Johns Hopkins researchers have devised a computerised process that could make minimally invasive surgery more accurate and streamlined using equipment already common in the operating room.

In a report the researchers say initial testing of the algorithm shows that their image-based guidance system is potentially superior to conventional tracking systems that have been the mainstay of surgical navigation over the last decade.

‘Imaging in the operating room opens new possibilities for patient safety and high-precision surgical guidance,’ says Jeffrey Siewerdsen, Ph.D., a professor of biomedical engineering in the Johns Hopkins University School of Medicine. ‘In this work, we devised an imaging method that could overcome traditional barriers in precision and workflow. Rather than adding complicated tracking systems and special markers to the already busy surgical scene, we realised a method in which the imaging system is the tracker and the patient is the marker.’

Siewerdsen explains that current state-of-the-art surgical navigation involves an often cumbersome process in which someone

Conventional digital mammography is the most widely-used screening modality for breast cancer, but may yield suspicious findings that turn out not to be cancer, known as false-positives. Such findings are associated with a higher recall rate, or the rate at which women are called back for additional imaging or biopsy that may be deemed unnecessary.
Tomosynthesis, however, allows for 3-D reconstruction of the breast tissue, giving radiologists a clearer view of the overlapping slices of breast tissue.  And though a relatively new technology, it has shown promise at reducing recall rates in all groups of patients, including younger women and those with dense breast tissue.  This study, presented by Emily F. Conant, MD, chief of Breast Imaging the department of Radiology at the Perelman School of Medicine at the University of Pennsylvania, is one of the largest prospective trials in tomosynthesis to date.
For the study, the research team compared imaging results from 15,633 women who underwent tomosynthesis at HUP beginning in 2011 to those of 10,753 patients imaged with digital mammography the prior year. Six radiologists trained in tomosynthesis interpretation reviewed the images.
Researchers found that, compared to conventional mammography, the average recall rate using tomosynthesis decreased from 10.40 percent to 8.78 percent, and the cancer detection rate increased from 4.28 to 5.24 per 1,000 patients, a 22 percent increase.

The American Society for Gastrointestinal Endoscopy (ASGE) has issued

A new angiographic analysis of the CHAMPION PHOENIX trial examined the incidence and impact of stent thrombosis (ST) in patients undergoing percutaneous coronary intervention (PCI).

CHAMPION PHOENIX was a prospective, double-blind, active-controlled trial which randomised 11,145 patients to receive intravenous cangrelor or oral clopidogrel administered at the time of PCI. In a previous analysis presented at TCT 2013 and published in the Journal of the American College of Cardiology, cangrelor significantly reduced periprocedural and 30-day ischemic events in patients undergoing PCI.

In this new analysis, an independent core laboratory (CRF) blinded to the treatment performed the angiographic analysis of 10,939 of the randomised patients. Stent thrombosis was defined as the occurrence of either intraprocedural ST (IPST) or ARC defined ST (definite or probable). Adverse events were adjudicated by an independent clinical events committee.

ST occurred in 120 patients (1.1 percent) at 48 hours and in 175 patients (1.6 percent) at 30 days. The occurrence of ST at 48 hours and 30 days was associated with a marked increase in 30-day mortality (OR [95%CI] = 15.3 [8.6, 27.2], p<0.001; and 55.2 [36.6, 83.3] p<0.001, respectively). IPST, ARC acute ST (=24 hrs), and ARC subacute ST (1-30 days) occurred in 89 (0.8 percent), 32 (0.3 percent), and 60 (0.5 percent) patients respectively. Each type of ST was also associated with an increase in 30-day mortality (IPST: 17.4 [8.4, 36.1], p<0.001, ARC acute ST: 43.3 [18.1, 103.5], p<0.001, ARC sub-acute ST: 189.1, [107.9, 331.4], p<0.001). 'Regardless of the exact type of stent thrombosis, it remains associated with a high rate of death,' stated Deepak L. Bhatt, MD, MPH, Executive Director of Interventional Cardiovascular Programs at Brigham and Women

Pancreatic cancer is a particularly devastating disease. At least 94 percent of patients will die within five years, and in 2013 it was ranked as one of the top 10 deadliest cancers.
This prototype of a microfluidic device has both curved and straight channels for transporting tissue biopsies. The silicon material is lightweight, flexible and transparent.
Routine screenings for breast, colon and lung cancers have improved treatment and outcomes for patients with these diseases, largely because the cancer can be detected early. But because little is known about how pancreatic cancer behaves, patients often receive a diagnosis when it