Advantages of real-time transabdominal ultrasound guidance in combined interstitial/intracavitary cervical brachytherapy: a case-based review

Thibodeau, Ryan; Simone, Brittany A.; Tanny, S; Hahn, Seung S.; Aridgides, Paul

doi:10.5114/jcb.2021.105290

Cited by 4 publications

(3 citation statements)

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“…In such cases, switching to TAUS has the advantage of obtaining images for tumors located in the deep pelvis (Figure 1). Thibodeau et al reported the usefulness of TAUS in detecting uterine perforation with tandem and in visualizing interstitial needles in IC/IS (20). With TR/TA-US guidance, it was shown in this report that not only intrauterine needle insertion but also iliac lymph nodes or ovarian direct tumor invasion could be treated with HDR-ISBT.…”

Section: Discussionmentioning

confidence: 59%

High-Dose-Rate Interstitial Brachytherapy for Deeply Situated Gynecologic Tumors Guided by Combination of Transrectal and Transabdominal Ultrasonography: A Technical Note

et al. 2022

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Background and PurposeHigh-dose-rate interstitial brachytherapy (HDR-ISBT) is recommended to obtain a better local tumor control for uterine cancer patients in specific situations such as bulky lesions, an extension to the lateral parametrium, or tumors with irregular shapes. Our group uses real-time transrectal ultrasonography (TRUS) to guide freehand interstitial needle insertion. Occasionally, target tumors locate deeper beyond the rectum and cannot be visualized by TRUS. CT can guide needles to deeply located tumors, but in such cases, repeated image obtainment is required to achieve ideal needle localization. In this report, we present nine cases of patients who underwent HDR-ISBT for deeply situated tumors guided by a combination of transrectal and transabdominal ultrasonography (TR/TA-US).Material and MethodsNine uterine cancer patients whose tumors were located deeper than the reach of TRUS and underwent HDR-ISBT guided by TR/TA-US were presented. All nine cases had no distal organ metastasis and underwent external beam radiation therapy (EBRT) to the pelvic region for 45–50.4 Gy in 25–28 fractions followed by boost HDR-ISBT for deeply situated tumors guided by TR/TA-US.ResultsThere were seven cervical cancer and two endometrial cancer patients: six with extensive uterine corpus invasion, one cervical cancer with massive pelvic lymph node metastasis, one cervical cancer with postoperative pelvic recurrence, and one with left ovarian direct tumor invasion. The median follow-up period was 15 months (range 3–28 months). The average clinical target volume at the time of first HDR-ISBT was 131 ml (range 44–335 ml). The linear distance from the vaginal entrance to the deepest part of the tumor at first time brachytherapy of nine cases was 14.0 (9.0–17.0) cm. HDR-ISBT dose fractionation was 24–30 Gy in four or five fractions. Seven out of nine cases had no local recurrence in the follow-up period. One had local in-field recurrence 25 months after HDR-ISBT. Another case with carcinosarcoma could not obtain local control and underwent salvage hysterectomy for a residual uterine tumor 11 months after HDR-ISBT. Four cases had extra-field recurrence in lymph nodes or distant organs.ConclusionsIn brachytherapy for gynecologic malignancies, deeply situated tumors located out of reach of TRUS may obtain favorable local control by HDR-ISBT guided with TR/TA-US.

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Section: Discussionmentioning

confidence: 59%

High-Dose-Rate Interstitial Brachytherapy for Deeply Situated Gynecologic Tumors Guided by Combination of Transrectal and Transabdominal Ultrasonography: A Technical Note

et al. 2022

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“…Another compelling benefit of the technique lies in the minimal to even no scarring it produces. The smaller incision and precision-guided nature of the needle knife approach result in esthetically pleasing outcomes that are particularly important in visible areas like the wrist (25). This can have positive psychological effects on patients, enhancing their body image and self-confidence during the recovery process.…”

Section: Discussionmentioning

confidence: 99%

Case report: Ultrasound-guided needle knife technique for carpal ligament release in carpal tunnel syndrome treatment

Sun,

Zou,

et al. 2023

Front. Neurol.

