual health examinations to Occupational Medicine Clinic of Baharloo Hospital, Tehran University of Medical Sciences. Demographic characteristics of participants were recorded. Blood pressure, body mass index and waist circumference of drivers were measured. Participants’ blood sample for fasting blood sugar, triglyceride, high and low density lipoproteins were collected. Metabolic syndrome was defined according to the NCEP ATP III criteria.
Results: All of the participants were males. Their mean age and BMI was 43±10 year and 26.60±3.67 Kg/m2, respectively. Fifty three (21%) of the participants were diagnosed with metabolic syndrome. The more frequent risk factor for metabolic syndrome was triglyceride more than 150mg/dl.
Conclusion: Findings of the present study revealed high prevalence of metabolic syndrome among train drivers. Further studies are needed for screening the metabolic syndrome in this occupational group as it is a sensitive occupation.
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Najafi A, Caspar SM, Meienberg J, Rohrbach M, Steinmann B, Matyas G. Variant filtering, digenic variants, and other challenges in clinical sequencing: a lesson from fibrillinopathies. Clin Genet 2020; 97:235-245. [PMID: 31506931 PMCID: PMC7004123 DOI: 10.1111/cge.13640] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/04/2019] [Accepted: 09/07/2019] [Indexed: 12/23/2022]
Abstract
Genome-scale high-throughput sequencing enables the detection of unprecedented numbers of sequence variants. Variant filtering and interpretation are facilitated by mutation databases, in silico tools, and population-based reference datasets such as ExAC/gnomAD, while variants are classified using the ACMG/AMP guidelines. These methods, however, pose clinically relevant challenges. We queried the gnomAD dataset for (likely) pathogenic variants in genes causing autosomal-dominant disorders. Furthermore, focusing on the fibrillinopathies Marfan syndrome (MFS) and congenital contractural arachnodactyly (CCA), we screened 500 genomes of our patients for co-occurring variants in FBN1 and FBN2. In gnomAD, we detected 2653 (likely) pathogenic variants in 253 genes associated with autosomal-dominant disorders, enabling the estimation of variant-filtering thresholds and disease predisposition/prevalence rates. In our database, we discovered two families with hitherto unreported co-occurrence of FBN1/FBN2 variants causing phenotypes with mixed or modified MFS/CCA clinical features. We show that (likely) pathogenic gnomAD variants may be more frequent than expected and are challenging to classify according to the ACMG/AMP guidelines as well as that fibrillinopathies are likely underdiagnosed and may co-occur. Consequently, selection of appropriate frequency cutoffs, recognition of digenic variants, and variant classification represent considerable challenges in variant interpretation. Neglecting these challenges may lead to incomplete or missed diagnoses.
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Affiliation(s)
- Arash Najafi
- Center for Cardiovascular Genetics and Gene DiagnosticsFoundation for People with Rare DiseasesSchlieren‐ZurichSwitzerland
- Cantonal Hospital WinterthurInstitute of Radiology and Nuclear MedicineWinterthurSwitzerland
| | - Sylvan M. Caspar
- Center for Cardiovascular Genetics and Gene DiagnosticsFoundation for People with Rare DiseasesSchlieren‐ZurichSwitzerland
| | - Janine Meienberg
- Center for Cardiovascular Genetics and Gene DiagnosticsFoundation for People with Rare DiseasesSchlieren‐ZurichSwitzerland
| | - Marianne Rohrbach
- Division of Metabolism and Children's Research CenterUniversity Children's Hospital Zurich Eleonore FoundationZurichSwitzerland
| | - Beat Steinmann
- Division of Metabolism and Children's Research CenterUniversity Children's Hospital Zurich Eleonore FoundationZurichSwitzerland
| | - Gabor Matyas
- Center for Cardiovascular Genetics and Gene DiagnosticsFoundation for People with Rare DiseasesSchlieren‐ZurichSwitzerland
- Zurich Center for Integrative Human PhysiologyUniversity of ZurichZurichSwitzerland
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Najafi A, Caspar SM, Meienberg J, Rohrbach M, Steinmann B, Matyas G. Front Cover. Clin Genet 2020. [DOI: 10.1111/cge.13707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Arash Najafi
- Center for Cardiovascular Genetics and Gene DiagnosticsFoundation for People with Rare Diseases Schlieren‐Zurich Switzerland
- Cantonal Hospital WinterthurInstitute of Radiology and Nuclear Medicine Winterthur Switzerland
| | - Sylvan M. Caspar
- Center for Cardiovascular Genetics and Gene DiagnosticsFoundation for People with Rare Diseases Schlieren‐Zurich Switzerland
| | - Janine Meienberg
- Center for Cardiovascular Genetics and Gene DiagnosticsFoundation for People with Rare Diseases Schlieren‐Zurich Switzerland
| | - Marianne Rohrbach
- Division of Metabolism and Children's Research CenterUniversity Children's Hospital Zurich Eleonore Foundation Zurich Switzerland
| | - Beat Steinmann
- Division of Metabolism and Children's Research CenterUniversity Children's Hospital Zurich Eleonore Foundation Zurich Switzerland
| | - Gabor Matyas
- Center for Cardiovascular Genetics and Gene DiagnosticsFoundation for People with Rare Diseases Schlieren‐Zurich Switzerland
- Zurich Center for Integrative Human PhysiologyUniversity of Zurich Zurich Switzerland
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Sartoretti T, Stürmer J, Sartoretti E, Najafi A, Schwenk Á, Wyss M, Binkert C, Sartoretti-Schefer S. Long segment 3D double inversion recovery (DIR) hypersignal on MRI in glaucomatous optic neuropathy. BMC Ophthalmol 2019; 19:258. [PMID: 31842814 PMCID: PMC6916010 DOI: 10.1186/s12886-019-1273-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/11/2019] [Indexed: 01/26/2023] Open
