Tenet Healthcare’s Post

A published review authored by our #MedicalStudent, Julia Telischi, delves into the simultaneous performance of two distinct surgical procedures frequently undertaken for #cancer patients encountering #CarotidStenosis. Learn more about this proposed and innovative #ENT procedure.

This study assessed using shear wave elastography to measure lesion-to-fat ratio in BI-RADS 3 or 4 breast lesions. Data from 1288 women were analysed. Conventional B-mode ultrasound had false positives and undetected malignancies. Incorporating lesion-to-fat ratio in BI-RADS 4a lesions with a cutoff of 1.85 reduced benign biopsies by 44.04%. However, 1.98% of malignancies were missed, aligning with American College of Radiology BI-RADS 3 definition (<2% undetected malignancies). This addition enhances breast cancer diagnostics by refining assessments and reducing unnecessary biopsies. #SupportingSonographers https://loom.ly/sVfmqkg

Ultrasonographic Assessment of Depth Infiltration in Melanoma and Non-melanoma Skin Cancer: Ultrasound's role in presurgical settings is growing, assessing skin tumour parameters like size and extension accurately. This aids in identifying patients needing non-standard treatments and optimising therapy for melanoma patients, preventing unnecessary surgeries and delays. Ultrasound reduces the need for expensive imaging like MRI or CT and unnecessary operations. It requires no patient preparation and provides clinicians with preoperative insights for optimal treatment planning and patient counselling. #SupportingSonographers https://loom.ly/o8d9VOU

In the evolving realm of medical diagnostics, the synergy of radiology and pathology has been pivotal for breast cancer detection and management. Dive into our latest article to explore how mobile X-ray cabinets are revolutionizing this space, ushering in quicker, more efficient diagnostic procedures and reshaping the future of breast cancer care. #BreastCancerDiagnostics, #SpecimenRadiography, #PathologyAdvancements, #betterpatientoutcomes, #ARESScientific

https://lnkd.in/e6Vbz82g Here is the first paper derived from the NTCP models of my medical physics specialization thesis on the side effects of tangential RT treatments in breast cancer. Analyzing over a thousand patients with 48 months of follow-up, we focused on the dose to the first 5 mm of the skin as a potential structure responsible for these late events. Results highlight the impact of volume in cc at 20 Gy (50% of the prescription dose) and 42 Gy (105%) for patients tested without RT boost. However, for those experiencing cosmetic deterioration post-surgery, radiation therapy's impact can be challenging and may lead to a high risk of late symptoms (no surgery effects found in the acute phase). Currently working on the paper exploring acute skin reaction models, validated on a population treated with tomo, vmat, and partial arc techniques. #MedicalPhysics #BreastCancerResearch #RadiotherapyEffects #pain #fibrosis #radonc #greenjournal

A Complete Guide to 𝐁𝐫𝐞𝐚𝐬𝐭 𝐁𝐢𝐨𝐩𝐬𝐲 𝐃𝐞𝐯𝐢𝐜𝐞𝐬 - [PDF Guide] 📚 𝗗𝗼𝘄𝗻𝗹𝗼𝗮𝗱 𝘁𝗵𝗶𝘀 𝗣𝗗𝗙 𝗮𝘁 https://lnkd.in/dJTeWY-8 Breast biopsy devices are #medical instruments used to collect tissue samples from the breast for further examination, typically to diagnose or rule out breast cancer. #Biopsies are crucial for determining the nature of abnormalities found in breast imaging studies, such as mammograms or ultrasound scans. Different types of breast biopsy devices are available, each with its own advantages and applications. Some common breast biopsy techniques include: ➡ 𝐅𝐢𝐧𝐞 𝐍𝐞𝐞𝐝𝐥𝐞 𝐀𝐬𝐩𝐢𝐫𝐚𝐭𝐢𝐨𝐧 (𝐅𝐍𝐀): This technique uses a thin, hollow needle to withdraw a small sample of tissue or fluid from a suspicious area in the breast. FNA is often used for cystic lesions or to sample cells from a palpable mass. ➡ 𝐂𝐨𝐫𝐞 𝐍𝐞𝐞𝐝𝐥𝐞 𝐁𝐢𝐨𝐩𝐬𝐲 (𝐂𝐍𝐁): Core needle biopsy uses a larger, spring-loaded needle to remove a small, cylindrical core of tissue from the breast. This method is more effective than FNA for sampling solid masses and provides a larger tissue sample for analysis. ➡ 𝐕𝐚𝐜𝐮𝐮𝐦-𝐀𝐬𝐬𝐢𝐬𝐭𝐞𝐝 𝐁𝐢𝐨𝐩𝐬𝐲 (𝐕𝐀𝐁): VAB uses a vacuum-powered device to collect multiple tissue samples with a single insertion of the needle. This method allows for sampling larger areas and is often used for non-palpable lesions identified through imaging. ➡ 𝐒𝐭𝐞𝐫𝐞𝐨𝐭𝐚𝐜𝐭𝐢𝐜 𝐁𝐢𝐨𝐩𝐬𝐲: This technique involves using mammographic guidance to precisely locate the abnormality in three-dimensional space. Stereotactic biopsy is typically employed for non-palpable lesions that are visible on mammograms but not easily felt. ➡ 𝐔𝐥𝐭𝐫𝐚𝐬𝐨𝐮𝐧𝐝-𝐆𝐮𝐢𝐝𝐞𝐝 𝐁𝐢𝐨𝐩𝐬𝐲: In this procedure, ultrasound imaging is used to guide the biopsy needle to the targeted area. It is particularly useful for lesions that are visible on ultrasound but not clearly seen on mammograms. ➡ 𝐌𝐚𝐠𝐧𝐞𝐭𝐢𝐜 𝐑𝐞𝐬𝐨𝐧𝐚𝐧𝐜𝐞 𝐈𝐦𝐚𝐠𝐢𝐧𝐠 (𝐌𝐑𝐈)-𝐆𝐮𝐢𝐝𝐞𝐝 𝐁𝐢𝐨𝐩𝐬𝐲: For lesions identified through breast MRI, this technique uses MRI guidance to precisely target and sample suspicious areas.

