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Biomedical subjects

L Thanos

Publications and source records attributed to L Thanos.

16 recordsLinked to original sources
PubMed2006

Percutaneous radiofrequency ablation of lung tumors with expandable needle electrodes: current status.

Percutaneous radiofrequency thermal ablation (RFA) has been used to treat primary and secondary liver tumors under ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) guidance for the past decade [Park et al., Radiol Clin North Am 38:545-561, 2000; Siperstein and Gotomirski, Cancer J 6:S293-S301, 2000; Kelekis et al., Eur Radiol 13:1100-1105, 2003]. RFA is a low-cost, minimally invasive treatment that has recently attracted attention for treating tumors in different solid organs with promising results [Dupuy and Goldberg, J Vasc Interv Radiol 12:1135-1148, 2001; Friedman et al., Cardiovasc Intervent Radiol 27:427-434, 2004]. It can be provided with minimal hospitalization, and experienced practitioners have reported low complication rates [Dupuy and Goldberg, J Vasc Interv Radiol 12:1135-1148, 2001; Livraghi et al., Radiology 226:441-451, 2003]. Patients with lung malignancies (primary lung cancer or pulmonary metastases), who cannot be operated, might be candidates for RFA treatment. It can also be used in association with other treatments (i.e., chemotherapy, radiotherapy) for better disease control. Combination of the above with RFA may help reduce morbidity and mortality. Many ways to apply energy to the tumor exist (monopolar and bipolar RFA, microwave, laser, brachytherapy). In this review we will focus on expandable monopolar systems, which despite their deficiencies are the most popular in the interventional radiology sector.

Carcinoma, Non-Small-Cell Lung↗
PubMed2006

Percutaneous CT-guided nephrostomy: a safe and quick alternative method in management of obstructive and nonobstructive uropathy.

PURPOSE: To present the indications, technique, complications, and contraindications for CT-guided percutaneous nephrostomy (PCN) as an alternative to standard fluoroscopy-guided puncture that involves no radiation exposure for the radiologist. PATIENTS AND METHODS: Between June 2000 and July 2004, 258 percutaneous CT-guided nephrostomies were performed in 215 patients in our department. Most patients (201; 93%) underwent PCN for obstructive uropathy, while 14 (7%) required the procedure as treatment for nonobstructive bladder trauma. All patients had subsequent insertion of a nephrostomy tube under CT guidance. RESULTS: Percutaneous access was achieved without major complications in all patients. The most common complication was pain at the puncture site. In 50 patients (23%), the nephrostomy catheter remained in place until full decompression of the obstruction. In the 14 patients with bladder trauma, the catheter was removed after trauma repair. In 151 patients (70%), the catheter's placement was permanent. CONCLUSION: Percutaneous CT-guided nephrostomy is a reliable, safe, fast, and highly effective method associated with a low complication rate that involves no radiation for the interventional radiologist.

Adolescent↗
PubMed2006

Scalp actinomycosis mimicking soft tissue mass.

Actinomycosis is a rare, subacute or chronic bacterial infection, characterized by localized swelling with suppuration, abscess formation, tissue fibrosis, and draining sinuses. It is caused by gram-positive, pleomorphic non-spore-forming, non-acid-fast anaerobic or microaerophilic bacilli of the genus Actinomyces. In humans, actinomyces are often normally found in the oral cavity, the gastrointestinal tract and the female genital tract. Infections of the oral and cervicofacial regions are the most commonly reported cases. We present a case of subcutaneous actinomycosis, localized at the upper segment of the posterior neck space, with scalp involvement.

Actinomycosis↗
PubMed2005

Percutaneous treatment of true splenic cysts: report of two cases.

We report two cases of successful percutaneous therapy of epithelial splenic cysts. A 19-year-old woman and a 48-year-old man underwent drainage of their epithelial cysts with subsequent instillation of alcohol into the cavities under computed tomographic guidance.

Adult↗
PubMed2003

Primary lung cancer: treatment with radio-frequency thermal ablation.

