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- Eklöf, Hampus, et al.
(author)
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Teleradiology Uppsala-Sydney for nighttime emergencies : preliminary experience
- 2007
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In: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 48:8, s. 851-853
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Journal article (peer-reviewed)abstract
- BACKGROUND: The development of digital imaging systems for radiology in combination with the possibility to transfer large quantities of data over the Internet has increased the interest in teleradiology. Transferring nighttime examinations to an evaluation center in a daytime zone may provide improved patient security, better working hours for radiologists, and reduced costs for emergency radiological services. PURPOSE: To evaluate the time required for transferring radiological information from Uppsala (Sweden) to Sydney (Australia). MATERIAL AND METHODS: A radiologist in Sydney reported on radiological examinations performed in Uppsala. The time required for downloading 75 examinations and returning 24 reports was registered. RESULTS: Downloading was completed in <60 min for all conventional radiological examinations, but only 44% of computed tomography (CT) examinations with >65 images. Reports were completed in <10 min. Turnaround time was directly related to the time required for downloading the images. The Sydney report was available in Uppsala within 30 min of the in-house report in 79% of examinations. CONCLUSION: The main challenge for emergency teleradiology is the time required for downloading large volumes of data over the Internet.
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| 3. |
- Radecka, Eva, et al.
(author)
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An unusual case of tumor thrombus in the inferior vena cava : A case report
- 2003
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In: Acta Radiologica. - 0284-1851 .- 1600-0455. ; 44:2, s. 160-161
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Journal article (peer-reviewed)abstract
- Adrenal cortical carcinoma (ACC) is a rare malignancy. Patients present either with a functional tumor or secondary to mass effect. In non-functioning tumors, the tumor size often exceeds 5 cm by the time of diagnosis, and tumor thrombus can occur. We report on a case of a small non-functioning ACC causing a large tumor thrombus in the inferior vena cava.
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| 6. |
- Radecka, Eva, et al.
(author)
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Pelvicaliceal biomodeling as an aid to achieving optimal access in percutaneous nephrolithotripsy
- 2006
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In: Journal of endourology. - 0892-7790 .- 1557-900X. ; 20:2, s. 92-101
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Journal article (peer-reviewed)abstract
- PURPOSE: To investigate prospectively the benefits of three-dimensional stereolithographic biomodeling produced from CT data as an aid to achieving optimal access for percutaneous nephrolithotripsy (PCNL). PATIENTS AND METHODS: Eight patients with complex urinary calculi were selected. Multislice CT scans of the kidney in native and excretory phases were acquired with the patient in the prone position to simulate the position during surgery. Contiguous reconstructed slices were produced from the data volume. The data of interest were processed to transform them into a format acceptable for production of a biomodel. Exact plastic replicas of the pelvicaliceal system and the calculi were created and used for morphologic assessment, preoperative planning, patient education, and surgical navigation. RESULTS: The survey results were based on subjective opinions rather than objective data. The biomodels enhanced the ability to visualize a patient's unique anatomy before surgery. This aided the planning and rehearsal of endourologic procedures. CONCLUSION: Although this study is only a preliminary investigation, we postulate that biomodeling has the advantage of allowing imaging data to be displayed in a physical form. In difficult cases, this technique may improve treatment, operative planning, and communication with colleagues and patients. The limitations of the technology include the manufacturing time and cost, but more accurate puncture-site selection may reduce costs by saving operating time.