Abstract
Background In this retrospective study the relationship between intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness and pathologic hypersignal in optic nerve segments on 3D double inversion recovery (DIR) MR sequence in 21 patients with proven glaucoma of different origin was evaluated. Methods All patients were examined on a 3 T MR Philips® scanner. Pathologic optic nerve DIR hypersignal was determined in four different nerve segments. IOP was measured in mmHg by applanation tonometry. RNFL thickness was measured in μm with optical coherence tomography (OCT Heidelberg Engineering Spectralis® apparatus). Wilcoxon rank sum tests, student’s t-tests and (multivariate) linear regression models were appied. Results 3D DIR hypersignal was present in 17 (41.5%) optic nerves. 3D DIR hypersignal was not related to ischemic or demyelinating optic nerve pathology but was associated with increased IOP (19.8 [24–18]; versus 15.45; [18.85–13.75] mmHg; p = 0.008) and decreased RNFL thickness (61.06 ± 12.1 versus 82.5 ± 21.6 μm; p < 0.001) in comparison to optic nerves of glaucoma patients without DIR hypersignal. Specifically, presence of DIR hypersignal in optic nerves in at least one optic nerve segment lowered RNFL thickness on average by 17.54 μm (p = 0.005) in comparison to optic nerves without DIR hypersignal. Conclusions In patients with glaucomatous optic neuropathy (GON) and pathologic optic nerve DIR hypersignal, significantly increased IOP and significantly decreased RNFL thickness values are present. DIR hypersignal seems to be a marker for disease severity in GON related to decreased RNFL thickness and may thus represent long-segment severe axonal degeneration in optic nerves in patients with GON. Venous congestion and edema within the optic nerve related to high IOP may contribute to the DIR hypersignal as well.
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Affiliation(s)
- Thomas Sartoretti
- Laboratory of Translational Nutrition Biology, Department of Health Sciences and Technology, 8603, ETH Zürich, Schwerzenbach, Switzerland.
| | - Jörg Stürmer
- Department of Ophthalmology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Elisabeth Sartoretti
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.,Faculty of Medicine, University of Zürich, Zürich, Switzerland
| | - Arash Najafi
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Árpád Schwenk
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
| | - Michael Wyss
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.,Philips Health Systems, Zürich, Switzerland
| | - Christoph Binkert
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.,Faculty of Medicine, University of Zürich, Zürich, Switzerland
| | - Sabine Sartoretti-Schefer
- Department of Radiology, Cantonal Hospital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.,Faculty of Medicine, University of Zürich, Zürich, Switzerland
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Sartoretti E, Sartoretti T, Wyss M, Becker AS, Schwenk Á, van Smoorenburg L, Najafi A, Binkert C, Thoeny HC, Zhou J, Jiang S, Graf N, Czell D, Sartoretti-Schefer S, Reischauer C. Amide Proton Transfer Weighted Imaging Shows Differences in Multiple Sclerosis Lesions and White Matter Hyperintensities of Presumed Vascular Origin. Front Neurol 2019; 10:1307. [PMID: 31920930 PMCID: PMC6914856 DOI: 10.3389/fneur.2019.01307] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 11/26/2019] [Indexed: 01/14/2023] Open
Abstract
Objectives: To assess the ability of 3D amide proton transfer weighted (APTw) imaging based on magnetization transfer analysis to discriminate between multiple sclerosis lesions (MSL) and white matter hyperintensities of presumed vascular origin (WMH) and to compare APTw signal intensity of healthy white matter (healthy WM) with APTw signal intensity of MSL and WHM. Materials and Methods: A total of 27 patients (16 female, 11 males, mean age 39.6 years) with multiple sclerosis, 35 patients (17 females, 18 males, mean age 66.6 years) with small vessel disease (SVD) and 20 healthy young volunteers (9 females, 11 males, mean age 29 years) were included in the MSL, the WMH, and the healthy WM group. MSL and WMH were segmented on fluid attenuated inversion recovery (FLAIR) images underlaid onto APTw images. Histogram parameters (mean, median, 10th, 25th, 75th, 90th percentile) were calculated. Mean APTw signal intensity values in healthy WM were defined by "Region of interest" (ROI) measurements. Wilcoxon rank sum tests and receiver operating characteristics (ROC) curve analyses of clustered data were applied. Results: All histogram parameters except the 75 and 90th percentile were significantly different between MSL and WMH (p = 0.018-p = 0.034). MSL presented with higher median values in all parameters. The histogram parameters offered only low diagnostic performance in discriminating between MSL and WMH. The 10th percentile yielded the highest diagnostic performance with an AUC of 0.6245 (95% CI: [0.532, 0.717]). Mean APTw signal intensity values of MSL were significantly higher than mean values of healthy WM (p = 0.005). The mean values of WMH did not differ significantly from the values of healthy WM (p = 0.345). Conclusions: We found significant differences in APTw signal intensity, based on straightforward magnetization transfer analysis, between MSL and WMH and between MSL and healthy WM. Low AUC values from ROC analyses, however, suggest that it may be challenging to determine type of lesion with APTw imaging. More advanced analysis of the APT CEST signal may be helpful for further differentiation of MSL and WMH.
