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Optimization and Dose Reduction in Hybrid Imaging: PET/CT and SPECT/CT
Published in Lawrence T. Dauer, Bae P. Chu, Pat B. Zanzonico, Dose, Benefit, and Risk in Medical Imaging, 2018
Adam M. Alessio, Frederic H. Fahey
On the other hand, small children and, in some cases, even adolescents can be among the most challenging patients to image. SPECT/CT and PET/CT studies typically take tens of minutes to complete, and, for the best results, the patient must lie still for the duration of the study. For smaller children, this may require sedation or, in some cases, the use of general anesthesia. Even in older children, some coaching is typically necessary to get the patient to lie still for 20–30 minutes. Therefore, technical improvements in hardware or image processing that have been applied to make SPECT/CT or PET/CT more efficient may lead to either lower administered activity or a faster scan time. A balance must be struck between dose optimization and minimizing patient motion or the need for sedation or anesthesia.
Microcomputed Tomography
Published in George C. Kagadis, Nancy L. Ford, Dimitrios N. Karnabatidis, George K. Loudos, Handbook of Small Animal Imaging, 2018
For in vivo rodent imaging, the animal should be immobilized to prevent escape of the animal and ensure that there are no gross movements during the scan. General anesthesia is used to sedate the rodent for the duration of the imaging session. Anesthesia can be administered either by injection or by inhalation. In vivo micro-CT systems can accommodate tubing to deliver a constant flow of gaseous anesthesia to the rodent during the scan setup and acquisition of the projection views. As the anesthesia agents have different effects on the animal, including alterations in respiratory and cardiac rates, decreased body temperature, and different duration of anesthetic effects, the agents and concentrations should be determined for each study independently.
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Published in Marilyn Sue Bogner, Human Error in Medicine, 2018
A brief overview of the world of anesthesia may put some of these issues into focus. Anesthesiology is the branch of medicine that deals with the processes of rendering patients insensible to pain during surgery (surgical anesthesia) or when faced with acute or chronic pain states (pain management). Critical care medicine is another specialty of anesthesiology. The anesthetized patient can be thought of as one who has been purposefully made critically ill. Such patients typically are dependent on mechanical ventilation and under the influence of powerful drugs. This chapter primarily deals with surgical anesthesia.
Treatment for lumbar spinal stenosis in elderly patients using percutaneous endoscopic lumbar discectomy combined with postoperative three-dimensional traction
Published in Expert Review of Medical Devices, 2019
Dexin Hu, Jun Fei, Genjun Chen, Yongjie Yu, Zhen Lai
The surgical approach was performed via the posterolateral intervertebral foramen. Before the operation, CT images were used to measure the distance from the skin to the intervertebral foramen. This was taken as the space between the quadratus lumborum and the musculus sacrospinalis, which was the depth limit of the first puncture. The patients were placed in a prone position to keep the abdomen vacant and to create sufficient expansion in the posterolateral intervertebral space. A C-shaped X-ray system was then used to locate the intervertebral space. A cross or oblique paralleled line was marked 11–12 cm away from the posterior midline with an 18 G puncture needle to ensure that the puncture position was accurate. Patients received local anesthesia via intravenous injection or inhalation. A spinal needle was then inserted and localization was adjusted using the lateral view (Figure 2). After removing the core needle, the guide wire was inserted. The endoscope was positioned through a working casing pipe that was inserted via a 0.7 cm skin incision centered on the guide wire. Next, the working casing pipe was moved into the canalis spinalis to find the ligamentum flavum, which was excised using a rongeur. The posterior longitudinal ligament was excised in patients who had unsatisfactory decompression or lumbar spinal stenosis combined with central lumbar disc herniation. Finally, intervertebral disc ablation, decompression, and intradiscal annuloplasty were performed.