Use this URL to cite or link to this record in EThOS: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.703120
Title: Validation of three-dimensional ultrasound in the imaging of the renal pelvi-calyceal system and investigation of the use of four- dimensional ultrasound in renal percutaneous intervention
Author: John, Babbin S.
ISNI:       0000 0004 6060 3786
Awarding Body: St George's, University of London
Current Institution: St George's, University of London
Date of Award: 2016
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Abstract:
Standard two-dimensional (20) ultrasound is widely utilised in diagnosis and intervention in urinary tract stone disease. 20 ultrasound as an interventional tool is limited to the well dilated renal pelvi-calyceal system. Three-dimensional (3~) and real-time (four-dimensional, 40) ultrasound has had minimal utility so far in the imaging of the renal pelvi-calyceal system and percutaneous intervention. The use of ultrasound technology also needs to be expanded to minimise radiation exposure to patients. The aim of this thesis is to explore the radiation exposure to patients in a stone episode and the application of three-dimensional ultrasound in the imaging of the renal pelvi-calyceal system (PCS). It also looks at the utility of 40 ultrasound for access in to less-dilated pelvi-calyceal systems, with the help of a dedicated model. Cumulative radiation exposure to patients undergoing stone investigation and treatment was assessed. We utilised an anthropomorphic renal model to perform measurements of the renal PCS using 20 and 3D ultrasound in order to validate 3D ultrasound use in the complex anatomy of the kidney. 40 ultrasound was investigated as a guidance tool in renal percutaneous intervention by building a dedicated interventional model and assessing accuracy of 40 ultrasound guided punctures with the help of fluoroscopy. Patients undergoing urinary tract stone diagnosis and treatment were exposed an average of 5.3 miliiSieverts (mSv) of radiation but could be as high 14.4 mSv. 30 ultrasound was found to be more accurate in assessing the renal PCS compared to 20 ultrasound. 40 ultrasound punctures were accurate and helped better placement of guidewires but overall accuracy was equivalent to 20 and some limitations were also seen. Radiation exposure to stone patients is a significant problem and imaging modalities like ultrasound need to be utilised more. 30 ultrasound proved accurate in the assessment of the complex anatomy of the PCS and showed promise as a guidance tool in intervention. However, some limitations were seen and technology advancements are awaited.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.703120  DOI: Not available
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