Imaging and Technology in Urology

✍ Scribed by Sotonye Tolofari (editor), Dora Moon (editor), Benjamin Starmer (editor), Steve Payne (editor)

• Publisher: Springer
• Tongue: English
• Leaves: 475
• Category: Library

✦ Synopsis

This book offers a new edition of the hugely successful title, Imaging & Technology in Urology--Principles and Clinical Applications edited by Steve Payne, Ian Eardley, Kieran O'Flynn in 2012. Essential reading for preparation of exit exams in Urology, it is used worldwide by exam candidates. Fully updated in essential areas of the book following on from recent developments in the last decade, it helps give preparation to candidates.  

The most comprehensive and reliable source of information on this particular topic.

✦ Table of Contents

Contents
List of Contributors
Part I: Imaging Radiology
Chapter 1: Principles of X-ray Production and Radiation Protection
Principles of X-Ray Production
Bremsstrahlung or Breaking Radiation
Characteristic Radiation
X-ray Tube
X-ray Detection
Radiation Protection
Deterministic Effects
Stochastic Effects
Ionising Radiations Regulations 2017
Ionising Radiation (Medical Exposure) Regulations 2017
Further Reading
Chapter 2: How to Perform a Clinical Radiograph and Use a C-arm
How to Perform a Clinical Radiograph
How to Use a C-arm
Further Reading
Chapter 3: Contrast Agents
Iodinated Agents
Contraindications
Gadolinium Based Contrast Agents (GBCAs)
Micro-bubble Particles
Further Reading
Chapter 4: Dual Energy X-Ray Absorptiometry (DXA)
How Does It Work?
Patient Preparation for and DXA Scanning
How Are the Results Expressed?
Z- and T-Scores—What Is the Difference and Why Use Them?
Why Diagnose Osteoporosis in Someone with No Fractures?
What Else Can a DXA Scanner Do?
Further Reading
Chapter 5: The Physics of Ultrasound and Doppler
Production and Propagation of the Sound Wave
Transducer Selection
Transducer Design
Frame Rate
Gain
Focus
Doppler Ultrasound
Colour Flow Doppler
Range Gated Doppler
Power Doppler
Elastography
Further Reading
Chapter 6: How to Ultrasound a Suspected Renal Mass
Patient Preparation
Image Optimisation
Scan Technique and Pathology
Pseudotumours (Benign Variant Anatomy)
Stones (Nephrolithiasis)
Cysts
Solid masses
Further Reading
Chapter 7: How to Ultrasound a Painful Testicle and Mass
Patient Preparation
Image Optimisation
Technique
The Painful Testicle
Infection (epididymo-orchitis)
Ischaemia
Trauma
The Testicular Mass
Further Reading
Chapter 8: How to Do a Trans-Perineal Ultrasound Guided Biopsy of the Prostate
Introduction
Indications for Trans-perineal Biopsy of the Prostate
Principles of Ultrasound and Probe Selection
Planes of Scanning
Patient Information
Antibiotics
Positioning and Patient Preparation
Taking a Biopsy
Post-Procedure Care
Template and Fusion Biopsy
Further Reading
Chapter 9: How to Manage an Infected Obstructed Kidney
Initial Assessment
Management
Decompression
Factors to Consider When Deciding on Clinical Management
Further Reading
Chapter 10: Principles of Computed Tomography (CT)
Interaction with Matter
Physics of Computed Tomography
Types of CT Scanner
Use of Contrast
Radiation Dose
Further Reading
Chapter 11: How to Do a CT Urogram (CT)
Introduction
Technique
Split Bolus Protocol
Technical Challenges
Image Presentation
Further Reading
Chapter 12: How to Do a Renal and Adrenal CT
CT Renal Study
Protocol
Technical Considerations
Image Presentation
CT Adrenal Scan
Introduction
CT Adrenal Protocol
Pitfalls
Further Reading
Chapter 13: How to Do a CT in a Patient with Presumed Upper Tract Trauma
Introduction
What Do You Tell the Patient Prior to the Test?
