Translating contrast enhanced computed tomography images to liver radioembolization dose distribution for more comprehensively indicating patients.

Contrast-enhanced computed tomography (CECT) is commonly used in the pre-treatment evaluation of liver Y-90 radioembolization feasibility. CECT provides detailed imaging of the liver and surrounding structures, allowing healthcare providers to assess the size, location, and characteristics of liver tumors prior to the treatment. Here we propose a method for translating CECT images to an expected dose distribution for tumor(s) and normal liver tissue.

Incidental deep venous thrombosis diagnosed on lower extremity computed tomography is a rare but clinically impactful finding.

Background: In the setting of a known thrombotic event, computed tomography (CT) studies provide reasonable sensitivity for the diagnosis of deep venous thrombosis (DVT). However, the incidence and accuracy of a DVT diagnosis on CT studies not targeted for the detection of DVT are not well described. In addition, the clinical impact of DVTs incidentally identified on CT is unknown.

Incidence, Presentation, and Natural History of Adrenal Hemorrhage: An Institutional Analysis.

Introduction: Adrenal hemorrhage (AH) can occur due to multiple etiologies with variable radiographic appearance, often indistinguishable from underlying adrenal neoplasms. There is a lack of AH literature and evidence-based guidelines. Our study aimed to understand the prevalence and etiology of AH, follow-up, and incidence of underlying neoplasm.

Alternate Cervical Venous Access Sites for Implantable Port Catheters: Experience at a Single Quaternary Care Institution.

Introduction: Clinical outcomes of implantable port catheters (IPCs) placed via alternative veins such as the external jugular and cervical collaterals have not been well established. This investigation evaluates the short- and long-term outcomes of IPCs inserted via alternate cervical veins (ACV) compared to traditionally inserted IPCs via the internal jugular vein (IJV).

Materials And Methods: A total of 24 patients who received an IPC between 2010 and 2020 via an ACV-defined as the external jugular vein, superficial cervical vein, or unnamed collateral veins-were identified.

Erratum: Subclavian Effort Thrombosis: Pathophysiology, Diagnosis, and Management.

[This corrects the article DOI: 10.1055/s-0042-1753481.].

Comparative Oncology: Management of Hepatic Neoplasia in Humans and Dogs.

Primary hepatic neoplasia is uncommonly reported in dogs. Hepatocellular carcinoma (HCC) is the most frequent neoplasia identified in dogs and considerable effort has been committed towards identifying definitive and palliative treatment options. HCC is well recognized in humans as a sequelae of liver disease such as hepatitis or cirrhosis, while in dogs a similar link has failed to be fully elucidated.

Subclavian Effort Thrombosis: Pathophysiology, Diagnosis, and Management.

Subclavian vein (SCV) effort thrombosis, also known as Paget-Schroetter syndrome or venous thoracic outlet syndrome, is an uncommon condition that affects individuals with an irregularly narrow thoracic outlet who engage in repetitive overhead motions of the affected arm. Venous injury arises from microtraumas that occur from the repetitive compression of the SCV between the first rib and the overlying clavicle. Additional sources of extrinsic compression can be due to the anterior scalene muscle, subclavius muscle, and costoclavicular ligament.

The Impact of Injection Distance to Bifurcations on Yttrium-90 Distribution in Liver Cancer Radioembolization.

Purpose: To model the effect of the injection location on the distribution of yttrium-90 (Y) microspheres in the liver during radioembolization using computational simulation and to determine the potential effects of radial movements of the catheter tip.

Materials And Methods: Numerical studies were conducted using images from a representative patient with hepatocellular carcinoma. The right hepatic artery (RHA) was segmented from contrast-enhanced cone-beam computed tomography scans.

A Survey of Interventional Radiologists Regarding the Use of Morbidity and Mortality Conferencing in Departmental Quality Improvement Programs.

Purpose: To investigate the degree to which morbidity and mortality (M&M) conferencing is utilized in interventional radiology (IR), identify impediments to its adoption, and assess the experience of those using this tool.

Materials And Methods: Members of the Society of Interventional Radiology (SIR) were offered a 9-question survey of practices and experiences regarding M&M conferencing within their quality assessment (QA) programs.

Results: Among 604 respondents, 37.

Cross-Modal Data Programming Enables Rapid Medical Machine Learning.

A major bottleneck in developing clinically impactful machine learning models is a lack of labeled training data for model supervision. Thus, medical researchers increasingly turn to weaker, noisier sources of supervision, such as leveraging extractions from unstructured text reports to supervise image classification. A key challenge in weak supervision is combining sources of information that may differ in quality and have correlated errors.

Diagnostic performance of lower extremity Doppler ultrasound in detecting iliocaval obstruction.

