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European Journal of Surgical Oncology :... Nov 2022In the pelvis, anatomic complexity and difficulty in visualization and access make surgery a formidable task. Surgeons are prone to work-related musculoskeletal injuries...
In the pelvis, anatomic complexity and difficulty in visualization and access make surgery a formidable task. Surgeons are prone to work-related musculoskeletal injuries from the frequently poor design and flow of their work environment. This is exacerbated by the strain of surgery in the pelvis. These injuries can result in alterations to a surgeons practice, inadvertent patient injury, and even early retirement. Human factors examines the relationships between the surgeon, their instruments and their environment. By bridging physiology, psychology, and ergonomics, human factors allows a better understanding of some of the challenges posed by pelvic surgery. The operative approach involved (open, laparoscopic, robotic, or perineal) plays an important role in the relevant human factors. Improved understanding of ergonomics can mitigate these risks to surgeons. Other human factors approaches such as standardization, use of checklists, and employing resiliency efforts can all improve patient safety in the operating theatre.
Topics: Humans; Ergonomics; Surgeons; Operating Rooms; Pelvis; Laparoscopy
PubMed: 35012835
DOI: 10.1016/j.ejso.2021.12.468 -
Orthopadie (Heidelberg, Germany) Dec 2022The spinal shape and the pelvic ante-/retroversion of an individual are determined by its innate, genetically fixed lumbosacral angulation. This can be measured with... (Review)
Review
The spinal shape and the pelvic ante-/retroversion of an individual are determined by its innate, genetically fixed lumbosacral angulation. This can be measured with little effort in the lateral standing radiograph of the patient. In spinal surgery, there are a lot of original papers on the topic. In hip surgery, however, the individual pelvic version and its consequences for the acetabular orientation have not received the same attention so far.This review focuses on previous data on the relationship between lumbosacral angulation and pelvic ante-/retroversion. Four anatomically definable pelvic types can be distinguished; three of those have to be considered as facultatively pathogenetic. Clinical consequences arise for the clinical pictures of spondylolisthesis, non-specific lower back pain, acetabular retroversion and developmental dysplasia of the hip, as well as for acetabular cup positioning in total hip arthroplasty.
Topics: Humans; Acetabulum; Arthroplasty, Replacement, Hip; Pelvis; Radiography; Standing Position
PubMed: 36222867
DOI: 10.1007/s00132-022-04321-x -
Current Oncology (Toronto, Ont.) Dec 2023The triad of 3D design, 3D printing, and xReality technologies is explored and exploited to collaboratively realize patient-specific products in a timely manner with an...
BACKGROUND
The triad of 3D design, 3D printing, and xReality technologies is explored and exploited to collaboratively realize patient-specific products in a timely manner with an emphasis on designs with meta-(bio)materials.
METHODS
A case study on pelvic reconstruction after oncological resection (osteosarcoma) was selected and conducted to evaluate the applicability and performance of an inter-epistemic workflow and the feasibility and potential of 3D technologies for modeling, optimizing, and materializing individualized orthopedic devices at the point of care (PoC).
RESULTS
Image-based diagnosis and treatment at the PoC can be readily deployed to develop orthopedic devices for pre-operative planning, training, intra-operative navigation, and bone substitution.
CONCLUSIONS
Inter-epistemic symbiosis between orthopedic surgeons and (bio)mechanical engineers at the PoC, fostered by appropriate quality management systems and end-to-end workflows under suitable scientifically amalgamated synergies, could maximize the potential benefits. However, increased awareness is recommended to explore and exploit the full potential of 3D technologies at the PoC to deliver medical devices with greater customization, innovation in design, cost-effectiveness, and high quality.
Topics: Humans; Point-of-Care Systems; Medical Oncology; Pelvis
PubMed: 38248099
DOI: 10.3390/curroncol31010014 -
Abdominal Radiology (New York) Aug 2022Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are... (Review)
Review
Involvement of the abdomen and pelvis is common in lymphoma. Nodal and extranodal abdominal and pelvic lymphoma may present with various complications. Complications are most common in high-grade lymphomas, especially diffuse large B-cell lymphoma. Complications may occur as the initial manifestation of lymphoma, during treatment course, or late following complete disease remission. Most complications are associated with worse prognosis and increased mortality. Imaging is essential in evaluation of disease extent and diagnosis of complications. Therefore, radiologists should be familiar with the clinical context and imaging features of abdominal and pelvic lymphoma complications. We provide a comprehensive, organ system-based approach, and clinical and imaging review of complications of abdominal and pelvic lymphoma along with radiologic images of illustrated cases of the most commonly encountered complications.
