-
[show abstract]
[hide abstract]
ABSTRACT: Aims and background. "Augmented reality" is a technique to create a composite view by augmenting the real intervention field, visualized by the doctor, with additional information coming from a virtual volume generated using computed tomography (CT), magnetic resonance or ultrasound images previously acquired from the same patient. In the present study we verified the accuracy and validated the clinical use of an augmented reality navigation system produced to perform percutaneous CT-guided lung biopsies. Methods. One hundred and eighty consecutive patients with solitary parenchymal lung lesions, enrolled using a nonrandom enrollment system, underwent percutaneous CT-guided aspiration and core biopsy using a traditional technique (group C, 90 patients) and navigation system assistance (group S, 90 patients). For each patient we recorded the largest lesion diameter, procedure time, overall number of CT scans, radiation dose, and complications. The entire experimental project was evaluated and approved by the local institutional review board (ethics committee). Results. Each procedure was concluded successfully and a pathological diagnosis was reached in 96% of cases in group S and 90% of cases in group C. Procedure time, overall number of CT scans and incident x-ray radiation dose (CTDIvol) were significantly reduced in navigation system-assisted procedures (P <0.001; z = 5.64) compared with traditional CT-guided procedures. The percentage of procedural complications was 14% in group S and 17% in group C. Conclusion. The augmented reality navigation system used in this study was a highly safe, technically reliable and effective support tool in percutaneous CT-guided lung biopsy, allowing to shorten the procedure time and reduce the incident x-ray radiation dose to patients and the rate of insufficient specimens. Furthermore, it has the potential to increase the number of procedures executed in the allocated time without increasing the number of complications.
Tumori. 11/2012; 98(6):775-82.
-
Journal of vascular and interventional radiology: JVIR 11/2011; 22(11):1637-8. · 1.81 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Arteriovenous malformation (AVM) of the pancreas is a rare condition. Most patients are asymptomatic or alternatively may present with a wide spectrum of symptoms. Traditionally, surgery has been considered the treatment of choice; however, alternative approaches, such as transcatheter embolization (TAE), may be proposed. We report a case of a 48-year-old man with a pancreatic head AVM, presenting with upper abdominal pain and slight anemia. The patient refused surgery and underwent TAE by means of ethylene-vinyl alcohol copolymer (EVOH). At 3 months follow-up, the patient was able to eat regularly, with no residual pain and no signs of anemia.
CardioVascular and Interventional Radiology 09/2011; 35(4):958-62. · 2.09 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the capability of echo-planar diffusion-weighted magnetic resonance imaging (MRI) (EPI-DWI) in diagnosing relapsing/residual cholesteatomas after canal wall-up mastoidectomy.
In a blinded study design, we investigated with MRI, including standard spin-echo sequences, 18 patients evaluated with clinical examination and computed tomography (CT) suspected for relapsing/residual cholesteatoma 7 to 19 months after a canal wall-up mastoidectomy. Images were evaluated by two radiologists blinded to patients' identities, CT findings, and clinical data set, who decided in a consensus agreement whether there was a pathologic signal increase in the petrous bone in a single-shot EPI-DWI sequence. All the patients underwent a second tympanoplasty or revision surgery of the mastoidectomy cavity within 15 days after magnetic resonance investigation.Sensitivity, specificity, and predictive values were evaluated separately for standard sequences and EPI-DWI.
In EPI-DWI, five of six patients with cholesteatoma showed a bright signal, whereas those patients with a noncholesteatomatous tissue showed no anomalies. The only misdiagnosed cholesteatoma was a pearl 2 mm in diameter. Sensitivity, specificity, and positive predictive values, and negative predictive values of EPI-DWI in diagnosing relapsing/residual cholesteatomas were 86, 100, 100, and 92%, respectively.
EPI-DWI may be a useful tool in differentiating between cholesteatomatous and noncholesteatomatous tissues after closed cavity mastoidectomy. Further investigations are, however, required to establish the practical utility of EPI-DWI on larger series as a screening modality in the follow-up after closed cavity mastoidectomies.
Ontology & Neurotology 12/2004; 25(6):879-84. · 1.90 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To assess the utility of echo-planar diffusion-weighted magnetic resonance imaging (EPI-DWI) in the diagnosis of secondary cholesteatoma of the middle ear and in the differential diagnosis between residual/relapsing cholesteatoma and non-cholesteatomatous tissues (scar, granulation and inflammatory tissue) after conservative mastoidectomy.
Twenty-four patients, who had previously undergone clinical and CT investigation, were prospectively examined by standard and EPI-DWI magnetic resonance imaging (MRI) after conservative mastoidectomy. Secondary cholesteatoma was suspected in 5 patients and residual/relapsing cholesteatoma in 19 patients. Two radiologists, blinded to patient's identity, clinical data and CT findings, reached consensus on the presence of tissue consistent with cholesteatoma in conventional CT and areas of altered signal in EPI-DWI in the petrous bone. All patients underwent mastoidectomy, second time of tympanoplasty or review surgery within 15 days from MR investigation. Sensitivity, specificity and negative and positive predictive values were evaluated separately for standard and EPI-DWI MRI.
In EPI-DWI sequences, 11/12 patients with cholesteatoma showed an area of hyperintense signal, whereas patients with non-cholesteatomatous tissue showed no pathologic signal in the petrous bone. In the single case of cholesteatoma undetected on EPI-DWI a cholesteatomatous pearl approx. 2 mm in diameter was visible in the surgical cavity. Sensitivity, specificity, positive and negative predictive values were 92%, 100%, 100%, 92% for EPI-DWI MRI and 92%, 25%, 55%,75% for standard MRI, respectively.
EPI-DWI sequences are useful in the diagnosis of secondary cholesteatoma and in the differential diagnosis between residual/relapsing cholesteatoma and non-cholesteatomatous tissues after conservative mastoidectomy. However, the usefulness of EPI-DWI sequences as a screening test after conservative mastoidectomy requires further assessment.
La radiologia medica 107(5-6):556-68. · 1.44 Impact Factor
