Imperial College London

DrMarthaKedrzycki

Faculty of MedicineDepartment of Surgery & Cancer

Clinical Research Fellow
 
 
 
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m.kedrzycki

 
 
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Paterson WingSt Mary's Campus

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Summary

 

Publications

Publication Type
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34 results found

Leiloglou M, Kedrzycki M, Chalau V, Chiarini N, Thiruchelvam P, Hadjiminas D, Hogben K, Rashid F, Ramakrishnan R, Darzi A, Leff D, Elson Det al., 2022, Indocyanine green fluorescence image processing techniques for breast cancer macroscopic demarcation, Scientific Reports, Vol: 12, ISSN: 2045-2322

Re-operation due to disease being inadvertently close to the resection margin is a major challenge in breast conserving surgery (BCS). Indocyanine green (ICG) fluorescence imaging could be used to visualize the tumor boundaries and help surgeons resect disease more efficiently. In this work, ICG fluorescence and color images were acquired with a custom-built camera system from 40 patients treated with BCS. Images were acquired from the tumor in-situ, surgical cavity post-excision, freshly excised tumor and histopathology tumour grossing. Fluorescence image intensity and texture were used as individual or combined predictors in both logistic regression (LR) and support vector machine models to predict the tumor extent. ICG fluorescence spectra in formalin-fixed histopathology grossing tumor were acquired and analyzed. Our results showed that ICG remains in the tissue after formalin fixation. Therefore, tissue imaging could be validated in freshly excised and in formalin-fixed grossing tumor. The trained LR model with combined fluorescence intensity (pixel values) and texture (slope of power spectral density curve) identified the tumor’s extent in the grossing images with pixel-level resolution and sensitivity, specificity of 0.75 ± 0.3, 0.89 ± 0.2.This model was applied on tumor in-situ and surgical cavity (post-excision) images to predict tumor presence.

Journal article

Jiwa N, Kumar S, Gandhewar R, Chauhan H, Nagarajan V, Wright C, Hadjiminas D, Takats Z, Ashrafian H, Leff DRet al., 2021, Diagnostic Accuracy of Nipple Discharge Fluid Cytology: A Meta-Analysis and Systematic Review of the Literature, Publisher: SPRINGER, Pages: 1774-1786, ISSN: 1068-9265

Conference paper

Teh JJ, Cai W, Kedrzycki M, Thiruchelvam P, Leff D, Elson Det al., 2021, 392 Magseed-guided wide local excision during the COVID-19 pandemic: a tenable solution to barriers in accessing elective breast cancer surgery, Association of Surgeons in Training, Publisher: British Journal of Surgery Society, ISSN: 0007-1323

Conference paper

Shah B, Kedrzycki M, 2021, COVID induced acute ischaemic limb, 2021 Association of Surgeons in Training International Surgical Conference, Publisher: British Journal of Surgery Society, Pages: 1-1, ISSN: 0007-1323

The coronavirus pandemic has overwhelmed healthcare systems worldwide, with more than 40 million affected and 1 million deaths. In addition to the typical symptoms, less clinically obvious was the underlying hypercoagulable state, termed COVID-19 associated coagulopathy (CAC). The exact mechanism of CAC is unknown, but it is suspected to involve all three aspects of Virchow’s Triad: endothelial injury, stasis, and a hypercoagulable state. Here we report the case of a woman in her 60’s who was admitted with COVID-19 and developed CAC with subsequent complications. She presented with a 3-day history of fevers, severe shortness of breath, and cough. Past medical history was significant for hypertension, poorly controlled insulin dependant diabetes, and obesity. She was admitted with COVID induced type 2 respiratory failure (pO2 of 5.5 on 15L), DKA (ketones 2.1), AKI (Cr 163), and a hypercoagulable state (D-dimer >20 000). She was intubated and commenced on an insulin sliding scale, therapeutic anticoagulation, and antibiotics. On day 2 she became anuric, with CT-angio demonstrating thrombus extending from renal arteries down to the right popliteal artery. She underwent an embolectomy and 4 compartment fasciotomy and was started on renal replacement therapy. Unfortunately, her leg was not deemed viable, and due to persistent hyperkalaemia required amputation 2 days later. She continued to deteriorate despite maximal multiple organ support and was palliated 15 days later. CAC can have life-threatening sequelae, and patients with COVID-19 infection should be commenced on anticoagulation upon diagnosis.

