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Background: Transesophageal echocardiography (TEE) is primarily used to guide transcatheter structural heart interventions, such as tricuspid transcatheter edge‐to‐edge repair (TEER). Although TEE has a good safety profile, it is still an invasive imaging technique that may be associated with complications, especially when performed during long transcatheter procedures or on frail patients. The aim of this study was to assess TEE‐related complications during tricuspid TEER. Methods: This is a prospective study enrolling 53 patients who underwent tricuspid TEER for severe tricuspid regurgitation (TR). TEE‐related complications were assessed clinically and divided into major (life‐threatening, major bleeding requiring transfusions or surgery, organ perforation, and persistent dysphagia) and minor (perioral hypesthesia, < 24 h dysphagia/odynophagia, minor intraoral bleeding and hematemesis not requiring transfusion) Results: The median age of the patient population was 79 years; 43.4% had severe, 39.6% massive, and 17.6% torrential TR. 62.3% of patients suffered from upper gastrointestinal disorders. Acute procedural success (APS) was achieved in 88.7% in a median device time of 36 min. A negative association was shown between APS and lead‐induced etiology (r = ‐.284, p =.040), baseline TR grade (r = ‐.410, p =.002), suboptimal TEE view (r = ‐.349, p =.012), device time (r = ‐.234, p =.043), and leaflet detachment (r = ‐.496, p <.0001). We did not observe any clinical manifest major or minor TEE‐related complications during the hospitalization. Conclusions: Our study reinforces the good safety profile and efficacy of TEE guidance during tricuspid TEER. Adequate preoperative management and intraprocedural precautions are mandatory in order to avoid serious complications. Furthermore, suboptimal intraprocedural TEE views are associated with lower TR reduction rates. Highlights: Transesophageal echocardiography is a crucial and safe technique for guiding transcatheter structural heart interventions.A mix of mid/deep esophageal and trans gastric views, as well as real‐time 3D imaging is generally used to guide the procedure.Adequate preoperative management and intraprocedural precautions are mandatory in order to avoid serious problems.A shorter device time is associated with more rarely probe‐related complications.Suboptimal intraprocedural TEE views are associated with lower TR reduction rates. [ABSTRACT FROM AUTHOR]

Introduction: Air‐dried slide preparation for fine needle aspiration cytology procedures is currently considered unsafe because of the risk of infectious aerosols of coronavirus 19. This study compares the safety and accuracy of two different protocols, one with and one without air‐dried slides. Methods: Starting from 3 March 2020, we discontinued the use of air‐dried slides during breast fine needle aspiration procedures. We selected cases collected during two periods: 2 months before and 2 months after 3 March. In both groups, the number of procedures was recorded together with the distribution of the diagnostic categories and the concordance between cytological and histological results on surgical specimens for lesions suggestive of malignancy, using the chi‐squared test. Results: Of the 100 procedures performed during the pre‐COVID‐19 period, 55% were negative (C2), 3% were non‐diagnostic (C1) and 40% were positive (C4 or C5). Of the 75 procedures obtained during the COVID‐19 period, 44% were negative (C2), 2.7% were non‐diagnostic (C1) and 52% were positive (C4 or C5). Despite the use of a new protocol during the COVID‐19 period, we observed concordance between cytological and histological results for lesions suggestive of malignancy. There was no statistically significant difference concerning the distribution of the diagnostic categories in the two groups. Conclusions: Taking into account the slightly lower number of procedures being analysed during the COVID‐19 period, the introduction of a new protocol that does not include air‐dried slides is safe and reliable. The pandemic period due to COVID19 has changed many methods in routine hospital and laboratory practice. Air‐dried slides, due to their risky preparation, should be avoided but cytologists lose the optimal definition of cytoplasmic and nuclear features provided by that method of preparation. A new protocol was introduced in our practice that appears to be safe and reliable. [ABSTRACT FROM AUTHOR]

Purpose: Compensation for respiratory motion is important during abdominal cancer treatments. In this work we report the results of the 2015 MICCAI Challenge on Liver Ultrasound Tracking and extend the 2D results to relate them to clinical relevance in form of reducing treatment margins and hence sparing healthy tissues, while maintaining full duty cycle. Methods: We describe methodologies for estimating and temporally predicting respiratory liver motion from continuous ultrasound imaging, used during ultrasound‐guided radiation therapy. Furthermore, we investigated the trade‐off between tracking accuracy and runtime in combination with temporal prediction strategies and their impact on treatment margins. Results: Based on 2D ultrasound sequences from 39 volunteers, a mean tracking accuracy of 0.9 mm was achieved when combining the results from the 4 challenge submissions (1.2 to 3.3 mm). The two submissions for the 3D sequences from 14 volunteers provided mean accuracies of 1.7 and 1.8 mm. In combination with temporal prediction, using the faster (41 vs 228 ms) but less accurate (1.4 vs 0.9 mm) tracking method resulted in substantially reduced treatment margins (70% vs 39%) in contrast to mid‐ventilation margins, as it avoided non‐linear temporal prediction by keeping the treatment system latency low (150 vs 400 ms). Acceleration of the best tracking method would improve the margin reduction to 75%. Conclusions: Liver motion estimation and prediction during free‐breathing from 2D ultrasound images can substantially reduce the in‐plane motion uncertainty and hence treatment margins. Employing an accurate tracking method while avoiding non‐linear temporal prediction would be favorable. This approach has the potential to shorten treatment time compared to breath‐hold and gated approaches, and increase treatment efficiency and safety. [ABSTRACT FROM AUTHOR]