THE ROLE OF THE CONSEQUENCE MANAGEMENT HOME TEAM IN THE FUKUSHIMA DAIICHI RESPONSE

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pemberton, Wendy; Mena, RaJah; Beal, William

The Consequence Management Home Team is a U.S. Department of Energy/National Nuclear Security Administration asset. It assists a variety of response organizations with modeling; radiological operations planning; field monitoring techniques; and the analysis, interpretation, and distribution of radiological data. These reach-back capabilities are activated quickly to support public safety and minimize the social and economic impact of a nuclear or radiological incident. In the Fukushima Daiichi response, the Consequence Management Home Team grew to include a more broad range of support than was historically planned. From the early days of the response to the continuing involvement in supporting late phasemore » efforts, each stage of the Consequence Management Home Team support had distinct characteristics in terms of management of incoming data streams as well as creation of products. Regardless of stage, the Consequence Management Home Team played a critical role in the Fukushima Daiichi response effort.« less

Errors in imaging patients in the emergency setting

PubMed Central

Reginelli, Alfonso; Lo Re, Giuseppe; Midiri, Federico; Muzj, Carlo; Romano, Luigia; Brunese, Luca

2016-01-01

Emergency and trauma care produces a “perfect storm” for radiological errors: uncooperative patients, inadequate histories, time-critical decisions, concurrent tasks and often junior personnel working after hours in busy emergency departments. The main cause of diagnostic errors in the emergency department is the failure to correctly interpret radiographs, and the majority of diagnoses missed on radiographs are fractures. Missed diagnoses potentially have important consequences for patients, clinicians and radiologists. Radiologists play a pivotal role in the diagnostic assessment of polytrauma patients and of patients with non-traumatic craniothoracoabdominal emergencies, and key elements to reduce errors in the emergency setting are knowledge, experience and the correct application of imaging protocols. This article aims to highlight the definition and classification of errors in radiology, the causes of errors in emergency radiology and the spectrum of diagnostic errors in radiography, ultrasonography and CT in the emergency setting. PMID:26838955

Errors in imaging patients in the emergency setting.

PubMed

Pinto, Antonio; Reginelli, Alfonso; Pinto, Fabio; Lo Re, Giuseppe; Midiri, Federico; Muzj, Carlo; Romano, Luigia; Brunese, Luca

2016-01-01

Emergency and trauma care produces a "perfect storm" for radiological errors: uncooperative patients, inadequate histories, time-critical decisions, concurrent tasks and often junior personnel working after hours in busy emergency departments. The main cause of diagnostic errors in the emergency department is the failure to correctly interpret radiographs, and the majority of diagnoses missed on radiographs are fractures. Missed diagnoses potentially have important consequences for patients, clinicians and radiologists. Radiologists play a pivotal role in the diagnostic assessment of polytrauma patients and of patients with non-traumatic craniothoracoabdominal emergencies, and key elements to reduce errors in the emergency setting are knowledge, experience and the correct application of imaging protocols. This article aims to highlight the definition and classification of errors in radiology, the causes of errors in emergency radiology and the spectrum of diagnostic errors in radiography, ultrasonography and CT in the emergency setting.

EPA’s Role in Emergency Response - Special Teams

EPA Pesticide Factsheets

The Environmental Response Team; Radiological Response Team; Chemical, Biological, Radiological, and Nuclear Consequence Management Advisory Division; and National Criminal Enforcement Response Team provide specialized support.

Chemical, Biological, Radiological, and Nuclear Consequence Management

EPA Pesticide Factsheets

The Chemical, Biological, Radiological, and Nuclear CMAD provides scientific support and technical expertise for decontamination of buildings, building contents, public infrastructure, agriculture, and associated environmental media.

Radiological protection issues arising during and after the Fukushima nuclear reactor accident.

PubMed

González, Abel J; Akashi, Makoto; Boice, John D; Chino, Masamichi; Homma, Toshimitsu; Ishigure, Nobuhito; Kai, Michiaki; Kusumi, Shizuyo; Lee, Jai-Ki; Menzel, Hans-Georg; Niwa, Ohtsura; Sakai, Kazuo; Weiss, Wolfgang; Yamashita, Shunichi; Yonekura, Yoshiharu

2013-09-01

Following the Fukushima accident, the International Commission on Radiological Protection (ICRP) convened a task group to compile lessons learned from the nuclear reactor accident at the Fukushima Daiichi nuclear power plant in Japan, with respect to the ICRP system of radiological protection. In this memorandum the members of the task group express their personal views on issues arising during and after the accident, without explicit endorsement of or approval by the ICRP. While the affected people were largely protected against radiation exposure and no one incurred a lethal dose of radiation (or a dose sufficiently large to cause radiation sickness), many radiological protection questions were raised. The following issues were identified: inferring radiation risks (and the misunderstanding of nominal risk coefficients); attributing radiation effects from low dose exposures; quantifying radiation exposure; assessing the importance of internal exposures; managing emergency crises; protecting rescuers and volunteers; responding with medical aid; justifying necessary but disruptive protective actions; transiting from an emergency to an existing situation; rehabilitating evacuated areas; restricting individual doses of members of the public; caring for infants and children; categorising public exposures due to an accident; considering pregnant women and their foetuses and embryos; monitoring public protection; dealing with 'contamination' of territories, rubble and residues and consumer products; recognising the importance of psychological consequences; and fostering the sharing of information. Relevant ICRP Recommendations were scrutinised, lessons were collected and suggestions were compiled. It was concluded that the radiological protection community has an ethical duty to learn from the lessons of Fukushima and resolve any identified challenges. Before another large accident occurs, it should be ensured that inter alia: radiation risk coefficients of potential health effects are properly interpreted; the limitations of epidemiological studies for attributing radiation effects following low exposures are understood; any confusion on protection quantities and units is resolved; the potential hazard from the intake of radionuclides into the body is elucidated; rescuers and volunteers are protected with an ad hoc system; clear recommendations on crisis management and medical care and on recovery and rehabilitation are available; recommendations on public protection levels (including infant, children and pregnant women and their expected offspring) and associated issues are consistent and understandable; updated recommendations on public monitoring policy are available; acceptable (or tolerable) 'contamination' levels are clearly stated and defined; strategies for mitigating the serious psychological consequences arising from radiological accidents are sought; and, last but not least, failures in fostering information sharing on radiological protection policy after an accident need to be addressed with recommendations to minimise such lapses in communication.

Job Aids for Using Preventive Radiological/Nuclear Detection Equipment for Consequence Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buddemeier, Brooke R.; Haynes, Daniel; Wood-Zika, Annmarie R.

The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection equipment (PRND) to provide state and local agencies with guidance on how to best use this equipment for response after a radiological/nuclear release or detonation.

Preparing for the Unthinkable: DOD Support to Foreign Consequence Management

DTIC Science & Technology

2010-05-03

Nuclear Disaster ” (research paper, Maxwell Air Force Base, AL: Air University, 2001), 23. 17 Department of Defense Consequence Management...States Government Response to an Overseas Chemical, Biological, Radiological, or Nuclear Disaster ” (research paper, Maxwell Air Force Base, AL: Air...Government Response to an Overseas Chemical, Biological, Radiological, or Nuclear Disaster .” Research paper, Maxwell Air Force Base, AL: Air University

Evaluation of radiological dispersion/consequence codes supporting DOE nuclear facility SARs

DOE Office of Scientific and Technical Information (OSTI.GOV)

O`Kula, K.R.; Paik, I.K.; Chung, D.Y.

1996-12-31

Since the early 1990s, the authorization basis documentation of many U.S. Department of Energy (DOE) nuclear facilities has been upgraded to comply with DOE orders and standards. In this process, many safety analyses have been revised. Unfortunately, there has been nonuniform application of software, and the most appropriate computer and engineering methodologies often are not applied. A DOE Accident Phenomenology and Consequence (APAC) Methodology Evaluation Program was originated at the request of DOE Defense Programs to evaluate the safety analysis methodologies used in nuclear facility authorization basis documentation and to define future cost-effective support and development initiatives. Six areas, includingmore » source term development (fire, spills, and explosion analysis), in-facility transport, and dispersion/ consequence analysis (chemical and radiological) are contained in the APAC program. The evaluation process, codes considered, key results, and recommendations for future model and software development of the Radiological Dispersion/Consequence Working Group are summarized in this paper.« less

Idiopathic pulmonary fibrosis in a Christmas Island nuclear test veteran

PubMed Central

Parfrey, H; Babar, J; Fiddler, CA; Chilvers, ER

2010-01-01

We describe the case of a 71-year-old man with idiopathic pulmonary fibrosis (usual interstitial pneumonia (UIP) pattern) diagnosed on clinical, radiological and lung function criteria, in accordance with the American Thoracic Society/European Respiratory Society consensus criteria (2000), who had been in close proximity to three atmospheric nuclear bomb blasts during military service in 1957. He does not have clubbing and clinically and radiologically his lung disease is stable. He also has bladder carcinoma and carotid arteriosclerosis, both recognised consequences of radiation injury. This is the first reported case of UIP in a nuclear test veteran. Awareness of this potential association is important given the current attempts of the British Nuclear Test Veterans Association to gain compensation for claimed injuries. PMID:22797205

Offsite Radiological Consequence Analysis for the Bounding Flammable Gas Accident

DOE Office of Scientific and Technical Information (OSTI.GOV)

CARRO, C.A.

2003-07-30

This document quantifies the offsite radiological consequences of the bounding flammable gas accident for comparison with the 25 rem Evaluation Guideline established in DOE-STD-3009, Appendix A. The bounding flammable gas accident is a detonation in a single-shell tank The calculation applies reasonably conservation input parameters in accordance with DOE-STD-3009, Appendix A, guidance. Revision 1 incorporates comments received from Office of River Protection.

Radioactivity and radiological risk associated with effluent sediment containing technologically enhanced naturally occurring radioactive materials in amang (tin tailings) processing industry.

PubMed

Bahari, Ismail; Mohsen, Nasirian; Abdullah, Pauzi

2007-01-01

The processing of amang, or tin tailings, for valuable minerals has been shown to technologically enhance NORM and this has stirred significant radiological safety and health concerns among Malaysia's regulatory authority. A growing radiological concern is now focused on the amang effluent containing NORM in recycling ponds, since these ponds may be reclaimed for future residential developments. A study was carried out to assess the radiological risk associated with amang processing and the accumulated effluent in the recycling ponds. Twenty-six sediment samples from the recycling ponds of two amang plants in the states of Selangor and Perak, Malaysia, were collected and analyzed. The maximum activity concentrations of (238)U, (226)Ra, (232)Th and (40)K recorded in sediments from these ponds were higher than Malaysia's and the world's natural highest. Correspondingly, the mean radium equivalent activity concentration indices, Ra(eq), and gamma radiation representative level index, I(gammar), were higher than the world's average. The enhancement of NORM in effluent sediments as a consequence of amang processing, and the use of a closed water management recycling system created Effective Dose Rates, E (nSv h(-1)), that signal potential environmental radiological risks in these ponds, should they be reclaimed for future land use.

Weapons of mass destruction: Overview of the CBRNEs (Chemical, Biological, Radiological, Nuclear, and Explosives).

PubMed

Prockop, Leon D

2006-11-01

The events of September 11, 2001, made citizens of the world acutely aware of disasters consequent to present-day terrorism. This is a war being waged for reasons obscure to many of its potential victims. The term "NBCs" was coined in reference to terrorist weapons of mass destruction, i.e., nuclear, biological and chemical. The currently accepted acronym is "CBRNE" which includes Chemical, Biological, Radiological, Nuclear, and Explosive weapons. Non-nuclear explosives are the most common terrorist weapon now in use. Nuclear and radiological weapons are beyond the scope of this publication, which focuses on the "CBEs", i.e. chemical, biological and explosive weapons. Although neurologists will not be the first responders to CBEs, they must know about the neurological effects in order to provide diagnosis and treatment to survivors. Neurological complications of chemical, biological and explosive weapons which have or may be used by terrorists are reviewed by international experts in this publication. Management and treatment profiles are outlined.

Offsite radiological consequence analysis for the bounding flammable gas accident

DOE Office of Scientific and Technical Information (OSTI.GOV)

CARRO, C.A.

2003-03-19

The purpose of this analysis is to calculate the offsite radiological consequence of the bounding flammable gas accident. DOE-STD-3009-94, ''Preparation Guide for U.S. Department of Energy Nonreactor Nuclear Facility Documented Safety Analyses'', requires the formal quantification of a limited subset of accidents representing a complete set of bounding conditions. The results of these analyses are then evaluated to determine if they challenge the DOE-STD-3009-94, Appendix A, ''Evaluation Guideline,'' of 25 rem total effective dose equivalent in order to identify and evaluate safety class structures, systems, and components. The bounding flammable gas accident is a detonation in a single-shell tank (SST).more » A detonation versus a deflagration was selected for analysis because the faster flame speed of a detonation can potentially result in a larger release of respirable material. As will be shown, the consequences of a detonation in either an SST or a double-shell tank (DST) are approximately equal. A detonation in an SST was selected as the bounding condition because the estimated respirable release masses are the same and because the doses per unit quantity of waste inhaled are generally greater for SSTs than for DSTs. Appendix A contains a DST analysis for comparison purposes.« less

Experiences of an Engineer working in Reactor Safety and Emergency Response

NASA Astrophysics Data System (ADS)

Osborn, Douglas

2015-04-01

The U.S. Department of Energy's Federal Radiological Monitoring and Assessment Center Consequence Management Home Team (FRMAC/CMHT) Assessment Scientist's roles, responsibilities incorporate the FRMAC with other federal, state, and local agencies during a nuclear/radiological emergency. Before the Consequence Management Response Team arrives on-site, the FRMAC/CMHT provides technical and logistical support to the FRMAC and to state, local, and tribal authorities following a nuclear/radiological event. The FRMAC/CMHT support includes analyzing event data, evaluating hazards that relate to protection of the public, and providing event information and data products to protective action decision makers. The Assessment Scientist is the primary scientist responsible for performing calculations and analyses and communicating results to the field during any activation of the FRMAC/CMHT assets. As such, the FRMAC/CMHT Assessment Scientist has a number of different roles and responsibilities to fill depending upon the type of response that is required. Additionally, the Sandia National Laboratories (SNL) Consequence Assessment Team (CAT) Consequence Assessor roles, responsibilities involve hazardous materials operational emergency at SNL New Mexico facilities (SNL/NM) which include loss of control over radioactive, chemical, or explosive hazardous materials. When a hazardous materials operational emergency occurs, key decisions must be made in order to regain control over the hazards, protect personnel from the effects of the hazards, and mitigate impacts on operations, facilities, property, and the environment. Many of these decisions depend in whole or in part on the evaluation of potential consequences from a loss of control over the hazards. As such, the CAT has a number of different roles and responsibilities to fill depending upon the type of response that is required. Primary consequence-based decisions supported by the CAT during a hazardous materials operational emergency at SNL/NM include: (1) Onsite Protective Actions (2) Offsite Protective Action Recommendations (3) Event categorization (4) Event classification Other consequence-based decisions supported by the CAT include: (1) Response planning and operations (2) Event termination (3) Reentry planning and operations (4) Recovery planning and operations Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration.

78 FR 35058 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses and Combined Licenses...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-11

... controverted. In addition, the requestor/petitioner shall provide a brief explanation of the bases for the..., containment isolation, or radiological release assumptions used in evaluating the radiological consequences of...

Workflow management systems in radiology

NASA Astrophysics Data System (ADS)

Wendler, Thomas; Meetz, Kirsten; Schmidt, Joachim

1998-07-01

In a situation of shrinking health care budgets, increasing cost pressure and growing demands to increase the efficiency and the quality of medical services, health care enterprises are forced to optimize or complete re-design their processes. Although information technology is agreed to potentially contribute to cost reduction and efficiency improvement, the real success factors are the re-definition and automation of processes: Business Process Re-engineering and Workflow Management. In this paper we discuss architectures for the use of workflow management systems in radiology. We propose to move forward from information systems in radiology (RIS, PACS) to Radiology Management Systems, in which workflow functionality (process definitions and process automation) is implemented through autonomous workflow management systems (WfMS). In a workflow oriented architecture, an autonomous workflow enactment service communicates with workflow client applications via standardized interfaces. In this paper, we discuss the need for and the benefits of such an approach. The separation of workflow management system and application systems is emphasized, and the consequences that arise for the architecture of workflow oriented information systems. This includes an appropriate workflow terminology, and the definition of standard interfaces for workflow aware application systems. Workflow studies in various institutions have shown that most of the processes in radiology are well structured and suited for a workflow management approach. Numerous commercially available Workflow Management Systems (WfMS) were investigated, and some of them, which are process- oriented and application independent, appear suitable for use in radiology.

Manned space flight nuclear system safety. Volume 3: Reactor system preliminary nuclear safety analysis. Part 3: Nuclear Safety Analysis Document (NSAD)

NASA Technical Reports Server (NTRS)

1972-01-01

Nuclear safety analysis as applied to a space base mission is presented. The nuclear safety analysis document summarizes the mission and the credible accidents/events which may lead to nuclear hazards to the general public. The radiological effects and associated consequences of the hazards are discussed in detail. The probability of occurrence is combined with the potential number of individuals exposed to or above guideline values to provide a measure of accident and total mission risk. The overall mission risk has been determined to be low with the potential exposure to or above 25 rem limited to less than 4 individuals per every 1000 missions performed. No radiological risk to the general public occurs during the prelaunch phase at KSC. The most significant risks occur from prolonged exposure to reactor debris following land impact generally associated with the disposal phase of the mission where fission product inventories can be high.

Sedation/anaesthesia in paediatric radiology

PubMed Central

Arlachov, Y; Ganatra, R H

2012-01-01

Objectives In this article we will give a comprehensive literature review on sedation/general anaesthesia (S/GA) and discuss the international variations in practice and options available for S/GA for imaging children. Methods The key articles were obtained primarily from PubMed, MEDLINE, ERIC, NHS Evidence and The Cochrane Library. Results Recently, paediatric radiology has seen a surge of diagnostic and therapeutic procedures, some of which require children to be still and compliant for up to 1 h. It is difficult and sometimes even impossible to obtain quick and high-quality images without employing sedating techniques in certain children. As with any medical procedure, S/GA in radiological practice is not without risks and can have potentially disastrous consequences if mismanaged. In order to reduce any complications and practice safety in radiological units, it is imperative to carry out pre-sedation assessments of children, obtain parental/guardian consent, monitor them closely before, during and after the procedure and have adequate equipment, a safe environment and a well-trained personnel. Conclusion Although the S/GA techniques, sedative drugs and personnel involved vary from country to country, the ultimate goal of S/GA in radiology remains the same; namely, to provide safety and comfort for the patients. Advances in knowledge Imaging children under general anaesthesia is becoming routine and preferred by operators because it ensures patient conformity and provides a more controlled environment. PMID:22898157

[eLearning-radiology.com--sustainability for quality assurance].

PubMed

Ketelsen, D; Talanow, R; Uder, M; Grunewald, M

2009-04-01

The aim of the study was to analyze the availability of published radiological e-learning tools and to establish a solution for quality assurance. Substantial pubmed research was performed to identify radiological e-learning tools. 181 e-learning programs were selected. As examples two databases expanding their programs with external links, Compare (n = 435 external links) and TNT-Radiology (n = 1078 external links), were evaluated. A concept for quality assurance was developed by an international taskforce. At the time of assessment, 56.4 % (102 / 181) of the investigated e-learning tools were accessible at their original URL. A subgroup analysis of programs published 5 to 8 years ago showed significantly inferior availability to programs published 3 to 5 years ago (p < 0.01). The analysis of external links showed 49.2 % and 61.0 % accessible links for the programs Compare (published 2003) and TNT-Radiology (published 2006), respectively. As a consequence, the domain www.eLearning-radiology.com was developed by the taskforce and published online. This tool allows authors to present their programs and users to evaluate the e-learning tools depending on several criteria in order to remove inoperable links and to obtain information about the complexity and quality of the e-learning tools. More than 50 % of investigated radiological e-learning tools on the Internet were not accessible after a period of 5 to 8 years. As a consequence, an independent, international tool for quality assurance was designed and published online under www.eLearning-radiology.com .

Defense Science Board 2005 Summer Study on Reducing Vulnerabilities to Weapons of Mass Destruction

DTIC Science & Technology

2007-05-01

the potential of massive destruction from nuclear weapons in the former Soviet Union for nearly half a century during the Cold War. The principle...on limited aspects of a single modality—whether biological, chemical, nuclear , or radiological. Concerns such as detection, defeat, or consequence...as difficult and dangerous as possible and to minimize the likelihood that he will achieve his goals. The worst forms of WMD— nuclear and, in some

Volcanic hazards: Perspectives from eruption prediction to risk assessment for disposal of radioactive waste

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crowe, B.

1980-12-31

This document summarizes an oral presentation that described the potential for volcanic activity at the proposed Yucca Mountain, Texas repository site. Yucca Mountain is located in a broad zone of volcanic activity known as the Death Valley-Pancake Ridge volcanic zone. The probability estimate for the likelihood that some future volcanic event will intersect a buried repository at Yucca Mountain is low. Additionally, the radiological consequences of penetration of a repository by basaltic magma followed by eruption of the magma at the surface are limited. The combination of low probability and limited consequence suggests that the risk posed by waste storagemore » at this site is low. (TEM)« less

Ensuring the safety of surgical teams when managing casualties of a radiological dirty bomb.

PubMed

Williams, Geraint; O'Malley, Michael; Nocera, Antony

2010-09-01

The capacity for surgical teams to ensure their own safety when dealing with the consequences caused by the detonation of a radiological dirty bomb is primarily determined by prior knowledge, familiarity and training for this type of event. This review article defines the associated radiological terminology with an emphasis on the personal safety of surgical team members in respect to the principles of radiological protection. The article also describes a technique for use of hand held radiation monitors and will discuss the identification and management of radiologically contaminated patients who may pose a significant danger to the surgical team. 2010 Elsevier Ltd. All rights reserved.

Preventive Rad/Nuc Detection Equipment Categorization for Consequence Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Buddemeier, B. R.; Musolino, S. V.; Klemic, G.

The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection equipment (PRND) to provide state and local agencies with guidance on how to best use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed for detection and interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management response take place. This effort will provide scientific guidance on the best way to deploy and operate this class of equipment for consequence managementmore » missions. With the support of the US Department of Homeland Security’s (DHS) Domestic Nuclear Detection Office (DNDO), PRND equipment has been placed into service at federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be repurposed to support the emergency response in the aftermath of a radiological of nuclear event. This report evaluates PRND equipment to define key categories of equipment and the types of missions they can be used for. This is important because there are over 100 different types of PRND equipment, often with significantly different capabilities with respect to the consequence management mission. The current DNDO draft NIMS PRND equipment types were used as a foundation and expanded, when necessary, to address key characteristics important for the consequence mission. Table 1 provides a summary of the PRND instrument categories developed for this effort. Also included on the table are some common response mission detection equipment categories that will be used for capability comparisons.« less

Investigation of occupational radiation exposures to NORM at an Irish peat-fired power station and potential use of peat fly ash by the construction industry.

PubMed

Organo, C; Lee, E M; Menezes, G; Finch, E C

2005-12-01

Annually, approximately 15% of Ireland's electricity requirement is provided through the combustion of 3 x 10(6) tonnes of peat. While the literature on coal-fired power generation is quite abundant, studies on the peat-fired power generation industry from a radiological point of view are scarce. A study of the largest Irish peat-fired power plant was initiated to review the potential occupational radiation exposures arising from the occurrence of naturally occurring radioactive material (NORM) at different stages of the industrial process and to investigate any radiological health consequences that may arise should peat fly ash be used as a component of building materials. Ambient gamma dose rate measurements, radon measurements, quantification of the occupational exposure from inhalation of airborne particles (personal air sampling) and gamma spectrometry analysis of peat, peat ash and effluent samples from the ash ponds were undertaken. The results indicate that the radiation dose received by any worker involved in the processing of the peat and the handling of the ash resulting from peat combustion does not exceed 150 microSv per annum. Regulatory control of the peat-fired power generation is therefore unnecessary according to the Irish legislation with regards to NORM. The potential use of peat fly ash as a by-product in the building industry was also found to have a negligible radiological impact for construction workers and for members of the public.

Generalized “Satisfaction of Search”: Adverse Influences on Dual-Target Search Accuracy

PubMed Central

Fleck, Mathias S.; Samei, Ehsan; Mitroff, Stephen R.

2013-01-01

The successful detection of a target in a radiological search can reduce the detectability of a second target, a phenomenon termed satisfaction of search (SOS). Given the potential consequences, here we investigate the generality of SOS with the goal of simultaneously informing radiology, cognitive psychology, and nonmedical searches such as airport luggage screening. Ten experiments utilizing nonmedical searches and untrained searchers suggest that SOS is affected by a diverse array of factors, including (1) the relative frequency of different target types, (2) external pressures (reward and time), and (3) expectations about the number of targets present. Collectively, these experiments indicate that SOS arises when searchers have a biased expectation about the low likelihood of specific targets or events, and when they are under pressure to perform efficiently. This first demonstration of SOS outside of radiology implicates a general heuristic applicable to many kinds of searches. In an example like airport luggage screening, the current data suggest that the detection of an easy-to-spot target (e.g., a water bottle) might reduce detection of a hard-to-spot target (e.g., a box cutter). PMID:20350044

[Legal aspects of post-mortem radiology in the Netherlands].

PubMed

Venderink, W; Dute, J C J

2016-01-01

In the Netherlands, the application of post-mortem radiology (virtual autopsy) is on the rise. Contrary to conventional autopsy, with post-mortem radiology the body remains intact. There is uncertainty concerning the legal admissibility of post-mortem radiology, since the Dutch Corpse Disposal Act does not contain any specific regulations for this technique. Autopsy and post-mortem radiology differ significantly from a technical aspect, but these differences do not have far-reaching legal consequences from a legal perspective. Even though the body remains intact during post-mortem radiology, the bodily integrity of a deceased person is breached if it would be applied without previously obtained consent. This permission can only be obtained after the relatives are fully informed about the proposed activity. In this respect, it is not relevant which technique is used, be it post-mortem radiology or autopsy. Therefore, the other legal conditions for post-mortem radiology are essentially identical to those for autopsy.

Psychosocial consequences and severity of disclosed incidental findings from whole-body MRI in a general population study.

PubMed

Schmidt, Carsten Oliver; Hegenscheid, Katrin; Erdmann, Pia; Kohlmann, Thomas; Langanke, Martin; Völzke, Henry; Puls, Ralf; Assel, Heinrich; Biffar, Reiner; Grabe, Hans Jörgen

2013-05-01

Little is known about the psychosocial impact and subjective interpretation of communicated incide ntal findings from whole-body magnetic resonance imaging (wb-MRI). This was addressed with this general population study. Data was based on the Study of Health in Pomerania (SHIP), Germany. SHIP comprised a 1.5-T wb-MRI examination. A postal survey was conducted among the first 471 participants, aged 23-84 years, who received a notification about incidental findings (response 86.0 %, n = 405). The severity of incidental findings was assessed from the participants' and radiologists' perspective. In total, 394 participants (97.3 %) wanted to learn about their health by undergoing wb-MRI. Strong distress while waiting for a potential notification of an incidental finding was reported by 40 participants (9.9 %), whereas 116 (28.6 %) reported moderate to severe psychological distress thereafter. Strong disagreement was noted between the subjective and radiological evaluation of the findings' severity (kappa = 0.02). Almost all participants (n = 389, 96.0 %) were very satisfied with their examination. Despite the high satisfaction of most participants, there were numerous adverse consequences concerning the communication of incidental findings and false expectations about the likely potential benefits of whole-body-MRI. • Disclosed incidental findings from MRI may lead to substantial psychosocial distress. • Subjective and radiological evaluations of incidental findings' severity differ strongly. • Disclosing incidental findings is strongly endorsed by study volunteers. • Study volunteers tend to have false expectations about potential benefits from MRI. • Minimizing stress in study volunteers should be a key aim in MRI research.

A discussion on the methodology for calculating radiological and toxicological consequences for the spent nuclear fuel project at the Hanford Site

DOE Office of Scientific and Technical Information (OSTI.GOV)

RITTMANN, P.D.

1999-07-14

This report contains technical information used to determine accident consequences for the Spent Nuclear Fuel Project safety documents. It does not determine accident consequences or describe specific accident scenarios, but instead provides generic information.

Radiation terrorism: what society needs from the radiobiology-radiation protection and radiation oncology communities.

PubMed

Coleman, C Norman; Parker, Gerald W

2009-06-01

Society's and individuals' concerns about the adverse effects from radiation are logically amplified many times when radiological terrorism is considered. The spectrum of events include industrial sabotage, the use of an explosive or non-explosive radiological dispersal device, the placement of a radiological exposure device in a public facility and the use of an improvised nuclear device. The consequences of an event relate to the physical and medical damage of the event itself, the financial impact, and the acute and long-term medical consequences, including fear of radiation-induced cancer. The magnitude of a state-sponsored nuclear event is so great that limited detailed response planning had been done in the past, as compared to the work now ongoing. Planning is done on the basis of scenario modelling. Medical response planning includes medical triage, distribution of victims to care by experienced physicians, developing medical countermeasures to mitigate or treat radiation injury, counselling and appropriately following exposed or potentially exposed people, and helping the local community develop confidence in their own response plan. Optimal response must be based on the best available science. This requires scientists who can define, prioritise and address the gaps in knowledge with the range of expertise from basic physics to biology to translational research to systems expertise to response planning to healthcare policy to communications. Not only are there unique needs and career opportunities, but there is also the opportunity for individuals to serve their communities and country with education regarding radiation effects and by formulating scientifically based government policy.

Outsourcing to teleradiology companies: bad for radiology, bad for radiologists.

PubMed

Levin, David C; Rao, Vijay M

2011-02-01

Outsourcing night and weekend call to teleradiology companies has become a common practice among private radiology groups. While this may lead to an easier lifestyle, the authors discuss the serious negative consequences for radiologists and the specialty as a whole. These include the likelihood of commoditization of the field, lowering of fees, displacement from hospital contracts and outpatient reading contracts, greater encroachment by other specialties, and lowering of quality. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Long-term fate of depleted uranium at Aberdeen and Yuma Proving Grounds: Human health and ecological risk assessments

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ebinger, M.H.; Beckman, R.J.; Myers, O.B.

1996-09-01

The purpose of this study was to evaluate the immediate and long-term consequences of depleted uranium (DU) in the environment at Aberdeen Proving Ground (APG) and Yuma Proving Ground (YPG) for the Test and Evaluation Command (TECOM) of the US Army. Specifically, we examined the potential for adverse radiological and toxicological effects to humans and ecosystems caused by exposure to DU at both installations. We developed contaminant transport models of aquatic and terrestrial ecosystems at APG and terrestrial ecosystems at YPG to assess potential adverse effects from DU exposure. Sensitivity and uncertainty analyses of the initial models showed the portionsmore » of the models that most influenced predicted DU concentrations, and the results of the sensitivity analyses were fundamental tools in designing field sampling campaigns at both installations. Results of uranium (U) isotope analyses of field samples provided data to evaluate the source of U in the environment and the toxicological and radiological doses to different ecosystem components and to humans. Probabilistic doses were estimated from the field data, and DU was identified in several components of the food chain at APG and YPG. Dose estimates from APG data indicated that U or DU uptake was insufficient to cause adverse toxicological or radiological effects. Dose estimates from YPG data indicated that U or DU uptake is insufficient to cause radiological effects in ecosystem components or in humans, but toxicological effects in small mammals (e.g., kangaroo rats and pocket mice) may occur from U or DU ingestion. The results of this study were used to modify environmental radiation monitoring plans at APG and YPG to ensure collection of adequate data for ongoing ecological and human health risk assessments.« less

Comparison of the radiological and chemical toxicity of lead

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beitel, G.A.; Mott, S.

1995-03-01

This report estimates the worst-case radiological dose to an individual from ingested lead containing picocurie levels of radionuclides and then compares the calculated radiological health effects to the chemical toxic effects from that same lead. This comparison provides an estimate of the consequences of inadvertently recycling, in the commercial market, lead containing nominally undetectable concentrations of radionuclides. Quantitative expressions for the radiological and chemical toxicities of lead are based on concentrations of lead in the blood stream. The result shows that the chemical toxicity of lead is a greater health hazard, by orders of magnitude, than any probable companion radiationmore » dose.« less

Linking DICOM pixel data with radiology reports using automatic semantic annotation

NASA Astrophysics Data System (ADS)

Pathak, Sayan D.; Kim, Woojin; Munasinghe, Indeera; Criminisi, Antonio; White, Steve; Siddiqui, Khan

2012-02-01

Improved access to DICOM studies to both physicians and patients is changing the ways medical imaging studies are visualized and interpreted beyond the confines of radiologists' PACS workstations. While radiologists are trained for viewing and image interpretation, a non-radiologist physician relies on the radiologists' reports. Consequently, patients historically have been typically informed about their imaging findings via oral communication with their physicians, even though clinical studies have shown that patients respond to physician's advice significantly better when the individual patients are shown their own actual data. Our previous work on automated semantic annotation of DICOM Computed Tomography (CT) images allows us to further link radiology report with the corresponding images, enabling us to bridge the gap between image data with the human interpreted textual description of the corresponding imaging studies. The mapping of radiology text is facilitated by natural language processing (NLP) based search application. When combined with our automated semantic annotation of images, it enables navigation in large DICOM studies by clicking hyperlinked text in the radiology reports. An added advantage of using semantic annotation is the ability to render the organs to their default window level setting thus eliminating another barrier to image sharing and distribution. We believe such approaches would potentially enable the consumer to have access to their imaging data and navigate them in an informed manner.

SOARCA Peach Bottom Atomic Power Station Long-Term Station Blackout Uncertainty Analysis: Knowledge Advancement.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gauntt, Randall O.; Mattie, Patrick D.; Bixler, Nathan E.

2014-02-01

This paper describes the knowledge advancements from the uncertainty analysis for the State-of- the-Art Reactor Consequence Analyses (SOARCA) unmitigated long-term station blackout accident scenario at the Peach Bottom Atomic Power Station. This work assessed key MELCOR and MELCOR Accident Consequence Code System, Version 2 (MACCS2) modeling uncertainties in an integrated fashion to quantify the relative importance of each uncertain input on potential accident progression, radiological releases, and off-site consequences. This quantitative uncertainty analysis provides measures of the effects on consequences, of each of the selected uncertain parameters both individually and in interaction with other parameters. The results measure the modelmore » response (e.g., variance in the output) to uncertainty in the selected input. Investigation into the important uncertain parameters in turn yields insights into important phenomena for accident progression and off-site consequences. This uncertainty analysis confirmed the known importance of some parameters, such as failure rate of the Safety Relief Valve in accident progression modeling and the dry deposition velocity in off-site consequence modeling. The analysis also revealed some new insights, such as dependent effect of cesium chemical form for different accident progressions. (auth)« less

RISKIND : an enhanced computer code for National Environmental Policy Act transportation consequence analysis

DOT National Transportation Integrated Search

1996-01-01

The RISKIND computer program was developed for the analysis of radiological consequences and health risks to individuals and the collective population from exposures associated with the transportation of spent nuclear fuel (SNF) or other radioactive ...

Key Planning Factors for Recovery from a Radiological Terrorism Incident

DTIC Science & Technology

2012-09-01

United States, Health Phys. 82(5), 591–608. Bromet E.J. (2012). Mental health consequences of the Chernobyl disaster, J Radiol Prot. 2012 Mar; 32(1...Recovery Planning Tools: Recommendations for Developing Regional Disaster Recovery Plans. Draft. Steinhausler, F. (2005), Chernobyl and Goiania Lessons for Responding to Radiological Terrorism. Health Phys. 89(5):566 –574

White Paper: Curriculum in Interventional Radiology.

PubMed

Mahnken, Andreas H; Bücker, Arno; Hohl, Christian; Berlis, Ansgar

2017-04-01

Purpose  Scope and clinical importance of interventional radiology markedly evolved over the last decades. Consequently it was acknowledged as independent subspecialty by the "European Union of Medical Specialists" (UEMS). Based on radiological imaging techniques Interventional Radiology is an integral part of Radiology. Materials und Methods  In 2009 the German Society for Interventional Radiology and minimally-invasive therapy (DeGIR) developed a structured training in Interventional Radiology. In cooperation with the German Society of Neuroradiology (DGNR) this training was extended to also cover Interventional Neuroradiology in 2012. Tailored for this training in Interventional Radiology a structured curriculum was developed, covering the scope of this modular training. Results  The curriculum is based on the DeGIR/DGNR modular training concept in Interventional Radiology. There is also an European Curriculum and Syllabus for Interventional Radiology developed by the "Cardiovascular and Interventional Radiological Society of Europe" (CIRSE). The presented curriculum in Interventional Radiology is designed to provide a uniform base for the training in Interventional Radiology in Germany, based on the competencies obtained during residency. Conclusion  This curriculum can be used as a basis for training in Interventional Radiology by all training sites. Key Points: · Interventional Radiology is an integral part of clinical radiology. · The German Society for Interventional Radiology and minimally-invasive therapy (DeGIR) developed a curriculum in Interventional Radiology. · This curriculum is an integrative basis for the training in interventional. Citation Format · Mahnken AH, Bücker A, Hohl C et al. White Paper: Curriculum in Interventional Radiology. Fortschr Röntgenstr 2017; 189: 309 - 311. © Georg Thieme Verlag KG Stuttgart · New York.

Final safety analysis report for the Galileo mission: Volume 3 (Book 2), Nuclear risk analysis document: Appendices: Revision 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1989-01-25

It is the purpose of the NRAD to provide an analysis of the range of potential consequences of accidents which have been identified that are associated with the launching and deployment of the Galileo mission spacecraft. The specific consequences analyzed are those associated with the possible release of radioactive material (fuel) of the Radioisotope Thermoelectric Generators (RTGs). They are in terms of radiation doses to people and areas of deposition of radioactive material. These consequence analyses can be used in several ways. One way is to identify the potential range of consequences which might have to be dealt with ifmore » there were to be an accident with a release of fuel, so as to assure that, given such an accident, the health and safety of the public will be reasonably protected. Another use of the information, in conjunction with accident and release probabilities, is to estimate the risks associated with the mission. That is, most space launches occur without incident. Given an accident, the most probable result relative to the RTGs is complete containment of the radioactive material. Only a small fraction of accidents might result in a release of fuel and subsequent radiological consequences. The combination of probability with consequence is risk, which can be compared to other human and societal risks to assure that no undue risks are implied by undertaking the mission. Book 2 contains eight appendices.« less

Safety analysis report for the Galileo Mission. Volume 3, book 2: Nuclear risk analysis document. Appendices, revision 1

NASA Astrophysics Data System (ADS)

1989-01-01

It is the purpose of the NRAD to provide an analysis of the range of potential consequences of accidents which have been identified that are associated with the launching and deployment of the Galileo mission spacecraft. The specific consequences analyzed are those associated with the possible release of radioactive material (fuel) of the Radioisotope Thermoelectric Generators (RTGs). They are in terms of radiation doses to people and areas of deposition of radioactive material. These consequence analyses can be used in several ways. One way is to identify the potential range of consequences which might have to be dealt with if there were to be an accident with a release of fuel, so as to assure that, given such an accident, the health and safety of the public will be reasonably protected. Another use of the information, in conjunction with accident and release probabilities, is to estimate the risks associated with the mission. That is, most space launches occur without incident. Given an accident, the most probable result relative to the RTGs is complete containment of the radioactive material. Only a small fraction of accidents might result in a release of fuel and subsequent radiological consequences. The combination of probability with consequence is risk, which can be compared to other human and societal risks to assure that no undue risks are implied by undertaking the mission. Book 2 contains eight appendices.

Surgical considerations in the management of combined radiation blast injury casualties caused by a radiological dirty bomb.

PubMed

Williams, Geraint; O'Malley, Michael

2010-09-01

The capacity for surgical teams to respond appropriately to the consequences caused by the detonation of a radiological dirty bomb will be determined by prior knowledge, familiarity and training for this type unique terrorist event. This paper will focus on the surgical aspects of this scenario with particular emphasis on the management of combined trauma-radiological injury. The paper also describes some of the more serious explosion-contamination incidents from nuclear industrial sources, summarises learning points and parallels taken from these scenarios in relation to subject of a radiological dirty bomb and describes the likely radioactive substances involved. 2010 Elsevier Ltd. All rights reserved.

Clinical and Radiologic Outcomes of a Fully Hydroxyapatite-Coated Femoral Revision Stem: Excessive Stress Shielding Incidence and its Consequences.

PubMed

Sanli, Ilknur; Arts, Jacobus Johannes Christiaan; Geurts, Jan

2016-01-01

Stress shielding remains a concern in total hip arthroplasty. The consequences of stress shielding in hydroxyapatite-coated femoral component revisions were evaluated in a prospective cohort study. A total of 106 patients operated on by revision total hip arthroplasty were identified. Sixty-three patients were eligible for clinical and radiologic assessment of osseointegration, bone remodeling, and stress shielding. Five patients showed evidence of excessive stress shielding. One patient experienced a periprosthetic fracture. No adverse events occurred in the remaining patients with a low rate of thigh pain and reliable osseointegration. This is the only available study concerning mid- to long-term consequences of excessive stress shielding in hydroxyapatite-coated revision stems. We advocate surgeons using these stems to remain vigilant and be aware of possible stress shielding side effects. Copyright © 2016 Elsevier Inc. All rights reserved.

Toxicity assessment of the water used for human consumption from the Cameron/Tuba City abandoned uranium mining area prior/after the combined electrochemical treatment/advanced oxidation.

PubMed

Gajski, Goran; Oreščanin, Višnja; Gerić, Marko; Kollar, Robert; Lovrenčić Mikelić, Ivanka; Garaj-Vrhovac, Vera

2015-01-01

The purpose of this work was detailed physicochemical, radiological, and toxicological characterization of the composite sample of water intended for human consumption in the Cameron/Tuba City abandoned uranium mining area before and after a combined electrochemical/advanced oxidation treatment. Toxicological characterization was conducted on human lymphocytes using a battery of bioassays. On the bases of the tested parameters, it could be concluded that water used for drinking from the tested water sources must be strictly forbidden for human and/or animal consumption since it is extremely cytogenotoxic, with high oxidative stress potential. A combined electrochemical treatment and posttreatment with ozone and UV light decreased the level of all physicochemical and radiological parameters below the regulated values. Consequently, the purified sample was neither cytotoxic nor genotoxic, indicating that the presented method could be used for the improvement of water quality from the sites highly contaminated with the mixture of heavy metals and radionuclides.

Radiological emergency response for community agencies with cognitive task analysis, risk analysis, and decision support framework.

PubMed

Meyer, Travis S; Muething, Joseph Z; Lima, Gustavo Amoras Souza; Torres, Breno Raemy Rangel; del Rosario, Trystyn Keia; Gomes, José Orlando; Lambert, James H

2012-01-01

Radiological nuclear emergency responders must be able to coordinate evacuation and relief efforts following the release of radioactive material into populated areas. In order to respond quickly and effectively to a nuclear emergency, high-level coordination is needed between a number of large, independent organizations, including police, military, hazmat, and transportation authorities. Given the complexity, scale, time-pressure, and potential negative consequences inherent in radiological emergency responses, tracking and communicating information that will assist decision makers during a crisis is crucial. The emergency response team at the Angra dos Reis nuclear power facility, located outside of Rio de Janeiro, Brazil, presently conducts emergency response simulations once every two years to prepare organizational leaders for real-life emergency situations. However, current exercises are conducted without the aid of electronic or software tools, resulting in possible cognitive overload and delays in decision-making. This paper describes the development of a decision support system employing systems methodologies, including cognitive task analysis and human-machine interface design. The decision support system can aid the coordination team by automating cognitive functions and improving information sharing. A prototype of the design will be evaluated by plant officials in Brazil and incorporated to a future trial run of a response simulation.

Delegations of authority and organization; Center for Devices and Radiological Health--FDA. Final rule.

PubMed

1991-10-10

The Commissioner of Food and Drugs is redelegating authorities to certain officials of the Food and Drug Administration's (FDA's) Center for Devices and Radiological Health (CDRH) to temporarily suspend premarket approval applications and to recall devices in the event those devices would cause serious adverse consequences to health or death. These authorities were given to the FDA by the Safe Medical Devices Act of 1990.

Preliminary evaluation of solution-mining intrusion into a salt-dome repository

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1981-06-01

This report is the product of the work of an ONWI task force to evaluate inadvertant human intrusion into a salt dome repository by solution mining. It summarizes the work in the following areas: a general review of the levels of defense that could reduce both the likelihood and potential consequences of human intrusion into a salt dome repository; evaluation of a hypothetical intrusion scenario and its consequences; recommendation for further studies. The conclusions of this task force report can be summarized as follows: (1) it is not possible at present to establish with certainty that solution mining is crediblemore » as a human-intrusion event. The likelihood of such an intrusion will depend on the effectiveness of the preventive measures; (2) an example analysis based on the realistic approach is presented in this report; it concluded that the radiological consequences are strongly dependent upon the mode of radionuclide release from the waste form, time after emplacement, package design, impurities in the host salt, the amount of a repository intercepted, the solution mining cavity form, the length of time over which solution mining occurs, the proportion of contaminated salt source for human consumption compared to other sources, and the method of salt purification for culinary purposes; (3) worst case scenarios done by other studies suggest considerable potential for exposures to man while preliminary evaluations of more realistic cases suggest significantly reduced potential consequences. Mathematical model applications to process systems, guided by more advanced assumptions about human intrusion into geomedia, will shed more light on the potential for concerns and the degree to which mitigative measures will be required.« less

The Impact of Nonphysician Providers on Diagnostic and Interventional Radiology Practices: Operational and Educational Implications.

