22 results on '"Matthew J Scheidt"'
Search Results
2. Cone-Beam CT With Enhanced Needle Guidance and Augmented Fluoroscopy Overlay: Applications in Interventional Radiology
- Author
-
Brandon M. Key, Sean M. Tutton, and Matthew J. Scheidt
- Subjects
Radiology, Nuclear Medicine and imaging ,General Medicine - Published
- 2023
3. ACR Appropriateness Criteria® Management of Liver Cancer: 2022 Update
- Author
-
Erica M. Knavel Koepsel, Amanda R. Smolock, Jason W. Pinchot, Charles Y. Kim, Osmanuddin Ahmed, Murthy R.K. Chamarthy, Elizabeth M. Hecht, Gloria L. Hwang, David E. Kaplan, Join Y. Luh, Jorge A. Marrero, Eric J. Monroe, George A. Poultsides, Matthew J. Scheidt, and Eric J. Hohenwalter
- Subjects
Radiology, Nuclear Medicine and imaging - Published
- 2022
4. Vertebroplasty, Kyphoplasty, and Implant-Based Mechanical Vertebral Augmentation
- Author
-
Brandon M, Key, John, Symanski, Matthew J, Scheidt, and Sean M, Tutton
- Subjects
Vertebroplasty ,Treatment Outcome ,Fractures, Compression ,Humans ,Spinal Fractures ,Kyphoplasty ,Radiology, Nuclear Medicine and imaging ,Orthopedics and Sports Medicine ,Osteoporotic Fractures - Abstract
Vertebral compression fractures are a global public health issue with a quantifiable negative impact on patient morbidity and mortality. The contemporary approach to the treatment of osteoporotic fragility fractures has moved beyond first-line nonsurgical management. An improved understanding of biomechanical forces, consequential morbidity and mortality, and the drive to reduce opioid use has resulted in multidisciplinary treatment algorithms and significant advances in augmentation techniques. This review will inform musculoskeletal radiologists, interventionalists, and minimally invasive spine surgeons on the proper work-up of patients, imaging features differentiating benign and malignant pathologic fractures, high-risk fracture morphologies, and new mechanical augmentation device options, and it describes the appropriate selection of devices, complications, outcomes, and future trends.
- Published
- 2021
5. Comparison of Outcomes with Triple-Regimen versus Double-Regimen Transarterial Chemoembolization
- Author
-
Amanda R. Smolock, Osmani Deochand, William S. Rilling, Parag J. Patel, Eric J. Hohenwalter, Sarah B. White, and Matthew J. Scheidt
- Subjects
Gastroenterology ,Radiology, Nuclear Medicine and imaging ,Surgery - Abstract
We sought to evaluate differences in outcomes between double versus triple transarterial chemoembolization (TACE). TACEs over a 1-year period were retrospectively reviewed and divided into two groups: double and triple. Imaging response and complications were made on a per-procedure basis. Student's t-test was used to calculate differences in continuous variables, and chi-square test was used to calculate differences in categorical values.Overall tumor response was similar between the two groups, and there were no significant differences in complications between groups. Outcomes are similar between double and triple conventional TACE, suggesting that adding a third drug may only contribute to cost.