ESMO TRACERx update: Dr. James Black shows how NeXT Personal, an ultra-sensitive and specific ctDNA assay, provides novel pre-operative disease stratification in early stage lung cancer: • Superior performance at pre-surgical baseline for lung adenocarcinoma and non-adenocarcinoma • Baseline ctDNA detection sensitivity increased by factor of 4x for ctDNA positive lung adenocarcinoma versus assays used previously by TRACERx • Pre-surgical ctDNA status is highly predictive of 5-year OS and RFS, a novel use case unique to NeXT Personal • Landmark ctDNA predicts clinical outcomes and identifies patients that recur with 331 days median lead time • Longitudinal monitoring strongly predictive of clinical outcomes with high PPV (94%) and NPV (89%) Discussant, Dr. Federica do Nicolantonio, shows potential applications of the ultra-sensitive NeXT Personal assay in clinical trials in non-metastatic NSCLC: • Neoadjuvant therapy even in cN0-1 when ctDNA high (threshold TBD) • De-escalation of adjuvant therapy when ctDNA is negative after surgery • Upfront surgery without neoadjuvant therapy even if cN2 when ctDNA is low • Treatment intensification if MRD is detected after surgery/adjuvant therapy NeXT Personal ultra-sensitivity is clinically meaningful. Please PM me immediately if you would like to discuss at ESMO this weekend, or to meet with me directly after the conference. #ctdna #lungcancer #adenocarcinoma #NSCLC #ultrasensitive #WGS #NGS #liquidbiopsy #MRD #TRACERx #Personalis #NeXTPersonal

If you follow #surgicalrobotics then I highly recommend this as a must read. It’s a great paper for many reasons - but as an industry expert it starts to line up feasibility and insights into the various systems on the market. Of course it is not an RCT of all the systems at once / but a great review paper. It nicely starts to show comparator sentiment between systems and starts to hint at similarities and key differences when used for the same clinical application. It starts to unfold “marketing claims” as real world experience. It’s a very good overview of one of the great applications of surgical robotics / advanced assisted laparoscopy in CME. Ideal for where #robotivsurgery brings benefits. Well done to the entire team Guglielmo Niccolò Piozzi #roboticsurgery #cme Intuitive Medicaroid MicroPort CMR Surgical Medtronic Robotic-Assisted Surgery LivsMed Asensus Surgical Johnson & Johnson MedTech #colorectal #surgery

We are delighted to share our latest systematic review publication involving 1300+ targeted axillary dissection procedures. We conclude: All four wire-free and tattoo-free localisation technologies are deemed safe and reliable for facilitating TAD in initially node-positive patients who respond well to NST. The sole utilisation of SLNB seems notably less effective than TAD in accurately staging the axilla post-NST. TAD’s precise identification of axillary pCR enables the de-escalation of axillary surgery and regional nodal irradiation in nearly half of all breast cancer patients with low-burden axillary disease. Currently, the radiation-free Savi Scout stands out as the preferred wire-free technology for TAD, offering minimal magnetic resonance imaging artefacts, single-step localisation, and superior depth of detection. #breastcancer #axilla #TAD #scout #Magseed #LOCalizer

ECG PICC tip location and PLSVC - Full Text... "Herein, we detailed a case involving a breast cancer patient whose PLSVC was identified during the placement of PICC because of the negative P-wave in electrocardiogram (ECG)" Pan et al (2024).