Lyn Jones

Multidetector CT angiography in live donor renal transplantation: experience from 156 consecutive cases at a single centre

The performance of multidetector computed tomography (CT) angiography was assessed in the pre‐operative evaluation of live renal donors. Between July 1998 and March 2006, 156 consecutive patients underwent open donor nephrectomy following pre‐operative multidetector CT angiography (MDCTA). Operative notes were compared with radiological reports and discrepancies identified. MDCTA missed five of 28 accessory arteries (four visible with hindsight), accuracy of 96%. Of 30 early‐branching renal arteries, eight were missed (all visible with hindsight), accuracy 95%. MDCTA missed only one of 13 venous anomalies (accuracy 97%) and also missed the only duplicated collecting system: both were undetectable with hindsight. Following modifications to image acquisition and interpretation sensitivity, negative‐predictive value and accuracy were significantly increased. The results were compared with pooled data from published studies of live donor imaging. This study and previous studies of MDCTA had improved sensitivity for arterial and venous anomalies over single detector CT angiography and MR angiography. We conclude that multidetector CT angiography is an accurate modality in the pre‐operative evaluation of live renal donors. Regular communication between the transplant surgeon and the radiologist is paramount to improve reporting of surgically relevant anatomy. Mechanisms should exist for auditing and improving pre‐operative imaging in any live donor programme.

MARIA M4: clinical evaluation of a prototype ultrawideband radar scanner for breast cancer detection.

Abstract. A microwave imaging system has been developed as a clinical diagnostic tool operating in the 3- to 8-GHz region using multistatic data collection. A total of 86 patients recruited from a symptomatic breast care clinic were scanned with a prototype design. The resultant three-dimensional images have been compared “blind” with available ultrasound and mammogram images to determine the detection rate. Images show the location of the strongest signal, and this corresponded in both older and younger women, with sensitivity of >74%, which was found to be maintained in dense breasts. The pathway from clinical prototype to clinical evaluation is outlined.

Correlation of post-neoadjuvant chemotherapy response on MRI with final histology in breast cancer patients

We used MRI breasts to assess neoadjuvant chemotherapy response in line with departmental protocol. The aims were to see the correlation of findings on MRI with final histology in patients with breast cancer receiving neoadjuvant chemotherapy, and to assess the accuracy of our reporting and to evaluate the cause for any discordancy.

Can public consultation effectively optimise the design of a patient information leaflet about breast magnetic resonance imaging

Breast magnetic resonance imaging (MRI) involves multiple aspects that are unique to a medical environment and may seem frightening and strange to a person from a non-medical background (the tunnel, no credit cards, keys or watches, loud noises, intravenous pump injector). The purpose of an information leaflet is to inform people about what they should expect, and to prepare them for the experience. During public consultation about breast MRI, we discovered that women considered the current information provided by the NHS (from several different hospitals) to be inadequate. They told us that their experience of the process of breast MRI had been more distressing that it would have been had they been better informed. We decided to ask their advice on the design of an information leaflet to see if it could be optimised to better prepare women for the experience.

Using out-of-programme training to establish interventional radiology training for current and future surgeons

Results: The 30-day mortality was 2·6% in AAD and 7·5% in CAD. The 30-day stroke and paraplegia rates were 5·3% and 0% in AAD and zero in patients with CAD. At 30 months, the cumulative re-intervention rate was 62% and 55% in AAD and CAD, respectively. In AAD, at 12 months, the false lumen thrombosis rate was 85% at the stent and 60% below it. In CAD, thrombosis rates were 68% above the stent and 33% below it. Conclusion: Aortic remodelling is greater in AAD. In AAD and in the segment, for both dissection types, false lumen thrombosis rates are higher. In AAD and CAD there is a significant re-intervention rate. The length of aorta covered with the stent should be greater, particularly in CAD.