- Published
- 2022
6. ACR Appropriateness Criteria® Radiologic Management of Portal Hypertension
- Author
-
O. Ahmed, Sumeet K Asrani, Charles Y. Kim, Karin E Dill, Eric J. Hohenwalter, Vascular Imaging, Matthew J Scheidt, Jens Eldrup-Jorgensen, Bill S. Majdalany, Brooks D Cash, A Tuba Kendi, David M. Sella, Jason W Pinchot, and Sanjeeva P. Kalva
- Subjects
medicine.medical_specialty ,Cirrhosis ,business.industry ,Portal venous pressure ,Disease ,medicine.disease ,Appropriate Use Criteria ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Hepatorenal syndrome ,030220 oncology & carcinogenesis ,medicine ,Portal hypertension ,Radiology, Nuclear Medicine and imaging ,Upper gastrointestinal bleeding ,Intensive care medicine ,business ,Medical literature - Abstract
Cirrhosis is a heterogeneous disease that cannot be studied as a single entity and is classified in two main prognostic stages: compensated and decompensated cirrhosis. Portal hypertension, characterized by a pathological increase of the portal pressure and by the formation of portal-systemic collaterals that bypass the liver, is the initial and main consequence of cirrhosis and is responsible for the majority of its complications. A myriad of treatment options exists for appropriately managing the most common complications of portal hypertension, including acute variceal bleeding and refractory ascites. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2021
7. Society for Vascular Surgery appropriate use criteria for management of intermittent claudication
- Author
-
Karen Woo, Jeffrey J. Siracuse, Kyle Klingbeil, Larry W. Kraiss, Nicholas H. Osborne, Niten Singh, Tze-Woei Tan, Shipra Arya, Subhash Banerjee, Marc P. Bonaca, Thomas Brothers, Michael S. Conte, David L. Dawson, Young Erben, Benjamin M. Lerner, Judith C. Lin, Joseph L. Mills, Derek Mittleider, Deepak G. Nair, Leigh Ann O’Banion, Robert B. Patterson, Matthew J. Scheidt, and Jessica P. Simons
- Subjects
Femoral Artery ,Lower Extremity ,Humans ,Surgery ,Intermittent Claudication ,Cardiology and Cardiovascular Medicine ,Vascular Surgical Procedures ,Exercise Therapy - Abstract
The Society for Vascular Surgery appropriate use criteria (AUC) for the management of intermittent claudication were created using the RAND appropriateness method, a validated and standardized method that combines the best available evidence from medical literature with expert opinion, using a modified Delphi process. These criteria serve as a framework on which individualized patient and clinician shared decision-making can grow. These criteria are not absolute. AUC should not be interpreted as a requirement to administer treatments rated as appropriate (benefit outweighs risk). Nor should AUC be interpreted as a prohibition of treatments rated as inappropriate (risk outweighs benefit). Clinical situations will occur in which moderating factors, not included in these AUC, will shift the appropriateness level of a treatment for an individual patient. Proper implementation of AUC requires a description of those moderating patient factors. For scenarios with an indeterminate rating, clinician judgement combined with the best available evidence should determine the treatment strategy. These scenarios require mechanisms to track the treatment decisions and outcomes. AUC should be revisited periodically to ensure that they remain relevant. The panelists rated 2280 unique scenarios for the treatment of intermittent claudication (IC) in the aortoiliac, common femoral, and femoropopliteal segments in the round 2 rating. Of these, only nine (0.4%) showed a disagreement using the interpercentile range adjusted for symmetry formula, indicating an exceptionally high degree of consensus among the panelists. Post hoc, the term "inappropriate" was replaced with the phrase "risk outweighs benefit." The term "appropriate" was also replaced with "benefit outweighs risk." The key principles for the management of IC reflected within these AUC are as follows. First, exercise therapy is the preferred initial management strategy for all patients with IC. Second, for patients who have not completed exercise therapy, invasive therapy might provide net a benefit for selected patients with IC who are nonsmokers, are taking optimal medical therapy, are considered to have a low physiologic and technical risk, and who are experiencing severe lifestyle limitations and/or a short walking distance. Third, considering the long-term durability of the currently available technology, invasive interventions for femoropopliteal disease should be reserved for patients with severe lifestyle limitations and a short walking distance. Fourth, in the common femoral segment, open common femoral endarterectomy will provide greater net benefit than endovascular intervention for the treatment of IC. Finally, in the infrapopliteal segment, invasive intervention for the treatment of IC is of unclear benefit and could be harmful.