Objective: To retrospectively evaluate the performance of two commonly used Doppler ultrasound parameters, namely, venous flow phasicity and response to Valsalva maneuver, in detecting iliocaval obstruction.

Methods: All imaging studies of patients seen by interventional radiology for lower extremity venous disease at a single institution from 1996 to 2018 were retrospectively identified. Lower extremity ultrasounds with a concurrent magnetic resonance, computed tomography, or conventional venogram performed within the next 7 days, which served as gold standard, were further identified (n = 192 examinations, including 313 limbs).

Snorkel MeTaL: Weak Supervision for Multi-Task Learning.

Many real-world machine learning problems are challenging to tackle for two reasons: (i) they involve multiple sub-tasks at different levels of granularity; and (ii) they require large volumes of labeled training data. We propose Snorkel MeTaL, an end-to-end system for multi-task learning that leverages supervision provided at by domain expert users. In MeTaL, a user specifies a problem consisting of multiple, hierarchically-related sub-tasks-for example, classifying a document at multiple levels of granularity-and then provides for each sub-task as weak supervision.

MR-Compatible Haptic Display of Membrane Puncture in Robot-Assisted Needle Procedures.

Multilayer electroactive polymer films actuate a small hand-held device that can display tool tip forces during MR-guided interventions. The display produces localized skin stretch at the thumb and index fingertips. Tests confirm that the device does not significantly affect MR imaging and produces detectable stimuli in response to forces measured by a biopsy needle instrumented with optical fibers.

Intelligent Word Embeddings of Free-Text Radiology Reports.

Radiology reports are a rich resource for advancing deep learning applications in medicine by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the ambiguity and subtlety of natural language. We propose a hybrid strategy that combines semantic-dictionary mapping and word2vec modeling for creating dense vector embeddings of free-text radiology reports.

Endovascular Management of May-Thurner Syndrome in Adolescents: A Single-Center Experience.

Purpose: To report a single-center experience in regard to the technique, safety, and clinical outcomes of endovascular therapy for treatment of May-Thurner syndrome (MTS) in adolescent patients.

Materials And Methods: A retrospective review identified 10 patients (6 female; mean age, 16 y; range, 12-18 y; mean weight, 73 kg; range, 50-116 kg) treated by endovascular therapy for MTS from 1998 to 2015. Clinical presentations consisted of acute thrombotic MTS (n = 6) and nonthrombotic MTS (n = 4).

Electromagnetic navigation with multimodality image fusion for image-guided percutaneous interventions.

Percutaneous image-guided interventions are performed for a variety of clinical indications: to obtain tissue biopsies, to alleviate pain, and to treat diseases including a variety of malignancies. The efficacy of all of the above is directly related to accurate positioning of the procedural device using imaging guidance. The ability to achieve accurate positioning can be limited by a variety of technical factors including small lesion size, a lesion that is best seen on an imaging modality that is impractical for guiding intervention, and a lesion that is difficult to access or in a tenuous location.

Design and Coordination Kinematics of an Insertable Robotic Effectors Platform for Single-Port Access Surgery.

Single port access surgery (SPAS) presents surgeons with added challenges that require new surgical tools and surgical assistance systems with unique capabilities. To address these challenges, we designed and constructed a new insertable robotic end-effectors platform (IREP) for SPAS. The IREP can be inserted through a Ø15 mm trocar into the abdomen and it uses 21 actuated joints for controlling two dexterous arms and a stereo-vision module.

Design and performance evaluation of a minimally invasive telerobotic platform for transurethral surveillance and intervention.

Bladder cancer, a significant cause of morbidity and mortality worldwide, presents a unique opportunity for aggressive treatment due to the ease of transurethral accessibility. While the location affords advantages, transurethral resection of bladder tumors can pose a difficult challenge for surgeons encumbered by current instrumentation or difficult anatomic tumor locations. This paper presents the design and evaluation of a telerobotic system for transurethral surveillance and surgical intervention.

Robot-assisted ophthalmic surgery.

Surgical robots have revolutionized a number of surgical subspecialties, including laparoscopic surgery, urology, gynecology, and orthopedics. Robots offer a number of potential improvements over unassisted human hands, such as tremor filtration, scaling of motion, enhanced dexterity in confined spaces, and extremely high precision. Several designs and prototypes have recently been introduced for use in ophthalmic surgery and they have been tested in animal models.

In vivo pan/tilt endoscope with integrated light source, zoom and auto-focusing.

We describe a surgical imaging device with pan, tilt, zoom and integrated LED light source. It can be fully inserted into the abdomen, leaving the insertion port free for tooling. Using a porcine model we have tested the device and performed surgical procedures including cholecystectomy, appendectomy, running (measuring) the bowel, suturing, and nephrectomy.