Journal of Vascular and Interventional Radiology, 2015
The informed consent conversation is a key component of patient-centered medicine, a concept that... more The informed consent conversation is a key component of patient-centered medicine, a concept that emphasizes the importance of patients actively participating in their care. Studies reveal that many informed consent conversations throughout medical practice lack essential elements and leave patients' needs unmet. This review addresses these deficiencies, discusses solutions, and introduces a standardized checklist that values the patient's role in shared decision making during the informed consent conversation. The checklist could be particularly helpful to interventional radiologists and other consulting physicians who usually obtain informed consent early in their encounters with patients.
Journal of the American College of Radiology : JACR, 2017
Breast cancer is the most common malignancy in women in the United States. Breast reconstruction ... more Breast cancer is the most common malignancy in women in the United States. Breast reconstruction surgery is a commonly used therapy for patients with breast cancer. The technique for the deep inferior epigastric perforator flap uses a preserved rectus muscle, which decreases donor site morbidity. Accurate identification and measurement of the perforator branches of the deep inferior epigastric artery is pivotal during pre-operative planning so that the surgeon can prioritize the best vessel to use and ultimately improve clinical outcome. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Developme...
Background: 3D printing (3DP) has enabled medical professionals to create patient-specific medica... more Background: 3D printing (3DP) has enabled medical professionals to create patient-specific medical devices to assist in surgical planning. Anatomical models can be generated from patient scans using a wide array of software, but there are limited studies on the geometric variance that is introduced during the digital conversion of images to models. The final accuracy of the 3D printed model is a function of manufacturing hardware quality control and the variability introduced during the multiple digital steps that convert patient scans to a printable format. This study provides a brief summary of common algorithms used for segmentation and their principal features. We also identify critical parameters and steps in the workflow where geometric variation may be introduced. We then provide suggested methods to measure or reduce the variation and mitigate these risks.Methods: Using a clinical head CT scan of a mandible containing a tumor, we performed segmentations in four separate prog...
Muti-row-detector CT (MDCT) is the primary modality for evaluation of both congenital and acquire... more Muti-row-detector CT (MDCT) is the primary modality for evaluation of both congenital and acquired chest wall disorders. Imaging data from MDCT examinations provide anatomical detail and delineate relationships between adjacent structures. Three-dimensional reconstructions from the raw data can be used to enhance visualization of complex three-dimensional (3D) anatomy and for volumetric quantification to aid in surgical planning. This chapter illustrates the technical and practical considerations of utilizing MDCT in the evaluation of chest wall lesions, tumors, infections, and trauma and highlights MDCT advances in surgical planning, including 4D imaging and three-dimensional modeling and printing.
Frontiers in Bioengineering and Biotechnology, 2022
Critical-sized defects of irregular bones requiring bone grafting, such as in craniofacial recons... more Critical-sized defects of irregular bones requiring bone grafting, such as in craniofacial reconstruction, are particularly challenging to repair. With bone-grafting procedures growing in number annually, there is a reciprocal growing interest in bone graft substitutes to meet the demand. Autogenous osteo(myo)cutaneous grafts harvested from a secondary surgical site are the gold standard for reconstruction but are associated with donor-site morbidity and are in limited supply. We developed a bone graft strategy for irregular bone-involved reconstruction that is customizable to defect geometry and patient anatomy, is free of synthetic materials, is cellularized, and has an outer pre-vascularized tissue layer to enhance engraftment and promote osteogenesis. The graft, comprised of bioprinted human-derived demineralized bone matrix blended with native matrix proteins containing human mesenchymal stromal cells and encased in a simple tissue shell containing isolated, human adipose micro...
Journal of Vascular and Interventional Radiology, 2015
The informed consent conversation is a key component of patient-centered medicine, a concept that... more The informed consent conversation is a key component of patient-centered medicine, a concept that emphasizes the importance of patients actively participating in their care. Studies reveal that many informed consent conversations throughout medical practice lack essential elements and leave patients' needs unmet. This review addresses these deficiencies, discusses solutions, and introduces a standardized checklist that values the patient's role in shared decision making during the informed consent conversation. The checklist could be particularly helpful to interventional radiologists and other consulting physicians who usually obtain informed consent early in their encounters with patients.
Journal of the American College of Radiology : JACR, 2017
Breast cancer is the most common malignancy in women in the United States. Breast reconstruction ... more Breast cancer is the most common malignancy in women in the United States. Breast reconstruction surgery is a commonly used therapy for patients with breast cancer. The technique for the deep inferior epigastric perforator flap uses a preserved rectus muscle, which decreases donor site morbidity. Accurate identification and measurement of the perforator branches of the deep inferior epigastric artery is pivotal during pre-operative planning so that the surgeon can prioritize the best vessel to use and ultimately improve clinical outcome. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Developme...
Background: 3D printing (3DP) has enabled medical professionals to create patient-specific medica... more Background: 3D printing (3DP) has enabled medical professionals to create patient-specific medical devices to assist in surgical planning. Anatomical models can be generated from patient scans using a wide array of software, but there are limited studies on the geometric variance that is introduced during the digital conversion of images to models. The final accuracy of the 3D printed model is a function of manufacturing hardware quality control and the variability introduced during the multiple digital steps that convert patient scans to a printable format. This study provides a brief summary of common algorithms used for segmentation and their principal features. We also identify critical parameters and steps in the workflow where geometric variation may be introduced. We then provide suggested methods to measure or reduce the variation and mitigate these risks.Methods: Using a clinical head CT scan of a mandible containing a tumor, we performed segmentations in four separate prog...
Muti-row-detector CT (MDCT) is the primary modality for evaluation of both congenital and acquire... more Muti-row-detector CT (MDCT) is the primary modality for evaluation of both congenital and acquired chest wall disorders. Imaging data from MDCT examinations provide anatomical detail and delineate relationships between adjacent structures. Three-dimensional reconstructions from the raw data can be used to enhance visualization of complex three-dimensional (3D) anatomy and for volumetric quantification to aid in surgical planning. This chapter illustrates the technical and practical considerations of utilizing MDCT in the evaluation of chest wall lesions, tumors, infections, and trauma and highlights MDCT advances in surgical planning, including 4D imaging and three-dimensional modeling and printing.
Frontiers in Bioengineering and Biotechnology, 2022
Critical-sized defects of irregular bones requiring bone grafting, such as in craniofacial recons... more Critical-sized defects of irregular bones requiring bone grafting, such as in craniofacial reconstruction, are particularly challenging to repair. With bone-grafting procedures growing in number annually, there is a reciprocal growing interest in bone graft substitutes to meet the demand. Autogenous osteo(myo)cutaneous grafts harvested from a secondary surgical site are the gold standard for reconstruction but are associated with donor-site morbidity and are in limited supply. We developed a bone graft strategy for irregular bone-involved reconstruction that is customizable to defect geometry and patient anatomy, is free of synthetic materials, is cellularized, and has an outer pre-vascularized tissue layer to enhance engraftment and promote osteogenesis. The graft, comprised of bioprinted human-derived demineralized bone matrix blended with native matrix proteins containing human mesenchymal stromal cells and encased in a simple tissue shell containing isolated, human adipose micro...
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Papers by Beth Ripley