Conference paper

Kedrzycki MS, Leiloglou M, Chalau V, Chiarini N, Thiruchelvam PTR, Hadjiminas DJ, Hogben KR, Rashid F, Ramakrishnan R, Darzi AW, Elson DS, Leff DRet al., 2021, ASO visual abstract: the impact of temporal variation in indocyanine green administration on tumor identification during fluorescence-guided breast surgery, Annals of Surgical Oncology, Vol: 28, Pages: 650-651, ISSN: 1068-9265

Journal article

Leiloglou M, Kedrzycki MS, Elson DS, Leff DRet al., 2021, ASO author reflections: towards fluorescence guided tumor identification for precision breast conserving surgery., Annals of Surgical Oncology, ISSN: 1068-9265

Journal article

Kedrzycki MS, Leiloglou M, Chalau V, Chiarini N, Thiruchelvam PTR, Hadjiminas DJ, Hogben KR, Rashid F, Ramakrishnan R, Darzi AW, Elson DS, Leff DRet al., 2021, The impact of temporal variation in indocyanine green administration on tumor identification during fluorescence guided breast surgery., Annals of Surgical Oncology, Vol: 28, Pages: 5617-5625, ISSN: 1068-9265

BACKGROUND: On average, 21% of women in the USA treated with Breast Conserving Surgery (BCS) undergo a second operation because of close positive margins. Tumor identification with fluorescence imaging could improve positive margin rates through demarcating location, size, and invasiveness of tumors. We investigated the technique's diagnostic accuracy in detecting tumors during BCS using intravenous indocyanine green (ICG) and a custom-built fluorescence camera system. METHODS: In this single-center prospective clinical study, 40 recruited BCS patients were sub-categorized into two cohorts. In the first 'enhanced permeability and retention' (EPR) cohort, 0.25 mg/kg ICG was injected ~ 25 min prior to tumor excision, and in the second 'angiography' cohort, ~ 5 min prior to tumor excision. Subsequently, an in-house imaging system was used to image the tumor in situ prior to resection, ex vivo following resection, the resection bed, and during grossing in the histopathology laboratory to compare the technique's diagnostic accuracy between the cohorts. RESULTS: The two cohorts were matched in patient and tumor characteristics. The majority of patients had invasive ductal carcinoma with concomitant ductal carcinoma in situ. Tumor-to-background ratio (TBR) in the angiography cohort was superior to the EPR cohort (TBR = 3.18 ± 1.74 vs 2.10 ± 0.92 respectively, p = 0.023). Tumor detection reached sensitivity and specificity scores of 0.82 and 0.93 for the angiography cohort and 0.66 and 0.90 for the EPR cohort, respectively (p = 0.1051 and p = 0.9099). DISCUSSION: ICG administration timing during the angiography phase compared with the EPR phase improved TBR and diagnostic accuracy. Future work will focus on image pattern analysis and adaptation of the camera system to targeting fluorophores specific to breast cancer.

Journal article

Kedrzycki MS, Leiloglou M, Ashrafian H, Jiwa N, Thiruchelvam PTR, Elson DS, Leff DRet al., 2021, Meta-analysis comparing fluorescence imaging with radioisotope and blue dye-guided sentinel node identification for breast cancer surgery., Annals of Surgical Oncology, Vol: 28, Pages: 3738-3748, ISSN: 1068-9265

INTRODUCTION: Conventional methods for axillary sentinel lymph node biopsy (SLNB) are fraught with complications such as allergic reactions, skin tattooing, radiation, and limitations on infrastructure. A novel technique has been developed for lymphatic mapping utilizing fluorescence imaging. This meta-analysis aims to compare the gold standard blue dye and radioisotope (BD-RI) technique with fluorescence-guided SLNB using indocyanine green (ICG). METHODS: This study was registered with PROSPERO (CRD42019129224). The MEDLINE, EMBASE, Scopus, and Web of Science databases were searched using the Medical Subject Heading (MESH) terms 'Surgery' AND 'Lymph node' AND 'Near infrared fluorescence' AND 'Indocyanine green'. Studies containing raw data on the sentinel node identification rate in breast cancer surgery were included. A heterogeneity test (using Cochran's Q) determined the use of fixed- or random-effects models for pooled odds ratios (OR). RESULTS: Overall, 1748 studies were screened, of which 10 met the inclusion criteria for meta-analysis. ICG was equivalent to radioisotope (RI) at sentinel node identification (OR 2.58, 95% confidence interval [CI] 0.35-19.08, p < 0.05) but superior to blue dye (BD) (OR 9.07, 95% CI 6.73-12.23, p < 0.05). Furthermore, ICG was superior to the gold standard BD-RI technique (OR 4.22, 95% CI 2.17-8.20, p < 0.001). CONCLUSION: Fluorescence imaging for axillary sentinel node identification with ICG is equivalent to the single technique using RI, and superior to the dual technique (RI-BD) and single technique with BD. Hospitals using RI and/or BD could consider changing their practice to ICG given the comparable efficacy and improved safety profile, as well as the lesser burden on hospital infrastructure.