PubMed

Hawkins, C Matthew; Bowen, Michael A; Gilliland, Charles A; Walls, D Gail; Duszak, Richard

2015-09-01

The numbers of nurse practitioners (NPs) and physician assistants (PAs) are increasing throughout the entire health care enterprise, and a similar expansion continues within radiology. The use of radiologist assistants is growing in some radiology practices as well. The increased volume of services rendered by this growing nonphysician provider subset of the health care workforce within and outside radiology departments warrants closer review, particularly with regard to their potential influence on radiology education and medical imaging resource utilization. In this article (the second in a two-part series), the authors review recent literature and offer recommendations for radiology practices regarding the impact NPs, PAs, and radiologist assistants may have on interventional and diagnostic radiology practices. Their potential impact on medical education is also discussed. Finally, staffing for radiology departments, as a result of an enlarging nonradiology NP and PA workforce ordering diagnostic imaging, is considered. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Modeling of workflow-engaged networks on radiology transfers across a metro network.

PubMed

Camorlinga, Sergio; Schofield, Bruce

2006-04-01

Radiology metro networks bear the challenging proposition of interconnecting several hospitals in a region to provide a comprehensive diagnostic imaging service. Consequences of a poorly designed and implemented metro network could cause delays or no access at all when health care providers try to retrieve medical cases across the network. This could translate into limited diagnostic services to patients, resulting in negative impacts to the patients' medical treatment. A workflow-engaged network (WEN) is a new network paradigm. A WEN appreciates radiology workflows and priorities in using the network. A WEN greatly improves the network performance by guaranteeing that critical image transfers experience minimal delay. It adjusts network settings to ensure the application's requirements are met. This means that high-priority image transfers will have guaranteed and known delay times, whereas lower-priority traffic will have increased delays. This paper introduces a modeling to understand the benefits that WEN brings to a radiology metro network. The modeling uses actual data patterns and flows found in a hospital metro region. The workflows considered are based on the Integrating the Healthcare Enterprise profiles. This modeling has been applied to metropolitan workflows of a health region. The modeling helps identify the kind of metro network that supports data patterns and flows in a metro area. The results of the modeling show that a 155-Mb/s metropolitan area network (MAN) with WEN operates virtually equal to a normal 622-Mb/s MAN without WEN, with potential cost savings for leased line services measured in the millions of dollars per year.

Radiology workstation design for the medical intensive care unit.

PubMed

Moise, Adrian; Atkins, Stella M

2002-01-01

The "one-size-fits-all" approach for radiology workstation design is not good enough anymore. While most of the picture archiving and communication system (PACS) vendors are racing to add more features to the radiology workstation, there is little interest in addressing the specific needs of other hospital departments. Significant delays in the availability of radiology reports are often caused by the fact there is not enough Intensive Care Unit (ICU) volume to justify a full time radiologist. Consequently, the radiologist assigned to cover the ICU exams, most likely working from a different building, will read the ICU exams only at certain times, depending on the limitations for remote image availability. This paper addresses the main objectives in designing a digital radiology workstation for use in the medical ICU (MICU), requiring enhancements to current PACS systems. Our suggestions for PACS improvement follow the ICU digital workflow starting with the transfer of the images from the modality, continuing with the presentation of the radiology examination to different types of users (radiologists or ICU staff), up to the creation and distribution of the reports.

Contracts in radiology practices: breaches and remedies.

PubMed

Muroff, Julie A; Muroff, Lawrence R

2004-08-01

Contracts between radiology groups and their physician members are often ambiguous. Key clauses may not be precise as to the intent of the contracting parties. For example, the requirements for a group member to achieve shareholder status may be discussed but not reduced to a written form. Other contract provisions, such as termination or noncompete clauses, may be subject to different interpretations. The ambiguities of these provisions often generate disparate expectations regarding the parties' obligations to one another. When this occurs, the results may vary from disappointment to litigation. This paper discusses the causes and consequences of common breaches of radiology contracts. The types of remedies that may be available to the parties of the contract are also enumerated, and case law is cited to illustrate the challenges that radiology groups and their members may encounter. Finally, alternative forms of dispute resolution are discussed.

Radiological and practical aspects of body packing

PubMed Central

Reginelli, A; Pinto, F; Sica, G; Scaglione, M; Berger, F H; Romano, L; Brunese, L

2014-01-01

Body packing represents the concealment of illegal substances in a person's body with the aim of smuggling. “Body packers” either swallow drug-filled packets or introduce drug-filled packets into their bodies rectally or vaginally with the purpose of concealing them. The three main smuggled drugs are cocaine, heroin and cannabis products. Body packing represents a serious risk of acute narcotic toxicity from drug exposure, intestinal obstruction owing to pellet impaction and bowel perforation with consequent abdominal sepsis. A suspected body packer is generally admitted to hospital to perform imaging investigations and confirm the presence of drugs in his/her body. Radiological imaging methods are essential to diagnose body packing and to detect potential complications. Increasing sophistication of traffickers and improvements in packaging add to the detection difficulty. Radiologists should be aware of the appearance of drug packets in a range of imaging modalities. This article informs physicians about the challenging aspects of body packing, its background and medicolegal issues, what imaging methods can be used and what criteria are necessary to perform a correct diagnosis. PMID:24472727

Advantages and Disadvantages in Image Processing with Free Software in Radiology.

PubMed

Mujika, Katrin Muradas; Méndez, Juan Antonio Juanes; de Miguel, Andrés Framiñan

2018-01-15

Currently, there are sophisticated applications that make it possible to visualize medical images and even to manipulate them. These software applications are of great interest, both from a teaching and a radiological perspective. In addition, some of these applications are known as Free Open Source Software because they are free and the source code is freely available, and therefore it can be easily obtained even on personal computers. Two examples of free open source software are Osirix Lite® and 3D Slicer®. However, this last group of free applications have limitations in its use. For the radiological field, manipulating and post-processing images is increasingly important. Consequently, sophisticated computing tools that combine software and hardware to process medical images are needed. In radiology, graphic workstations allow their users to process, review, analyse, communicate and exchange multidimensional digital images acquired with different image-capturing radiological devices. These radiological devices are basically CT (Computerised Tomography), MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography), etc. Nevertheless, the programs included in these workstations have a high cost which always depends on the software provider and is always subject to its norms and requirements. With this study, we aim to present the advantages and disadvantages of these radiological image visualization systems in the advanced management of radiological studies. We will compare the features of the VITREA2® and AW VolumeShare 5® radiology workstation with free open source software applications like OsiriX® and 3D Slicer®, with examples from specific studies.

File format for normalizing radiological concentration exposure rate and dose rate data for the effects of radioactive decay and weathering processes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kraus, Terrence D.

2017-04-01

This report specifies the electronic file format that was agreed upon to be used as the file format for normalized radiological data produced by the software tool developed under this TI project. The NA-84 Technology Integration (TI) Program project (SNL17-CM-635, Normalizing Radiological Data for Analysis and Integration into Models) investigators held a teleconference on December 7, 2017 to discuss the tasks to be completed under the TI program project. During this teleconference, the TI project investigators determined that the comma-separated values (CSV) file format is the most suitable file format for the normalized radiological data that will be outputted frommore » the normalizing tool developed under this TI project. The CSV file format was selected because it provides the requisite flexibility to manage different types of radiological data (i.e., activity concentration, exposure rate, dose rate) from other sources [e.g., Radiological Assessment and Monitoring System (RAMS), Aerial Measuring System (AMS), Monitoring and Sampling). The CSV file format also is suitable for the file format of the normalized radiological data because this normalized data can then be ingested by other software [e.g., RAMS, Visual Sampling Plan (VSP)] used by the NA-84’s Consequence Management Program.« less

Radiological Exposure Devices (RED) Technical Basis for Threat Profile.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bland, Jesse John; Potter, Charles A.; Homann, Steven

Facilities that manufacture, store or transport significant quantities of radiological material must protect against the risk posed by sabotage events. Much of the analysis of this type of event has been focused on the threat from a radiological dispersion device (RDD) or "dirty bomb" scenario, in which a malicious assailant would, by explosives or other means, loft a significant quantity of radioactive material into a plume that would expose and contaminate people and property. Although the consequences in cost and psychological terror would be severe, no intentional RDD terrorism events are on record. Conversely, incidents in which a victim ormore » victims were maliciously exposed to a Radiological Exposure Device (RED), without dispersal of radioactive material, are well documented. This paper represents a technical basis for the threat profile related to the risk of nefarious use of an RED, including assailant and material characterization. Radioactive materials of concern are detailed in Appendix A.« less

Coping in a calamity: Radiology during the cloudburst at Leh

PubMed Central

Sen, Debraj

2013-01-01

The service hospital at Leh is a multispeciality hospital situated at an altitude of 11000 feet above mean sea level. On the nights of 4 and 5 Aug 2010, Leh was struck by a cloudburst leading to mudslides and consequently extensive damage to life and property. Being the only functional hospital, over a period of about 48 hours, 331 casualties were received. 549 casualties were received over the week with 108 admissions, 16 major surgeries and 138 minor surgeries. 178 radiographs, 17 CT scans and 09 ultrasound-colour Doppler examinations were performed on an urgent basis over 48 hours apart from the routine radiological investigations. Apart from chronicling the event, we hope that sharing the unique experience of the Radiology Department in dealing with the large influx of patients would provide an insight into the role of Radiology during the disaster and help in planning and developing management protocols during other calamities. PMID:23986626

Interventional Radiology of Male Varicocele: Current Status

DOE Office of Scientific and Technical Information (OSTI.GOV)

Iaccarino, Vittorio, E-mail: vittorio.iaccarino@unina.it; Venetucci, Pietro

2012-12-15

Varicocele is a fairly common condition in male individuals. Although a minor disease, it may cause infertility and testicular pain. Consequently, it has high health and social impact. Here we review the current status of interventional radiology of male varicocele. We describe the radiological anatomy of gonadal veins and the clinical aspects of male varicocele, particularly the physical examination, which includes a new clinical and ultrasound Doppler maneuver. The surgical and radiological treatment options are also described with the focus on retrograde and antegrade sclerotherapy, together with our long experience with these procedures. Last, we compare the outcomes, recurrence andmore » persistence rates, complications, procedure time and cost-effectiveness of each method. It clearly emerges from this analysis that there is a need for randomized multicentre trials designed to compare the various surgical and percutaneous techniques, all of which are aimed at occlusion of the anterior pampiniform plexus.« less

Teleradiology in Singapore--taking stock and looking ahead.

PubMed

Cheng, Lionel T E; Ng, Samuel E S

2006-08-01

Teleradiology will have a significant impact on the delivery of healthcare and the practice of medicine. In order to ensure a positive outcome, the expected benefits, limitations and potential pitfalls of teleradiology must be carefully considered. For Singapore, teleradiology can be used to facilitate a quantum leap in the standards of radiological services. This can be achieved through the development of an integrated, nationwide, high-speed radiology network which will allow patients to have access to high-quality and responsive subspecialty radiology expertise located throughout the country. If judiciously implemented, teleradiology has the potential to propel Singapore radiology to an unprecedented level of professional quality and service delivery, and will provide the framework for sustainable radiological insourcing from other countries.

Radiologic Professionalism in Modern Health Care.

PubMed

Hryhorczuk, Anastasia L; Hanneman, Kate; Eisenberg, Ronald L; Meyer, Elaine C; Brown, Stephen D

2015-10-01

Modern radiology is at the forefront of technological progress in medicine, a position that often places unique challenges on its professional character. This article uses "Medical Professionalism in the New Millennium: A Physician Charter," a document published in 2002 and endorsed by several major radiology organizations, as a lens for exploring professional challenges in modern radiology. The three main tenets of the Charter emphasize patient welfare, patient autonomy, and the reduction of disparities in health care distribution. This article reviews the ways in which modern technology and financial structures potentially create stressors on professionalism in radiology, while highlighting the opportunities they provide for radiologists seeking to fulfill the professional goals articulated in the Charter. Picture archiving and communication systems (PACS) and voice recognition systems have transformed the speed of radiology and enhanced the ability of radiologists to improve patient care but also have brought new tensions to the workplace. Although teleradiology may improve global access to radiologists, it may also promote the commoditization of radiology, which diminishes the professional stature of radiologists. Social media and patient portals provide radiologists with new forums for interacting with the public and patients, potentially promoting patient welfare. However, patient privacy and autonomy are important considerations. Finally, modern financial structures provide radiologists with both entrepreneurial opportunities as well as the temptation for unprofessional conduct. Each of these advances carries the potential for professional growth while testing the professional stature of radiology. By considering the risks and benefits of emerging technologies in the modern radiology world, radiologists can chart an ethical and professional future path. © RSNA, 2015.

Relativity Screens for Misvalued Medical Services: Impact on Noninvasive Diagnostic Radiology.

PubMed

Rosenkrantz, Andrew B; Silva, Ezequiel; Hawkins, C Matthew

2017-11-01

In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services. The frequency of having ever undergone a screen was compared between the two groups. Screened radiology codes were further evaluated regarding the RVU impact of subsequent revaluation. Of noninvasive diagnostic radiology codes, 46.0% (201 of 437) were screened versus 22.2% (1,460 of 6,575) of remaining codes (P < .001). Most common screens for which radiology codes were identified as potentially misvalued were (1) high expenditures (27.5%) and (2) high utilization (25.6%). The modality and body region most likely to be identified in a screen were CT (82.1%) and breast (90.9%), respectively. Among screened radiology codes, work RVUs, practice expense RVUs, and nonfacility total RVUs decreased in 20.3%, 65.9%, and 75.3%, respectively. All screened CT, MRI, brain, and spine codes exhibited decreased total RVUs. Policymakers' ongoing search for potentially misvalued medical services has disproportionately impacted noninvasive diagnostic radiology services, risking the introduction of unintended or artificial shifts in physician practice. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Conflict with China: Prospects, Consequences, and Strategies for Deterrence

DTIC Science & Technology

2011-01-01

Burma / Myanmar . Above and beyond the dangers posed by a clash between the world’s two most populous countries, the presence of nuclear weapons on...Reconnaissance CBRNE Chemical, Biological, Radiological, Nuclear , High-Yield Explosives DMZ Demilitarized Zone DPRK Democratic People’s Republic of Korea EEZ...most concern to the United States. 2 Conflict with China: Prospects, Consequences, and Strategies for Deterrence Occasions for Conflict North Korea

Interagency Nuclear Safety Review Panel: Biomedical and Environmental Effects Subpanel report for Galileo

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anspaugh, L.R.; Blanton, J.O.; Bollinger, L.J.

1989-10-01

This report of the Biomedical and Environmental Effects Subpanel (BEES) of the Interagency Nuclear Safety Review Panel (INSRP), for the Galileo space mission addresses the possible radiological consequences of postulated accidents that release radioactivity into the environment. This report presents estimates of the consequences and uncertainties given that the source term is released into the environment. 10 refs., 6 tabs.

Utilization management in radiology, part 2: perspectives and future directions.

PubMed

Duszak, Richard; Berlin, Jonathan W

2012-10-01

Increased utilization of medical imaging in the early part of the last decade has resulted in numerous efforts to reduce associated spending. Recent initiatives have focused on managing utilization with radiology benefits managers and real-time order entry decision support systems. Although these approaches might seem mutually exclusive and their application to radiology appears unique, the historical convergence and broad acceptance of both programs within the pharmacy sector may offer parallels for their potential future in medical imaging. In this second installment of a two-part series, anticipated trends in radiology utilization management are reviewed. Perspectives on current and future potential roles of radiologists in such initiatives are discussed, particularly in light of emerging physician payment models. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Accountable care organizations and radiology: threat or opportunity?

PubMed

Abramson, Richard G; Berger, Paul E; Brant-Zawadzki, Michael N

2012-12-01

Although the anticipated rise of accountable care organizations brings certain potential threats to radiologists, including direct threats to revenue and indirect systemic changes jeopardizing the bargaining leverage of radiology groups, accountable care organizations, and other integrated health care delivery models may provide radiology with an important opportunity to reassert its leadership and assume a more central role within health care systems. Capitalizing on this potential opportunity, however, will require radiology groups to abandon the traditional "film reader" mentality and engage actively in the design and implementation of nontraditional systems service lines aimed at adding differentiated value to larger health care organizations. Important interlinked and mutually reinforcing components of systems service lines, derived from radiology's core competencies, may include utilization management and decision support, IT leadership, quality and safety assurance, and operational enhancements to meet organizational goals. Such systems-oriented service products, tailored to the needs of individual integrated care entities and supported by objective performance metrics, may provide market differentiation to shield radiology from commoditization and could become an important source of new nonclinical revenue. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Singapore National Medical Image Resource Centre (SN.MIRC): a world wide web resource for radiology education.

PubMed

Yang, Guo-Liang; Lim, C C Tchoyoson

2006-08-01

Radiology education is heavily dependent on visual images, and case-based teaching files comprising medical images can be an important tool for teaching diagnostic radiology. Currently, hardcopy film is being rapidly replaced by digital radiological images in teaching hospitals, and an electronic teaching file (ETF) library would be desirable. Furthermore, a repository of ETFs deployed on the World Wide Web has the potential for e-learning applications to benefit a larger community of learners. In this paper, we describe a Singapore National Medical Image Resource Centre (SN.MIRC) that can serve as a World Wide Web resource for teaching diagnostic radiology. On SN.MIRC, ETFs can be created using a variety of mechanisms including file upload and online form-filling, and users can search for cases using the Medical Image Resource Center (MIRC) query schema developed by the Radiological Society of North America (RSNA). The system can be improved with future enhancements, including multimedia interactive teaching files and distance learning for continuing professional development. However, significant challenges exist when exploring the potential of using the World Wide Web for radiology education.

Maternal transfer of anthropogenic radionuclides to eggs in a small shark.

PubMed

Jeffree, Ross A; Oberhansli, Francois; Teyssie, Jean-Louis; Fowler, Scott W

2015-09-01

Maternal transfer of radionuclides to progeny is one of the least known sources of contamination in marine biota and more information is needed to assess its radiological significance. A radiotracer study on spotted dogfish, Scyliorhinus canicula, evaluated the hypothesis that four anthropogenic radionuclides (Cobalt-60, Zinc-65, Americium-241 and Cesium-134) could be maternally transferred to eggs and each of their major components during maternal ingestion of radiolabelled food. The linear regressions between cumulative radioactivity that had been maternally ingested and the level in subsequently laid eggs were used to derive maternal-to-egg transfer factors (mTFs). These maternal transfers varied over an order of magnitude and were ranked (134)Cs > (65)Zn > (60)Co > (241)Am. This ranking was the same as their relative assimilation efficiencies in radiolabelled food consumed by adults. Among these four radionuclides the potential radiological exposure of embryos is accentuated for (65)Zn and (134)Cs due to their predominant transfer to egg yolk where they are available for subsequent absorption by the embryo as it develops prior to hatching from the egg capsule. Thus, for cartilaginous fish like shark, the potential radioecological consequences of a pulsed release of these radionuclides into the marine environment may extend beyond the temporal duration of the release. Copyright © 2015 Elsevier Ltd. All rights reserved.

Risk factors and biomarkers of life-threatening cancers

PubMed Central

Autier, Philippe

2015-01-01

There is growing evidence that risk factors for cancer occurrence and for cancer death are not necessarily the same. Knowledge of cancer aggressiveness risk factors (CARF) may help in identifying subjects at high risk of developing a potentially deadly cancer (and not just any cancer). The availability of CARFs may have positive consequences for health policies, medical practice, and the search for biomarkers. For instance, cancer chemoprevention and cancer screening of subjects with CARFs would probably be more ethical and cost-effective than recommending chemoprevention and screening to entire segments of the population. Also, the harmful consequences of chemoprevention and of screening would be reduced while effectiveness would be optimised. We present examples of CARF already in use (e.g. mutations of the breast cancer (BRCA) gene), of promising avenues for the discovery of biomarkers thanks to the investigation of CARFs (e.g. breast radiological density and systemic inflammation), and of biomarkers commonly used that are not real CARFs (e.g. certain mammography images, prostate-specific antigen (PSA) concentration, nevus number). PMID:26635900

Nanotechnology and its Relationship to Interventional Radiology. Part I: Imaging

DOE Office of Scientific and Technical Information (OSTI.GOV)

Power, Sarah; Slattery, Michael M.; Lee, Michael J., E-mail: mlee@rcsi.ie

2011-04-15

Nanotechnology refers to the design, creation, and manipulation of structures on the nanometer scale. Interventional radiology stands to benefit greatly from advances in nanotechnology because much of the ongoing research is focused toward novel methods of imaging and delivery of therapy through minimally invasive means. Through the development of new techniques and therapies, nanotechnology has the potential to broaden the horizon of interventional radiology and ensure its continued success. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part I ofmore » the article deals with an introduction to some of the basic concepts of nanotechnology and outlines some of the potential imaging applications, concentrating mainly on advances in oncological and vascular imaging.« less

Consensus Paper: Radiological Biomarkers of Cerebellar Diseases

PubMed Central

Baldarçara, Leonardo; Currie, Stuart; Hadjivassiliou, M.; Hoggard, Nigel; Jack, Allison; Jackowski, Andrea P.; Mascalchi, Mario; Parazzini, Cecilia; Reetz, Kathrin; Righini, Andrea; Schulz, Jörg B.; Vella, Alessandra; Webb, Sara Jane; Habas, Christophe

2016-01-01

Hereditary and sporadic cerebellar ataxias represent a vast and still growing group of diseases whose diagnosis and differentiation cannot only rely on clinical evaluation. Brain imaging including magnetic resonance (MR) and nuclear medicine techniques allows for characterization of structural and functional abnormalities underlying symptomatic ataxias. These methods thus constitute a potential source of radiological biomarkers, which could be used to identify these diseases and differentiate subgroups of them, and to assess their severity and their evolution. Such biomarkers mainly comprise qualitative and quantitative data obtained from MR including proton spectroscopy, diffusion imaging, tractography, voxel-based morphometry, functional imaging during task execution or in a resting state, and from SPETC and PET with several radiotracers. In the current article, we aim to illustrate briefly some applications of these neuroimaging tools to evaluation of cerebellar disorders such as inherited cerebellar ataxia, fetal developmental malformations, and immune-mediated cerebellar diseases and of neurodegenerative or early-developing diseases, such as dementia and autism in which cerebellar involvement is an emerging feature. Although these radiological biomarkers appear promising and helpful to better understand ataxia-related anatomical and physiological impairments, to date, very few of them have turned out to be specific for a given ataxia with atrophy of the cerebellar system being the main and the most usual alteration being observed. Consequently, much remains to be done to establish sensitivity, specificity, and reproducibility of available MR and nuclear medicine features as diagnostic, progression and surrogate biomarkers in clinical routine. PMID:25382714

Radiological Dispersal Devices: Select Issues in Consequence Management

DTIC Science & Technology

2004-03-10

goals, following which medical treatment of the radiation effects can be provided.10 Post- exposure medical therapy is designed to treat the consequences ...the approach that radiation related health effects can be extrapolated, i.e. the damage caused by radiation exposure CRS-3 8 For example, see Health...effort to determine the validity of these models, the federal government funds research into the health effects of radiation exposure through the

Federal funding for health security in FY2015.

PubMed

Boddie, Crystal; Sell, Tara Kirk; Watson, Matthew

2014-01-01

Previous articles in this series have provided funding information for federal civilian biodefense programs and programs focused on radiological and nuclear preparedness and consequence management. This year the authors have expanded the focus of the analysis to US federal funding for health security. This article provides proposed funding amounts for FY2015, estimated amounts for FY2014, and actual amounts for FY2010 through FY2013 in 5 domains critical to health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs.

[Radiological estimation of the protective measures used in agricultural complex of Belarus Republic in 2000-2005 (20 years after the accident on the Chernobyl NPP)].

PubMed

Podoliak, A G; Bogdevich, I M; Ageets, V Iu; Timofeev, S F

2007-01-01

The radiological estimation of the basic agrochemistry measures spent for the agriculture of the Republic of Belarus in 2000-2005 is given. Laws of behavior radionuclides 137Cs and 90Sr in agrosystems are considered depending on used protective a measures (countermeasures) and the primary goals on liquidation of consequences in sphere of agrarian and industrial complex which are necessary for solving during the remote period after accident ChNNP (in 2006-2010) are studied.

Radiological emergency: Malaysian preparedness and response.

PubMed

Yusof, Mohd Abd Wahab; Ali, Hamrah Mohd

2011-07-01

Planning and preparation in advance for radiological emergencies can help to minimise potential public health and environmental threats if and when an actual emergency occurs. During the planning process, emergency response organisations think through how they would respond to each type of incident and the resources that will be needed. In Malaysia, planning, preparation for and response to radiological emergencies involve many parties. In the event of a radiological emergency and if it is considered a disaster, the National Security Council, the Atomic Energy Licensing Board and the Malaysian Nuclear Agency (Nuclear Malaysia) will work together with other federal agencies, state and local governments, first responders and international organisations to monitor the situation, contain the release, and clean up the contaminated site. Throughout the response, these agencies use their protective action guidelines. This paper discusses Malaysian preparedness for, and response to, any potential radiological emergency.

Integrating Radiology and Anatomy Teaching in Medical Education in the UK--The Evidence, Current Trends, and Future Scope.

PubMed

Heptonstall, N B; Ali, T; Mankad, K

2016-04-01

This review article presents the current evidence of the importance of integrating radiology and anatomy in medical education in the UK, a recommendation by a number of key anatomy, education, and radiology organizations. Current evidence highlights that on average only 5% of total teaching time in medical education is dedicated to radiology. Often, radiology teaching does not adequately fulfill students' learning needs and potentially leaves them underprepared for medical practice. Benefits of integrating radiology and anatomy include improved clinical application of anatomy, an increase in student's interest in anatomy, and ultimately improved radiological interpretation. Various modalities exist for the integration of radiology and anatomy, facilitated by the vast portability of radiological images. It appears that combining radiological resources with traditional anatomy teaching methodology in a blended approach is most beneficial. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Effects of ionizing radiation on wildlife: what knowledge have we gained between the Chernobyl and Fukushima accidents?

PubMed

Beresford, Nicholas A; Copplestone, David

2011-07-01

The recent events at the Fukushima Daiichi nuclear power plant in Japan have raised questions over the effects of radiation in the environment. This article considers what we have learned about the radiological consequences for the environment from the Chernobyl accident, Ukraine, in April 1986. The literature offers mixed opinions of the long-term impacts on wildlife close to the Chernobyl plant, with some articles reporting significant effects at very low dose rates (below natural background dose rate levels in, for example, the United Kingdom). The lack of agreement highlights the need for further research to establish whether current radiological protection criteria for wildlife are adequate (and to determine if there are any implications for human radiological protection). Copyright © 2011 SETAC.

Romanian Experience for Enhancing Safety and Security in Transport of Radioactive Material - 12223

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vieru, Gheorghe

2012-07-01

The transport of Dangerous Goods-Class no.7 Radioactive Material (RAM), is an important part of the Romanian Radioactive Material Management. The overall aim of this activity is for enhancing operational safety and security measures during the transport of the radioactive materials, in order to ensure the protection of the people and the environment. The paper will present an overall of the safety and security measures recommended and implemented during transportation of RAM in Romania. Some aspects on the potential threat environment will be also approached with special referring to the low level radioactive material (waste) and NORM transportation either by roadmore » or by rail. A special attention is given to the assessment and evaluation of the possible radiological consequences due to RAM transportation. The paper is a part of the IAEA's Vienna Scientific Research Contract on the State Management of Nuclear Security Regime (Framework) concluded with the Institute for Nuclear Research, Romania, where the author is the CSI (Chief Scientific Investigator). The transport of RAM in Romania is a very sensible and complex problem taking into consideration the importance and the need of the security and safety for such activities. The Romanian Nuclear Regulatory Body set up strictly regulation and procedures according to the Recommendation of the IAEA Vienna and other international organizations. There were implemented the adequate regulation and procedures in order to keep the environmental impacts and the radiological consequences at the lower possible level and to assure the effectiveness of state nuclear security regime due to possible malicious acts in carrying out these activities including transport and the disposal site at the acceptable international levels. The levels of the estimated doses and risk expectation values for transport and disposal are within the acceptable limits provided by national and international regulations and recommendations but can increase, significantly during potential malicious acts. (authors)« less

Health effects model for nuclear power plant accident consequence analysis. Part I. Introduction, integration, and summary. Part II. Scientific basis for health effects models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Evans, J.S.; Moeller, D.W.; Cooper, D.W.

1985-07-01

Analysis of the radiological health effects of nuclear power plant accidents requires models for predicting early health effects, cancers and benign thyroid nodules, and genetic effects. Since the publication of the Reactor Safety Study, additional information on radiological health effects has become available. This report summarizes the efforts of a program designed to provide revised health effects models for nuclear power plant accident consequence modeling. The new models for early effects address four causes of mortality and nine categories of morbidity. The models for early effects are based upon two parameter Weibull functions. They permit evaluation of the influence ofmore » dose protraction and address the issue of variation in radiosensitivity among the population. The piecewise-linear dose-response models used in the Reactor Safety Study to predict cancers and thyroid nodules have been replaced by linear and linear-quadratic models. The new models reflect the most recently reported results of the follow-up of the survivors of the bombings of Hiroshima and Nagasaki and permit analysis of both morbidity and mortality. The new models for genetic effects allow prediction of genetic risks in each of the first five generations after an accident and include information on the relative severity of various classes of genetic effects. The uncertainty in modeloling radiological health risks is addressed by providing central, upper, and lower estimates of risks. An approach is outlined for summarizing the health consequences of nuclear power plant accidents. 298 refs., 9 figs., 49 tabs.« less

Mitigated Transfer Line Leaks that Result in Surface Pools and Spray Leaks into Pits

DOE Office of Scientific and Technical Information (OSTI.GOV)

HEY, B.E.

This analysis provides radiological and toxicological consequence calculations for postulated mitigated leaks during transfers of six waste compositions. Leaks in Cleanout Boxes equipped with supplemental covers and leaks in pits are analyzed.

Radiation exposures due to fossil fuel combustion

NASA Astrophysics Data System (ADS)

Beck, Harold L.

The current consensus regarding the potential radiation exposures resulting from the combustion of fossil fuels is examined. Sources, releases and potential doses to humans are discussed, both for power plants and waste materials. It is concluded that the radiation exposure to most individuals from any pathway is probably insignificant, i.e. only a tiny fraction of the dose received from natural sources in soil and building materials. Any small dose that may result from power-plant emissions will most likely be from inhalation of the small insoluble ash particles from the more poorly controlled plants burning higher than average activity fuel, rather than from direct or indirect ingestion of food grown on contaminated soil. One potentially significant pathway for exposure to humans that requires further evaluation is the effect on indoor external γ-radiation levels resulting from the use of flyash in building materials. The combustion of natural gas in private dwellings is also discussed, and the radiological consequences are concluded to be generally insignificant, except under certain extraordinary circumstances.

Emotional Wellness of Current Musculoskeletal Radiology Fellows.

PubMed

Porrino, Jack; Mulcahy, Michael J; Mulcahy, Hyojeong; Relyea-Chew, Annemarie; Chew, Felix S

2017-06-01

Burnout is a psychological syndrome composed of emotional exhaustion, depersonalization, and sense of lack of personal accomplishment, as a result of prolonged occupational stress. The purpose of our study was to determine the prevalence of burnout among current musculoskeletal radiology fellows and to explore causes of emotional stress. A 24-item survey was constructed on SurveyMonkey using the Maslach Burnout Inventory. We identified 82 musculoskeletal radiology fellowship programs. We recruited subjects indirectly through the program director or equivalent. Fifty-eight respondents (48 male, 10 female) identified themselves as current musculoskeletal radiology fellows and completed the survey. Comparison of the weighted subscale means in our data to the Maslach normative subscale thresholds for medical occupations indicates that musculoskeletal radiology fellows report relatively high levels of burnout with regard to lack of personal accomplishment and depersonalization, whereas emotional exhaustion levels in our sample are within the average range reported by Maslach. Although male musculoskeletal radiology fellows experience relatively high levels in two of the three dimensions of burnout (depersonalization and personal accomplishment), female musculoskeletal radiology fellows experience relatively high burnout across all three dimensions. Job market-related stress and the effort required providing care for dependents significantly affect personal accomplishment. Conversely, imbalances in the work-life relationship and feelings of powerlessness are significantly associated with depersonalization and emotional exhaustion. Musculoskeletal radiology fellows report relatively high levels of burnout. Because the consequences of burnout can be severe, early identification and appropriate intervention should be a priority. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Chernobyl and Goiânia lessons for responding to radiological terrorism.

PubMed

Steinhausler, Friedrich

2005-11-01

The deployment of a radiological dispersal device (RDD) is likely to result in relatively low radiation exposure of the targeted population, insufficient to cause a severe radiation detriment. Nevertheless, due to atmospheric dispersion of the radioactive material, an urban area equaling several city blocks could be affected. The current knowledge base concerning the response to radiological terrorism, focusing mainly on environmental cleanup and site recovery (CSR) of areas with radioactive contamination due to the deployment of an RDD, is largely derived from military scientific tests or exercises assembled over the past 50 y with only limited applicability to the consequences of an RDD detonating in a city. This paper focuses on the extensive experience in CSR gained in the management of the radiological accident contaminating the Brazilian city of Goiânia in 1987, and managing the aftermath of the Chernobyl reactor accident in 1986. The incident in Goiânia demonstrated the numerous practical difficulties of implementing a sound CSR, based on a balanced judgment of all relevant factors, such as radiation safety, environmental issues, economic consequences, and public fear. A review of the different stages of the intervention policy in the former Soviet Union reveals that risk-benefit cost analysis was not used for the decision-making process during the later stages of the post-accident situation. Instead, a CSR policy was adopted that resulted in continuously escalating costs. The results of this analysis are used to develop an Integrated Cleanup and Site Restoration Concept and recommend practically applicable solutions from Lessons Learned.

Local, Regional and National Responses for Medical Management of a Radiological/Nuclear Incident

PubMed Central

Dainiak, Nicholas; Skudlarska, Beata; Albanese, Joseph

2013-01-01

Radiological and nuclear devices may be used by terrorists or may be the source of accidental exposure. A tiered approach has been recommended for response to a terrorist event wherein local, regional, state and federal assets become involved sequentially, as the magnitude in severity of the incident increases. State-wide hospital plans have been developed and published for Connecticut, New York and California. These plans address delineation of responsibilities of various categories of health professionals, protection of healthcare providers, identification and classification of individuals who might have been exposed to and/or contaminated by radiation and, in the case of Connecticut response plan, early management of victims. Regional response programs such as the New England Regional Health Compact (consisting of 6 member states) have been developed to manage consequences of radiation injury. The Department of Homeland Security is ultimately responsible for managing both health consequences and the crisis. Multiple US national response assets may be called upon for use in radiological incidents. These include agencies and programs that have been developed by the Department of Energy, the Environmental Protection Agency and the Department of Defense. Coordination of national, regional and state assets with local response efforts is necessary to provide a timely and efficient response. PMID:23447742

Local, regional and national responses for medical management of a radiological/nuclear incident.

PubMed

Dainiak, Nicholas; Skudlarska, Beata; Albanese, Joseph

2013-01-01

Radiological and nuclear devices may be used by terrorists or may be the source of accidental exposure. A tiered approach has been recommended for response to a terrorist event wherein local, regional, state and federal assets become involved sequentially, as the magnitude in severity of the incident increases. State-wide hospital plans have been developed and published for Connecticut, New York and California. These plans address delineation of responsibilities of various categories of health professionals, protection of healthcare providers, identification and classification of individuals who might have been exposed to and/or contaminated by radiation and, in the case of Connecticut response plan, early management of victims. Regional response programs such as the New England Regional Health Compact (consisting of 6 member states) have been developed to manage consequences of radiation injury. The Department of Homeland Security is ultimately responsible for managing both health consequences and the crisis. Multiple US national response assets may be called upon for use in radiological incidents. These include agencies and programs that have been developed by the Department of Energy, the Environmental Protection Agency and the Department of Defense. Coordination of national, regional and state assets with local response efforts is necessary to provide a timely and efficient response.

Emergency Response Health Physics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mena, RaJah; Pemberton, Wendy; Beal, William

2012-05-01

Health physics is an important discipline with regard to understanding the effects of radiation on human health; however, there are major differences between health physics for research or occupational safety and health physics during a large-scale radiological emergency. The deployment of a U.S. Department of Energy/National Nuclear Security Administration (DOE/NNSA) monitoring and assessment team to Japan in the wake of the March 2011 accident at Fukushima Daiichi Nuclear Power Plant yielded a wealth of lessons on these difference. Critical teams (CMOC (Consequence Management Outside the Continental U.S.) and CMHT (Consequence Management Home Team) ) worked together to collect, compile, review,more » and analyze radiological data from Japan to support the response needs of and answer questions from the Government of Japan, the U.S. military in Japan, the U.S. Embassy and U.S. citizens in Japan, and U.S. citizens in America. This paper addresses the unique challenges presented to the health physicist or analyst of radiological data in a large-scale emergency. A key lesson learned was that public perception and the availability of technology with social media requires a diligent effort to keep the public informed of the science behind the decisions in a manner that is meaningful to them.« less

Atoms for peace and the nonproliferation treaty: unintended consequences

DOE Office of Scientific and Technical Information (OSTI.GOV)

Streeper, Charles Blamires

2009-01-01

In April 2009, President Obama revived nonproliferation and arms control efforts with a speech calling for the worldwide abolition of nuclear weapons. His speech correctly acknowledged the threat of nuclear terrorism and the vulnerabilities of the related unsecure nuclear materials. Unfortunately, the president did not mention and has not mentioned in any speech the threat posed by at-risk radiological materials. Nonproliferation efforts have a well documented history of focus on special nuclear materials (fissionable weapons usable materials or SNM), and other key materials (chemical and biological) and technologies for a Weapon of Mass Destruction (WMD). Such intense focus on WMDmore » related materials/technologies is essential for international safety and security and merit continued attention and funding. However, the perception that radioactive sealed sources (sources) are of less concern than WMD is unfortunate. These perceptions are based solely on the potentially enormous and tragic consequences associated with their deliberate or accidental misuse and proliferation concerns. However, there is a documented history of overemphasis on the nuclear threat at the expense of ignoring the far more likely and also devastating chemical and biological threats. The radiological threat should not be minimized or excluded from policy discussions and decisions on these far ranging scopes of threat to the international community. Sources have a long history of use; and a wider distribution worldwide than fissile materials. Pair this with their broad ranges in isotopes/activities along with scant national and international attention and mechanisms for their safe and secure management and it is not difficult to envision a deadly threat. Arguments that minimize or divert attention away from sources may have the effect of distracting necessary policy attention on preventing/mitigating a radiological dispersal event. The terrorist attacks on 9/11 should be a clear reminder of the inherent danger of diminishing or dismissing lower-level threats in exchange for enhanced focus on high priority special nuclear materials with the basis for this emphasis being solely on the magnitude of the consequences of a single event. Mitigating all possible or likely terrorist attacks is impossible; however, weaponized sources, in the form of a radiological dispersal device, have been a declared target material of Al-Qaida. Eisenhower's Atoms for Peace initiative promoted the spread of the paradoxical beneficial yet destructive properties of the atom. Typically, the focus of nonproliferation efforts focuses on the fissile materials associated with Weapons of Mass Destruction, with less emphasis on radioactive materials that could be used for a Weapon of Mass Disruption. Most nonproliferation policy discussion involves securing or preventing the diversion of weapons grade fissile materials (uranium (U) with concentration of over 90% of the isotope {sup 235}U (HEU) and plutonium with more than 90% of the isotope {sup 239}Pu), with scant attention given to the threat posed by a prolific quantity of sources spread worldwide. Further acerbating the problem of inattention, it appears that the momentum of the continued evolution in the beneficial applications of sources will only increase in the near future. Several expert studies have demonstrated on the potentially devastating economic, psychological and public health impacts of terrorist use of a radiological dispersal or radiation emitting device (ROD/RED) in a metropolis. The development of such a weapon, from the acquisition of the radioactive material to the technical knowledge needed to fashion it into an ROD, is many orders of magnitude easier than diverting enough fissile material for and fabrication/acquisition of a nuclear weapon. Unlike nuclear weapons, worldwide, there are many well documented accounts of accidental and purposeful diversions of radioactive materials from regulatory control. As of the end of 2008, the International Atomic Energy Agency's (IAEA) Illicit Trafficking Database had logged 1562 incidents, of which only 18 include weapons grade nuclear materials. As much as 66% of the radioactive material involved in these incidents was not recovered. Since 2004, there has been a 75% increase in incidents of unrecoverable material, much of which is labeled dangerous with potential for deterministic health affects if misused. This makes clear that a black market of illicit trade in sources exists. The incidents reported to the IAEA's database rely only on voluntary state reporting; therefore, the number of lost or stolen sources is expected to be much higher.« less

Natural Language Processing in Radiology: A Systematic Review.

PubMed

Pons, Ewoud; Braun, Loes M M; Hunink, M G Myriam; Kors, Jan A

2016-05-01

Radiological reporting has generated large quantities of digital content within the electronic health record, which is potentially a valuable source of information for improving clinical care and supporting research. Although radiology reports are stored for communication and documentation of diagnostic imaging, harnessing their potential requires efficient and automated information extraction: they exist mainly as free-text clinical narrative, from which it is a major challenge to obtain structured data. Natural language processing (NLP) provides techniques that aid the conversion of text into a structured representation, and thus enables computers to derive meaning from human (ie, natural language) input. Used on radiology reports, NLP techniques enable automatic identification and extraction of information. By exploring the various purposes for their use, this review examines how radiology benefits from NLP. A systematic literature search identified 67 relevant publications describing NLP methods that support practical applications in radiology. This review takes a close look at the individual studies in terms of tasks (ie, the extracted information), the NLP methodology and tools used, and their application purpose and performance results. Additionally, limitations, future challenges, and requirements for advancing NLP in radiology will be discussed. (©) RSNA, 2016 Online supplemental material is available for this article.

Risk Due to Radiological Terror Attacks With Natural Radionuclides

DOE Office of Scientific and Technical Information (OSTI.GOV)

Friedrich, Steinhaeusler; Lyudmila, Zaitseva; Stan, Rydell

The naturally occurring radionuclides radium (Ra-226) and polonium (Po-210) have the potential to be used for criminal acts. Analysis of international incident data contained in the Database on Nuclear Smuggling, Theft and Orphan Radiation Sources (CSTO), operated at the University of Salzburg, shows that several acts of murder and terrorism with natural radionuclides have already been carried out in Europe and Russia. Five different modes of attack (T) are possible: (1) Covert irradiation of an individual in order to deliver a high individual dose; (2) Covert irradiation of a group of persons delivering a large collective dose; (3) Contamination ofmore » food or drink; (4) Generation of radioactive aerosols or solutions; (5) Combination of Ra-226 with conventional explosives (Dirty Bomb).This paper assesses the risk (R) of such criminal acts in terms of: (a) Probability of terrorist motivation deploying a certain attack mode T; (b) Probability of success by the terrorists for the selected attack mode T; (c) Primary damage consequence (C) to the attacked target (activity, dose); (d) Secondary damage consequence (C') to the attacked target (psychological and socio-economic effects); (e) Probability that the consequences (C, C') cannot be brought under control, resulting in a failure to manage successfully the emergency situation due to logistical and/or technical deficits in implementing adequate countermeasures. Extensive computer modelling is used to determine the potential impact of such a criminal attack on directly affected victims and on the environment.« less

Risk Due to Radiological Terror Attacks With Natural Radionuclides

NASA Astrophysics Data System (ADS)

Friedrich, Steinhäusler; Stan, Rydell; Lyudmila, Zaitseva

2008-08-01

The naturally occurring radionuclides radium (Ra-226) and polonium (Po-210) have the potential to be used for criminal acts. Analysis of international incident data contained in the Database on Nuclear Smuggling, Theft and Orphan Radiation Sources (CSTO), operated at the University of Salzburg, shows that several acts of murder and terrorism with natural radionuclides have already been carried out in Europe and Russia. Five different modes of attack (T) are possible: (1) Covert irradiation of an individual in order to deliver a high individual dose; (2) Covert irradiation of a group of persons delivering a large collective dose; (3) Contamination of food or drink; (4) Generation of radioactive aerosols or solutions; (5) Combination of Ra-226 with conventional explosives (Dirty Bomb). This paper assesses the risk (R) of such criminal acts in terms of: (a) Probability of terrorist motivation deploying a certain attack mode T; (b) Probability of success by the terrorists for the selected attack mode T; (c) Primary damage consequence (C) to the attacked target (activity, dose); (d) Secondary damage consequence (C') to the attacked target (psychological and socio-economic effects); (e) Probability that the consequences (C, C') cannot be brought under control, resulting in a failure to manage successfully the emergency situation due to logistical and/or technical deficits in implementing adequate countermeasures. Extensive computer modelling is used to determine the potential impact of such a criminal attack on directly affected victims and on the environment.

[Clinical and organizational way of innovative development of regenerative medicine in security agencies].

PubMed

Ryzhman, N N; Maksimov, A G; Tyrenko, V V; Karamullin, M A; Yurkin, A K; Golota, A S; Lisovets, D G; Sarana, A M; Barsevich, O V

2015-03-01

The article covers organizational aspects of development of innovative technologies in the field of regenerative medicine. It is shown that for the effective design and implementation into medical practice of regenerative medicine requires a united complex of military health care, military medical research and education. The main goal is to formate a biological insurance of personnel to treat different consequences of radiological incidents, burn disease, identification of the remains of the victims; the maximum returning to action after disturbed as a result of health services. Proposes the creation of "Interdepartmental Clinical Research and Education Center for Regenerative Medicine", combining research, clinical, industrial and educational potential of the leading institutions of various departments that will enhance the national security of the Russian Federation.