Topics: Abdomen; Abdominal Neoplasms; Humans; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Non-Hodgkin; Pelvis; Prognosis
PubMed: 35690955
DOI: 10.1007/s00261-022-03567-5 -
Abdominal Radiology (New York) Jun 2021Infections are the most commonly encountered complications in patients with cancer. The classical signs and symptoms of infections are often not present in this patient... (Review)
Review
Infections are the most commonly encountered complications in patients with cancer. The classical signs and symptoms of infections are often not present in this patient population, which makes the diagnosis more challenging. Host factors play a major role in the development and prognosis of infections in cancer patients; these can be related to the underlying type of malignancy (solid organ versus hematological), tumor burden, anatomic obstruction, altered integrity of barriers (skin or mucosa), treatment-related factors (from chemotherapy, radiation treatment, surgery, interventional procedures, and/or medical device placement) and the degree of immunosuppression. This article reviews common, as well as less common, imaging manifestations of infections and their potential mimics in the abdomen and pelvis in cancer patients and discusses their differentiating features, with the role of imaging in various organs in the abdomen and pelvis taking into consideration relevant clinical background information and the main risk factors.
Topics: Abdomen; Diagnostic Imaging; Humans; Neoplasms; Pelvic Infection; Pelvis
PubMed: 33386914
DOI: 10.1007/s00261-020-02896-7 -
The British Journal of Surgery Nov 2023
Topics: Humans; Pelvis; Pelvic Exenteration
PubMed: 37757457
DOI: 10.1093/bjs/znad301 -
Skeletal Radiology Nov 2023Diagnosis of hip osteoarthritis (OA) is based on clinical arguments, and medical imaging is obtained to confirm the diagnosis and rule out other possible sources of... (Review)
Review
Diagnosis of hip osteoarthritis (OA) is based on clinical arguments, and medical imaging is obtained to confirm the diagnosis and rule out other possible sources of pain. Conventional radiographs are recommended as the first line imaging modality to investigate chronic hip pain. They should be obtained in a rigorous technique that includes an antero-posterior (AP) radiograph of the pelvis. The choice of the appropriate lateral view depends on the clinical indication, Lequesne's false profile being valuable in the assessment of OA. Magnetic resonance imaging (MRI) is more sensitive to detect joint effusion/synovitis, cartilage, labral, and bone marrow lesions. However, structural joint changes are frequent in asymptomatic population and neither radiographs nor MRI have shown a good correlation with pain and functional impairment. MRI seems to be more suitable than radiographs as a biomarker for clinical trials addressing early OA. The absence of a validated MR biomarker of early OA, together with issues related to machine availability and MRI protocol repeatability, prevent the widespread use of MRI in clinical trials.
Topics: Humans; Osteoarthritis, Hip; Radiography; Magnetic Resonance Imaging; Pelvis; Biomarkers; Osteoarthritis, Knee; Cartilage, Articular
PubMed: 36538067
DOI: 10.1007/s00256-022-04270-8 -
Medical Physics May 2022Organ autosegmentation efforts to date have largely been focused on adult populations, due to limited availability of pediatric training data. Pediatric patients may...
PURPOSE
Organ autosegmentation efforts to date have largely been focused on adult populations, due to limited availability of pediatric training data. Pediatric patients may present additional challenges for organ segmentation. This paper describes a dataset of 359 pediatric chest-abdomen-pelvis and abdomen-pelvis Computed Tomography (CT) images with expert contours of up to 29 anatomical organ structures to aid in the evaluation and development of autosegmentation algorithms for pediatric CT imaging.
