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James B Spies - One of the best experts on this subject based on the ideXlab platform.

  • uterine fibroid embolization the utility of Aortography in detecting ovarian artery collateral supply
    Radiology, 2007
    Co-Authors: Amy White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B Spies
    Abstract:

    Purpose: To retrospectively determine the sensitivity of ovarian artery (OA) visualization at Aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at Aortography with selective ovarian arteriography, to establish the utility of Aortography and ovarian arteriography in the routine practice of UFE. Materials and Methods: This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21–60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the...

  • uterine fibroid embolization the utility of Aortography in detecting ovarian artery collateral supply
    Radiology, 2007
    Co-Authors: Amy M. White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B Spies
    Abstract:

    PURPOSE: To retrospectively determine the sensitivity of ovarian artery (OA) visualization at Aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at Aortography with selective ovarian arteriography, to establish the utility of Aortography and ovarian arteriography in the routine practice of UFE. MATERIALS AND METHODS: This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21-60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the senior observer, and interobserver variability was determined. RESULTS: Of 1072 UFE patients, 184 (17.2%) had at least one visible OA. Ten (0.8%) patients were identified at Aortography with collateral OA supply to more than 10% of the uterus. In total, 251 OAs were visualized, and 157 of these were further evaluated with selective study. Sixty-two (5.8%) patients were identified at selective arteriography as having collateral OA supply. The sensitivity of Aortography was approximately 18%. Interobserver concordance was high (kappa values of 0.81 and 0.90 for Aortography and selective study, respectively), but not perfect. CONCLUSION: Aortography rarely helps identify patients with substantial residual OA supply to the uterus and is a poor predictor of the extent of that supply, and thus may be of limited utility in routine UFE.

  • Patient radiation exposure during uterine fibroid embolization and the dose attributable to Aortography.
    Journal of vascular and interventional radiology : JVIR, 2007
    Co-Authors: Amy M. White, Filip Banovac, James B Spies
    Abstract:

    The techniques used for uterine fibroid embolization (UFE) have rapidly evolved during the past decade. One source of uncertainty in the UFE technique has been the importance of the contribution of the ovarian artery to the blood supply of the uterus and fibroids. Although conventional Aortography is often used after embolization to assess for collateral arterial supply, few patients are identified with sufficient collateral vessels to warrant supplemental embolization. One potential downside of routine Aortography is the additional radiation dose. In this study, the radiation dose associated with UFE and the contribution of each component of the procedure to this dose were evaluated, with the specific goal of identifying the contribution from Aortography. Although the overall radiation dose associated with UFE is moderate, Aortography contributes a substantial amount of additional radiation, more than 20% of the total, which, coupled with its low clinical utility, suggests that the routine use of Aortography at the conclusion of UFE should be reconsidered.

  • Uterine fibroid embolization: the utility of Aortography in detecting ovarian artery collateral supply.
    Radiology, 2007
    Co-Authors: Amy M. White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B Spies
    Abstract:

    To retrospectively determine the sensitivity of ovarian artery (OA) visualization at Aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at Aortography with selective ovarian arteriography, to establish the utility of Aortography and ovarian arteriography in the routine practice of UFE. This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21-60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the senior observer, and interobserver variability was determined. Of 1072 UFE patients, 184 (17.2%) had at least one visible OA. Ten (0.8%) patients were identified at Aortography with collateral OA supply to more than 10% of the uterus. In total, 251 OAs were visualized, and 157 of these were further evaluated with selective study. Sixty-two (5.8%) patients were identified at selective arteriography as having collateral OA supply. The sensitivity of Aortography was approximately 18%. Interobserver concordance was high (kappa values of 0.81 and 0.90 for Aortography and selective study, respectively), but not perfect. Aortography rarely helps identify patients with substantial residual OA supply to the uterus and is a poor predictor of the extent of that supply, and thus may be of limited utility in routine UFE. (c) RSNA, 2007.

Amy M. White - One of the best experts on this subject based on the ideXlab platform.

