1
|
Abstract
Uterine cervix is the lower constricted part of uterus which is best evaluated by magnetic resonance imaging (MRI) due to its higher soft tissue and contrast resolution. The cervical cancer is a common gynecological cancer causing much morbidity and mortality especially in developing countries. Cervical carcinomas mainly occurs in reproductive age group with prognosis mainly depending on the extent of disease at the time of diagnosis, hence it is important to identify these cancerous lesions early and stage them accurately for optimal treatment. In this article, we will review the following: (1) the normal MRI anatomy of uterine cervix; (2) MRI protocol and techniques in evaluation of cervical lesions; (3) imaging of spectrum of various congenital abnormalities and pathologies affecting uterine cervix which ranges from congenital abnormalities to various benign lesions of cervix like nabothian cysts, tunnel cysts, cervicitis, cervical fibroid, and, lastly, endometriosis which usually coexists with adenomyosis; the malignant lesions include carcinoma cervix, adenoma malignum or direct extension from carcinoma endometrium or from carcinoma of vagina; (4) Accurately stage carcinoma of cervix using FIGO classification (2018); and (5) posttreatment evaluation of cervical cancers. MRI is the most reliable imaging modality in evaluation of various cervical lesions, identification of cervical tumors, staging of the cervical malignancy, and stratifying patients for surgery and radiation therapy. It also plays an important role in detection of local disease recurrence.
Collapse
Affiliation(s)
- Foram B Gala
- Department of Radiology, Lifescan Imaging Centre, Mumbai, Maharashtra, India.,Department of Radiology, Bai Jerbai Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Kunal B Gala
- Department of Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Bharat M Gala
- Department of Radiology, Lifescan Imaging Centre, Mumbai, Maharashtra, India
| |
Collapse
|
2
|
Kulkarni SS, Shetty NS, Gala KB, Shariq M, Gulia A, Polnaya AM, Shetty NG, Janu AK, Choudhari A, Puri A. Percutaneous Radiofrequency Ablation of Appendicular Skeleton Chondroblastoma-an Experience from a Tertiary Care Cancer Center. J Vasc Interv Radiol 2021; 32:504-509. [PMID: 33612370 DOI: 10.1016/j.jvir.2020.07.027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/24/2020] [Accepted: 07/28/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To evaluate safety and long-term efficacy of radiofrequency (RF) ablation in treatment of chondroblastoma. MATERIALS AND METHODS This retrospective analysis comprised 27 consecutive patients with histopathologically proven chondroblastoma treated by RF ablation. The tumors were located in the proximal humerus (n = 6), proximal tibia (n = 8), proximal femur (n = 6), distal femur (n = 5), acromion process (n = 1), and lunate (n = 1). In 19 patients (70.3%), the tumor was in the weight-bearing area of the bone. Clinical response was assessed by comparing pain scores and functional assessment by Musculoskeletal Tumor Society (MSTS) score before and after ablation. Patients were followed for a minimum of 1 year to rule out complications and recurrence. RESULTS Technical success rate was 100%. Mean pain score before the procedure was 7.34 (range, 7-9); all patients experienced a reduction in pain, with 25 (92.6%) patients reporting complete pain relief at 6 weeks. Mean MSTS score before the procedure was 15.4, whereas mean MSTS score at 6 weeks after the procedure was 28.6, suggesting significant functional improvement (P < .0001). Two patients developed osteonecrosis and collapse of the treated bone. There were no recurrences. CONCLUSIONS Percutaneous RF ablation is a safe and effective option for treating chondroblastoma of the appendicular skeleton.
Collapse
Affiliation(s)
- Suyash S Kulkarni
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Dr Ernest Borges Road, Parel, Mumbai, Maharashtra 400012, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India
| | - Nitin Sudhakar Shetty
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Dr Ernest Borges Road, Parel, Mumbai, Maharashtra 400012, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India.
