Ultrasound-guided percutaneous thrombin injection for the management of upper extremity pseudoaneurysms: 20 years of tertiary care center experience.

Purpose: To evaluate the safety and efficacy of ultrasound-guided percutaneous thrombin injection for the treatment of upper extremity pseudoaneurysms.

Methods: An institutional database containing 8,316,467 radiology reports was searched for suitable cases over a 241-month period. Fourteen female and 10 male patients, average age of 69.

The Effect of Time Pressure on Motion Economy and Smoothness of Interventional Radiology Trainee Performance in Simulated Central Venous Line Placement.

Purpose: To evaluate the effect of being under time pressure on procedural performance using hand motion analysis.

Materials And Methods: Eight radiology trainees performed central venous access on a phantom while recording video and hand motion data using an electromagnetic motion tracker. Each trainee performed the procedure six times: the first three trials without any prompts (control), while for the next three, they were asked to perform the task as fast as possible (time pressure).

The role of urology and radiology in prostate biopsy: current trends and future perspectives.

Purpose: Prostate biopsy is central to the accurate histological diagnosis of prostate cancer. In current practice, the biopsy procedure can be performed using a transrectal or transperineal route with different technologies available for targeting of lesions within the prostate. Historically, the biopsy procedure was performed solely by urologists, but with the advent of image-guided techniques, the involvement of radiologists in prostate biopsy has become more common.

Image-Guided Prostate Cryoablation: State-of-the-Art.

Image-guided focal therapy has increased in popularity as a treatment option for patients with primary and locally recurrent prostate cancer. This review will cover the basic indications, evaluation, treatment algorithm, and follow-up for patients undergoing image-guided ablation of the prostate. Additionally, this paper will serve as an overview of some technical approaches to cases so that physicians can familiarize themselves with working in this space.

Interventional Approach to Portal Vein Thrombosis and Liver Transplantation: State of the Art.

Porto-mesenteric vein thrombosis (PVT) is a well-recognized but uncommon disease entity in patients with and without cirrhosis. Given the complexity of these patients, there are many differing treatment algorithms depending on the individual circumstances of a given patient. The focus of this review is primarily patients with cirrhosis, with an emphasis on liver transplantation considerations.

Evaluation of an Artificial Intelligence Chatbot for Delivery of IR Patient Education Material: A Comparison with Societal Website Content.

Purpose: To assess the accuracy, completeness, and readability of patient educational material produced by a machine learning model and compare the output to that provided by a societal website.

Materials And Methods: Content from the Society of Interventional Radiology Patient Center website was retrieved, categorized, and organized into discrete questions. These questions were entered into the ChatGPT platform, and the output was analyzed for word and sentence counts, readability using multiple validated scales, factual correctness, and suitability for patient education using the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) instrument.

Deployment of an Interventional Radiology Telemedicine Program During the COVID-19 Pandemic: Initial Experience With 10,056 Visits.

Objective: To evaluate the clinical, operational, and financial effects of using telemedicine services in an academic interventional radiology setting during the coronavirus disease 2019 pandemic and to identify potential barriers to equitable telemedicine access for patients.

Methods: Evaluation and management (E&M) data over a 104-week period from September 2019 to August 2021 were reviewed. Data related to the visits were recorded including visit type, billing provider, patient demographic information, Current Procedural Terminology code charged, and reimbursement received.

Radiofrequency Ablation of Spine Metastases: A Clinical and Technical Approach.

Percutaneous radiofrequency ablation (RFA) is an integral component of the multidisciplinary treatment algorithm for both local tumor control and palliation of painful spine metastases. This minimally invasive therapy complements additional treatment strategies, such as pain medications, systemic chemotherapy, surgical resection, and radiotherapy. The location and size of the metastatic lesion dictate preprocedure planning and the technical approach.

Factors influencing cumulative radiation dose from percutaneous intra-abdominal abscess drainage in the setting of inflammatory bowel disease.

Purpose: Patients with inflammatory bowel disease (IBD) are at risk for intra-abdominal abscesses requiring CT-guided drainage. These patients are at baseline risk of high cumulative radiation exposure from imaging, which may be exacerbated by CT-guided drainage. This study aimed to determine the radiation dose associated with percutaneous drainage in the setting of IBD and identify risk factors associated with high exposure.

Utilization of Endovascular and Surgical Treatments for Symptomatic Uterine Leiomyomas: A Population Health Perspective.

Purpose: To conduct a population-level analysis of surgical and endovascular interventions for symptomatic uterine leiomyomata by using administrative data from outpatient medical encounters.

Materials And Methods: By using administrative data from all outpatient hospital encounters in California (2005-2011) and Florida (2005-2014), all patients in the outpatient setting with symptomatic uterine leiomyomata were identified. Patients were categorized as undergoing hysterectomy, myomectomy, uterine artery embolization (UAE), or no intervention.

Transjugular Intrahepatic Portosystemic Shunts Reduce Variceal Bleeding and Improve Survival in Patients with Cirrhosis: A Population-Based Analysis.

Purpose: To investigate from a population health perspective the effects of transjugular intrahepatic portosystemic shunt (TIPS) creation on recurrent variceal bleeding and survival in patients with cirrhosis.

Materials And Methods: Patients with cirrhosis who presented to outpatient and acute-care hospitals in California (2005-2011) and Florida (2005-2014) with variceal bleeding comprised the study cohort. Patients entered the study cohort at their first presentation for variceal bleeding; all subsequent hospital encounters were then evaluated to determine subsequent interventions, complications, and mortality data.