Strengths and Deficiencies in the Content of US Radiology Private Practices' Websites.

PubMed

Johnson, Evan J; Doshi, Ankur M; Rosenkrantz, Andrew B

2017-03-01

The Internet provides a potentially valuable mechanism for radiology practices to communicate with patients and enhance the patient experience. The aim of this study was to assess the websites of US radiology private practices, with attention to the frequency of content of potential patient interest. The 50 largest private practice radiology facilities in the United States were identified from RadiologyBusiness.com. Websites were reviewed for information content and functionality. Content regarding radiologists' names, medical schools, residencies, fellowships, photographs, and board certification status; contact for billing questions; and ability to make online payments was present on 80% to 98% of sites. Content regarding examination preparation, contrast use, examination duration, description of examination experience, scheduling information, directions, privacy policy, radiologists' role in interpretation, and ACR accreditation was present on 60% to 78%. Content regarding accepted insurers, delivery of results to referrers, report turnaround times, radiologists' years of experience, radiation safety, and facility hours was present on 40% to 58%. Content regarding technologist certification, registration forms, instructions for requesting a study on disc, educational videos, and patient testimonials was present on 20% to 38%. Content regarding examination prices, patient satisfaction scores, peer review, online scheduling, online report and image access, and parking was present on <20%. Radiology practices' websites most frequently provided information regarding their radiologists' credentials, as well as billing and payment options. Information regarding quality, safety, and the examination experience, as well as non-payment-related online functionality, was less common. These findings regarding the most common deficiencies may be useful for radiology practices in expanding their websites' content, thereby improving communication and potentially the patient experience. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiation protection and dosimetry issues in the medical applications of ionizing radiation

NASA Astrophysics Data System (ADS)

Vaz, Pedro

2014-11-01

The technological advances that occurred during the last few decades paved the way to the dissemination of CT-based procedures in radiology, to an increasing number of procedures in interventional radiology and cardiology as well as to new techniques and hybrid modalities in nuclear medicine and in radiotherapy. These technological advances encompass the exposure of patients and medical staff to unprecedentedly high dose values that are a cause for concern due to the potential detrimental effects of ionizing radiation to the human health. As a consequence, new issues and challenges in radiological protection and dosimetry in the medical applications of ionizing radiation have emerged. The scientific knowledge of the radiosensitivity of individuals as a function of age, gender and other factors has also contributed to raising the awareness of scientists, medical staff, regulators, decision makers and other stakeholders (including the patients and the public) for the need to correctly and accurately assess the radiation induced long-term health effects after medical exposure. Pediatric exposures and their late effects became a cause of great concern. The scientific communities of experts involved in the study of the biological effects of ionizing radiation have made a strong case about the need to undertake low dose radiation research and the International System of Radiological Protection is being challenged to address and incorporate issues such as the individual sensitivities, the shape of dose-response relationship and tissue sensitivity for cancer and non-cancer effects. Some of the answers to the radiation protection and dosimetry issues and challenges in the medical applications of ionizing radiation lie in computational studies using Monte Carlo or hybrid methods to model and simulate particle transport in the organs and tissues of the human body. The development of sophisticated Monte Carlo computer programs and voxel phantoms paves the way to an accurate dosimetric assessment of the medical applications of ionizing radiation. In this paper, the aforementioned topics will be reviewed. The current status and the future trends in the implementation of the justification and optimization principles, pillars of the International System of Radiological Protection, in the medical applications of ionizing radiation will be discussed. Prospective views will be provided on the future of the system of radiological protection and on dosimetry issues in the medical applications of ionizing radiation.

Communicating with the public following radiological terrorism: results from a series of focus groups and national surveys in Britain and Germany.

PubMed

Pearce, Julia M; Rubin, G James; Selke, Piet; Amlôt, Richard; Mowbray, Fiona; Rogers, M Brooke

2013-04-01

Incidents involving the exposure of large numbers of people to radiological material can have serious consequences for those affected, their community and wider society. In many instances, the psychological effects of these incidents have the greatest impact. People fear radiation and even incidents which result in little or no actual exposure have the potential to cause widespread anxiety and behavior change. The aim of this study was to assess public intentions, beliefs and information needs in the UK and Germany in response to a hidden radiological exposure device. By assessing how the public is likely to react to such events, strategies for more effective crisis and risk communication can be developed and designed to address any knowledge gaps, misperceptions and behavioral responses that are contrary to public health advice. This study had three stages. The first stage consisted of focus groups which identified perceptions of and reactions to a covert radiological device. The incident was introduced to participants using a series of mock newspaper and broadcast injects to convey the evolving scenario. The outcomes of these focus groups were used to inform national telephone surveys, which quantified intended behaviors and assessed what perceptions were correlated with these behaviors. Focus group and survey results were used to develop video and leaflet communication interventions, which were then evaluated in a second round of focus groups. In the first two stages, misperceptions about the likelihood and routes of exposure were associated with higher levels of worry and greater likelihood of engaging in behaviors that might be detrimental to ongoing public health efforts. The final focus groups demonstrated that both types of misunderstanding are amenable to change following targeted communication. Should terrorists succeed in placing a hidden radiological device in a public location, then health agencies may find that it is easier to communicate effectively with the public if they explicitly and clearly discuss the mechanisms through which someone could be affected by the radiation and the known geographical spread of any risk. Messages which explain how the risk from a hidden radiological device "works" should be prepared and tested in advance so that they can be rapidly deployed if the need arises.

Congenital abnormalities of the osseous spine: a radiological approach.

PubMed

Vanhoenacker, F M; De Schepper, A M; Parizel, P M

2005-01-01

The spine may act as a useful window to the diagnosis of many congenital malformations syndromes and skeletal dysplasias. However, radiological identification of these syndromes remains a difficult task, because there are so many syndromes and dysplasias to remember. Moreover, many spinal abnormalities are non-specific and there is much overlap between different genetic and congenital disorders. Consequently, many radiologists cringe when these topics are discussed. The purpose of this short review is to provide the general radiologist a workable primer for systematic analysis of spinal abnormalities encountered in genetic disorders, which may be helpful in (differential) diagnosis.

Federal Funding for Health Security in FY2015

PubMed Central

Sell, Tara Kirk; Watson, Matthew

2014-01-01

Previous articles in this series have provided funding information for federal civilian biodefense programs and programs focused on radiological and nuclear preparedness and consequence management. This year the authors have expanded the focus of the analysis to US federal funding for health security. This article provides proposed funding amounts for FY2015, estimated amounts for FY2014, and actual amounts for FY2010 through FY2013 in 5 domains critical to health security: biodefense programs, radiological and nuclear programs, chemical programs, pandemic influenza and emerging infectious disease programs, and multiple-hazard and preparedness programs. PMID:24988432

Flood and Fire Monitoring and Forecasting Within the Chornobyl Exclusion Zone

NASA Astrophysics Data System (ADS)

Los, Victor

2001-03-01

Taking into consideration that radioactivity from the contaminating elements of the Chernobyl Exclusion Zone (CEZ) amounts to a huge number, one of the most urgent tasks, at present, is the resolution of problems related to secondary radioactive contamination caused by floods and fires. These factors may lead to critical consequences. For instance, if radioactive contaminants migrate into the water system, namely into the Dnipro River, a threat arises to more than 20 million inhabitants of Ukraine. Additionally, fires in the CEZ potentially could cause contaminants to be dispersed into the air and to migrate in the atmosphere for long distances. The elements of information support system for administrative decision-making to respond to the appearances and consequences of forest fires and floods in contaminated areas of the CEZ have been developed. The system proposes: using Earth Remote Sensing (R/S) data for timely detection of forest fires; integration by Geographic Information System (GIS) of mathematical models for radionuclide migration by air in order to forecast radiological consequences of forest fires; forecasting and assessing flood consequences by means of spatial analysis of GIS and R/S; and development of a system for dissemination of information. This project was performed within the framework of USAID Cooperative Agreement #121-A-00-98-00615-00, dedicated to the establishment of the Ukrainian Land and Resource Management Center.

Radiological assessment. A textbook on environmental dose analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Till, J.E.; Meyer, H.R.

1983-09-01

Radiological assessment is the quantitative process of estimating the consequences to humans resulting from the release of radionuclides to the biosphere. It is a multidisciplinary subject requiring the expertise of a number of individuals in order to predict source terms, describe environmental transport, calculate internal and external dose, and extrapolate dose to health effects. Up to this time there has been available no comprehensive book describing, on a uniform and comprehensive level, the techniques and models used in radiological assessment. Radiological Assessment is based on material presented at the 1980 Health Physics Society Summer School held in Seattle, Washington. Themore » material has been expanded and edited to make it comprehensive in scope and useful as a text. Topics covered include (1) source terms for nuclear facilities and Medical and Industrial sites; (2) transport of radionuclides in the atmosphere; (3) transport of radionuclides in surface waters; (4) transport of radionuclides in groundwater; (5) terrestrial and aquatic food chain pathways; (6) reference man; a system for internal dose calculations; (7) internal dosimetry; (8) external dosimetry; (9) models for special-case radionuclides; (10) calculation of health effects in irradiated populations; (11) evaluation of uncertainties in environmental radiological assessment models; (12) regulatory standards for environmental releases of radionuclides; (13) development of computer codes for radiological assessment; and (14) assessment of accidental releases of radionuclides.« less

Machine Learning in Radiology: Applications Beyond Image Interpretation.

PubMed

Lakhani, Paras; Prater, Adam B; Hutson, R Kent; Andriole, Kathy P; Dreyer, Keith J; Morey, Jose; Prevedello, Luciano M; Clark, Toshi J; Geis, J Raymond; Itri, Jason N; Hawkins, C Matthew

2018-02-01

Much attention has been given to machine learning and its perceived impact in radiology, particularly in light of recent success with image classification in international competitions. However, machine learning is likely to impact radiology outside of image interpretation long before a fully functional "machine radiologist" is implemented in practice. Here, we describe an overview of machine learning, its application to radiology and other domains, and many cases of use that do not involve image interpretation. We hope that better understanding of these potential applications will help radiology practices prepare for the future and realize performance improvement and efficiency gains. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

78 FR 26373 - Agency Information Collection Activities; Proposed Collection; Comment Request; Electronic...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-06

... for Devices and Radiological Health (CDRH) on actual or potential health risk concerns about a medical... submitted to the Center for Devices and Radiological Health (CDRH) on actual or potential health risk... guidelines or instructions on how to submit a compliant to CDRH, complaints often contain minimal information...

Defining quality in radiology.

PubMed

Blackmore, C Craig

2007-04-01

The introduction of pay for performance in medicine represents an opportunity for radiologists to define quality in radiology. Radiology quality can be defined on the basis of the production model that currently drives reimbursement, codifying the role of radiologists as being limited to the production of timely and accurate radiology reports produced in conditions of maximum patient safety and communicated in a timely manner. Alternately, quality in radiology can also encompass the professional role of radiologists as diagnostic imaging specialists responsible for the appropriate use, selection, interpretation, and application of imaging. Although potentially challenging to implement, the professional model for radiology quality is a comprehensive assessment of the ways in which radiologists add value to patient care. This essay is a discussion of the definition of radiology quality and the implications of that definition.

RCT: Module 2.11, Radiological Work Coverage, Course 8777

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hillmer, Kurt T.

2017-07-20

Radiological work is usually approved and controlled by radiation protection personnel by using administrative and procedural controls, such as radiological work permits (RWPs). In addition, some jobs will require working in, or will have the potential for creating, very high radiation, contamination, or airborne radioactivity areas. Radiological control technicians (RCTs) providing job coverage have an integral role in controlling radiological hazards. This course will prepare the student with the skills necessary for RCT qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and will provide in-the-field skills.

Effectiveness of Current Practices for Disinfecting Medical Equipment in a Radiology Department.

PubMed

Hubble, William L; Turner, James Austin; Heuertz, Rita

2016-01-01

To evaluate the effectiveness of routine, daily disinfection practices on the control of microorganisms on nuclear medicine equipment in a radiology department. During phase 1, surface samples were collected from various sites in the nuclear medicine division of a radiology department at a single institution. These samples were transferred onto growth plates for evaluation and speciation by a clinical microbiologist. Collection sites that yielded potentially pathogenic bacteria or high numbers (> 100) of colonies of likely nonpathogenic bacteria were identified for resampling. During phase 2, secondary samples were taken at the resampling sites after disinfection. These secondary samples also were evaluated to determine the efficacy of the departmental disinfection practices on surface cleanliness. Phase 1 sampling identified 10 sites that harbored either potentially pathogenic bacteria or high numbers of likely nonpathogenic bacteria. Evaluation of postdisinfection samples indicated elimination of potentially pathogenic bacteria and reduction of likely nonpathogenic colonies. The variety of surfaces and equipment found in radiology departments can present unique challenges for effective disinfection. Porous materials and intricate imaging and peripheral devices require special consideration when designing and maintaining department cleaning policies. The disinfection practices in place at the institution were effective in reducing or eliminating bacteria; however, recolonization after cleaning was recognized as a possibility. Educating staff about the value of disinfecting contact surfaces between patients is necessary to achieve optimum sanitization in the radiology department. © 2016 American Society of Radiologic Technologists.

Combating terrorism : federal response teams provide varied capabilities; opportunities remain to improve coordination

DOT National Transportation Integrated Search

2000-01-01

The General Accounting Office (GAO) was asked to review federal agency teams that can respond to and help manage the consequences of a domestic terrorist incident involving chemical, biological, radiological, or nuclear agents or weapons. This report...

Radiation in Yolo County

NASA Astrophysics Data System (ADS)

Dickie, H.; Colwell, K.

2013-12-01

In today's post-nuclear age, there are many man-made sources of radioactivity, in addition to the natural background we expect from cosmic and terrestrial origins. While all atoms possess unstable isotopes, there are few that are abundant enough, energetic enough, and have long enough half-lives to pose a signicant risk of ionizing radiation exposure. We hypothesize a decreasing relative radiation measurement (in detected counts per minute [CPM]) at nine locations that might pose occupational or environmental hazard: 1. A supermarket produce aisle (living tissue has high concentration of 40K) 2. A hospital (medical imaging uses X-rays and radioactive dyes) 3. The electronics section of a superstore (high voltage electronics have the potential to produce ionizing radiation) 4. An electrical transformer (similar reasons) 5. An antique store (some ceramics and glazes use radioisotopes that are now outlawed) 6. A gasoline pump (processing and terrestrial isotope contamination might leave a radioactive residue) 7. A fertilized eld (phosphate rock contains uranium and thorium, in addition to potassium) 8. A house (hopefully mild background, but potential radon contamination) 9. A school (should be radiologically neutral) We tested the hypothesis by measuring 100 minutes of counts on a self-assembled MightyOhmTM Geiger counter at each location. Our results show that contrary to the hypothesized ordering, the house was the most radiologically active. We present possible explanations for the observed radiation levels, as well as possible sources of measurement error, possible consequences of prolonged exposure to the measured levels, and suggestions for decreasing exposure and environmental impact.

Environmental Protection Agency Radiological Emergency Response Plan

EPA Pesticide Factsheets

The EPA-RERP identifies the overall roles, responsibilities, and coordination for management of potential or actual radiological incidents and emergencies and coordination among the following EPA offices and Special Teams.

Radiological Protection in Space: Indication from the ICRP Task Group

NASA Astrophysics Data System (ADS)

Dietze, Günther

In 2007 the International Commission on Radiological Protection (ICRP) has established a Task Group (Radiation Protection in Space) dealing with the problems of radiation protection of astronauts in space missions. Its first task is a report on "Assessment of Radiation Exposure of Astronauts in Space". When the ICRP published its general recommendations for radiological protection in 2007 (ICRP Publication 103 following ICRP Publication 60 (1991)) it was obvious that these recommendations do not really consider the special situation of astronauts in space. The radiation field with its high content of charged particles of very high energies strongly differs from usual radiation fields on ground. For example, this has consequences for the assessment of doses in the body of astronauts. The ICRP Task Group has discussed this situation and the presentation will deal with some consequences for the concept of radiation dosimetry and radiological protection in space. This includes e. g. the assessment of organ doses and the application of the effective dose concept with its definition of radiation weighting factors. Radiation quality of high energy heavy ions may be defined different than usually performed on ground. An approach of using the quality factor concept in the definition of an "effective dose" is favored for application in space missions similar to the method proposed in NCRP Report 142. New data calculated on the basis of the reference anthropomorphic voxel phantoms recommended by ICRP support this procedure. Individual dosimetry is a further subject of discussion in the Task Group. While the operational dose equivalent quantities generally in use in radiation protection on ground are not helpful for applications in space, different procedures of the assessment of organ and effective doses are applied. The Task Group is dealing with this situation.

[Quality of life and job performance resulting from operatively treated tibial plateau fractures].

PubMed

Roßbach, B P; Faymonville, C; Müller, L P; Stützer, H; Isenberg, J

2016-01-01

The aim of this article is to present the functional results and the effect on quality of life of surgically treated tibial plateau fractures in physically active and working patients with multiple and serious injuries. In addition, the relationships between functional and radiological outcome were evaluated and compared with activity in daily and professional life. In all, 41 injured patients were followed up a mean of 47 months after surgical treatment and examined with radiological, functional, as well as quality of life score. In the radiological scoring, a mean value of 72 points (max 100 points) was achieved. In the activity score, there was an average of 63.5 points (max 100 points). When evaluating the health-related quality of life, an average score of 69.6 points was achieved. There was a significant relationship between radiological and activity scores and the radiological and life quality scores. Furthermore, the relationship between activity and quality of life scores was considered significant. Surgeon's influence on the functional outcome could be confirmed. The functional and the radiological results were moderate. Quality of life was permanently affected by the consequences of tibial plateau fracture in 12 patients; 11 patients were not re-employed. However, the quality of life was assessed as good or very good and 28 patients had returned to work. The quality of life was firmly linked to the radiological and functional parameters, which tended to be influenced by the quality of the primary surgical treatment when looking at the overall population.

Machine Learning and Radiology

PubMed Central

Wang, Shijun; Summers, Ronald M.

2012-01-01

In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers. PMID:22465077

Paediatric musculoskeletal interventional radiology.

PubMed

Natali, Gian L; Paolantonio, Guglielmo; Fruhwirth, Rodolfo; Alvaro, Giuseppe; Parapatt, George K; Toma', Paolo; Rollo, Massimo

2016-01-01

Interventional radiology technique is now well established and widely used in the adult population. Through minimally invasive procedures, it increasingly replaces surgical interventions that involve higher percentages of invasiveness and, consequently, of morbidity and mortality. For these advantageous reasons, interventional radiology in recent years has spread to the paediatric age as well. The aim of this study was to review the literature on the development, use and perspectives of these procedures in the paediatric musculoskeletal field. Several topics are covered: osteomuscle neoplastic malignant and benign pathologies treated with invasive diagnostic and/or therapeutic procedures such as radiofrequency ablation in the osteoid osteoma; invasive and non-invasive procedures in vascular malformations; treatment of aneurysmal bone cysts; and role of interventional radiology in paediatric inflammatory and rheumatic inflammations. The positive results that have been generated with interventional radiology procedures in the paediatric field highly encourage both the development of new ad hoc materials, obviously adapted to young patients, as well as the improvement of such techniques, in consideration of the fact that childrens' pathologies do not always correspond to those of adults. In conclusion, as these interventional procedures have proven to be less invasive, with lower morbidity and mortality rates as well, they are becoming a viable and valid alternative to surgery in the paediatric population.

Interactive anatomical teaching: Integrating radiological anatomy within topographic anatomy.

PubMed

Abed Rabbo, F; Garrigues, F; Lefèvre, C; Seizeur, R

2016-03-01

Hours attributed to teaching anatomy have been reduced in medical curricula through out the world. In consequence, changes in anatomical curriculum as well as in teaching methods are becoming necessary. New methods of teaching are being evaluated. We present in the following paper an example of interactive anatomical teaching associating topographic anatomy with ultrasonographic radiological anatomy. The aim was to explicitly show anatomical structures of the knee and the ankle through dissection and ultrasonography. One cadaver was used as an ultrasonographic model and the other was dissected. Anatomy of the knee and ankle articulations was studied through dissection and ultrasonography. The students were able to simultaneously assimilate both anatomical aspects of radiological and topographic anatomy. They found the teaching very helpful and practical. This body of work provides example of a teaching method combining two important aspects of anatomy to help the students understand both aspects simultaneously. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Measuring the quality-of-life effects of diagnostic and screening tests.

PubMed

Swan, J Shannon; Miksad, Rebecca A

2009-08-01

Health-related quality of life (HRQL) is a central concept for understanding the outcomes of medical care. When used in cost-effectiveness analysis, HRQL is typically measured for conditions persisting over long time frames (years), and quality-adjusted life year (QALY) values are generated. Consequently, years are the basic unit of time for cost-effectiveness analysis results: dollars spent per QALY gained. However, shorter term components of health care may also affect HRQL, and there is increased interest in measuring and accounting for these events. In radiology, the short-term HRQL effects of screening and diagnostic testing may affect a test's cost-effectiveness, even though they may only last for days. The unique challenge in radiology HRQL assessment is to realistically tap into the testing and screening experience while remaining consistent with QALY theory. The authors review HRQL assessment and highlight methods developed to specifically address the short-term effects of radiologic screening and testing.

Verification bias an underrecognized source of error in assessing the efficacy of medical imaging.

PubMed

Petscavage, Jonelle M; Richardson, Michael L; Carr, Robert B

2011-03-01

Diagnostic tests are validated by comparison against a "gold standard" reference test. When the reference test is invasive or expensive, it may not be applied to all patients. This can result in biased estimates of the sensitivity and specificity of the diagnostic test. This type of bias is called "verification bias," and is a common problem in imaging research. The purpose of our study is to estimate the prevalence of verification bias in the recent radiology literature. All issues of the American Journal of Roentgenology (AJR), Academic Radiology, Radiology, and European Journal of Radiology (EJR) between November 2006 and October 2009 were reviewed for original research articles mentioning sensitivity or specificity as endpoints. Articles were read to determine whether verification bias was present and searched for author recognition of verification bias in the design. During 3 years, these journals published 2969 original research articles. A total of 776 articles used sensitivity or specificity as an outcome. Of these, 211 articles demonstrated potential verification bias. The fraction of articles with potential bias was respectively 36.4%, 23.4%, 29.5%, and 13.4% for AJR, Academic Radiology, Radiology, and EJR. The total fraction of papers with potential bias in which the authors acknowledged this bias was 17.1%. Verification bias is a common and frequently unacknowledged source of error in efficacy studies of diagnostic imaging. Bias can often be eliminated by proper study design. When it cannot be eliminated, it should be estimated and acknowledged. Published by Elsevier Inc.

Fourth-year medical student opinions and basic knowledge regarding the field of radiology.

PubMed

Prezzia, Charles; Vorona, Gregory; Greenspan, Robin

2013-03-01

This study evaluates the opinions and knowledge of fourth-year US medical students regarding radiology and analyzes the influence of a required or nonrequired radiology rotation as a reflection of the effectiveness of radiology medical student education. Our institutional review board granted exempt status. An invitation e-mail was sent to 137 US medical schools. Upon receiving approval a second email was sent containing our voluntary anonymous online survey hyperlink to forward to their fourth-year class. Survey topics included demographics, radiology educational experiences, attitudes toward the field, and basic radiology knowledge. Responses were collected between August 4 and September 26, 2011. A total of 444 fourth-year medical students from 37 medical schools participated: 89% planned to enter a nonradiology specialty, 10.8% were required to take a dedicated radiology rotation, 34.9% completed one, 77% planned to complete one by graduation, 88.4% thought radiology often changes patient care or is at least as important as physical exam, 91.4% underestimated the cancer risk of an abdomen and pelvis computed tomography by at least one order of magnitude, and 72.9% by at least two orders. Seventy-seven percent had never heard of the American College of Radiology (ACR) Appropriateness Criteria. Respondents underestimated the potential risks of magnetic resonance imaging (MRI); with 58.3% aware intravenous gadolinium can cause nephrogenic systemic fibrosis and 79.4% aware of potential injury from metallic projectiles. 40.4% indicated that non-radiologist clinicians in specific medical specialties interpret their respective imaging studies at least as accurately as corresponding subspecialty radiologists. Other results include student opinions regarding teleradiology, radiologist lifestyle, and compensation. Fourth-year medical students recognize the importance of radiology but are poorly informed regarding radiation safety, MRI safety, and ACR Appropriateness Criteria, despite 34.9% having a dedicated rotation. This highlights the need for adoption of the Alliance of Medical Student Educators in Radiology curriculum. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

FRMAC Operations Manual

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frandsen, K.

In the event of a major radiological incident, the Federal Radiological Monitoring and Assessment Center (FRMAC) will coordinate the federal agencies that have various statutory responsibilities. The FRMAC is responsible for coordinating all environmental radiological monitoring, sampling, and assessment activities for the response. This manual describes the FRMAC’s response activities in a radiological incident. It also outlines how FRMAC fits in the National Incident Management System (NIMS) under the National Response Framework (NRF) and describes the federal assets and subsequent operational activities which provide federal radiological monitoring and assessment of the affected areas. In the event of a potential ormore » existing major radiological incident, the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) is responsible for establishing and managing the FRMAC during the initial phases.« less

Stress management for the radiologic technologist.

PubMed

Romano, Jeannine M

2012-01-01

Changes in technology in the radiology department and an emphasis on multitasking can lead to stress and burnout, along with the potential for medical errors. A shift in viewpoint and exercises in self-evaluation can help radiologic technologists learn to manage change in a positive manner. Learning to approach change through a series of transitions and positive steps can reduce stress at work and at home.

Succession Planning and Management: The Backbone of the Radiology Group's Future.

PubMed

Donner, E Michael; Gridley, Daniel; Ulreich, Sidney; Bluth, Edward I

2017-01-01

The transition of leadership within radiology practices is often not a planned replacement process with formal development of potential future leaders. To ensure their ongoing success, however, practices need to develop comprehensive succession plans that include a robust developmental program for potential leaders consisting of mentoring, coaching, structured socialization, 360-degree feedback, developmental stretch assignments, job rotation, and formal education. Succession planning and leadership development will be necessary in the future for a practice to be successful in its business relationships and to be financially viable. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Results of a National Radiology Attending Physician Survey: The Effects of In-House Late and Overnight Attending Coverage on Radiology Resident Training.

PubMed

Hoffmann, Jason C; Singh, Ayushi; Mittal, Sameer; Peterkin, Yuri; Flug, Jonathan

2016-01-01

Over the past 10 years, there has been increased attending-level image interpretation during what has typically been considered the on-call period. The purpose of this study is to survey radiology attending physicians and assess their perceptions about how the presence of radiology attending physicians during the on-call period affects patient care and resident education. Two hundred eighty-eight radiology attendings completed the online survey. 70% believe that after hours final reads by radiology attendings improves patient care. 56% believe that this additional attending presence has a negative impact on the ability of graduating residents to efficiently interpret studies independently. A majority of radiology attending physicians in this study believe that increased in-house radiology attending coverage is harming resident training across the United States, yet also believe this attending presence is important for patient care. Additional studies are needed to quantify and further evaluate this effect, and develop strategies to address potential negative impacts on radiology resident education. Copyright © 2016 Elsevier Inc. All rights reserved.

Radiation Exposure and Attributable Cancer Risk in Patients With Esophageal Atresia.

PubMed

Yousef, Yasmine; Baird, Robert

2018-02-01

Cases of esophageal carcinoma have been documented in survivors of esophageal atresia (EA). Children with EA undergo considerable amounts of diagnostic imaging and consequent radiation exposure potentially increasing their lifetime cancer mortality risk. This study evaluates the radiological procedures performed on patients with EA and estimates their cumulative radiation exposure and attributable lifetime cancer mortality risk. Medical records of patients with EA managed at a tertiary care center were reviewed for demographics, EA subtype, and number and type of radiological investigations. Existing normative data were used to estimate the cumulative radiation exposure and lifetime cancer risk per patient. The present study included 53 patients with a mean follow-up of 5.7 years. The overall median and maximum estimated effective radiation dose in the neonatal period was 5521.4 μSv/patient and 66638.6 μSv/patient, respectively. This correlates to a median and maximum estimated cumulative lifetime cancer mortality risk of 1:1530 and 1:130, respectively. Hence, radiation exposure in the neonatal period increased the cumulative cancer mortality risk a median of 130-fold and a maximum of 1575-fold in EA survivors. Children with EA are exposed to significant amounts of radiation and an increased estimated cumulative cancer mortality risk. Efforts should be made to eliminate superfluous imaging.

Imaging of acute traumatic aortic tear in patients with an aberrant right subclavian artery.

PubMed

Haesemeyer, S W; Gavant, M L

1999-01-01

This report describes the radiologic findings and discusses the clinical consequences of acute traumatic aortic tear occurring with an aberrant right subclavian artery. Identification of an aberrant right subclavian artery with acute traumatic aortic tear must be emphasized to reduce iatrogenic morbidity and mortality.

Machine learning and radiology.

PubMed

Wang, Shijun; Summers, Ronald M

2012-07-01

In this paper, we give a short introduction to machine learning and survey its applications in radiology. We focused on six categories of applications in radiology: medical image segmentation, registration, computer aided detection and diagnosis, brain function or activity analysis and neurological disease diagnosis from fMR images, content-based image retrieval systems for CT or MRI images, and text analysis of radiology reports using natural language processing (NLP) and natural language understanding (NLU). This survey shows that machine learning plays a key role in many radiology applications. Machine learning identifies complex patterns automatically and helps radiologists make intelligent decisions on radiology data such as conventional radiographs, CT, MRI, and PET images and radiology reports. In many applications, the performance of machine learning-based automatic detection and diagnosis systems has shown to be comparable to that of a well-trained and experienced radiologist. Technology development in machine learning and radiology will benefit from each other in the long run. Key contributions and common characteristics of machine learning techniques in radiology are discussed. We also discuss the problem of translating machine learning applications to the radiology clinical setting, including advantages and potential barriers. Copyright © 2012. Published by Elsevier B.V.

The New Interventional Radiology Pathways: Options for Implementation.

PubMed

Recht, Michael; McKinney, J Mark; Alleman, Anthony M; Lowe, Lisa H; Spies, James B

2016-07-01

The new interventional radiology (IR) pathways have generated much discussion with articles and editorials pointing out perceived advantages and disadvantages compared to the current pathways. To briefly review, under the new system, there are three pathways to enter IR: the integrated (INT) IR residency, the independent (IND) IR residency, and the early specialization in interventional radiology (ESIR) program. The pathways have been designed to provide maximum flexibility to programs for implementation and to radiology residents for planning their subspecialty training. As a result, there are many potential permutations for these training programs, and understanding the variety of options can be a challenge at first. We offer three potential solutions, based on the different circumstances or requirements a department might face. The first two solutions involve integrated programs created through newly funded and converted diagnostic radiology slots, respectively. The third involves establishing ESIR and IND programs only. Hopefully, the examples provided will be useful for those currently planning for the future of their IR training programs. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

A critical review of the readability of online patient education resources from RadiologyInfo.Org.

PubMed

Hansberry, David R; John, Ann; John, Elizabeth; Agarwal, Nitin; Gonzales, Sharon F; Baker, Stephen R

2014-03-01

Health consumers and their families rely on the Internet as a source of authoritative information regarding the procedures used to reach a diagnosis, effect treatment, and influence prognosis. In radiology, online materials can be a means by which to offer patients comprehensible explanations of the capabilities, the risks and rewards, and the techniques under our purview. Consequently, estimations of health literacy should take into account the reading level of the average American when composing and transmitting such information to the lay public without the mediation of a referring physician. In December 2012, patient education reports from the files of RadiologyInfo.org, a jointly sponsored website of the American College of Radiology and the Radiological Society of North America, were downloaded to assess their textual sophistication. All 138 patient education articles including the glossary were analyzed for their respective level of "readability" using the following 10 evaluative scales: Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook Grading, Coleman-Liau Index, Gunning Fog Index, New Dale-Chall scale, FORCAST, Fry graph, Raygor Readability Estimate, and New Fog Count. The 138 online patient education articles were written, on average, between the 10th and 14th grade levels, which exceeds both the American Medical Association and the National Institutes of Health recommendations that patient education resources be comprehensible to those who read no higher than the seventh grade level. Patients may accrue a greater benefit from written articles available on RadiologyInfo.org if the texts were revised to be in compliance with the National Institutes of Health and American Medical Association grade level recommendations. This could lead to a broadened appreciation of the capabilities of radiology's role in general and enhanced understanding of imaging techniques and their application to clinical practice.

Radiology preparedness in ebola virus disease: guidelines and challenges for disinfection of medical imaging equipment for the protection of staff and patients.

PubMed

Mollura, Daniel J; Palmore, Tara N; Folio, Les R; Bluemke, David A

2015-05-01

The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. The purpose of this article is to consider the effect of EVD on radiology departments and imaging equipment, with particular consideration of guidelines currently available from the Centers for Disease Control and Prevention that may be applicable to radiology. (©) RSNA, 2015.

Office of the Assistant Secretary for Preparedness and Response; HHS Public Health Emergency Medical Countermeasures Enterprise implementation plan for chemical, biological, radiological and nuclear threats. Notice.

PubMed

2007-04-23

The United States faces serious public health threats from the deliberate use of weapons of mass destruction (WMD)--chemical, biological, radiological, or nuclear (CBRN)--by hostile States or terrorists, and from naturally emerging infectious diseases that have a potential to cause illness on a scale that could adversely impact national security. Effective strategies to prevent, mitigate, and treat the consequences of CBRN threats is an integral component of our national security strategy. To that end, the United States must be able to rapidly develop, stockpile, and deploy effective medical countermeasures to protect the American people. The HHS Public Health Emergency Medical Countermeasures Enterprise (PHEMCE) has taken a holistic, end-to-end approach that considers multiple aspects of the medical countermeasures mission including research, development, acquisition, storage, maintenance, deployment, and guidance for utilization. Phase one of this approach established the HHS PHEMCE Strategy for Chemical, Biological, Radiological, and Nuclear Threats (HHS PHEMCE Strategy). The HHS PHEMCE Strategy, published in the Federal Register on March 20, 2007, described a framework of strategic policy goals and objectives for identifying medical countermeasure requirements and establishing priorities for medical countermeasure evaluation, development and acquisition. These strategic policy goals and objectives were used to establish the Four Pillars upon which this HHS Public Health Emergency Medical Countermeasures Enterprise Implementation Plan (HHS PHEMCE Implementation Plan) is based. The HHS PHEMCE Implementation Plan considers the full spectrum of medical countermeasures-related activities, including research, development, acquisition, storage/maintenance, deployment, and utilization. The HHS PHEMCE Implementation Plan is consistent with the President's Biodefense for the 21st Century and is aligned with the National Strategy for Medical Countermeasures against Weapons of Mass Destruction.

Cloud rise model for radiological dispersal devices events

NASA Astrophysics Data System (ADS)

Sharon, Avi; Halevy, Itzhak; Sattinger, Daniel; Yaar, Ilan

2012-07-01

As a part of the preparedness and response to possible radiological terror events, it is important to model the evolution of the radioactive cloud immediately after its formation, as a function of time, explosive quantity and local meteorological conditions. One of the major outputs of a cloud rise models is the evaluation of cloud top height, which is an essential input for most of the succeeding atmospheric dispersion models. This parameter strongly affects the radiological consequences of the event. Most of the cloud rise models used today, have been developed according to experiments were large quantities of explosives were used, within the range of hundreds of kilograms of TNT. The majority of these models, however, fail to address Radiological Dispersion Devices (RDD) events, which are typically characterized by smaller amounts of TNT. In this paper, a new, semi-empirical model that describes the vertical evolution of the cloud up to its effective height as a function of time, explosive quantity, atmospheric stability and horizontal wind speed, is presented. The database for this model is taken from five sets of experiments done in Israel during 2006-2009 under the "Green Field" (GF) project, using 0.25-100 kg of TNT.

Canadian Association of Radiologists White Paper on Artificial Intelligence in Radiology.

PubMed

Tang, An; Tam, Roger; Cadrin-Chênevert, Alexandre; Guest, Will; Chong, Jaron; Barfett, Joseph; Chepelev, Leonid; Cairns, Robyn; Mitchell, J Ross; Cicero, Mark D; Poudrette, Manuel Gaudreau; Jaremko, Jacob L; Reinhold, Caroline; Gallix, Benoit; Gray, Bruce; Geis, Raym

2018-05-01

Artificial intelligence (AI) is rapidly moving from an experimental phase to an implementation phase in many fields, including medicine. The combination of improved availability of large datasets, increasing computing power, and advances in learning algorithms has created major performance breakthroughs in the development of AI applications. In the last 5 years, AI techniques known as deep learning have delivered rapidly improving performance in image recognition, caption generation, and speech recognition. Radiology, in particular, is a prime candidate for early adoption of these techniques. It is anticipated that the implementation of AI in radiology over the next decade will significantly improve the quality, value, and depth of radiology's contribution to patient care and population health, and will revolutionize radiologists' workflows. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI working group with the mandate to discuss and deliberate on practice, policy, and patient care issues related to the introduction and implementation of AI in imaging. This white paper provides recommendations for the CAR derived from deliberations between members of the AI working group. This white paper on AI in radiology will inform CAR members and policymakers on key terminology, educational needs of members, research and development, partnerships, potential clinical applications, implementation, structure and governance, role of radiologists, and potential impact of AI on radiology in Canada. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Nuclear risk analysis of the Ulysses mission

NASA Astrophysics Data System (ADS)

Bartram, Bart W.; Vaughan, Frank R.; Englehart, Richard W.

An account is given of the method used to quantify the risks accruing to the use of a radioisotope thermoelectric generator fueled by Pu-238 dioxide aboard the Space Shuttle-launched Ulysses mission. After using a Monte Carlo technique to develop probability distributions for the radiological consequences of a range of accident scenarios throughout the mission, factors affecting those consequences are identified in conjunction with their probability distributions. The functional relationship among all the factors is then established, and probability distributions for all factor effects are combined by means of a Monte Carlo technique.

A Novel Method for Quick Assessment of Internal And External Radiation Exposure in the Aftermath of a Large Radiological Incident.

PubMed

Korir, Geoffrey; Karam, P Andrew

2018-06-11

In the event of a significant radiological release in a major urban area where a large number of people reside, it is inevitable that radiological screening and dose assessment must be conducted. Lives may be saved if an emergency response plan and radiological screening method are established for use in such cases. Thousands to tens of thousands of people might present themselves with some levels of external contamination and/or the potential for internal contamination. Each of these individuals will require varying degrees of radiological screening, and those with a high likelihood of internal and/or external contamination will require radiological assessment to determine the need for medical attention and decontamination. This sort of radiological assessment typically requires skilled health physicists, but there are insufficient numbers of health physicists in any city to perform this function for large populations, especially since many (e.g., those at medical facilities) are likely to be engaged at their designated institutions. The aim of this paper is therefore to develop and describe the technical basis for a novel, scoring-based methodology that can be used by non-health physicists for performing radiological assessment during such radiological events.

Outcomes of asymptomatic anastomotic leaks found on routine postoperative water-soluble enema following anterior resection for cancer.

PubMed

Killeen, S; Souroullas, P; Ho Tin, H; Hunter, I A; O'Grady, H; Gunn, J; Hartley, J E

2013-11-01

The incidence and consequence of an anastomotic leak associated with low anterior resection for cancer mandates covering stoma in most cases. A water-soluble enema is often performed to assess anastomotic integrity prior to stoma reversal. The functional outcome following reversal in patients with occult radiologically detected leaks is poorly defined. The goal of the present study was to determine the functional outcome in patients with a radiologically detected anastomotic leak who subsequently underwent stoma reversal. This case control study used patients with and without radiologically detected occult anastomotic leak having undergone reversal of covering stomata. The study group was matched with controls for age, gender, procedure, tumor stage, and adjuvant/neoadjuvant therapy. Validated fecal incontinence quality of life (FIQL), Cleveland Clinic Fecal Incontinence Score (CCFIS), and the Memorial Sloan-Kettering Cancer Center (MSKCC) Bowel Function Index (BFI) were used. Patient satisfaction, medication use, and ancillary procedures prior to closure were also recorded. Thirteen patients with radiologically detected occult anastomotic leaks and 13 matched controls were identified from a prospectively maintained database. The FIQL, CCFIS, and MSKCC BFI scores were significantly reduced in those with occult leaks. The mean number of radiological and surgical interventions was significantly greater in the patients with occult leaks. Antidiarrheal and bulking agent use, as well as patient satisfaction, were the same for both groups. Only one patient in the occult leak group would not undergo stoma reversal again. Reversal of a defunctioning ileostomy in the presence of an occult radiological leak can be associated with poorer functional outcomes, but patient satisfaction is undiminished.

The consequences of the economic crisis in radiology.

PubMed

2015-12-01

The effects of the economic crisis have led to complex problems in radiology. The crisis has led to a reduction in the turnover of imaging equipment. This reflects on the quantity and quality of output, an aspect which is worsened by the contraction of the radiology market, late payments on supplies, and competitive procurement of medical goods centralized on a regional or national level. Many local and national institutions have operated with significant reductions of reimbursement for procedures, forcing a reorganization of facilities, manpower, and equipment. The reduction in operating margins of the industry has resulted in a reduction of invested capital for projects of industrial R&D and direct or indirect sponsorship. The quality of care will be affected with less comfortable conditions, reduction of local availability of radiologists, and failure to invest in lower dose equipment to control population medical radiation exposure. The crisis resulted in a reduction in the number of graduates in medicine and scholarships for specialization induced by linear cuts will result in a drastic reduction of radiological specialists. This will favour the development of teleradiology services, with the risk of accelerating the demedicalisation of radiology departments, and isolation of the professionals. • The economic crisis has led to reduction in the turnover of imaging equipment. • The economic crisis has led to reductions of reimbursement for procedures. • The economic crisis has led to reductions in operating margins of the industry. • The economic crisis has led to contraction of quantity and quality of output. • The economic crisis resulted in demedicalisation of radiology departments and isolation of professionals.

78 FR 64541 - Biweekly Notice; Applications and Amendments to Facility Operating Licenses and Combined Licenses...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... controverted. In addition, the requestor/petitioner shall provide a brief explanation of the bases for the... changes to the Bases or licensee-controlled document will be evaluated pursuant to the requirements of 10... isolation, or radiological consequences of any accident previously evaluated. Further, the proposed changes...

78 FR 6149 - Final Interim Staff Guidance Assessing the Radiological Consequences of Accidental Releases of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-29

... Accidental Releases of Radioactive Materials From Liquid Waste Tanks in Ground and Surface Waters for... Radioactive Materials from Liquid Waste Tanks in Ground and Surface Waters for Combined License Applications... Radioactive Materials from Liquid Waste Tanks in Ground and Surface Waters for Combined License Applications...

Radiology Preparedness in Ebola Virus Disease: Guidelines and Challenges for Disinfection of Medical Imaging Equipment for the Protection of Staff and Patients

PubMed Central

Palmore, Tara N.; Folio, Les R.; Bluemke, David A.

2015-01-01

The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. The purpose of this article is to consider the effect of EVD on radiology departments and imaging equipment, with particular consideration of guidelines currently available from the Centers for Disease Control and Prevention that may be applicable to radiology. © RSNA, 2015 PMID:25654616

Simulation Technology Laboratory Building 970 hazards assessment document

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wood, C.L.; Starr, M.D.

1994-11-01

The Department of Energy Order 5500.3A requires facility-specific hazards assessments be prepared, maintained, and used for emergency planning purposes. This hazards assessment document describes the chemical and radiological hazards associated with the Simulation Technology Laboratory, Building 970. The entire inventory was screened according to the potential airborne impact to onsite and offsite individuals. The air dispersion model, ALOHA, estimated pollutant concentrations downwind from the source of a release, taking into consideration the toxicological and physical characteristics of the release site, the atmospheric conditions, and the circumstances of the release. The greatest distances at which a postulated facility event will producemore » consequences exceeding the ERPG-2 and Early Severe Health Effects thresholds are 78 and 46 meters, respectively. The highest emergency classification is a Site Area Emergency. The Emergency Planning Zone is 100 meters.« less

A REVIEW OF THE FUNDAMENTAL PRINCIPLES OF RADIATION PROTECTION WHEN APPLIED TO THE PATIENT IN DIAGNOSTIC RADIOLOGY.

PubMed

Moores, B Michael

2017-06-01

A review of the role and relevance of the principles of radiation protection of the patient in diagnostic radiology as specified by ICRP has been undertaken when diagnostic risks arising from an examination are taken into account. The increase in population doses arising from diagnostic radiology over the past 20 years has been due to the widespread application of higher dose CT examinations that provide significantly more clinical information. Consequently, diagnostic risks as well as radiation risks need to be considered within the patient radiation protection framework. Justification and optimisation are discussed and the limitations imposed on patient protection by employing only a radiation risk framework is highlighted. The example of radiation protection of the patient in breast screening programmes employing mammography is used to highlight the importance of defined diagnostic outcomes in any effective radiation protection strategy. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Systematic Review of the Application of Lean and Six Sigma Quality Improvement Methodologies in Radiology.