Are There Any Specific Contraindications to CT?
A Typical Blunt Trauma Protocol
Important CT Findings and Impact on Patient Management
Further Reading
Chapter 14: Principles of Magnetic Resonance Imaging (MRI)
How Does MRI Work?
Understanding Basic MRI Terminology
T1W and T2W Imaging
Contrast-Enhanced Imaging
Diffusion Weighted Imaging
Spectroscopy
Current Role of MRI
MRI-guided Biopsy
Future Developments
Further Reading
Chapter 15: Safety in MR Scanning
Magnetic Field B0
Time Varying Radiofrequency Fields B1
Effects of RF B1
Heating
Burns
Time Varying Gradient Field (dB/dt)
Gadolinium-based Contrast Agents (GBCA)
MR Safety
MR Item Classification
Understanding MR Conditional Labelling
Further Reading
Chapter 16: Urological Applications of MRI Scanning
Introduction
MRI Kidney
MRI Bladder
MRI Prostate
Further Reading
Chapter 17: Vascular Embolisation Techniques in Urology
Introduction
Vascular Access and Closure
Guidewires and Catheters
Embolic Agents
Mechanical Embolic Materials
Liquid Embolic Materials
The Use of Embolization in Clinical Urology
Renal Hemorrhage
Devascularisation of Renal Tumours
Post-surgical Pelvic Bleeding
Further Reading
Part II: Imaging Nuclear Medicine
Chapter 18: Radionuclides and Their Uses in Urology
Radiopharmaceuticals
Radionuclides
Radionuclide Dosimetry
Radiation Protection in Nuclear Medicine
Further Reading
Chapter 19: Counting and Imaging in Nuclear Medicine
Sample Counting and External Counting
The Gamma Camera and Collimation
SPECT and SPECT-CT
Data Analysis
Further Reading
Chapter 20: Principles of Positron Emission Tomography (PET) Scanning
Introduction
PET Radionuclides
The Physics of PET Scanning
PET Scanners in Clinical Practice
PET-CT Interpretation and Reporting
Advances in Molecular Imaging
Further Reading
Chapter 21: PET-CT Imaging in Prostate Cancer
18F-Fluorodeoxyglucose (18F-FDG)
18F-Sodium Fluoride (18F-NaF)
11C-Choline and 18F-Choline
68Ga-PSMA and 18F-PSMA
18F-Fluciclovine
PSMA-PET Guided Targeted Radioligand Therapy (RLT)
Further Reading
Chapter 22: Understanding the Renogram: How It’s Done and How to Interpret It
Indications
Radiopharmaceuticals
Patient Preparation
Data Acquisition
Computer Data Analysis
Interpretation of the Result
Assessment of Renal Perfusion
Side Effects of Renography
Further Reading
Chapter 23: The Diuresis Renogram: How It’s Done and How to Interpret It
Indications
Radiopharmaceuticals
Patient Preparation
Data Acquisition
Computer Data Analysis
Interpretation of the Results
Limitations
Side Effects and Complications
Further Reading
Chapter 24: Understanding the DMSA Scan: How It’s Done and How to Interpret It
Indications
Radiopharmaceutical
Data Acquisition
Computer Data Analysis
Interpretation of the Result
Side Effects
Further Reading
Chapter 25: How to Do a Radioisotope Glomerular Filtration Rate Study
Indications
Radiopharmaceutical
Preparation
Procedure
Slope Intercept Method
Single Sample Method
Choice of Method
Interpretation of the Result
Further Reading
Chapter 26: Understanding the Radionuclide Bone Scan: How It’s Done and How To Interpret It
Indications in Urology
Radiopharmaceuticals
Patient Preparation
Multi-Phase Data Acquisition
Interpretation of the Result
Limitations
Side Effects
Further Reading
Chapter 27: Renography of the Transplanted Kidney: How It’s Done and How to Interpret It
Indications
Radiopharmaceutical
Patient Preparation
