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Biomedical subjects

Peter L Cooperberg

Publications and source records attributed to Peter L Cooperberg.

8 recordsLinked to original sources
PubMed2006

Computer-aided detection in screening CT for pulmonary nodules.

OBJECTIVE: Our objective was to evaluate the performance of a computer-aided detection (CAD) system for pulmonary nodule detection using low-dose screening CT images. MATERIALS AND METHODS: One hundred fifty consecutive low-dose screening CT examinations were independently evaluated by a radiologist and a CAD pulmonary nodule detection system (R2 Technology) designed to identify nodules larger than 4 mm in maximum long-axis diameter. All discrepancies between the two techniques were reviewed by one of another two radiologists working in consensus with the initial interpreting radiologist, and a "true" nodule count was determined. Detected nodules were classified by size, density, and location. The performance of the initial radiologist and the CAD system were compared. RESULTS: The radiologist detected 518 nodules and the CAD system, 934 nodules. Of the 1,106 separate nodules detected using the two techniques, 628 were classified as true nodules on consensus review. Of the true nodules present, the radiologist detected 518 (82%) of 628 nodules and the CAD, 456 (73%) of 628 nodules. All 518 radiologist-detected nodules were true nodules, and 456 (49%) of 934 of CAD-detected nodules were true nodules. The radiologist missed 110 true nodules that were only detected by CAD. In six patients, these were the only nodules detected in the examination, changing the imaging follow-up protocol. CAD identified 478 lesions that on consensus review were false-positive nodules, a rate of 3.19 (478/150) per patient. CONCLUSION: CAD detected 72.6% of true nodules and detected nodules in six (4%) patients not identified by radiologists, changing the imaging follow-up protocol of these subjects. In this study, the combined review of low-dose CT scans by both the radiologist and CAD was necessary to identify all nodules.

Diagnosis, Computer-Assisted↗
PubMed2006

Tolerance of local anesthetic for transrectal ultrasound-guided prostate biopsy: our experience and a literature review.

PURPOSE: To determine whether local anesthetic injection or gel reduced pain during transrectal ultrasound-guided prostate biopsies and whether there was significant difference between quadrant and apex-only anesthesia. METHODS: Between September 2001 and May 2002, 240 male patients with elevated prostate-specific antigen and (or) abnormal digital rectal examination were randomized into 1 of 4 groups: 1) transrectal lidocaine gel, 2) quadrant lidocaine injections, 3) apex-only lidocaine injections, or 4) no local anesthetic. Patients scored their pain on a numerical rating scale where 0 indicated no pain and 10 indicated worst pain. We analyzed mean and standard deviations of scores, using a 1-way analysis of variance (ANOVA) and post hoc multiple comparisons with Tukey's honestly significant difference (HSD) studentized range test to determine whether there were significant differences across the groups. RESULTS: There was no significant difference between local anesthetic gel (mean 3.1, SD 1.9) and no anesthetic (mean 3.5, SD 1.9) or between quadrant (mean 1.7, SD 1.7) and apex-only (mean 2.0, SD 1.8) local anesthetic injections. There was significant difference between quadrant injections (mean 1.7, SD 1.7) and no local anesthetic (mean 3.5, SD 1.9) and between apex-only injections (mean 2.0, SD 1.8) and no local anesthetic (mean 3.5, SD 1.9). CONCLUSION: There was significant pain reduction with local anesthetic injections but not with gel, and since there was no significant difference in efficacy between quadrant and apex-only injections, we recommend apex-only local anesthetic injections for transrectal ultrasound--guided prostate biopsies because it simplifies the injection procedure.

Administration, Topical↗
PubMed2004

High-resolution sonography of the triangular fibrocartilage: initial experience and correlation with MRI and arthroscopic findings.

OBJECTIVE: The aim of our study was to compare the findings of high-resolution sonography of the triangular fibrocartilage with those of MRI and arthroscopy. SUBJECTS AND METHODS. Thirteen patients with clinically suspected triangular fibrocartilage tears prospectively underwent sonography, followed by MRI, of their wrists. Triangular fibrocartilage tears were classified as predominantly ulnar or predominantly radial. Only the surgeon was aware of the results of both studies, and eight patients subsequently underwent arthroscopy. The findings of the different techniques were compared. RESULTS: For the presence or absence of a tear, seven (87.5%) of eight sonographic examinations correlated with arthroscopy, and 11 (84.6%) of 13 sonographic examinations correlated with MRI. Sonography missed one small radial tear that was detected at arthroscopy and MRI, but sonography showed an ulnar tear in triangular fibrocartilage that appeared normal on MRI. CONCLUSION: High-resolution sonography shows good correlation with MRI and arthroscopy for the evaluation of triangular fibrocartilage tears. Sonography has the potential to be a rapid and cost-effective means of diagnosing tears of the triangular fibrocartilage, particularly those involving the ulnar aspect of the cartilage.