PubMed

Amaratunga, Thelina; Dobranowski, Julian

2016-09-01

Preventable yet clinically significant rates of medical error remain systemic, while health care spending is at a historic high. Industry-based quality improvement (QI) methodologies show potential for utility in health care and radiology because they use an empirical approach to reduce variability and improve workflow. The aim of this review was to systematically assess the literature with regard to the use and efficacy of Lean and Six Sigma (the most popular of the industrial QI methodologies) within radiology. MEDLINE, the Allied & Complementary Medicine Database, Embase Classic + Embase, Health and Psychosocial Instruments, and the Ovid HealthStar database, alongside the Cochrane Library databases, were searched on June 2015. Empirical studies in peer-reviewed journals were included if they assessed the use of Lean, Six Sigma, or Lean Six Sigma with regard to their ability to improve a variety of quality metrics in a radiology-centered clinical setting. Of the 278 articles returned, 23 studies were suitable for inclusion. Of these, 10 assessed Six Sigma, 7 assessed Lean, and 6 assessed Lean Six Sigma. The diverse range of measured outcomes can be organized into 7 common aims: cost savings, reducing appointment wait time, reducing in-department wait time, increasing patient volume, reducing cycle time, reducing defects, and increasing staff and patient safety and satisfaction. All of the included studies demonstrated improvements across a variety of outcomes. However, there were high rates of systematic bias and imprecision as per the Grading of Recommendations Assessment, Development and Evaluation guidelines. Lean and Six Sigma QI methodologies have the potential to reduce error and costs and improve quality within radiology. However, there is a pressing need to conduct high-quality studies in order to realize the true potential of these QI methodologies in health care and radiology. Recommendations on how to improve the quality of the literature are proposed. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Prospects for improved detection of chemical, biological, radiological, and nuclear threats

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wuest, Craig R.; Hart, Brad; Slezak, Thomas R.

2012-07-31

Acquisition and use of Chemical, Biological, Radiological, and Nuclear (CBRN) weapons continue to be a major focus of concern form the security apparatus of nation states because of their potential for mass casualties when used by a determined adversary.

Survey of UK radiology trainees in the aftermath of ‘Modernising Medical Careers’

PubMed Central

2012-01-01

Background Following implementation of Modernising Medical Careers (MMC) in the UK, potential radiology trainees must decide on their career and apply sooner than ever before. We aimed to determine whether current trainees were sufficiently informed to make an earlier career decision by comparing the early radiology experiences of Traditional and Foundation Trainees. Methods 344 radiology trainees were appointed through MMC in 2007/08. This cohort was surveyed online. Results Response rate was 174/344 (51%). Traditional Trainees made their career decision 2.6 years after graduation compared with 1.2 years for Foundation Trainees (57/167, 34%). Nearly half of responders (79/169, 47%) experienced no formal radiology teaching as undergraduates. Most trainees regularly attended radiology meetings, spent time in a radiology department and/or performed radiology research. Many trainees received no career advice specific to radiology (69/163, 42%) at any point prior to entering the specialty; this includes both formal and informal advice. Junior doctor experiences were more frequently cited as influencing career choice (98/164, 60%). An earlier career decision was associated with; undergraduate radiology projects (-0.72 years, p = 0.018), career advice (-0.63 years, p = 0.009) and regular attendance at radiology meetings (-0.65 years, p = 0.014). Conclusion Early experience of radiology enables trainees to make an earlier career decision, however current radiology trainees were not always afforded relevant experiences prior to entering training. Radiologists need to be more proactive in encouraging the next generation of trainees. PMID:23031228

Ethical Issues in Radiology Journalism, Peer Review, and Research.

PubMed

Katz, Douglas S; Gardner, James B; Hoffmann, Jason C; Patlas, Michael N; Bhargava, Puneet; Moshiri, Mariam; Remer, Erick M; Gould, Elaine S; Smith, Stacy

2016-08-17

Although some research and publication practices are clearly unethical, including fraud and plagiarism, other areas of research and publication, such as informed consent and conflicts of interest, fall into grayer areas. The purposes of this article are, therefore, to review a variety of relevant ethical issues in radiology-related journalism, peer review, and research; to review the radiology literature to date that has addressed these issues; and to present position statements and potential solutions to these problems.

Interventional radiology procedures in adult patients who underwent liver transplantation

PubMed Central

Miraglia, Roberto; Maruzzelli, Luigi; Caruso, Settimo; Milazzo, Mariapina; Marrone, Gianluca; Mamone, Giuseppe; Carollo, Vincenzo; Gruttadauria, Salvatore; Luca, Angelo; Gridelli, Bruno

2009-01-01

Interventional radiology has acquired a key role in every liver transplantation (LT) program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplantation. The aim of this paper is to review indications, technical consideration, results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT. PMID:19222091

After Fukushima: managing the consequences of a radiological release.

PubMed

Fitzgerald, Joe; Wollner, Samuel B; Adalja, Amesh A; Morhard, Ryan; Cicero, Anita; Inglesby, Thomas V

2012-06-01

Even amidst the devastation following the earthquake and tsunami in Japan that killed more than 20,000 people, it was the accident at the Fukushima Daiichi nuclear power plant that led the country's prime minister, Naoto Kan, to fear for "the very existence of the Japanese nation." While accidents that result in mass radiological releases have been rare throughout the operating histories of existing nuclear power plants, the growing number of plants worldwide increases the likelihood that such releases will occur again in the future. Nuclear power is an important source of energy in the U.S. and will be for the foreseeable future. Accidents far smaller in scale than the one in Fukushima could have major societal consequences. Given the extensive, ongoing Nuclear Regulatory Commission (NRC) and industry assessment of nuclear power plant safety and preparedness issues, the Center for Biosecurity of UPMC focused on offsite policies and plans intended to reduce radiation exposure to the public in the aftermath of an accident. This report provides an assessment of Japan's efforts at nuclear consequence management; identifies concerns with current U.S. policies and practices for "outside the fence" management of such an event in the U.S.; and makes recommendations for steps that can be taken to strengthen U.S. government, industry, and community response to large-scale accidents at nuclear power plants.

Potential clinical impact of advanced imaging and computer-aided diagnosis in chest radiology: importance of radiologist's role and successful observer study.

PubMed

Li, Feng

2015-07-01

This review paper is based on our research experience in the past 30 years. The importance of radiologists' role is discussed in the development or evaluation of new medical images and of computer-aided detection (CAD) schemes in chest radiology. The four main topics include (1) introducing what diseases can be included in a research database for different imaging techniques or CAD systems and what imaging database can be built by radiologists, (2) understanding how radiologists' subjective judgment can be combined with technical objective features to improve CAD performance, (3) sharing our experience in the design of successful observer performance studies, and (4) finally, discussing whether the new images and CAD systems can improve radiologists' diagnostic ability in chest radiology. In conclusion, advanced imaging techniques and detection/classification of CAD systems have a potential clinical impact on improvement of radiologists' diagnostic ability, for both the detection and the differential diagnosis of various lung diseases, in chest radiology.

RELEASE OF DRIED RADIOACTIVE WASTE MATERIALS TECHNICAL BASIS DOCUMENT

DOE Office of Scientific and Technical Information (OSTI.GOV)

KOZLOWSKI, S.D.

2007-05-30

This technical basis document was developed to support RPP-23429, Preliminary Documented Safety Analysis for the Demonstration Bulk Vitrification System (PDSA) and RPP-23479, Preliminary Documented Safety Analysis for the Contact-Handled Transuranic Mixed (CH-TRUM) Waste Facility. The main document describes the risk binning process and the technical basis for assigning risk bins to the representative accidents involving the release of dried radioactive waste materials from the Demonstration Bulk Vitrification System (DBVS) and to the associated represented hazardous conditions. Appendices D through F provide the technical basis for assigning risk bins to the representative dried waste release accident and associated represented hazardous conditionsmore » for the Contact-Handled Transuranic Mixed (CH-TRUM) Waste Packaging Unit (WPU). The risk binning process uses an evaluation of the frequency and consequence of a given representative accident or represented hazardous condition to determine the need for safety structures, systems, and components (SSC) and technical safety requirement (TSR)-level controls. A representative accident or a represented hazardous condition is assigned to a risk bin based on the potential radiological and toxicological consequences to the public and the collocated worker. Note that the risk binning process is not applied to facility workers because credible hazardous conditions with the potential for significant facility worker consequences are considered for safety-significant SSCs and/or TSR-level controls regardless of their estimated frequency. The controls for protection of the facility workers are described in RPP-23429 and RPP-23479. Determination of the need for safety-class SSCs was performed in accordance with DOE-STD-3009-94, Preparation Guide for US. Department of Energy Nonreactor Nuclear Facility Documented Safety Analyses, as described below.« less

Terrorism's Psychologic Effects and Their Implications for Primary Care Policy, Research, and Education

PubMed Central

Eisenman, David P; Stein, Bradley D; Tanielian, Terri L; Pincus, Harold Alan

2005-01-01

This paper examines primary care physicians' (PCP) roles in helping the nation prepare for, respond to, and recover from the psychologic consequences of chemical, biologic, radiologic, or nuclear (CBRN) terrorism. First, we discuss the psychologic consequences of a CBRN attack and PCPs' roles in responding to these consequences. Second, we analyze these roles in light of the known barriers to delivering high-quality, primary care–based, mental health care. Third, we offer recommendations for mitigating these barriers and preparing PCPs to respond to the psychosocial consequences of a CBRN weapon. Importantly, our recommendations provide dual-use benefits to PCPs faced with the daily concerns of primary care mental health, including improved linkages and electronic connectivity with mental health, information technology, and decision support for providers, and needed education and research. PMID:16050892

Ethical foundations of environmental radiological protection.

PubMed

Oughton, D H

2016-06-01

Assessing the potential ecological impact of ionising radiation raises a number of ethical questions. These include fundamental questions such as what exactly constitutes harming the environment, and how the environment should be valued, as well as links to political protection principles such as sustainability and biodiversity. Starting from developments within ecological risk assessment, this paper summarises some of the ethical issues concerning the protection of the environment from radiation. Chapter 2 gives a brief overview of different philosophical and cultural world views on valuing the environment in a context of radiation risk. Chapter 3 addresses some recent challenges to proposed environmental protection frameworks, including practical applications following the Chernobyl and Fukushima accidents, and some scientific developments such as the ecosystem approach. Finally, Chapter 4 offers some recommendations on how ethical evaluation can help produce a more robust and transparent approach to the protection of the environment. In conclusion, there is a need for a holistic evaluation of the environmental impacts of ionising radiation that not only considers the direct consequences on the health of humans and non-human species, but also the more complex social, ethical, and economic consequences of both human and non-human exposures. © The International Society for Prosthetics and Orthotics.

Individual Radiological Protection Monitoring of Utrok Atoll Residents Based on Whole Body Counting of Cesium-137 (137Cs) and Plutonium Bioassay

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hamilton, T; Kehl, S; Brown, T

2007-06-08

This report contains individual radiological protection surveillance data developed during 2006 for adult members of a select group of families living on Utrok Atoll. These Group I volunteers all underwent a whole-body count to determine levels of internally deposited cesium-137 ({sup 137}Cs) and supplied a bioassay sample for analysis of plutonium isotopes. Measurement data were obtained and the results compared with an equivalent set of measurement data for {sup 137}Cs and plutonium isotopes from a second group of adult volunteers (Group II) who were long-term residents of Utrok Atoll. For the purposes of this comparison, Group II volunteers were consideredmore » representative of the general population on Utrok Atoll. The general aim of the study was to determine residual systemic burdens of fallout radionuclides in each volunteer group, develop data in response to addressing some specific concerns about the preferential uptake and potential health consequences of residual fallout radionuclides in Group I volunteers, and generally provide some perspective on the significance of radiation doses delivered to volunteers (and the general Utrok Atoll resident population) in terms of radiological protection standards and health risks. Based on dose estimates from measurements of internally deposited {sup 137}Cs and plutonium isotopes, the data and information developed in this report clearly show that neither volunteer group has acquired levels of internally deposited fallout radionuclides specific to nuclear weapons testing in the Marshall Islands that are likely to have any consequence on human health. Moreover, the dose estimates are well below radiological protection standards as prescribed by U.S. regulators and international agencies, and are very small when compared to doses from natural sources of radiation in the Marshall Islands and the threshold where radiation health effects could be either medically diagnosed in an individual or epidemiologically discerned in a group of people. In general, the results from the whole-body counting measurements of 137Cs are consistent with our knowledge that a key pathway for exposure to residual fallout contamination on Utrok Atoll is low-level chronic uptake of {sup 137}Cs from the consumption of locally grown produce (Robison et al., 1999). The error-weighted, average body burden of {sup 137}Cs measured in Group I and Group II volunteers was 0.31 kBq and 0.62 kBq, respectively. The associated average, annual committed effective dose equivalent (CEDE) delivered to Group I and Group II volunteers from {sup 137}Cs during the year of measurement was 2.1 and 4.0 mrem. For comparative purposes, the annual dose limit for members of the public as recommended by the National Council on Radiation Protection and Measurements (NCRP) and the International Commission on Radiological Protection (ICRP) is 100 mrem. Consequently, specific concerns about elevated levels of {sup 137}Cs uptake and higher risks from radiation exposure to Group I volunteers would be considered unfounded. Moreover, the urinary excretion of plutonium-239 ({sup 239}Pu) from Group I and Group II volunteers is statistically indistinguishable. In this case, the error-weighted, average urinary excretion of {sup 239}Pu from Group I volunteers of 0.10 {mu}Bq per 24-h void with a range between -0.01 and 0.23 {mu}Bq per 24-h void compares with an error-weighted average from Group II volunteers of 0.11 {mu}Bq per 24-h void with a range between -0.20 and 0.47 {mu}Bq per 24-h void. The range in urinary excretion of {sup 239}Pu from Utrok Atoll residents is very similar to that observed for other population groups in the Marshall Islands (Bogen et al., 2006; Hamilton et al., 2006a; 2006b; 2006c, 2007a; 2007b; 2007c) and is generally considered representative of worldwide background.« less

Technical basis for implementation of remote reading capabilities for radiological control instruments at tank farms

DOE Office of Scientific and Technical Information (OSTI.GOV)

PIERSON, R.M.

1999-10-27

This document provides the technical basis for use of remote reading capabilities with radiological control instruments at River Protection Project facilities. The purpose of this document is to evaluate applications of remote reading capabilities with Radiological Control instrumentation to allow continuous monitoring of radiation dose rates at River Protection Project (RPP) facilities. In addition this document provides a technical basis and implementing guidelines for remote monitoring of dose rates and their potential contribution to maintaining radiation exposures ALARA.

A practical approach for inexpensive searches of radiology report databases.

PubMed

Desjardins, Benoit; Hamilton, R Curtis

2007-06-01

We present a method to perform full text searches of radiology reports for the large number of departments that do not have this ability as part of their radiology or hospital information system. A tool written in Microsoft Access (front-end) has been designed to search a server (back-end) containing the indexed backup weekly copy of the full relational database extracted from a radiology information system (RIS). This front end-/back-end approach has been implemented in a large academic radiology department, and is used for teaching, research and administrative purposes. The weekly second backup of the 80 GB, 4 million record RIS database takes 2 hours. Further indexing of the exported radiology reports takes 6 hours. Individual searches of the indexed database typically take less than 1 minute on the indexed database and 30-60 minutes on the nonindexed database. Guidelines to properly address privacy and institutional review board issues are closely followed by all users. This method has potential to improve teaching, research, and administrative programs within radiology departments that cannot afford more expensive technology.

[Digitalization of radiological imaging information and consequences for patient care in the hospital ].

PubMed

den Heeten, G J; Barneveld Binkhuysen, F H

2001-08-25

Determining the rate at which radiology must be digitalised has been a controversial issue for many years. Much radiological information is still obtained from the film-screen combination (X-rays) with all of its known inherent restrictions. The importance of imaging information in the healthcare process continues to increase for both radiologists and referring physicians, and the ongoing developments in information technology means that it is possible to integrate imaging information and electronic patient files. The healthcare process can only become more effective and efficient when the appropriate information is in the right place at the right time, something that conventional methods, using photos that need to be physically moved, can scarcely satisfy. There is also a desire for integration with information obtained from nuclear medicine, pathology and endoscopy, and eventually of all stand-alone data systems with relevance for the individually oriented hospital healthcare. The transition from a conventional to a digital process is complex; it is accompanied by the transition from a data-oriented to a process-oriented system. Many years have already been invested in the integration of information systems and the development of digital systems within radiology, the current performance of which is such that many hospitals are considering the digitalisation process or are already implementing parts of it.

Professional profile of radiologic technology educators.

PubMed

Legg, Jeffrey S; Pollard, Debra K; Fauber, Terri L

2005-01-01

Full-time radiologic technology educators (n = 565) were surveyed to determine their demographic characteristics and professional profile. Overall, the majority of radiologic technology educators surveyed were women between the ages of 40 and 59, had a bachelor's or master's degree, were certified in radiography and reported annual incomes from 40,001 dollars to 60,000 dollars. Most educators spent between 1 hour and 8 hours per week on classroom instruction/laboratory and in the clinical setting. Additionally, hospital or community college programs employed the majority of educators. Demographic characteristics of radiologic technology educators varied according to the type of institution in which they were employed and by education level. Study findings show a potential loss of qualified educators in the near future and the need for increased efforts to prepare and recruit radiologic technologists into the education career path.

Moving Away From Spoon-Feeding as a Teaching Style in Radiology.

PubMed

Rahim, Shiraz; Ros, Pablo

2016-12-01

Medical education has been an important topic in the literature, with many new attempts to revitalize and improve efforts to teach physicians and students. As a unique subspecialty that incorporates visual learning, knowledge of clinical management and presentation, basic science topics such as physics and mechanics, and procedural skills, radiology affords itself to new and more effective methods of teaching. Much of radiology education has currently focused on the concept of spoon-feeding information from the teacher to the learners. This article outlines the dangers of this approach in radiology and offers solutions for educators to improve their teaching skills and use the potential afforded by the diversity of the field.

Development of RAD-Score: A Tool to Assess the Procedural Competence of Diagnostic Radiology Residents.

PubMed

Isupov, Inga; McInnes, Matthew D F; Hamstra, Stan J; Doherty, Geoffrey; Gupta, Ashish; Peddle, Susan; Jibri, Zaid; Rakhra, Kawan; Hibbert, Rebecca M

2017-04-01

The purpose of this study is to develop a tool to assess the procedural competence of radiology trainees, with sources of evidence gathered from five categories to support the construct validity of tool: content, response process, internal structure, relations to other variables, and consequences. A pilot form for assessing procedural competence among radiology residents, known as the RAD-Score tool, was developed by evaluating published literature and using a modified Delphi procedure involving a group of local content experts. The pilot version of the tool was tested by seven radiology department faculty members who evaluated procedures performed by 25 residents at one institution between October 2014 and June 2015. Residents were evaluated while performing multiple procedures in both clinical and simulation settings. The main outcome measure was the percentage of residents who were considered ready to perform procedures independently, with testing conducted to determine differences between levels of training. A total of 105 forms (for 52 procedures performed in a clinical setting and 53 procedures performed in a simulation setting) were collected for a variety of procedures (eight vascular or interventional, 42 body, 12 musculoskeletal, 23 chest, and 20 breast procedures). A statistically significant difference was noted in the percentage of trainees who were rated as being ready to perform a procedure independently (in postgraduate year [PGY] 2, 12% of residents; in PGY3, 61%; in PGY4, 85%; and in PGY5, 88%; p < 0.05); this difference persisted in the clinical and simulation settings. User feedback and psychometric analysis were used to create a final version of the form. This prospective study describes the successful development of a tool for assessing the procedural competence of radiology trainees with high levels of construct validity in multiple domains. Implementation of the tool in the radiology residency curriculum is planned and can play an instrumental role in the transition to competency-based radiology training.

Single-centre experience of radiation exposure in acute surgical patients: assessment of therapeutic impact and future recommendations.

PubMed

Fitzmaurice, Gerard J; Brown, Robin; Cranley, Brian; Conlon, Enda F; Todd, R Alan J; O'Donnell, Mark E

2010-09-01

Radiological investigations have become a key adjunct in patient management and consequently radiation exposure to patients is increasing. The study objectives were to examine the use of radiological investigations in the management of acute surgical patients and to assess whether a guideline-based radiation exposure risk/benefit analysis can aid in the choice of radiological investigation used. A prospective observational study was completed over a 12-week period from April to July 2008 for all acute surgical admissions. Data recorded included demographics, clinical presentation, differential diagnosis, investigations, surgical interventions, and final clinical outcome. The use of radiological investigative modalities as an adjunct to clinical assessment was then evaluated against The Royal College of Radiologists (RCR) guidelines. A total of 380 acute surgical admissions (M = 174, F = 185, children = 21) were assessed during the study period. Seven hundred thirty-four radiological investigations were performed with a mean of 1.93 investigations per patient. Based on the RCR guidelines, 680 (92.6%) radiological investigations were warranted and included 142 CT scans (19.3%), 129 chest X-rays (17.6%), and 85 abdominal X-rays (11.6%). Clinically, radiological imaging complemented surgical management in 326 patients (85.8%) and the management plan remained unchanged for the remaining 54 patients (14.2%). This accounted for an average radiation dose of 4.18 millisievert (mSv) per patient or 626 days of background radiation exposure. CT imaging was responsible for the majority of the radiation exposure, with a total of 1310 mSv (82.6%) of the total radiation exposure being attributed to CT imaging in 20.8% of acute admissions. Subgroup analysis demonstrated that 92.8% of the CT scans performed were appropriate. Radiation exposure was generally low for the majority of acute surgical admissions. However, it is recommended that CT imaging requests be evaluated carefully, particularly for patients with clinically confirmed pathologies and in younger women.

Basis for Interim Operation for Fuel Supply Shutdown Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

BENECKE, M.W.

2003-02-03

This document establishes the Basis for Interim Operation (BIO) for the Fuel Supply Shutdown Facility (FSS) as managed by the 300 Area Deactivation Project (300 ADP) organization in accordance with the requirements of the Project Hanford Management Contract procedure (PHMC) HNF-PRO-700, ''Safety Analysis and Technical Safety Requirements''. A hazard classification (Benecke 2003a) has been prepared for the facility in accordance with DOE-STD-1027-92 resulting in the assignment of Hazard Category 3 for FSS Facility buildings that store N Reactor fuel materials (303-B, 3712, and 3716). All others are designated Industrial buildings. It is concluded that the risks associated with the currentmore » and planned operational mode of the FSS Facility (uranium storage, uranium repackaging and shipment, cleanup, and transition activities, etc.) are acceptable. The potential radiological dose and toxicological consequences for a range of credible uranium storage building have been analyzed using Hanford accepted methods. Risk Class designations are summarized for representative events in Table 1.6-1. Mitigation was not considered for any event except the random fire event that exceeds predicted consequences based on existing source and combustible loading because of an inadvertent increase in combustible loading. For that event, a housekeeping program to manage transient combustibles is credited to reduce the probability. An additional administrative control is established to protect assumptions regarding source term by limiting inventories of fuel and combustible materials. Another is established to maintain the criticality safety program. Additional defense-in-depth controls are established to perform fire protection system testing, inspection, and maintenance to ensure predicted availability of those systems, and to maintain the radiological control program. It is also concluded that because an accidental nuclear criticality is not credible based on the low uranium enrichment, the form of the uranium, and the required controls, a Criticality Alarm System (CAS) is not required as allowed by DOE Order 420.1 (DOE 2000).« less

Agreement Between Computed Tomography and Pathologic Nodule Counts in Colorectal Lung Metastases.

PubMed

Marron, M Carmen; Lora, David; Gamez, Pablo; Rivas, Juan J; Embun, Raul; Molins, Laureano; de la Cruz, Javier

2016-01-01

Computed tomography is the most common technique used to estimate the number of pulmonary metastases and their resectability. A lack of agreement between radiologic and surgical pathologic findings could potentially lead to incomplete resection or to rejection of patients for potentially curative treatments. The objective of this study was to estimate the disagreement between the number of radiologic lesions and the number of histologically confirmed malignant lesions excised from patients with pulmonary metastases from colorectal cancer. This was a multicenter longitudinal study using a national registry. All patients underwent open surgery for pulmonary metastasectomy. Radiologic unilateral involvement was documented in 345 of 404 patients (85%); 253 (73%) presented with single nodules. The radiologic and malignant pathologic findings were concordant in 316 (78%) patients. The two independent predictors of discordance between computed tomography and the number of pathologic metastases were the bilateral involvement and the number of radiologic nodules. This model explained 28% of the variability in the disagreement frequency and discriminated between agreement and disagreement in 85% of the patients. Discrepancies increased with the nodule count with an odds ratio of 6.17 (95% confidence interval, 4.08 to 9.33) per additional nodule. For similar nodule counts, a lower disagreement frequency was observed among bilateral cases (odds ratio, 0.2; 95% confidence interval, 0.07 to 0.55). Differences between the radiologic and pathologic findings were documented in 1 of every 5 patients. The correlation was very accurate in patients with single radiologic nodules. However, half of the patients with more nodules showed discrepancies. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

ESR paper on the proper use of mobile devices in radiology.

PubMed

2018-04-01

Mobile devices (smartphones, tablets, etc.) have become key methods of communication, data access and data sharing for the population in the past decade. The technological capabilities of these devices have expanded very rapidly; for example, their in-built cameras have largely replaced conventional cameras. Their processing power is often sufficient to handle the large data sets of radiology studies and to manipulate images and studies directly on hand-held devices. Thus, they can be used to transmit and view radiology studies, often in locations remote from the source of the imaging data. They are not recommended for primary interpretation of radiology studies, but they facilitate sharing of studies for second opinions, viewing of studies and reports by clinicians at the bedside, etc. Other potential applications include remote participation in educational activity (e.g. webinars) and consultation of online educational content, e-books, journals and reference sources. Social-networking applications can be used for exchanging professional information and teaching. Users of mobile device must be aware of the vulnerabilities and dangers of their use, in particular regarding the potential for inappropriate sharing of confidential patient information, and must take appropriate steps to protect confidential data. • Mobile devices have revolutionized communication in the past decade, and are now ubiquitous. • Mobile devices have sufficient processing power to manipulate and display large data sets of radiological images. • Mobile devices allow transmission & sharing of radiologic studies for purposes of second opinions, bedside review of images, teaching, etc. • Mobile devices are currently not recommended as tools for primary interpretation of radiologic studies. • The use of mobile devices for image and data transmission carries risks, especially regarding confidentiality, which must be considered.

A Clinical Decision Support System Using Ultrasound Textures and Radiologic Features to Distinguish Metastasis From Tumor-Free Cervical Lymph Nodes in Patients With Papillary Thyroid Carcinoma.

PubMed

Abbasian Ardakani, Ali; Reiazi, Reza; Mohammadi, Afshin

2018-03-30

This study investigated the potential of a clinical decision support approach for the classification of metastatic and tumor-free cervical lymph nodes (LNs) in papillary thyroid carcinoma on the basis of radiologic and textural analysis through ultrasound (US) imaging. In this research, 170 metastatic and 170 tumor-free LNs were examined by the proposed clinical decision support method. To discover the difference between the groups, US imaging was used for the extraction of radiologic and textural features. The radiologic features in the B-mode scans included the echogenicity, margin, shape, and presence of microcalcification. To extract the textural features, a wavelet transform was applied. A support vector machine classifier was used to classify the LNs. In the training set data, a combination of radiologic and textural features represented the best performance with sensitivity, specificity, accuracy, and area under the curve (AUC) values of 97.14%, 98.57%, 97.86%, and 0.994, respectively, whereas the classification based on radiologic and textural features alone yielded lower performance, with AUCs of 0.964 and 0.922. On testing the data set, the proposed model could classify the tumor-free and metastatic LNs with an AUC of 0.952, which corresponded to sensitivity, specificity, and accuracy of 93.33%, 96.66%, and 95.00%. The clinical decision support method based on textural and radiologic features has the potential to characterize LNs via 2-dimensional US. Therefore, it can be used as a supplementary technique in daily clinical practice to improve radiologists' understanding of conventional US imaging for characterizing LNs. © 2018 by the American Institute of Ultrasound in Medicine.

Double Fellowships in Radiology: A Survey of 2014 Graduating Fellows.

PubMed

Wong, Thomas Y; Moriarity, Andrew; Lall, Neil; Hoffmann, Jason C; Katz, Douglas S; Flug, Jonathan A

Radiology fellowship training has evolved from being an uncommon option to being a near requisite for post-training employment in the United States. A subset of fellows elect to pursue second fellowships with potentially substantial implications on both the private sector and academic radiology workforce. The purpose of this study was to assess the proportion of current radiology fellows pursuing multiple years of post-residency fellowship training. After obtaining IRB approval, an anonymous web-based survey was emailed to 1,269 radiology fellows listed as "completing fellowship" in the American College of Radiology database in June 2014. Questions were asked regarding current fellowship training, post-fellowship employment plans, and individual experience pursuing employment. Results were analyzed using the survey analytical software. There were 219 responses received, representing a 17.3% response rate. Ten-percent of respondents were currently completing their second radiology fellowship. Of those completing their first year of fellowship training, 11% indicated plans to complete a second radiology fellowship. This survey provides a snapshot of the percentage of radiology trainees who pursue a second year of fellowship training, currently in the range of 10%. Pursuing a second radiology fellowship may represent a safety net to a substantial subset of fellows who are not able to obtain satisfactory employment following training. Academic programs who rely heavily on fellows should be aware of the proportion of fellows pursuing two fellowships and should be prepared to adapt should this change over time. Copyright © 2017 Elsevier Inc. All rights reserved.

[Persistent neonatal hypoglycaemia caused by arterial positioning of the umbilical venous catheter].

PubMed

Peters, P A G; Brus, F; Noordam, C; Smorenburg, M K; van Setten, P A

2007-10-06

Two neonates, a girl born at 40 2/7 weeks weighing 4165 g and a boy born at 37 6/7 weeks weighing 4040 g, received umbilical venous catheters to help manage hypoglycaemia. The catheter was ineffective or only effective when high doses of glucose were used, due to what later appeared to be arterial positioning of the catheter. Both patients recovered without consequences. Persistent hypoglycaemia is a common problem in newborns and can cause severe neurological sequelae. A relatively uncommon cause is malpositioning of the umbilical catheter. Positioning in an artery leads to direct infusion of glucose into the pancreas, which causes hyperinsulinaemia and can lead to potentially dangerous nonketotic hypoglycaemia. Arterial positioning of the umbilical catheter should be ruled out at an early stage. Correct catheter positioning can be determined using careful inspection of the umbilical veins, radiological examination of the catheter position, blood gas analysis or vascular pulsation.

Improved classification of evidence for EMF health risks.

PubMed

Leitgeb, Norbert

2012-08-01

Classifying evidence of causality between a risk factor and its potential health effect is challenging, in particular in an already emotional situation. Even the assessment of health risks by designated bodies may still depend on their composition of individuals with their background, bias, and, in worst case, their interests. This may explain opposing conclusions from the same pool of data which, consequently, may undermine credibility if not communicated properly. To overcome existing weakness in classifying and communicating evidence of health risks such as from electromagnetic fields, a new rule-based approach is presented. Developed by the German Commission on Radiological Protection (SSK), it discloses step-by-step the criteria for weighing scientific data and pools partial evidences of different scientific approaches to conclude on the overall evidence of causality between risk factor and effects. The validity of the approach is demonstrated by analyzing evidence of carcinogenicity of ionizing radiation, mobile phone use, and nocturnal exposure to visible light.

[Three-dimensional 3D modeling: First applications in radioanatomy and interventional radiology under CT guidance].

PubMed

Aubry, S; Pousse, A; Sarliève, P; Laborie, L; Delabrousse, E; Kastler, B

2006-11-01

To model vertebrae in 3D to improve radioanatomic knowledge of the spine with the vascular and nerve environment and simulate CT-guided interventions. Vertebra acquisitions were made with multidetector CT. We developed segmentation software and specific viewer software using the Delphi programming environment. This segmentation software makes it possible to model 3D high-resolution segments of vertebrae and their environment from multidetector CT acquisitions. Then the specific viewer software provides multiplanar reconstructions of the CT volume and the possibility to select different 3D objects of interest. This software package improves radiologists' radioanatomic knowledge through a new 3D anatomy presentation. Furthermore, the possibility of inserting virtual 3D objects in the volume can simulate CT-guided intervention. The first volumetric radioanatomic software has been born. Furthermore, it simulates CT-guided intervention and consequently has the potential to facilitate learning interventions using CT guidance.

Radiological Dispersal Devices: Select Issues in Consequence Management

DTIC Science & Technology

2004-12-07

STATEMENT Approved for public release, distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17...Surveying the Security Risks, Center for Nonproliferation Studies, Monterey Institute of International Studies, January 2003; Anthony H. Cordesman...the radiation-exposure-related damage itself. For example, the DOD uses granisetron , an anti-vomiting drug, to allow soldiers to complete mission

Collaborative filtering to improve navigation of large radiology knowledge resources.

PubMed

Kahn, Charles E

2005-06-01

Collaborative filtering is a knowledge-discovery technique that can help guide readers to items of potential interest based on the experience of prior users. This study sought to determine the impact of collaborative filtering on navigation of a large, Web-based radiology knowledge resource. Collaborative filtering was applied to a collection of 1,168 radiology hypertext documents available via the Internet. An item-based collaborative filtering algorithm identified each document's six most closely related documents based on 248,304 page views in an 18-day period. Documents were amended to include links to their related documents, and use was analyzed over the next 5 days. The mean number of documents viewed per visit increased from 1.57 to 1.74 (P < 0.0001). Collaborative filtering can increase a radiology information resource's utilization and can improve its usefulness and ease of navigation. The technique holds promise for improving navigation of large Internet-based radiology knowledge resources.

A Business Analytics Software Tool for Monitoring and Predicting Radiology Throughput Performance.

PubMed

Jones, Stephen; Cournane, Seán; Sheehy, Niall; Hederman, Lucy

2016-12-01

Business analytics (BA) is increasingly being utilised by radiology departments to analyse and present data. It encompasses statistical analysis, forecasting and predictive modelling and is used as an umbrella term for decision support and business intelligence systems. The primary aim of this study was to determine whether utilising BA technologies could contribute towards improved decision support and resource management within radiology departments. A set of information technology requirements were identified with key stakeholders, and a prototype BA software tool was designed, developed and implemented. A qualitative evaluation of the tool was carried out through a series of semi-structured interviews with key stakeholders. Feedback was collated, and emergent themes were identified. The results indicated that BA software applications can provide visibility of radiology performance data across all time horizons. The study demonstrated that the tool could potentially assist with improving operational efficiencies and management of radiology resources.

Utility of simultaneous interventional radiology and operative surgery in a dedicated suite for seriously injured patients.

PubMed

D'Amours, Scott K; Rastogi, Pratik; Ball, Chad G

2013-12-01

In recent years, combined interventional radiology and operative suites have been proposed and are now becoming operational in select trauma centres. Given the infancy of this technology, this review aims to review the rationale, benefits and challenges of hybrid suites in the management of seriously injured patients. No specific studies exist that investigate outcomes within hybrid trauma suites. Endovascular and interventional radiology techniques have been successfully employed in thoracic, abdominal, pelvic and extremity trauma. Although the association between delayed haemorrhage control and poorer patient outcomes is intuitive, most supporting scientific data are outdated. The hybrid suite model offers the potential to expedite haemorrhage control through synergistic operative, interventional radiology and resuscitative platforms. Maximizing the utility of these suites requires trained multidisciplinary teams, ergonomic and workplace considerations, as well as a fundamental paradigm shift of trauma care. This often translates into a more damage-control orientated philosophy. Hybrid suites offer tremendous potential to expedite haemorrhage control in trauma patients. Outcome evaluations from trauma units that currently have operational hybrid suites are required to establish clearer guidelines and criteria for patient management.

White Paper Report of the RAD-AID Conference on International Radiology for Developing Countries: identifying challenges, opportunities, and strategies for imaging services in the developing world.

PubMed

Mollura, Daniel J; Azene, Ezana M; Starikovsky, Anna; Thelwell, Aduke; Iosifescu, Sarah; Kimble, Cary; Polin, Ann; Garra, Brian S; DeStigter, Kristen K; Short, Brad; Johnson, Benjamin; Welch, Christian; Walker, Ivy; White, David M; Javadi, Mehrbod S; Lungren, Matthew P; Zaheer, Atif; Goldberg, Barry B; Lewin, Jonathan S

2010-07-01

The RAD-AID Conference on International Radiology for Developing Countries was an assembly of individuals and organizations interested in improving access to medical imaging services in developing countries where the availability of radiology has been inadequate for both patient care and public health programs. The purpose of the meeting was to discuss data, experiences, and models pertaining to radiology in the developing world and to evaluate potential opportunities for future collaboration. Conference participants included radiologists, technologists, faculty members of academic medical institutions, and leadership of nongovernmental organizations involved in international health care and social entrepreneurship. Four main themes from the conference are presented in this white paper as important factors for the implementation and optimization of radiology in the developing world: (1) ensuring the economic sustainability of radiologic services through financial and administrative training support of health care personnel; (2) designing, testing, and deploying clinical strategies adapted for regions with limited resources; (3) structuring and improving the role of American radiology residents interested in global health service projects; and (4) implementing information technology models to support digital imaging in the developing world. Published by Elsevier Inc.

Data Fusion for a Vision-Radiological System: a Statistical Calibration Algorithm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Enqvist, Andreas; Koppal, Sanjeev; Riley, Phillip

2015-07-01

Presented here is a fusion system based on simple, low-cost computer vision and radiological sensors for tracking of multiple objects and identifying potential radiological materials being transported or shipped. The main focus of this work is the development of calibration algorithms for characterizing the fused sensor system as a single entity. There is an apparent need for correcting for a scene deviation from the basic inverse distance-squared law governing the detection rates even when evaluating system calibration algorithms. In particular, the computer vision system enables a map of distance-dependence of the sources being tracked, to which the time-dependent radiological datamore » can be incorporated by means of data fusion of the two sensors' output data. (authors)« less

Calibration of an eye lens dosemeter in terms of Hp(3) to be used in interventional radiology

NASA Astrophysics Data System (ADS)

Borges, F. L. S.; Guimarães, M. C.; Da Silva, T. A.; Nogueira Tavares, M. S.

2014-11-01

Recently, the International Commission on Radiological Protection has reviewed epidemiological evidences suggesting that there were tissue reaction effects in the eye lens below the previously considered absorbed dose threshold. A new statement related to the eye lens was issued that changed the absorbed dose threshold and reduced the dose limits for occupationally exposed persons. As consequence, some planned exposures require eye lens dosimetry and a debate was raised on the adequacy of the dosimetric quantity and on its method of measurement. The aim of this work was to study the methodology for calibrating the EYE-DTM holder with a TLD-100H Harshaw chip detector and to determine its angular and energy dependences in terms of personal dose equivalent, Hp(3).

2013 Dade W. Moeller lecture: medical countermeasures against radiological terrorism.

PubMed

Moulder, John E

2014-08-01

Soon after the 9-11 attacks, politicians and scientists began to question our ability to cope with a large-scale radiological terrorism incident. The outline of what was needed was fairly obvious: the ability to prevent such an attack, methods to cope with the medical consequences, the ability to clean up afterward, and the tools to figure out who perpetrated the attack and bring them to justice. The medical response needed three components: the technology to determine rapidly the radiation doses received by a large number of people, methods for alleviating acute hematological radiation injuries, and therapies for mitigation and treatment of chronic radiation injuries. Research done to date has shown that a realistic medical response plan is scientifically possible, but the regulatory and financial barriers to achieving this may currently be insurmountable.

Compression for radiological images

NASA Astrophysics Data System (ADS)

Wilson, Dennis L.

1992-07-01

The viewing of radiological images has peculiarities that must be taken into account in the design of a compression technique. The images may be manipulated on a workstation to change the contrast, to change the center of the brightness levels that are viewed, and even to invert the images. Because of the possible consequences of losing information in a medical application, bit preserving compression is used for the images used for diagnosis. However, for archiving the images may be compressed to 10 of their original size. A compression technique based on the Discrete Cosine Transform (DCT) takes the viewing factors into account by compressing the changes in the local brightness levels. The compression technique is a variation of the CCITT JPEG compression that suppresses the blocking of the DCT except in areas of very high contrast.

Vertebral sclerosis in adults.

PubMed Central

Russell, A S; Percy, J S; Lentle, B C

1979-01-01

Narrowing of the intervertebral disc space with sclerosis of the adjacent vertebral bodies may occur as a consequence of infection, neoplasia, trauma, or rheumatic disease. Some patients have been described with backache and these radiological appearances without any primary cause being apparent. The lesions were almost always of 1 or, at most, 2 vertebrae and most frequently involved the inferior margin of L4. We describe 3 patients with far more extensive vertebral involvement and present the clinical, radiological, scintiscan, and histological findings. The only patient we have seen with the better known, isolated L4/5 lesion was shown on biopsy to have staphylococcal osteomyelitis. For this reason we would still recommend a biopsy of all such sclerotic vertebral lesions if they occur in the absence of other rheumatic disease. Images PMID:434941

ESR paper on structured reporting in radiology.

PubMed

2018-02-01

Structured reporting is emerging as a key element of optimising radiology's contribution to patient outcomes and ensuring the value of radiologists' work. It is being developed and supported by many national and international radiology societies, based on the recognised need to use uniform language and structure to accurately describe radiology findings. Standardisation of report structures ensures that all relevant areas are addressed. Standardisation of terminology prevents ambiguity in reports and facilitates comparability of reports. The use of key data elements and quantified parameters in structured reports ("radiomics") permits automatic functions (e.g. TNM staging), potential integration with other clinical parameters (e.g. laboratory results), data sharing (e.g. registries, biobanks) and data mining for research, teaching and other purposes. This article outlines the requirements for a successful structured reporting strategy (definition of content and structure, standard terminologies, tools and protocols). A potential implementation strategy is outlined. Moving from conventional prose reports to structured reporting is endorsed as a positive development, and must be an international effort, with international design and adoption of structured reporting templates that can be translated and adapted in local environments as needed. Industry involvement is key to success, based on international data standards and guidelines. • Standardisation of radiology report structure ensures completeness and comparability of reports. • Use of standardised language in reports minimises ambiguity. • Structured reporting facilitates automatic functions, integration with other clinical parameters and data sharing. • International and inter-society cooperation is key to developing successful structured report templates. • Integration with industry providers of radiology-reporting software is also crucial.

Ethical foundations of the radiological protection system.

PubMed

Cho, K W

2016-06-01

The International Commission on Radiological Protection (ICRP) has established Task Group 94 under Committee 4 to develop a report on the ethical foundations of the system of radiological protection. The aim of this report is to consolidate the basis of ICRP recommendations, to improve understanding of the system, and to provide a basis for communication on radiation risk and its perception. Through a series of workshops organised by the Commission in cooperation with the International Radiation Protection Association and its associate societies involving radiological protection professionals and specialists of ethics around the world, Task Group 94 has identified the key ethical and social values underpinning the system of radiological protection. The purpose of eliciting the ethical principles and values of the radiological protection system is not only to clarify the rationale for recommendations made by the Commission, but also to assist in discussions related to its practical implementation. A clear understanding of the ethical principles will help resolve dilemmas caused by potential conflicts in actions that might be considered, or decisions that must be made. © The International Society for Prosthetics and Orthotics.

Strategy development for anticipating and handling a disruptive technology.

PubMed

Chan, Stephen

2006-10-01

The profession of radiology has greatly benefited from the introduction of new imaging technologies throughout its history. Therefore, it would seem reasonable for radiologists to believe that the emergence of a new imaging technology can generally be foreseen with sufficient advance notice to allow the appropriate levels of time, effort, and money to be devoted toward incorporating it into radiology practice. However, in his seminal work, Christiansen characterized a new form of technologic innovation, known as "disruptive technology," whose emergence often heralds the replacement of market leaders in an industry by competitors who are quicker in adopting and deploying the new technology. This article briefly describes the phenomenon of disruptive technology and addresses the challenges that organizations face in dealing with disruptive technology. The article raises 4 questions about the future of radiology: (1) Are health care and radiology vulnerable to disruptive technology? (2) What kinds of change may be in store for the radiology profession? (3) Can the radiology profession prepare itself to recognize and respond to a disruptive innovation among a group of new imaging technologies? and (4) How should a radiology organization decide whether to invest significant resources in a potentially disruptive technology? This article addresses these questions by reviewing key insights from leading "gurus" in the fields of competitive strategy and technology management and applying them to radiology. This illustrates how and why (despite past successes) the radiology profession may still have a blind spot in recognizing and handling disruptive technologies.

Some reflections on the role of the Scientific Advisory Panel to the Marshall Islands nationwide radiological study.

PubMed

McEwan, A C; Simon, S L; Baverstock, K F; Trott, K R; Sankaranarayanan, K; Paretzke, H G

1997-07-01

As a consequence of the U.S. Atomic Weapons Testing Program in the Trust Territory of the Pacific, now the Republic of the Marshall Islands, numerous scientists have advised the Marshallese on matters of radiation and radioactive contamination. Some of the previous advice has appeared to vary or conflict resulting in consequent uncertainty for the people. In a new initiative in 1989, the RMI Government engaged a five member multi-disciplinary Scientific Advisory Panel to oversee the assessment of, and to advise on, the radiological status of the entire nation. The formation of the Panel was accompanied by the establishment of a Resident Scientist position, and ultimately a small scientific team and laboratory on Majuro. The nationwide radiological study was conducted using ground survey methods over the period 1990-1994. Tasks undertaken by the Panel included formulating reasonable objectives for the study and attempting to establish effective communication and understanding of issues with political leaders and RMI Government agencies and people, as well as advising on and monitoring the scientific integrity of the study itself. The attempt was also made to initiate investigations to address matters of concern that emerged. The problem was faced of providing not only technical guidance on radioactivity and radiation measurements, but also explaining the significance of measured values and concepts, such as risk and probability of health effects to a diverse but nontechnical audience, generally across cultural and language barriers. The experience of the Panel in providing advice and guidance to the Republic of the Marshall Islands, while unique in many ways, parallels the difficulties experienced elsewhere in communicating information about risks from radiation exposure.