Data Acquisition
Computer Data Analysis
Interpretation of the Result
Side Effects
Limitations
Further Reading
Chapter 28: Dynamic Sentinel Lymph Node Biopsy in Penile Cancer
Finding the Sentinel Nodes
The Technique
Further Reading
Part III: Technology Diagnostic Technology
Chapter 29: Urinalysis
Using a Dipstick
Urinalysis: Chemistry, Significance, and Errors
Blood/Haemoglobin
Protein
Leucocytes
Nitrites
pH
Glycosuria
Potential Errors When Reading a Dipstick
References
Further Reading
Chapter 30: Principles of Urine Microscopy and Microbiological Culture
Introduction
Methods of Urine Collection
Traditional Microscopy and Non-culture Methods
Pyuria and / or Bacteriuria
Culture Methods
Interpretation and Use of Culture Results
Further Reading
Chapter 31: Urinary Flow Cytometry
Principles of Flow Cytometry
Components and Function of a Urinary Flow Cytometer
Applications of Urinary Flow Cytometry Within Clinical Microbiology
Further Reading
Chapter 32: Urine Cytology
Introduction
Sampling Types
Voided Urine
Catheterised and Ilieal Conduit Urine
Aspirated Urine, Washes and Brushes
Preparation
Diagnostic Categories
Summary
Further Reading
Chapter 33: Histopathological Processing, Staining and Immuno-Histochemistry
Introduction
Tissue Fixation
Processing of Tissue Samples
Staining
Immuno-Histochemical Stains Commonly Used in Urological Diagnosis
New Developments in Pathology
Further Reading
Chapter 34: Tumour Markers
Bladder Cancer
Prostate Cancer
Testicular cancer
Renal Cancer and Penile Cancer
The Future
Reference
Further Reading
Chapter 35: Measurement of Glomerular Filtration Rate (GFR)
Introduction
Endogenous Markers
Creatinine
eGFR
Cystatin C
Exogenous Markers
Cr-EDTA Clearance
Further Reading
Chapter 36: Assessment of Urinary Tract Stones
Introduction
Stone Composition
Risk Factors of Stone Formation
Basic Evaluation of all Stone Formers
Generic Diet and Fluid Advice
Specialised Evaluation
Twenty-Four Hour Urine Collections
Metabolic Treatments
Further Reading
Chapter 37: Principles of Pressure Measurement
Measuring Pressure
External Pressure Transducers
Internal Transducers
Further Reading
Chapter 38: Principles of Measurement of Urinary Flow
Why Measure Flow?
International Continence Society (ICS) Definitions and Their Application
Limitations of Urine Flowmetry
Future Developments
Further Reading
Chapter 39: How to Carry Out a Video Cystometrogram (VCMG) in an Adult
Introduction
Pre-procedure Checks
Preparation
The Study
What is Measures or Observed?
Further Reading
Chapter 40: Sphincter Electromyography (EMG)
Electrophysiology
Detailed EMG of Urethral Sphincter
Motor Unit Action Potentials (MUAP)
Clinical Uses of EMG
MSA and IPD
Fowler's Syndrome
Botulinum Toxin Injection
Further Reading
Part IV: Technology Operative
Chapter 41: Operating Theatre Safety
Theatre Design to Minimise Wound Infection
Factors to Minimise Patient Wound Infection Secondary to Surgical Intervention
Factors to Minimise Risks to Surgical Personnel
Further Reading
Chapter 42: Principles of Decontamination
Introduction
Methods of Decontamination
Cleaning
Disinfection
Sterilisation
Incineration
Decontamination of Urological Instruments
Flexible Endoscopes
Rigid Endoscopes
Laparoscopic and Robotic Surgical Equipment
Open Surgical Equipment (Scalpel Blade, Scissors, Forceps)
Specific Decontamination Issues
Further Reading
Chapter 43: Patient Safety in the Operating Theatre Environment