Primary lung cancer is the most frequently diagnosed malignancy in the world and the leading cause of death from cancer [1]. When the initial diagnosis is made, most cases are inoperable or the patients' condition does not permit surgical interventions [2]. For patients with inoperable lung cancer, percutaneous radio-frequency thermal ablation (RFA) under CT guidance represents an alternative and minimally invasive treatment. It can also be applied in combination with radiation therapy and chemotherapy. We report three cases treated by percutaneous CT-guided RF ablation, from which two had post-operative recurrent tumor and one was inoperable.

Adenocarcinoma↗
PubMed2002

Chondrosarcoma of the larynx: treatment with radiotherapy.

The case of a 50-year-old man with chondrosarcoma of the larynx treated with radiotherapy is reported. The patient presented with hoarseness and dyspnea. He underwent computed tomography (CT), which demonstrated a soft tissue mass of the larynx. Direct laryngoscopy with biopsy established the diagnosis of chondrosarcoma. Although experience with radiotherapy in these cases has been lacking in the literature, it was considered and eventually used, as radical surgery would result in severe cosmetic and functional impairment. Radiation therapy alone resulted in long-term remission of the tumour for more than 3 years. The patient has been followed up using CT and direct laryngoscopy for early detection of recurrence or metastases.

Chondrosarcoma↗
PubMed2001

Sternal tuberculosis after coronary artery bypass graft surgery.

We report a case of sternal tuberculosis following sternotomy, which was performed during coronary artery bypass graft surgery. Although pre-operative evaluation revealed signs of asymptomatic tuberculosis of the lung, isoniazid chemoprophylaxis was not instituted, and the patient developed active tuberculosis in both the lung and sternum 5 y later.

Coronary Artery Bypass↗
PubMed2000

Ruptured adrenal artery aneurysm: a case report.

A case of ruptured adrenal artery aneurysm is presented. The ultrasound, computed tomography and selective renal angiography findings are described in detail. Aneurysms of adrenal arteries are particularly rare. Early diagnosis is important because of their tendency towards rupture and subsequent high mortality rate.

Adrenal Glands↗
PubMed1995

Unusually located osteoid osteomas.

The files of 12 patients (aged 12-33 years) with an equal number of surgically proven osteoid osteomas (OOs) were reviewed in attempt to find a diagnostic algorithm in cases of unusually located OOs. Plain radiography (PR) and thin collimation computed tomography (CT) had been performed in all patients, while bone scintigraphy (BS) had been performed in eight and magnetic resonance imaging (MRI) in two. The OOs were located at juxta- or intra-articular sites, except for one located at the left neck of the L4 vertebra. The diagnosis based on the MRI examinations was synovitis. BS showed increased accumulation of the radioisotope at the site of the lesions, without the 'double density' sign. PR showed the nidus of OO in only six patients, whereas CT located the nidus in all patients. In conclusion, we believe that when an OO is clinically suspected at an unusual location, CT should be performed in all cases, even when a lesion is depicted by PR and BS, because CT will not only locate the nidus but will also provide a precise anatomy of the area around the nidus and help in therapeutic decision making and surgical planning. MRI can be misleading and must not be used in the initial assessment of a possible osteoid osteoma.

Acetabulum↗
PubMedDate not supplied

Ileocecal actinomycosis: a case report.

A 51-year-old male with a clinical history of abdominal pain and bloody diarrhea underwent spiral computed tomography of the abdomen with intravenous contrast medium enhancement. The findings were an inflammatory mass with cystic and solid characteristics arising from the ileocecal region and extending to the peritoneum and right iliopsoas muscle, with adjacent lymphadenopathy. Histology after surgical resection confirmed the diagnosis of actinomycosis lesions in perienteric fat.

Actinomycosis↗
PubMedDate not supplied

Potentially life-threatening neck abscesses: therapeutic management under CT-guided drainage.

