1.Pre- and post-operative parameters among patients undergoing pre-operative embolization of meningioma: A tertiary referral center experience
Dennis Raymond L. Sacdalan ; Orlando R. Ignacio ; Glenn Marc G. Ignacio
Acta Medica Philippina 2025;59(5):52-57
BACKGROUND AND OBJECTIVE
Meningiomas represent the most prevalent benign intracranial tumors, comprising 13- 26% of primary intracranial neoplasms. These tumors derive their blood supply from both extracranial and intracranial circulation. Over recent decades, pre-operative embolization (POE) has emerged as a potential adjunctive therapy to surgery, aiming to reduce tumor vascularity. Our study seeks to explore the potential correlation between the extent of devascularization following POE of meningiomas and intraoperative blood loss.
METHODSThis cross-sectional study involved nine meningioma patients at a tertiary hospital, involving chart review of patients across four years. These patients were referred for POE due to angiographic evidence of a hypervascular mass between January 2018 and January 2022. We collected demographic data, tumor characteristics (including location, size, and vascular supply), and intraoperative variables such as total operative time and blood loss. Statistical analyses aimed to uncover correlations between vascularization degree and various factors.
RESULTSOur population consists predominantly of females (53.68%), with a mean age of 45.85 ± 13.65 years. Only one mortality was recorded (7.7%). Pre-operative embolization achieved devascularization in the majority (69.2%) of cases, with approximately two-thirds (66.7%) experiencing complete devascularization. Mean total operative time stood at 336.11 ± 301.88 minutes, with a mean post-operative blood loss of 985.56 ± 1013.72 milliliters. Additionally, for those with recorded recovery times, the mean recovery time was 14.32 ± 13.51 hours.
Mortality rates showed no association with sex, devascularization status, or number of feeding vessel zones. Furthermore, the extent of devascularization did not correlate with age, sex, number of feeding vessel zones, postoperative blood loss, total operative time, or recovery time (p >0.05).
CONCLUSIONIn summary, this study represents a significant endeavor to elucidate factors influencing meningioma outcomes following pre-operative embolization. Despite limitations regarding patient numbers, our study offers valuable insights into operative parameters and embolization considerations for future analyses in our tertiary center.
Meningioma ; Radiology, Interventional
2.Low-Cost Phantom Model for Simulation Training in Ultrasound-Guided Ethanol Ablation of a Cystic Thyroid Nodule
Darryl Young S Duguil ; Raphael S Rojas ; Maria Karen A Capuz
Philippine Journal of Otolaryngology Head and Neck Surgery 2025;40(1):37-41
Objective:To describe a low-cost, reproducible phantom model for training medical practitioners in ultrasound-guided ethanol ablation (EA) of a cystic thyroid nodule.
Methods:The model of cyst contents was created using a mixture of coffee powder, cornstarch and water to mimic colloidal contents. This was injected into the finger of a cut surgical glove secured with transparent tape to serve as an inflatable capsule and placed inside a chicken breast. This setup allows practitioners to perform key ultrasound-guided ethanol ablation techniques including spinal needle insertion, cyst aspiration, saline flushing, re-aspiration and ethanol injection.
Results:The phantom model was assembled for PhP 150.30 per unit and took approximately 5 minutes to construct. This model was demonstrated to be a cost-effective and simple method for enabling specialists to practice and enhance their skills in ultrasound-guided ethanol ablation of a cystic thyroid nodule.
Conclusion:The described phantom model provides an accessible and practical training tool for healthcare providers to gain proficiency in ultrasound-guided ethanol ablation of a cystic thyroid nodule in a safe and controlled setting prior to actual patient handling.
Medical Education ; Otorhinolaryngology ; Radiology ; Ultrasonography
3.Pre- and post-operative parameters among patients undergoing pre-operative embolization of meningioma: A tertiary referral center experience
Dennis Raymond L. Sacdalan ; Orlando R. Ignacio ; Glenn Marc G. Ignacio
Acta Medica Philippina 2024;58(Early Access 2024):1-6
Background and Objective:
Meningiomas represent the most prevalent benign intracranial tumors, comprising 13- 26% of primary intracranial neoplasms. These tumors derive their blood supply from both extracranial and intracranial circulation. Over recent decades, pre-operative embolization (POE) has emerged as a potential adjunctive therapy to surgery, aiming to reduce tumor vascularity. Our study seeks to explore the potential correlation between the extent of devascularization following POE of meningiomas and intraoperative blood loss.
