Evaluation of targeting accuracy of cone beam CT guided histotripsy in an porcine model.

Purpose: The application of histotripsy, an emerging noninvasive, non-ionizing, and non-thermal tumor treatment, is currently limited by the inherent limitations of diagnostic ultrasound as the sole targeting modality. This study evaluates the feasibility and accuracy of cone beam computed tomography (CBCT) guidance for histotripsy treatments in an porcine model.

Materials And Methods: Histotripsy treatments were performed in the liver of seven healthy swine under the guidance of a C-arm CBCT system that was calibrated to the robotic arm of the histotripsy system.

Histotripsy of the Proximal Ureter and Renal Pelvis: Evaluation of Urothelial Injury in a Porcine Survival Model.

Purpose: To evaluate the response of the ureter and renal pelvis to direct targeting by histotripsy guided by cone-beam computed tomography (CT) in a human-scale porcine chronic-survival model.

Materials And Methods: Bilateral ureteral histotripsy treatments were completed on 6 female swine (n = 12). Animals were divided into 2 groups: (a) acute (n = 2 animals, 4 treatments, sacrificed at Day 0) and (b) chronic (n = 4 animals, 8 treatments, sacrificed at Day 7 [n = 2] and Day 28 [n = 2]).

Safety and efficacy of histotripsy delivery through overlying gas-filled small bowel in an ex vivo swine model.

Purpose: To evaluate the safety and efficacy of performing histotripsy through overlying gas-filled bowel in an swine model.

Methods: An model was created to simulate histotripsy treatment of solid organs through gas-filled bowel. Spherical 2.

CT Navigation for Percutaneous Needle Placement: How I Do It.

CT navigation (CTN) has recently been developed to combine many of the advantages of conventional CT and CT-fluoroscopic guidance for needle placement. CTN systems display real-time needle position superimposed on a CT dataset. This is accomplished by placing electromagnetic (EM) or optical transmitters/sensors on the patient and needle, combined with fiducials placed within the scan field to superimpose a known needle location onto a CT dataset.

Artificial Intelligence-Aided Selection of Needle Pathways: Proof-of-Concept in Percutaneous Lung Biopsies.

Purpose: To evaluate the concordance between lung biopsy puncture pathways determined by artificial intelligence (AI) and those determined by expert physicians.

Materials And Methods: An AI algorithm was created to choose optimal lung biopsy pathways based on segmented thoracic anatomy and emphysema in volumetric lung computed tomography (CT) scans combined with rules derived from the medical literature. The algorithm was validated using pathways generated from CT scans of randomly selected patients (n = 48) who had received percutaneous lung biopsies and had noncontrast CT scans of 1.

Unreimbursed Costs of Multidisciplinary Conferences to a Radiology Department: A Prospective Analysis at an Academic Medical Center.

Purpose: Multidisciplinary conferences (MDCs) are important for clinical care but are unreimbursed and can be time-consuming for radiologists to prepare for and present. The purpose of this single-center, prospective, survey-based study is to measure the per-conference time and total time radiologists devote to MDCs at a single academic medical center. Secondary objectives are to determine the source of radiologist preparation time, and calculate the per conference and overall radiology departmental costs of MDC participation.

Clinical translation of abdominal histotripsy: a review of preclinical studies in large animal models.

Histotripsy is an emerging noninvasive, non-thermal, and non-ionizing focused ultrasound (US) therapy that can be used to destroy targeted tissue. Histotripsy has evolved from early laboratory prototypes to clinical systems which have been comprehensively evaluated in the preclinical environment to ensure safe translation to human use. This review summarizes the observations and results from preclinical histotripsy studies in the liver, kidney, and pancreas.

A Comparison of Histotripsy and Percutaneous Cryoablation in a Chronic Healthy Swine Kidney Model.

Purpose: To compare the safety and efficacy of histotripsy with cryoablation in a chronic human-scale normal porcine kidney model.

Materials And Methods: Eighteen female domestic swine were divided evenly into histotripsy and cryoablation treatment arms. A planned 2-3 cm diameter treatment was performed under ultrasound (histotripsy) or ultrasound and computed tomography (CT) guidance (cryoablation).

Percutaneous CT-Guided Abdominal and Pelvic Biopsies: Comparison of an Electromagnetic Navigation System and CT Fluoroscopy.

Purpose: To compare electromagnetic navigation (EMN) with computed tomography (CT) fluoroscopy for guiding percutaneous biopsies in the abdomen and pelvis.

Materials And Methods: A retrospective matched-cohort design was used to compare biopsies in the abdomen and pelvis performed with EMN (consecutive cases, n = 50; CT-Navigation; Imactis, Saint-Martin-d'Hères, France) with those performed with CT fluoroscopy (n = 100). Cases were matched 1:2 (EMN:CT fluoroscopy) for target organ and lesion size (±10 mm).

Linking Hospitals to Communities Through Evidence-Based Practice.

Evidence-based practice (EBP) and innovation are critical to quality and improved outcomes in the acute care setting and are often driven by bedside caregiver and clinical nurse specialist collaboration. Several EBP models and frameworks exist to guide these efforts. Although existing models do not preclude external evidence and community-based stakeholders, they largely do not explicitly connect the hospital-based effort to the community either.

Implementation of a Protocol: Dexmedetomidine for Use in Long-Term Procedural Sedation in Non-Intubated Pediatric Patients.

The objective of this quality initiative was to evaluate the process of implementing a new protocol using the Iowa model and evidence-base interventions. The first aim included deploying a protocol guiding sedation with dexmedetomidine for up to 24 h; the procedure involved non-intubated pediatric patients in the pediatric intensive care unit (PICU) while monitored by certified registered nurses. Dexmedetomidine is supported within the literature to be a safe and effective medication for pediatric patients, exceeding 24 h, without the adverse event of respiratory depression.

Lose the Whoosh: An Evidence-Based Project to Improve NG Tube Placement Verification in Infants and Children in the Hospital Setting.

Purpose: The purpose of this EBP project was to align NG and OG tube placement and verification practices with evidence-based recommendations for children.

Practice Change: An evidence-based NG/OG Tube Placement Algorithm was developed. The algorithm provided an individualized approach based on patient condition as well as a tiered approach that incorporated radiographs, tube measurement and marking, and pH testing.

Kinetic Measurements Reveal Enhanced Protein-Protein Interactions at Intercellular Junctions.

The binding properties of adhesion proteins are typically quantified from measurements with soluble fragments, under conditions that differ radically from the confined microenvironment of membrane bound proteins in adhesion zones. Using classical cadherin as a model adhesion protein, we tested the postulate that confinement within quasi two-dimensional intercellular gaps exposes weak protein interactions that are not detected in solution binding assays. Micropipette-based measurements of cadherin-mediated, cell-cell binding kinetics identified a unique kinetic signature that reflects both adhesive (trans) bonds between cadherins on opposing cells and lateral (cis) interactions between cadherins on the same cell.