PURPOSE: To evaluate the effectiveness of CT-guided drainage of potentially life-threatening neck abscesses. METHODS: Between September 2001 and December 2003, 15 patients presented to the emergency room with potentially life-threatening neck abscesses. Their clinical condition was critical due to the abscess size (larger than 3 cm in diameter; mean diameter 5.2 cm, SD 0.91 cm) and/or abscess location. A CT scan was carried out immediately to assess the lesion. At the same time, under CT guidance, an 8 Fr trocar-type pigtail catheter was inserted, in order to drain the abscess. The decision to drain percutaneously was based on a consensus between the surgical, infectious disease and radiology teams . The catheter was kept in place until drainage stopped, and a follow-up scan was performed. RESULTS: In 14 (93%) patients, the abscess was completely drained, and in 1 (7%) case the collection was still present because of multiple internal septation. That patient was treated by surgical management. The catheter was in place for a mean of 3 days (SD 0.96 day). CONCLUSION: Despite the fact that the number of our patients is small, CT-guided percutaneous drainage seems to be a fast, safe and highly effective low-cost method for the treatment of potentially life-threatening neck abscesses.

Abscess↗
PubMedDate not supplied

Palliation of painful perineal metastasis treated with radiofrequency thermal ablation.

We report a case of painful perineal metastasis from urinary bladder carcinoma in a 73-years-old woman, treated with CT-guided radiofrequency ablation (RFA). The pain was immediately relieved and follow-up at 1 and 6 months showed total necrosis of the mass. One year later, the patient has no pain and her quality of life is improved.

Aged↗
PubMedDate not supplied

Long-term outcome of a hepatocellular carcinoma 7(1/2) years after surgery and repeated radiofrequency ablation: case report and review of the literature.

An interesting case is presented of a 78-year-old patient with cirrhosis who was managed with combined treatment (surgery and radiofrequency (RF) ablation) for hepatocellular carcinoma (HCC) and has survived for 7(1/2) years. Elevation of the alpha-FP (alpha-fetoprotein) levels was noted 2 years after surgery. CT demonstrated two lesions: one central at the remaining right liver lobe, and the other at the excision site. Biopsy of the lesions confirmed the diagnosis of HCC for both of them. RF ablation of these two lesions was performed in one session with technical success. Four and a half years after the first RF ablation a new recurrence was demonstrated at the CT follow-up control. RF ablation was again applied successfully. The imaging findings and the therapeutic percutaneous management of this patient along with the natural course of HCC and its recurrence are discussed, and the literature concerning risk factors is reviewed.

Aged↗
PubMedDate not supplied

CT portography and post-lipiodol CT in the preinterventional work-up of primary and secondary liver tumors. A single center experience.

BACKGROUND/AIMS: The evaluation of the clinical use of CT portography (CTp) and post-lipiodol CT (CT post-lip) in terms of therapeutic implications in patients with liver malignancies, particularly hepatocellular carcinoma (HCC). METHODOLOGY: We prospectively evaluated 130 patients with CTp and CT post-lip: 109 with HCC and underlying cirrhosis (group I) and 21 with liver metastases considered for surgical resection (group II). All patients also underwent hepatic angiography (hA). Mean lesion size was 4.6 cm and 2.2 cm for group I and II respectively. Previous contrast-enhanced CT studies were available for comparison. RESULTS: Diagnostic CTp examinations resulted in only 84.4% of group I due to enhancement in homogeneities and in all patients from group II. In comparison with the referral CT, additional lesions were seen in 83.6% of the HCC group and in 66.6% of the metastatic group that implicated treatment alterations in 15.21% and in 23.8% of them, respectively. Hepatic angiography revealed hypervascularity in 91.3% of HCC lesions and in 33.3% of metastatic ones. CT post-lip images suitable for evaluation resulted in 104/130 patients (80%). At CT post-lip false negative results were observed in 33.73% patients with HCC and in 30.95% patients with liver metastases. Selective lipiodol retention was seen in only 50% of the biopsy proved satellites. CONCLUSIONS: CTp reveals additional lesions that have therapeutic implications in at least 15% of HCC patients and in 20% of patients with metastatic disease, and should be routinely included in the preinterventional work-up particularly for cases in which intraarterial or percutaneous treatment is scheduled. By contrast, CT post-lip seems to be of limited value unless it is evaluated in combination with CTp and angiography.

Adult↗