Adolescent↗
PubMed2004

Limited-sequence magnetic resonance imaging in the evaluation of the ultrasonographically indeterminate pelvic mass.

OBJECTIVE: To evaluate the usefulness of limited-sequence magnetic resonance imaging (MRI) in the elucidation of ultrasonographically indeterminate pelvic masses. This study focused only on pelvic masses in which the origin of the mass (uterine v. extrauterine) could not be determined by ultrasonography (US). The origin of a pelvic mass has clinical implications. A mass arising from the uterus is most likely to be a leiomyoma, which is a benign lesion, whereas an extrauterine mass will have a higher likelihood of malignancy and usually requires surgery. METHODS: Eighty-one female patients whose pelvic mass was of indeterminate origin on US also underwent limited-sequence MRI of the pelvis. Most of the MRI examinations were performed on the same day as the US. Limited-sequence MRI sequences included a quick gradient-echo T1-weighted localizer and a fast spin-echo T2-weighted sequence. Final diagnoses were established by surgical pathology or by clinical and imaging follow-up. RESULTS: Limited-sequence MRI was helpful in 79 of the 81 cases (98%). Fifty-two of the 81 masses (64%) were leiomyomas. One was a leiomyosarcoma. The extrauterine masses (26/81 [32%]) were identified as 14 ovarian malignancies, 4 endometriomas, 3 dermoids, an ovarian fibroma, an infarcted fibrothecoma, an infarcted hemorrhagic cyst, a sigmoid diverticular abscess and a gastrointestinal stromal tumour of the ileum. In the other 2 cases (2/81 [2%]), the origin of the pelvic mass remained indeterminate. Both of these indeterminate masses showed low signal on T2-weighted images and were interpreted as probable leiomyomas. They were not surgically removed but were followed clinically and had a stable course. CONCLUSION: Limited-sequence MRI is a quick and efficient way to further evaluate ultrasonographically indeterminate pelvic masses. Limited-sequence MRI of the pelvis can suffice, in these cases, without requiring a full MRI examination.

Adult↗
PubMed2002

Early discharge after core liver biopsy: is it safe and cost-effective?

OBJECTIVE: To determine if ambulatory patients who have undergone image-guided core liver biopsy with an 18-gauge needle and spring-loaded biopsy gun can be safely discharged after 1 hour of observation in the radiology department. METHODS: Fifty-four consecutive patients underwent ultrasound-guided core liver biopsy for a variety of suspected diffuse liver diseases. Post-biopsy, they were asked to grade their pain on a scale of 1-10 after 1 hour of recumbency on a hospital gurney in the department. At 2 weeks, all patients were contacted and asked about their level of pain and when they returned to normal activities. RESULTS: Of the 54 patients enrolled, 4 were lost to follow-up. Pain was the most common minor complication, occurring in 31 (62%) of patients. The average level of pain after 1 hour was 2.1 (1 = no pain) and after 24 hours, 1.5. Seven patients were admitted to a medical daycare bed for a total of 4 hours and were then discharged. The remainder were discharged after 1 hour. Forty (80%) patients were pain-free after 24 hours, 36 (90%) of the 40 patients who were working returned to work the following day, and within a week, all patients had returned to all normal activities. No patients required an inpatient hospital stay or sought assistance at an emergency department. CONCLUSION: These preliminary results demonstrate that ultrasound-guided 18-gauge liver core biopsy is a safe procedure, and, provided larger series confirm these findings, patients showing no complications can be discharged from the department after 1 hour with notable cost savings.

Adult↗
PubMedDate not supplied

Sonographic examination of the carotid arteries.

Ultrasonography (US) of the carotid arteries is a common imaging study performed for diagnosis of carotid artery disease. In the United States, carotid US may be the only diagnostic imaging modality performed before carotid endarterectomy. Therefore, the information obtained with carotid US must be reliable and reproducible. Technical parameters that can affect the accuracy of carotid US results include the Doppler angle, sample volume box, color Doppler sampling window, color velocity scale, and color gain. Important factors in diagnosis of atherosclerotic disease of the extracranial carotid arteries are the intima-media thickness, plaque morphology, criteria for grading stenosis, limiting factors such as the presence of dissection or cardiac abnormalities, distinction between near occlusion and total occlusion, and the presence of a subclavian steal. Challenges to the consistency of carotid US results may include lack of a standard protocol, poor Doppler technique, inexperience in interpretation of hemodynamic changes reflected in the Doppler waveform, artifacts, and physical challenges. Hindrances in the classification of problematic carotid artery stenoses may be overcome by following a standard protocol and optimizing scanning techniques and Doppler settings.

Carotid Arteries↗