Brain lymphoma: usefulness of the magnetic resonance spectroscopy.

PubMed

Taillibert, Sophie; Guillevin, Rémy; Menuel, Carole; Sanson, Marc; Hoang-Xuan, Khê; Chiras, Jacques; Duffau, Hugues

2008-01-01

The diagnosis of primary central nervous system lymphoma (PCNSL) should always be considered as an emergency because of the therapeutic consequences it implies. In immunocompetent patients, it relies on stereotactic biopsy. Unfortunately, clinical and radiological features may be misleading and delay the diagnostic procedure. The case we report here illustrates the contribution of magnetic resonance spectroscopy in the diagnostic approach of a very atypical PCNSL.

Cervical auscultation in the diagnosis of oropharyngeal aspiration in children: a study protocol for a randomised controlled trial.

PubMed

Frakking, Thuy T; Chang, Anne B; O'Grady, Kerry-Ann F; Walker-Smith, Katie; Weir, Kelly A

2013-11-07

Oropharyngeal aspiration (OPA) can lead to recurrent respiratory illnesses and chronic lung disease in children. Current clinical feeding evaluations performed by speech pathologists have poor reliability in detecting OPA when compared to radiological procedures such as the modified barium swallow (MBS). Improved ability to diagnose OPA accurately via clinical evaluation potentially reduces reliance on expensive, less readily available radiological procedures. Our study investigates the utility of adding cervical auscultation (CA), a technique of listening to swallowing sounds, in improving the diagnostic accuracy of a clinical evaluation for the detection of OPA. We plan an open, unblinded, randomised controlled trial at a paediatric tertiary teaching hospital. Two hundred and sixteen children fulfilling the inclusion criteria will be randomised to one of the two clinical assessment techniques for the clinical detection of OPA: (1) clinical feeding evaluation only (CFE) group or (2) clinical feeding evaluation with cervical auscultation (CFE + CA) group. All children will then undergo an MBS to determine radiologically assessed OPA. The primary outcome is the presence or absence of OPA, as determined on MBS using the Penetration-Aspiration Scale. Our main objective is to determine the sensitivity, specificity, negative and positive predictive values of 'CFE + CA' versus 'CFE' only compared to MBS-identified OPA. Early detection and appropriate management of OPA is important to prevent chronic pulmonary disease and poor growth in children. As the reliability of CFE to detect OPA is low, a technique that can improve the diagnostic accuracy of the CFE will help minimise consequences to the paediatric respiratory system. Cervical auscultation is a technique that has previously been documented as a clinical adjunct to the CFE; however, no published RCTs addressing the reliability of this technique in children exist. Our study will be the first to establish the utility of CA in assessing and diagnosing OPA risk in young children. Australia and New Zealand Clinical Trials Register (ANZCTR) number ACTRN12613000589785.

Cervical auscultation in the diagnosis of oropharyngeal aspiration in children: a study protocol for a randomised controlled trial

PubMed Central

2013-01-01

Background Oropharyngeal aspiration (OPA) can lead to recurrent respiratory illnesses and chronic lung disease in children. Current clinical feeding evaluations performed by speech pathologists have poor reliability in detecting OPA when compared to radiological procedures such as the modified barium swallow (MBS). Improved ability to diagnose OPA accurately via clinical evaluation potentially reduces reliance on expensive, less readily available radiological procedures. Our study investigates the utility of adding cervical auscultation (CA), a technique of listening to swallowing sounds, in improving the diagnostic accuracy of a clinical evaluation for the detection of OPA. Methods We plan an open, unblinded, randomised controlled trial at a paediatric tertiary teaching hospital. Two hundred and sixteen children fulfilling the inclusion criteria will be randomised to one of the two clinical assessment techniques for the clinical detection of OPA: (1) clinical feeding evaluation only (CFE) group or (2) clinical feeding evaluation with cervical auscultation (CFE + CA) group. All children will then undergo an MBS to determine radiologically assessed OPA. The primary outcome is the presence or absence of OPA, as determined on MBS using the Penetration-Aspiration Scale. Our main objective is to determine the sensitivity, specificity, negative and positive predictive values of ‘CFE + CA’ versus ‘CFE’ only compared to MBS-identified OPA. Discussion Early detection and appropriate management of OPA is important to prevent chronic pulmonary disease and poor growth in children. As the reliability of CFE to detect OPA is low, a technique that can improve the diagnostic accuracy of the CFE will help minimise consequences to the paediatric respiratory system. Cervical auscultation is a technique that has previously been documented as a clinical adjunct to the CFE; however, no published RCTs addressing the reliability of this technique in children exist. Our study will be the first to establish the utility of CA in assessing and diagnosing OPA risk in young children. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR) number ACTRN12613000589785. PMID:24199872

Entrepreneurial Women in Radiology: Role Models of Success.

PubMed

Anzai, Yoshimi; Meltzer, Carolyn C; DeStigter, Kristen K; Destounis, Stamatia; Pawley, Barbara K; Oates, M Elizabeth

2016-11-01

Radiology is undeniably male dominated. Alongside surgery and orthopedic surgery, academic radiology ranks near the bottom in having the lowest proportion of full-time female faculty members. Despite many efforts to recruit talented women, the pipeline entering the radiologic disciplines continues to flow at a trickle. One factor is the relative lack of role models for female medical students. Entrepreneurial women in radiology can lead the field with their innovation and creativity, courage, and commitment. In this article, the authors highlight two entrepreneurial female radiologists who shared their success stories at the American Association for Women Radiologists' session at the 2015 ACR annual meeting. Their successes underscore the potential for such women to serve as role models to female medical students and even college undergraduates. Despite the gender gap in radiology, the field has yielded some exceptional women who can take on challenges, overcome barriers and assume risks, create strategies and processes to operationalize their visions, secure funding, and expand their enterprises to make sustainable impacts both at home and abroad. As we move toward more patient- and family-centered care models and become increasingly visible to diverse populations, there is no better time for female leaders in radiology to inspire the next generation to join our essential and rewarding specialty. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A survey of nurse staffing levels in interventional radiology units throughout the UK.

PubMed

Christie, A; Robertson, I

2016-07-01

To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. Copyright © 2016. Published by Elsevier Ltd.

Interventional radiology in living donor liver transplant

PubMed Central

Cheng, Yu-Fan; Ou, Hsin-You; Yu, Chun-Yen; Tsang, Leo Leung-Chit; Huang, Tung-Liang; Chen, Tai-Yi; Hsu, Hsien-Wen; Concerjero, Allan M; Wang, Chih-Chi; Wang, Shih-Ho; Lin, Tsan-Shiun; Liu, Yueh-Wei; Yong, Chee-Chien; Lin, Yu-Hung; Lin, Chih-Che; Chiu, King-Wah; Jawan, Bruno; Eng, Hock-Liew; Chen, Chao-Long

2014-01-01

The shortage of deceased donor liver grafts led to the use of living donor liver transplant (LDLT). Patients who undergo LDLT have a higher risk of complications than those who undergo deceased donor liver transplantation (LT). Interventional radiology has acquired a key role in every LT program by treating the majority of vascular and non-vascular post-transplant complications, improving graft and patient survival and avoiding, in the majority of cases, surgical revision and/or re-transplant. The aim of this paper is to review indications, diagnostic modalities, technical considerations, achievements and potential complications of interventional radiology procedures after LDLT. PMID:24876742

INTERNAL HAZARDS ANALYSIS FOR LICENSE APPLICATION

DOE Office of Scientific and Technical Information (OSTI.GOV)

R.J. Garrett

2005-02-17

The purpose of this internal hazards analysis is to identify and document the internal hazards and potential initiating events associated with preclosure operations of the repository at Yucca Mountain. Internal hazards are those hazards presented by the operation of the facility and by its associated processes that can potentially lead to a radioactive release or cause a radiological hazard. In contrast to external hazards, internal hazards do not involve natural phenomena and external man-made hazards. This internal hazards analysis was performed in support of the preclosure safety analysis and the License Application for the Yucca Mountain Project. The methodology formore » this analysis provides a systematic means to identify internal hazards and potential initiating events that may result in a radiological hazard or radiological release during the repository preclosure period. These hazards are documented in tables of potential internal hazards and potential initiating events (Section 6.6) for input to the repository event sequence categorization process. The results of this analysis will undergo further screening and analysis based on the criteria that apply to the performance of event sequence analyses for the repository preclosure period. The evolving design of the repository will be re-evaluated periodically to ensure that internal hazards that have not been previously evaluated are identified.« less

Scheduling, revenue management, and fairness in an academic-hospital radiology division.

PubMed

Baum, Richard; Bertsimas, Dimitris; Kallus, Nathan

2014-10-01

Physician staff of academic hospitals today practice in several geographic locations including their main hospital. This is referred to as the extended campus. With extended campuses expanding, the growing complexity of a single division's schedule means that a naive approach to scheduling compromises revenue. Moreover, it may provide an unfair allocation of individual revenue, desirable or burdensome assignments, and the extent to which the preferences of each individual are met. This has adverse consequences on incentivization and employee satisfaction and is simply against business policy. We identify the daily scheduling of physicians in this context as an operational problem that incorporates scheduling, revenue management, and fairness. Noting previous success of operations research and optimization in each of these disciplines, we propose a simple unified optimization formulation of this scheduling problem using mixed-integer optimization. Through a study of implementing the approach at the Division of Angiography and Interventional Radiology at the Brigham and Women's Hospital, which is directed by one of the authors, we exemplify the flexibility of the model to adapt to specific applications, the tractability of solving the model in practical settings, and the significant impact of the approach, most notably in increasing revenue by 8.2% over previous operating revenue while adhering strictly to a codified fairness and objectivity. We found that the investment in implementing such a system is far outweighed by the large potential revenue increase and the other benefits outlined. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Radiation Protection Studies of International Space Station Extravehicular Activity Space Suits

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A. (Editor); Shavers, Mark R. (Editor); Saganti, Premkumar B. (Editor); Miller, Jack (Editor)

2003-01-01

This publication describes recent investigations that evaluate radiation shielding characteristics of NASA's and the Russian Space Agency's space suits. The introduction describes the suits and presents goals of several experiments performed with them. The first chapter provides background information about the dynamic radiation environment experienced at ISS and summarized radiation health and protection requirements for activities in low Earth orbit. Supporting studies report the development and application of a computer model of the EMU space suit and the difficulty of shielding EVA crewmembers from high-energy reentrant electrons, a previously unevaluated component of the space radiation environment. Chapters 2 through 6 describe experiments that evaluate the space suits' radiation shielding characteristics. Chapter 7 describes a study of the potential radiological health impact on EVA crewmembers of two virtually unexamined environmental sources of high-energy electrons-reentrant trapped electrons and atmospheric albedo or "splash" electrons. The radiological consequences of those sources have not been evaluated previously and, under closer scrutiny. A detailed computational model of the shielding distribution provided by components of the NASA astronauts' EMU is being developed for exposure evaluation studies. The model is introduced in Chapters 8 and 9 and used in Chapter 10 to investigate how trapped particle anisotropy impacts female organ doses during EVA. Chapter 11 presents a review of issues related to estimating skin cancer risk form space radiation. The final chapter contains conclusions about the protective qualities of the suit brought to light form these studies, as well as recommendations for future operational radiation protection.

Educating medical staff about responding to a radiological or nuclear emergency.

PubMed

McCurley, M Carol; Miller, Charles W; Tucker, Florie E; Guinn, Amy; Donnelly, Elizabeth; Ansari, Armin; Holcombe, Maire; Nemhauser, Jeffrey B; Whitcomb, Robert C

2009-05-01

A growing body of audience research reveals medical personnel in hospitals are unprepared for a large-scale radiological emergency such as a terrorist event involving radioactive or nuclear materials. Also, medical personnel in hospitals lack a basic understanding of radiation principles, as well as diagnostic and treatment guidelines for radiation exposure. Clinicians have indicated that they lack sufficient training on radiological emergency preparedness; they are potentially unwilling to treat patients if those patients are perceived to be radiologically contaminated; and they have major concerns about public panic and overloading of clinical systems. In response to these findings, the Centers for Disease Control and Prevention (CDC) has developed a tool kit for use by hospital medical personnel who may be called on to respond to unintentional or intentional mass-casualty radiological and nuclear events. This tool kit includes clinician fact sheets, a clinician pocket guide, a digital video disc (DVD) of just-in-time basic skills training, a CD-ROM training on mass-casualty management, and a satellite broadcast dealing with medical management of radiological events. CDC training information emphasizes the key role that medical health physicists can play in the education and support of emergency department activities following a radiological or nuclear mass-casualty event.

Extended outlook: description, utilization, and daily applications of cloud technology in radiology.

PubMed

Gerard, Perry; Kapadia, Neil; Chang, Patricia T; Acharya, Jay; Seiler, Michael; Lefkovitz, Zvi

2013-12-01

The purpose of this article is to discuss the concept of cloud technology, its role in medical applications and radiology, the role of the radiologist in using and accessing these vast resources of information, and privacy concerns and HIPAA compliance strategies. Cloud computing is the delivery of shared resources, software, and information to computers and other devices as a metered service. This technology has a promising role in the sharing of patient medical information and appears to be particularly suited for application in radiology, given the field's inherent need for storage and access to large amounts of data. The radiology cloud has significant strengths, such as providing centralized storage and access, reducing unnecessary repeat radiologic studies, and potentially allowing radiologic second opinions more easily. There are significant cost advantages to cloud computing because of a decreased need for infrastructure and equipment by the institution. Private clouds may be used to ensure secure storage of data and compliance with HIPAA. In choosing a cloud service, there are important aspects, such as disaster recovery plans, uptime, and security audits, that must be considered. Given that the field of radiology has become almost exclusively digital in recent years, the future of secure storage and easy access to imaging studies lies within cloud computing technology.

RADIOLOGY EDUCATION: A PILOT STUDY TO ASSESS KNOWLEDGE OF MEDICAL STUDENTS REGARDING IMAGING IN TRAUMA.

PubMed

Siddiqui, Saad; Saeed, Muhammad Anwar; Shah, Noreen; Nadeem, Naila

2015-01-01

Trauma remains one of the most frequent presentations in emergency departments. Imaging has established role in setting of acute trauma with ability to identify potentially fatal conditions. Adequate knowledge of health professionals regarding trauma imaging is vital for improved healthcare. In this work we try to assess knowledge of medical students regarding imaging in trauma as well as identify most effective way of imparting radiology education. This cross-sectional pilot study was conducted at Aga Khan University Medical College & Khyber Girls Medical College, to assess knowledge of medical students regarding imaging protocols practiced in initial management of trauma patients. Only 40 & 20% respectively were able to identify radiographs included in trauma series. Very few had knowledge of correct indication for Focused abdominal sonography in trauma. Clinical radiology rotation was reported as best way of learning radiology. Change in curricula & restructuring of clinical radiology rotation structure is needed to improve knowledge regarding Trauma imaging.

A national UK survey of radiology trainees special interest choices: what and why?

PubMed

Parvizi, Nassim; Bhuva, Shaheel

2017-11-01

A national survey was designed to better understand factors influencing special interest choices, future aspirations of UK radiology trainees and perceptions of breast radiology. A SurveyMonkey questionnaire was developed and distributed to all radiology trainees in the UK through the British Institute of Radiology, RCR Junior Radiologists Forum and by directly contacting UK training schemes as well as by social media between December 2015 and January 2016. From 21 training schemes across the UK, 232 responses were received. Over half entered radiology after foundation training and 62% were ST1-3; one-fifth of trainees intended to leave the NHS. The most popular special interests were musculoskeletal (18%), abdominal imaging (16%) and neuroradiology (13%). Gynaecological and oncological imaging proved to be the least popular. Strong personal interest, a successful rotation during training, a mix of imaging modalities, direct impact on patient care and job prospects were the most popular factors influencing career choice. Research and potential for private income were the least influential factors. Respondents detailed their perceptions of breast radiology, selecting an awareness of career prospects (41%) and a better trainee experience (36%) as factors that would increase their interest in pursuing it as a career. Understanding the factors that influence special interest choice is essential to addressing the alarming staffing shortfalls that will befall certain radiology special interests. Addressing trainee's preconceptions and improving the trainee experience are key to attracting trainees to breast radiology. Advances in knowledge: This is the first survey of its kind in the UK literature designed to evaluate special interest career choices and the factors that influence those among radiology trainees.

75 FR 77010 - Nextera Energy Point Beach, LLC; Point Beach Nuclear Plant, Units 1 and 2, Draft Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-10

.... Approximately 1,050 acres (425 hectares) are used for agriculture, and the remaining land is a mixture of woods... radiological impacts in the environment that may result from the proposed EPU. Non-Radiological Impacts Land Use and Aesthetic Impacts Potential land use and aesthetic impacts from the proposed EPU include...

Instructional Vignettes in Publication and Journalism Ethics in Radiology Research: Assessment via a Survey of Radiology Trainees.

PubMed

Rosenkrantz, Andrew B; Ginocchio, Luke A

2016-07-01

The aim of the present study was to assess the potential usefulness of written instructional vignettes relating to publication and journalism ethics in radiology via a survey of radiology trainees. A literature review was conducted to guide the development of vignettes, each describing a scenario relating to an ethical issue in research and publication, with subsequent commentary on the underlying ethical issue and potential approaches to its handling. Radiology trainees at a single institution were surveyed regarding the vignettes' perceived usefulness. A total of 21 vignettes were prepared, addressing institutional review board and human subjects protection, authorship issues, usage of previous work, manuscript review, and other miscellaneous topics. Of the solicited trainees, 24.7% (16/65) completed the survey. On average among the vignettes, 94.0% of the participants found the vignette helpful; 19.9 received prior formal instruction on the issue during medical training; 40.0% received prior informal guidance from a research mentor; and 42.0% indicated that the issue had arisen in their own or a peer's prior research experience. The most common previously experienced specific issue was authorship order (93.8%). Free-text responses were largely favorable regarding the value of the vignettes, although also indicated numerous challenges in properly handling the ethical issues: impact of hierarchy, pressure to publish, internal politics, reluctance to conduct sensitive conversations with colleagues, and variability in journal and professional society policies. Radiology trainees overall found the vignettes helpful, addressing commonly encountered topics for which formal and informal guidance were otherwise lacking. The vignettes are publicly available through the Association of University Radiologists (AUR) website and may foster greater insights by investigators into ethical aspects of the publication and journalism process, thus contributing to higher quality radiology research. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Cerebral candidiasis in a 4-year-old boy after intestinal surgery.

PubMed

Zhang, Shu-Cheng

2015-03-01

Cerebral candidiasis is a devastating disease which contributes to a high mortality. Most of the cerebral candidiasis are never microbiologically or radiologically confirmed. In this case, a 4-year-old boy who developed cerebral candidiasis was successfully rescued and presented. The diagnosis of cerebral candidiasis was established based on both microbiologic and radiologic examinations. The pathogen was revealed to be Candida albicans by cerebrospinal fluid and central venous catheter cultures, and the cerebral involvement was recorded by series head magnetic resonance imaging (MRI) with an appearance of special encephalitis demonstrated. The imaging studies played a critical role throughout the diagnosis and treatment. Familiarity with the imaging findings in the appropriate clinical setting may result in a heightened level of awareness of this infection and, consequently, in earlier diagnosis and treatment. © The Author(s) 2014.

Assessment of environmental consequences of the normal operations of the ESS facility

NASA Astrophysics Data System (ADS)

Ene, D.; Avila, R.; Hjerpe, T.; Bugay, D.; Stenberg, K.

2018-06-01

As other accelerator based facilities, the European Spallation Source ESS facility will interact with the environment. The Swedish legislation requires a demonstration that the sum of the doses resulting from the exposure of any member of the public to ionizing radiation dose does not exceed the specified limit of 50 μSv/year. A radiological assessment has been produced to provide that demonstration. This evaluation was based upon the actual status of the ESS design. A graded approach was adopted through over the assessment allowing estimating dose for all radionuclides and exposure pathways, but the degree of detail in the assessment depend upon their relative radiological importance. The total dose was obtained making the sum of the contribution of all-important radionuclides treated realistically with that of all screened out radionuclides, derived by means a conservative method.

The 2013 Dade W. Moeller Lecture: Medical Countermeasures Against Radiological Terrorism

PubMed Central

Moulder, John E.

2014-01-01

Soon after the 9–11 attacks, politicians and scientists began to question our ability to cope with a large-scale radiological terrorism incident. The outline of what was needed was fairly obvious: the ability to prevent such an attack; methods to cope with the medical consequences; the ability to clean up afterwards; and the tools to figure out who perpetrated the attack and bring them to justice. The medical response needed three components: the technology to rapidly determine the radiation doses received by a large number of people, methods for alleviating acute hematological radiation injuries, and therapies for mitigation and treatment of chronic radiation injuries. Research done to date has shown that a realistic medical response plan is scientifically possible, but the regulatory and financial barriers to achieving this may currently be insurmountable. PMID:24978287

Radon Exposure and the Definition of Low Doses-The Problem of Spatial Dose Distribution.

PubMed

Madas, Balázs G

2016-07-01

Investigating the health effects of low doses of ionizing radiation is considered to be one of the most important fields in radiological protection research. Although the definition of low dose given by a dose range seems to be clear, it leaves some open questions. For example, the time frame and the target volume in which absorbed dose is measured have to be defined. While dose rate is considered in the current system of radiological protection, the same cancer risk is associated with all exposures, resulting in a given amount of energy absorbed by a single target cell or distributed among all the target cells of a given organ. However, the biological effects and so the health consequences of these extreme exposure scenarios are unlikely to be the same. Due to the heterogeneous deposition of radon progeny within the lungs, heterogeneous radiation exposure becomes a practical issue in radiological protection. While the macroscopic dose is still within the low dose range, local tissue doses on the order of Grays can be reached in the most exposed parts of the bronchial airways. It can be concluded that progress in low dose research needs not only low dose but also high dose experiments where small parts of a biological sample receive doses on the order of Grays, while the average dose over the whole sample remains low. A narrow interpretation of low dose research might exclude investigations with high relevance to radiological protection. Therefore, studies important to radiological protection should be performed in the frame of low dose research even if the applied doses do not fit in the dose range used for the definition of low doses.

Restriction of ACGME fellowships to candidates completing US and Canadian accredited residencies: level of support and expected consequences.

PubMed

Orru', Emanuele; Arenson, Ronald A; Schaefer, Pamela W; Mukherji, Suresh K; Yousem, David M

2014-08-01

The aim of this study was to determine the level of support for the proposal to restrict ACGME-accredited fellowships to candidates who completed residencies accredited by the ACGME or the Royal College of Physicians and Surgeons of Canada. Perceptions of foreign-trained international medical graduates during and after fellowships were also assessed. An e-mail survey was sent to the members of the organizations that represent academic chairpersons (the Society of Chairs of Academic Radiology Departments) and radiology residency and fellowship program directors (the Association of Program Directors in Radiology) and to the program directors of the largest American radiology subspecialty society (the American Society of Neuroradiology). Results were analyzed separately for each of the 3 societies interviewed and then as a composite report for all 3 societies. Approximately 60% of the respondents said that they have offered at least one fellowship or faculty position to foreign-trained applicants in the past 5 years. More than 70% of the respondents said that these doctors performed equally to or better than American-trained ones both clinically and academically. The majority of members of all 3 societies responding opposed enactment of the rule, with the American Society of Neuroradiology being the most disapproving. The main concerns of those supporting the new rule were the inhomogeneous and sometimes unknown levels of training of the foreign-trained doctors and the need to favor American graduates. Those opposed were mostly worried about diminishing the quality of fellowship candidates, programs being unable to fill their positions, and a decrease in academic-oriented people. Most respondents opposed the proposed rule. The majority were supportive of foreign-trained physicians continuing their training in the United States. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Intuition versus rational thinking: psychological challenges in radiology and a potential solution.

PubMed

Marcovici, Peter; Blume-Marcovici, Amy

2013-01-01

Humans think overwhelmingly intuitively rather than rationally. We perceive what is apparent to us and attribute differences in perception to the fault of others. Many cognitive biases are unconscious, and we assume they affect others more than ourselves. Radiologists should understand these limitations and seek methods to address them. A potential method is the checklist, which has been used to improve consistency and quality both outside and within medicine. Structured reporting can serve as a checklist and, although promising, has yet to widely demonstrate benefits. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Chemical, Biological, Radiological, Nuclear, and High-Yield Explosives Consequences Management

DTIC Science & Technology

2006-10-02

cause three types of injuries: blast, thermal and radiation, as well as electromagnetic pulse (EMP) effects described further in a later section. (1...occur with conventional explosives and are further described in the next section. (2) Thermal injuries present as flash burns (burns from direct...exposure to the thermal radiation pulse, typically ultraviolet, visible, and infrared waves) or flame burns (burns from materials set afire by the infrared

ADVANCED SURVEILLANCE OF ENVIROMENTAL RADIATION IN AUTOMATIC NETWORKS.

PubMed

Benito, G; Sáez, J C; Blázquez, J B; Quiñones, J

2018-06-01

The objective of this study is the verification of the operation of a radiation monitoring network conformed by several sensors. The malfunction of a surveillance network has security and economic consequences, which derive from its maintenance and could be avoided with an early detection. The proposed method is based on a kind of multivariate distance, and the verification for the methodology has been tested at CIEMAT's local radiological early warning network.

Probabilistic accident consequence uncertainty analysis -- Late health effects uncertain assessment. Volume 2: Appendices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Little, M.P.; Muirhead, C.R.; Goossens, L.H.J.

1997-12-01

The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library ofmore » uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA late health effects models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the expert panel on late health effects, (4) short biographies of the experts, and (5) the aggregated results of their responses.« less

Probabilistic accident consequence uncertainty analysis -- Uncertainty assessment for internal dosimetry. Volume 2: Appendices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goossens, L.H.J.; Kraan, B.C.P.; Cooke, R.M.

1998-04-01

The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library ofmore » uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA internal dosimetry models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the panel on internal dosimetry, (4) short biographies of the experts, and (5) the aggregated results of their responses.« less

The malpractice liability of radiology reports: minimizing the risk.

PubMed

Srinivasa Babu, Aparna; Brooks, Michael L

2015-01-01

The art and science of interpreting radiologic examinations, an ability that is acquired over years of training, is on display in every radiology report. It is vital that these reports be crafted so as to both reflect the radiologist's expertise and capability and eliminate any factors that might result in unintended harm to the patient. Unfortunately, a deficient report may result in legal action against the radiologist; thus, a thorough understanding of the litigious potential of the language used in radiology reports is crucial. It is important that ambiguous vocabulary, undefined modifiers, double negatives, and generalizations be avoided. Errors in radiology reports may result from inappropriate terminology, transcription mistakes, or deficient or inadequately documented communication. Critical findings that may have an immediate impact on patient management must be promptly communicated to the referring physician and such communication fully documented. A meticulous and well-written report is the best way for radiologists to care for their patients. In addition, a well-worded report can be the deciding factor in a successful defense against a malpractice claim. Understanding the legal implications of radiology reports will enable radiologists to develop strategies for avoiding malpractice suits. (©)RSNA, 2015.

Image Sharing in Radiology-A Primer.

PubMed

Chatterjee, Arindam R; Stalcup, Seth; Sharma, Arjun; Sato, T Shawn; Gupta, Pushpender; Lee, Yueh Z; Malone, Christopher; McBee, Morgan; Hotaling, Elise L; Kansagra, Akash P

2017-03-01

By virtue of its information technology-oriented infrastructure, the specialty of radiology is uniquely positioned to be at the forefront of efforts to promote data sharing across the healthcare enterprise, including particularly image sharing. The potential benefits of image sharing for clinical, research, and educational applications in radiology are immense. In this work, our group-the Association of University Radiologists (AUR) Radiology Research Alliance Task Force on Image Sharing-reviews the benefits of implementing image sharing capability, introduces current image sharing platforms and details their unique requirements, and presents emerging platforms that may see greater adoption in the future. By understanding this complex ecosystem of image sharing solutions, radiologists can become important advocates for the successful implementation of these powerful image sharing resources. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Image Gently(SM): a national education and communication campaign in radiology using the science of social marketing.

PubMed

Goske, Marilyn J; Applegate, Kimberly E; Boylan, Jennifer; Butler, Priscilla F; Callahan, Michael J; Coley, Brian D; Farley, Shawn; Frush, Donald P; Hernanz-Schulman, Marta; Jaramillo, Diego; Johnson, Neil D; Kaste, Sue C; Morrison, Gregory; Strauss, Keith J

2008-12-01

Communication campaigns are an accepted method for altering societal attitudes, increasing knowledge, and achieving social and behavioral change particularly within public health and the social sciences. The Image Gently(SM) campaign is a national education and awareness campaign in radiology designed to promote the need for and opportunities to decrease radiation to children when CT scans are indicated. In this article, the relatively new science of social marketing is reviewed and the theoretical basis for an effective communication campaign in radiology is discussed. Communication strategies are considered and the type of outcomes that should be measured are reviewed. This methodology has demonstrated that simple, straightforward safety messages on radiation protection targeted to medical professionals throughout the radiology community, utilizing multiple media, can affect awareness potentially leading to change in practice.

The radiology conglomerate: optimizing the structure and function of the 50-plus radiology organizations--a summary of the 2010 Intersociety Conference.

PubMed

Dodd, Gerald D

2011-08-01

There has been a substantial proliferation in the number of radiology organizations over the past 30 years. This has occurred without integrated planning or the development of a central administration. Although each of the 50-plus organizations was created for specific reasons, the lack of coordination among them has led to considerable duplication of missions, services, and resources. The majority of the members attending the 2010 meeting of the Intersociety Conference believe that radiology as a whole would benefit from collaboration and consolidation of our organizations. Specific opportunities for collaboration include joint annual meetings between 2 or more organizations, the creation of a clearinghouse for meeting scheduling that would minimize meeting conflicts, coordinated development of self-assessment modules, the development of an online site for "one-stop shopping" for paying dues and making foundation contributions, consolidation of the 15-plus radiology foundations to increase the investment corpus and allow larger targeted investments in specific research projects that would benefit radiology as a whole, and the creation of a new Web site that would link all radiology organizations to facilitate information access and collaboration. To move forward with meaningful and successful collaboration or consolidation will require an accurate database of the mission, structure, and function of our organizations; a careful analysis of potential synergies; and, full buy-in by the participating organizations. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Regulatory Technology Development Plan - Sodium Fast Reactor: Mechanistic Source Term – Trial Calculation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Grabaskas, David; Bucknor, Matthew; Jerden, James

2016-10-01

The potential release of radioactive material during a plant incident, referred to as the source term, is a vital design metric and will be a major focus of advanced reactor licensing. The U.S. Nuclear Regulatory Commission has stated an expectation for advanced reactor vendors to present a mechanistic assessment of the potential source term in their license applications. The mechanistic source term presents an opportunity for vendors to realistically assess the radiological consequences of an incident, and may allow reduced emergency planning zones and smaller plant sites. However, the development of a mechanistic source term for advanced reactors is notmore » without challenges, as there are often numerous phenomena impacting the transportation and retention of radionuclides. This project sought to evaluate U.S. capabilities regarding the mechanistic assessment of radionuclide release from core damage incidents at metal fueled, pool-type sodium fast reactors (SFRs). The purpose of the analysis was to identify, and prioritize, any gaps regarding computational tools or data necessary for the modeling of radionuclide transport and retention phenomena. To accomplish this task, a parallel-path analysis approach was utilized. One path, led by Argonne and Sandia National Laboratories, sought to perform a mechanistic source term assessment using available codes, data, and models, with the goal to identify gaps in the current knowledge base. The second path, performed by an independent contractor, performed sensitivity analyses to determine the importance of particular radionuclides and transport phenomena in regards to offsite consequences. The results of the two pathways were combined to prioritize gaps in current capabilities.« less

Induced activation studies for the LHC upgrade to High Luminosity LHC

NASA Astrophysics Data System (ADS)

Adorisio, C.; Roesler, S.

2018-06-01

The Large Hadron Collider (LHC) will be upgraded in 2019/2020 to increase its luminosity (rate of collisions) by a factor of five beyond its design value and the integrated luminosity by a factor ten, in order to maintain scientific progress and exploit its full capacity. The novel machine configuration, called High Luminosity LHC (HL-LHC), will increase consequently the level of activation of its components. The evaluation of the radiological impact of the HL-LHC operation in the Long Straight Sections of the Insertion Region 1 (ATLAS) and Insertion Region 5 (CMS) is presented. Using the Monte Carlo code FLUKA, ambient dose equivalent rate estimations have been performed on the basis of two announced operating scenarios and using the latest available machine layout. The HL-LHC project requires new technical infrastructure with caverns and 300 m long tunnels along the Insertion Regions 1 and 5. The new underground service galleries will be accessible during the operation of the accelerator machine. The radiological risk assessment for the Civil Engineering work foreseen to start excavating the new galleries in the next LHC Long Shutdown and the radiological impact of the machine operation will be discussed.

Radiological implications of top-off operation at national synchrotron light source-II

NASA Astrophysics Data System (ADS)

Job, P. K.; Casey, W. R.

2011-08-01

High current and low emittance have been specified to achieve ultra high brightness in the third generation medium energy Synchrotron Radiation Sources. This leads to the electron beam lifetime limited by Touschek scattering, and after commissioning may settle in at as low as ∼3 h. It may well be less in the early days of operation. At the same time, the intensity stability specified by the user community for the synchrotron beam is 1% or better. Given the anticipated lifetime of the beam, incremental filling called top-off injection at intervals on the order of ∼1 min will be required to maintain this beam stability. It is judged to be impractical to make these incremental fills by closing the beam shutters at each injection. In addition, closing the front end beam shutters during each injection will adversely affect the stability of beamline optics due to thermal cycling. Hence the radiological consequences of injection with front end beam shutters open must be evaluated. This paper summarizes results of radiological analysis carried out for the proposed top-off injection at National Synchrotron Light Source-II (NSLS-II) with beam shutters open.

Design and implementation of disaster recovery and business continuity solution for radiology PACS.

PubMed

Mansoori, Bahar; Rosipko, Beverly; Erhard, Karen K; Sunshine, Jeffrey L

2014-02-01

In the digital era of radiology, picture archiving and communication system (PACS) has a pivotal role in retrieving and storing the images. Integration of PACS with all the health care information systems e.g., health information system, radiology information system, and electronic medical record has greatly improved access to patient data at anytime and anywhere throughout the entire enterprise. In such an integrated setting, seamless operation depends critically on maintaining data integrity and continuous access for all. Any failure in hardware or software could interrupt the workflow or data and consequently, would risk serious impact to patient care. Thus, any large-scale PACS now have an indispensable requirement to include deployment of a disaster recovery plan to ensure secure sources of data. This paper presents our experience with designing and implementing a disaster recovery and business continuity plan. The selected architecture with two servers in each site (local and disaster recovery (DR) site) provides four different scenarios to continue running and maintain end user service. The implemented DR at University Hospitals Health System now permits continuous access to the PACS application and its contained images for radiologists, other clinicians, and patients alike.

Novel Application of FTIR Spectroscopy for the Passive Standoff Detection of Radiological Materials

DTIC Science & Technology

2006-08-01

possibility of applying the long-wave passive standoff detection technique to the identification of radiological materials. This work is based on...infrared (FTIR) radiometry is a well-known technique for detecting and identifying chemical warfare agents. In addition to these potential threats...necessary tools and techniques available for detecting and identifying radioactive products. At present, the main detection techniques depend on methods

Computer-assisted virtual autopsy using surgical navigation techniques.

PubMed

Ebert, Lars Christian; Ruder, Thomas D; Martinez, Rosa Maria; Flach, Patricia M; Schweitzer, Wolf; Thali, Michael J; Ampanozi, Garyfalia

2015-01-01

OBJECTIVE; Virtual autopsy methods, such as postmortem CT and MRI, are increasingly being used in forensic medicine. Forensic investigators with little to no training in diagnostic radiology and medical laypeople such as state's attorneys often find it difficult to understand the anatomic orientation of axial postmortem CT images. We present a computer-assisted system that permits postmortem CT datasets to be quickly and intuitively resliced in real time at the body to narrow the gap between radiologic imaging and autopsy. Our system is a potentially valuable tool for planning autopsies, showing findings to medical laypeople, and teaching CT anatomy, thus further closing the gap between radiology and forensic pathology.

Implementation of the integrated approach in different types of exposure scenarios.

PubMed

Copplestone, D; Hirth, G; Johansen, M; Lazo, E; Takala, J; Sakai, K; Yankovich, T

2018-01-01

The International Commission on Radiological Protection (ICRP) recognises three types of exposure situations: planned, existing, and emergency. In all three situations, the release of radionuclides into the natural environment leads to exposures of non-human biota, as well as the potential for exposures of the public. This paper describes how the key principles of the ICRP system of radiological protection apply to non-human biota and members of the public in each of these exposure situations. Current work in this area within ICRP Task Group 105 is highlighted. For example, how simplified numeric criteria may be used in planned exposure situations that are protective of both the public and non-human biota. In emergency exposure situations, the initial response will always be focused on human protection; however, understanding the potential impacts of radionuclide releases on non-human biota will likely become important in terms of communication as governments and the public seek to understand the exposures that are occurring. For existing exposure situations, there is a need to better understand the potential impacts of radionuclides on animals and plants, especially when deciding on protective actions. Understanding the comparative impacts from radiological, non-radiological, and physical aspects is often important in managing the remediation of legacy sites. Task Group 105 is making use of case studies of how exposure situations have been managed in the past to provide additional guidance and advice for the protection of non-human biota.

Coupled calculation of the radiological release and the thermal-hydraulic behavior of a 3-loop PWR after a SGTR by means of the code RELAP5

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van Hove, W.; Van Laeken, K.; Bartsoen, L.

1995-09-01

To enable a more realistic and accurate calculation of the radiological consequences of a SGTR, a fission product transport model was developed. As the radiological releases strongly depend on the thermal-hydraulic transient, the model was included in the RELAP5 input decks of the Belgian NPPs. This enables the coupled calculation of the thermal-hydraulic transient and the radiological release. The fission product transport model tracks the concentration of the fission products in the primary circuit, in each of the SGs as well as in the condenser. This leads to a system of 6 coupled, first order ordinary differential equations with timemore » dependent coefficients. Flashing, scrubbing, atomisation and dry out of the break flow are accounted for. Coupling with the thermal-hydraulic calculation and correct modelling of the break position enables an accurate calculation of the mixture level above the break. Pre- and post-accident spiking in the primary circuit are introduced. The transport times in the FW-system and the SG blowdown system are also taken into account, as is the decontaminating effect of the primary make-up system and of the SG blowdown system. Physical input parameters such as the partition coefficients, half life times and spiking coefficients are explicitly introduced so that the same model can be used for iodine, caesium and noble gases.« less

Federal Radiological Monitoring and Assessment Center Monitoring Manual Volume 1, Operations

DOE Office of Scientific and Technical Information (OSTI.GOV)

NSTec Aerial Measurement Systems

2012-07-31

The Monitoring division is primarily responsible for the coordination and direction of: Aerial measurements to delineate the footprint of radioactive contaminants that have been released into the environment. Monitoring of radiation levels in the environment; Sampling to determine the extent of contaminant deposition in soil, water, air and on vegetation; Preliminary field analyses to quantify soil concentrations or depositions; and Environmental and personal dosimetry for FRMAC field personnel, during a Consequence Management Response Team (CMRT) and Federal Radiological Monitoring and Assessment Center (FRMAC) response. Monitoring and sampling techniques used during CM/FRMAC operations are specifically selected for use during radiological emergenciesmore » where large numbers of measurements and samples must be acquired, analyzed, and interpreted in the shortest amount of time possible. In addition, techniques and procedures are flexible so that they can be used during a variety of different scenarios; e.g., accidents involving releases from nuclear reactors, contamination by nuclear waste, nuclear weapon accidents, space vehicle reentries, or contamination from a radiological dispersal device. The Monitoring division also provides technicians to support specific Health and Safety Division activities including: The operation of the Hotline; FRMAC facility surveys; Assistance with Health and Safety at Check Points; and Assistance at population assembly areas which require support from the FRMAC. This volume covers deployment activities, initial FRMAC activities, development and implementation of the monitoring and assessment plan, the briefing of field teams, and the transfer of FRMAC to the EPA.« less

Potential time savings to radiology department personnel in a PACS-based environment

NASA Astrophysics Data System (ADS)

Saarinen, Allan O.; Wilson, M. C.; Iverson, Scott C.; Loop, John W.

1990-08-01

A purported benefit of digital imaging and archiving of radiographic procedures is the presumption of time savings to radiologists, radiology technologists, and radiology departmentpersonnel involved with processingfilms and managing theflimfile room. As part of the University of Washington's evaluation of Picture Archiving and Communication Systems (PACS)for the U.S. Army Medical Research and Development Command, a study was performed which evaluated the current operationalpractices of the film-based radiology department at the University of Washington Medical Center (UWMC). Industrial engineering time and motion studies were conducted to document the length of time requiredforfilm processing in various modalities, the proportion of the total exam time usedforfilm processing, the amount of time radiologists spent searchingfor and looking at images, and the amount of time file room personnel spent collating reports, making loans, updatingfilm jacket information, and purging files. This evaluation showed that better than one-half of the tasks in the file room may be eliminated with PACS and radiologists may save easily 10 percent of the time they spend reading films by no longer having to searchforfilms. Radiology technologists may also save as much as 10 percent of their time with PACS, although this estimate is subject to significant patient mix aberrations and measurement error. Given that the UWMC radiology department operates efficiently, similar improvements are forecast for other radiology departments and larger improvements areforecastfor less efficient departments.

Remote Handled WIPP Canisters at Los Alamos National Laboratory Characterized for Retrieval

DOE Office of Scientific and Technical Information (OSTI.GOV)

Griffin, J.; Gonzales, W.

2007-07-01

The Los Alamos National Laboratory (LANL) is pursuing retrieval, transportation, and disposal of 16 remote handled transuranic waste canisters stored below ground in shafts since 1994. These canisters were retrievably stored in the shafts to await Nuclear Regulatory Commission certification of the Model Number RH-TRU 72B transportation cask and authorization of the Waste Isolation Pilot Plant (WIPP) to accept the canisters for disposal. Retrieval planning included radiological characterization and visual inspection of the canisters to confirm historical records, verify container integrity, determine proper personnel protection for the retrieval operations, provide radiological dose and exposure rate data for retrieval operations, andmore » to provide exterior radiological contamination data. The radiological characterization and visual inspection of the canisters was performed in May 2006. The effort required the development of remote techniques and equipment due to the potential for personnel exposure to radiological doses approaching 300 R/hr. Innovations included the use of two nested 1.5 meter (m) (5-feet [ft]) long concrete culvert pipes (1.1-m [42 inch (in.)] and 1.5-m [60-in] diameter, respectively) as radiological shielding and collapsible electrostatic dusting wands to collect radiological swipe samples from the annular space between the canister and shaft wall. Visual inspection indicated that the canisters are in good condition with little or no rust, the welded seams are intact, and ten of the canisters include hydrogen gas sampling equipment on the pintle that will have to be removed prior to retrieval. The visual inspection also provided six canister identification numbers that matched historical storage records. The exterior radiological data indicated alpha and beta contamination below LANL release criteria and radiological dose and exposure rates lower than expected based upon historical data and modeling of the canister contents. (authors)« less

Informatics in radiology (infoRAD): multimedia extension of medical imaging resource center teaching files.

PubMed

Yang, Guo Liang; Aziz, Aamer; Narayanaswami, Banukumar; Anand, Ananthasubramaniam; Lim, C C Tchoyoson; Nowinski, Wieslaw Lucjan

2005-01-01

A new method has been developed for multimedia enhancement of electronic teaching files created by using the standard protocols and formats offered by the Medical Imaging Resource Center (MIRC) project of the Radiological Society of North America. The typical MIRC electronic teaching file consists of static pages only; with the new method, audio and visual content may be added to the MIRC electronic teaching file so that the entire image interpretation process can be recorded for teaching purposes. With an efficient system for encoding the audiovisual record of on-screen manipulation of radiologic images, the multimedia teaching files generated are small enough to be transmitted via the Internet with acceptable resolution. Students may respond with the addition of new audio and visual content and thereby participate in a discussion about a particular case. MIRC electronic teaching files with multimedia enhancement have the potential to augment the effectiveness of diagnostic radiology teaching. RSNA, 2005.

Radiology: "killer app" for next generation networks?

PubMed

McNeill, Kevin M

2004-03-01

The core principles of digital radiology were well developed by the end of the 1980 s. During the following decade tremendous improvements in computer technology enabled realization of those principles at an affordable cost. In this decade work can focus on highly distributed radiology in the context of the integrated health care enterprise. Over the same period computer networking has evolved from a relatively obscure field used by a small number of researchers across low-speed serial links to a pervasive technology that affects nearly all facets of society. Development directions in network technology will ultimately provide end-to-end data paths with speeds that match or exceed the speeds of data paths within the local network and even within workstations. This article describes key developments in Next Generation Networks, potential obstacles, and scenarios in which digital radiology can become a "killer app" that helps to drive deployment of new network infrastructure.