  • uterine fibroid embolization the utility of Aortography in detecting ovarian artery collateral supply
    Radiology, 2007
    Co-Authors: Amy M. White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B Spies
    Abstract:

    PURPOSE: To retrospectively determine the sensitivity of ovarian artery (OA) visualization at Aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at Aortography with selective ovarian arteriography, to establish the utility of Aortography and ovarian arteriography in the routine practice of UFE. MATERIALS AND METHODS: This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21-60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the senior observer, and interobserver variability was determined. RESULTS: Of 1072 UFE patients, 184 (17.2%) had at least one visible OA. Ten (0.8%) patients were identified at Aortography with collateral OA supply to more than 10% of the uterus. In total, 251 OAs were visualized, and 157 of these were further evaluated with selective study. Sixty-two (5.8%) patients were identified at selective arteriography as having collateral OA supply. The sensitivity of Aortography was approximately 18%. Interobserver concordance was high (kappa values of 0.81 and 0.90 for Aortography and selective study, respectively), but not perfect. CONCLUSION: Aortography rarely helps identify patients with substantial residual OA supply to the uterus and is a poor predictor of the extent of that supply, and thus may be of limited utility in routine UFE.

  • Patient radiation exposure during uterine fibroid embolization and the dose attributable to Aortography.
    Journal of vascular and interventional radiology : JVIR, 2007
    Co-Authors: Amy M. White, Filip Banovac, James B Spies
    Abstract:

    The techniques used for uterine fibroid embolization (UFE) have rapidly evolved during the past decade. One source of uncertainty in the UFE technique has been the importance of the contribution of the ovarian artery to the blood supply of the uterus and fibroids. Although conventional Aortography is often used after embolization to assess for collateral arterial supply, few patients are identified with sufficient collateral vessels to warrant supplemental embolization. One potential downside of routine Aortography is the additional radiation dose. In this study, the radiation dose associated with UFE and the contribution of each component of the procedure to this dose were evaluated, with the specific goal of identifying the contribution from Aortography. Although the overall radiation dose associated with UFE is moderate, Aortography contributes a substantial amount of additional radiation, more than 20% of the total, which, coupled with its low clinical utility, suggests that the routine use of Aortography at the conclusion of UFE should be reconsidered.

  • Uterine fibroid embolization: the utility of Aortography in detecting ovarian artery collateral supply.
    Radiology, 2007
    Co-Authors: Amy M. White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B Spies
    Abstract:

    To retrospectively determine the sensitivity of ovarian artery (OA) visualization at Aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at Aortography with selective ovarian arteriography, to establish the utility of Aortography and ovarian arteriography in the routine practice of UFE. This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21-60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the senior observer, and interobserver variability was determined. Of 1072 UFE patients, 184 (17.2%) had at least one visible OA. Ten (0.8%) patients were identified at Aortography with collateral OA supply to more than 10% of the uterus. In total, 251 OAs were visualized, and 157 of these were further evaluated with selective study. Sixty-two (5.8%) patients were identified at selective arteriography as having collateral OA supply. The sensitivity of Aortography was approximately 18%. Interobserver concordance was high (kappa values of 0.81 and 0.90 for Aortography and selective study, respectively), but not perfect. Aortography rarely helps identify patients with substantial residual OA supply to the uterus and is a poor predictor of the extent of that supply, and thus may be of limited utility in routine UFE. (c) RSNA, 2007.

Kent M. Koprowicz - One of the best experts on this subject based on the ideXlab platform.

  • Prospective comparison of dual-energy CT Aortography using 70% reduced iodine dose versus single-energy CT Aortography using standard iodine dose in the same patient
    Abdominal radiology (New York), 2017
    Co-Authors: William P. Shuman, Ryan B. O’malley, Janet M. Busey, Mario Ramos, Kent M. Koprowicz
    Abstract:

    Purpose To compare dual-energy computed tomography (DECT) Aortography using a 70% reduced iodine dose to single-energy CT (SECT) Aortography using a standard iodine dose in the same patient.