- Published
- 2022
8. Image guidance in osteoplasty and fixation
- Author
-
Brandon M. Key, Matthew J. Scheidt, Adam N. Wooldridge, Alan A. Sag, and Sean M. Tutton
- Subjects
Treatment Outcome ,Neoplasms ,Humans ,Pain Management ,Radiology, Nuclear Medicine and imaging ,Bone Neoplasms ,Cone-Beam Computed Tomography ,Cardiology and Cardiovascular Medicine - Abstract
Oncology patients, particularly those with breast, colorectal, prostate, renal and pancreatic cancers, are living longer due to advances in detection, and treatment. Unfortunately, this has come with a commensurate increase in the prevalence of osseous metastases and skeletal related events approaching 100,000 new patients each year. Patients are now experiencing serious morbidity and mortality due to pathologic fractures, altered structural mechanics, and cancer related bone pain. This patient population poses challenges for conventional open surgical and/or medical management often due to disease extent, location, and, in general, poor surgical candidacy. Percutaneous techniques may also be challenging under image guidance due to limited ability to use traditional orthopedic corridors, loss of cortical landmarks with destructive lesions, and need for live image guidance. Modern angiography suites with cone beam computed tomography (CBCT) and advanced imaging applications including needle guidance, 3D fusion, tumor segmentation, and angio-CT have facilitated the development of novel minimally invasive techniques for pain palliation and stabilization. The interventional radiologist is uniquely positioned to harness these advanced imaging applications and offer effective, safe, minimally invasive treatment options to patients with neoplastic disease within the axial, and appendicular skeletons. The focus of this article is to address the technical aspects of patient preparation, positioning, advanced imaging system capabilities, guidance strategies, and pitfalls during osteoplasty and fixation procedures.
- Published
- 2022
9. ACR Appropriateness Criteria® Radiologic Management of Gastric Varices
- Author
-
Aaron R Braun, David M. Sella, O. Ahmed, Eric J. Hohenwalter, Charles Y. Kim, Barry W. Feig, Brooks D. Cash, Jason W Pinchot, Clifford R. Weiss, Kristofer Schramm, Sanjeeva P. Kalva, Matthew J Scheidt, and Erica M. Knavel Koepsel
- Subjects
medicine.medical_specialty ,business.industry ,Gastric varices ,medicine.disease ,Appropriate Use Criteria ,Splenic vein ,medicine ,Etiology ,Radiology, Nuclear Medicine and imaging ,Upper gastrointestinal bleeding ,business ,Intensive care medicine ,Grading (tumors) ,Medical literature - Abstract
Hemorrhage, resulting from gastric varies, can be challenging to treat, given the various precipitating etiologies. A wide variety of treatment options exist for managing the diverse range of the underlying disease processes. While cirrhosis is the most common cause for gastric variceal bleeding, occlusion of the portal or splenic vein in noncirrhotic states results in a markedly different treatment paradigm. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2020
10. ACR Appropriateness Criteria® Radiologic Management of Urinary Tract Obstruction
- Author
-
O. Ahmed, Marc A. Bjurlin, David M. Sella, Jason W Pinchot, Kristofer Schramm, Clifford R. Weiss, Aaron R Braun, Charles Y. Kim, Jonathan M. Lorenz, Matthew J Scheidt, Eric J. Hohenwalter, and Erica M. Knavel Koepsel
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Interventional radiology ,medicine.disease ,Appropriate Use Criteria ,030218 nuclear medicine & medical imaging ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous nephrostomy ,030220 oncology & carcinogenesis ,medicine ,Radiology, Nuclear Medicine and imaging ,Intensive care medicine ,business ,Urinary tract obstruction ,Obstructive uropathy ,Medical literature - Abstract
Acute obstructive uropathy is a medical emergency, which often is accompanied by acute renal failure or sepsis. Treatment options to resolve the acute obstructive process include conservative medical management, retrograde ureteral stenting, or placement of percutaneous nephrostomy or nephroureteral catheters. It is important to understand the various treatment options in differing clinical scenarios in order to guide appropriate consultation. Prompt attention to the underlying obstructive process is often imperative to avoid further deterioration of the patient's clinical status. A summary of the data and most up-to-date clinical trials regarding treatment options for urinary tract obstruction is outlined in this publication. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2020
