Prostate Artery Embolisation

PAE is an embolisation procedure. It is a new application of a longstanding tried and tested technology. Embolisation is the deliberate occlusion of vessels in the body, in this case the arteries to the prostate.  The objective of PAE is to stem the blood flow to the prostate, targeting the enlarging tissue and rendering it ischaemic (reduced supply of oxygenated blood).…

Pancreatic cancer and T2D – how are they related?

6th October 2019. Dr Chee L Khoo

Last month we looked at the state of play with screening for the deadly disease, pancreatic ductal adenocarcinoma (PDAC). We saw how it may not be useful to screen the general population with the technology that we have but there are select higher risk groups where screening may be useful. Long standing type 2 diabetes (T2DM) is a modest risk factor for PDAC.…

Diagnosis of breast invasive ductal carcinoma – a case study

26th September 2019. Spectrum Medical Imaging

Breast cancer is the most common cancer affecting women. In 2019, it is estimated that 19,535 Australians will be diagnosed with breast cancer. However it is important to remember that most women survive breast cancer. Diagnosis of breast cancer patients in early stages is one of important aspects of breast cancer treatment. Among of many diagnostic platforms, imaging techniques are main diagnostic approaches which could provide valuable data on patients with breast cancer.…

Breast cancer – should we offer risk reducing medications?

26th September 2019. Dr Chee L Khoo

We put patients at high risk of cardiovascular events on statins as primary prevention. We sometimes put patients with high risk of cerebrovascular disease on aspirin to prevent strokes. What about patients who are at high risk of breast cancer? Now, these are not patients who already had breast cancer. We are talking about patients who have not had cancer but are at higher than average risk of developing breast cancer.…

Pancreatic cancer screening – why are we not there yet?

10th September, 2019. Dr Chee L Khoo

Let’s face it. We all dread the diagnosis of pancreatic cancer in any of our patients. There aren’t too many red flags that we can rely on to warn us that something is not right with this deep seated abdominal organ. Many of the symptoms are either subtle or non-specific like nausea, intermittent epigastric pain, nausea, weight loss, loss of appetite or back pain.…

Abbreviated breast MRI – what is it?

22nd June 2019, Spectrum Medical Imaging

Dynamic contrast enhanced breast – MRI must contain a minimal number of MRI sequences that is necessary to detect small enhancing breast lesions. What if we cut down the number of sequences but yet have enough accuracy to detect small early cancers? That’s what AB-MRI is – less number of sequences but yet enough to detect small lesions. …

Paediatric intracranial tumours – ordering the right test

A meningioma is a benign tumour that arises from the meninges. Meningiomas are often slow-growing, however in some instances, they may be fast-growing and their effects on adjacent brain tissue, nerves or vessels may cause serious disability. Timely access to a Bulk Billable MRI scan can enable a quick diagnosis and appropriate referral for neurosurgery without the patient requiring a CT scan with the associated ionizing radiation, especially relevant given the patient’s age.…

Fournier’s gangrene & SGLT2i – how rare is it?

23rd March 2019, Dr Chee L Khoo

You may remember receiving warnings recently from the Therapeutics Goods Administration (TGA) about a serious “rare” infection, called necrotising fasciitis of the perineum, also referred to as Fournier’s gangrene (FG). FG is reported to be associated with the use of SGLT2 inhibitors in patients with type 2 diabetes (T2D). The warning came on the back of similar warnings by the US Food and Drug Authority (FDA) in August 2018.…

How long does a knee replacement last?

23rd February 2019, Dr Chee L Khoo

Joint replacement is the mainstay treatment for advanced arthritis. Unfortunately, almost all joint replacements fail over time. We are frequently asked by patients “how long does the replacement last?”. It’s important to know how long a joint is supposed to last because it determines the “ideal” age to have the first knee replacement. Further, we can anticipate when symptoms will be coming up and start exploring the feasibility of the next joint replacement.…

Case Study – man with increasing neck pain for one month

44-year-old male with 1 month of increasing neck pain was referred for a cervical spine injection. A CT scan of the cervical spine two weeks prior (Figure A), revealed foraminal narrowing at the C5-6 level. There was a significant difference between the new scan and the previous scan. There was severe destruction of the C5-6 disc and of the adjacent C5 and C6 vertebral end plates with retrolisthesis of C5 on C6.

Floppy Iris Syndrome – is your patient at risk?

12th November 2018, Dr Chee L Khoo

Intraoperative floppy iris syndrome (IFIS) was first described by Chang and Campbell. It is characterised by floppiness of the iris, miosis and ultimately, iris prolapse through the surgical wounds. It can occur during surgery for cataract and if not anticipated, it increases the risk of posterior capsule rupture, vitreous loss, retained nuclear fragments, post op intraocular pressure spikes, irido-dialysis, hyphema and corneal endothelial loss.…

Morton’s Neuroma – is it a neuroma?

1st September, 2018, Dr Chee L Khoo

It would seem to me that just about every doctor who graduated from Australian medical schools know about Morton’s neuroma. It’s part of the long list of differential diagnoses of forefoot pain but either I have missed many or it’s not that common. I’m also not sure what else to do once diagnosed apart from referring to an orthopaedic surgeon.…