| | - Kunal B Gala
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Dr Ernest Borges Road, Parel, Mumbai, Maharashtra 400012, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India
| | - Mohd Shariq
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Dr Ernest Borges Road, Parel, Mumbai, Maharashtra 400012, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India
| | - Ashish Gulia
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India; Orthopedic Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Dr Ernest Borges Road, Parel East, Parel, Mumbai, Maharashtra 400012, India
| | - Ashwin M Polnaya
- Department of Radio-Diagnosis and Imaging, A.J. Institute of Medical Science and Research Centre, Mangalore, Karnataka, India
| | - Neeraj G Shetty
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Dr Ernest Borges Road, Parel, Mumbai, Maharashtra 400012, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India
| | - Amit Kumar Janu
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Dr Ernest Borges Road, Parel, Mumbai, Maharashtra 400012, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India
| | - Amitkumar Choudhari
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Dr Ernest Borges Road, Parel, Mumbai, Maharashtra 400012, India; Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India
| | - Ajay Puri
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, Maharashtra 400094, India; Orthopedic Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Dr Ernest Borges Road, Parel East, Parel, Mumbai, Maharashtra 400012, India
| |
Collapse
|
3
|
Gala KB, Gala BM, Gala FB. Are radiological diagnostic centres ready to tackle COVID-19 pandemic? An Indian perspective. Indian J Radiol Imaging 2021; 31:S15-S20. [PMID: 33814757 PMCID: PMC7996697 DOI: 10.4103/ijri.ijri_466_20] [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: 06/12/2020] [Revised: 06/18/2020] [Accepted: 07/05/2020] [Indexed: 11/04/2022] Open
Abstract
Corona virus disease 2019 (COVID-19) is caused by severe acute respiratory coronavirus 2 (SARS-CoV-2) and has been declared as pandemic. Its transmission is mainly by droplets and touching infected surfaces. Health care workers including personnel working at diagnostic centers are more prone to contact the disease through infected patients and hence various precautionary measures have to be implemented which has been discussed in this article. This manuscript shall brief about the preparedness by the diagnostic center in terms of the modification in the work flow, the precautions and protections to be taken by the personnel and patients, disinfection of the equipment and surfaces, and new norms of social distancing. This article will be addressing mainly to the diagnostic centers and the changes to be made as per their convenience.
Collapse
Affiliation(s)
- Kunal B Gala
- Department of Radiodiagnosis, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | - Bharat M Gala
- Gala Imaging Centre, B.J. Wadia Hospital, Mumbai, Maharashtra, India.,Lifescan Imaging Centre, B.J. Wadia Hospital, Mumbai, Maharashtra, India
| | - Foram B Gala
- Gala Imaging Centre, B.J. Wadia Hospital, Mumbai, Maharashtra, India.,Lifescan Imaging Centre, B.J. Wadia Hospital, Mumbai, Maharashtra, India.,Department of Radiodiagnosis, B.J. Wadia Hospital, Mumbai, Maharashtra, India
| |
Collapse
|
4
|
Kulkarni SS, Shetty NS, Gala KB, Patkar S, Narang A, Polnaya AM, Patil S, Shetty NG, Hota F, Goel M. A Validation Study of Liver Volumetry Estimation by a Semiautomated Software in Patients Undergoing Hepatic Resections. Journal of Clinical Interventional Radiology ISVIR 2020. [DOI: 10.1055/s-0040-1721534] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
AbstractPurpose The purpose of this study was to validate the use of a semiautomated software for liver volumetry preoperatively by comparing it with the volume of resected specimen in patients undergoing hepatic resections.Materials and Methods This is a single-center retrospective study of patients who underwent estimation of future liver remnant (FLR) using Myrian XP-Liver which is a semiautomated software for hepatectomy. The estimated resection volume, which is the sum of volume of normal liver to be resected and tumor volume, was compared with actual specimen weight to calculate the accuracy of the software. The statistical analysis was performed with SPSS software version 24.Results Data on FLR estimation using the semiautomated software was available for 200 out of 388 patients who underwent formal hepatic resections. The median resected volume of surgical specimen was 650 mL (interquartile range [IQR] 364–950), while the median estimated volume using the Myrian software was 617 mL (IQR 362–979). There was significant correlation between estimated resection volume calculated using the semiautomated method and actual specimen weight (p-value < 0.0001) with the Spearman’s correlation value of 0.956.Conclusion The estimated volume of liver to be resected as calculated by the semiautomated software was accurate and correlated significantly with the volume of resected specimen, and hence, the estimation of FLR volume may likely correlate with the true postoperative residual liver volume. In addition, the software-based liver segmentation, FLR estimation, and color-coded three-dimensional images provide a clear road map to the surgeon to facilitate safe resection.
Collapse
Affiliation(s)
- Suyash S. Kulkarni
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Mumbai, India
| | - Nitin Sudhakar Shetty
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Mumbai, India
| | - Kunal B. Gala
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Mumbai, India
| | - Shraddha Patkar
- Homi Bhabha National Institute, Mumbai, India
- Gastrointestinal and HPB Surgery, Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Amrita Narang
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Mumbai, India
| | - Ashwin M. Polnaya
- Department of Radio-Diagnosis and Imaging, A. J. Institute of Medical Science and Research Centre, Mangalore, Karnataka, India
| | - Sushil Patil
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - Neeraj G. Shetty
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Mumbai, India
| | - Falguni Hota
- Interventional Radiology, Department of Radio-Diagnosis, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
- Homi Bhabha National Institute, Mumbai, India
| | - Mahesh Goel
- Homi Bhabha National Institute, Mumbai, India
- Gastrointestinal and HPB Surgery, Department of Surgical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, Maharashtra, India
| |
Collapse
|
5
|
Gala KB, Shetty NS, Patel P, Kulkarni SS. Microwave ablation: How we do it? Indian J Radiol Imaging 2020; 30:206-213. [PMID: 33100690 PMCID: PMC7546284 DOI: 10.4103/ijri.ijri_240_19] [Citation(s) in RCA: 4] [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: 06/01/2019] [Revised: 10/23/2019] [Accepted: 02/20/2020] [Indexed: 12/23/2022] Open
Abstract
Minimally invasive techniques such as Image guided thermal ablation are now widely used in the treatment of tumors. Microwave ablation (MWA) is one of the newer modality of thermal ablation and has proven its safety and efficacy in the management of the tumors amenable for ablation for primary and metastatic diseases. It is used in the treatment of primary and secondary liver malignancies, primary and secondary lung malignancies, renal and adrenal tumors and bone metastases. We wanted to share our initial experience with this newer modality. In this article we will describe the mechanism and technique of MWA, comparison done with RFA, advantages and disadvantages of MWA along with pre procedure workup, post procedure follow-up and review of literature.