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Affiliation(s)
| | - Thomas Sartoretti
- Laboratory of Translational Nutrition Biology, Department of Health Sciences and Technology, ETH Zurich, Schwerzenbach, Switzerland
| | - Michael Wyss
- Institute of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland.,Philips Healthsystems, Zurich, Switzerland
| | - Anton S Becker
- Laboratory of Translational Nutrition Biology, Department of Health Sciences and Technology, ETH Zurich, Schwerzenbach, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Árpád Schwenk
- Institute of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland
| | | | - Arash Najafi
- Institute of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Christoph Binkert
- Institute of Radiology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Harriet C Thoeny
- Department of Medicine, University of Fribourg, Fribourg, Switzerland.,Department of Radiology, HFR Fribourg-Hôpital Cantonal, Fribourg, Switzerland
| | - Jinyuan Zhou
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Shanshan Jiang
- Division of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | | | - David Czell
- Department of Neurology, Spital Linth, Uznach, Switzerland
| | | | - Carolin Reischauer
- Department of Medicine, University of Fribourg, Fribourg, Switzerland.,Department of Radiology, HFR Fribourg-Hôpital Cantonal, Fribourg, Switzerland
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Najafi A, Naeimabadi N, Sadeghniiat-Haghighi K, Salmani-Nodoushan M, Rahimi-Golkhandan A. Continuous positive airway pressure adherence in patients with obstructive sleep apnea syndrome. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mehrabinejad M, Najafi A, Hajighadery A, Saraei M, Izadi N, Alemohammad Z. Association of sleep characteristics and respiratory symptoms at a smelting factory. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Aminian O, Noorani A, Sadeghniiat-Haghighi K, Najafi A. Evaluation of psychomotor performance in patients with obstructive sleep apnea syndrome. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sadeghniiat-Haghighi K, Najafi A, Adib B, Alemohammad Z, Akbarpour S. Association of rem characteristics as a state marker of depression among Iranian patients: a case-control study. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sadeghniiat-Haghighi K, Najafi A, Rahimi-Golkhandan A, Akbarpour S, Mohammadzade M. Insomnia severity and depression among patients with obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sadeghniiat-Haghighi K, Afzalinejad E, Najafi A, Alemohammad Z, Akbarpour S. Development of an objective tool for predicting obstructive sleep apnea among adults: PAN apnea index. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sartoretti T, Sartoretti E, Wyss M, Schwenk Á, van Smoorenburg L, Eichenberger B, Najafi A, Binkert C, Becker AS, Sartoretti-Schefer S. Compressed SENSE accelerated 3D T1w black blood turbo spin echo versus 2D T1w turbo spin echo sequence in pituitary magnetic resonance imaging. Eur J Radiol 2019; 120:108667. [PMID: 31550639 DOI: 10.1016/j.ejrad.2019.108667] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/23/2019] [Accepted: 09/08/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE To compare image quality between a 2D T1w turbo spin echo (TSE) sequence and a Compressed SENSE accelerated 3D T1w black blood TSE sequence (equipped with a black blood prepulse for blood signal suppression) in pre- and postcontrast imaging of the pituitary and to assess scan time reductions. METHODS AND MATERIALS For this retrospective study, 56 patients underwent pituitary MR imaging at 3T. 28 patients were scanned with the 2D- and 28 patients with the accelerated 3D sequence. Two board certified neuroradiologists independently evaluated 13 qualitative image features (12 features on postcontrast- and 1 feature on precontrast images).SNR and CNR measurements were obtained. Interreader agreement was assessed with the intraclass correlation coefficient while differences in scores were assessed with exact Wilcoxon rank sum tests. RESULTS The interreader agreement ranged from fair (visibility of the ophthalmic nerve, ICC = 0.57) to excellent (presence and severity of pulsation artefacts, ICC = 0.97). The Compressed SENSE accelerated 3D sequence outperformed the 2D sequence in terms of "overall image quality" (median: 4 versus 3, p = 0.04) and "presence and severity of pulsation artefacts" (median: 0 versus 1, p < 0.001). There were no significant differences in any other qualitative and quantitative (SNR, CNR) image quality features. Scan time was reduced by 03:53 min (33.1%) by replacing the 2D with the 3D sequence. CONCLUSION The Compressed SENSE accelerated 3D T1w black blood TSE sequence is a reliable alternative for the standard 2D sequence in pituitary imaging. The black blood prepulse may aid in suppression of pulsation artefacts.