  • prospective comparison of dual energy ct Aortography using 70 reduced iodine dose versus single energy ct Aortography using standard iodine dose in the same patient
    Abdominal Radiology, 2017
    Co-Authors: William P. Shuman, Janet M. Busey, Mario Ramos, Ryan B Omalley, Kent M. Koprowicz
    Abstract:

    Purpose To compare dual-energy computed tomography (DECT) Aortography using a 70% reduced iodine dose to single-energy CT (SECT) Aortography using a standard iodine dose in the same patient.

  • dual energy ct Aortography with 50 reduced iodine dose versus single energy ct Aortography with standard iodine dose
    Academic Radiology, 2016
    Co-Authors: William P. Shuman, Janet M. Busey, Keith T Chan, Lee M Mitsumori, Kent M. Koprowicz
    Abstract:

    Rationale and Objectives Because many patients with aortic pathology also have compromised renal function, we wished to investigate dual-energy computed tomography (DECT) Aortography with 50% reduced iodine dose compared to single-energy computed tomography (SECT) Aortography with standard iodine dose. Materials and Methods Fifty patients had DECT Aortography with 50% reduced iodine dose. Thirty-four of these patients had prior SECT Aortography with standard iodine dose. DECT images were reconstructed at both 50 and 77 keV and were compared to SECT 120 kVp images. Reviewers measured aortic attenuation, image noise, and scored vascular enhancement. Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were calculated. Volume CT dose index was recorded. Results Mean iodine dose was 47 g for SECT and 24 g for DECT. Aortic attenuation was highest at reduced iodine dose DECT 50 keV (570 ± 105 Hounsfield units [HU]) compared to 77 keV (239 ± 40 HU) or to standard iodine dose SECT 120 kVp (356 ± 69 HU) (P   0.05). SNR and CNR were the same at 50 keV and 120 kVp (P > 0.05). Mean vascular enhancement scores were all above 3.0 (good, typical enhancement). Volume CT dose index was 11.7 mGy for DECT and 11.8 mGy for SECT (P = 0.37). Conclusions DECT Aortography with 50% reduced iodine reconstructed at 50 keV resulted in significantly greater aortic attenuation, good subjective vascular enhancement, and comparable SNR and CNR compared to standard iodine dose SECT. DECT image noise at 77 keV was similar to SECT at 120 kVp.

  • Dual-energy CT Aortography with 50% Reduced Iodine Dose Versus Single-energy CT Aortography with Standard Iodine Dose
    Academic radiology, 2016
    Co-Authors: William P. Shuman, Janet M. Busey, Keith T Chan, Lee M Mitsumori, Kent M. Koprowicz
    Abstract:

    Because many patients with aortic pathology also have compromised renal function, we wished to investigate dual-energy computed tomography (DECT) Aortography with 50% reduced iodine dose compared to single-energy computed tomography (SECT) Aortography with standard iodine dose. Fifty patients had DECT Aortography with 50% reduced iodine dose. Thirty-four of these patients had prior SECT Aortography with standard iodine dose. DECT images were reconstructed at both 50 and 77 keV and were compared to SECT 120 kVp images. Reviewers measured aortic attenuation, image noise, and scored vascular enhancement. Signal-to-noise ratios (SNR) and contrast-to-noise ratios (CNR) were calculated. Volume CT dose index was recorded. Mean iodine dose was 47 g for SECT and 24 g for DECT. Aortic attenuation was highest at reduced iodine dose DECT 50 keV (570 ± 105 Hounsfield units [HU]) compared to 77 keV (239 ± 40 HU) or to standard iodine dose SECT 120 kVp (356 ± 69 HU) (P < 0.05). Image noise was greatest at 50 keV compared to 77 keV and 120 kVp (P < 0.05) but was similar between 77 keV and 120 kVp (P > 0.05). SNR and CNR were the same at 50 keV and 120 kVp (P > 0.05). Mean vascular enhancement scores were all above 3.0 (good, typical enhancement). Volume CT dose index was 11.7 mGy for DECT and 11.8 mGy for SECT (P = 0.37). DECT Aortography with 50% reduced iodine reconstructed at 50 keV resulted in significantly greater aortic attenuation, good subjective vascular enhancement, and comparable SNR and CNR compared to standard iodine dose SECT. DECT image noise at 77 keV was similar to SECT at 120 kVp. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Filip Banovac - One of the best experts on this subject based on the ideXlab platform.