Journal article

Leiloglou M, Chalau V, Kedrzycki MS, Thiruchelvam P, Darzi A, Leff DR, Elson DSet al., 2021, Tissue texture extraction in indocyanine green fluorescence imaging for breast-conserving surgery, Journal of Physics D: Applied Physics, Vol: 54, ISSN: 0022-3727

A two-camera fluorescence system for indocyanine green (ICG) signal detection has been developed and tested in a clinical feasibility trial of ten patients, with a resolution in the submillimetre scale. Immediately after systemic ICG injection, the two-camera system can detect ICG signals in vivo (~2.5 mg ${{\text{l}}^{ - 1}}$ or 3.2 × ${10^{ - 6}}{ }$ M). Qualitative assessment has shown that the fluorescence signal does not always correlate with the cancer location in the surgical scene. Conversely, fluorescence image texture metrics when used with the logistic regression model yields good accuracy scores in detecting cancer. We have demonstrated that intraoperative fluorescence imaging for resection guidance is a feasible solution to tackle the current challenge of positive resection margins in breast conserving surgery.

Journal article

Kedrzycki M, Leiloglou M, Thiruchelvam P, Elson D, Leff Det al., 2021, P051. Fluorescence guided surgery in breast cancer: A systematic review of the literature, Association of Breast Surgery Conference 2021, Publisher: Elsevier, Pages: e309-e309, ISSN: 0748-7983

Conference paper

Kedrzycki MS, Leiloglou M, Chalau V, Lin J, Thiruchelvam PTR, Elson DS, Leff DRet al., 2021, Guiding light to optimize wide local excisions: the "GLOW" study, Volume XXII 2021 Annual Meeting Scientific Session, Publisher: Springer, Pages: S199-S200, ISSN: 1068-9265

Conference paper

Kedrzycki M, Teh J, Cai W, Ezzat A, Thiruchelvam P, Elson D, Leff Det al., 2021, P053. Prospective single-centre qualitative service evaluation on magseed for wide local excision, Association of Breast Surgery Conference 2021, Publisher: Elsevier, Pages: e310-e310, ISSN: 0748-7983

Conference paper

Kedrzycki M, Leiloglou M, Leff D, Elson D, Chalau V, Thiruchelvam P, Darzi Aet al., 2021, Versatility in fluorescence guided surgery with the GLOW camera system, Surgical Life: The Journal of the Association of Surgeons of Great Britain and Ireland, Vol: 59

Journal article

Kedrzycki MS, Roy Choudhury J, Hakky S, 2021, Caecal volvulus: untwisting the mystery, BMJ Case Reports, Vol: 14, ISSN: 1757-790X

Caecal volvulus is an infrequent cause of acute surgical abdomen, where an abnormally mobile cecum twists on its own axis. It can lead to the development of closed-loop obstruction, small bowel ischaemia and perforation. Early recognition and prompt treatment is key; however, due to the rarity of this pathology, it is seldom listed as a differential diagnosis. Here, we present a single-centre case series of two patients presenting with caecal volvulus to an Emergency Surgery Unit at a University Hospital.

Journal article

Leiloglou M, Gkouzionis I, Kedrzycki MS, Cartucho J, Vadzim C, Darzi A, Leff DR, Elson DSet al., 2021, Real-time spectral tracking routine for fluorescence hyperspectral guidance in breast conserving surgery

Fast spectral tracking routine, using simultaneous analysis of color and monochrome images, was developed and tested in phantoms. This routine could improve the efficiency of fluorescence hyperspectral imaging for breast conserving surgery guidance.