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Affiliation(s)
- Thomas Sartoretti
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Elisabeth Sartoretti
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Michael Wyss
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland; Philips Healthsystems, Zürich, Switzerland.
| | - Árpád Schwenk
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Luuk van Smoorenburg
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Barbara Eichenberger
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Arash Najafi
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Christoph Binkert
- Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
| | - Anton S Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zürich, University of Zürich, Raemistrasse 100, CH-8091, Zürich, Switzerland; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
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Sartoretti T, Wyss M, Sartoretti E, Reischauer C, Hainc N, Graf N, Binkert C, Najafi A, Sartoretti-Schefer S. Sex and Age Dependencies of Aqueductal Cerebrospinal Fluid Dynamics Parameters in Healthy Subjects. Front Aging Neurosci 2019; 11:199. [PMID: 31427956 PMCID: PMC6688190 DOI: 10.3389/fnagi.2019.00199] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/16/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives To assess the influence of age and sex on 10 cerebrospinal fluid (CSF) flow dynamics parameters measured with an MR phase contrast (PC) sequence within the cerebral aqueduct at the level of the intercollicular sulcus. Materials and Methods 128 healthy subjects (66 female subjects with a mean age of 52.9 years and 62 male subjects with a mean age of 51.8 years) with a normal Evans index, normal medial temporal atrophy (MTA) score, and without known disorders of the CSF circulation were included in the study. A PC MR sequence on a 3T MR scanner was used. Ten different flow parameters were analyzed using postprocessing software. Ordinal and linear regression models were calculated. Results The parameters stroke volume (sex: p < 0.001, age: p = 0.003), forward flow volume (sex: p < 0.001, age: p = 0.002), backward flow volume (sex: p < 0.001, age: p = 0.018), absolute stroke volume (sex: p < 0.001, age: p = 0.005), mean flux (sex: p < 0.001, age: p = 0.001), peak velocity (sex: p = 0.009, age: p = 0.0016), and peak pressure gradient (sex: p = 0.029, age: p = 0.028) are significantly influenced by sex and age. The parameters regurgitant fraction, stroke distance, and mean velocity are not significantly influenced by sex and age. Conclusion CSF flow dynamics parameters measured in the cerebral aqueduct are partly age and sex dependent. For establishment of reliable reference values for clinical use in future studies, the impact of sex and age should be considered and incorporated.
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Affiliation(s)
- Thomas Sartoretti
- Laboratory of Translational Nutrition Biology, Department of Health Sciences and Technology, ETH Zürich, Zurich, Switzerland
| | - Michael Wyss
- Philips Healthcare, Zurich, Switzerland.,Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | | | - Carolin Reischauer
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Department of Medicine, University of Fribourg, Fribourg, Switzerland.,Department of Radiology, HFR Fribourg - Hôpital Cantonal, Fribourg, Switzerland
| | - Nicolin Hainc
- Department of Neuroradiology, University Hospital Zürich, University of Zürich, Zurich, Switzerland
| | | | - Christoph Binkert
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Arash Najafi
- Department of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
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Cunier M, Najafi A, Sheikh GT, Binkert CA. Alternative crossing technique for iliaco-femoro-popliteal CTOs with a catheter only. CVIR Endovasc 2019; 2:23. [PMID: 32026995 PMCID: PMC6966370 DOI: 10.1186/s42155-019-0065-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 07/09/2019] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The standard approach for crossing peripheral CTOs is to use a combination of hydrophilic guidewires and catheters. The path is either intraluminally or in most cases at least partially subintimal. This standard approach with a guidewire-tip as leading point ("wire first") to cross CTOs has a success rate of about 80%. We hypothesize that a "catheter first" approach, using the catheter alone for the entire recanalization till re-entering the vessel is less traumatic and might lead to a longer intraluminal recanalization due to a softer leading point. Based on this assumption we analyzed the success and duration of this approach with a gradual step-up approach from catheter tip to guidewire front-end to guidewire back-end. To the best of our knowledge, no studies measuring the time of recanalization of lower extremity CTOs using conventional devices were published yet. RESULTS Data of 46 consecutive chronic total iliaco-femoro-popliteal occlusions in 43 symptomatic patients treated by percutaneous transluminal angioplasty were collected prospectively between May 1st 2014 and June 30th 2016 and evaluated retrospectively. Chronic occlusion was defined as clinical symptoms or imaging features lasting more than 1 month. Patient age and gender, diabetes status, localization of occlusion, occlusion length, duration of symptoms, severity of vessel calcification, and recanalization time were assessed. Technical success was defined as placement of a catheter beyond the distal end of the lesion into the true lumen, confirmed by contrast injection. All 46 CTOs were successfully recanalized. In 22 cases (47.8%) recanalization was successful with the catheter tip only without the use of a guide wire. In 17 cases (36.9%) the guide wire was used in addition to the catheter. Localization of occlusion did not have an effect on the recanalization technique (p = 0.915). The mean rank for length of occlusion was not significant for different recanalization techniques (p = 0.095). The success rate for the catheter only approach was lower for higher grades of calcification (p = 0.008). There was no correlation between time of recanalization and length of occlusion (Pearson's r = 0.004; adjusted R square = - 0.024; p = 0.980), diabetes (p = 1.000), sex (p = 0.244), or grade of calcification (p = 0.621). Recanalization time is significantly right-skewed with most recanalizations being successful under 30 min. CONCLUSION This "catheter first" approach is somewhat contradictory to the prevailing dogma of "wire first". The concept to use the catheter to start a recanalization is well known, but to perform the entire recanalization including the re-entry seems possible and potentially less traumatic, likely leading to a longer intraluminal course. Our data shows that recanalization of occluded lower extremity arteries between the aortic bifurcation and the popliteal artery can be achieved in the majority of cases (84.7%) solely by using an angled angiographic catheter +/- glide wire. We suggest a "5 min - 15 min - 30 min" rule on how long to attempt each recanalization technique. More precisely, we suggest trying 5 min with the catheter alone, then 10 min with the soft end of the guidewire and then switching to the stiffer back-end of the guidewire for another 15 min.
