Science topic
Interventional Radiology - Science topic
Those involved in Research regarding interventional Radiology.
Questions related to Interventional Radiology
Massive obstetric haemorrhage (MOH) remains a leading cause of maternal mortality worldwide, accounting for up to 50% of maternal deaths in some countries and currently constitutes the seventh commonest cause of death in the United Kingdom with a rate of 0.6/100,000 maternities.
Optimum management of this condition require up to date knowledge of relevant treatment modalities (such as Tranexamic Acid and interventional radiology), competent surgical techniques and an appreciation of non-technical skills (i.e. human factors). In particular, decision making and speed of action by the most experienced clinician present (often the registrar) is paramount so that obstetric haemorrhage could be controlled before it deteriorated to coagulopathy and ultimately maternal death.
For this issue, the editors aim to garner a collection of articles to cover the broad aspects pertaining to MOH for the benefit of clinicians and patients alike.
The potential applications encompass a wide spectrum and include, but are not restricted to, the following areas:
- Human factors in MOH.
- Cell salvage technology in MOH.
- Top tips on bedside visual estimation of blood loss.
- Pelvic packing in PPH: A review of worldwide literature.
- The role of Interventional Radiology in MOH.
- The role of Tranexamic Acid in MOH: Review of Evidence
- Placenta Accreta Spectrum.
- Management of women who decline blood transfusion.
- Uterine compression sutures: Which ones should we use?
I have been studying about X-ray Fluoroscopy imaging technique lately and it's immense use in medical diagnosis and therapy. However I find there are many disadvantages to it, such as we can only see a 2D image of a 3D object. Minor details are hard to acquire and/or observe on screen. Monochromatic display is also another problem as I see it.
What type of improvements are being currently being researched to this imaging technique? I have hit dead ends in my search through google, pubmed, Radiographics Journal & so on.
Please let me know. Thank you.
I have to summarize model of care for staffing of diagnostic imaging that includes the following modalities: Xray, CT, MRI, interventional radiology, nuclear medicine.
Looking at number of staff required on a shift based on number of inpatients and outpatients
I want to know , i search interventional radiology for unresectable colorectal cancer, but i don't get the answers, i get about colorectal liver metastasis treatment with interventional radiology. I ask can resectable or unresectable colorectal cancer treat with interventional treatment like embolisation or such as?
Would like to ask of any experience or evidence of anyone in Nuclear medicine or Interventional radiology regarding MAA lung shunting pre therapy for a case of SIRT therapy of Hepatocellular carcinoma?
1. If there is evidence of portal vein thrombosis, how accurate are the findings of MAA lung shunting percentage?
2. If there is no uptake on the MAA, at the site of liver lesions seen on CT, is there any value to do a FDG PET CT for this case, even though its a Hepatocellular carcinoma? Given that HCC has low FDG avidity unless it is an aggressive tumour?
Please share your experience. Thank you in advanced!
Interventional Radiologist or Radiologist with a inclinations towards intervention is a very handy resource especially at peripheral or community level health care centres and help the patient and clinicians in a variety of situations provided the radiologist is aware of 'what he can offer in a given situation'. The problem may be inserting a central line, local injections into joints to treat a painful condition or a nerve block or simple FNAC or aspiration.
Exposing the residents to such procedures, rather, exposing them to think out of the box in such situations and help them to develop an attitude in intervention ingrained is surely going to help patients at large.
What according to you can be done and how this can be achieved. Please share your views.
We have many techniques for revascularization [angiplasties, new stents, vascular bypass], yet we are not doing early screening in patients with multiple vascular risk factors.
Should we be more active in our early screening of the carotid and cerebral vessel circulations?
Are we missing the boat?
Currently I am employed in a hospital based patient care center that supports several hospital areas including: Interventional Radiology, surgery, Infusion therapy, Endoscopy and Procedural Sedation. Cardioversion and the post care of the of the patient has been added. Although not a telemetry unit the phase 2 nurses were given an EKG class and ACLS class. The patients currently seen in the phase 2 area include: Surgical outpatient, Monitored Anesthesia Care (MAC) anesthesia patients (inhouse and outpatient), interventional radiology patients (including angiograms, AV fistuala declot, organ biopsy etc), post endoscopy patients, Blood transfusion, IV infusion, bone marrow transfusion, and apheresis. I am attempting to clarify if there has been any studies to determine limits in nursing knowledge to diluted to maintain proficient and safe care.
a. Allow them to transfer into DR.
b. Make them finish their IR residency commitment first.
IR residency will be challenged by being one of the most specialized residencies in the NRMP match and yet not having a required clerkship in the medical school curriculum. How do you plan on ensuring that students have adequate exposure to IR prior to making their career decisions?
a. Heavily. We will likely recruit at least one resident per year on the Independent Pathway.
b. Sporadically. We will likely use it only to fill in gaps every few years.
c. Seldomly. We will likely never use that pathway to recruit.
d. We haven’t thought about this.
e. We won’t have an IR residency.
Do you currently participate in any of the following activities to improve medical student exposure to IR:
a. IR Student Interest Group
b. IR Sub-Internship
c. IR Electives
d. Participation in an IR Medical Student Symposium
e. IR faculty teaching in the M1-M3 medical school curriculum
f. Encourage student engagement in the SIR RFS
Looking for a validated questionnaire on occupational radiation exposure for interventional radiology/cardiology. Study is on using FISH to assess translocation frequencies of low dose ionizing radiation. Questionnaire to asses occupational exposure history and other confounding factors of translocation.