11. ACR Appropriateness Criteria® Radiologic Management of Infected Fluid Collections
- Author
-
Clifford R. Weiss, Christopher R. Bailey, Eric J. Hohenwalter, Jason W. Pinchot, Osmanuddin Ahmed, Aaron R. Braun, Brooks D. Cash, Samir Gupta, Charles Y. Kim, Erica M. Knavel Koepsel, Matthew J. Scheidt, Kristofer Schramm, David M. Sella, and Jonathan M. Lorenz
- Subjects
Radiology, Nuclear Medicine and imaging - Published
- 2020
12. Endovascular Management of Chronic Type B Aortic Dissection
- Author
-
Matthew J Scheidt, Peter J. Rossi, Monica Cooley, Neel A. Mansukhani, Parag J. Patel, Joseph P. Hart, Anatoly Loskutov, and Robert A. Hieb
- Subjects
medicine.medical_specialty ,Time Factors ,Aortic Aneurysm, Thoracic ,Type B aortic dissection ,business.industry ,False lumen ,Endovascular Procedures ,Dissection (medical) ,Aortic repair ,medicine.disease ,Surgery ,Aortic Dissection ,Blood Vessel Prosthesis Implantation ,Blood pressure ,Treatment Outcome ,Heart rate ,cardiovascular system ,Endovascular interventions ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Retrospective Studies - Abstract
Acute uncomplicated type B aortic dissection (aTBAD) is often treated non operatively, with medical management primarily focused on blood pressure and heart rate control. After a 3 month period following the initial diagnosis, the dissection is considered chronic. Frequent clinical and imaging follow-up is performed to evaluate for dissection stability, aneurysmal degeneration, and visceral malperfusion, which would represent indication for surgical or endovascular repair. In this article we discuss four cases of chronic type B aortic dissection (cTBAD) managed with thoracic endovascular aortic repair (TEVAR) and varying techniques.
- Published
- 2021
13. ACR Appropriateness Criteria® Radiologic Management of Biliary Obstruction
- Author
-
Matthew G. Gipson, Eric J. Hohenwalter, Aaron R Braun, Waddah B. Al-Refaie, Brooks D. Cash, Jason W Pinchot, Jonathan M. Lorenz, Clifford R. Weiss, Charles Y. Kim, Matthew J Scheidt, Kristofer Schramm, David M. Sella, and Alexandra H. Fairchild
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Percutaneous ,business.industry ,Decompression ,General surgery ,Jaundice ,Appropriate Use Criteria ,Appropriateness criteria ,medicine ,Etiology ,Radiology, Nuclear Medicine and imaging ,medicine.symptom ,business ,Grading (tumors) ,Medical literature - Abstract
Biliary obstruction is a serious condition that can occur in the setting of both benign and malignant pathologies. In the setting of acute cholangitis, biliary decompression can be lifesaving; for patients with cancer who are receiving chemotherapy, untreated obstructive jaundice may lead to biochemical derangements that often preclude continuation of therapy unless biliary decompression is performed (see the ACR Appropriateness Criteria® topic on "Jaundice"). Recommended therapy including percutaneous decompression, endoscopic decompression, and/or surgical decompression is based on the etiology of the obstruction and patient factors including the individual's anatomy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2019
14. ACR Appropriateness Criteria® Management of Vertebral Compression Fractures
- Author
-
Lubdha M. Shah, Jack W. Jennings, Claudia F.E. Kirsch, Eric J. Hohenwalter, Francesca D. Beaman, R. Carter Cassidy, Michele M. Johnson, A. Tuba Kendi, Simon Shek-Man Lo, Charles Reitman, Arjun Sahgal, Matthew J. Scheidt, Kristofer Schramm, Daniel E. Wessell, Mark J. Kransdorf, Jonathan M. Lorenz, and Julie Bykowski
- Subjects
Radiology, Nuclear Medicine and imaging - Published
- 2018
15. ACR Appropriateness Criteria ® Radiologic Management of Uterine Leiomyomas
- Author
-
Jonathan M. Lorenz, Linda D. Bradley, Charles Y. Kim, M. Knuttinen, Eric J. Hohenwalter, Gregory Stark, Matthew G. Gipson, David M. Sella, Matthew J Scheidt, Clifford R. Weiss, Jason W Pinchot, and Aaron R Braun
- Subjects
medicine.medical_specialty ,030219 obstetrics & reproductive medicine ,Uterine fibroids ,business.industry ,medicine.medical_treatment ,General surgery ,medicine.disease ,Appropriate Use Criteria ,030218 nuclear medicine & medical imaging ,Benign tumor ,Clinical trial ,03 medical and health sciences ,0302 clinical medicine ,Uterine artery embolization ,Endometrial ablation ,medicine ,Radiology, Nuclear Medicine and imaging ,business ,Grading (tumors) ,Medical literature - Abstract