10 CFR 76.76 - Backfitting.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Corporation in order to complete the backfit; (3) Potential change in the risk to the public from the accidental release of radioactive material; (4) Potential impact on radiological exposure of facility... downtime; (6) The potential safety impact of changes in plant or operational complexity, including the...

10 CFR 76.76 - Backfitting.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Corporation in order to complete the backfit; (3) Potential change in the risk to the public from the accidental release of radioactive material; (4) Potential impact on radiological exposure of facility... downtime; (6) The potential safety impact of changes in plant or operational complexity, including the...

10 CFR 76.76 - Backfitting.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Corporation in order to complete the backfit; (3) Potential change in the risk to the public from the accidental release of radioactive material; (4) Potential impact on radiological exposure of facility... downtime; (6) The potential safety impact of changes in plant or operational complexity, including the...

10 CFR 76.76 - Backfitting.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Corporation in order to complete the backfit; (3) Potential change in the risk to the public from the accidental release of radioactive material; (4) Potential impact on radiological exposure of facility... downtime; (6) The potential safety impact of changes in plant or operational complexity, including the...

10 CFR 76.76 - Backfitting.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Corporation in order to complete the backfit; (3) Potential change in the risk to the public from the accidental release of radioactive material; (4) Potential impact on radiological exposure of facility... downtime; (6) The potential safety impact of changes in plant or operational complexity, including the...

[Traumatically caused prolapse of the vaginal mucosa and retroflexion of the bladder in the bitch].

PubMed

Arbeiter, K; Bucher, A

1994-02-01

Four years after having been heavily injured in the perineal region by a firearm the presented bitch showed dysuria and signs of intense irritation. Clinical and radiological examinations revealed the fact of a partial loss of the vaginal channel and supporting tissues, consequently leading to a retroflexion of the bladder into the extroverted part of the vagina. The bitch recovered completely after a plastic operation.

Wavelet-based multifractal analysis of dynamic infrared thermograms to assist in early breast cancer diagnosis

PubMed Central

Gerasimova, Evgeniya; Audit, Benjamin; Roux, Stephane G.; Khalil, André; Gileva, Olga; Argoul, Françoise; Naimark, Oleg; Arneodo, Alain

2014-01-01

Breast cancer is the most common type of cancer among women and despite recent advances in the medical field, there are still some inherent limitations in the currently used screening techniques. The radiological interpretation of screening X-ray mammograms often leads to over-diagnosis and, as a consequence, to unnecessary traumatic and painful biopsies. Here we propose a computer-aided multifractal analysis of dynamic infrared (IR) imaging as an efficient method for identifying women with risk of breast cancer. Using a wavelet-based multi-scale method to analyze the temporal fluctuations of breast skin temperature collected from a panel of patients with diagnosed breast cancer and some female volunteers with healthy breasts, we show that the multifractal complexity of temperature fluctuations observed in healthy breasts is lost in mammary glands with malignant tumor. Besides potential clinical impact, these results open new perspectives in the investigation of physiological changes that may precede anatomical alterations in breast cancer development. PMID:24860510

Forgotten/retained double J ureteric stents: A source of severe morbidity in children

PubMed Central

Nerli, Rajendra B.; Magdum, Prasad V.; Sharma, Vikas; Guntaka, Ajay Kumar; Hiremath, Murigendra B.; Ghagane, Shridhar

2016-01-01

Background: The increase in the usage of double J (DJ) ureteral stents in the management of a variety of urinary tract disease processes mandates familiarity with these devices, their consequences and their potential complications, which at times can be devastating. We retrospectively reviewed our series of children with forgotten/retained DJ ureteric stents. Materials and Methods: Hospital records of all patients’ <18 years old who underwent removal of forgotten/retained DJ ureteral stent at our hospital were reviewed for age, gender, indication for insertion of DJ stent, duration of stent insertion, radiological images and surgical procedures performed. Results: During the study period, January 2000 to December 2014 (a 15-year period), a total of 14 children underwent removal of forgotten/retained DJ ureteral stent. A combination of extracorporeal shock wave lithotripsy, cystolitholapaxy and percutaneous nephrolithotomy was done to free the DJ stent and extract it. Conclusions: Forgotten/retained stents in children are a source of severe morbidity, additional/unnecessary hospitalisation and definitely financial strain. PMID:27251521

Two years of debilitating pain in a football spearing victim: slipping rib syndrome.

PubMed

Peterson, Laurie L; Cavanaugh, Daniel G

2003-10-01

Blunt chest trauma can occur in a variety of sports, and lead to rib fractures and less commonly known and diagnosed injuries. We report the case of a 14-yr-old student athlete who was speared (helmet tackled) in a practice scrimmage sustaining a painful injury that eluded diagnosis and treatment for more than 2 yr. The case history of pain treatments and radiological evaluations is presented. Ultimately, a definitive diagnosis of "slipping rib syndrome" was achieved through a simple clinical manipulation (the hooking maneuver), combined with a history of symptomatic relief provided with costochondral blockade. Surgical resection of the slipping rib provided total resolution of the problem. Very few clinicians are aware either of the syndrome or the maneuver used to diagnose this condition. Although spearing has been outlawed in American football for years, it remains a commonplace occurrence, and sports physicians should be aware of the potential consequences to the victim as well as those to the perpetrator.

Workflow in interventional radiology: nerve blocks and facet blocks

NASA Astrophysics Data System (ADS)

Siddoway, Donald; Ingeholm, Mary Lou; Burgert, Oliver; Neumuth, Thomas; Watson, Vance; Cleary, Kevin

2006-03-01

Workflow analysis has the potential to dramatically improve the efficiency and clinical outcomes of medical procedures. In this study, we recorded the workflow for nerve block and facet block procedures in the interventional radiology suite at Georgetown University Hospital in Washington, DC, USA. We employed a custom client/server software architecture developed by the Innovation Center for Computer Assisted Surgery (ICCAS) at the University of Leipzig, Germany. This software runs in an internet browser, and allows the user to record the actions taken by the physician during a procedure. The data recorded during the procedure is stored as an XML document, which can then be further processed. We have successfully gathered data on a number if cases using a tablet PC, and these preliminary results show the feasibility of using this software in an interventional radiology setting. We are currently accruing additional cases and when more data has been collected we will analyze the workflow of these procedures to look for inefficiencies and potential improvements.

Use of a simulation laboratory to train radiology residents in the management of acute radiologic emergencies.

PubMed

Sarwani, Nabeel; Tappouni, Rafel; Flemming, Donald

2012-08-01

Simulation laboratories use realistic clinical scenarios to train physicians in a controlled environment, especially in potentially life-threatening complications that require prompt management. The objective of our study was to develop a comprehensive program using the simulation laboratory to train radiology residents in the management of acute radiologic emergencies. All radiology residents attended a dedicated simulation laboratory course lasting 3 hours, divided over two sessions. Training included basic patient management skills, management of a tension pneumothorax, massive hemorrhage, and contrast agent reactions. Participants were presented with 20 multiple-choice questions before and after the course. Pre- and posttest results were analyzed, and the McNemar test was used to compare correct responses by individual question. Twenty-six radiology residents attended the class. The average pre- and posttest scores and the average difference between the scores for all residents were 13.8, 17.1, and 3.3, respectively (p < 0.0001). Incorrect answers on the pretest examination that were subsequently answered correctly concerned administration of epinephrine for severe reactions, management of a tension pneumothorax, oxygen therapy, ECG placement, cardiopulmonary resuscitation technique, and where to stand during a code situation. Persistent incorrect answers concerned vasovagal reactions and emergency telephone numbers at an off-site imaging center. Simulation laboratories can be used to teach crisis management and crisis resource management for radiology residents and should be part of the education toolbox. Defined objectives lead to a comprehensive course dealing with the management of acute radiologic emergencies. Such programs can improve the role of radiologists as members of the health care team.

Is it adequate to carry out a chest-CT in patients with mild-moderate chest trauma?

PubMed

García de Pereda de Blas, V; Carreras Aja, M; Carbajo Azabal, S; Arana-Arri, E

2017-10-12

Mild-moderate blunt chest trauma is defined as a blunt chest trauma that is not caused by a high-energy mechanism, causing thoracic tenderness with or without rib fractures and that has no immediate life-threatening consequences for the patient. It is a frequent clinical situation in the emergency department. The most common radiological techniques that are used in this context are chest X-ray and thoracic computed tomography (CT). The CT scan is set as the gold standard. However, there are no current clinical-radiological guidelines that establish the adequacy of the requests of the CT scan. Therefore, we decided to search for evidence-based recommendations to improve the adequacy of the chest X-ray and CT scan in our daily practice in order to reduce the costs and avoid unnecessary radiation exposure. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Calculational note for the radiological and toxicological effects of a UO{sub 3} release from the T-hopper storage pad

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldberg, H.J.

1998-06-18

UO{sub 3} powder is stored at the T-hopper storage area associated with the 2714-U building in the 200 west area. The T-hopper containers and 13 drums containing this material are used to store the powder on pads immediately north of the building. An interim safety basis document (WHC,1996) was issued in 1996 for the UO{sub 3} powder storage area. In this document the isotope {sup 99}Tc was not included in the source term used to calculate the radiological consequences of a postulated release of the powder. A calculations note (HNF, 1998) was issued to remedy that deficiency. The present documentmore » is a revision to that document to reflect updated data concerning the solubility of UO{sub 3} in simulated lung fluid and to utilize more realistic powder release fractions.« less

[Testicular cancer: a model to optimize the radiological follow-up].

PubMed

Stebler, V; Pauchard, B; Schmidt, S; Valerio, M; De Bari, B; Berthold, D

2015-05-20

Despite being rare cancers, testicular seminoma and non-seminoma play an important role in oncology: they represent a model on how to optimize radiological follow-up, aiming at a lowest possible radiation exposure and secondary cancer risk. Males diagnosed with testicular cancer undergo frequently prolonged follow-up with CT-scans with potential toxic side effects, in particular secondary cancers. To reduce the risks linked to ionizing radiation, precise follow-up protocols have been developed. The number of recommended CT-scanners has been significantly reduced over the last 10 years. The CT scanners have evolved technically and new acquisition protocols have the potential to reduce the radiation exposure further.

Radiology equipment maintenance and contract procurement in the UK.

PubMed

Wright, Christopher J

2012-01-01

Radiology equipment maintenance has a similar financial value to new device acquisition over the lifetime of the device. Comprehensive style contracts are dominant largely due to their ease of use and the potential to control budgetary costs, but costs are high. Creative procurement solutions can offer better value. The corrective portion of comprehensive contracts is estimated to be between 50% (Mobile C-Arm) to 92% (CT), which equates to $29.4 million; 80% of the total contract costs within the research population of this study. Many organizations could free up cash by better managing their maintenance costs, potentially creating funding opportunities for new equipment.

Data Science in Radiology: A Path Forward.

PubMed

Aerts, Hugo J W L

2018-02-01

Artificial intelligence (AI), especially deep learning, has the potential to fundamentally alter clinical radiology. AI algorithms, which excel in quantifying complex patterns in data, have shown remarkable progress in applications ranging from self-driving cars to speech recognition. The AI application within radiology, known as radiomics, can provide detailed quantifications of the radiographic characteristics of underlying tissues. This information can be used throughout the clinical care path to improve diagnosis and treatment planning, as well as assess treatment response. This tremendous potential for clinical translation has led to a vast increase in the number of research studies being conducted in the field, a number that is expected to rise sharply in the future. Many studies have reported robust and meaningful findings; however, a growing number also suffer from flawed experimental or analytic designs. Such errors could not only result in invalid discoveries, but also may lead others to perpetuate similar flaws in their own work. This perspective article aims to increase awareness of the issue, identify potential reasons why this is happening, and provide a path forward. Clin Cancer Res; 24(3); 532-4. ©2017 AACR . ©2017 American Association for Cancer Research.

[Radiology in managed care environment: opportunities for cost savings in an HMO].

PubMed

Schmidt, C; Mohr, A; Möller, J; Levin-Scherz, J; Heller, M

2003-09-01

A large regional health plan in the Northeastern United States noted that its radiology costs were increasing more than it anticipated in its pricing, and noted further that other similar health plans in markets with high managed care penetration had significantly lower expenses for radiology services. This study describes the potential areas of improvement and managed care techniques that were implemented to reduce costs and reform processes. We performed an in-depth analysis of financial data, claims logic, contracting with provider units and conducted interviews with employees, to identify potential areas of improvement and cost reduction. A detailed market analysis of the environment, competitors and vendors was accompanied by extensive literature, Internet and Medline search for comparable projects. All data were docu-mented in Microsoft Excel(R) and analyzed by non-parametric tests using SPSS(R) 8.0 (Statistical Package for the Social Sciences) for Windows(R). The main factors driving the cost increases in radiology were divided into those internal or external to the HMO. Among the internal factors, the claims logic was allowing overpayment due to limitations of the IT system. Risk arrangements between insurer and provider units (PU) as well as the extent of provider unit management and administration showed a significant correlation with financial performance in terms of variance from budget. Among the external factors, shared risk arrangements between HMO and provider unit were associated with more efficient radiology utilization and overall improvement in financial performance. PU with full-time management had significantly less variance from their budget than those without. Finally, physicians with imaging equipment in their offices ordered up to 4 to 5 times more imaging procedures than physicians who did not perform imaging studies themselves. We identified initiatives with estimated potential savings of approximately $ 5.5 million. Some of these initiatives are similar to the reforms to reduce cost and improve quality that are already implemented or proposed within the German healthcare system.

Hospital management of mass radiological casualties: reassessing exposures from contaminated victims of an exploded radiological dispersal device.

PubMed

Smith, James M; Ansari, Armin; Harper, Frederick T

2005-11-01

One of the key issues in the aftermath of an exploded radiological dispersal device from a terrorist event is that of the contaminated victim and the concern among healthcare providers for the harmful exposures they may receive in treating patients, especially if the patient has not been thoroughly decontaminated. This is critically important in the event of mass casualties from a nuclear or radiological incident because of the essential rapidity of acute medical decisions and that those who have life- or limb-threatening injuries may have treatment unduly delayed by a decontamination process that may be unnecessary for protecting the health and safety of the patient or the healthcare provider. To estimate potential contamination of those exposed in a radiological dispersal device event, results were used from explosive aerosolization tests of surrogate radionuclides detonated with high explosives at the Sandia National Laboratories. Computer modeling was also used to assess radiation dose rates to surgical personnel treating patients with blast injuries who are contaminated with any of a variety of common radionuclides. It is demonstrated that exceptional but plausible cases may require special precautions by the healthcare provider, even while managing life-threatening injuries of a contaminated victim from a radiological dispersal device event.

Eponyms in cardiothoracic radiology: part III--interstitium.

PubMed

Mohammed, Tan-Lucien H; Saettele, Megan R; Saettele, Timothy; Patel, Vikas; Kanne, Jeffrey P

2014-01-01

Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in the medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in the medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the science of medicine. In this third installment of this series, the authors discuss a number of chest radiology eponyms as they relate to the pulmonary interstitium, including relevant clinical and imaging features, as well biographical information of the respective eponym's namesake. Copyright © 2014 Mosby, Inc. All rights reserved.

Eponyms in cardiothoracic radiology: Part I. Neoplasms.

PubMed

Mohammed, Tan-Lucien H; Saettele, Megan R; Saettele, Timothy; Patel, Vikas; Kanne, Jeffrey P

2014-01-01

Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the field of medicine. In this article, the first of a multipart series, the authors discuss a number of chest radiology eponyms as they relate to neoplasms, including relevant clinical and imaging features, as well biographic information of the respective eponym׳s namesake. Copyright © 2014 Elsevier Inc. All rights reserved.

Eponyms in cardiothoracic radiology--part II: vascular.

PubMed

Mohammed, Tan-Lucien H; Saettele, Megan R; Saettele, Timothy; Patel, Vikas; Kanne, Jeffrey P

2014-01-01

Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in the medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in the medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the science of medicine. In this second part of a multipart series, the authors discuss a number of chest radiology eponyms as they relate to the pulmonary vasculature, including relevant clinical and imaging features, as well biographic information of the respective eponym׳s namesake. Copyright © 2014 Elsevier Inc. All rights reserved.

Natural radiation and its hazard in copper ore mines in Poland

NASA Astrophysics Data System (ADS)

Chau, Nguyen; Jodłowski, Paweł; Kalita, Stefan; Olko, Paweł; Chruściel, Edward; Maksymowicz, Adam; Waligórski, Michał; Bilski, Paweł; Budzanowski, Maciej

2008-06-01

The doses of gamma radiation, concentrations of radium isotopes in water and sediments, radon concentration and concentration of alpha potential energy of radon decay products in the copper ore mine and in the mining region in the vicinity of Lubin town in Poland are presented. These data served as a basis for the assessment of radiological hazard to the mine workers and general public. The results of this assessment indicate that radiological hazard in the region does not differ substantially from typical values associated with natural radiation background. The calculated average annual effective dose for copper miners is 1.48 mSv. In general, copper ore mines can be regarded as radiologically safe workplaces.

The radiology digital dashboard: effects on report turnaround time.

PubMed

Morgan, Matthew B; Branstetter, Barton F; Lionetti, David M; Richardson, Jeremy S; Chang, Paul J

2008-03-01

As radiology departments transition to near-complete digital information management, work flows and their supporting informatics infrastructure are becoming increasingly complex. Digital dashboards can integrate separate computerized information systems and summarize key work flow metrics in real time to facilitate informed decision making. A PACS-integrated digital dashboard function designed to alert radiologists to their unsigned report queue status, coupled with an actionable link to the report signing application, resulted in a 24% reduction in the time between transcription and report finalization. The dashboard was well received by radiologists who reported high usage for signing reports. Further research is needed to identify and evaluate other potentially useful work flow metrics for inclusion in a radiology clinical dashboard.

Computer-aided diagnosis in radiological imaging: current status and future challenges

NASA Astrophysics Data System (ADS)

Doi, Kunio

2009-10-01

Computer-aided diagnosis (CAD) has become one of the major research subjects in medical imaging and diagnostic radiology. Many different types of CAD schemes are being developed for detection and/or characterization of various lesions in medical imaging, including conventional projection radiography, CT, MRI, and ultrasound imaging. Commercial systems for detection of breast lesions on mammograms have been developed and have received FDA approval for clinical use. CAD may be defined as a diagnosis made by a physician who takes into account the computer output as a "second opinion". The purpose of CAD is to improve the quality and productivity of physicians in their interpretation of radiologic images. The quality of their work can be improved in terms of the accuracy and consistency of their radiologic diagnoses. In addition, the productivity of radiologists is expected to be improved by a reduction in the time required for their image readings. The computer output is derived from quantitative analysis of radiologic images by use of various methods and techniques in computer vision, artificial intelligence, and artificial neural networks (ANNs). The computer output may indicate a number of important parameters, for example, the locations of potential lesions such as lung cancer and breast cancer, the likelihood of malignancy of detected lesions, and the likelihood of various diseases based on differential diagnosis in a given image and clinical parameters. In this review article, the basic concept of CAD is first defined, and the current status of CAD research is then described. In addition, the potential of CAD in the future is discussed and predicted.

Research Challenges and Opportunities for Clinically Oriented Academic Radiology Departments.

PubMed

Decker, Summer J; Grajo, Joseph R; Hazelton, Todd R; Hoang, Kimberly N; McDonald, Jennifer S; Otero, Hansel J; Patel, Midhir J; Prober, Allen S; Retrouvey, Michele; Rosenkrantz, Andrew B; Roth, Christopher G; Ward, Robert J

2016-01-01

Between 2004 and 2012, US funding for the biomedical sciences decreased to historic lows. Health-related research was crippled by receiving only 1/20th of overall federal scientific funding. Despite the current funding climate, there is increased pressure on academic radiology programs to establish productive research programs. Whereas larger programs have resources that can be utilized at their institutions, small to medium-sized programs often struggle with lack of infrastructure and support. To address these concerns, the Association of University Radiologists' Radiology Research Alliance developed a task force to explore any untapped research productivity potential in these smaller radiology departments. We conducted an online survey of faculty at smaller clinically funded programs and found that while they were interested in doing research and felt it was important to the success of the field, barriers such as lack of resources and time were proving difficult to overcome. One potential solution proposed by this task force is a collaborative structured research model in which multiple participants from multiple institutions come together in well-defined roles that allow for an equitable distribution of research tasks and pooling of resources and expertise. Under this model, smaller programs will have an opportunity to share their unique perspective on how to address research topics and make a measureable impact on the field of radiology as a whole. Through a health services focus, projects are more likely to succeed in the context of limited funding and infrastructure while simultaneously providing value to the field. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

10 CFR 70.76 - Backfitting.

Code of Federal Regulations, 2013 CFR

2013-01-01

...) The potential impact of differences in facility type, design, or age on the relevancy and practicality... licensee in order to complete the backfit; (3) Potential change in the risk to the public from the...) Potential impact on radiological exposure or exposure to hazardous chemicals produced from licensed material...

10 CFR 70.76 - Backfitting.

Code of Federal Regulations, 2012 CFR

2012-01-01

...) The potential impact of differences in facility type, design, or age on the relevancy and practicality... licensee in order to complete the backfit; (3) Potential change in the risk to the public from the...) Potential impact on radiological exposure or exposure to hazardous chemicals produced from licensed material...

10 CFR 70.76 - Backfitting.

Code of Federal Regulations, 2010 CFR

2010-01-01

...) The potential impact of differences in facility type, design, or age on the relevancy and practicality... licensee in order to complete the backfit; (3) Potential change in the risk to the public from the...) Potential impact on radiological exposure or exposure to hazardous chemicals produced from licensed material...

10 CFR 70.76 - Backfitting.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) The potential impact of differences in facility type, design, or age on the relevancy and practicality... licensee in order to complete the backfit; (3) Potential change in the risk to the public from the...) Potential impact on radiological exposure or exposure to hazardous chemicals produced from licensed material...

10 CFR 70.76 - Backfitting.

Code of Federal Regulations, 2011 CFR

2011-01-01

...) The potential impact of differences in facility type, design, or age on the relevancy and practicality... licensee in order to complete the backfit; (3) Potential change in the risk to the public from the...) Potential impact on radiological exposure or exposure to hazardous chemicals produced from licensed material...

Health effects models for nuclear power plant accident consequence analysis: Low LET radiation: Part 2, Scientific bases for health effects models

DOE Office of Scientific and Technical Information (OSTI.GOV)

Abrahamson, S.; Bender, M.; Book, S.

1989-05-01

This report provides dose-response models intended to be used in estimating the radiological health effects of nuclear power plant accidents. Models of early and continuing effects, cancers and thyroid nodules, and genetic effects are provided. Two-parameter Weibull hazard functions are recommended for estimating the risks of early and continuing health effects. Three potentially lethal early effects -- the hematopoietic, pulmonary and gastrointestinal syndromes -- are considered. Linear and linear-quadratic models are recommended for estimating cancer risks. Parameters are given for analyzing the risks of seven types of cancer in adults -- leukemia, bone, lung, breast, gastrointestinal, thyroid and ''other''. Themore » category, ''other'' cancers, is intended to reflect the combined risks of multiple myeloma, lymphoma, and cancers of the bladder, kidney, brain, ovary, uterus and cervix. Models of childhood cancers due to in utero exposure are also provided. For most cancers, both incidence and mortality are addressed. Linear and linear-quadratic models are also recommended for assessing genetic risks. Five classes of genetic disease -- dominant, x-linked, aneuploidy, unbalanced translocation and multifactorial diseases --are considered. In addition, the impact of radiation-induced genetic damage on the incidence of peri-implantation embryo losses is discussed. The uncertainty in modeling radiological health risks is addressed by providing central, upper, and lower estimates of all model parameters. Data are provided which should enable analysts to consider the timing and severity of each type of health risk. 22 refs., 14 figs., 51 tabs.« less

Radiological hazards of Narghile (hookah, shisha, goza) smoking: activity concentrations and dose assessment.

PubMed

Khater, Ashraf E M; Abd El-Aziz, Nawal S; Al-Sewaidan, Hamed A; Chaouachi, Kamal

2008-12-01

Narghile (hookah, shisha, goza, "water-pipe") smoking has become fashionable worldwide. Its tobacco pastes, known as moassel and jurak, are not standardized and generally contain about 30-50% (sometimes more) tobacco, molasses/juice of sugarcane, various spices and dried fruits (particularly in jurak) and, in the case of moassel, glycerol and flavoring essences. Tobacco contains minute amounts of radiotoxic elements such as (210)Pb, (210)Po and uranium, which are inhaled via smoking. Only very few data have been published on the concentrations of natural radionuclides in narghile tobacco mixtures. Consequently, the aim of this study was to draw first conclusions on the potential hazards of radioactivity in moassel tobacco in relation to narghile smoking. The results indicate the existence of a wide range in the radioactivity contents where the average (range) activity concentrations of (238)U, (234)Th (226)Ra, (210)Pb, (210)Po, (232)Th and (40)K, in Bq/kg dry weight were 55 (19-93), 11 (3-23), 3 (1.2-8), 14 (3-29), 13 (7-32), 7 (4-10) and 719 (437-1044)Bq/kg dry weight, respectively. The average concentrations of natural radionuclides in moassel tobacco pastes are comparable to their concentration in Greek cigarettes and tobacco leaves, and lower than that of Brazilian tobacco leaves. The distribution pattern of these radionuclides after smoking, between smoke, ash and filter, is unknown, except for (210)Po during cigarette smoking and from one existing study during moassel smoking. Radiological dose assessment due to intake of natural radionuclides was calculated and the possible radio-toxicity of the measured radionuclides is briefly discussed.

RADIOLOGICAL SEALED SOURCE LIBRARY: A NUCLEAR FORENSICS TOOL

DOE Office of Scientific and Technical Information (OSTI.GOV)

Canaday, Jodi; Chamberlain, David; Finck, Martha

If a terrorist were to obtain and possibly detonate a device that contained radiological material, radiological forensic analysis of the material and source capsule could provide law enforcement with valuable clues about the origin of the radiological material; this information could then provide further leads on where the material and sealed source was obtained, and the loss of control point. This information could potentially be utilized for attribution and prosecution. Analyses of nuclear forensic signatures for radiological materials are generally understood to include isotopic ratios, trace element concentrations, the time since irradiation or purification, and morphology. Radiological forensic signatures formore » sealed sources provide additional information that leverages information on the physical design and chemical composition of the source capsule and containers, physical markings indicative of an owner or manufacturer. Argonne National Laboratory (Argonne), in collaboration with Idaho National Laboratory (INL), has been working since 2003 to understand signatures that could be used to identify specific source manufacturers. These signatures include the materials from which the capsule is constructed, dimensions, weld details, elemental composition, and isotopic abundances of the radioactive material. These signatures have been compiled in a library known as the Argonne/INL Radiological Sealed Source Library. Data collected for the library has included open-source information from vendor catalogs and web pages; discussions with source manufacturers and touring of production facilities (both protected through non-disclosure agreements); technical publications; and government registries such as the U.S. Nuclear Regulatory Commission’s Sealed Source and Device Registry.« less

What causes increasing and unnecessary use of radiological investigations? a survey of radiologists' perceptions

PubMed Central

Lysdahl, Kristin B; Hofmann, Bjørn M

2009-01-01

Background Growth in use and overuse of diagnostic imaging significantly impacts the quality and costs of health care services. What are the modifiable factors for increasing and unnecessary use of radiological services? Various factors have been indentified, but little is known about their relative impact. Radiologists hold key positions for providing such knowledge. Therefore the purpose of this study was to obtain radiologists' perspective on the causes of increasing and unnecessary use of radiological investigations. Methods In a mailed questionnaire radiologist members of the Norwegian Medical Association were asked to rate potential causes of increased investigation volume (fifteen items) and unnecessary investigations (six items), using five-point-scales. Responses were analysed by using summary statistics and Factor Analysis. Associations between variables were determined using Students' t-test, Spearman rank correlation and Chi-Square tests. Results The response rate was 70% (374/537). The highest rated causes of increasing use of radiological investigations were: a) new radiological technology, b) peoples' demands, c) clinicians' intolerance for uncertainty, d) expanded clinical indications, and e) availability. 'Over-investigation' and 'insufficient referral information' were reported the most frequent causes of unnecessary investigations. Correlations between causes of increasing and unnecessary radiology use were identified. Conclusion In order to manage the growth in radiological imaging and curtail inappropriate investigations, the study findings point to measures that influence the supply and demand of services, specifically to support the decision-making process of physicians. PMID:19723302

Towards case-based medical learning in radiological decision making using content-based image retrieval

PubMed Central

2011-01-01

Background Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education. Methods We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment. Results We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system. Conclusions The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer. PMID:22032775

Historical influence on the practice of chiropractic radiology: part II - thematic analysis on the opinions of diplomates of the American Chiropractic College of Radiology about the future.

PubMed

Young, Kenneth J

2017-01-01

Over the past 20 years, various authors have addressed the question of the future of chiropractic. Most were positive about the future, with some advocating evidence-based practice and integration with mainstream healthcare, some advocating continued separation with an emphasis on subluxation-based care or the traditional/historical paradigm of chiropractic, and some calling for tolerance and unity. No papers were found specifically inquiring about the future of chiropractic radiology. The study population consisted of all current members of the American Chiropractic College of Radiology (ACCR), estimated at 190 people, known as chiropractic radiologists or Diplomates of the American Chiropractic Board of Radiology (DACBRs). An internet-based, anonymous survey using SurveyMonkey was implemented, supplemented by hard copies distributed at a conference. The main point of interest for this paper is the final item of the overall questionnaire. This item inquired about the future of chiropractic radiology. Thematic analysis was used on the responses, coded in both constructionist and inductive ways to extract both a general outlook and more specific themes. The inductive themes were also assigned secondarily to a SWOT (strengths, weaknesses, opportunities, and threats) analysis. The overall response rate to the survey was 38% (73/190); within the group of respondents, 71 of 73 (98%) answered the item that is the subject of this paper. Opinions on the outlook for chiropractic radiology in the future were more negative than positive, with 14 respondents giving a positive outlook, 26 negative, and 14 non-committal. 28 respondents advocated integration with the wider healthcare community, 11 recommended emphasising separateness or a focus on working within chiropractic, and 15 did not express an opinion on this issue. Ten strengths were noted, 11 weaknesses, 57 opportunities, and 30 threats. The increasing necessity of demonstrating evidence for diagnostic and therapeutic procedures in healthcare makes it likely that chiropractic radiologists and the wider chiropractic profession will need to take a more active position on evidence-based practice. Re-evaluation of guidelines and legislation as well as enforcement policies and practices will be necessary. The consequences of failing to do so may include increased marginalisation and reduced viability as a profession.

Towards case-based medical learning in radiological decision making using content-based image retrieval.

PubMed

Welter, Petra; Deserno, Thomas M; Fischer, Benedikt; Günther, Rolf W; Spreckelsen, Cord

2011-10-27

Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education. We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment. We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system. The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer.

Probabilistic accident consequence uncertainty analysis -- Uncertainty assessment for deposited material and external doses. Volume 2: Appendices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goossens, L.H.J.; Kraan, B.C.P.; Cooke, R.M.

1997-12-01

The development of two new probabilistic accident consequence codes, MACCS and COSYMA, was completed in 1990. These codes estimate the consequence from the accidental releases of radiological material from hypothesized accidents at nuclear installations. In 1991, the US Nuclear Regulatory Commission and the Commission of the European Communities began cosponsoring a joint uncertainty analysis of the two codes. The ultimate objective of this joint effort was to systematically develop credible and traceable uncertainty distributions for the respective code input variables. A formal expert judgment elicitation and evaluation process was identified as the best technology available for developing a library ofmore » uncertainty distributions for these consequence parameters. This report focuses on the results of the study to develop distribution for variables related to the MACCS and COSYMA deposited material and external dose models. This volume contains appendices that include (1) a summary of the MACCS and COSYMA consequence codes, (2) the elicitation questionnaires and case structures, (3) the rationales and results for the panel on deposited material and external doses, (4) short biographies of the experts, and (5) the aggregated results of their responses.« less

Health Risk Assessment for Uranium in Groundwater - An Integrated Case Study Based on Hydrogeological Characterization and Dose Calculation

NASA Astrophysics Data System (ADS)

Franklin, M. R.; Veiga, L. H.; Py, D. A., Jr.; Fernandes, H. M.

2010-12-01

The uranium mining and milling facilities of Caetité (URA) is the only active uranium production center in Brazil. Operations take place at a very sensitive semi-arid region in the country where water resources are very scarce. Therefore, any contamination of the existing water bodies may trigger critical consequences to local communities because their sustainability is closely related to the availability of the groundwater resources. Due to the existence of several uranium anomalies in the region, groundwater can present radionuclide concentrations above the world average. The radiological risk associated to the ingestion of these waters have been questioned by members of the local communities, NGO’s and even regulatory bodies that suspected that the observed levels of radionuclide concentrations (specially Unat) could be related to the uranium mining and milling operations. Regardless the origin of these concentrations the fear that undesired health effects were taking place (e.g. increase in cancer incidence) remain despite the fact that no evidence - based on epidemiological studies - is available. This paper intends to present the connections between the local hydrogeology and the radiological characterization of groundwater in the neighboring areas of the uranium production center to understand the implications to the human health risk due to the ingestion of groundwater. The risk assessment was performed, taking into account the radiological and the toxicological risks. Samples from 12 wells have been collected and determinations of Unat, Thnat, 226Ra, 228Ra and 210Pb were performed. The radiation-related risks were estimated for adults and children by the calculation of the annual effective doses. The potential non-carcinogenic effects due to the ingestion of uranium were evaluated by the estimation of the hazard index (HI). Monte Carlo simulations were used to calculate the uncertainty associated with these estimates, i.e. the 95% confidence interval for Hazard Index and Effective dose estimation. No significant radiological related health effect could be attributed to the ingestion of this water by members of the local community. The calculated doses, for example, were below the internationally recommended limit of 1mSv/y to members of the public to be adopted in the regulation of planned exposures. This limit corresponds to an excess lifetime cancer risk of 4.0 x 10-3. However, if the non-carcinogenic effects of uranium are to be taken into account, it was observed that the ingestion of water from some of the investigated wells would be associated with a hazard index above unity indicating a potential risk for an adverse health effect. In the case of uranium these effects would be mainly associated with primarily damage to kidney, although it is also dependent on several factors, including physicochemical form and solubility. The regulatory implications of these findings will also be discussed in the paper.

Influences of Radiology Trainees on Screening Mammography Interpretation.

PubMed

Hawley, Jeffrey R; Taylor, Clayton R; Cubbison, Alyssa M; Erdal, B Selnur; Yildiz, Vedat O; Carkaci, Selin

2016-05-01

Participation of radiology trainees in screening mammographic interpretation is a critical component of radiology residency and fellowship training. The aim of this study was to investigate and quantify the effects of trainee involvement on screening mammographic interpretation and diagnostic outcomes. Screening mammograms interpreted at an academic medical center by six dedicated breast imagers over a three-year period were identified, with cases interpreted by an attending radiologist alone or in conjunction with a trainee. Trainees included radiology residents, breast imaging fellows, and fellows from other radiology subspecialties during breast imaging rotations. Trainee participation, patient variables, results of diagnostic evaluations, and pathology were recorded. A total of 47,914 mammograms from 34,867 patients were included, with an overall recall rate for attending radiologists reading alone of 14.7% compared with 18.0% when involving a trainee (P < .0001). Overall cancer detection rate for attending radiologists reading alone was 5.7 per 1,000 compared with 5.2 per 1,000 when reading with a trainee (P = .517). When reading with a trainee, dense breasts represented a greater portion of recalls (P = .0001), and more frequently, greater than one abnormality was described in the breast (P = .013). Detection of ductal carcinoma in situ versus invasive carcinoma or invasive cancer type was not significantly different. The mean size of cancers in patients recalled by attending radiologists alone was smaller, and nodal involvement was less frequent, though not statistically significantly. These results demonstrate a significant overall increase in recall rate when interpreting screening mammograms with radiology trainees, with no change in cancer detection rate. Radiology faculty members should be aware of this potentiality and mitigate tendencies toward greater false positives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

What is the relation between number of sessions worked and productivity of radiologists-a pilot study?

PubMed

Khan, Shah H M; Hedges, William P

2016-04-01

Increasing workloads and the current austerity measures are putting UK radiology departments under considerable stress. We need to look at the most efficient ways to manage radiology departments in order to cope with increasing demand. Consequently, a system is needed that can compare productivity between radiologists with different jobs. We measured workload in a UK radiology department and compared the productivities of consultants working different numbers of sessions, which are called programmed activities (PAs), to identify the optimal job plan structure for reporting productivity. Reporting data was gathered from electronic records for 14 consultants working different numbers of PA during the period April 2010-March 2011. These were converted into relative value unit (RVU) scores using a modified RCSI RVU system. Crude and net workloads were calculated for each consultant by dividing their total RVU score by the number of PAs they were contracted for and how many they spent reporting. The consultants reported 118,001 imaging studies. There was statistically significant variation in productivity between consultants working different numbers of PAs on χ (2) analysis (p < 0.05). Consultants working 12 PAs were more productive than consultants working 11 PAs, with net workloads of 7636 RVU/PA/year versus net 6146 RVU/PA/year, p < 0.05. Although UK consultants working 12 PAs per week are more productive than their colleagues, the reasons why are unclear. We have identified a method that can be developed further to identify efficient working practices in UK radiology departments. However, a UK-specific RVU system would make this productivity analysis more accurate.

Weapons of mass destruction, WMD.

PubMed

Vogel, H

2007-08-01

Since the invasion into Iraq in 2003, weapons of mass destruction (WMD), have come to general notice; they include today chemical, biological, and atomic/nuclear weapons, (CW, BW, and AW). Radiological findings shall be described. X-ray findings of victims of WMD are described. From CW, own observations are reported. Examples of (possible) X-ray findings of victims of BW are described. AW may induce radiation disease. Exposure to sulfur-lost induces severe bronchitis; if the radiograph shows pulmonary infiltrations, the prognosis is bad; a late consequence maybe bronchiectasis. BW can be based on bacteria, virus or toxins. An approach of the X-ray findings for BW victims is based on the assumption that the disease induced by BW has the same (or a similar) clinic and radiology as that induced by the original microorganism or by the unchanged toxism. This approximation may have its limits, if the germ or toxin has been modified. In survivors of AW, the radiology is probably that of victims of thermal radiation and blast. WMD seem to be a real or a possible threat. They can be used in war, in terrorist attacks, in crime, and in action of secret services. In case that WMD are employed, X-ray diagnostic will be used to evaluate the prognosis (triage) and the risk of infection.

Ground Penetrating Radar as a Contextual Sensor for Multi-Sensor Radiological Characterisation

PubMed Central

Ukaegbu, Ikechukwu K.; Gamage, Kelum A. A.

2017-01-01

Radioactive sources exist in environments or contexts that influence how they are detected and localised. For instance, the context of a moving source is different from a stationary source because of the effects of motion. The need to incorporate this contextual information in the radiation detection and localisation process has necessitated the integration of radiological and contextual sensors. The benefits of the successful integration of both types of sensors is well known and widely reported in fields such as medical imaging. However, the integration of both types of sensors has also led to innovative solutions to challenges in characterising radioactive sources in non-medical applications. This paper presents a review of such recent applications. It also identifies that these applications mostly use visual sensors as contextual sensors for characterising radiation sources. However, visual sensors cannot retrieve contextual information about radioactive wastes located in opaque environments encountered at nuclear sites, e.g., underground contamination. Consequently, this paper also examines ground-penetrating radar (GPR) as a contextual sensor for characterising this category of wastes and proposes several ways of integrating data from GPR and radiological sensors. Finally, it demonstrates combined GPR and radiation imaging for three-dimensional localisation of contamination in underground pipes using radiation transport and GPR simulations. PMID:28387706

10 CFR 50.109 - Backfitting.

Code of Federal Regulations, 2014 CFR

2014-01-01

... availability of such resources; (8) The potential impact of differences in facility type, design or age on the... licensee or applicant in order to complete the backfit; (3) Potential change in the risk to the public from the accidental off-site release of radioactive material; (4) Potential impact on radiological exposure...

10 CFR 50.109 - Backfitting.

Code of Federal Regulations, 2010 CFR

2010-01-01

... availability of such resources; (8) The potential impact of differences in facility type, design or age on the... licensee or applicant in order to complete the backfit; (3) Potential change in the risk to the public from the accidental off-site release of radioactive material; (4) Potential impact on radiological exposure...

10 CFR 50.109 - Backfitting.

Code of Federal Regulations, 2012 CFR

2012-01-01

... availability of such resources; (8) The potential impact of differences in facility type, design or age on the... licensee or applicant in order to complete the backfit; (3) Potential change in the risk to the public from the accidental off-site release of radioactive material; (4) Potential impact on radiological exposure...

Fuzzy risk analysis of a modern γ-ray industrial irradiator.

PubMed

Castiglia, F; Giardina, M

2011-06-01

Fuzzy fault tree analyses were used to investigate accident scenarios that involve radiological exposure to operators working in industrial γ-ray irradiation facilities. The HEART method, a first generation human reliability analysis method, was used to evaluate the probability of adverse human error in these analyses. This technique was modified on the basis of fuzzy set theory to more directly take into account the uncertainties in the error-promoting factors on which the methodology is based. Moreover, with regard to some identified accident scenarios, fuzzy radiological exposure risk, expressed in terms of potential annual death, was evaluated. The calculated fuzzy risks for the examined plant were determined to be well below the reference risk suggested by International Commission on Radiological Protection.

Visual Simultaneous Localization And Mapping (VSLAM) methods applied to indoor 3D topographical and radiological mapping in real-time

NASA Astrophysics Data System (ADS)

Hautot, Felix; Dubart, Philippe; Bacri, Charles-Olivier; Chagneau, Benjamin; Abou-Khalil, Roger

2017-09-01

New developments in the field of robotics and computer vision enables to merge sensors to allow fast realtime localization of radiological measurements in the space/volume with near-real time radioactive sources identification and characterization. These capabilities lead nuclear investigations to a more efficient way for operators' dosimetry evaluation, intervention scenarii and risks mitigation and simulations, such as accidents in unknown potentially contaminated areas or during dismantling operations

Management of Ultimate Risk of Nuclear Power Plants by Source Terms - Lessons Learned from the Chernobyl Accident

DOE Office of Scientific and Technical Information (OSTI.GOV)

Genn Saji

2006-07-01

The term 'ultimate risk' is used here to describe the probabilities and radiological consequences that should be incorporated in siting, containment design and accident management of nuclear power plants for hypothetical accidents. It is closely related with the source terms specified in siting criteria which assures an adequate separation of radioactive inventories of the plants from the public, in the event of a hypothetical and severe accident situation. The author would like to point out that current source terms which are based on the information from the Windscale accident (1957) through TID-14844 are very outdated and do not incorporate lessonsmore » learned from either the Three Miles Island (TMI, 1979) nor Chernobyl accident (1986), two of the most severe accidents ever experienced. As a result of the observations of benign radionuclides released at TMI, the technical community in the US felt that a more realistic evaluation of severe reactor accident source terms was necessary. In this background, the 'source term research project' was organized in 1984 to respond to these challenges. Unfortunately, soon after the time of the final report from this project was released, the Chernobyl accident occurred. Due to the enormous consequences induced by then accident, the one time optimistic perspectives in establishing a more realistic source term were completely shattered. The Chernobyl accident, with its human death toll and dispersion of a large part of the fission fragments inventories into the environment, created a significant degradation in the public's acceptance of nuclear energy throughout the world. In spite of this, nuclear communities have been prudent in responding to the public's anxiety towards the ultimate safety of nuclear plants, since there still remained many unknown points revolving around the mechanism of the Chernobyl accident. In order to resolve some of these mysteries, the author has performed a scoping study of the dispersion and deposition mechanisms of fuel particles and fission fragments during the initial phase of the Chernobyl accident. Through this study, it is now possible to generally reconstruct the radiological consequences by using a dispersion calculation technique, combined with the meteorological data at the time of the accident and land contamination densities of {sup 137}Cs measured and reported around the Chernobyl area. Although it is challenging to incorporate lessons learned from the Chernobyl accident into the source term issues, the author has already developed an example of safety goals by incorporating the radiological consequences of the accident. The example provides safety goals by specifying source term releases in a graded approach in combination with probabilities, i.e. risks. The author believes that the future source term specification should be directly linked with safety goals. (author)« less

The role of radiology in the Oklahoma City bombing.

PubMed

Nye, P J; Tytle, T L; Jarman, R N; Eaton, B G

1996-08-01

To evaluate the role of radiologic services in the assessment of injuries and identification of deceased victims of the bombing of the Alfred P. Murrah Federal Building in Oklahoma City, Okla. In cooperation with the Oklahoma University Health Sciences Center Disaster Studies Group, all victims of the Oklahoma City bombing who were treated in hospitals were evaluated. All radiologic studies performed in these patients during a 4-week period after the bombing were recorded. Major injuries incurred by the victims were noted but were not documented. In addition, assistance provided by radiologic services to the medical examiner's office for identification of deceased victims was assessed. On the day of the bombing, 99% (480 of 485) of the imaging studies performed were either plain radiography, primarily of the extremities and chest, or computed tomography (CT), half of which were of the head. Six deceased victims were identified solely by means of characteristics on radiographs. Almost all bombing-related radiologic studies were either plain radiography or CT. Other modalities had only limited roles. In deceased victims, plain radiography aided identification, and in many other victims it allowed localization of materials that were potential pieces of evidence.

[Health technology assessment (HTA). Developments in healthcare and potential for radiology].