Methods:
This cross-sectional study involved nine meningioma patients at a tertiary hospital, involving chart review of patients across four years. These patients were referred for POE due to angiographic evidence of a hypervascular mass between January 2018 and January 2022. We collected demographic data, tumor characteristics (including location, size, and vascular supply), and intraoperative variables such as total operative time and blood loss. Statistical analyses aimed to uncover correlations between vascularization degree and various factors.
Results:
Our population consists predominantly of females (53.68%), with a mean age of 45.85 ± 13.65 years. Only one mortality was recorded (7.7%). Pre-operative embolization achieved devascularization in the majority (69.2%) of cases, with approximately two-thirds (66.7%) experiencing complete devascularization. Mean total operative time stood at 336.11 ± 301.88 minutes, with a mean post-operative blood loss of 985.56 ± 1013.72 milliliters. Additionally, for those with recorded recovery times, the mean recovery time was 14.32 ± 13.51 hours.
:
Mortality rates showed no association with sex, devascularization status, or number of feeding vessel zones. Furthermore, the extent of devascularization did not correlate with age, sex, number of feeding vessel zones, postoperative blood loss, total operative time, or recovery time (p >0.05).
Conclusion
In summary, this study represents a significant endeavor to elucidate factors influencing meningioma outcomes following pre-operative embolization. Despite limitations regarding patient numbers, our study offers valuable insights into operative parameters and embolization considerations for future analyses in our tertiary center.
Meningioma
;
Radiology, Interventional
4.Research Progress in Diagnostic Reference Levels in Interventional Radiology.
Pei-Yi QIAN ; Yun LIU ; Jia REN ; Xiao-Jun XU ; Zhi-Xin ZHAO ; Cheng-Jian CAO ; Lei YANG
Acta Academiae Medicinae Sinicae 2023;45(3):506-511
During interventional procedures,subjects are exposed to direct and scattered X-rays.Establishing diagnostic reference levels is an ideal way to optimize the radiation dose and reduce radiation hazard.In recent years,diagnostic reference levels in interventional radiology have been established in different countries.However,because of the too many indicators for characterizing the radiation dose,the indicators used to establish diagnostic reference levels vary in different countries.The research achievements in this field remain to be reviewed.We carried out a retrospective analysis of the definition,establishment method,application,and main factors influencing the dose difference of the diagnostic reference level,aiming to provide a basis for establishing the diagnostic reference level for interventional procedures in China.
Humans
;
Diagnostic Reference Levels
;
Radiology, Interventional/methods*
;
Radiation Dosage
;
Retrospective Studies
;
Radiography
5.Diagnostic Value of American Thyroid Association Guidelines,American College of Radiology Thyroid Imaging Reporting and Data System,and Chinese Thyroid Imaging Reporting and Data System Alone and Combined With BRAFV600E Mutation in Atypia of Undetermined Significance/Follicular Lesion of Undetermined Significance.
Yu LIN ; Yu-Kun LUO ; Jie LI ; Xiu-Yun REN ; Hong-Wei WANG
Acta Academiae Medicinae Sinicae 2023;45(6):921-928
Objective To explore the diagnostic efficacy of American Thyroid Association(ATA)guidelines,American College of Radiology Thyroid Imaging Report and Data System(ACR-TIRADS),and Chinese Thyroid Imaging Reporting and Data System(C-TIRADS)alone and combined with BRAFV600E mutation in atypia of undetermined significance/follicular lesion of undetermined significance(AUS/FLUS).Methods A total of 138 patients who underwent ultrasound-guided fine needle aspiration(FNA)in the Chinese PLA General Hospital from January 2020 to May 2023 were selected.The clinicopathological and ultrasound characteristics were retrospectively analyzed for each nodule.Each nodule underwent preoperative BRAFV600E mutation testing and was diagnosed according to the ATA guidelines,ACR-TIRADS,and C-TIRADS.The diagnostic efficacy of ATA guidelines,ACR-TIRADS,and C-TIRADS alone and combined with BRAFV600E mutation was assessed based on the results of histopathological diagnosis.Results The 138 AUS/FLUS thyroid nodules included 45(32.6%)benign ones and 93(67.4%)malignant ones.The patient age(t=1.444,P=0.151),gender(χ2=0.259,P=0.611),and location of nodules(χ2=2.055,P=0.358)had no statistical significance for the differentiation between benign and malignant nodules,while nodule size(Z=2.500,P=0.012),echo(χ2=14.693,P<0.001),composition(χ2=17.075,P<0.001),aspect ratio ≥1(χ2=9.477,P=0.002),and microcalcification(χ2=6.892,P=0.009)were of significance for the differentiation.When applied alone,BRAFV600E mutation showed high specificity(95.56%)and positive predictive value(95.65%).Among the three ultrasound grading