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Affiliation(s)
- Marc Cunier
- Department of Radiology and Nuclear medicine, Canton Hospital Winterthur, 8401 Winterthur, Switzerland
| | - Arash Najafi
- Department of Radiology and Nuclear medicine, Canton Hospital Winterthur, 8401 Winterthur, Switzerland
| | - Gabriel T. Sheikh
- Department of Radiology and Nuclear medicine, Canton Hospital Winterthur, 8401 Winterthur, Switzerland
| | - Christoph A. Binkert
- Department of Radiology and Nuclear medicine, Canton Hospital Winterthur, 8401 Winterthur, Switzerland
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Affiliation(s)
- P. Bayati
- Department of Physics, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan 45137-66731, Iran
| | - A. Najafi
- Department of Physics, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan 45137-66731, Iran
- Research Center for Basic Sciences & Modern Technologies (RBST), Institute for Advanced Studies in Basic Sciences, Zanjan, Iran
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Sartoretti T, Sartoretti E, Wyss M, Schwenk Á, Najafi A, Binkert C, Reischauer C, Zhou J, Jiang S, Becker AS, Sartoretti-Schefer S. Amide Proton Transfer Contrast Distribution in Different Brain Regions in Young Healthy Subjects. Front Neurosci 2019; 13:520. [PMID: 31178687 PMCID: PMC6538817 DOI: 10.3389/fnins.2019.00520] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/06/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives To define normal signal intensity values of amide proton transfer-weighted (APTw) magnetic resonance (MR) imaging in different brain regions. Materials and Methods Twenty healthy subjects (9 females, mean age 29 years, range 19 - 37 years) underwent MR imaging at 3 Tesla. 3D APTw (RF saturation B1,rms = 2 μT, duration 2 s, 100% duty cycle) and 2D T2-weighted turbo spin echo (TSE) images were acquired. Postprocessing (image fusion, ROI measurements of APTw intensity values in 22 different brain regions) was performed and controlled by two independent neuroradiologists. Values were measured separately for each brain hemisphere. A subject was scanned both in prone and supine position to investigate differences between hemispheres. A mixed model on a 5% significance level was used to assess the effect of gender, brain region and side on APTw intensity values. Results Mean APTw intensity values in the hippocampus and amygdala varied between 1.13 and 1.57%, in the deep subcortical nuclei (putamen, globus pallidus, head of caudate nucleus, thalamus, red nucleus, substantia nigra) between 0.73 and 1.84%, in the frontal, occipital and parietal cortex between 0.56 and 1.03%; in the insular cortex between 1.11 and 1.15%, in the temporal cortex between 1.22 and 1.37%, in the frontal, occipital and parietal white matter between 0.32 and 0.54% and in the temporal white matter between 0.83 and 0.89%. APTw intensity values were significantly impacted both by brain region (p < 0.001) and by side (p < 0.001), whereby overall values on the left side were higher than on the right side (1.13 vs. 0.9%). Gender did not significantly impact APTw intensity values (p = 0.24). APTw intensity values between the left and the right side were partially reversed after changing the position of one subject from supine to prone. Conclusion We determined normal baseline APTw intensity values in different anatomical localizations in healthy subjects. APTw intensity values differed both between anatomical regions and between left and right brain hemisphere.
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Affiliation(s)
- Thomas Sartoretti
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Elisabeth Sartoretti
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Michael Wyss
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Philips Health Systems, Zurich, Switzerland
| | - Árpád Schwenk
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Arash Najafi
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Christoph Binkert
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Carolin Reischauer
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Jinyuan Zhou
- Department of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Shanshan Jiang
- Department of MR Research, Department of Radiology, Johns Hopkins University, Baltimore, MD, United States
| | - Anton S Becker
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sabine Sartoretti-Schefer
- Institute of Radiology, Cantonal Hospital Winterthur, Winterthur, Switzerland.,Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Abstract
PURPOSE Desmoids are locally infiltrative, nonmalignant soft tissue tumors. Surgery, radiation therapy, and chemotherapy have been the mainstay of treatment, but relapse is common and side effects can result in significant morbidity. MR-HIFU is increasingly recognized as an alternative treatment modality. We assessed the success rate of MR-HIFU for the treatment of extra-abdominal desmoids at our institute. MATERIALS AND METHODS Five patients with relapsing desmoid tumors (three males, two females; age range 40-79 years) were treated using the Sonalleve system in an outpatient setting without general anesthesia. Changes in total tumor volumes were measured with a tumor tracking software. Adverse events were documented. RESULTS MR-HIFU was successful in all patients without severe side effects. Follow up ranged from 13 to 60 months. Three patients required more than one treatment session. In 3 patients with small lesions (mean = 9.7 mL), complete ablation was achieved with no evidence of viable tumor on follow up MRI at an average of 35.7 months, while in two patients with larger lesions (mean = 46 mL) the targeted tumor volumes decreased by 73% at 14 months. Skin injuries comprised first- and second-degree burns and were observed with short distance to skin (mean = 0.9 cm) and proximity to bone (i.e. ribs). Skin burns healed within weeks with topical treatment. CONCLUSION MR-HIFU shows good mid-term result for extra-abdominal desmoids with complete response for small lesions and stabilization of larger lesions. MR-HIFU for desmoids can be performed under regional anesthesia/sedation as outpatients.
