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Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
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Continuing Medical Education (State CME)
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Noon Conference (Free)
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Case of the Week (Free)
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Case Crunch: Rapid Case Review (Free)
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Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
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Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
3 topics, 5 min.
2 topics, 4 min.
4 topics, 8 min.
5 topics, 22 min.
7 topics, 33 min.
0:00
So let's review.
0:02
Some procedural and Perry procedural considerations in image guided
0:05
biopsies of intra-abdominal lesions.
0:08
So it's very important for us to understand the indications as
0:11
well as the contraindications of any thing. We
0:14
do particularly biopsies.
0:16
So let's discuss indications.
0:18
So when it comes to introdominal biopsies, it's important
0:21
to know one of the reasons why we could perform
0:24
this procedure is to differentiate a suspected
0:27
primary tumor from a probable peritoneal spread
0:30
in the case of peritoneal carcinomatosis. We
0:33
want to understand whether or not the primary
0:36
tumor is actually migrated and has
0:39
become stage 4 disease.
0:41
Secondly if there's a societies that's of
0:44
a known origin in the setting of a specialist lesion because that
0:47
and of itself would also suggest that the patient has now stage
0:50
4 disease if there's a primary cancer and
0:53
we're uncertain what the staging
0:56
of this particular cancer is a biopsy would be
0:59
appropriate in the setting as well.
1:01
If there's concomitant malignancy.
1:03
This is in settings where a diagnosis may actually
1:06
alter the treatment regimen, of course, there's surgery which
1:09
is very different than surgery and chemotherapy which
1:12
is very different than chemotherapy by itself. And so
1:15
being able to understand exactly what we're doing and
1:18
what we're offering to the patient data-driven management is
1:21
really what we want to use these biopsies
1:24
for when it comes to infiltrative lesions and potential
1:27
initiation that has a history of TB or
1:30
sorekaidosis.
1:32
This is also another indication for this sort of
1:35
tissue sampling.
1:37
So when it comes to interabdominal biopsychondrainications, of
1:40
course we are well aware that if we're biopsying
1:43
a patient we want to be mindful of the hematologic parameters.
1:46
Is there a risk for bleeding INR is
1:49
greater than 1.5 or two PT is
1:52
greater than 15 seconds of normal ptts
1:55
greater than 40 seconds platelets count
1:58
less than 50,000 would be
2:01
things that would sort of give us pause before we move forward
2:04
with performing a biopsy.
2:07
And in some certain situations these parameters could
2:10
be corrected. And so we're going to be mindful of them as we
2:13
proceed.
Interactive Transcript
0:00
So let's review.
0:02
Some procedural and Perry procedural considerations in image guided
0:05
biopsies of intra-abdominal lesions.
0:08
So it's very important for us to understand the indications as
0:11
well as the contraindications of any thing. We
0:14
do particularly biopsies.
0:16
So let's discuss indications.
0:18
So when it comes to introdominal biopsies, it's important
0:21
to know one of the reasons why we could perform
0:24
this procedure is to differentiate a suspected
0:27
primary tumor from a probable peritoneal spread
0:30
in the case of peritoneal carcinomatosis. We
0:33
want to understand whether or not the primary
0:36
tumor is actually migrated and has
0:39
become stage 4 disease.
0:41
Secondly if there's a societies that's of
0:44
a known origin in the setting of a specialist lesion because that
0:47
and of itself would also suggest that the patient has now stage
0:50
4 disease if there's a primary cancer and
0:53
we're uncertain what the staging
0:56
of this particular cancer is a biopsy would be
0:59
appropriate in the setting as well.
1:01
If there's concomitant malignancy.
1:03
This is in settings where a diagnosis may actually
1:06
alter the treatment regimen, of course, there's surgery which
1:09
is very different than surgery and chemotherapy which
1:12
is very different than chemotherapy by itself. And so
1:15
being able to understand exactly what we're doing and
1:18
what we're offering to the patient data-driven management is
1:21
really what we want to use these biopsies
1:24
for when it comes to infiltrative lesions and potential
1:27
initiation that has a history of TB or
1:30
sorekaidosis.
1:32
This is also another indication for this sort of
1:35
tissue sampling.
1:37
So when it comes to interabdominal biopsychondrainications, of
1:40
course we are well aware that if we're biopsying
1:43
a patient we want to be mindful of the hematologic parameters.
1:46
Is there a risk for bleeding INR is
1:49
greater than 1.5 or two PT is
1:52
greater than 15 seconds of normal ptts
1:55
greater than 40 seconds platelets count
1:58
less than 50,000 would be
2:01
things that would sort of give us pause before we move forward
2:04
with performing a biopsy.
2:07
And in some certain situations these parameters could
2:10
be corrected. And so we're going to be mindful of them as we
2:13
proceed.
Report
Faculty
Mikhail CSS Higgins, MD, MPH
Director, Radiology Medical Student Clerkships; Director, ESIR
Boston University Medical Center
Tags
Ultrasound
Retroperitoneum
Peritoneum/Mesentery
Oncologic Imaging
Interventional
Genitourinary (GU)
Gastrointestinal (GI)
CT
Body
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