In the words of the great GP, can anyone say,

"Scienfic Session"???

Cynthia, I think you may have to keep a close watch on this thread!

Good Luck Alexis

Alexis, this could be a great Scientific Session topic!

Anyone else out there performing novel imaging techniques...keep it in mind that the Scientific Session will love to hear about it!

 Cynthia

 I have not personally participated in US guided biopsy, nor plaque placement.  To my knowledge, generally, this technique involves STANDARDIZED A Scan technique for the placement of radiation plaque.   As the metal clips that are implanted adjcent to the tumor would create hyper reflectivty this is an effective tool for this application.  

Your best bet for information would be those very niche experts that perform standardized echography such as Sandra Frazier Bryne, Diane Chialant, Cynthia Kendall, and Cathy DeBernardo to name a few.  Kelly Babic at UCSF is also an "expert" in this.  I could connect you to any one of these people via eMail if it would be helpful.

Denice Barsness, CDOS ( the CDOS standing for Certified Diagnostic Ophthalmic Sonographer) but, even as such, this type of US is very very specialized and not widely done.  Generally found in the large teaching institution or those that work exclusively in Oncology.

You can eMail me off line at cpmceyelab@sutterhealth.org and I will do what I can to help.

For Lacrimal Gland, a B scan probe ( at 10Mhz) is generally sufficient to image the gland.  Remember however, that B scan is 150 micron resolution so there are obstacles in "seeing" what you wish to see.

I would liken Standardized A scan with intraoperative hand held OCT.  Not for the faint of heart, must be done regularly to be done well, must have the instrumentation, must have an MD on the other end that can interpret these esoteric readings.  Not to be done casually, part time.

My two cents

Denice

I did go in during the lacrimal gland biopsy, and I did ultrasound - - however, I was unable to save any pertinant ultrasound videos because I was scrubbed in, so I couldn't touch the keyboard and the mouse and we were discussing the live scan as the physician was manipulating surgical instruments while I was holding the probe, so we left the live scan function on, but didn't stop scanning or talking in order to take the time to freeze frames.  There was too much going on and documentation wasn't required in this case as they had already had an ultrasound done in clinic.

Hopefully we will continue to explore new uses of ultrasound that will help; this case wasn't ideal but I'll keep track in case there is something that screams sci session - - no worries Cynthia and Jim : )

Denise  - - our oncologist does all his own plaque placement ultrasounds.  He uses the B-scan to do longitudinal and transverse scans to make sure the plaque is effectively covering the base of the tumor.  I know Rhonda Waldron in Atlanta does all of the plaque placement ultrasounds for her doc.  I checked with Cathy DiBernardo to see if she had ever done a biopsy guided ultrasound and she said no.

I think this wasn't so effective in this case - - they were just doublechecking location one more time before biopsying but it was all information that could have been gleaned from the scan done in clinic.  Where i think this may be really helpful is for a needle biopsy.  I have yet to have a case that would require that come up . . .

Thanks again everyone : )