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The hybrid OR suite: Design collaboration for success
The hybrid OR suite, page 3
June 5, 2014
2014 06 05 14 39 39 432 Figure4 Final Design2 500
Home
The hybrid OR suite: Design collaboration for success
The hybrid OR suite, page 2
June 5, 2014
2014 06 05 14 33 25 349 Figure1 Breakable Surg Table Left 450
Digital X-Ray
The hybrid OR suite: Design collaboration for success
Many hospitals are considering the installation of hybrid operating rooms (ORs) -- suites in which both image-guided, minimally invasive procedures and open surgeries can be performed. In this article, a team from Massachusetts General Hospital describes how it went about creating an advanced hybrid OR suite.
June 5, 2014
2014 06 05 14 33 25 349 Figure1 Breakable Surg Table Left 450 20140605215023
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Representative longitudinal chest CT images and five-year parametric response mapping (PRM), pulmonary vascular CT reconstructions, and hyperpolarized xenon-129 (Xe-129) ventilation MRI scans from survivors of nonsevere and severe COVID-19 pneumonia. (A–F) Images in a 68-year-old male survivor of nonsevere COVID-19 pneumonia, (G–L) 62-year-old male survivor of severe COVID-19 pneumonia, and (M–R) 55-year-old male survivor of severe COVID-19 pneumonia. For each participant, the first three columns show coronal chest CT images from the acute phase (A, G, M), two-year follow-up (B, H, N), and five-year follow-up (C, I, O) (left to right). The fourth column (D, J, P) shows a coronal PRM image for each participant at five-year follow-up derived from paired inspiratory and expiratory CT scans, showing the spatial distribution of lung functional categories. Green indicates normal lung tissue, yellow indicates functional small airway disease, and red indicates emphysema. The second-to-last column shows volume-rendered small pulmonary vessel visualization (red) at five-year follow-up per participant (E, K, Q). The column on the far right (F, L, R) shows a hyperpolarized Xe-129 MRI ventilation defect percentage (VDP) map at five-year follow-up per participant. Dark blue represents high Xe-129 signal intensity, corresponding to well-ventilated lung regions, whereas red represents no Xe-129 signal intensity, corresponding to ventilation defects. At five-year follow-up, the 68-year-old survivor of nonsevere COVID-19 pneumonia (top row) showed near-complete radiologic resolution, no respiratory symptoms, and preserved pulmonary function. In contrast, the 62-year-old survivor of severe COVID-19 pneumonia (middle row) showed persistent fibrotic linear opacities without respiratory symptoms and mildly reduced pulmonary function. The 55-year-old survivor of severe COVID-19 pneumonia (bottom row) showed persistent scattered fibrotic linear opacities and focal emphysematous changes in both lungs, with dyspnea and impaired gas exchange function. The VDP values obtained from F, L, and R were 7.7%, 7.1%, and 6.3%, respectively.
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What are the effects of COVID-19 pneumonia after 5 years?
After five years, residual lesions persisted in 35.6% of survivors (37 of 104).
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Representative MRI scans for which the independently assigned imaging-derived extranodal extension (iENE) grades differed among the readers. (A) Axial and sagittal images in a 56-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Readers 1 and 3 interpreted the finding as a metastatic lymph node invading the left sternocleidomastoid muscle (arrow) and assessed an iENE grade of 3, whereas reader 2 assigned a grade of 2. After joint review, the radiologists reached a consensus on the absence of definite sternocleidomastoid muscle invasion, and the final iENE grade was 2. (B) Axial and sagittal images in a 52-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Reader 1 interpreted the findings as a single enlarged metastatic lymph node and assessed an iENE grade of 1, whereas readers 2 and 3 interpreted them as two coalescent metastatic lymph nodes (arrows) and assessed a grade of 2. After joint review, the radiologists reached a consensus on the coalescence of the two metastatic lymph nodes, and the final iENE grade was 2.
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Representative longitudinal chest CT images and five-year parametric response mapping (PRM), pulmonary vascular CT reconstructions, and hyperpolarized xenon-129 (Xe-129) ventilation MRI scans from survivors of nonsevere and severe COVID-19 pneumonia. (A–F) Images in a 68-year-old male survivor of nonsevere COVID-19 pneumonia, (G–L) 62-year-old male survivor of severe COVID-19 pneumonia, and (M–R) 55-year-old male survivor of severe COVID-19 pneumonia. For each participant, the first three columns show coronal chest CT images from the acute phase (A, G, M), two-year follow-up (B, H, N), and five-year follow-up (C, I, O) (left to right). The fourth column (D, J, P) shows a coronal PRM image for each participant at five-year follow-up derived from paired inspiratory and expiratory CT scans, showing the spatial distribution of lung functional categories. Green indicates normal lung tissue, yellow indicates functional small airway disease, and red indicates emphysema. The second-to-last column shows volume-rendered small pulmonary vessel visualization (red) at five-year follow-up per participant (E, K, Q). The column on the far right (F, L, R) shows a hyperpolarized Xe-129 MRI ventilation defect percentage (VDP) map at five-year follow-up per participant. Dark blue represents high Xe-129 signal intensity, corresponding to well-ventilated lung regions, whereas red represents no Xe-129 signal intensity, corresponding to ventilation defects. At five-year follow-up, the 68-year-old survivor of nonsevere COVID-19 pneumonia (top row) showed near-complete radiologic resolution, no respiratory symptoms, and preserved pulmonary function. In contrast, the 62-year-old survivor of severe COVID-19 pneumonia (middle row) showed persistent fibrotic linear opacities without respiratory symptoms and mildly reduced pulmonary function. The 55-year-old survivor of severe COVID-19 pneumonia (bottom row) showed persistent scattered fibrotic linear opacities and focal emphysematous changes in both lungs, with dyspnea and impaired gas exchange function. The VDP values obtained from F, L, and R were 7.7%, 7.1%, and 6.3%, respectively.
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Representative MRI scans for which the independently assigned imaging-derived extranodal extension (iENE) grades differed among the readers. (A) Axial and sagittal images in a 56-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Readers 1 and 3 interpreted the finding as a metastatic lymph node invading the left sternocleidomastoid muscle (arrow) and assessed an iENE grade of 3, whereas reader 2 assigned a grade of 2. After joint review, the radiologists reached a consensus on the absence of definite sternocleidomastoid muscle invasion, and the final iENE grade was 2. (B) Axial and sagittal images in a 52-year-old male patient with nasopharyngeal carcinoma and cervical nodal metastases. Reader 1 interpreted the findings as a single enlarged metastatic lymph node and assessed an iENE grade of 1, whereas readers 2 and 3 interpreted them as two coalescent metastatic lymph nodes (arrows) and assessed a grade of 2. After joint review, the radiologists reached a consensus on the coalescence of the two metastatic lymph nodes, and the final iENE grade was 2.
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