systems,ACR-TIRADS had the highest sensitivity(χ2=37.923,P<0.001;χ2=40.462,P<0.001)and accuracy(χ2=81.595,P<0.001;χ2=76.912,P<0.001),while C-TIRADS had the highest specificity(χ2=11.746,P<0.001;χ2=21.235,P<0.001).However,the three systems showed no statistically significant difference in the diagnostic efficiency when applied alone(Z=1.177,P=0.239;Z=0.213,P=0.831;Z=1.016,P=0.310).The combination of BRAFV600E mutation with ACR-TIRADS or C-TIRADS improved the diagnostic efficacy of BRAFV600E mutation in distinguishing the benign and malignant AUS/FLUS nodules(Z=2.107,P=0.035;Z=2.752,P=0.006).The combination of ATA guidelines with BRAFV600E mutation increased the diagnostic accuracy of BRAFV600E mutation(χ2=20.679,P<0.001),while it had no statistically significant difference in distinguishing the benign and malignant AUS/FLUS nodules(Z=1.321,P=0.186).The combination of ATA guidelines,ACR-TIRADS,or C-TIRADS with BRAFV600E mutation improved the diagnostic efficacy of ultrasound grading systems for AUS/FLUS nodules(Z=2.770,P=0.006;Z=2.770,P=0.006;Z=2.890,P=0.004).Specifically,ACR-TIRADS combined with BRAFV600E mutation showed the highest sensitivity(χ2=4.712,P=0.030;χ2=4.712,P=0.030),while C-TIRADS combined with BRAFV600E mutation showed the highest accuracy(χ2=77.627,P<0.001;χ2=85.827,P<0.001).However,there were no statistically significant differences in diagnostic performance between the combinations(Z=1.276,P=0.202;Z=0.808,P=0.419;Z=1.615,P=0.106).Conclusion ATA guidelines,ACR-TIRADS,and C-TIRADS combined with BRAFV600E mutation can improve the diagnostic efficacy of BRAFV600E mutation or ultrasound grading system alone in AUS/FLUS nodules,which can facilitate the further management and treatment of such patients.
Humans
;
United States
;
Infant
;
Thyroid Neoplasms/genetics*
;
Proto-Oncogene Proteins B-raf/genetics*
;
Adenocarcinoma, Follicular/pathology*
;
Retrospective Studies
;
Data Systems
;
Thyroid Nodule/genetics*
;
Ultrasonography/methods*
;
Mutation
;
China
;
Radiology
6.Guidelines for Diagnosis and Treatment of Pancreatic Cystic Neoplasms Based on Radiology.
Xi-Heng WANG ; Hua-Dan XUE ; Zheng-Yu JIN
Acta Academiae Medicinae Sinicae 2022;44(2):324-331
As the detection rate of pancreatic cystic neoplasms (PCN) increases,recommendations or guidelines for the diagnosis and treatment of PCN have been released from professional organizations.From the perspective of radiology,we compared seven guidelines in terms of general introduction,preoperative monitoring methods and strategies,stratification of risk factors,surgical indications,and postoperative follow-ups,aiming to provide references for the evaluation of images and the formulation of individualized approach for the treatment of PCN.
Humans
;
Pancreatic Cyst/therapy*
;
Pancreatic Neoplasms/therapy*
;
Pregnenolone Carbonitrile
;
Radiography
;
Radiology
8.Analysis on individual dosage monitoring of some interventional radiology staffs in Tianjin City from 2016 to 2020.
Xue Ying YANG ; Pei HAO ; Jin Wei YU ; Li Na FAN ; Qiang ZENG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2022;40(9):684-688
Objective: To investigate the individual external dose level of some interventional radiology staffs from 2016 to 2020 in Tianjin City. Methods: All 2068 interventional radiology staffs who were included in the work of the Radiation Monitoring Project from 2016 to 2020 were selected as study subjects in March 2021. The individual dose monitoring results of interventional radiology staffs of different ages, working years, time and medical institutions were analyzed. Results: Among 2068 interventional radiology workers, 1406 (67.99%) were male and 662 (32.01%) were female. The age was 44.6 (39.2, 50.3) years, and the working years was 10.5 (4.3, 14.6) years. The annual effective doses per capita of 40-49 age group and ≥50 age group were higher than that of 30-39 age group (P<0.05) . The annual effective dose per capita of 5-9 working years was higher than that of <5 working years, and the annual effective dose per capita of 10-29 working years was higher than that of 5-9 working years (P<0.05) . The median per capita annual effective dose of the interventional radiology staffs was 0.164 mSv. There were 1976 interventional radiology staffs with an annual effective dose of <0.50 mSv/a (95.6%) . The collective dose distribution ration SR(0.5) was 41.1%. The difference of effective dose per capita in each year was statistically significant (H=19.23, P<0.05) . The per capita annual effective dose of interventional radiology staffs in tertiary medical institutions was higher than that in secondary medical institutions, and the difference was statistically significant (P<0.05) . Conclusion: The personal dose of interventional radiology staffs in Tianjin City is at a low level. It is necessary to emphasize the radiation hazard protection of interventional radiology staffs in tertiary medical institutions, 40-49 years old, ≥50 years old age groups and 5-9, 10-29 working years groups.