Association of Inferior Vena Cava Filter Placement With Rates of Pulmonary Embolism in Patients With Cancer and Acute Lower Extremity Deep Venous Thrombosis.

Importance: Venous thromboembolism is the second overall leading cause of death for patients with cancer, and there is an approximately 2-fold increase in fatal pulmonary embolism (PE) in patients with cancer. Inferior vena cava (IVC) filters are designed to prevent PE, but defining the appropriate use of IVC filters in patients with cancer remains a substantial unmet clinical need.

Objective: To evaluate the association of IVC filters with the development of PE in patients with cancer and deep venous thrombosis (DVT).

Magnetic resonance imaging/transrectal ultrasonography fusion guided seed placement in a phantom: Accuracy between 2-seed versus 1-seed strategies.

Purpose: To investigate whether the 2-seed placement per Magnetic Resonance Imaging (MRI) suspicious lesion yields a higher seed placement accuracy than a 1-seed strategy on a phantom.

Methods: Eight olives embedded in gelatin, each simulating a prostate, underwent MRI. Three virtual spherical lesions (3, 5, and 8 mm diameters) were marked in each olive on the MRI images and co-registered to the MRI/Transrectal Ultrasonography (TRUS) fusion biopsy system.

Changes in inferior vena cava filter placement and retrieval practice patterns from a population health perspective.

Purpose: Inferior vena cava (IVC) filters are placed to reduce venous thromboembolism (VTE)-related morbidity and mortality, though the evidence supporting this practice is limited. In 2010, the Food and Drug Administration (FDA) released a device safety advisory due to the risk of filter migration, fracture, and thrombosis with long-term use. The purpose of this study was to evaluate trends and predictors for IVCF placement and retrieval over a 10-year time period from a population health perspective.

Implementing Virtual and Augmented Reality Tools for Radiology Education and Training, Communication, and Clinical Care.

Advances in virtual immersive and augmented reality technology, commercially available for the entertainment and gaming industry, hold potential for education and clinical use in medicine and the field of medical imaging. Radiology departments have begun exploring the use of these technologies to help with radiology education and clinical care. The purpose of this review article is to summarize how three institutions have explored using virtual and augmented reality for radiology.

A Low-Cost Highly Configurable Phantom for Simulation of Imaging-Guided Endocavitary Procedures.

We developed a method to create customizable phantoms suitable for endocavitary imaging and interventional research, based on the fabrication of an acrylic phantom mold, and development of a phantom matrix composed of gelatin, agar, graphite particles, and propanol. Our phantom was mechanically stable, easily fabricated, and highly adjustable, and its ultrasound (US) and magnetic resonance imaging (MRI) scans showed the qualification for the procedure guidance compared with the human prostate image using the same US system. To test the feasibility of the phantom for the research, the seeds placement guided by MRI/US fusion was performed, and the overall test error (distance from the seed center to the virtual lesion center in olives) was 2.

Radiation Dose and Risk Estimates of CT-Guided Percutaneous Liver Ablations and Factors Associated with Dose Reduction.

Purpose: To determine the radiation dose associated with CT-guided percutaneous liver ablations and identify potential risk factors that result in higher radiation doses.

Materials And Methods: Between June 2011 and June 2015, 245 consecutive patients underwent 304 CT-guided liver ablation treatments. Patient demographics, tumor characteristics and procedural parameters were identified and analyzed.

Decision Making: Thermal Ablation Options for Small Renal Masses.

Renal cell carcinoma is a relatively common tumor, with an estimated 63,000 new cases being diagnosed in the United States in 2016. Surgery, be it with partial or total nephrectomy, is considered the mainstay of treatment for many patients. However, those patients with small renal masses, typically less than 3 to 4 cm in size who are deemed unsuitable for surgery, may be suitable for percutaneous thermal ablation.

Long-Term Outcomes Following Percutaneous Cholecystostomy Tube Placement for Treatment of Acute Calculous Cholecystitis.

Introduction: Percutaneous cholecystostomy tube (PCT) placement is considered a safe alternative to cholecystectomy for the treatment of acute calculous cholecystitis (ACC), but data regarding long-term outcomes following PCT are limited.

Methods: We retrospectively reviewed our institutional experience of patients undergoing PCT for ACC between 1997 and 2015. Recurrent biliary events were defined as cholecystitis, cholangitis, or gallstone pancreatitis.

Air Embolism: Diagnosis, Clinical Management and Outcomes.

Air embolism is a rare but potentially fatal complication of surgical procedures. Rapid recognition and intervention is critical for reducing morbidity and mortality. We retrospectively characterized our experience with air embolism during medical procedures at a tertiary medical center.

Radiology of renal stone disease.

Nephrolithiasis is a common cause of abdominal pain and will affect approximately 1 in 10 people in their lifetime. In the past two decades, there have been several technological advances that have changed the imaging approach to stone diagnosis and follow-up. We present a review of the current imaging evaluation for renal stone disease, and outline how new technology has helped with diagnosis and management.

Air Embolism: Practical Tips for Prevention and Treatment.

Air embolism is a rarely encountered but much dreaded complication of surgical procedures that can cause serious harm, including death. Cases that involve the use of endovascular techniques have a higher risk of air embolism; therefore, a heightened awareness of this complication is warranted. In particular, central venous catheters and arterial catheters that are often placed and removed in most hospitals by a variety of medical practitioners are at especially high risk for air embolism.