CT-Guided Percutaneous Drainage Catheter Placement in the Abdomen and Pelvis: Predictors of Outcome and Protocol for Follow-up

Commander, Clayton W.; Wilson, Sarah Beth; Bilaj, Fatmir; Isaacson, Ari J.; Burke, Charles T.; Yu, Hyeon

doi:10.1016/j.jvir.2019.09.026

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…CT-guided drainage was performed using standard techniques [ 28 , 29 ] covered by internal standard operating procedures. The ideal skin entry site was determined using planning scans with a radiopaque grid placed on the patient’s skin.…”

Section: Methodsmentioning

confidence: 99%

Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach

Skusa

Wohlfarth

et al. 2022

Diagnostics

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The aim of this investigation was to evaluate predictive CT imaging features and clinical parameters to distinguish infected from sterile fluid collections. Detection of infectious agents by advanced microbiological analysis was used as the reference standard. From April 2018 to October 2019, all patients undergoing CT-guided drainages were prospectively enrolled, if drainage material volume was at least 5 mL. Univariate analysis revealed attenuation (p = 0.001), entrapped gas (p < 0.001), fat stranding (p < 0.001), wall thickness (p < 0.001) and enhancement (p < 0.001) as imaging biomarkers and procalcitonin (p = 0.003) as clinical predictive parameters for infected fluid collections. On multivariate analysis, attenuation > 10 HU (p = 0.038), presence of entrapped gas (p = 0.027) and wall enhancement (p = 0.028) were independent parameters for distinguishing between infected and non-infected fluids. Gas entrapment had high specificity (93%) but low sensitivity (48%), while wall enhancement had high sensitivity (91%) but low specificity (50%). CT attenuation > 10 HU showed intermediate sensitivity (74%) and specificity (70%). Evaluation of the published proposed scoring systems did not improve diagnostic accuracy over independent predictors in our study. In conclusion, this prospective study confirmed that CT attenuation > 10 HU, entrapped gas and wall enhancement are the key imaging features to distinguish infected from sterile fluid collections on CT.

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Section: Methodsmentioning

confidence: 99%

Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach

Skusa

Wohlfarth

et al. 2022

Diagnostics

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“…1,20,49,53,56,57 Patients with an improving and uncomplicated clinical course and decreasing catheter output (e.g., <10 mL/day) typically need no follow-up imaging. 19,[57][58][59] However, repeated cross-sectional imaging may be advised before catheter removal to confirm correct catheter positioning and resolution of the collection in patients with persistent fever/symptoms or high drain output. 49,57,58,[60][61][62] For example, a recent study conducted by Sari et al showed a low rate (0.8%) of abscess recurrence if the catheter is removed without routine imaging when drainage is less than 10 mL/day for at least 2 days, and the patient is clinically stable.…”

Section: Catheter Carementioning

confidence: 99%

Percutaneous Image-Guided Drainage of Abdominal Fluid Collections in Children: Technical Considerations and Clinical Scenarios

Gallo-Bernal

Cahalane

Gee

2022

Digestive Disease Interventions

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While initially conceived and designed for adults, percutaneous image-guided drainage of abdominal pelvic and fluid collections has revolutionized the management of several pediatric pathologies. Interventional radiology procedures markedly reduce morbidity and mortality by offering a definitive minimally invasive approach or allowing a cleaner and less challenging subsequent open approach. These procedures are associated with improved patient comfort and rapid recovery. While similar techniques apply to children and adults, successful adaptation of image-guided interventional techniques in children requires consideration of several critical differences. This review aims to discuss the indications, contraindications, and technical aspects of percutaneous image-guided drainage of abdominal and pelvic fluid collections in children.

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“…The management of oncological patients has changed profoundly and, although the main goal is overall survival (OS), new knowledge of the molecular cancer profile and the development of new pharmacologic treatments has led to the use of surrogate end-points to measure interim treatment efficacy [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ] related to the disease setting, including disease-free (DF), recurrence-free (RF), and progression-free survival (PFS) [ 8 , 9 , 10 , 11 , 12 ]. In this context, interventional radiology (IR), especially ablation treatment, is one of the most rapidly growing areas in oncology [ 13 , 14 , 15 , 16 ]. Its success is essentially due to the minimally invasive nature of the treatment with lower complication rates and superior toxicity profiles, and often with comparable or superior mid- and long-term oncologic outcomes compared to conventional therapies, such as surgical procedures or systemic treatments [ 17 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Complications Risk Assessment and Imaging Findings of Thermal Ablation Treatment in Liver Cancers: What the Radiologist Should Expect

Granata

Fusco

Muzio

et al. 2022

JCM

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One of the major fields of application of ablation treatment is liver tumors. With respect to HCC, ablation treatments are considered as upfront treatments in patients with early-stage disease, while in colorectal liver metastases (CLM), they can be employed as an upfront treatment or in association with surgical resection. The main prognostic feature of ablation is the tumor size, since the goal of the treatment is the necrosis of all viable tumor tissue with an adequate tumor-free margin. Radiofrequency ablation (RFA) and microwave ablation (MWA) are the most employed ablation techniques. Ablation therapies in HCC and liver metastases have presented a challenge to radiologists, who need to assess response to determine complication-related treatment. Complications, defined as any unexpected variation from a procedural course, and adverse events, defined as any actual or potential injury related to the treatment, could occur either during the procedure or afterwards. To date, RFA and MWA have shown no statistically significant differences in mortality rates or major or minor complications. To reduce the rate of major complications, patient selection and risk assessment are essential. To determine the right cost-benefit ratio for the ablation method to be used, it is necessary to identify patients at high risk of infections, coagulation disorders and previous abdominal surgery interventions. Based on risk assessment, during the procedure as part of surveillance, the radiologists should pay attention to several complications, such as vascular, biliary, mechanical and infectious. Multiphase CT is an imaging tool chosen in emergency settings. The radiologist should report technical success, treatment efficacy, and complications. The complications should be assessed according to well-defined classification systems, and these complications should be categorized consistently according to severity and time of occurrence.

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CT-Guided Percutaneous Drainage Catheter Placement in the Abdomen and Pelvis: Predictors of Outcome and Protocol for Follow-up

Cited by 5 publications

References 16 publications

Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach

Imaging and Clinical Parameters for Distinction between Infected and Non-Infected Fluid Collections in CT: Prospective Study Using Extended Microbiological Approach

Percutaneous Image-Guided Drainage of Abdominal Fluid Collections in Children: Technical Considerations and Clinical Scenarios

Complications Risk Assessment and Imaging Findings of Thermal Ablation Treatment in Liver Cancers: What the Radiologist Should Expect

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