In the course of measuring the transmission of lead glass shielding for fluoro in interventional radiology machines, I got different results in my ion chamber , for mSv/h or mSv ( for 10 ms irradiation) mode.
Continuing my previous question on the the dose rate measurements as compared to integral dose in interventional radiology, I used the ion chamber RAM ION Of ROTEM as the main detector but also tried the DMC3000 of Mirion ; but I was disappointed by its performance ( low sensitivity and difficulty to move from dose to dose rate).Do you have experience with this new model?
Hello!
I am a field physicist and I perform QA measurements of various types of X-ray units. Due to recent changes in legal requirements in my country, we have to provide the radiation output value for each unit/tube measured (in mGy/mA.s at 1 meter from focal spot) at filtration of 2,5 mm Al equivalent. This unfortunately cannot be directly achieved for interventional radiology units, some CTs and occasionally other types of X-ray inits.
My question is: how can one calculate the dose at filtration of 2.5 mm Al equivalent from the measured dose at other filtration, assuming HF generators and 0% ripple?
For example: GE Innova 2100 interventional radiography unit, dose rate at 83 kVp and 165,5 mA (single shot) is 14,47 mGy/s and total filtration is 8,33 mm Al equivalent (actual filtration is combination of Al and Cu filters, but I do not have the precise values of both of these).
Thank you very much!
Looking for privileging criteria for pediatric interventional radiology
- Utilizes algorithmic checklists to minimize data entry and validate data
- Web based, no installation or direct costs, just your feedback
- Procedural data only, outcomes need separate tracking
- Faster than dictation, avoids abstraction, auto-coded
Does anyone have an idea or that overuse of the neck can cause cerebral infarction resulted from thrombus in the internal carotid artery?
A 61-year-old male was brought to the emergency department with complaints of left side paralysis and speech disturbance. The symptoms supposedly appeared while he was sleeping. Apparently, the patient could not move his left hand and leg. He was alert and his blood pressure was 120/60 mmHg. He has no history of hypertension, diabetes, or hyperlipidemia. He does not consume alcohol or smoke. According to his wife, he complained of right side neck pain in the preceding day after he played Kendo _ Japanese martial art. There were no apparent bruises or wounds in his right neck.
USG revealed the thrombus at the trunk of right internal carotid artery. CT revealed no bleeding but the high intensity lesion in the right middle cerebral artery, indicating clots in the vessel. MRI showed the high intensity lesion in the right basal ganglia. MRA showed the deficit of the blood flow in the right ICA. Then, he was diagnosed as acute stroke resulting from thrombosis in the ICA. Thinking of the interval of the onset, he was not considered as a candidate of interventional radiology followed by iv t-PA treatment. Then, conservative treatment by edaravone and antithrombin agent were initiated.
In this case, I wonder if there are some relationships between sports and cerebral infarction. I am interested in the involvement of external force or overuse of neck as the cause of his illness.
In pulmonary CT angiography, different protocols are applied with different contrast volumes. However, if we know the physiological average amount of CM that fills the pulmonary artery down to the tertiary branches, we can do good exam.
In timing the scan, we need to exclude the CM-filled SVC and the left side of the heart in order to avoid artifacts. So knowing the physiological CM volume on average patient and adjusting the scan time given the size of the chest, and heart rate, a good timing of pulmonary angiography can be performed.
One more technical factor is calculating the scan time in testing bolus technique. This method ensures a maximum concentration of CM in the pulmonary trunk. But giving that we start the scan in the caudo-cranial direction, the CM may be not maximum by the time PA is scanned. It is said that 5 seconds should be added to the time to peak, I don't understand why 5 second? In fact, rationally some seconds should be deducted from the time to peak because this time is consumed by scanning the chest from the base till it reaches the pulmonary artery.
I would like to hear on your experience on how to measure and calculate the skin dose to patients in interventional radiology.What is the best detector and what method gives the most accurate results during a clinical procedure?Do you calibrate the Dose-Area detector for each machine?Can you suggest also a simple method to do it?
I am aware of the IEC 61331-1 protocol for X-Ray attenuation measurements, both for narrow beam and broad beam geometry. Do you use table interpolation or you calibrate with known Pb samples? Do you get different lead equivalent thicknesses for these geometries? What are the preferred specification of lead equivalency by the apron manufacturers?
Any further role for the radiologist in this case?
In a prospective study on patients with pelvic malignancies undergoing pelvic radiotherapy, we found an association between vitamin D deficiency and severity of radiation induced proctitis. This association was independent from age, gender, cancer type, and BMI. What could be the mechanisms behind this association?
Hemobilia is not uncommon following PTBD. It is particularly true in cases where the confluence is non-patent and excessive manipulation is required during the procedure. Hemobilia secondary to venous and arterial injury has a clear protocol of management that is well discussed in literature. However, there is paucity of data in general on management of hemobilia not related to vascular injury. Should we clamp the catheter if there is hemobilia in an attempt to create a tamponade effect? My experience is that lesser the manipulation, lesser the chances of hemobilia. However, much needs to be learnt about this distressing complication.
Those 4D can then be displayed in volume rendering or multiplanar reformations. Imagine, real 3D vascular roadmapping would become feasible ? Can you think of any advantages ? Any new procedures that can be performed ? Will it make vascular interventions faster and more secure ?
Looking for animal models that would be suitable for intra-arterial infusion therapy (eg, chemoembolization) (ie, rabbit size or larger), other than the VX2 (HCC) model. Starting from either biopsy cells or other sources. Can anyone recommend advice for planning, handing, duration, ease of use, cost, or any other useful tips?