PURPOSE To determine if Live Implant Dosimetry (LIDO) utilizing intraoperative transrectal ultras... more PURPOSE To determine if Live Implant Dosimetry (LIDO) utilizing intraoperative transrectal ultrasound (TRUS) is equivalent to postimplant CT dosimetry (either day 0 or day 30) in patients with localized prostate cancer (PC) treated with low dose rate (LDR) prostate seed brachytherapy. METHODS AND MATERIALS The treated population consisted of 628 men with localized (T1-T2) PC. All d'Amico risk categories (low, intermediate, and high) were included, and 437 patients were treated with monotherapy (160 Gy) [low and low tier intermediate], and the remainder (191) [high tier intermediate and high risk] with an implant boost (106 Gy) post external beam radiation, to a volume including the prostate and seminal vesicles (46 Gy). LIDO with intraoperative TRUS, postimplant CT (day 0 and day 30) were performed in all cases. Prostate volumes (V), V100 (prostate) and dose (D) D90 (prostate), D30 (urethra), and Rectum D2cc, were recorded. No urinary catheter was used on Day 30 CT. RESULTS More...
This review aims to identify the role of augmented, virtual or mixed reality (AR, VR or MR) techn... more This review aims to identify the role of augmented, virtual or mixed reality (AR, VR or MR) technologies in setting of spinal surgery. The authors address the challenges surrounding the implementation of this technology in the operating room. A technical standpoint addresses the efficacy of these imaging modalities based on the current literature in the field. Ultimately, these technologies must be cost-effective to ensure widespread adoption. This may be achieved through reduced surgical times and decreased incidence of post-operative complications and revisions while maintaining equivalent safety profile to alternative surgical approaches. While current studies focus mainly on the successful placement of pedicle screws via AR-guided instrumentation, a wider scope of procedures may be assisted using AR, VR or MR technology once efficacy and safety have been validated. These emerging technologies offer a significant advantage in the guidance of complex procedures that require high p...
Biomaterials have had an increasingly important role in recent decades, in biomedical device desi... more Biomaterials have had an increasingly important role in recent decades, in biomedical device design and the development of tissue engineering solutions for cell delivery, drug delivery, device integration, tissue replacement, and more. There is an increasing trend in tissue engineering to use natural substrates, such as macromolecules native to plants and animals to improve the biocompatibility and biodegradability of delivered materials. At the same time, these materials have favourable mechanical properties and often considered to be biologically inert. More importantly, these macromolecules possess innate functions and properties due to their unique chemical composition and structure, which increase their bioactivity and therapeutic potential in a wide range of applications. While much focus has been on integrating these materials into these devices via a spectrum of cross-linking mechanisms, little attention is drawn to residual bioactivity that is often hampered during isolatio...
Intervertebral disc (IVD) degeneration is a leading cause of low back pain worldwide, incurring a... more Intervertebral disc (IVD) degeneration is a leading cause of low back pain worldwide, incurring a significant burden on the healthcare system and society. IVD degeneration is characterized by an abnormal cell-mediated response leading to the stimulation of different catabolic biomarkers and activation of signalling pathways. In the last few decades, hyaluronic acid (HA), which has been broadly used in tissue-engineering, has popularised due to its anti-inflammatory, analgesic and extracellular matrix enhancing properties. Hence, there is expressed interest in treating the IVD using different HA compositions. An ideal HA-based biomaterial needs to be compatible and supportive of the disc microenvironment in general and inhibit inflammation and downstream cascades leading to the innervation, vascularisation and pain sensation in particular. High molecular weight hyaluronic acid (HMW HA) and HA-based biomaterials used as therapeutic delivery platforms have been trialled in preclinical ...
PURPOSE To determine if Live Implant Dosimetry (LIDO) utilizing intraoperative transrectal ultras... more PURPOSE To determine if Live Implant Dosimetry (LIDO) utilizing intraoperative transrectal ultrasound (TRUS) is equivalent to postimplant CT dosimetry (either day 0 or day 30) in patients with localized prostate cancer (PC) treated with low dose rate (LDR) prostate seed brachytherapy. METHODS AND MATERIALS The treated population consisted of 628 men with localized (T1-T2) PC. All d'Amico risk categories (low, intermediate, and high) were included, and 437 patients were treated with monotherapy (160 Gy) [low and low tier intermediate], and the remainder (191) [high tier intermediate and high risk] with an implant boost (106 Gy) post external beam radiation, to a volume including the prostate and seminal vesicles (46 Gy). LIDO with intraoperative TRUS, postimplant CT (day 0 and day 30) were performed in all cases. Prostate volumes (V), V100 (prostate) and dose (D) D90 (prostate), D30 (urethra), and Rectum D2cc, were recorded. No urinary catheter was used on Day 30 CT. RESULTS More...
This review aims to identify the role of augmented, virtual or mixed reality (AR, VR or MR) techn... more This review aims to identify the role of augmented, virtual or mixed reality (AR, VR or MR) technologies in setting of spinal surgery. The authors address the challenges surrounding the implementation of this technology in the operating room. A technical standpoint addresses the efficacy of these imaging modalities based on the current literature in the field. Ultimately, these technologies must be cost-effective to ensure widespread adoption. This may be achieved through reduced surgical times and decreased incidence of post-operative complications and revisions while maintaining equivalent safety profile to alternative surgical approaches. While current studies focus mainly on the successful placement of pedicle screws via AR-guided instrumentation, a wider scope of procedures may be assisted using AR, VR or MR technology once efficacy and safety have been validated. These emerging technologies offer a significant advantage in the guidance of complex procedures that require high p...
Biomaterials have had an increasingly important role in recent decades, in biomedical device desi... more Biomaterials have had an increasingly important role in recent decades, in biomedical device design and the development of tissue engineering solutions for cell delivery, drug delivery, device integration, tissue replacement, and more. There is an increasing trend in tissue engineering to use natural substrates, such as macromolecules native to plants and animals to improve the biocompatibility and biodegradability of delivered materials. At the same time, these materials have favourable mechanical properties and often considered to be biologically inert. More importantly, these macromolecules possess innate functions and properties due to their unique chemical composition and structure, which increase their bioactivity and therapeutic potential in a wide range of applications. While much focus has been on integrating these materials into these devices via a spectrum of cross-linking mechanisms, little attention is drawn to residual bioactivity that is often hampered during isolatio...
Intervertebral disc (IVD) degeneration is a leading cause of low back pain worldwide, incurring a... more Intervertebral disc (IVD) degeneration is a leading cause of low back pain worldwide, incurring a significant burden on the healthcare system and society. IVD degeneration is characterized by an abnormal cell-mediated response leading to the stimulation of different catabolic biomarkers and activation of signalling pathways. In the last few decades, hyaluronic acid (HA), which has been broadly used in tissue-engineering, has popularised due to its anti-inflammatory, analgesic and extracellular matrix enhancing properties. Hence, there is expressed interest in treating the IVD using different HA compositions. An ideal HA-based biomaterial needs to be compatible and supportive of the disc microenvironment in general and inhibit inflammation and downstream cascades leading to the innervation, vascularisation and pain sensation in particular. High molecular weight hyaluronic acid (HMW HA) and HA-based biomaterials used as therapeutic delivery platforms have been trialled in preclinical ...
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Papers by Kieran Joyce