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Affiliation(s)
- Arash Najafi
- a Department of Radiology and Nuclear Medicine , Canton Hospital Winterthur , Winterthur , Switzerland
| | - Bruno Fuchs
- b Department of Orthopedics and Trauma Surgery , Canton Hospital Winterthur , Winterthur , Switzerland
| | - Christoph A Binkert
- a Department of Radiology and Nuclear Medicine , Canton Hospital Winterthur , Winterthur , Switzerland
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Abstract
Background Endovascular aortic sealing (EVAS) using the Nellix system was a new approach to reduce the frequency of type II endoleaks after endovascular aortic repair. We analyzed the mid-term results, specifically looking at device migration, endoleaks and subsequent necessary secondary interventions. Results Ten patients underwent elective EVAS treatment during our study period. 7 patients were within the IFU while 3 patients had a proximal neck shorter than 10 mm. Technical success rate was 100% and there were no short-term vascular complications. One patient died from urosepsis 14 days after the procedure and was excluded from further analysis. A total of 6 out of 9 patients (67%) experienced device complications such as proximal graft kinking, limb separation or caudal migration. 5 also showed type Ia endoleak. Discussion While no complication occurred short-term (up to 12 months), the Nellix system showed a high percentage of limb separation, caudal graft migration, and type Ia endoleak on mid-term follow-up, likely due to insufficient proximal anchoring of the device. Possible salvage treatments are discussed.
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Affiliation(s)
- Arash Najafi
- Department of Radiology and Nuclear Medicine, Canton Hospital Winterthur, 8401, Winterthur, Switzerland.
| | - Gabriel Tobias Sheikh
- Department of Radiology and Nuclear Medicine, Canton Hospital Winterthur, 8401, Winterthur, Switzerland
| | - Pius Wigger
- Department of Vascular Surgery, Canton Hospital Winterthur, 8401, Winterthur, Switzerland
| | - Christoph A Binkert
- Department of Radiology and Nuclear Medicine, Canton Hospital Winterthur, 8401, Winterthur, Switzerland
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Sartoretti E, Sartoretti T, Binkert C, Najafi A, Schwenk Á, Hinnen M, van Smoorenburg L, Eichenberger B, Sartoretti-Schefer S. Reduction of procedure times in routine clinical practice with Compressed SENSE magnetic resonance imaging technique. PLoS One 2019; 14:e0214887. [PMID: 30978232 PMCID: PMC6461228 DOI: 10.1371/journal.pone.0214887] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/21/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives Acceleration of MR sequences beyond current parallel imaging techniques is possible with the Compressed SENSE technique that has recently become available for 1.5 and 3 Tesla scanners, for nearly all image contrasts and for 2D and 3D sequences. The impact of this technique on examination timing parameters and MR protocols in a clinical setting was investigated in this retrospective study. Material and methods A numerical analysis of the examination timing parameters (scan time, exam time, procedure time, interscan delay time, changeover time, nonscan time) based on the MR protocols of 6 different body regions (brain, knee, lumbar spine, breast, shoulder) using MR log files was performed and the total number of examinations acquired from January to April both in 2017 and 2018 on a 1.5 T MR scanner was registered. Percentages, box plots and unpaired two-sided t tests were obtained for statistical evaluation. Results All examination timing parameters of the six anatomical regions analysed were significantly shortened after implementation of Compressed SENSE. On average, scan times were accelerated by 20.2% (p<0.0001) while procedure times were shortened by 16% (p<0.0001). Considering all anatomical regions and all MR protocols, 27% more examinations were performed over the same 4 month period in 2018 compared to 2017. Conclusion Compressed SENSE allows for a significant acceleration of MR examinations and a considerable increase in the total number of MR examinations is possible.