PubMed

Gizewski, E R; Forsting, M; Krombach, G A; Schöffski, O

2014-06-01

Cost-intensive measures and procedures, such as also employed in radiology, have far-reaching economic implications in respect to increasing expenditure with limited resources. Health technology assessment (HTA) describes the systematic evaluation of medical procedures and technologies which in recent years has been introduced by many countries into healthcare politics. In many cases HTA analyses can be directly implemented into practice as shown by the examples given in this article; however, in the current form of HTA the practical implementation for radiology often presents the problem that the cost-benefit ratio does not yet have a comprehensive view in the HTA report but is limited to a subsection, e.g. current costs versus sensitivity of a method. Since its inception radiology has had a high power of innovation and new developments will also substantially determine the future years. These procedures must not only be evaluated with respect to feasibility but also in the sense of the HTA in the total concept. In radiology there are also a large number of possibilities for radiologists not only as passive consumers of HTA reports but also to become active participants in this process, an opportunity which should be taken advantage of.

Is past academic productivity predictive of radiology resident academic productivity?

PubMed

Patterson, Stephanie K; Fitzgerald, James T; Boyse, Tedric D; Cohan, Richard H

2002-02-01

The authors performed this study to determine whether academic productivity in college and medical school is predictive of the number of publications produced during radiology residency. The authors reviewed the records of 73 radiology residents who completed their residency from 1990 to 2000. Academic productivity during college, medical school, and radiology residency, other postgraduate degrees, and past careers other than radiology were tabulated. The personal essay attached to the residency application was reviewed for any stated academic interest. Residents were classified as being either previously productive or previously unproductive. Publication rates during residency and immediately after residency were compared for the two groups. For the productive residents, a correlation analysis was used to examine the relationship between past frequency of publication and type of previous activity. Least-squares regression analysis was used to investigate the relationship between preresidency academic productivity, advanced degrees, stated interest in academics, and other careers and radiology residency publications. There was no statistically significant difference in the number of articles published by those residents who were active and those who were not active before residency (P = .21). Only authorship of papers as an undergraduate was weakly predictive of residency publication. These selected measures of academic productivity as an undergraduate and during medical school are not helpful for predicting publication during residency. There was no difference in publication potential between those residents who were academically productive in the past and those who were not.

Radiological Features in Patients with Short Stature Homeobox-Containing (SHOX) Gene Deficiency and Turner Syndrome before and after 2 Years of GH Treatment.

PubMed

Child, Christopher J; Kalifa, Gabriel; Jones, Christine; Ross, Judith L; Rappold, Gudrun A; Quigley, Charmian A; Zimmermann, Alan G; Garding, Gina; Cutler, Gordon B; Blum, Werner F

2015-01-01

The short stature homeobox-containing (SHOX) gene is one of many genes that regulate longitudinal growth. The SHOX deficiency (SHOX-D) phenotype, caused by intragenic or regulatory region defects, ranges from normal stature to mesomelic skeletal dysplasia. We investigated differences in radiological anomalies between patients with SHOX-D and Turner syndrome (TS) and the effect of 2 years of growth hormone (GH) treatment on these anomalies. Left hand/wrist, forearm and lower leg radiographs were assessed at baseline and after 2 years in children with genetically confirmed SHOX-D (GH-treated and untreated groups) and TS (GH-treated) in a randomised, controlled, multinational study. Radiological anomalies of hand, wrist and forearm were common in SHOX-D and TS. Radial bowing appeared more prevalent in SHOX-D, while lower leg anomalies were more common in TS. There were no significant differences in radiological findings between GH-treated and untreated patients with SHOX-D after 2 years. GH treatment had no systematic effect on skeletal findings in SHOX-D, based on limited radiological differences between the GH-treated and untreated groups at 2 years. Bone age radiographs allow assessment of radiological signs indicating a potential diagnosis of SHOX-D and may lead to earlier genetic confirmation and initiation of GH therapy. © 2015 S. Karger AG, Basel.

Meaningful Peer Review in Radiology: A Review of Current Practices and Potential Future Directions.

PubMed

Moriarity, Andrew K; Hawkins, C Matthew; Geis, J Raymond; Dreyer, Keith J; Kamer, Aaron P; Khandheria, Paras; Morey, Jose; Whitfill, James; Wiggins, Richard H; Itri, Jason N

2016-12-01

The current practice of peer review within radiology is well developed and widely implemented compared with other medical specialties. However, there are many factors that limit current peer review practices from reducing diagnostic errors and improving patient care. The development of "meaningful peer review" requires a transition away from compliance toward quality improvement, whereby the information and insights gained facilitate education and drive systematic improvements that reduce the frequency and impact of diagnostic error. The next generation of peer review requires significant improvements in IT functionality and integration, enabling features such as anonymization, adjudication by multiple specialists, categorization and analysis of errors, tracking, feedback, and easy export into teaching files and other media that require strong partnerships with vendors. In this article, the authors assess various peer review practices, with focused discussion on current limitations and future needs for meaningful peer review in radiology. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology operations: what you don't know could be costing you millions.

PubMed

Joffe, Sam; Drew, Donna; Bansal, Manju; Hase, Michael

2007-01-01

Rapid growth in advanced imaging procedures has left hospital radiology departments struggling to keep up with demand, resulting in loss of patients to facilities that can offer service more quickly. While the departments appear to be working at full capacity, an operational analysis of over 400 hospital radiology departments in the US by GE Healthcare has determined that, paradoxically, many departments are in fact underutilized and operating for below their potential capacity. While CT cycle time in hospitals that were studied averaged 35 minutes, top performing hospitals operated the same equipment at a cycle time of 15 minutes, yielding approximately double the throughput volume. Factors leading to suboptimal performance include accounting metrics that mask true performance, leadership focus on capital investment rather than operations, under staffing, under scheduling, poorly aligned incentives, a fragmented view of operations, lack of awareness of latent opportunities, and lack of sufficient skills and processes to implement improvements. The study showed how modest investments in radiology operations can dramatically improve access to services and profitability.

Enterprise imaging: planning and business justification.

PubMed

Avrin, David; Hou, Stephanie W

2012-02-01

To evaluate financial performance, academic radiology departments most often measure examination volume and general technical and professional expenses. Although these metrics are not standardized, their frequency of use reflects that productivity and financial health are high priorities for academic radiology departments across the United States. In this article, we discuss both of these topics, in the context of projects to expand services, particularly those with an information technology (IT) component. First, we discuss several informatics innovations that increase productivity or expand service. Second, we explain core financial analysis concepts applicable to radiology departments. Third, we discuss the unique challenge of evaluating a potential IT project for an academic radiology department, when intangible benefits are difficult to quantify. Financial models are only one of several components used for guidance in strategic decisions, but are crucial to building a business case that justifies the initial or capital investment as well as startup and ongoing operational expenses. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

A Combined Pharmacokinetic and Radiologic Assessment of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Predicts Response to Chemoradiation in Locally Advanced Cervical Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Semple, Scott; Harry, Vanessa N. MRCOG.; Parkin, David E.

2009-10-01

Purpose: To investigate the combination of pharmacokinetic and radiologic assessment of dynamic contrast-enhanced magnetic resonance imaging (MRI) as an early response indicator in women receiving chemoradiation for advanced cervical cancer. Methods and Materials: Twenty women with locally advanced cervical cancer were included in a prospective cohort study. Dynamic contrast-enhanced MRI was carried out before chemoradiation, after 2 weeks of therapy, and at the conclusion of therapy using a 1.5-T MRI scanner. Radiologic assessment of uptake parameters was obtained from resultant intensity curves. Pharmacokinetic analysis using a multicompartment model was also performed. General linear modeling was used to combine radiologic andmore » pharmacokinetic parameters and correlated with eventual response as determined by change in MRI tumor size and conventional clinical response. A subgroup of 11 women underwent repeat pretherapy MRI to test pharmacokinetic reproducibility. Results: Pretherapy radiologic parameters and pharmacokinetic K{sup trans} correlated with response (p < 0.01). General linear modeling demonstrated that a combination of radiologic and pharmacokinetic assessments before therapy was able to predict more than 88% of variance of response. Reproducibility of pharmacokinetic modeling was confirmed. Conclusions: A combination of radiologic assessment with pharmacokinetic modeling applied to dynamic MRI before the start of chemoradiation improves the predictive power of either by more than 20%. The potential improvements in therapy response prediction using this type of combined analysis of dynamic contrast-enhanced MRI may aid in the development of more individualized, effective therapy regimens for this patient group.« less

Fatal and nonfatal risk associated with recycle of D&D-generated concrete

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boren, J.K.; Ayers, K.W.; Parker, F.L.

1997-02-01

As decontamination and decommissioning activities proceed within the U.S. Department of Energy Complex, vast volumes of uncontaminated and contaminated concrete will be generated. The current practice of decontaminating and landfilling the concrete is an expensive and potentially wasteful practice. Research is being conducted at Vanderbilt University to assess the economic, social, legal, and political ramifications of alternate methods of dealing with waste concrete. An important aspect of this research work is the assessment of risk associated with the various alternatives. A deterministic risk assessment model has been developed which quantifies radiological as well as non-radiological risks associated with concrete disposalmore » and recycle activities. The risk model accounts for fatal as well as non-fatal risks to both workers and the public. Preliminary results indicate that recycling of concrete presents potentially lower risks than the current practice. Radiological considerations are shown to be of minor importance in comparison to other sources of risk, with conventional transportation fatalities and injuries dominating. Onsite activities can also be a major contributor to non-fatal risk.« less

American Society for Therapeutic Radiology and Oncology (ASTRO) Emerging Technology Committee report on electronic brachytherapy.

PubMed

Park, Catherine C; Yom, Sue S; Podgorsak, Matthew B; Harris, Eleanor; Price, Robert A; Bevan, Alison; Pouliot, Jean; Konski, Andre A; Wallner, Paul E

2010-03-15

The development of novel technologies for the safe and effective delivery of radiation is critical to advancing the field of radiation oncology. The Emerging Technology Committee of the American Society for Therapeutic Radiology and Oncology appointed a Task Group within its Evaluation Subcommittee to evaluate new electronic brachytherapy methods that are being developed for, or are already in, clinical use. The Task Group evaluated two devices, the Axxent Electronic Brachytherapy System by Xoft, Inc. (Fremont, CA), and the Intrabeam Photon Radiosurgery Device by Carl Zeiss Surgical (Oberkochen, Germany). These devices are designed to deliver electronically generated radiation, and because of their relatively low energy output, they do not fall under existing regulatory scrutiny of radioactive sources that are used for conventional radioisotope brachytherapy. This report provides a descriptive overview of the technologies, current and future projected applications, comparison of competing technologies, potential impact, and potential safety issues. The full Emerging Technology Committee report is available on the American Society for Therapeutic Radiology and Oncology Web site. Copyright 2010. Published by Elsevier Inc.

American Society for Therapeutic Radiology and Oncology (ASTRO) Emerging Technology Committee Report on Electronic Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, Catherine C., E-mail: cpark@radonc.ucsf.ed; Yom, Sue S.; Podgorsak, Matthew B.

The development of novel technologies for the safe and effective delivery of radiation is critical to advancing the field of radiation oncology. The Emerging Technology Committee of the American Society for Therapeutic Radiology and Oncology appointed a Task Group within its Evaluation Subcommittee to evaluate new electronic brachytherapy methods that are being developed for, or are already in, clinical use. The Task Group evaluated two devices, the Axxent Electronic Brachytherapy System by Xoft, Inc. (Fremont, CA), and the Intrabeam Photon Radiosurgery Device by Carl Zeiss Surgical (Oberkochen, Germany). These devices are designed to deliver electronically generated radiation, and because ofmore » their relatively low energy output, they do not fall under existing regulatory scrutiny of radioactive sources that are used for conventional radioisotope brachytherapy. This report provides a descriptive overview of the technologies, current and future projected applications, comparison of competing technologies, potential impact, and potential safety issues. The full Emerging Technology Committee report is available on the American Society for Therapeutic Radiology and Oncology Web site.« less

Tacrolimus Optic Neuropathy.

PubMed

Rasool, Nailyn; Boudreault, Katherine; Lessell, Simmons; Prasad, Sashank; Cestari, Dean M

2018-06-01

Tacrolimus (FK506, Prograf) is a potent immunosuppressant, which inhibits cytokine synthesis and blocks T-cell development. Optic neuropathy from tacrolimus toxicity is very uncommon but, when present, can result in severe vision loss. Case series and review of the literature. We present 3 patients with tacrolimus optic neuropathy after bone marrow transplantation complicated by graft-vs-host disease and demonstrate the differing clinical and radiologic presentation of this presumed toxic optic neuropathy. Tacrolimus optic neuropathy can manifest in a multitude of clinical presentations and can have devastating visual consequences.

Patient Safety in Interventional Radiology: A CIRSE IR Checklist

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, M. J., E-mail: mlee@rcsi.ie; Fanelli, F.; Haage, P.

2012-04-15

Interventional radiology (IR) is an invasive speciality with the potential for complications as with other invasive specialities. The World Health Organization (WHO) produced a surgical safety checklist to decrease the morbidity and mortality associated with surgery. The Cardiovascular and Interventional Society of Europe (CIRSE) set up a task force to produce a checklist for IR. Use of the checklist will, we hope, reduce the incidence of complications after IR procedures. It has been modified from the WHO surgical safety checklist and the RAD PASS from Holland.

Percutaneous BioOrganic Sealing of Duodenal Fistulas: Case Report and Review of Biological Sealants with Potential Use in Interventional Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wadhwa, Vibhor, E-mail: vwadhwa1@jhmi.edu; Leeper, William R., E-mail: rob.leeper@jhmi.edu; Tamrazi, Anobel, E-mail: atamraz1@jhmi.edu

2015-08-15

Biological sealants are being increasingly used in a variety of surgical specialties for their hemostatic and sealing capabilities. However, their use in interventional radiology has not been widely reported. The authors describe a case of duodenal perforation occurring after 15 years of gastric bypass surgery, in whom surgical diversion was unsuccessfully attempted and the leakage was successfully controlled using percutaneous administration of a combination of biological and organic sealants.

Targeting the Insulin-Like Growth Factor 1 Receptor in Ewing's Sarcoma: Reality and Expectations

PubMed Central

Olmos, David; Martins, Ana Sofia; Jones, Robin L.; Alam, Salma; Scurr, Michelle; Judson, Ian R.

2011-01-01

Ewing's sarcoma family of tumours comprises a group of very aggressive diseases that are potentially curable with multimodality treatment. Despite the undoubted success of current treatment, approximately 30% of patients will relapse and ultimately die of disease. The insulin-like growth factor 1 receptor (IGF-1R) has been implicated in the genesis, growth, proliferation, and the development of metastatic disease in Ewing's sarcoma. In addition, IGF1-R has been validated, both in vitro and in vivo, as a potential therapeutic target in Ewing's sarcoma. Phase I studies of IGF-1R monoclonal antibodies reported several radiological and clinical responses in Ewing's sarcoma patients, and initial reports of several Phase II studies suggest that about a fourth of the patients would benefit from IGF-1R monoclonal antibodies as single therapy, with approximately 10% of patients achieving objective responses. Furthermore, these therapies are well tolerated, and thus far severe toxicity has been rare. Other studies assessing IGF-1R monoclonal antibodies in combination with traditional cytotoxics or other targeted therapies are expected. Despite, the initial promising results, not all patients benefit from IGF-1R inhibition, and consequently, there is an urgent need for the identification of predictive markers of response. PMID:21647361

Sabotage at Nuclear Power Plants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Purvis, James W.

1999-07-21

Recently there has been a noted worldwide increase in violent actions including attempted sabotage at nuclear power plants. Several organizations, such as the International Atomic Energy Agency and the US Nuclear Regulatory Commission, have guidelines, recommendations, and formal threat- and risk-assessment processes for the protection of nuclear assets. Other examples are the former Defense Special Weapons Agency, which used a risk-assessment model to evaluate force-protection security requirements for terrorist incidents at DOD military bases. The US DOE uses a graded approach to protect its assets based on risk and vulnerability assessments. The Federal Aviation Administration and Federal Bureau of Investigationmore » conduct joint threat and vulnerability assessments on high-risk US airports. Several private companies under contract to government agencies use formal risk-assessment models and methods to identify security requirements. The purpose of this paper is to survey these methods and present an overview of all potential types of sabotage at nuclear power plants. The paper discusses emerging threats and current methods of choice for sabotage--especially vehicle bombs and chemical attacks. Potential consequences of sabotage acts, including economic and political; not just those that may result in unacceptable radiological exposure to the public, are also discussed. Applicability of risk-assessment methods and mitigation techniques are also presented.« less

The ABCs of the FDA: A Primer on the Role of the United States Food and Drug Administration in Medical Device Approvals and IR Research.

PubMed

Adamovich, Ashley; Park, Susie; Siskin, Gary P; Englander, Meridith J; Mandato, Kenneth D; Herr, Allen; Keating, Lawrence J

2015-09-01

The role of the US Food and Drug Administration (FDA) in medical device regulation is important to device-driven specialties such as interventional radiology. Whether it is through industry-sponsored trials during the approval process for new devices or investigator-initiated research prospectively evaluating the role of existing devices for new or established procedures, interaction with the FDA is an integral part of performing significant research in interventional radiology. This article reviews the potential areas of interface between the FDA and interventional radiology, as understanding these areas is necessary to continue the innovation that is the hallmark of this specialty. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Radiological dosimetry measurements in Costa Rica

DOE Office of Scientific and Technical Information (OSTI.GOV)

León, M., E-mail: mauisoiso@gmail.com; Santos, F., E-mail: fsantosg@gmail.com

The main cause of human exposure to artificial radiation corresponds to medical applications, so it is essential to reduce the dose to patients, workers and consequently the entire population [1]. Although there is no dose limit for patients, is necessary to reduce it to a minimum possible while still getting all the necessary diagnostic information, taking economic and social factors into account [2]. Based on this proposal, agencies such as the International Atomic Energy Agency has been dedicated to providing guidelines levels, whose function is to serve as standards for the optimization of the medical exposure [3]. This research wasmore » created as a preliminary survey with the claim of eventually determine the guidance levels in Costa Rica for three different studies of general radiology: Lumbar Spine-AP, Chest - PA and Thoracic Spine - AP (for screens with speeds of 400 and 800), and cranio-caudal study in mammography, applied to Costa Rica’s adult population, perform properly in the institutions of Caja Costarricense del Seguro Social (CCSS).« less

Image Format Conversion to DICOM and Lookup Table Conversion to Presentation Value of the Japanese Society of Radiological Technology (JSRT) Standard Digital Image Database.

PubMed

Yanagita, Satoshi; Imahana, Masato; Suwa, Kazuaki; Sugimura, Hitomi; Nishiki, Masayuki

2016-01-01

Japanese Society of Radiological Technology (JSRT) standard digital image database contains many useful cases of chest X-ray images, and has been used in many state-of-the-art researches. However, the pixel values of all the images are simply digitized as relative density values by utilizing a scanned film digitizer. As a result, the pixel values are completely different from the standardized display system input value of digital imaging and communications in medicine (DICOM), called presentation value (P-value), which can maintain a visual consistency when observing images using different display luminance. Therefore, we converted all the images from JSRT standard digital image database to DICOM format followed by the conversion of the pixel values to P-value using an original program developed by ourselves. Consequently, JSRT standard digital image database has been modified so that the visual consistency of images is maintained among different luminance displays.

Malpractice in Radiology: What Should You Worry About?

PubMed Central

Cannavale, Alessandro; Santoni, Mariangela; Mancarella, Paola; Passariello, Roberto; Arbarello, Paolo

2013-01-01

Over recent years the professional role of the radiologist has been evolved due to the increasing involvement in the clinical management of the patient. Radiologists have thus been increasingly charged by new duties and liabilities, exposing them to higher risks of legal claims made against them. Malpractice lawsuits in radiology are commonly related to inappropriate medical care or to the poor physician-patient relationship. In the present paper, we provide overview of the basic principles of the medical malpractice law and the main legal issues and causes of legal actions against diagnostic and interventional radiologists. We also address some issues to help radiologists to reduce risks and consequences of malpractice lawsuits. These include (1) following the standard of care to the best of their ability, (2) cautious use of off-label devices, (3) better communication skills among healthcare workers and with the patient, and (4) ensuring being covered by adequate malpractice insurance. Lastly, we described definitions of some medicolegal terms and concepts that are thought to be useful for radiologists to know. PMID:23691316

Radiological dosimetry measurements in Costa Rica

NASA Astrophysics Data System (ADS)

León, M.; Santos, F.

2016-07-01

The main cause of human exposure to artificial radiation corresponds to medical applications, so it is essential to reduce the dose to patients, workers and consequently the entire population [1]. Although there is no dose limit for patients, is necessary to reduce it to a minimum possible while still getting all the necessary diagnostic information, taking economic and social factors into account [2]. Based on this proposal, agencies such as the International Atomic Energy Agency has been dedicated to providing guidelines levels, whose function is to serve as standards for the optimization of the medical exposure [3]. This research was created as a preliminary survey with the claim of eventually determine the guidance levels in Costa Rica for three different studies of general radiology: Lumbar Spine-AP, Chest - PA and Thoracic Spine - AP (for screens with speeds of 400 and 800), and cranio-caudal study in mammography, applied to Costa Rica's adult population, perform properly in the institutions of Caja Costarricense del Seguro Social (CCSS).

Developing a Job Description for a Vice Chair of Education in Radiology: The ADVICER Template.

PubMed

Lewis, Petra J; Probyn, Linda; McGuinness, Georgeann; Nguyen, Jeremy; Mullins, Mark E; Resnik, Charles; Oldham, Sandra

2015-07-01

The newly formed Alliance of Directors and Vice Chairs of Education in Radiology (ADVICER), a group within the Alliance for Clinician Educators in Radiology, identified an acute need for a generic job description template for Vice Chairs of Education in Radiology, a role that is being developed in many academic Departments of Radiology. Eighty-three percent of current members who responded to a survey had no detailed job description, and over half had no job description at all. Having a comprehensive and detailed job description is vital to developing this key position. Using the results of a survey sent to ADVICER members and seven Education Vice Chair job descriptions provided by members, the authors developed a detailed job description encompassing all potential elements of this position. Only 17% of survey respondents had a detailed job description. The role of an Education Vice Chair varies significantly between institutions in its scope and level of responsibilities. The resultant generic job description that was devised is intended to provide a template that would be modified by the candidate or the Department Chair. It is unlikely that any one individual would perform all the described activities. ADVICER has developed a comprehensive, flexible job description for Vice Chair of Education in Radiology that can be adapted by institutions as appropriate. It can be downloaded from http://aur.org/ADVICER/. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Radiology coding, reimbursement, and economics: a practical playbook for housestaff.

PubMed

Petrey, W Banks; Allen, Bibb; Thorwarth, William T

2009-09-01

As radiologists-in-training, residents and fellows have little time to devote to understanding the complex and often confusing world of reimbursement and radiology economics. At best, housestaff are afforded only a modicum of exposure to the economics of medicine. Although most training programs try to provide some information on the subject, between learning radiology, taking call, and juggling life outside the hospital, the majority of residents and fellows have little time or energy to learn about the economics of radiology. Furthermore, information on medical economics and radiology has only occasionally been directed specifically to housestaff or widely distributed to residents across the country. This is unfortunate because the reimbursement and economic arena will significantly affect daily practice, relationships with other specialties, and compensation. In this article, the authors briefly describe the current reimbursement and economic climate: how we got here and where we may be headed, with specific attention to coding for radiologic services. In addition, and perhaps more important, the authors highlight aspects of residents' or fellows' daily practice that may have the potential to affect reimbursement in their years of practice ahead, such as proper dictation and coding techniques, the importance of adhering to new reporting guidelines, and the need for increased radiologist involvement in professional and community activities. The authors also emphasize measures that can be taken, specifically by housestaff, to promote and preserve the image of our specialty, which ultimately is intertwined with the reimbursement and economics of our field.

Views of radiology program directors on the role of mentorship in the training of radiology residents.

PubMed

Donovan, Andrea

2010-03-01

The successful mentoring of resident physicians has been linked to several beneficial outcomes for trainees including increased research productivity, improved career satisfaction, and retention in academics. Female residents may have greater difficulty establishing mentoring relationships than male residents. The purpose of this study was to assess the attitudes of radiology residency program directors toward the subject of mentorship, to determine the prevalence of formal mentoring programs, and to evaluate several issues specifically pertaining to the mentoring of female residents. An anonymous, voluntary survey was sent to 156 members of the Association of Program Directors in Radiology. The survey assessed views on mentorship during residency training, the potential role of mentorship in resident career development, and the prevalence of mentorship programs in residency programs. Subanalyses evaluated survey responses according to program director sex. Seventy program directors (45%) responded to the survey. The majority of respondents (85%) agreed it is important for residents to have mentors, but only 52% thought that current residents had identified mentors. Compared with male program directors, female program directors differed in their views on the role of mentorship and of the importance of female resident access to female mentors. Program directors consider mentoring relationships to be an important resource for resident professional development and a potential resource to increase the proportion of residents pursuing academic careers and positions of leadership. Female residents may have specific mentoring needs that should be explored with further study.

1995 Joseph E. Whitley, MD, Award. A World Wide Web gateway to the radiologic learning file.

PubMed

Channin, D S

1995-12-01

Computer networks in general, and the Internet specifically, are changing the way information is manipulated in the world at large and in radiology. The goal of this project was to develop a computer system in which images from the Radiologic Learning File, available previously only via a single-user laser disc, are made available over a generic, high-availability computer network to many potential users simultaneously. Using a networked workstation in our laboratory and freely available distributed hypertext software, we established a World Wide Web (WWW) information server for radiology. Images from the Radiologic Learning File are requested through the WWW client software, digitized from a single laser disc containing the entire teaching file and then transmitted over the network to the client. The text accompanying each image is incorporated into the transmitted document. The Radiologic Learning File is now on-line, and requests to view the cases result in the delivery of the text and images. Image digitization via a frame grabber takes 1/30th of a second. Conversion of the image to a standard computer graphic format takes 45-60 sec. Text and image transmission speed on a local area network varies between 200 and 400 kilobytes (KB) per second depending on the network load. We have made images from a laser disc of the Radiologic Learning File available through an Internet-based hypertext server. The images previously available through a single-user system located in a remote section of our department are now ubiquitously available throughout our department via the department's computer network. We have thus converted a single-user, limited functionality system into a multiuser, widely available resource.

Radiological protection, safety and security issues in the industrial and medical applications of radiation sources

NASA Astrophysics Data System (ADS)

Vaz, Pedro

2015-11-01

The use of radiation sources, namely radioactive sealed or unsealed sources and particle accelerators and beams is ubiquitous in the industrial and medical applications of ionizing radiation. Besides radiological protection of the workers, members of the public and patients in routine situations, the use of radiation sources involves several aspects associated to the mitigation of radiological or nuclear accidents and associated emergency situations. On the other hand, during the last decade security issues became burning issues due to the potential malevolent uses of radioactive sources for the perpetration of terrorist acts using RDD (Radiological Dispersal Devices), RED (Radiation Exposure Devices) or IND (Improvised Nuclear Devices). A stringent set of international legally and non-legally binding instruments, regulations, conventions and treaties regulate nowadays the use of radioactive sources. In this paper, a review of the radiological protection issues associated to the use of radiation sources in the industrial and medical applications of ionizing radiation is performed. The associated radiation safety issues and the prevention and mitigation of incidents and accidents are discussed. A comprehensive discussion of the security issues associated to the global use of radiation sources for the aforementioned applications and the inherent radiation detection requirements will be presented. Scientific, technical, legal, ethical, socio-economic issues are put forward and discussed.

International Data on Radiological Sources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Martha Finck; Margaret Goldberg

2010-07-01

ABSTRACT The mission of radiological dispersal device (RDD) nuclear forensics is to identify the provenance of nuclear and radiological materials used in RDDs and to aid law enforcement in tracking nuclear materials and routes. The application of databases to radiological forensics is to match RDD source material to a source model in the database, provide guidance regarding a possible second device, and aid the FBI by providing a short list of manufacturers and distributors, and ultimately to the last legal owner of the source. The Argonne/Idaho National Laboratory RDD attribution database is a powerful technical tool in radiological forensics. Themore » database (1267 unique vendors) includes all sealed sources and a device registered in the U.S., is complemented by data from the IAEA Catalogue, and is supported by rigorous in-lab characterization of selected sealed sources regarding physical form, radiochemical composition, and age-dating profiles. Close working relationships with global partners in the commercial sealed sources industry provide invaluable technical information and expertise in the development of signature profiles. These profiles are critical to the down-selection of potential candidates in either pre- or post- event RDD attribution. The down-selection process includes a match between an interdicted (or detonated) source and a model in the database linked to one or more manufacturers and distributors.« less

Scenario planning.

PubMed

Enzmann, Dieter R; Beauchamp, Norman J; Norbash, Alexander

2011-03-01

In facing future developments in health care, scenario planning offers a complementary approach to traditional strategic planning. Whereas traditional strategic planning typically consists of predicting the future at a single point on a chosen time horizon and mapping the preferred plans to address such a future, scenario planning creates stories about multiple likely potential futures on a given time horizon and maps the preferred plans to address the multiple described potential futures. Each scenario is purposefully different and specifically not a consensus worst-case, average, or best-case forecast; nor is scenario planning a process in probabilistic prediction. Scenario planning focuses on high-impact, uncertain driving forces that in the authors' example affect the field of radiology. Uncertainty is the key concept as these forces are mapped onto axes of uncertainty, the poles of which have opposed effects on radiology. One chosen axis was "market focus," with poles of centralized health care (government control) vs a decentralized private market. Another axis was "radiology's business model," with one pole being a unified, single specialty vs a splintered, disaggregated subspecialty. The third axis was "technology and science," with one pole representing technology enabling to radiology vs technology threatening to radiology. Selected poles of these axes were then combined to create 3 scenarios. One scenario, termed "entrepreneurialism," consisted of a decentralized private market, a disaggregated business model, and threatening technology and science. A second scenario, termed "socialized medicine," had a centralized market focus, a unified specialty business model, and enabling technology and science. A third scenario, termed "freefall," had a centralized market focus, a disaggregated business model, and threatening technology and science. These scenarios provide a range of futures that ultimately allow the identification of defined "signposts" that can suggest which basic features among the "possible futures" are playing out. Scenario planning provides for the implementation of appropriate constructed strategic responses. Scenarios allow for a pre-prepared game plan available for ready use as the future unfolds. They allow a deliberative response rather than a hastily constructed, urgent response. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Predicting No-Shows in Radiology Using Regression Modeling of Data Available in the Electronic Medical Record.

PubMed

Harvey, H Benjamin; Liu, Catherine; Ai, Jing; Jaworsky, Cristina; Guerrier, Claude Emmanuel; Flores, Efren; Pianykh, Oleg

2017-10-01

To test whether data elements available in the electronic medical record (EMR) can be effectively leveraged to predict failure to attend a scheduled radiology examination. Using data from a large academic medical center, we identified all patients with a diagnostic imaging examination scheduled from January 1, 2016, to April 1, 2016, and determined whether the patient successfully attended the examination. Demographic, clinical, and health services utilization variables available in the EMR potentially relevant to examination attendance were recorded for each patient. We used descriptive statistics and logistic regression models to test whether these data elements could predict failure to attend a scheduled radiology examination. The predictive accuracy of the regression models were determined by calculating the area under the receiver operator curve. Among the 54,652 patient appointments with radiology examinations scheduled during the study period, 6.5% were no-shows. No-show rates were highest for the modalities of mammography and CT and lowest for PET and MRI. Logistic regression indicated that 16 of the 27 demographic, clinical, and health services utilization factors were significantly associated with failure to attend a scheduled radiology examination (P ≤ .05). Stepwise logistic regression analysis demonstrated that previous no-shows, days between scheduling and appointments, modality type, and insurance type were most strongly predictive of no-show. A model considering all 16 data elements had good ability to predict radiology no-shows (area under the receiver operator curve = 0.753). The predictive ability was similar or improved when these models were analyzed by modality. Patient and examination information readily available in the EMR can be successfully used to predict radiology no-shows. Moving forward, this information can be proactively leveraged to identify patients who might benefit from additional patient engagement through appointment reminders or other targeted interventions to avoid no-shows. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Diagnostic challenges in clinical, radiological and histopathological tests regarding papillomatous lesions of the breast.

PubMed

Rasmussen, Birgitte Bruun; Balslev, Eva; Jarle Christensen, Ib; Lanng, Charlotte; Bak, Anne; Galatius, Hanne; Møller Talman, Maj-Lis; Sharghi Someh, Nahid; Vejborg, Ilse; Okholm, Mette

2018-05-22

Papillomas of the female breast is a relatively frequent lesion, and the majority are benign when excised. However, some may host malignant or premalignant areas. Consequently, it is a worldwide accepted principle to excise the lesion whenever diagnosed. However, this leads to a large number of patients having an unnecessary operation. The present study was designed to investigate whether we could find clinical, radiological and pathological factors in the preoperative, diagnostic setting that could identify patients hosting a benign papilloma in order to avoid operation. The patient material consisted of 260 patients, all with a preoperative diagnosis of a papillomatous process in core biopsy. The lesion was excised, and 71% had a benign lesion. The rest had lesions ranging from premalignant to malignant. In the clinical, radiological and histopathological investigations conducted, we were not able to identify factors that statistically significant could predict whether the lesion was benign or malignant. However, our data showed a higher prevalence of malignant and premalignant lesions for older patient, larger lesions, and lesions found at a longer distance from the papilla. We conclude that, since almost 30% of the patients in our study ended up with a premalignant or malignant diagnosis, where no statistically significant preoperative factors could indicate a benign outcome, operation is warranted in all patients with a preoperative diagnosis of a papillomatous lesion. Copyright © 2018 Elsevier Ltd. All rights reserved.

Amalgam bonding: visualization and clinical implications of adhesive displacement during amalgam condensation.

PubMed

Tyler, D W; Thurmeier, J

2001-01-01

Resin adhesive was visualized in this in vitro study of amalgam bonding using methylene blue dye incorporated into the resin or by scanning electron microscopy. Class II amalgam cavities were prepared in extracted teeth previously stored in buffered formalin. The preparations were then restored following manufacturers' instructions, but included methylene blue dissolved in ethanol into the adhesive resin mixture. This procedure had little effect on the setting time of the resin. Following condensation and carving, excess resin was incorporated into the body of the restorations as well as onto all adjacent coronal surfaces with significant occlusal and proximal accumulations. Resin also accumulated in significant amounts on the gingival floor of the proximal box and at line angles and retentive grooves within the preparation. In conclusion, radiological studies demonstrated that artifacts produced by resin accumulation at the gingival floor of the box could be mistaken for an open margin or recurrent caries. Other potential clinical consequences of resin residue on tooth surfaces are discussed, including the problem of interproximal ledges and occlusal discrepancies. The incorporation of a radiopaque material in the resin systems should be a universal requirement.

Whole-body to tissue concentration ratios for use in biota dose assessments for animals.

PubMed

Yankovich, Tamara L; Beresford, Nicholas A; Wood, Michael D; Aono, Tasuo; Andersson, Pål; Barnett, Catherine L; Bennett, Pamela; Brown, Justin E; Fesenko, Sergey; Fesenko, J; Hosseini, Ali; Howard, Brenda J; Johansen, Mathew P; Phaneuf, Marcel M; Tagami, Keiko; Takata, Hyoe; Twining, John R; Uchida, Shigeo

2010-11-01

Environmental monitoring programs often measure contaminant concentrations in animal tissues consumed by humans (e.g., muscle). By comparison, demonstration of the protection of biota from the potential effects of radionuclides involves a comparison of whole-body doses to radiological dose benchmarks. Consequently, methods for deriving whole-body concentration ratios based on tissue-specific data are required to make best use of the available information. This paper provides a series of look-up tables with whole-body:tissue-specific concentration ratios for non-human biota. Focus was placed on relatively broad animal categories (including molluscs, crustaceans, freshwater fishes, marine fishes, amphibians, reptiles, birds and mammals) and commonly measured tissues (specifically, bone, muscle, liver and kidney). Depending upon organism, whole-body to tissue concentration ratios were derived for between 12 and 47 elements. The whole-body to tissue concentration ratios can be used to estimate whole-body concentrations from tissue-specific measurements. However, we recommend that any given whole-body to tissue concentration ratio should not be used if the value falls between 0.75 and 1.5. Instead, a value of one should be assumed.

Interdisciplinary periodontics: the multidisciplinary approach to the planning and treatment of complex cases.

PubMed

Lyons, Karl M; Darby, Ivan

2017-06-01

Periodontics cannot be practiced in isolation as frequently many patients have multiple dental needs or medical health issues requiring management. In addition, pathology may manifest in the periodontal tissues, and the onset and progression of periodontitis can be affected by systemic conditions, such as diabetes, and vice versa. The focus of this volume of Periodontology 2000 is interdisciplinary periodontics, and the articles included discuss the interactions and the interrelationshipbetween periodontal tissues/periodontal diseases and endodontics, fixed prosthodontics, implant dentistry, esthetics, gerodontology, radiology, orthodontics, pediatric dentistry, oral and maxillofacial surgery, oral pathology, special needs dentistry and general medicine. Previous volumes of Periodontology 2000 have covered some of the interactions between periodontal diseases and other dental disciplines, especially implant dentistry, 'and the interaction between periodontal disease and systemic disease', but there has not been a volume on interdisciplinary periodontics. The intention therefore is to show how and why periodontics should be interdisciplinary, as well as the benefits of an interdisciplinary approach; in addition, the potential consequences of using a discipline in isolation are discussed. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Nuclear risk assessment for the Mars 2020 mission environmental impact statement.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clayton, Daniel James; Bignell, John L.; Jones, Christopher Andrew

In the summer of 2020, the National Aeronautics and Space Administration (NASA) plans to launch a spacecraft as part of the Mars 2020 mission. One option for the rover on the proposed spacecraft uses a Multi-Mission Radioisotope Thermoelectric Generator (MMRTG) to provide continuous electrical and thermal power for the mission. An alternative option being considered is a set of solar panels for electrical power with up to 80 Light-Weight Radioisotope Heater Units (LWRHUs) for local component heating. Both the MMRTG and the LWRHUs use radioactive plutonium dioxide. NASA is preparing an Environmental Impact Statement (EIS) in accordance with the Nationalmore » Environmental Policy Act. The EIS will include information on the risks of mission accidents to the general public and on-site workers at the launch complex. This Nuclear Risk Assessment (NRA) addresses the responses of the MMRTG or LWRHU options to potential accident and abort conditions during the launch opportunity for the Mars 2020 mission and the associated consequences. This information provides the technical basis for the radiological risks of both options for the EIS.« less

A Vertically Integrated Online Radiology Curriculum Developed as a Cognitive Apprenticeship: Impact on Student Performance and Learning.

PubMed

Lim-Dunham, Jennifer E; Ensminger, David C; McNulty, John A; Hoyt, Amy E; Chandrasekhar, Arcot J

2016-02-01

The principles of Collins' cognitive apprenticeship model were used to design a radiology curriculum in which medical students practice radiological skills using online case-based modules. The modules are embedded within clinical third-year clerkships, and students are provided with personalized feedback from the instructors. We describe the development of the vertical online radiology curriculum and evaluate its impact on student achievement and learning process using a mixed method approach. The curriculum was developed over a 2-year period. Student participation was voluntary in the first year and mandatory in the second year. For quantitative curriculum evaluation, student metrics for voluntary versus mandatory groups were assessed using independent sample t tests and variable entry method regression analysis. For qualitative analysis, responses from a survey of students about the value of the curriculum were organized into defined themes using consensus coding. Mandatory participation significantly improved (p = .001) the mean radiology examination score (82 %) compared to the voluntary group (73%), suggesting that mandatory participation had a beneficial effect on student performance. Potential preexisting differences in underlying general academic performance were accounted for by including mean basic science grades as the first variable in the regression model. The significant increase in R(2) from .16 to .28 when number of radiology cases completed was added to the original model, and the greater value of the standardized beta for this variable, suggest that the curriculum made a significant contribution to students' radiology examination scores beyond their baseline academic performance. Five dominant themes about curricular characteristics that enhanced student learning and beneficial outcomes emerged from consensus coding. These themes were (1) self-paced design, (2) receiving feedback from faculty, (3) clinical relevance of cases, (4) gaining confidence in interpreting radiological images, and (5) transfer of conceptual knowledge to actual practice. The vertically integrated online radiology curriculum can positively impact student performance and learning process in the context of the cognitive apprenticeship model. Copyright © 2015 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Paperless anesthesia: uses and abuses of these data.

PubMed

Anderson, Brian J; Merry, Alan F

2015-12-01

Demonstrably accurate records facilitate clinical decision making, improve patient safety, provide better defense against frivolous lawsuits, and enable better medical policy decisions. Anesthesia Information Management Systems (AIMS) have the potential to improve on the accuracy and reliability of handwritten records. Interfaces with electronic recording systems within the hospital or wider community allow correlation of anesthesia relevant data with biochemistry laboratory results, billing sections, radiological units, pharmacy, earlier patient records, and other systems. Electronic storage of large and accurate datasets has lent itself to quality assurance, enhancement of patient safety, research, cost containment, scheduling, anesthesia training initiatives, and has even stimulated organizational change. The time for record making may be increased by AIMS, but in some cases has been reduced. The question of impact on vigilance is not entirely settled, but substantial negative effects seem to be unlikely. The usefulness of these large databases depends on the accuracy of data and they may be incorrect or incomplete. Consequent biases are threats to the validity of research results. Data mining of biomedical databases makes it easier for individuals with political, social, or economic agendas to generate misleading research findings for the purpose of manipulating public opinion and swaying policymakers. There remains a fear that accessibility of data may have undesirable regulatory or legal consequences. Increasing regulation of treatment options during the perioperative period through regulated policies could reduce autonomy for clinicians. These fears are as yet unsubstantiated. © 2015 John Wiley & Sons Ltd.

Radiological protection in North American naturally occurring radioactive material industries.

PubMed

Chambers, D B

2015-06-01

All soils and rocks contain naturally occurring radioactive material (NORM). Many ores and raw materials contain relatively high levels of natural radionuclides, and processing such materials can further increase the concentrations of natural radionuclides, sometimes referred to as 'technologically enhanced naturally occurring radioactive material' (TENORM). Examples of NORM minerals include uranium ores, monazite (a source of rare earth minerals), and phosphate rock used to produce phosphate fertiliser. Such activities have the potential to result in above background radiation exposure to workers and the public. The objective of this paper is to review the sources and exposure from NORM in North American industries, and provide a perspective on the potential radiological hazards to workers and the environment. Proper consideration of NORM issues is important and needs to be integrated in the assessment of these projects. Concerns over radioactivity and radiation amongst non-governmental organisations and the local public have resulted in the cancellation of NORM mining and mineral extraction projects, as well as inhibition of the safe use of by-product materials from various NORM industries. This paper also briefly comments on the current regulatory framework for NORM (TENORM) in Canada and the USA, as well as the potential implications of the recent activities of the International Commission on Radiological Protection for NORM industries. © The International Society for Prosthetics and Orthotics Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Multiple external hazards compound level 3 PSA methods research of nuclear power plant

NASA Astrophysics Data System (ADS)

Wang, Handing; Liang, Xiaoyu; Zhang, Xiaoming; Yang, Jianfeng; Liu, Weidong; Lei, Dina

2017-01-01

2011 Fukushima nuclear power plant severe accident was caused by both earthquake and tsunami, which results in large amount of radioactive nuclides release. That accident has caused the radioactive contamination on the surrounding environment. Although this accident probability is extremely small, once such an accident happens that is likely to release a lot of radioactive materials into the environment, and cause radiation contamination. Therefore, studying accidents consequences is important and essential to improve nuclear power plant design and management. Level 3 PSA methods of nuclear power plant can be used to analyze radiological consequences, and quantify risk to the public health effects around nuclear power plants. Based on multiple external hazards compound level 3 PSA methods studies of nuclear power plant, and the description of the multiple external hazards compound level 3 PSA technology roadmap and important technical elements, as well as taking a coastal nuclear power plant as the reference site, we analyzed the impact of off-site consequences of nuclear power plant severe accidents caused by multiple external hazards. At last we discussed the impact of off-site consequences probabilistic risk studies and its applications under multiple external hazards compound conditions, and explained feasibility and reasonableness of emergency plans implementation.

