scholarly journals Techniques ‒ Ultrasound-guided percutaneous nephrolithotomy: How we do it

2019 ◽  
Vol 14 (3) ◽  
Author(s):  
Darren Beiko ◽  
Hassan Razvi ◽  
Naeem Bhojani ◽  
Jennifer Bjazevic ◽  
David B. Bayne ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Percutaneous Nephrolithotomy ◽  
Successful Implementation ◽  
Ultrasound Guided ◽  
Image Guided ◽  
Radiation Exposure To Patients

Ultrasonography has emerged as an alternative to fluoroscopy for image-guided percutaneous nephrolithotomy (PCNL) in many countries. Compared to fluoroscopy-guided PCNL (F-PCNL), ultrasound-guided PCNL (US-PCNL) is easier to learn and reduces radiation exposure to patients and providers. Despite these advantages, uptake of ultrasound-guided PCNL (US-PCNL) in Canada has been almost nonexistent, largely because it is not incorporated into urologists’ training. In this article, we seek to familiarize Canadian urologists with this approach by describing our step-by-step technique for US-PCNL. Additionally, we provide keys to successful implementation of this technique.

Reducing radiation exposure to patients from kV-CBCT imaging

2010 ◽  
Vol 97 (3) ◽  
pp. 585-592 ◽  
Author(s):  
George X. Ding ◽  
Peter Munro ◽  
Jason Pawlowski ◽  
Arnold Malcolm ◽  
Charles W. Coffey
Keyword(s):  
Radiation Exposure ◽  
Radiation Exposure To Patients

scholarly journals Universal Sinus Computed Tomography Protocol for Diagnostic Imaging and Intraoperative Navigation

2015 ◽  
Vol 6 (3) ◽  
pp. ar.2015.6.0134 ◽  
Author(s):  
Joseph M. Hoxworth ◽  
Devyani Lal
Keyword(s):  
Computed Tomography ◽  
Diagnostic Imaging ◽  
Radiation Exposure ◽  
Intraoperative Navigation ◽  
Sinus Surgery ◽  
Successful Implementation ◽  
Potential Cost ◽  
Imaging Protocol ◽  
Imaging Guidance ◽  
Ct Protocol

Background Sinus computed tomography (CT) is performed for the diagnosis of paranasal sinus disease and to assess response to medical therapy. In addition, sinus CT is used for intraoperative imaging guidance. Multiple CTs increase cost and radiation exposure. Objective To determine potential cost savings and radiation dose reduction that result from the use of a single universal sinus CT protocol for diagnostic imaging and intraoperative navigation. Materials and Methods For sinus CT at the authors' institution, a single imaging protocol was begun and deemed acceptable by neuroradiologists and surgeons for diagnostic imaging and intraoperative guidance. The electronic medical record was queried over a 4-year period to determine the number of sinus CTs performed, dose-length products, referring providers' specialties, percentage of CTs used for intraoperative navigation, and the elapsed time between CT and surgery. Results A total of 6187 sinus CTs were performed by using a 64-detector scanner during the study period (2759 women and 3428 men; 53.6 ± 16.7 years [mean ± SD]), and 596 endoscopic sinus surgery cases used imaging guidance, for which all the CTs were deemed technically adequate. The mean dose-length product for the CTs was 338.4 ± 31.9 mGy-cm (mean ± SD). Of the 3702 sinus CTs ordered by nonotolaryngology providers, 167 surgeries with intraoperative navigation (4.5%) were performed. A higher percentage of CT referrals from sinus surgeons (23.9%) and other otolaryngology providers (11.4%) was used for imaging guidance (p < 0.0001). The time interval between sinus CT and surgery was greatest for nonotolaryngology providers (63.1 days, p < 0.01). Based on Medicare reimbursement, the total estimated saving was $147,628. Conclusions Adopting a single universal sinus CT protocol for diagnostic imaging and intraoperative navigation can be an effective means of decreasing cost and radiation exposure. However, successful implementation must take into account multiple practice-based considerations.

Doppler Ultrasound-guided Percutaneous Nephrolithotomy With Two-step Tract Dilation for Management of Complex Renal Stones

Urology ◽  
2012 ◽  
Vol 79 (6) ◽  
pp. 1247-1251 ◽  
Author(s):  
Youming Xu ◽  
Zhonghua Wu ◽  
Jianhua Yu ◽  
Shulong Wang ◽  
Fang Li ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stones ◽  
Ultrasound Guided ◽  
Tract Dilation
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