Harm and ‘Never events’
Human Factors Generating Error and Which May Compromise Patient Safety
Mechanisms to Improve Patient Safety
Making the Operating Team ‘safe’
The Limitations of Checklists
Further Reading
Chapter 44: Venous Thromboembolic Prevention
Introduction
Causes of VTE Disease (Table 44.1)
Risk Assessment
Primary VTE Prophylaxis
Assessment of Bleeding Risk
Application of VTE Prophylaxis
Secondary VTE Prophylacis
Further Reading
Chapter 45: Anticoagulants and Their Reversal
Coagulation Cascade
Peri-operative Thrombosis and Bleeding Risks
Thrombosis Risk
Bleeding Risk
Peri-operative Cessation of Anticoagulants
Reversal of Anticoagulants
Reference
Chapter 46: Haemostatic Agents, Tissue Sealants and Adhesives
Haemostatic Agents
Mechanism of Action (see Table 46.1)
Safety
Sealants
Adhesives
Further Reading
Chapter 47: Transfusion in Urology
Immune-related
Non-Immune Related
Red Cell Antibodies and Haemolysis
Further Reading
Chapter 48: Cell Salvage in Urological Surgery
Benefits
Indications for Usage
Absolute Contraindications
Relative Contraindications and Controversies
ICS in Malignancy
Sepsis
Haemoglobinopathy
Performing ICS
Modification of the ICS Technique
Reinfusion of ICS Product
Further Reading
Chapter 49: Principles of Urological Endoscopes
Rod Lens Endoscopes
Flexible Endoscopes
Semi-rigid Endoscopes
Digital, Distal-tip Chip Endoscopes
Single-Use Endoscopes
Chapter 50: Rigid Endoscope Design
Rigid Endoscope Construction
Conventional Optical Systems
Rod-lens/Cold Light Optical Systems
Modified Conformations of the Rod Lens System
Identifying Problems in a Rod-lens Optical System
Chapter 51: Light Sources, Light Leads and Camera Systems
Diagnostic Light Sources
Photodynamic Diagnosis (PDD)
Therapeutic Light Sources
Light Leads or Guides
Camera Systems
Setting the Camera Up
White Balance
Iris Function
Automatic Gain Control (AGC)
Digital Enhancement
Trouble Shooting
Further Reading
Chapter 52: Peripherals for Endoscopic Use
Peripherals for Rigid Endoscopes
Peripherals for Flexible Endoscopes
Peripherals for Either Flexible or Rigid Endoscopes
Further Reading
Chapter 53: Peripherals for Laparoscopic Use
Dissection, Manipulation, and Retraction
Cutting and Haemostasis
Retrieval
Suction and Irrigation
Suturing, Stapling, and Clipping
Further Reading
Chapter 54: Peripherals for Mechanical Stone Manipulation
Background
Guidewire Selection
Ureteral Catheters
Ureteral Occlusion Devices
Basket and Grasper Selection
Rigid Instruments
Access Sheaths
Further Reading
Chapter 55: Sutures and Clips
Sutures
Suture Size
Needles
Needle/Suture Combinations
Stapling Devices
Clips
Further Reading
Chapter 56: Contact Lithotripters
Electro-Hydraulic Lithotripsy (EHL)
Ultrasonic Lithotripsy (USL)
Ballistic Lithotripsy
Two-Probe Dual-Modality Lithotripsy
Single-Probe Dual-Modality Lithotripsy
Lasertripsy
Further Reading
Chapter 57: Monopolar Diathermy
Basics of Electricity
How Monopolar Works
Waveforms
Precautions/Safety
Further Reading
Chapter 58: Bipolar Diathermy
Background
Bipolar Electrosurgery
Selected Uses in Urology
Further Reading
Chapter 59: Alternatives to Electrosurgery
Background
The Harmonic Scalpel
Comparison with Electrosurgery
The LigaSure™ System
Further Reading
Chapter 60: Operative Tissue Destruction
Introduction
Mechanical Morcellation
Devices for Mechanical Morcellation
Safety Aspects in Mechanical Morcellation