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| 8. |
- Radecka, Eva, 1973-
(author)
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Percutaneous Nephrostomies : Planning for an Optimal Access, Complications, Follow-up and Outcome
- 2005
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Doctoral thesis (other academic/artistic)abstract
- Percutaneous nephrostomy (PCN) is a well-established intervention performed to divert urine from the collecting system in ureteric obstruction or as a prelude to interventional procedures such as stent placement or percutaneous nephrolithotripsy (PCNL). The aim of this thesis is to enhance planning for an optimal insertion of PCN, investigate complications, long-term management, follow-up and outcome in patients with PCN treatment and to increase accuracy in CT-guided punctures.To enhance planning for an optimal insertion of PCN prior to PCNL, biomodels from CT data were performed. Eight patients with complex urinary calculi were selected. Multislice CT of the kidney was performed and the CT data were transformed into a biomodel. The biomodels visualised unique structures before surgery, which aided the planning of endourological procedures.PCNL is an essential procedure for treating complex urinary calculi. A subcostal approach is preferred to avoid laceration to the lung and pleura. However, a supracostal approach is often preferable, as it gives a better passage to the renal pelvis. The nature and frequency of complications after supra- versus subcostal punctures were studied in 85 patients treated with PCNL. In 63 patients, a subcostal track was established. In 22, a supracostal puncture was chosen. The main difference in preoperative complications was the higher number of patients in the supracostal group complaining of respiratory correlated pain (32%). In the subcostal group, this was (5%). 401 patients were reviewed retrospectively regarding underlying disease, subsequent management and complications of PCN treatment. The number of major complications was 4%. Minor complications were recorded in 38%, urinary tract infection being the most common. 151/401patients suffered from malignancy. 84/151 of the malignant patients died with the catheter. The median survival time of the patients with malignancies was 255 days and the median catheterisation time was 62 days. In order to increase accuracy when performing CT guided punctures, a new puncture guide was evaluated. In 15/17 patients the puncture was successful on the first attempt. The benefits of the puncture guide were the artefact from the needle guide pointing at the target indicating the puncture path and the needle support enhancing an accurate puncture.
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| 9. |
- Radecka, Eva, et al.
(author)
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Survival time and period of catheterisation in patients treated with percutaneous nephrostomy for urinary obstruction due to malignancy
- 2006
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In: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 47:3, s. 328-331
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Journal article (peer-reviewed)abstract
- PURPOSE:To assess patient mortality and survival time, period of catheterization, and indications for percutaneous nephrostomy (PCN) withdrawal in patients treated with PCN for urinary obstruction due to malignancy.MATERIAL AND METHODS:A retrospective analysis of 151 patients treated with 257 PCNs in a 5-year period was performed. Data on survival time, duration of catheterization, and clinical end-points for PCN treatment were collected.RESULTS:The median survival time of the patients was 255 days, while median catheterization time was 62 days. The majority of patients (84) died with the catheter. Indications for PCN withdrawal were surgery, stent treatment, catheter displacement, and response to medical treatment.CONCLUSION:The majority of patients with malignancy treated with PCN have advanced disease and short life expectancy. Factors such as diagnosis, prognosis, economy, and the patient's preference influence the choice of urinary diversion method. However, PCN should be considered in patients with malignancy on grounds of safety and low cost.
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| 10. |
- Schumacher, Martin C, et al.
(author)
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[11C]Acetate positron emission tomography-computed tomography imaging of prostate cancer lymph-node metastases correlated with histopathological findings after extended lymphadenectomy
- 2015
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In: Scandinavian journal of urology. - : Medical Journals Sweden AB. - 2168-1805 .- 2168-1813. ; 49:1, s. 35-42
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Journal article (peer-reviewed)abstract
- ObjectiveThe aim of this study was to determine the efficacy of combined [11C]acetate positron emission tomography and computed tomography ([11C]acetate-PET/CT) in regional lymph-node staging in patients with prostate cancer (PCa).Material and methods[11C]Acetate-PET/CT was performed in 19 PCa patients who subsequently underwent extended pelvic lymph-node dissection (ePLND). The [11C]acetate-PET/CT results were compared with the surgical and histopathological findings from 13 defined lymph-node regions.Results[11C]Acetate-PET/CT was true-positive for lymph-node metastases in nine patients, false-positive in three, false-negative in one patient and true-negative in six. The patient-by-patient-based sensitivity was 90% and the specificity 67%, the positive predictive value (PPV) was 75% and the negative predictive value (NPV) 86%. From a total of 114 nodal regions (mean 5.9 regions per patient), 484 lymph nodes (mean 25.5 nodes per patient) were removed and evaluated histopathologically. Forty-six lymph nodes from 24 out of 114 (21%) nodal regions were positive for PCa metastasis. The nodal-region-based sensitivity of [11C]acetate-PET/CT was 62%, specificity was 89%, PPV 62% and NPV 89%.Conclusion[11C]Acetate-PET/CT detects PCa lymph-node metastases with high patient-by-patient-based sensitivity but low specificity, and low nodal-region-based sensitivity but high specificity. Its limited ability to detect microscopic lymph-node involvement makes ePLND essential in all patients diagnosed with positive nodes on [11C]acetate-PET/CT.
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