ACQUISITION AND VALIDATION METHODS
The dataset collection consists of axial CT images in Digital Imaging and Communications in Medicine (DICOM) format of 180 male and 179 female pediatric chest-abdomen-pelvis or abdomen-pelvis exams acquired from one of three CT scanners at Children's Wisconsin. The datasets represent random pediatric cases based upon routine clinical indications. Subjects ranged in age from 5 days to 16 years, with a mean age of 7 years. The CT acquisition, contrast, and reconstruction protocols varied across the scanner models and patients, with specifications available in the DICOM headers. Expert contours were manually labeled for up to 29 organ structures per subject. Not all contours are available for all subjects, due to limited field of view or unreliable contouring due to high noise.
DATA FORMAT AND USAGE NOTES
The data are available on The Cancer Imaging Archive (TCIA_ (https://www.cancerimagingarchive.net/) under the collection Pediatric-CT-SEG. The axial CT image slices for each subject are available in DICOM format. The expert contours are stored in a single DICOM RTSTRUCT file for each subject. The contour names are listed in Table 2.
POTENTIAL APPLICATIONS
This dataset will enable the evaluation and development of organ autosegmentation algorithms for pediatric populations, which exhibit variations in organ shape and size across age. Automated organ segmentation from CT images has numerous applications including radiation therapy, diagnostic tasks, surgical planning, and patient-specific organ dose estimation.
Topics: Abdomen; Adult; Algorithms; Child; Female; Humans; Male; Pelvis; Tomography Scanners, X-Ray Computed; Tomography, X-Ray Computed
PubMed: 35067940
DOI: 10.1002/mp.15485 -
Scientific Reports Feb 2022Available methods for generating paediatric musculoskeletal geometry are to scale generic adult geometry, which is widely accessible but can be inaccurate, or to obtain...
Available methods for generating paediatric musculoskeletal geometry are to scale generic adult geometry, which is widely accessible but can be inaccurate, or to obtain geometry from medical imaging, which is accurate but time-consuming and costly. A population-based shape model is required to generate accurate and accessible musculoskeletal geometry in a paediatric population. The pelvis, femur, and tibia/fibula were segmented from 333 CT scans of children aged 4-18 years. Bone morphology variation was captured using principal component analysis (PCA). Subsequently, a shape model was developed to predict bone geometry from demographic and linear bone measurements and validated using a leave one out analysis. The shape model was compared to linear scaling of adult and paediatric bone geometry. The PCA captured growth-related changes in bone geometry. The shape model predicted bone geometry with root mean squared error (RMSE) of 2.91 ± 0.99 mm in the pelvis, 2.01 ± 0.62 mm in the femur, and 1.85 ± 0.54 mm in the tibia/fibula. Linear scaling of an adult mesh produced RMSE of 4.79 ± 1.39 mm in the pelvis, 4.38 ± 0.72 mm in the femur, and 4.39 ± 0.86 mm in the tibia/fibula. We have developed a method for capturing and predicting lower limb bone shape variation in a paediatric population more accurately than linear scaling without using medical imaging.
Topics: Adult; Child; Femur; Humans; Lower Extremity; Pelvis; Radiography; Tibia; Tomography, X-Ray Computed
PubMed: 35228607
DOI: 10.1038/s41598-022-07267-4 -
Archives of Orthopaedic and Trauma... Apr 2024The hip-spine relationship is a critical consideration in total hip arthroplasty (THA) procedures. While THA is generally successful in patient, complications such as... (Review)
Review
The hip-spine relationship is a critical consideration in total hip arthroplasty (THA) procedures. While THA is generally successful in patient, complications such as instability and dislocation can arise. These issues are significantly influenced by the alignment of implant components and the overall balance of the spine and pelvis, known as spinopelvic balance. Patients with alteration of those parameters, in particular rigid spines, often due to fusion surgery, face a higher risk of THA complications, with an emphasis on complications in instability, impingement and dislocation. For these reasons, over the years, computer modelling and simulation techniques have been developed to support clinicians in the different steps of surgery. The aim of the current review is to present current knowledge on hip-spine relationship to serve as a common platform of discussion among clinicians and engineers. The offered overview aims to update the reader on the main critical aspects of the issue, from both a theoretical and practical perspective, and to be a valuable introductory tool for those approaching this problem for the first time.
Topics: Humans; Spine; Arthroplasty, Replacement, Hip; Joint Dislocations; Pelvis; Range of Motion, Articular; Retrospective Studies
PubMed: 38472450
DOI: 10.1007/s00402-024-05227-3