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Carpal tunnel syndrome (CTS) is a common peripheral neuropathy of the hand, mainly manifesting as sensory disturbances, motor dysfunctions, and pain in the fingers and hand. The pathogenesis of the disease is associated with fibrosis of the transverse carpal ligament in the carpal tunnel, which compresses median nerve. In our case, we demonstrate an ultrasound-guided needle knife technique to treat CTS. We guided the patient to a supine position on the examination table. The skin of the wrist area was sterilized for the procedure. After the skin was dry, we positioned sterile drapes, located the median nerve and compression, and marked the compression point. Local anesthesia was administered. An ultrasound-guided needle knife was inserted. The needle knife was advanced under ultrasound guidance. The carpal ligament was incised. A gradual release of pressure on the median nerve was observed on the ultrasound monitor. After treatment, the patient’s finger sensation and motor function can significantly improve, and pain symptoms are markedly reduced, this case demonstrates that small needle-knife treatment can serve as a safe and effective minimally invasive therapeutic method.

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“…The side effects caused by the use of high-dose anesthetics will be greatly reduced. The concept of multimodal analgesia proposed in recent years is to combine a variety of analgesic methods, block the formation, transmission and integration of pain, strengthen the analgesic effect and reduce a variety of analgesic methods [8][9]. Systemic analgesics used for postoperative analgesia or / and paraspinal nerve blocks combined with non steroidal antipyretic analgesics have a good explanation for multimodal analgesia ISSN 2706-6819 Vol.3, Issue 4: 37-41, DOI: 10.25236/IJFM.2021.030407…”

Section: Introductionmentioning

confidence: 99%

Ultrasound Guided Paravertebral Nerve Block in Thoracotomy

2021

IJFM

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The pain after thoracic surgery is often moderate to severe. Perioperative analgesia has always been one of the research hotspots of thoracic anesthesia. The patients were prepared before operation according to the routine, and the fasting time was performed according to the fasting guidelines before anesthesia for adult surgery. After entering the operating room, first establish an infusion channel in the vein of the upper limb, and routinely use a monitor to monitor the basic vital signs. Puncture the right internal jugular vein and place the tube under ultrasound; Under local anesthesia, the radial artery was punctured and catheterized, and the catheter was connected with the transducer to monitor the invasive blood pressure. All patients in group P used the puncture method through the lateral approach. Use the same method on the opposite side. The plane was measured by acupuncture. If there was hypoesthesia, the effect of block was determined, and the spinal nerve block segments after plane fixation were recorded. The complications related to puncture (such as pneumothorax, hemothorax, local anesthetic poisoning, etc.), operation time, extubation time, propofol, remifentanil and the use of cisatracurium during maintenance were recorded. Among all patients, the patients with ID ≥ 2 in TPVB group and Gen group were 14.1% and 18.8% respectively, and the difference was not statistically significant (P > 0.05). Thoracic paravertebral block combined with general anesthesia is beneficial to reduce perioperative complications, incidence rate and mortality, and improve postoperative outcome.

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Advantages of real-time transabdominal ultrasound guidance in combined interstitial/intracavitary cervical brachytherapy: a case-based review

Cited by 4 publications

References 10 publications

High-Dose-Rate Interstitial Brachytherapy for Deeply Situated Gynecologic Tumors Guided by Combination of Transrectal and Transabdominal Ultrasonography: A Technical Note

High-Dose-Rate Interstitial Brachytherapy for Deeply Situated Gynecologic Tumors Guided by Combination of Transrectal and Transabdominal Ultrasonography: A Technical Note

Case report: Ultrasound-guided needle knife technique for carpal ligament release in carpal tunnel syndrome treatment

Ultrasound Guided Paravertebral Nerve Block in Thoracotomy

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