Further Reading
Chapter 61: Endoscopic Use of Laser Energy
Laser Physics and Tissue Interaction
Determinants of the Laser: Tissue Interaction
Laser Safety
Clinical Applications of Lasers in Urology (Table 61.2)
Benign Prostatic Hyperplasia (BPH)
Upper and Lower Tract Stones
Urothelial Carcinoma (UC)
Urethral Stricture Disease
Further Reading
Chapter 62: Double J Stents and Nephrostomy
How Stents and Nephrostomies Drain the Upper Urinary Tract
Pathological Consequences of Stent Insertion
Material Science
Specialised Stents
Further Reading
Chapter 63: Urinary Catheters, Design and Usage
Latex Catheters
Physical Properties of Latex
Silicone Catheters
Rigid Polyvinyl Chloride (PVC) Catheters
Intermittent Catheters
Supra-Pubic Catheters
Catheter Biology
Problems with Catheters
Catheter Associated Urinary Tract Infection
Encrustation/Repeated Blockage
Bypassing
Other Problems
Further Reading
Chapter 64: Urological Prosthetics
Penile Prostheses
Semi-Rigid Prostheses
Inflatable Prostheses (Figs. 64.1 and 64.2)
Surgical Outcomes
The Artificial Urinary Sphincter (AUS) (Fig. 64.3)
Testicular Prostheses
Prevention of Prosthetic Infection
Further Reading
Chapter 65: Mesh in Urological Surgery
Synthetic Mesh
Synthetic Non-absorbable Materials
Synthetic Biodegradable Materials
Biological Mesh
Extracellular Matrix (ECM)
Cell-Seeded Synthetic Implants
Non-synthetic Bioengineered Mesh
Outcomes
Complications
Further Reading
Chapter 66: Irrigation Fluids and Their Hazards
Introduction
TUR Syndrome
Incidence and Risk Factors for Developing TUR Syndrome
Intravascular Volume Shifts
Plasma Solute Effects
Hyperammonaemia
Hyperglycinaemia
Management of TUR Syndrome
Other Issues with Irrigation Fluid in Urology
Further Reading
Chapter 67: Insufflants and Their Hazards
Types of Insufflants
Use of CO2 in Laparoscopic Urological Surgery
Risks and Side Effects of CO2 Insufflation
Subcutaneous Insufflation
Metabolic Consequences of CO2 as an Insufflant
CO2 and Air Embolus
Physiological Effects of a Prolonged Pneumo-Peritoneum
Post-Operative Pain Due to Insufflants
Robotic Surgery
Reducing Risks of Pneumoperitoneum
Further Reading
Chapter 68: Laparoscopic Ports
Port Types and Sizes
Principles of Port Placement
Single Port Access
Natural Orifice Transluminal Endoscopic Surgery (NOTES)
Further Reading
Chapter 69: Principles of Robotic Surgery
Introduction
Robotic Systems and Setup
Advantages of Robotic Surgery
Robotic Surgical Training
Patient Considerations
Physiological Considerations
Further Reading
Chapter 70: Setting Up Robotic Surgery
Introduction
Robotic Surgical Training
Robotic Theatre Team
Practical Steps in Setting up a Robotic Service
Further Reading
Chapter 71: Principles of Tissue Transfer for Urologists
Grafts
Split Skin Grafts
Full Thickness Skin Grafts
Flaps
Urethral Reconstruction
Further Reading
Part V: Technology Interventional
Chapter 72: Neuromodulation by Sacral Nerve Stimulation
Background
Test Implantation Procedure
Permanent Implantation Procedure
Results
Further Reading
Chapter 73: Principles of Extracorporeal Shockwave Lithotripsy (ESWL)
Introduction
Physics of Lithotripsy
Theoretical Mechanisms of Stone Fragmentation
Shockwave Generators
Coupling
Imaging
Factors Influencing the Efficacy of ESWL
Further Reading
Chapter 74: How to Carry Out Shockwave Lithotripsy (SWL)
Introduction
Patient Selection: Which Modality of Treatment?