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Affiliation(s)
- Elisabeth Sartoretti
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Sartoretti
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph Binkert
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Arash Najafi
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Árpád Schwenk
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Martin Hinnen
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Luuk van Smoorenburg
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Barbara Eichenberger
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Sabine Sartoretti-Schefer
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
- * E-mail:
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Najafi A, Sheikh GT, Binkert C. Extensive Embolization of Splanchnic Artery Aneurysms due to Segmental Arterial Mediolysis. ROFO-FORTSCHR RONTG 2019; 191:1010-1014. [PMID: 30947350 DOI: 10.1055/a-0855-4198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM Segmental arterial mediolysis (SAM) is a rare non-atherosclerotic, non-inflammatory, non-infectious arteriopathy in middle-aged patients that tends to affect medium-sized splanchnic arteries typically leading to dissecting aneurysms which in case of rupture have a high mortality. Treatment options include watchful waiting and endovascular or surgical intervention. There are no official treatment guidelines and to the best of our knowledge, there has not been any report of extensive exclusion of multiple splanchnic vessel regions in affected patients to date. MATERIALS AND METHODS We retrospectively examined the outcome of extensive splanchnic embolization in four patients suffering from SAM between 2011 and 2016 with follow-up periods of up to 7 years. RESULTS One patient presented with abdominal pain due to rupture of aneurysms of the pancreaticoduodenal arcade, one with abdominal pain due to dissection, and two were clinically asymptomatic but displayed rapidly progressing disease over the course of 12 months. All patients were treated with complete exclusion of the diseased vessel segments by coiling all branches to and from the diseased segment. In three cases the main hepatic artery was excluded completely. In one case, the complete vascular bed of the celiac axis was excluded by coiling the distal vessel branches and placing a stent graft over the orifice of the celiac trunk. During a follow-up period of a minimum of 2 and a maximum of 7 years after intervention, there were no immediate or long-term complications except for a temporary arterio-portal fistula. Interestingly, no new diseased areas of SAM were detected afterwards. CONCLUSION Extensive endovascular exclusion of the entire diseased arterial segment with coils seems to be a safe and effective treatment option in patients with SAM presenting with ruptured or rapidly growing aneurysms. Provided that patients have normal liver function and proper portal venous flow, risk of hepatobiliary complications seems to be low even after extensive embolization. KEY POINTS · An asymptomatic SAM can be followed up.. · In case of disease progression or suspicion of aneurysm rupture, an endovascular approach is indicated where the whole pathological vessel bed should be excluded with coils.. · It seems that exclusion of even extensive vessel areas is tolerated.. CITATION FORMAT · Najafi A, Sheikh GT, Binkert C. Extensive Embolization of Splanchnic Artery Aneurysms due to Segmental Arterial Mediolysis. Fortschr Röntgenstr 2019; 191: 1010 - 1014.
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Affiliation(s)
- Arash Najafi
- Institut für Radiologie und Nuklearmedizin, Kantonsspital Winterthur, Switzerland
| | | | - Christoph Binkert
- Institut für Radiologie und Nuklearmedizin, Kantonsspital Winterthur, Switzerland
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Najafi A, Koulia K, Aubert P, Binkert CA. Multi loop snare technique for difficult inferior vena cava filter retrievals. CVIR Endovasc 2018; 1:33. [PMID: 30652164 PMCID: PMC6319532 DOI: 10.1186/s42155-018-0042-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/19/2018] [Indexed: 11/10/2022] Open
Abstract
Introduction Use of optional vena cava filters has steadily increased. In the majority of cases removal is successful using standard techniques. In cases of tilting and migration of the filter however, more advanced techniques are necessary. The "loop-snare" technique has been described for such cases. Difficulties arise when the loop starts to slip around the legs and arms of the filter. New technique We present an improved loop-snare technique which allows to retrieve IVC filters when the simple loop-snare technique fails. We used additional loops, in one case one additional loop in another case two additional loops around the filter tip which allowed successful retrieval. The additional loops were created with a reversed shaped catheter. All guidewires were then engaged with a snare and pulled into a large sheath. The additional loops stabilize the tip and the filter can be pulled into the sheath. Conclusion The "multiple-loop-snare" technique is a refinement of the previously described "single loop-snare" technique and can be used when one loop fails.
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Affiliation(s)
- Arash Najafi
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Brauerstrasse 15, 8405 Winterthur, Switzerland
| | - Katerina Koulia
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Brauerstrasse 15, 8405 Winterthur, Switzerland
| | - Philippe Aubert
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Brauerstrasse 15, 8405 Winterthur, Switzerland
| | - Christoph A Binkert
- Institute of Radiology and Nuclear Medicine, Kantonsspital Winterthur, Brauerstrasse 15, 8405 Winterthur, Switzerland
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Najafi A, Schuldt M, Pham T, Michels M, Schlossarek S, Carrier L, Jimenez C, Zaccolo M, van der Velden J, Kuster D. PKA’s favorite son: prioritizing phosphorylation of phospholamban over cardiac troponin I contributes to diastolic dysfunction in hypertrophic cardiomyopathy. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Saraei M, Najafi A, Heidarbagi E. Prevalence of metabolic syndrome and risk factors of obstructive sleep apnea among locomotive drivers. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arshi S, Salmani M, Sadeghniiat-Haghighi K, Najafi A, Alavi S, Shamsipour M. Prevalence of obstructive sleep apnea among adults in north-west of Iran. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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45
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Arshi S, Sadeghniiat-Haghighi K, Najafi A, Shamsipour M. The prevalence of restless leg syndrome in north-west of Iran. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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46
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Kardan MR, Fathabdi N, Attarilar A, Esmaeili-Gheshlaghi MT, Karimi M, Najafi A, Hosseini SS. A national survey of natural radionuclides in soils and terrestrial radiation exposure in Iran. J Environ Radioact 2017; 178-179:168-176. [PMID: 28843952 DOI: 10.1016/j.jenvrad.2017.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 06/07/2023]
Abstract
In the past, some efforts have been made for measuring natural radioactivity and evaluating public exposure to natural radiation in certain areas of Iran especially in well-known High Level Natural Radiation Areas (HLNRA) in Ramsar and Mahallat. However, the information on radionuclide concentrations, and, consequently, terrestrial radiation exposure for many other areas are not available. There was therefore a need for a systematic and nation-wide survey. For this purpose, 979 soil samples from 31 provinces were collected. The activity concentrations of 40K, 226Ra and 232Th were measured by HPGe detector. The average activity concentrations for Iran were found to be 457.7 Bq/kg for 40K, 24.3 Bq/kg for 226Ra and 25.8 Bq/kg for 232Th. Results were compared with previous regional or provincial surveys. The population-weighted average outdoor and indoor annual effective dose due to external exposure to terrestrial sources of radiation are 0.06 mSv and 0.33 mSv, respectively. It was shown that there is a significant correlation between the activity concentrations of 232Th and 40K in soil. In addition, the results of chi square tests show normal and lognormal distributions cannot be considered for the frequency distributions of activity concentration of 232Th and 226 Ra while 40K has a normal distribution.