Conference paper

Chalau V, Kedrzycki M, Leiloglou M, Thiruchelvam P, Leff D, Elson Det al., 2021, Variability of indocyanine green (ICG) near-infrared maximum emission wavelength in breast tissues, European Molecular Imaging Meeting

Conference paper

Kedrzycki MS, Elson DS, Leff DR, 2020, ASO author reflections: fluorescence-guided sentinel node biopsy for breast cancer, Annals of Surgical Oncology, Vol: 28, Pages: 3749-3750, ISSN: 1068-9265

Journal article

Kedrzycki M, Leiloglou M, Ashrafian H, Jiwa N, Thiruchelvam P, Elson D, Leff Det al., 2020, Meta-analysis of sentinel node mapping techniques comparing near-infrared fluorescence imaging to blue dye and radioisotope, 21st Annual Meeting of the American-Society-of-Breast-Surgeons (ASBS), Publisher: Springer, Pages: S535-S536, ISSN: 1068-9265

Conference paper

Kedrzycki M, Leiloglou M, Chalau V, Thiruchelvam P, Lin J, Elson D, Leff Det al., 2020, First-in-Human study using the 'GLOW' near infrared camera system in breast cancer, 21st Annual Meeting of the American-Society-of-Breast-Surgeons (ASBS), Publisher: Springer, Pages: S382-S383, ISSN: 1068-9265

Conference paper

Kedrzycki M, Leiloglou M, Leff D, Elson Det al., 2020, Illuminating Cancer: A Systematic Review of Fluorophores available for Fluorescence Guided Surgery in Humans, European Molecular Imaging Meeting

Conference paper

Leiloglou M, Gkouzionis I, Avila-Rencoret FB, Chalau V, Kedrzycki M, Darzi A, Leff DR, Elson DSet al., 2020, Snapshot hyperspectral system for breast conserving surgery guidance

There is an unmet need for accurate tumour localization in vivo during breast conserving surgery. Herein a novel snapshot hyperspectral system is presented for accurately detecting the intrinsic fluorescence signal in real-time fluorescence guided surgery.

Conference paper

Kedrzycki M, Leiloglou M, Chalau V, Lin J, Thiruchelvam P, Leff D, Elson Det al., 2020, Fluorescence Guided Surgery Using Indocyanine Green to Demarcate Vasculature in Breast Cancer, London Surgery Symposium

Conference paper

Cole A, Greenfield S, Kedrzycki M, Hassan F, Theivacumar Set al., 2019, Audit Comparing Clinical Practice in a Large Vascular Unit to Current NICE Recommendations for Secondary Prevention in Peripheral Arterial Disease, International Surgical Conference of the Association-of-Surgeons-in-Training (ASIT), Publisher: WILEY, Pages: 168-168, ISSN: 0007-1323

Conference paper

Lee MJ, Sayers AE, Drake TM, Singh P, Bradburn M, Wilson TR, Murugananthan A, Walsh CJ, Fearnhead NS, Abercrombie J, Acheson A, Alderson D, Anderson I, Bach S, Davies M, Hamady Z, Hind D, Hollyman M, Hare S, Lee E, Northover J, Lewis C, Marriott P, Maynard N, McFall M, Murray D, Tierney G, Verjee A, Wild J, Abbott S, Abdulaal Y, Afshar S, Ah-Chuen J, Ahmed T, Akhtar M, Akram F, Aldred E, Ali A, Aly M, Amajuoyi A, Amin V, Anderson D, Anderson O, Andreou A, Ansari A, Appleton S, Ardley R, Arshad F, Ashour O, Asour A, Athem A, Athersmith M, Ayoub F, Azeem H, Azhar B, Badenoch T, Baillie C, Bandyopadhyay D, Barker J, Barker S, Barkham B, Baron R, Barrie J, Barry-Yarrow E, Bashir G, Battersby N, Bazoua G, Behar N, Bellam S, Berger C, Bhandari S, Bhasin S, Biggs S, Bisset C, Blake L, Blencowe N, Boam T, Boddy A, Boereboom C, Bogdan M, Bogle R, Bohra P, Boland M, Bolkan H, Borg C, Boulton R, Bouras G, Boyer M, Boyle J, Branagan G, Brewer H, Briggs C, Broadhurst J, Brown E, Brown J, Brown L, Brown O, Burns K, Butcher K, Butler M, Byrne B, Campbell L, Capper C, Cartmell M, Cash T, Chan S, Chandratreya N, Chapman J, Chapman S, Charalabopoulos A, Cheek C, Chok S, Choong W, Chow M, Chowdhury J, Coe P, Conaghan P, Conn G, Cook N, Cook T, Cooper S, Cornish J, Cotton D, Cox C, Coyne P, Crook R, Crozier J, Cuffolo G, Cunha P, Curtis N, Cutting J, Da Costa K, da Silva L, Das B, Davenport M, Davies J, Davies T, Day A, Dayal S, Dean S, Demetriou G, Dengu F, Dennis R, Dent H, Dent P, Deputy M, Devoto L, Di Benedetto G, Dindyal S, Donnelly E, Doody P, Douka E, Downham C, Dowson H, Edent H, Edgerton K, Ekpete N, El Farran M, Elamin O, Eljaafari M, Elsaid N, El-Sharif M, Evans J, Evans M, Ewe R, Ewing A, Exarchou K, Fallaize R, Faoury M, Farag S, Farinella E, Faulkner G, Ferguson H, Fisher O, Fletcher J, Forouzanfar A, Foster A, Fox R, Francis N, Fretwell V, Fung D, Gammeri E, Garnham J, Geraghty A, Gilbert A, Gill C, Gill M, Gillespie M, Giordano P, Glasbey J, Goh M, Golder A, Green N Get al., 2019, Malnutrition, nutritional interventions and clinical outcomes of patients with acute small bowel obstruction: results from a national, multicentre, prospective audit, BMJ OPEN, Vol: 9, ISSN: 2044-6055