Collapse
Affiliation(s)
- Kunal B Gala
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Nitin S Shetty
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Paresh Patel
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Suyash S Kulkarni
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| |
Collapse
|
6
|
Kawthalkar AS, Janu AK, Deshpande MS, Gala KB, Gulia A, Puri A. Phosphaturic Mesenchymal Tumors from Head to Toe: Imaging Findings and Role of the Radiologist in Diagnosing Tumor-Induced Osteomalacia. Indian J Orthop 2020; 54:215-223. [PMID: 32257040 PMCID: PMC7096593 DOI: 10.1007/s43465-019-00005-5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/11/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study aimed at evaluating the imaging findings of phosphaturic mesenchymal tumors and tumor-induced osteomalacia and assess the clinical and biochemical profiles of patients with tumor-induced osteomalacia. MATERIALS AND METHODS Imaging findings in six patients with tumor-induced osteomalacia and histopathologically proven phosphaturic mesenchymal tumors were evaluated. Clinical and biochemical profiles of these patients were also assessed. RESULTS Along with having a characteristic biochemical profile, patients with phosphaturic mesenchymal tumors also have certain imaging findings which can aid in the diagnosis such as increased uptake on DOTA PET-CT and homogeneous post-contrast enhancement on CT and MRI. CONCLUSION Patients with tumor-induced osteomalacia have characteristic symptoms, imaging and biochemical profiles. For radiologists, raising the suspicion of a phosphaturic mesenchymal tumor in patients with refractory hypophosphatemic osteomalacia as well as localizing the tumor on imaging is crucial, as complete excision of the tumor leads to resolution of the osteomalacia and the patient's clinical symptoms.
Collapse
Affiliation(s)
- Ameya S. Kawthalkar
- grid.413283.f0000 0001 2152 2922Department of Radiology, Grant Medical College and Sir JJ Hospital, Mumbai, India
| | - Amit K. Janu
- grid.410871.b0000 0004 1769 5793Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
| | - Mrunmayee S. Deshpande
- grid.413161.00000 0004 1766 9130Department of General Medicine, Topiwala Nair Medical College and BYL Nair Hospital, Mumbai, India
| | - Kunal B. Gala
- grid.410871.b0000 0004 1769 5793Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
| | - Ashish Gulia
- grid.410871.b0000 0004 1769 5793Bone and Soft Tissue Services, Tata Memorial Hospital, Mumbai, India
| | - Ajay Puri
- grid.410871.b0000 0004 1769 5793Bone and Soft Tissue Services, Tata Memorial Hospital, Mumbai, India
| |
Collapse
|
7
|
Chivate RS, Kulkarni SS, Shetty NS, Polnaya AM, Gala KB, Patel PG. Percutaneous repair of iatrogenic subclavian artery injury by suture-mediated closure device. Indian J Radiol Imaging 2016; 26:262-6. [PMID: 27413277 PMCID: PMC4931789 DOI: 10.4103/0971-3026.184425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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] [Indexed: 11/24/2022] Open
Abstract
Central venous catheterization through internal jugular vein is done routinely in intensive care units. It is generally safe, more so when the procedure is performed under ultrasound guidance. However, there could be inadvertent puncture of other vessels in the neck when the procedure is not performed under real-time sonographic guidance. Closure of this vessel opening can pose a challenge if it is an artery, in a location difficult to compress, and is further complicated by deranged coagulation profile. Here, we discuss the removal of an inadvertently placed catheter from subclavian artery with closure of arteriotomy percutaneously using arterial suture-mediated closure device.
Collapse
Affiliation(s)
- Rahul S Chivate
- Department of Radiology/Interventional Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Suyash S Kulkarni
- Department of Radiology/Interventional Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Nitin S Shetty
- Department of Radiology/Interventional Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Ashwin M Polnaya
- Department of Radiology/Interventional Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Kunal B Gala
- Department of Radiology/Interventional Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Paresh G Patel
- Department of Radiology/Interventional Radiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| |
Collapse
|