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Affiliation(s)
- M R Kardan
- Reactor and Nuclear Safety Research School, Nuclear Science and Technology Research Institute, Tehran, Iran.
| | - N Fathabdi
- Iran Nuclear Regulatory Authority, Tehran, Iran
| | - A Attarilar
- Iran Nuclear Regulatory Authority, Tehran, Iran
| | | | - M Karimi
- Iran Nuclear Regulatory Authority, Tehran, Iran
| | - A Najafi
- Iran Nuclear Regulatory Authority, Tehran, Iran
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Yekta A, Khabazkhoob M, Hashemi H, Ali S, Ostadimoghaddam H, Najafi A, Heravian J. The prevalence of asthenopia and its determinants in a population of university students. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0f008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A.A. Yekta
- Optometry; Mashhad University of Medical Sciences; Mashhad Iran
| | - M. Khabazkhoob
- Shahid Beheshti University of Medical Sciences; School of Nursing and Midwifery; Tehran Iran
| | - H. Hashemi
- Noor Research Center for Ophthalmic Epidemiology; Noor Eye Hospital; Tehran Iran
| | - S.B. Ali
- Optometry; Mashhad University of Medical Sciences; Mashhad Iran
| | - H. Ostadimoghaddam
- Refractive Errors Research Center; School of Paramedical Sciences; Mashhad University of Medical Sciences; Mashhad Iran
| | - A. Najafi
- Ophthalmology Clinic; Valiasr Hospital; Kazerun Iran
| | - J. Heravian
- Optometry; Mashhad University of Medical Sciences; Mashhad Iran
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Mortazavi SMJ, Firoozabadi MA, Najafi A, Mansouri P. Evaluation of outcomes of suction drainage in patients with haemophilic arthropathy undergoing total knee arthroplasty. Haemophilia 2017; 23:e310-e315. [PMID: 28544490 DOI: 10.1111/hae.13224] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Closed suction drainage has been extensively applied for orthopaedic procedures for the sake of avoiding fluid collections around the wound at the operated limb. AIM We believed that without application of suction drainage after total knee arthroplasty (TKA), the risk of infection and haematoma formation will not increase while the need for blood transfusion because of decreased blood loss will be lesser. METHODS In a prospective randomized clinical trial from April 2010 to April 2014, 176 patients with haemophilia who underwent TKA were included. The study group consisted of 88 patients (108 knees), in which we did not insert suction drain and the control group included 88 patients (106 knees), in which drain was inserted at the end of the surgery. All patients underwent TKA via anterior knee incision and medial parapatellar approach. RESULTS The mean follow-up period of study group and control group was 21 ± 11 months vs. 20 ± 9 months consecutively (P = 0.54). The mean hospital stay was 13 ± 8 days vs. 14 ± 8 days in study and control group consecutively (P = 0.40). In both groups, the major part of improvement in clinical knee society score was due to increase in pain subset (mean increase of 42 vs. 39 points consecutively) and to a lesser extent to alleviation of flexion contracture (mean increase of 13 vs. 15 points consecutively). We observed no differences in the mean visual analogue scale (VAS) value between both groups. Average functional outcome in both groups improved during follow-up visits. CONCLUSION We can conclude that there is no rationale for the use of drain after primary TKA.
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Affiliation(s)
- S M J Mortazavi
- Joint reconstruction research center, Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M A Firoozabadi
- Joint reconstruction research center, Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Najafi
- Joint reconstruction research center, Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - P Mansouri
- Joint reconstruction research center, Imam Khomeini hospital, Tehran University of Medical Sciences, Tehran, Iran
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Moghimian P, Khosravi M, Najafi A, Afshar S, Javadpour J, Samadani M. Erratum to “Effect of low temperature on formation mechanism of calcium phosphate nano powder via precipitation method” [Adv. Powder Technol. 23 (2012) 744–751]. ADV POWDER TECHNOL 2017. [DOI: 10.1016/j.apt.2016.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fattah A, Sharafi M, Masoudi R, Shahverdi A, Esmaeili V, Najafi A. l -Carnitine in rooster semen cryopreservation: Flow cytometric, biochemical and motion findings for frozen-thawed sperm. Cryobiology 2017; 74:148-153. [DOI: 10.1016/j.cryobiol.2016.10.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 10/17/2016] [Accepted: 10/27/2016] [Indexed: 10/20/2022]
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