Journal article

Leiloglou M, Chalau V, Kedrzycki M, Qi J, Martin-Gonzalez P, Hanna G, Darzi A, Leff D, Elson Det al., 2019, Fluorescence Intensity Image Guided Breast Conserving Surgery (BCS)., European Molecular Imaging Meeting

Conference paper

Leiloglou M, Chalau V, Kedrzycki M, Avila-Rencoret F, Li Q, Lin J, Hanna G, Darzi A, Leff D, Elson Det al., 2019, Snapshot Fluorescence Hyperspectral System for Breast Cancer Surgery Guidance, Hamlyn Symposium Advanced Biophotonics Workshop

Conference paper

Kedrzycki M, Leiloglou M, Chalau V, Leff D, Elson Det al., 2019, Highlighting Breast Cancer: First-in-Human Testing of the Imperial Camera System for Fluorescence Guided Breast Cancer Surgery, London Surgery Symposium

Conference paper

Williams J, Allen F, Kedrzycki M, Shenava Y, Gupta Ret al., 2019, Use of multislice CT for investigation of occult geriatric hip fractures and impact on timing of surgery, Geriatric Orthopaedic Surgery and Rehabilitation, Vol: 10, Pages: 1-4, ISSN: 2151-4585

Introduction: The National Institute of Health and Clinical Excellence guidelines in the United Kingdom recommend magnetic resonance imaging (MRI) as the first-line investigation for radiographically occult hip fractures, if available within 24 hours. In our department, however, multislice computerized tomography (MSCT) is instead used as a first-line investigation due to significant delays associated with obtaining MRI. Our aim was to determine the validity and practicality of MSCT for diagnosis of occult hip fractures and its impact on timing of surgery. Materials and Methods: We retrospectively analyzed medical records and imaging for consecutive patients who underwent MSCT to investigate occult hip fractures between January 2014 and October 2016. We reviewed subsequent imaging and reattendances for patients with negative MSCT to exclude initially missed fractures. Results: Two hundred six patients underwent MSCT to investigate occult hip fracture during the study period. Hip fractures were identified in 59 patients, comprising 35 (59.3%) subcapital, 12 (20.0%) intertrochanteric, 8 (13.6%) transcervical, and 4 (6.8%) basicervical fractures. One missed hip fracture was identified: a patient with a negative MSCT was further investigated with MRI that demonstrated acute subcapital hip fracture. Multislice computerized tomography was obtained within 24 hours of initial radiograph in 145 (70.4%) patients. A total of 44.5% of occult hip fractures had surgery within the nationally recommended 36 hours of admission (hospital average for all hip fractures was 76.4% over the same period). Discussion and Conclusions: Multislice computerized tomography is a pragmatic approach to investigate the majority of occult hip fractures in a timely manner and minimize associated delay to surgery. However it cannot completely exclude the diagnosis, especially in abnormal anatomy. The lack of a true gold standard comparison (ie, MRI) means a true sensitivity and specificity cannot be ca

Journal article

Kedrzycki M, Naidoo K, McDonald P, 2018, Audit on Compliance of Antibiotic Prophylaxis with National Institute for Health and Clinical Excellence & Scottish Intercollegiate Guidelines Network Guidelines, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY, Pages: 74-74, ISSN: 0007-1323

Conference paper

Kedrzycki M, Williams J, Groom W, Shenava Yet al., 2018, Important Diagnostic Factors in Managing Necrotising Fasciitis in a District General Hospital, International Surgical Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY, Pages: 38-38, ISSN: 0007-1323

Conference paper

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