PVS DEPARTMENT OF DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY
- Multidetector Computerised Tomography -128 Slice
- Digital Substraction Angiography –DSA
- Digital Radiography
- Computer Radiography
- Ultrasonography with dedicated Color Doppler
- Portable X-ray
- 500 slice 4d dynamic CT scanning with volume helical shuttle
- Non-invasive CT coronary artery imaging with ultra low dose
- Paediatric coronary angiogram
- Triple rule out studies :- (coronary ,pulmonary and aortic angiogram)
- Ct angiography in neuro applications
- Perfusion ct in stroke and tumour
- CT Peripheral Angiography at Ultra Low Doses
- CT Colonoscopy
- CT Enterography
- CT Urography
- CT Renal Angiogram
- CT Radio Frequency Abalation (CT RFA)
- Various Therapeutic And Diagnostic Procedures:- (FNAC, Biopsy including Vertebral Biopsies Etc.)
Digital substraction Angiography – PHILIPS ALLURA CLARITY FD 10 C (1250mA)
- Bronchial artery embolisation
- Uterine artery embolisation
- Gastrointestinal tract bleed embolisation
- Urinary system bleed embolisation
- Peripheral aneurysm / vascular malformation embolisation
- Angioplasty and stenting of peripheral steno-occlusive lesions
- Endovascular thorasic and abdominal aortic aneurysm stenting
- Trans arterial chemoembolisation (TACE) including latest TACE with drug eluting beads
- Single / multi system percutaneousbiliarystenting
- Transjugularintrahepaticportosystemic shunt (TIPSS)
- Balloon retrograde transvenous obliteration (BRTO)
- Coil assisted retrograde transvenous obliteration (CARTO)
- Plug assisted retrograde transvenous obliteration (PARTO)
- Varicose vein ablation including recurrences and failures (EVLT / RFA)
- Transjugular liver / renal biopsy
- IVC filter placement / removal
- IVC / deep venous system venoplasty / stent
- Angioplasty of dialysis fistula
- Deep venous thrombosis (DVT) mechanical thrombectomy / thrombolysis
- Other peripheral interventions
Fluroscopy - SIEMENS AXIOM LUMINOUS DRF (1000 mA)
- Percutaneous Transhepatic Biliary Drainage (PTBD)
- Barium Studies:- Barium Swallow, Barium Meal, Barium Enema etc.
- Micturating Cystourethrogram (MCU)
- Hyterosalpangiogram (HSG)
GE Voluson E6 ultrasound including 3D / 4D
- Routine abdominal and pelvic ultrasound
- Small parts (Thyroid, neck etc) ultrasound
- Obstetric imaging including anomaly Scan (3D,4D Scan) Dedicated Doppler examination Elastography Ultrasound guided interventions (Including FNAC, Biopsy, Drainage, RFA , Percutaneous ethanol injection)
Digital Radiography- Wipro GE Brivo Drf (630mA)
- Routine X-Rays
- Special procedures
Siemens Sieromobil Compact L (20 mA)
Allengers AllScan up HP (40 mA)
PORTABLE X-RAY UNIT
Wipro GE Stallion 60 (60mA)
Siemens Multimobil 2.5 (60mA)
128 Slice Cardiac CT Scanner –WIPRO GE OPTIMA CT 660 SE
Salient Features Of Machine
- 128 Slice CT for both axial and helical mode.
- It gives 128 slice per rotation without any incremental dose and without any noise compromise.
- Employed ASIR (Adaptive Statistical Iterative Reconstruction) technology to reduce dose reduction up to 70%. It improves the low contrast detectability by 25%.
- Enables higher power for tube when in need.
- No cooling period between patients .
- Reduced artifacts from dense objects such as Metal implants, Dense calcifications, Orthopedic implants, Aneurysm clips, Stents, High contrast ,Barium densities etc.
- Reduced patient dose and less breath hold with fast and large coverage (whole body coverage less than 15 seconds). Coronary Angiogram within 5 heart beats (5 Beat cardiac CT) .
Radiofrequency Ablation (RFA)
PVS memorial hospital being an apex tertiary care centre for Gastroenterology makes us deal with cirrhosis and its complications on a regular basis. Hepatocellular carcinoma is the most common cancer in cirrhotic patients. In patients who are detected to have early stage hepatocellular carcinoma and who are not candidates for surgical resection RFA offers a chance for complete cure. In last 15 months close to 50 patients have undergone RFA in our institute. Complete tumour ablation was achieved in vast majority of the patients with all the patients discharged on the second day of procedure. No major complications reported till date.
What is Radiofrequency Ablation?
Using ultrasound, or computed tomography (usually both) , the radiologist places a slender probe with multiple deployable electrodes directly into the tumor. This ensures that treatment will focus on the diseased area. Then Using a radiofrequency generator, the doctor allows a carefully-controlled amount of energy to flow through the electrodes into the tissue. This causes the tissue to heat up. Heating is sustained for a predetermined length of time, usually just a few minutes. Temperature is constantly measured by tiny thermometers at the tips of the electrodes. This heat kills and destroys the tumor and the destroyed tissue is absorbed into normal body wastes.
How effective is it?
According to various studies RFA is the method of choice for curative treatment of HCC’s which are not operable. Recent studies have pointed out that RFA may be as effective as surgical resection even in resectable patients. The success rate of the procedure is high as 95-99% according to most studies.
How many days admission required?
We typically admit our patients one day prior to or on the day of procedure and discharge them on the second post procedure day if the patient shows no signs of bleeding.
How soon can one return to normal life after the procedure?
There is no restriction on daily activities though we advice our patients to not to indulge in rigorous activities for around 2 weeks post procedure. The patient can return to all activities after 1 month duration including athletic activities.
Who are the candidates for RFA ?
Less than 10%–30% of patients with primary or secondary hepatic malignancies are candidates for surgical resection because of the number of tumors, location of tumors that preclude a margin-negative resection, or because of coexistent chronic liver dysfunction producing an unacceptable risk of liver failure after resection. Most common use of RFA in liver worldwide is for HCC’s, however its efficacy is proven in treatment of hepatic metastases (liver spread from other cancers) especially colorectal cancer.
How safe is it?
RFA has worldwide proven to be a very safe procedure with early complications (within 30 days of procedure ) reported in the range of 5-7% and late complications (>30 days) reported in the range of 2-5%. Complications include thermal burn of adjacent organs like stomach, gall bladder , diaphragm or colon, bleeding from puncture site, infection, bile leakage through tract and very rarely skin burn, heart rhythm abnormalities and death. In our experience we have not encountered any major complications till date. 2 of our patients have complained of mild abdominal wall pain near puncture site which was relieved with medications.
How many sessions required?
RFA works through heat mechanism . Majority of the HCC’s in easily accessible areas require only single session. Some patients (eq: HCC in difficult locations, multiple lesions) require multiple sessions (usually 2) .
Post procedure how often monitoring required?
Post procedure a contrast CT is done at 4 wks to look for any residual lesion. If residual lesion is seen RFA is done after admission on next day. In case of complete ablation ultrasound surveillance is done monthly with a contrast CT at 6 months.