MEDRADSC 3C03 Lecture Notes - Lecture 4: Mediastinum, Chemotherapy, Seldinger Technique
27 May 2018
School
Department
Course
Professor
Interventional Equipment- Vascular and Non-Vascular Procedures
• Extensive overlap in many of the products and modalities used
A: gas
collected around the liver, want to relieve the pressure B: can see the needle being advanced into the
collection C: through the advancement of the needle, we can thread in guidewire, on top of guidewire
we can exchange needle tip for catheter, allows for the movement of air out of the body (vacuum
container)
Therapeutic:
1. Drain body fluids (abscess, ascites, pleural effusions)
2. Inject medications (managing pain in spine, injection of chemotherapy drugs)
3. Place tubes and or stents (ureters, esophagus, CBD, Colorectal) (because of some kind of
blockage/stricture preventing natural flow)
Diagnostic:
1. Biopsies
2. Drain body fluids (sending off to the lab to cause the fluid)
Interventional Equipment- Non-Vascular
find more resources at oneclass.com
find more resources at oneclass.com
pain management (under Fluoro, insert needles
in the Zygapophyseal joints)
Importance of Interventional Procedures in Radiation Oncology
• Diagnosis prior to treatment or diagnosis of metastatic disease
• Management of complications
o Ascites (natural response to disease process)
o Pleural effusion drainage
Interventional Modalities considered for this course:
• Ultrasound
• CT
• Fluoroscopy
Interventional Equipment- Ultrasound
• Real time imaging with no ionizing radiation
• Ideal for biopsies and drainages, although cotrast ad spatial res is’t as great as other
modalities, it is good enough for areas that usually require biopsy/drainage is easy to see with
US
• Limitations: bone, air and depth surgical sites
• Sterility of transducers:
o Sterile probe covers
o Sterile glove
o Sterile gel
o Drape patient and cable
find more resources at oneclass.com
find more resources at oneclass.com
•
• Ultrasound Needle Guidance
o needle needs to be in the
center of the probe to be able to see it
•
1. Free hand- requires experience (preferred, greater flexibility in the approach, not
constrained to the path of the needle guide)
2. Probe appropriate needle guide
o https://www.youtube.com/watch?v=-xMmGEjMSX8
• Needle guides: inexperienced scanners or very small lesions (or when trying to do transvaginal
or transrectal biopsies or drainages because it could be impossible to see the puncture sight,
ca’t aipulate the eedle aroud it)
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Interventional equipment- vascular and non-vascular procedures: extensive overlap in many of the products and modalities used. Therapeutic: drain body fluids (abscess, ascites, pleural effusions, place tubes and or stents (ureters, esophagus, cbd, colorectal) (because of some kind of. Inject medications (managing pain in spine, injection of chemotherapy drugs) blockage/stricture preventing natural flow) Diagnostic: biopsies, drain body fluids (sending off to the lab to cause the fluid) Interventional equipment- non-vascular pain management (under fluoro, insert needles in the zygapophyseal joints) Importance of interventional procedures in radiation oncology: diagnosis prior to treatment or diagnosis of metastatic disease, management of complications, ascites (natural response to disease process, pleural effusion drainage. Interventional modalities considered for this course: ultrasound, ct, fluoroscopy. Interventional equipment- ultrasound: real time imaging with no ionizing radiation. Ideal for biopsies and drainages, although co(cid:374)trast a(cid:374)d spatial res is(cid:374)"t as great as other modalities, it is good enough for areas that usually require biopsy/drainage is easy to see with.