Uterine fibroids, also known as leiomyomas, are the most common benign tumor in women of reproductive age. When symptomatic, these patients can present with bleeding and/or bulk-related symptoms. Treatment options for symptomatic uterine leiomyomas include medical management, minimally invasive treatment such as uterine artery embolization, and surgical options, such as myomectomy. It is important to understand the role of these treatment options in various clinical scenarios so that appropriate consultation is performed. Furthermore, patients should be presented with the outcomes and complications of each of these treatment options. A summary of the data and clinical trials of the treatment options for symptomatic uterine leiomyomas is outlined in this article. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2018
16. ACR Appropriateness Criteria
- Author
-
Alexandra H, Fairchild, Eric J, Hohenwalter, Matthew G, Gipson, Waddah B, Al-Refaie, Aaron R, Braun, Brooks D, Cash, Charles Y, Kim, Jason W, Pinchot, Matthew J, Scheidt, Kristofer, Schramm, David M, Sella, Clifford R, Weiss, and Jonathan M, Lorenz
- Subjects
Diagnosis, Differential ,Cholestasis ,Evidence-Based Medicine ,Contrast Media ,Humans ,Societies, Medical ,United States - Abstract
Biliary obstruction is a serious condition that can occur in the setting of both benign and malignant pathologies. In the setting of acute cholangitis, biliary decompression can be lifesaving; for patients with cancer who are receiving chemotherapy, untreated obstructive jaundice may lead to biochemical derangements that often preclude continuation of therapy unless biliary decompression is performed (see the ACR Appropriateness Criteria® topic on "Jaundice"). Recommended therapy including percutaneous decompression, endoscopic decompression, and/or surgical decompression is based on the etiology of the obstruction and patient factors including the individual's anatomy. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2019
17. Advanced Interventional Pain Management Approach to Neoplastic Disease Outside the Spine
- Author
-
Brandon M. Key, Sean Tutton, and Matthew J Scheidt
- Subjects
Ablation Techniques ,Osteoplasty ,medicine.medical_specialty ,Pathologic fracture ,Clinical Decision-Making ,Long bone ,Pain ,Bone Neoplasms ,Disease ,Radiography, Interventional ,Risk Factors ,medicine ,Humans ,Pain Management ,Radiology, Nuclear Medicine and imaging ,Bone pain ,business.industry ,Patient Selection ,Cancer ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,Cementoplasty ,Radiology ,Interventional pain management ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business - Abstract
Neoplastic disease of the musculoskeletal system may result in serious morbidity and mortality secondary to cancer related bone pain, pathologic fracture, altered structural mechanics, and involvement of adjacent structures.1 Recent advances in cancer detection and treatment have allowed more patients to live longer. The prevalence of osseous metastatic disease has increased to 100,000 new patients developing bone metastases each year.2 These patients are seeing long-term exposure to chemotherapy and radiation leading to increased skeletal events, morbidity, and a negative impact on quality of life. Bone metastases in conjunction with poor bone quality often prevent surgical therapy. Utilization of thermal ablation in this patient population is supported by contemporary literature and offers a minimally invasive approach to pain palliation, local tumor control, and decreased morbidity with unique advantages compared to surgery or radiation.3 In addition to spine disease, interventional radiologists are able to meaningfully impact pelvic, shoulder girdle, and long bone metastases. Adding to ablation we have in our repertoire the ability to provide structural support utilizing cement and/or screw fixation as an adjunct for both pain palliation and mechanical stabilization.4-6 These novel therapies have allowed more patients with metastatic disease to be treated. The focus of this chapter is to highlight importance of patient selection, ablative modality selection, integration of cementoplasty (also described as osteoplasty) and osseous fixation, and procedural techniques/strategy in the pelvis and other common sites of bone metastases outside the spine.
