Hungarian Radiology

[Radioguided localization of the non-palpable breast lesions and sentinel lymph nodes]

MONOKI Erzsébet1, VARGA Erika1, SZABÓ Tünde1, TARJÁN Tibor2, PETRI István3, ZS. TÓTH Endre4, BAGDI Enikő5, KRENÁCS László5

OCTOBER 20, 2007

Hungarian Radiology - 2007;81(05-06)

[INTRODUCTION - As the result of mammographic screening of breast cancer, the incidence of surgically removable, non-palpable breast lesions is increasing. The study is aimed to demonstrate the use of radioisotope and gamma-probe for identifying the sentinel lymph node and the intraoperative radioguided localization of occult breast lesions. PATIENTS AND METHODS - 26 patients with nonpalpable breast lesions underwent radioisotope guided sentinel lymh node localization for staging purposes. In eight patients non-palpable breast lesions were localized with use of radioisotope method intraoperatively. RESULTS - All breast lesions were successfully localized pre- and intraoperatively. The combined radioisotope and blue-dye staining method increased the sensitivity of the procedure for identifying sentinel lypmh node. In case of 14 patients with negative sentinel node, the surgical dissection of axillary lymph nodes was avoided. CONCLUSION - Radioguided localization is a simple, quick and accurate technique for localization of nonpalpable breast lesions and sentinel lymph node, which is utilized for the up-to-date and correct oncological management of the breast cancer patients.]

AFFILIATIONS

  1. Dr. Bugyi István Kórház, Röntgenosztály
  2. Dr. Bugyi István Kórház, Izotópdiagnosztika
  3. Dr. Bugyi István Kórház, Általános Sebészet
  4. Szegedi Tudományegyetem, Általános Orvostudományi Kar, Patológiai Intézet, CIT
  5. Daganatpatológiai és Molekuláris Diagnosztikai Laboratórium, Bay Zoltán Alkalmazott Kutatási Közalapítvány, Biotechnológiai Intézet

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Hungarian Radiology

[MRI-guided prostate brachytherapy: First Hungarian experiences based on a canine study]

LAKOSI Ferenc, ANTAL Gergely, VANDULEK Csaba, KOTEK Gyula, KOVÁCS Árpád, GARAMVÖLGYI Rita, PETNEHÁZY Örs, HADJIEV Janaki, BAJZIK Gábor, BOGNER Péter, REPA Imre

[INTRODUCTION - Modern radical radiotherapy can be an effective alternative of radical prostatectomy in low risk patients with prostate tumor. Our objective was to demonstrate the feasibility of transperineal MR-guided prostate interventions in an open MR unit and to present our early clinical experiences on canines. METHODS AND MATERIALS - The procedures were performed on 5 canines in an open-configuration 0.35T MR scanner. For interventions an MR compatible custom-made device was used. The canines were placed in the right lateral decubitus position. Template reconstruction, trajectory planning, target and OAR delineation were based on T2 FSE images. For image guidance and target confirmation, fast spoiled gradient-echo (FSPGR) sequence was used. MR compatible coaxial needles were inserted through the perineum to the base of the prostate. After satisfactory position was confirmed, brachytherapy catheters were placed through the coaxial needles, which were then removed. RESULTS - Mean and standard deviation of the needle displacements was 2.2 mm±1.2 mm, with a median of 2 mm. 96% of the errors were less than 4.0 mm. Implantation induced prostate motion was measured with a mean of 10.3 and 2.3 mm in cranio-caudal and transverse directions. Significant movement was only observed during the first 4 needle insertions. The average time needed for each step was: anesthesia 15 minutes, setup and positioning 15 minutes, initial imaging 15 minutes, template registration and projection 15 minutes, contouring, trajectory planning, insertion of 10 needles 60 minutes. CONCLUSION - Based on our canine model experiences our method seems to be a promising approach for performing feasible, accurate, reliable and high-quality prostate MR guidance within a reasonable time span. We plan to introduce MR-guided biopsy and brachytherapy in human patients in the near future.]

Hungarian Radiology

[Computed tomography brain perfusion in the management of acute stroke]

BAGI Róbert, SZABÓ Tünde, MONOKI Erzsébet

[INTRODUCTION - The multidetector CT-technology made the application of perfusion CT-examination in the diagnosis of vascular brain damages possible in recently. The purpose of this study was to introduce the method and to assess the importance of computed tomography brain perfusion in emergency patient care and early diagnosis of brain ischemia. PATIENTS AND METHODS - We perform brain perfusion examinations with a 2 slice multidetector computer tomography (General Electric Highspeed NX/i, 2004) in our hospital. We examined the results of native and perfusion CT of 27 patients who underwent CT brain perfusion examination during emergency patient care in our department between 2004 January and 2006 December. We also examined if the patients got systemic thrombolysation and the patients’ condition after therapy. RESULTS - The perfusion software can make quantitative colour maps of parameters (CBF, CBV, MTT) and can visualize mean value and percentil decrease of measuring parameters. There were 18 positive and 8 negative CTbrain perfusion examinations in the examined period. One examination was technically unvaluable. CONCLUSION - By measuring blood flow's decrease the CT-brain perfusion examination can separate the reversible and irreversible damage of brain parenchyma. The examination protocol of brain vascular damages are native CT-scan, postcontrast perfusion CT-examination and CTangiography by the recommendation of international literature. Despite the multidetector CT-s and CT-perfusion technic is available for years, the CT-brain perfusion examination is not a routine process in the emergency patient care in our country.]

Hungarian Radiology

[XV. Symposium and Postgradual Training of the Pediatric Radiologists]

KIS Éva

Hungarian Radiology

[XII. Congress of the Hungarian Radiographers]

TIHANYI Gyöngyi, VANDULEK Csaba

Hungarian Radiology

[“Magic photos” in Szeged]

GYENES György

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