Adult
;
Female
;
Humans
;
Male
;
Middle Aged
;
Occupational Exposure/prevention & control*
;
Radiation Dosage
;
Radiation Monitoring/methods*
;
Radiation Protection
;
Radiology, Interventional
9.An arthroscopic "inlay" Bristow procedure with suture button fixation: Surgical technique and radiology evaluation.
Zhen Xing SHAO ; Qing Fa SONG ; Yu Qing ZHAO ; Guo Qing CUI
Journal of Peking University(Health Sciences) 2021;53(5):896-901
OBJECTIVE:
To introduce an arthroscopic "inlay" Bristow procedure based on the Mortise-Tenon joint structure concept using suture button fixation, and to evaluate its clinical and radiology results postoperatively with a minimal 3-year follow-up.
METHODS:
A total of 56 patients who received arthroscopic "inlay" Bristow procedure with suture button fixation between June 2015 to June 2016 were eventually enrolled in this study. Radiological assessment on the 3D CT scan was performed preoperatively, immediately after operation, and postoperatively at the end of 3 months, 6 months and the final follow-up. Complications postoperatively were also recorded.
RESULTS:
A total of 56 patients were finally included in this study. The mean follow-up time was (36.1±3.7) months. Coracoid grafts (middle point) were positioned at about 4 o'clock (123.8°±12.3°) in the En-face view. In the axial view, 95% (53/56) of the grafts positioning were measured as flush, 5% (3/56) as medial. Bone union rate was 96.4% at the final follow-up. At the end of 3 months, 6 months, and the final follow-up, the length of the coracoid graft was 96.9%±4.9%, 91.9%±6.2%, and 91.6%±6.6% of the immediate postoperative length, respectively. Compared with the immediate postoperative length, the length measured at the end of 3 months shortened not significantly (t=2.12, P > 0.05). The coracoid graft shortened more pronouncedly 6 months postoperatively (t=4.98, P < 0.05) and then remained almost constant over time (t=-0.75, P > 0.05), with all grafted coracoid graft retaining more than 90% of their initial length by the 3-year follow-up. And new bone formation at the junction between the coracoid graft and glenoid neck in the axial view were obviously noted in 25 cases. The quantitative evaluation showed that the glenoid area in En-face view was significantly increased at the final follow-up than that immediately after surgery [(9.72±1.22) cm2 vs. (9.42±1.11) cm2]. No degenerative changes were noted on CT images in all the patients at the final follow-up.
CONCLUSION
This study reported a series of "inlay" Bristow procedure with suture button fixation for recurrent shoulder dislocation, providing satisfactory union rate and excellent graft positioning. And using suture button fixation instead of screw can reduce osteolysis and complications related to hardware implantation. Moreover, the bone remodeling between the coracoid process and glenoid could be beneficial to restoring the anterior stability of shoulder joint in a long term follow-up.
Arthroscopy
;
Humans
;
Joint Instability
;
Radiology
;
Shoulder Dislocation
;
Shoulder Joint
;
Sutures
10.Research Progress on Computer-Aided Skeleton-Based Individual Identification in Forensic Radiology.
Yuan LI ; Huan ZHAO ; Wei Bo LIANG ; Zhen Hua DENG ; Lin ZHANG
Journal of Forensic Medicine 2021;37(2):239-247
Individual identification based on imaging data of the skeleton of a corpse is a key technique for forensic identification. To reduce the influence of artificial factors, computer-aided semi-automatic or automatic individual identification has become one of the research directions of skeleton-based individual identification in forensic radiology. Therefore, this paper reviews and summarizes literatures related to estimation of anthropological information such as, age and sex by computer-aided forensic radiology bone characteristics and individual identification based on bone imaging characteristics, in order to provide reference on skeleton-based individual identification in forensic radiology.
Age Determination by Skeleton
;
Bone and Bones
;
Computers
;
Forensic Anthropology
;
Radiology


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