- Published
- 2020
18. 3:27 PM Abstract No. 185 Safety and efficacy of Angio-Seal for Hemostasis after PTFE Graft Access
- Author
-
Sean Tutton, Parag J. Patel, Peter J. Rossi, B. Key, Sarah B. White, William S. Rilling, Matthew J Scheidt, and Robert A. Hieb
- Subjects
medicine.medical_specialty ,business.industry ,Hemostasis ,medicine ,Angio seal ,Radiology, Nuclear Medicine and imaging ,Ptfe graft ,Cardiology and Cardiovascular Medicine ,business ,Surgery - Published
- 2020
19. ACR Appropriateness Criteria
- Author
-
Lubdha M, Shah, Jack W, Jennings, Claudia F E, Kirsch, Eric J, Hohenwalter, Francesca D, Beaman, R Carter, Cassidy, Michele M, Johnson, A Tuba, Kendi, Simon Shek-Man, Lo, Charles, Reitman, Arjun, Sahgal, Matthew J, Scheidt, Kristofer, Schramm, Daniel E, Wessell, Mark J, Kransdorf, Jonathan M, Lorenz, and Julie, Bykowski
- Subjects
Diagnosis, Differential ,Evidence-Based Medicine ,Fractures, Compression ,Humans ,Pain Management ,Spinal Fractures ,Recovery of Function ,Societies, Medical ,United States - Abstract
Vertebral compression fractures (VCFs) have various causes, including osteoporosis, neoplasms, and acute trauma. As painful VCFs may contribute to general physical deconditioning, management of painful VCFs has the potential for improving quality of life and preventing superimposed medical complications. Various imaging modalities can be used to evaluate a VCF to help determine the etiology and guide intervention. The first-line treatment of painful VCFs has been nonoperative or conservative management as most VCFs show gradual improvement in pain over 2 to 12 weeks, with variable return of function. There is evidence that vertebral augmentation (VA) is associated with better pain relief and improved functional outcomes compared to conservative therapy for osteoporotic VCFs. A multidisciplinary approach is necessary for the management of painful pathologic VCFs, with management strategies including medications to affect bone turnover, radiation therapy, and interventions such as VA and percutaneous thermal ablation to alleviate symptoms. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2018
20. ACR Appropriateness Criteria
- Author
-
M-Grace, Knuttinen, Gregory, Stark, Eric J, Hohenwalter, Linda D, Bradley, Aaron R, Braun, Matthew G, Gipson, Charles Y, Kim, Jason W, Pinchot, Matthew J, Scheidt, David M, Sella, Clifford R, Weiss, and Jonathan M, Lorenz
- Subjects
Adult ,Evidence-Based Medicine ,Adolescent ,Leiomyoma ,Uterine Neoplasms ,Humans ,Female ,Middle Aged ,Societies, Medical ,United States - Abstract
Uterine fibroids, also known as leiomyomas, are the most common benign tumor in women of reproductive age. When symptomatic, these patients can present with bleeding and/or bulk-related symptoms. Treatment options for symptomatic uterine leiomyomas include medical management, minimally invasive treatment such as uterine artery embolization, and surgical options, such as myomectomy. It is important to understand the role of these treatment options in various clinical scenarios so that appropriate consultation is performed. Furthermore, patients should be presented with the outcomes and complications of each of these treatment options. A summary of the data and clinical trials of the treatment options for symptomatic uterine leiomyomas is outlined in this article. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
- Published
- 2018
21. Safety and efficacy of synchronous robotic surgery for colorectal cancer with liver metastases
- Author
-
Rozana H. Dwyer, Steven S. Tsoraides, Matthew J Scheidt, and J. Stephen Marshall
- Subjects