  • uterine fibroid embolization the utility of Aortography in detecting ovarian artery collateral supply
    Radiology, 2007
    Co-Authors: Amy White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B Spies
    Abstract:

    Purpose: To retrospectively determine the sensitivity of ovarian artery (OA) visualization at Aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at Aortography with selective ovarian arteriography, to establish the utility of Aortography and ovarian arteriography in the routine practice of UFE. Materials and Methods: This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21–60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the...

  • uterine fibroid embolization the utility of Aortography in detecting ovarian artery collateral supply
    Radiology, 2007
    Co-Authors: Amy M. White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B Spies
    Abstract:

    PURPOSE: To retrospectively determine the sensitivity of ovarian artery (OA) visualization at Aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at Aortography with selective ovarian arteriography, to establish the utility of Aortography and ovarian arteriography in the routine practice of UFE. MATERIALS AND METHODS: This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21-60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the senior observer, and interobserver variability was determined. RESULTS: Of 1072 UFE patients, 184 (17.2%) had at least one visible OA. Ten (0.8%) patients were identified at Aortography with collateral OA supply to more than 10% of the uterus. In total, 251 OAs were visualized, and 157 of these were further evaluated with selective study. Sixty-two (5.8%) patients were identified at selective arteriography as having collateral OA supply. The sensitivity of Aortography was approximately 18%. Interobserver concordance was high (kappa values of 0.81 and 0.90 for Aortography and selective study, respectively), but not perfect. CONCLUSION: Aortography rarely helps identify patients with substantial residual OA supply to the uterus and is a poor predictor of the extent of that supply, and thus may be of limited utility in routine UFE.

  • Patient radiation exposure during uterine fibroid embolization and the dose attributable to Aortography.
    Journal of vascular and interventional radiology : JVIR, 2007
    Co-Authors: Amy M. White, Filip Banovac, James B Spies
    Abstract:

    The techniques used for uterine fibroid embolization (UFE) have rapidly evolved during the past decade. One source of uncertainty in the UFE technique has been the importance of the contribution of the ovarian artery to the blood supply of the uterus and fibroids. Although conventional Aortography is often used after embolization to assess for collateral arterial supply, few patients are identified with sufficient collateral vessels to warrant supplemental embolization. One potential downside of routine Aortography is the additional radiation dose. In this study, the radiation dose associated with UFE and the contribution of each component of the procedure to this dose were evaluated, with the specific goal of identifying the contribution from Aortography. Although the overall radiation dose associated with UFE is moderate, Aortography contributes a substantial amount of additional radiation, more than 20% of the total, which, coupled with its low clinical utility, suggests that the routine use of Aortography at the conclusion of UFE should be reconsidered.

  • Uterine fibroid embolization: the utility of Aortography in detecting ovarian artery collateral supply.
    Radiology, 2007
    Co-Authors: Amy M. White, Filip Banovac, Shadi Yousefi, Rebecca Slack, James B Spies
    Abstract:

    To retrospectively determine the sensitivity of ovarian artery (OA) visualization at Aortography performed after uterine fibroid embolization (UFE) and, using OA arteriography as the reference standard, compare the extent of arterial flow to the uterus at Aortography with selective ovarian arteriography, to establish the utility of Aortography and ovarian arteriography in the routine practice of UFE. This study received institutional review board approval with waiver of informed consent and was HIPAA compliant. Retrospective review of 1129 consecutive UFE patients (1072 with aortograms, 57 excluded; mean age, 44 years; range, 21-60 years) was performed to identify all visible OAs. Visible OAs were independently graded by two interventional radiologists according to extent of pelvic arterial flow. If selective arteriography was performed, a second grade was assigned based on assessment of the selective study. Descriptive and summary statistics were used for assessment by the senior observer, and interobserver variability was determined. Of 1072 UFE patients, 184 (17.2%) had at least one visible OA. Ten (0.8%) patients were identified at Aortography with collateral OA supply to more than 10% of the uterus. In total, 251 OAs were visualized, and 157 of these were further evaluated with selective study. Sixty-two (5.8%) patients were identified at selective arteriography as having collateral OA supply. The sensitivity of Aortography was approximately 18%. Interobserver concordance was high (kappa values of 0.81 and 0.90 for Aortography and selective study, respectively), but not perfect. Aortography rarely helps identify patients with substantial residual OA supply to the uterus and is a poor predictor of the extent of that supply, and thus may be of limited utility in routine UFE. (c) RSNA, 2007.

Paolo Stritoni - One of the best experts on this subject based on the ideXlab platform.

  • Comparative diagnostic value of transesophageal echocardiography and retrograde Aortography in the evaluation of thoracic aortic dissection
    The American journal of cardiology, 1994
    Co-Authors: Fabio Chirillo, Claudio Cavallini, Carlo Longhini, Paolo Ius, Oscar Totis, Antonio Cavarzerani, Andrea Bruni, Carlo Valfré, Paolo Stritoni
    Abstract:

    The aim of this study was to assess the comparative diagnostic value of transesophageal echocardiography (TEE) and retrograde Aortography for morphologic evaluation and anatomic mapping of aortic dissection. Seventy patients (aged 18 to 79 years) were prospectively evaluated with both techniques for suspected aortic dissection. In 64 patients, findings on Aortography and TEE could be validated against intraoperative (n = 53) and postmortem (n = 11) findings. Examination time was significantly shorter for TEE (9 +/- 6 vs 48 +/- 25 minutes; p < 0.001). For the detection of aortic dissection, Aortography showed lower sensitivity (87.5% vs 97.5%) and negative predictive value (85.3% vs 96.7%; both trends did not reach statistical significance) due mostly to the inability to identify noncommunicating dissection (dissection without intimal tears). For the epiphenomena of aortic dissection, Aortography was significantly more accurate (97.2% vs 78%; p < 0.05) in assessing the site of entry, and TEE was more accurate in identifying thrombus formation (90% vs 65%; p < 0.05). There was no significant difference between Aortography and TEE with regard to assessing secondary tears, aortic regurgitation, coronary dissection, and extension of the dissection. Thus, both TEE and Aortography offer detailed anatomic mapping for guided surgical interventions. In elective patients, integration of both techniques seems the best approach; in unstable patients, TEE may be preferential because it is less invasive, requires no contrast injection, and provides accurate diagnosis in a short time at the bedside.

  • comparative diagnostic value of transesophageal echocardiography and retrograde Aortography in the evaluation of thoracic aortic dissection
    American Journal of Cardiology, 1994
    Co-Authors: Fabio Chirillo, Claudio Cavallini, Carlo Longhini, Paolo Ius, Oscar Totis, Antonio Cavarzerani, Andrea Bruni, Carlo Valfré, Paolo Stritoni
    Abstract:

    Abstract The aim of this study was to assess the comparative diagnostic value of transesophageal echocardiography (TEE) and retrograde Aortography for morphologic evaluation and anatomic mapping of aortic dissection. Seventy patients (aged 18 to 79 years) were prospectively evaluated with both techniques for suspected aortic dissection. In 64 patients, findings on Aortography and TEE could be validated against intraoperative (n = 53) and postmortem (n = 11) findings. Examination time was significantly shorter for TEE (9 ± 6 vs 48 ± 25 minutes; p