Advice in Specific Situations and Potential Complications of Treatment
Day of Treatment: Pre-treatment Protocol
SWL Delivery
Post-treatment Management
Further Reading
Chapter 75: Novel Technologies for BPH
Prostate Enucleation
Photo-Selective Vaporisation of the Prostate (PVP)
Prostate Artery Embolisation
Minimally Invasive Techniques
Prostatic Urethral Lift—Urolift®
Teleflex
Convective Water Vapour Energy Ablation—Rezum™
Boston Scientific
Temporarily Implanted Nitinol device—iTind
Olympus
Aquablation—AquaBeam Robotic System
PROCEPT BioRobotics Inc.
Further Reading
Chapter 76: Ablative Therapies
High-Intensity Focused Ultrasound (HIFU)
Cryotherapy
Radio-Frequency Ablation (RFA)
Irreversible Electroporation (IRE)
Laser-Targeted Therapies for Prostate Cancer
Laser Interstitial Thermotherapy (LITT)
Photodynamic Therapy (PDT)
Further Reading
Chapter 77: Principles of Radiotherapy
Introduction
Radiotherapy Regimens and Fractionation
External Beam Radiotherapy
Radiotherapy Treatment Planning
Image Guided Radiotherapy
Proton Therapy
Radiosensitisers
Brachytherapy
Systemic Use of Radioisotopes
Further Reading
Chapter 78: Brachytherapy for Prostate Cancer
Overview of Brachytherapy
Patient Selection
Prostate Brachytherapy as Monotherapy
LDR Prostate Brachytherapy
Indications
Isotopes
Technical Aspects
Treatment Planning and Dosimetry
Radiation Protection
HDR Prostate Brachytherapy
Indications
Technical Aspects
Treatment Planning and Dosimetry
Prostate Brachytherapy as a Boost
Indications
Salvage Brachytherapy
Indications
Further Reading
Chapter 79: Augmented Intravesical Drug Administration
Introduction
Electromotive Drug Administration (EMDA)
Chemohyerthermia (CHT)
Internal Devices
External Devices
Clinical Application of CHT
Future Developments
Further Reading
Part VI: Technology of Renal Failure
Chapter 80: Principles of Renal Replacement Therapy (RRT)
Chronic Kidney Disease (CKD)
Renal Replacement Therapy (RRT)
The Economics of RRT
Efficacy of RRT
Benefits of Transplantation
Further Reading
Chapter 81: Principles of Peritoneal Dialysis
Principles of PD
Types of PD
CAPD
APD
Patient Selection
PD Catheters and Placement
Prescribing PD
Complications Associated with PD
Imaging in PD
Care of PD Patient
Surgical Support for PD
Further Reading
Chapter 82: Haemodialysis
Principles of Haemodialysis
Initiation of Haemodialysis
Vascular Access for Haemodialysis
Complications of Haemodialysis
Practical Points Relating to the Management of Surgical Patients on Haemodialysis
Further Reading
Chapter 83: Principles of Renal Transplantation
Indications
Contraindications
Types of Renal Transplant
The National Waiting List Allocation
Surgical Technique of Kidney Transplantation
Immunosuppression
Complications of Kidney Transplantation
Outcome from Renal Transplantation
Further Reading
Part VII: Assessment of Technology
Chapter 84: Key Concepts in the Design of Randomised Controlled Trials
Introduction
Key Concepts in Trial Design Planning
Clinical Equipoise
Null Hypothesis and p Values
Power in Randomised Controlled Trials
Conducting an RCT
Types of RCTs
Randomisation Procedures
Further Reading
Chapter 85: Reporting and Interpreting Data from RCTs
Basic Principles
Confidence Intervals (CI)
Relative Risk Reduction, Absolute Risk Reduction and Numbers Needed to Treat (NNT)
Kaplan Meier Curves and Hazard Ratio
RCTs in Surgery
Further Reading
Chapter 86: Health Technology Assessment (HTA)
What is the Process?
What Does it Involve?
Specification
Safety
Reliability and Validity
Efficacy and Effectiveness
Adoption
Further Reading
Appendices
Appendix 1: The Electromagnetic Spectrum
Appendix 2. MR Conditional List: Urological Device Safety
Appendix 3: Radionuclides Used in Urology
Appendix 4: Expected Laboratory Values
Appendix 5: Levels of Evidence for Therapeutic Studiesa