Ablation Techniques ,Male ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,Health Informatics ,030230 surgery ,Anastomosis ,Lesion ,03 medical and health sciences ,Ileostomy ,0302 clinical medicine ,Postoperative Complications ,Robotic Surgical Procedures ,medicine ,Hepatectomy ,Humans ,Robotic surgery ,Colectomy ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Microwave ablation ,Liver Neoplasms ,Middle Aged ,Ablation ,medicine.disease ,Colorectal surgery ,Surgery ,030220 oncology & carcinogenesis ,Female ,Laparoscopy ,medicine.symptom ,business ,Colorectal Neoplasms - Abstract
Timing of resection and treatment of colorectal cancer (CRC) with liver metastases varies based on patient characteristics and center protocols. Concerns of increased morbidity and mortality (MM) related to anesthetic time and blood loss have limited widespread adaptation of synchronous colorectal and liver resections. Furthermore, technical challenges have made minimally invasive synchronous resections less common. We present our series of synchronous robotic surgery for CRC with liver metastases. Retrospective review of prospectively collected data of patients with stage IV CRC with liver metastases treated at a tertiary center from February 2013 to June 2014. Patients who underwent synchronous robotic surgery for CRC with liver metastasis(es) were included and selected by a multidisciplinary cancer committee. Data included patient demographics, disease stage, OR time, EBL, and complications. All resections were performed robotically by the same well-experienced surgeons. A radiologist was present for intraoperative ultrasound. Liver treatment was performed first in consideration of intraoperative bleeding risk. Sixty-six patients with Stage IV CRC were seen at the tertiary center during the study period. Six patients met inclusion criteria (2 male, 4 female). Mean age was 59.3 years and mean BMI was 23.46. Mean of 2.25 liver segments were resected and mean of 1.75 liver segments were ablated. Four patients underwent metastatectomy; three with concurrent microwave ablation. One patient had ablation without resection and another had no identifiable lesion on ultrasound. The colonic resections included 3 low anterior resections, 2 abdominal perineal resections (APR), and 1 right hemicolectomy. Mean operative time was 401 min (349-506 min) with mean EBL of 316 mL (150-1000 mL). No conversions to an open approach occurred. Median length of stay (LOS) was 4.5 days (3-10 days). Complications included delayed wound healing after an APR and a delayed rectal anastomotic failure after ileostomy reversal. There was no 30-day mortality. At a mean follow-up of 19 months, one death occurred at 26 months and the remaining patients had documented metastatic disease. Synchronous resection for metastatic CRC carries risks. We report our series of synchronous robotic surgery for CRC with liver metastases. The robotic approach contributed to low blood loss, appropriate LOS, and no 30-day mortality. Morbidity experienced was consistent with the procedures and not related to the robotic technique. This series supports the potential benefits of synchronous resection from a technical standpoint. Further data are required to determine treatment and survival benefits. Limitations include small number and retrospective review of data.
- Published
- 2018
22. Abstract No. 96: Cumulative radiation dosage in consecutive dialysis patients presenting over a 3 month period at a single institution
- Author
-
Eric J. Hohenwalter, William S. Rilling, Sarah B. White, Parag J. Patel, Matthew J Scheidt, Sean Tutton, and Robert A. Hieb
- Subjects
Pediatrics ,medicine.medical_specialty ,business.industry ,Period (gene) ,medicine ,Radiology, Nuclear Medicine and imaging ,Single institution ,Cardiology and Cardiovascular Medicine ,Nuclear medicine ,business ,Dialysis patients - Published
- 2012
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.