Results of the radiological survey at 31 Lily Street, Albany, New York (AL171)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espergren, M.L.; Marley, J.L.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 31 Lily Street in Albany, New York was the subject of a radiological investigation initiated July 19, 1986. The residential property consists of a one-story frame house located on a rectangular lot. An asphalt driveway connects the house to the street. A diagram of the property showing the approximate boundaries and the 4-m grid network established for measurements outside the house is shown. The lot includedmore » in the radiological survey was /approximately/18 m wide by 25 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 23 Lily Street, Albany, New York

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.; Carrier, R.F.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 23 Lily Street in Albany, New York (AL174), was the subject of a radiological investigation initiated July 21, 1986. The residential property consists of a two-story frame house located on a rectangular lot. An asphalt driveway connects the house to the street. A diagram of the property showing the approximate boundaries and the 5-m grid network established for measurements outside the house is shown. The lotmore » included in the radiological survey was /approximately/20 m wide by 30 m deep. Front and side views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 20 Lily Street, Albany, New York (AL168)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 20 Lily Street in Albany, New York, was the subject of a radiological investigation initiated July 18, 1986. The residential property consists of a two-story frame house located on a rectangular lot. An asphalt driveway connects the house to the street. A diagram of the property showing the approximate boundaries and the 5-m grid network established for measurements outside the house is shown. the lot includedmore » in the radiological survey was /approximately/14 m wide by 37 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 22 Lily Street, Albany, New York (AL169)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 22 Lily Street in Albany, New York, was the subject of a radiological investigation initiated July 18, 1986. The residential property consists of a two-story frame house located on a rectangular lot. An asphalt driveway connects the house to the street. A diagram of the property showing the approximate boundaries and the 4-m grid network established for measurements outside the house is shown. The lot includedmore » in the radiological survey was /approximately/11 m wide by 30 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 21 Lily Street, Albany, New York

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 21 Lily Street in Albany, New York (AL164) was the subject of a radiological investigation initiated July 16, 1986. The residential property consists of a two-story frame house located on a rectangular lot. A gravel drive is located on the lot. A diagram of the property showing the approximate boundaries and the 5-m grid network established for measurements outside the house is shown. The lot includedmore » in the radiological survey was /approximately/21 m wide by 26 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 18 Lily Street, Albany, New York (AL167)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 18 Lily Street in Albany, New York was the subject of a radiological investigation initiated July 18, 1986. The residential property consists of a two-story frame house located on a rectangular lot. An asphalt driveway connects the house to the street. A diagram of the property showing the approximate boundaries and the 5-m grid network established for measurements outside the house is shown. The lot includedmore » in the radiological survey was /approximately/15 m wide by 37 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 15 Lily Street, Albany, New York (AL165)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 15 Lily Street in Albany, New York was the subject of a radiological investigation initiated July 17, 1986. The residential property consists of a one-story frame house located on a rectangular lot. An asphalt driveway connects the house to the street. A diagram of the property showing the approximate boundaries and the 4-m grid network established for measurements outside the house is shown. The lot includedmore » in the radiological survey was /approximately/20 m wide by 26 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 27 Lily Street, Albany, New York (AL172)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.; Carrier, R.F.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 27 Lily Street in Albany, New York, was the subject of a radiological investigation initiated July 19, 1986. The residential property consists of a two-story frame house located on a rectangular lot. An asphalt driveway connects the house to the street. A diagram of the property showing the approximate boundaries and the 5-m grid network established for measurements outside the house is shown. The lot includedmore » in the radiological survey was /approximately/20 m wide by 34 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 26 Lily Street, Albany, New York (AL170)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 26 Lily Street in Albany, New York, was the subject of a radiological investigation initiated July 18, 1986. The residential property consists of a two-story frame house located on a rectangular lot. An asphalt driveway connects the house to the street. A diagram of the property showing the approximate boundaries and the 10-m grid network established for measurements outside the house is shown. The lot includedmore » in the radiological survey was /approximately/29 m wide by 74 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Results of the radiological survey at 15 Keller Street, Albany, New York (AL176)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Espegren, M.L.; Marley, J.L.; Carrier, R.F.

1987-12-01

A number of properties in the Albany/Colonie area have been identified as being potentially contaminated with uranium originating from the former National Lead Company's uranium forming plant in Colonie, New York. The property at 15 Keller Street in Albany, New York was the subject of a radiological investigation initiated July 22, 1986. The residential property consists of a one-story frame house with an asphalt drive connects the house to the street. A diagram of the property showing the approximate boundaries and the grid network established for measurements outside the house is shown. The lot included in the radiological survey wasmore » /approximately/20 m wide by 27 m deep. Front and rear views of the property are shown. 13 refs., 5 figs., 5 tabs.« less

Assessing first year radiology resident competence pre-call: development and implementation of a computer-based exam before and after the 12 month training requirement.

PubMed

Khan, Rihan; Krupinski, Elizabeth; Graham, J Allen; Benodin, Les; Lewis, Petra

2012-06-01

Whether first-year radiology residents are ready to start call after 6 or 12 months has been a subject of much debate. The purpose of this study was to establish an assessment that would evaluate the call readiness of first-year radiology residents and identify any individual areas of weakness using a comprehensive computerized format. Secondarily, we evaluated for any significant differences in performance before and after the change in precall training requirement from 6 to 12 months. A list of >140 potential emergency radiology cases was given to first-year radiology residents at the beginning of the academic year. Over 4 years, three separate versions of a computerized examination were constructed using hyperlinked PowerPoint presentations and given to both first-year and second-year residents. No resident took the same version of the exam twice. Exam score and number of cases failed were assessed. Individual areas of weakness were identified and remediated with the residents. Statistical analysis was used to evaluate exam score and the number of cases failed, considering resident year and the three versions of the exam. Over 4 years, 17 of 19 (89%) first-year radiology residents passed the exam on first attempt. The two who failed were remediated and passed a different version of the exam 6 weeks later. Using the oral board scoring system, first-year radiology residents scored an average of 70.7 with 13 cases failed, compared to 71.1 with eight cases failed for second-year residents who scored statistically significantly higher. No significant difference was found in first-year radiology resident scoring before and after the 12-month training requirement prior to call. An emergency radiology examination was established to aid in the assessment of first-year radiology residents' competency prior to starting call, which has become a permanent part of the first-year curriculum. Over 4 years, all first-year residents were ultimately judged ready to start call. Of the variables assessed, only resident year showed a significant difference in scoring parameters. In particular, length of training prior to taking call showed no significant difference. Areas of weakness were identified for further study. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

The long-term problems of contaminated land: Sources, impacts and countermeasures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baes, C.F. III

1986-11-01

This report examines the various sources of radiological land contamination; its extent; its impacts on man, agriculture, and the environment; countermeasures for mitigating exposures; radiological standards; alternatives for achieving land decontamination and cleanup; and possible alternatives for utilizing the land. The major potential sources of extensive long-term land contamination with radionuclides, in order of decreasing extent, are nuclear war, detonation of a single nuclear weapon (e.g., a terrorist act), serious reactor accidents, and nonfission nuclear weapons accidents that disperse the nuclear fuels (termed ''broken arrows'').

Artificial intelligence and deep learning - Radiology's next frontier?

PubMed

Mayo, Ray Cody; Leung, Jessica

Tracing the use of computers in the radiology department from administrative functions through image acquisition, storage, and reporting, to early attempts at improved diagnosis, we begin to imagine possible new frontiers for their use in exam interpretation. Given their initially slow but ultimately substantial progress in the noninterpretive areas, we are left desiring and even expecting more in the interpretation realm. New technological advances may provide the next wave of progress and radiologists should be early adopters. Several potential applications are discussed and hopefully will serve to inspire future progress. Published by Elsevier Inc.

Assessing potential radiological harm to fukushima recovery workers.

PubMed

Scott, Bobby R

2011-01-01

A radiological emergency exists at the Fukushima Daiichi (Fukushima I) nuclear power plant in Japan as a result of the March 11, 2011 magnitude 9.0 earthquake and the massive tsunami that arrived later. News media misinformation related to the emergency triggered enormous social fear worldwide of the radioactivity that is being released from damaged fuel rods. The heroic recovery workers are a major concern because they are being exposed to mostly gamma radiation during their work shifts and life-threatening damage to the radiosensitive bone marrow could occur over time. This paper presents a way in which the bone marrow equivalent dose (in millisieverts), as estimated per work shift, could be used along with the hazard function model previously developed for radiological risk assessment to repeatedly check for potential life-threatening harm (hematopoietic system damage) to workers. Three categories of radiation hazard indication are proposed: 1, life-threatening damage unlikely; 2, life-threatening damage possible; 3, life-threatening damage likely. Categories 2 and 3 would be avoided if the whole body effective dose did not exceed the annual effective dose limit of 250 mSv. For down-wind populations, hormetic effects (activated natural protective processes) are much more likely than are deleterious effects.

An intra-abdominal abscess or "rind" as a consequence of peritoneal dialysis-associated pseudomonas peritonitis.

PubMed

Culpepper, R Michael; Gore, Sarah; Rutecki, Gregory W

2013-01-01

Abdominal CT imaging has defined characteristics of two pathological entities specific to peritoneal dialysis patients. Both are associated with serious peritoneal complications. One is comprised of ascites accompanied by septation and loculated fluid pockets as a complication of bacterial peritonitis. The other is the syndrome of encapsulating peritoneal sclerosis. We present the evolution of a single, thick-walled fluid collection as a consequence of relapsing Pseudomonas aeruginosa peritonitis. The entity had distinctive features differing from either of the two previously described entities, and to our knowledge, has not been described previously. Our patient's radiological evolution resembled the formation of a pleural or peritoneal "rind." Peritonitis, as a result of Pseudomonas aeruginosa , may lead to "rind" formation as described with empyemas and is distinct from previously described intra-abdominal pathologies in peritoneal dialysis patients.

Radiological impact of 2016 operations at the Savannah River Site

DOE Office of Scientific and Technical Information (OSTI.GOV)

Minter, K. L.; Jannik, G. T.; Dixon, K. M.

This report presents the environmental dose assessment methods and the estimated potential doses to the offsite public from 2016 Savannah River Site (SRS) air and liquid radioactive releases. Also documented are potential doses from special-case exposure scenarios, such as the consumption of wildlife or goat milk.

The radiologist's workflow environment: evaluation of disruptors and potential implications.

PubMed

Yu, John-Paul J; Kansagra, Akash P; Mongan, John

2014-06-01

Workflow interruptions in the health care delivery environment are a major contributor to medical errors and have been extensively studied within numerous hospital settings, including the nursing environment and the operating room, along with their effects on physician workflow. Less understood, though, is the role of interruptions in other highly specialized clinical domains and subspecialty services, such as diagnostic radiology. The workflow of the on-call radiologist, in particular, is especially susceptible to disruption by telephone calls and other modes of physician-to-physician communication. Herein, the authors describe their initial efforts to quantify the degree of interruption experienced by on-call radiologists and examine its potential implications in patient safety and overall clinical care. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Improving Shipboard Decision Making in the CBR-D (Chemical/Biological Radiological Defense) Environment: Concepts of Use for and Functional Description of a Decision Aid/Training System (DECAID)

DTIC Science & Technology

1988-08-19

take place over the period of several days. Decisions regarding MOPP level or resource allocation made on day I may have no immediate impact, but a...present -- conditions, and manage a resource library to assist the DCA in making decisions under conditions of uncertainty. Several areas of utilization are...students work through a scenario, the device couid then display the consequences of those decisions or provide optimal decision recommendations

Skin decontamination: principles and perspectives.

PubMed

Chan, Heidi P; Zhai, Hongbo; Hui, Xiaoying; Maibach, Howard I

2013-11-01

Skin decontamination is the primary intervention needed in chemical, biological and radiological exposures, involving immediate removal of the contaminant from the skin performed in the most efficient way. The most readily available decontamination system on a practical basis is washing with soap and water or water only. Timely use of flushing with copious amounts of water may physically remove the contaminant. However, this traditional method may not be completely effective, and contaminants left on the skin after traditional washing procedures can have toxic consequences. This article focuses on the principles and practices of skin decontamination.

Waste Sampling & Characterization Facility (WSCF) Complex Safety Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

MELOY, R.T.

2002-04-01

This document was prepared to analyze the Waste Sampling and Characterization Facility for safety consequences by: Determining radionuclide and highly hazardous chemical inventories; Comparing these inventories to the appropriate regulatory limits; Documenting the compliance status with respect to these limits; and Identifying the administrative controls necessary to maintain this status. The primary purpose of the Waste Sampling and Characterization Facility (WSCF) is to perform low-level radiological and chemical analyses on various types of samples taken from the Hanford Site. These analyses will support the fulfillment of federal, Washington State, and Department of Energy requirements.

Development of emergency response tools for accidental radiological contamination of French coastal areas.

PubMed

Duffa, Céline; Bailly du Bois, Pascal; Caillaud, Matthieu; Charmasson, Sabine; Couvez, Céline; Didier, Damien; Dumas, Franck; Fievet, Bruno; Morillon, Mehdi; Renaud, Philippe; Thébault, Hervé

2016-01-01

The Fukushima nuclear accident resulted in the largest ever accidental release of artificial radionuclides in coastal waters. This accident has shown the importance of marine assessment capabilities for emergency response and the need to develop tools for adequately predicting the evolution and potential impact of radioactive releases to the marine environment. The French Institute for Radiological Protection and Nuclear Safety (IRSN) equips its emergency response centre with operational tools to assist experts and decision makers in the event of accidental atmospheric releases and contamination of the terrestrial environment. The on-going project aims to develop tools for the management of marine contamination events in French coastal areas. This should allow us to evaluate and anticipate post-accident conditions, including potential contamination sites, contamination levels and potential consequences. In order to achieve this goal, two complementary tools are developed: site-specific marine data sheets and a dedicated simulation tool (STERNE, Simulation du Transport et du transfert d'Eléments Radioactifs dans l'environNEment marin). Marine data sheets are used to summarize the marine environment characteristics of the various sites considered, and to identify vulnerable areas requiring implementation of population protection measures, such as aquaculture areas, beaches or industrial water intakes, as well as areas of major ecological interest. Local climatological data (dominant sea currents as a function of meteorological or tidal conditions) serving as the basis for an initial environmental sampling strategy is provided whenever possible, along with a list of possible local contacts for operational management purposes. The STERNE simulation tool is designed to predict radionuclide dispersion and contamination in seawater and marine species by incorporating spatio-temporal data. 3D hydrodynamic forecasts are used as input data. Direct discharge points or atmospheric deposition source terms can be taken into account. STERNE calculates Eulerian radionuclide dispersion using advection and diffusion equations established offline from hydrodynamic calculations. A radioecological model based on dynamic transfer equations is implemented to evaluate activity concentrations in aquatic organisms. Essential radioecological parameters (concentration factors and single or multicomponent biological half-lives) have been compiled for main radionuclides and generic marine species (fish, molluscs, crustaceans and algae). Dispersion and transfer calculations are performed simultaneously on a 3D grid. Results can be plotted on maps, with possible tracking of spatio-temporal evolution. Post-processing and visualization can then be performed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Evaluation of clinicians' knowledge and practices regarding medical radiological exposure: findings from a mixed-methods investigation (survey and qualitative study)

PubMed Central

Lumbreras, B; Vilar, J; González-Álvarez, I; Guilabert, M; Parker, L A; Pastor-Valero, M; Domingo, M L; Fernández-Lorente, M F; Hernández-Aguado, I

2016-01-01

Objectives To assess the impact of initiatives aiming to increase clinician awareness of radiation exposure; to explore the challenges they face when communicating with patients; to study what they think is the most appropriate way of communicating the long-term potential risks of medical radiological exposure to patients. Design A quantitative and qualitative evaluation through a survey and focal groups. Setting San Juan Hospital and Dr Peset Hospital (Southeast Spain) and clinicians from Spanish scientific societies. Participants The surveys were answered (a) in person (216: all the radiologists (30), urologists (14) and surgeons (44) working at both participant hospitals; a sample of general practitioners from the catchment area of one hospital (45), and a consecutive sample of radiologists attending a scientific meeting (60)) or (b) electronically through Spanish scientific societies (299: radiologists (45), pneumologists (123), haematologists (75) and surgeons (40)). Clinicians were not randomly selected and thus the results are limited by the diligence of the individuals filling out the survey. Primary and secondary outcome measures Clinicians' knowledge and practices regarding medical radiological exposure, and what they considered most appropriate for communicating information to patients. Results Nearly 80% of the clinicians surveyed had never heard of the European recommendations. Fewer than 20% of the clinicians surveyed identified correctly the radiation equivalence dose of intravenous urography or barium enema. It was reported by 31.7% that they inform patients about the long-term potential risks of ionising radiation. All participants agreed that the most appropriate way to present information is a table with a list of imaging tests and their corresponding radiation equivalence dose in terms of chest X-rays and background radiation exposure. Conclusions Medical radiological exposure is frequently underestimated and rarely explained to patients. With a clear understanding of medical radiological exposure and proper communication tools, clinicians will be able to accurately inform patients. PMID:27799242

Persistent distress after psychological exposure to the Nagasaki atomic bomb explosion.

PubMed

Kim, Yoshiharu; Tsutsumi, Atsuro; Izutsu, Takashi; Kawamura, Noriyuki; Miyazaki, Takao; Kikkawa, Takehiko

2011-11-01

Although there is speculation that individuals living in the vicinity of nuclear disasters have persistent mental health deterioration due to psychological stress, few attempts have been made to examine this issue. To determine whether having been in the vicinity of the Nagasaki atomic bomb explosion in the absence of substantial exposure to radiation affected the mental health of local inhabitants more than half a century later. Participants were randomly recruited from individuals who lived in the vicinity of the atomic bomb explosion in uncontaminated suburbs of Nagasaki. This sample (n = 347) was stratified by gender, age, perception of the explosion and current district of residence. Controls (n = 288) were recruited from among individuals who had moved into the area from outside Nagasaki 5-15 years after the bombing, matched for gender, age and district of residence. The primary outcome measure was the proportion of those at high risk of mental disorder based on the 28-item version of the General Health Questionnaire, with a cut-off point of 5/6. Other parameters related to individual perception of the explosion, health status, life events and habits were also assessed. Having been in the vicinity of the explosion was the most significant factor (OR = 5.26, 95% CI 2.56-11.11) contributing to poorer mental health; erroneous knowledge of radiological hazard showed a mild association. In the sample group, anxiety after learning of the potential radiological hazard was significantly correlated with poor mental health (P<0.05), whereas anxiety about the explosion, or the degree of perception of it, was not; 74.5% of the sample group believed erroneously that the flash of the explosion was synonymous with radiation. Having been in the vicinity of the atomic bomb explosion without radiological exposure continued to be associated with poorer mental health more than half a century after the event. Fear on learning about the potential radiological hazard and lack of knowledge about radiological risk are responsible for this association.

Is the timing of radiological intervention and treatment day associated with economic outcomes in DRG-financed health care systems: a case study.

PubMed

Napierala, Christoph; Boes, Stefan

2017-02-28

In 2012, Switzerland has introduced a diagnosis related group (DRG) system for hospital financing to increase the efficiency and transparency of hospital services and to reduce costs. However, little is known about the efficiency of specific processes within hospitals. The objective of this study is to describe the relationship between timing of radiological interventions, in particular scan and treatment day, and the length of stay (LOS) compliance in a hospital. This is a cross-sectional observational study based on administrative records of all DRG cases in a Swiss university hospital in 2013, enriched by data from the radiology information system and accounting details. The data are analysed using descriptive statistics and regression methods. Radiology and related treatment on a weekend is associated with a higher LOS compliance of approximately 22.12% (p<0.01) compared to scans and treatments on weekdays, controlling for gender, age and insurance of the patient, as well as detailed medical and radiology-related factors. The higher LOS compliance is driven by emergency cases, which supports the hypothesis that for those cases on weekends more efficient scan and treatment processes are in place. The study provides evidence on how days of radiological intervention are related to LOS compliance in a Swiss hospital under DRG and attempts to explain how this is linked to standardised operating procedures. Our results have implications regarding potential cost savings in hospital care through alignment of care processes, infrastructure planning and guidance of patient flows.

Disclosing neuroimaging incidental findings: a qualitative thematic analysis of health literacy challenges.

PubMed

Rancher, Caitlin E; Shoemaker, Jody M; Petree, Linda E; Holdsworth, Mark; Phillips, John P; Helitzer, Deborah L

2016-10-11

Returning neuroimaging incidental findings (IF) may create a challenge to research participants' health literacy skills as they must interpret and make appropriate healthcare decisions based on complex radiology jargon. Disclosing IF can therefore present difficulties for participants, research institutions and the healthcare system. The purpose of this study was to identify the extent of the health literacy challenges encountered when returning neuroimaging IF. We report on findings from a retrospective survey and focus group sessions with major stakeholders involved in disclosing IF. We surveyed participants who had received a radiology report from a research study and conducted focus groups with participants, parents of child participants, Institutional Review Board (IRB) members, investigators and physicians. Qualitative thematic analyses were conducted using standard group-coding procedures and descriptive summaries of health literacy scores and radiology report outcomes are examined. Although participants reported high health literacy skills (m = 87.3 on a scale of 1-100), 67 % did not seek medical care when recommended to do so; and many participants in the focus groups disclosed they could not understand the findings described in their report. Despite their lack of understanding, participants desire to have information about their radiology results, and the investigators feel ethically inclined to return findings. The language in clinically useful radiology reports can create a challenge for participants' health literacy skills and has the potential to negatively impact the healthcare system and investigators conducting imaging research. Radiology reports need accompanying resources that explain findings in lay language, which can help reduce the challenge caused by the need to communicate incidental findings.

Post-deployment usability evaluation of a radiology workstation.

PubMed

Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A; Oudkerk, Matthijs; Van Ooijen, Peter M A

2016-01-01

To determine the number, nature and severity of usability issues radiologists encounter while using a commercially available radiology workstation in clinical practice, and to assess how well the results of a pre-deployment usability evaluation of this workstation generalize to clinical practice. The usability evaluation consisted of semi-structured interviews and observations of twelve users using the workstation during their daily work. Usability issues and positive usability findings were documented. Each issue was given a severity rating and its root cause was determined. Results were compared to the results of a pre-deployment usability evaluation of the same workstation. Ninety-two usability issues were identified, ranging from issues that cause minor frustration or delay, to issues that cause significant delays, prevent users from completing tasks, or even pose a potential threat to patient safety. The results of the pre-deployment usability evaluation had limited generalizability to clinical practice. This study showed that radiologists encountered a large number and a wide variety of usability issues when using a commercially available radiology workstation in clinical practice. This underlines the need for effective usability engineering in radiology. Given the limitations of pre-deployment usability evaluation in radiology, which were confirmed by our finding that the results of a pre-deployment usability evaluation of this workstation had limited generalizability to clinical practice, it is vital that radiology workstation vendors devote significant resources to usability engineering efforts before deployment of their workstation, and to continue these efforts after the workstation is deployed in a hospital. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Teaching the Healthcare Economics Milestones to Radiology Residents: Our Pilot Curriculum Experience.

PubMed

Prober, Allen S; Mehan, William A; Bedi, Harprit S

2016-07-01

Since July 2013, the Accreditation Council for Graduate Medical Education (ACGME) has required radiology residency programs to implement a set of educational milestones to track residents' educational advancement in six core competencies, including Systems-based Practice. The healthcare economics subcompetency of Systems-based Practice has traditionally been relatively neglected, and given the new increased ACGME oversight, will specifically require greater focused attention. A multi-institutional health-care economics pilot curriculum combining didactic and practical components was implemented across five residency programs. The didactic portion included a package of online recorded presentations, reading, and testing materials developed by the American College of Radiology (ACR's) Radiology Leadership Institute. The practical component involved a series of local meetings led by program faculty with the production of a deliverable based on research of local reimbursement for a noncontrast head computed tomography. The capstone entailed the presentation of each program's deliverable during a live teleconference webcast with a Radiology Leadership Institute content expert acting as moderator and discussion leader. The pilot curriculum was well received by residents and faculty moderators, with 100% of survey respondents agreeing that the pilot met its objective of introducing how reimbursement works in American radiology in 2015 and how business terminology applies to their particular institutions. A health-care economics curriculum in the style of a Massive Open Online Course has strong potential to serve as many residency programs' method of choice in meeting the health-care economics milestones. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

[Telecommunications, health and radiology: potential synergies for the new millennium].

PubMed

Lagalla, R

2001-01-01

Healthcare telematics, or telemedicine, is a new methodology that applies the potentialities of telecommunications technologies to the needs of medicine, thereby greatly contributing to improving the management of clinical data and medical information for the benefit of the individual patient and the community at large. The fields of application of Telemedicine are becoming increasingly vast, and this gives rise to technical problems (interconnections) as well as professional, ethical, medico-legal and legal problems. The dissemination of Telemedicine will require changes to be made to the organisation and delivery of the medical/administrative services connected to the management of patient data, the remote provision of care, and the impact of Telemedicine itself (e.g. need to standardise the nomenclature for telemedicine services). In addition, it will also call for a careful analysis of costs and benefits for both healthcare providers and patients. One of the most interesting experiences in terms of impact is Teleradiology. This is neither a new discipline nor a (sub)specialty: the practice of Teleradiology must comply with the rules regulating any radiological medical act, the primary aim of which is to contribute to establishing - rapidly and accurately - a diagnosis that will affect treatment strategies. It may be anticipated that in some situations Teleradiology will significantly change the working practices of Radiology Specialists and Radiology Technicians. Because it is better to anticipate problems rather than wait for them to arise, our Scientific Society, which is always sensitive to emerging issues, intends to propose the following recommendations/guidelines for the use of Teleradiology in the common interest of the community and healthcare workers. The invitation to take part in the initiative proposed by the Italian Society of Medical Radiology (SIRM), the Italian Association of Nuclear Medicine (AIMN) and the Italian Association of Neuroradiology (AINR) was received with great satisfaction and is proof that we are working towards common goals. As on other occasions, this was reflected in the excellent collaboration between the National Radiologists' Union (SNR), the Italian Association of Medical Physics (AIFM) and the National Federation of Radiology Technicians (F.N.C.TSRM) in drafting the document. The document aims to highlight the potentialities and limitations in the use of Teleradiology and to provide a set of recommendations/guidelines, which are not, however, to be intended as strict, absolute rules. Because this field is continually evolving both in structural and regulatory terms, and because it is very difficult to establish universal criteria to rigidly define behavioural models for implementing and managing Teleradiology-related activities (which in any case fall into the category of radiological medical acts), the recommendations/guidelines proposed necessarily have an informative rather than prescriptive nature. The document starts by defining the meaning of the following currently used terms: Teleconsultation; Telediagnosis; Teledidactics. It then goes on to analyse the following aspects of Teleradiology: Technological requirements; Qualifications and training of Medical Personnel; Qualifications, training and competences of Radiology Technicians. Based on the regulations in force in Italy, these recommendations are structured in terms of rationale and possible professional issues arising from the use of Teleradiology. A section is devoted to data security and confidentiality, including legal implications, an area which is currently evolving and being studied in Italy and abroad. Finally, the professional liabilities of all the healthcare providers involved in Teleradiology (imprudence, incompetence, negligence) are outlined, as well as the responsibilities related to the necessary maintenance of equipment. The aim of the document is to propose recommendations/guidelines for the correct use and validation of Teleradiology. The Scientific Societies SIRM-AIMN-AINR and the Academic Institutions, together with the SNR, AIFM and the F.N.C.TSRM, the Regional Bodies and the Italian National Health Trusts are required to make a positive and constructive commitment to this new field, which has become the object of considerable attention and interests. While confirming that, if used correctly, this methodology will no doubt increase the overall efficiency of Diagnostic Imaging - in the primary interest of the patient's right to health - it is felt that attention should also be paid to the working practices of the Radiology Specialists and Radiology Technicians and to the training of both. It is necessary to standardise training and practice, and to make an integrated and coherent use of resources with respect to the healthcare goals we wish to attain. Many have described the undisputed advantages of Teleradiology, but there have been relatively few reports on the related risks and recommendations for its use. It is certain that an improper use of the method (forced& interpretation of the bill on complementary diagnostic activities, operational misunderstandings between Radiology Specialists and Radiology Technicians, rarefaction of the relationship between Radiologist and Patient, obligation to use teleconsultation in all situations) will lead to considerable disadvantages for all those working in the field of Radiology, specialists and radiology technicians alike. Therefore, by adopting this document, which is by no means against Teleradiology but for a rational use of the method and full awareness of what it actually implies, the Scientific Society intends on the one hand to participate actively and concretely in the process of regulating all those aspects of Teleradiology for which it is competent - rather than waiting for regulations to be imposed from above - and, on the other, to provide, through its highly qualified Study Group (Specialists in Radiology, Nuclear Medicine, Legal Medicine, Medical Physics, and Radiology Technicians), Radiologists, Specialists in Nuclear Medicine, Neuroradiologists and Radiology Technicians with practical recommendations for use/guidelines for the correct and rational performance of their (tele)radiological acts. These indications and recommendations are also being submitted to the Italian Government. Teleradiology has attracted so much attention that, even as a result of pressure from Industry, an international consensus conference is needed to regulate the rational and informed use of this new methodology.

Email notification combined with off site signing substantially reduces resident approval to faculty verification time.

PubMed

Deitte, Lori A; Moser, Patricia P; Geller, Brian S; Sistrom, Chris L

2011-06-01

Attending radiologist signature time (AST) is a variable and modifiable component of overall report turnaround time. Delays in finalized reports have potential to undermine radiologists' value as consultants and adversely affect patient care. This study was performed to evaluate the impact of notebook computer distribution and daily automated e-mail notification on reducing AST. Two simultaneous interventions were initiated in the authors' radiology department in February 2010. These included the distribution of a notebook computer with preloaded software for each attending radiologist to sign radiology reports and daily automated e-mail notifications for unsigned reports. The digital dictation system archive and the radiology information system were queried for all radiology reports produced from January 2009 through August 2010. The time between resident approval and attending radiologist signature before and after the intervention was analyzed. Potential unintended "side effects" of the intervention were also studied. Resident-authored reports were signed, on average, 2.53 hours sooner after the intervention. This represented a highly significant (P = .003) decrease in AST with all else held equal. Postintervention reports were authored by residents at the same rate (about 70%). An unintended "side effect" was that attending radiologists were less likely to make changes to resident-authored reports after the intervention. E-mail notification combined with offsite signing can reduce AST substantially. Notebook computers with preloaded software streamline the process of accessing, editing, and signing reports. The observed decrease in AST reflects a positive change in the timeliness of report signature. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

NCRP Program Area Committee 3: Nuclear and Radiological Security and Safety [Update on the Ncrp Program Area Committee 3 Activities: Nuclear And Radiological Security and Safety

DOE PAGES

Ansari, Armin; Buddemeier, Brooke

2018-02-01

The National Council on Radiation Protection and Measurements (NCRP) Program Area Committee (PAC) 3 covers the broad subject of nuclear and radiological security and safety and provides guidance and recommendations for response to nuclear and radiological incidents of both an accidental and deliberate nature. In 2017, PAC 3 Scientific Committee 3-1 completed the development of Guidance for Emergency Responder Dosimetry, and began development of a companion commentary on operational aspects of that guidance. PAC 3 members also organized the technical program for the 2017 Annual Meeting of the NCRP on “Assessment of National Efforts in Emergency Preparedness for Nuclear Terrorism:more » Is There a Need for Realignment to Close Remaining Gaps.” Based on discussions and presentations at the annual meeting, PAC 3 is working to develop a commentary on the subject that could serve as a roadmap for focusing our national efforts on the most pressing needs for preparing the nation for nuclear and radiological emergencies. PAC 3 is also engaged in active discussions, exploring the landscape of priority issues for its future activities. Lastly, an important consideration in this discussion is the extent of NCRP’s present and potential future resources to support the work of its scientific committees.« less

Handheld technology acceptance in radiologic science education and training programs

NASA Astrophysics Data System (ADS)

Powers, Kevin Jay

The purpose of this study was to explore the behavioral intention of directors of educational programs in the radiologic sciences to adopt handheld devices to aid in managing student clinical data. Handheld devices were described to participants as a technology representing a class of mobile electronic devices including, but not limited to, personal digital assistants such as a Palm TX, Apple iPod Touch, Apple iPad or Hewlett Packard iPaq, and cellular or smartphones with third generation mobile capabilities such as an Apple iPhone, Blackberry or Android device. The study employed a non-experimental, cross-sectional survey design to determine the potential of adopting handheld technologies based on the constructs of Davis's (1989) Technology Acceptance Model. An online self-report questionnaire survey instrument was used to gather study data from 551 entry level radiologic science programs specializing in radiography, radiation therapy, nuclear medicine and medical sonography. The study design resulted in a single point in time assessment of the relationship between the primary constructs of the Technology Acceptance Model: perceived usefulness and perceived ease of use, and the behavioral intention of radiography program directors to adopt the information technology represented by hand held devices. Study results provide justification for investing resources to promote the adoption of mobile handheld devices in radiologic science programs and study findings serve as a foundation for further research involving technology adoption in the radiologic sciences.

Social media in radiology: early trends in Twitter microblogging at radiology's largest international meeting.

PubMed

Hawkins, C Matthew; Duszak, Richard; Rawson, James V

2014-04-01

Twitter is a social media microblogging platform that allows rapid exchange of information between individuals. Despite its widespread acceptance and use at various other medical specialty meetings, there are no published data evaluating its use at radiology meetings. The purpose of this study is to quantitatively and qualitatively evaluate the use of Twitter as a microblogging platform at recent RSNA annual meetings. Twitter activity meta-data tagged with official meeting hashtags #RSNA11 and #RSNA12 were collected and analyzed. Multiple metrics were evaluated, including daily and hourly Twitter activity, frequency of microblogging activity over time, characteristics of the 100 most active Twitter users at each meeting, characteristics of meeting-related tweets, and the geographic origin of meeting microbloggers. The use of Twitter microblogging increased by at least 30% by all identifiable meaningful metrics between the 2011 and 2012 RSNA annual meetings, including total tweets, tweets per day, activity of the most active microbloggers, and total number of microbloggers. Similar increases were observed in numbers of North American and international microbloggers. Markedly increased use of the Twitter microblogging platform at recent RSNA annual meetings demonstrates the potential to leverage this technology to engage meeting attendees, improve scientific sessions, and promote improved collaboration at national radiology meetings. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Natural Language Processing Technologies in Radiology Research and Clinical Applications.

PubMed

Cai, Tianrun; Giannopoulos, Andreas A; Yu, Sheng; Kelil, Tatiana; Ripley, Beth; Kumamaru, Kanako K; Rybicki, Frank J; Mitsouras, Dimitrios

2016-01-01

The migration of imaging reports to electronic medical record systems holds great potential in terms of advancing radiology research and practice by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the heterogeneity of how these data are formatted. Indeed, although there is movement toward structured reporting in radiology (ie, hierarchically itemized reporting with use of standardized terminology), the majority of radiology reports remain unstructured and use free-form language. To effectively "mine" these large datasets for hypothesis testing, a robust strategy for extracting the necessary information is needed. Manual extraction of information is a time-consuming and often unmanageable task. "Intelligent" search engines that instead rely on natural language processing (NLP), a computer-based approach to analyzing free-form text or speech, can be used to automate this data mining task. The overall goal of NLP is to translate natural human language into a structured format (ie, a fixed collection of elements), each with a standardized set of choices for its value, that is easily manipulated by computer programs to (among other things) order into subcategories or query for the presence or absence of a finding. The authors review the fundamentals of NLP and describe various techniques that constitute NLP in radiology, along with some key applications. ©RSNA, 2016.

Imaging manifestations of autoimmune disease-associated lymphoproliferative disorders of the lung.

PubMed

Lee, Geewon; Lee, Ho Yun; Lee, Kyung Soo; Lee, Kyung Jong; Cha, Hoon-Suk; Han, Joungho; Chung, Man Pyo

2013-10-01

Lymphoproliferative disorders (LPDs) may involve intrathoracic organs in patients with autoimmune disease, but little is known about the radiologic manifestations of autoimmune disease-associated LPDs (ALPDs) of the lungs. The purpose of our work was to identify the radiologic characteristics of pulmonary involvement in ALPDs. A comprehensive search for PubMed database was conducted with the combination of MeSH words. All articles which had original images or description on radiologic findings were included in this analysis. Also, CT images of eight patients with biopsy-proven lymphoproliferative disorder observed from our institution were added. Overall, 44 cases of ALPD were identified, and consisted of 24 cases of bronchus-associated lymphoid tissue lymphoma (BALToma), eight cases of non-Hodgkin's lymphoma (NHL), six cases of lymphoid interstitial pneumonia (LIP), two cases of nodular lymphoid hyperplasia, two cases of unclassified lymphoproliferative disorder, and one case each of lymphomatoid granulomatosis and hyperblastic BALT. Multiple nodules (n = 14, 32 %) and single mass (n = 8, 18 %) were the predominant radiologic manifestations. The imaging findings conformed to previously described findings of BALToma, NHL, or LIP. Data suggest that BALToma, NHL, and LIP are the predominant ALPDs of the lung, and ALPD generally shared common radiologic features with sporadic LPDs. Familiarity with ALPDs and their imaging findings may enable radiologists or clinicians to include the disease as a potential differential diagnosis and thus, to prompt early biopsy followed by appropriate treatment.

Gamma-Ray imaging for nuclear security and safety: Towards 3-D gamma-ray vision

NASA Astrophysics Data System (ADS)

Vetter, Kai; Barnowksi, Ross; Haefner, Andrew; Joshi, Tenzing H. Y.; Pavlovsky, Ryan; Quiter, Brian J.

2018-01-01

The development of portable gamma-ray imaging instruments in combination with the recent advances in sensor and related computer vision technologies enable unprecedented capabilities in the detection, localization, and mapping of radiological and nuclear materials in complex environments relevant for nuclear security and safety. Though multi-modal imaging has been established in medicine and biomedical imaging for some time, the potential of multi-modal data fusion for radiological localization and mapping problems in complex indoor and outdoor environments remains to be explored in detail. In contrast to the well-defined settings in medical or biological imaging associated with small field-of-view and well-constrained extension of the radiation field, in many radiological search and mapping scenarios, the radiation fields are not constrained and objects and sources are not necessarily known prior to the measurement. The ability to fuse radiological with contextual or scene data in three dimensions, in analog to radiological and functional imaging with anatomical fusion in medicine, provides new capabilities enhancing image clarity, context, quantitative estimates, and visualization of the data products. We have developed new means to register and fuse gamma-ray imaging with contextual data from portable or moving platforms. These developments enhance detection and mapping capabilities as well as provide unprecedented visualization of complex radiation fields, moving us one step closer to the realization of gamma-ray vision in three dimensions.

NCRP Program Area Committee 3: Nuclear and Radiological Security and Safety [Update on the Ncrp Program Area Committee 3 Activities: Nuclear And Radiological Security and Safety

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ansari, Armin; Buddemeier, Brooke

The National Council on Radiation Protection and Measurements (NCRP) Program Area Committee (PAC) 3 covers the broad subject of nuclear and radiological security and safety and provides guidance and recommendations for response to nuclear and radiological incidents of both an accidental and deliberate nature. In 2017, PAC 3 Scientific Committee 3-1 completed the development of Guidance for Emergency Responder Dosimetry, and began development of a companion commentary on operational aspects of that guidance. PAC 3 members also organized the technical program for the 2017 Annual Meeting of the NCRP on “Assessment of National Efforts in Emergency Preparedness for Nuclear Terrorism:more » Is There a Need for Realignment to Close Remaining Gaps.” Based on discussions and presentations at the annual meeting, PAC 3 is working to develop a commentary on the subject that could serve as a roadmap for focusing our national efforts on the most pressing needs for preparing the nation for nuclear and radiological emergencies. PAC 3 is also engaged in active discussions, exploring the landscape of priority issues for its future activities. Lastly, an important consideration in this discussion is the extent of NCRP’s present and potential future resources to support the work of its scientific committees.« less

Natural Language Processing Technologies in Radiology Research and Clinical Applications

PubMed Central

Cai, Tianrun; Giannopoulos, Andreas A.; Yu, Sheng; Kelil, Tatiana; Ripley, Beth; Kumamaru, Kanako K.; Rybicki, Frank J.

2016-01-01

The migration of imaging reports to electronic medical record systems holds great potential in terms of advancing radiology research and practice by leveraging the large volume of data continuously being updated, integrated, and shared. However, there are significant challenges as well, largely due to the heterogeneity of how these data are formatted. Indeed, although there is movement toward structured reporting in radiology (ie, hierarchically itemized reporting with use of standardized terminology), the majority of radiology reports remain unstructured and use free-form language. To effectively “mine” these large datasets for hypothesis testing, a robust strategy for extracting the necessary information is needed. Manual extraction of information is a time-consuming and often unmanageable task. “Intelligent” search engines that instead rely on natural language processing (NLP), a computer-based approach to analyzing free-form text or speech, can be used to automate this data mining task. The overall goal of NLP is to translate natural human language into a structured format (ie, a fixed collection of elements), each with a standardized set of choices for its value, that is easily manipulated by computer programs to (among other things) order into subcategories or query for the presence or absence of a finding. The authors review the fundamentals of NLP and describe various techniques that constitute NLP in radiology, along with some key applications. ©RSNA, 2016 PMID:26761536

Emergency radiology eponyms: part 2--Naclerio's V sign to Fournier gangrene.

PubMed

Sliker, Clint W; Steenburg, Scott D; Archer-Arroyo, Krystal

2013-06-01

An eponym is a name based on the name of a person, frequently as a means to honor him/her, and it can be used to concisely communicate or summarize a complex abnormality or injury. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in medicine. Many commonly used eponyms applied to extremity fractures should be familiar to most emergency radiologists and have been previously reported. Yet, a number of non-extremity eponyms can be encountered in an emergency radiology practice as well. This other group of eponyms encompasses a spectrum of traumatic and nontraumatic pathology. In this second part of a two-part series, the authors discuss a number of non-extremity emergency radiology eponyms, including relevant clinical and imaging features, as well biographical information of the eponyms' namesakes.

Towards in vivo focal cortical dysplasia phenotyping using quantitative MRI.

PubMed

Adler, Sophie; Lorio, Sara; Jacques, Thomas S; Benova, Barbora; Gunny, Roxana; Cross, J Helen; Baldeweg, Torsten; Carmichael, David W

2017-01-01

Focal cortical dysplasias (FCDs) are a range of malformations of cortical development each with specific histopathological features. Conventional radiological assessment of standard structural MRI is useful for the localization of lesions but is unable to accurately predict the histopathological features. Quantitative MRI offers the possibility to probe tissue biophysical properties in vivo and may bridge the gap between radiological assessment and ex-vivo histology. This review will cover histological, genetic and radiological features of FCD following the ILAE classification and will explain how quantitative voxel- and surface-based techniques can characterise these features. We will provide an overview of the quantitative MRI measures available, their link with biophysical properties and finally the potential application of quantitative MRI to the problem of FCD subtyping. Future research linking quantitative MRI to FCD histological properties should improve clinical protocols, allow better characterisation of lesions in vivo and tailored surgical planning to the individual.

Data mining in radiology

PubMed Central

Kharat, Amit T; Singh, Amarjit; Kulkarni, Vilas M; Shah, Digish

2014-01-01

Data mining facilitates the study of radiology data in various dimensions. It converts large patient image and text datasets into useful information that helps in improving patient care and provides informative reports. Data mining technology analyzes data within the Radiology Information System and Hospital Information System using specialized software which assesses relationships and agreement in available information. By using similar data analysis tools, radiologists can make informed decisions and predict the future outcome of a particular imaging finding. Data, information and knowledge are the components of data mining. Classes, Clusters, Associations, Sequential patterns, Classification, Prediction and Decision tree are the various types of data mining. Data mining has the potential to make delivery of health care affordable and ensure that the best imaging practices are followed. It is a tool for academic research. Data mining is considered to be ethically neutral, however concerns regarding privacy and legality exists which need to be addressed to ensure success of data mining. PMID:25024513

Pipe Crawler{reg_sign} internal piping characterization system - deactivation and decommissioning focus area. Innovative Technology Summary Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1998-02-01

Pipe Crawler{reg_sign} is a pipe surveying system for performing radiological characterization and/or free release surveys of piping systems. The technology employs a family of manually advanced, wheeled platforms, or crawlers, fitted with one or more arrays of thin Geiger Mueller (GM) detectors operated from an external power supply and data processing unit. Survey readings are taken in a step-wise fashion. A video camera and tape recording system are used for video surveys of pipe interiors prior to and during radiological surveys. Pipe Crawler{reg_sign} has potential advantages over the baseline and other technologies in areas of cost, durability, waste minimization, andmore » intrusiveness. Advantages include potentially reduced cost, potential reuse of the pipe system, reduced waste volume, and the ability to manage pipes in place with minimal disturbance to facility operations. Advantages over competing technologies include potentially reduced costs and the ability to perform beta-gamma surveys that are capable of passing regulatory scrutiny for free release of piping systems.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Laurinat, J.; Kesterson, M.; Hensel, S.

The documented safety analysis for the Savannah River Site evaluates the consequences of a postulated 1000 °C fire in a glovebox. The radiological dose consequences for a pressurized release of plutonium oxide powder during such a fire depend on the maximum pressure that is attained inside the oxide storage vial. To enable evaluation of the dose consequences, pressure transients and venting flow rates have been calculated for exposure of the storage vial to the fire. A standard B vial with a capacity of approximately 8 cc was selected for analysis. The analysis compares the pressurization rate from heating and evaporationmore » of moisture adsorbed onto the plutonium oxide contents of the vial with the pressure loss due to venting of gas through the threaded connection between the vial cap and body. Tabulated results from the analysis include maximum pressures, maximum venting velocities, and cumulative vial volumes vented during the first 10 minutes of the fire transient. Results are obtained for various amounts of oxide in the vial, various amounts of adsorbed moisture, different vial orientations, and different surface fire exposures.« less

Weather modeling for hazard and consequence assessment operations during the 2006 Winter Olympic Games

NASA Astrophysics Data System (ADS)

Hayes, P.; Trigg, J. L.; Stauffer, D.; Hunter, G.; McQueen, J.

2006-05-01

Consequence assessment (CA) operations are those processes that attempt to mitigate negative impacts of incidents involving hazardous materials such as chemical, biological, radiological, nuclear, and high explosive (CBRNE) agents, facilities, weapons, or transportation. Incident types range from accidental spillage of chemicals at/en route to/from a manufacturing plant, to the deliberate use of radiological or chemical material as a weapon in a crowded city. The impacts of these incidents are highly variable, from little or no impact to catastrophic loss of life and property. Local and regional scale atmospheric conditions strongly influence atmospheric transport and dispersion processes in the boundary layer, and the extent and scope of the spread of dangerous materials in the lower levels of the atmosphere. Therefore, CA personnel charged with managing the consequences of CBRNE incidents must have detailed knowledge of current and future weather conditions to accurately model potential effects. A meteorology team was established at the U.S. Defense Threat Reduction Agency (DTRA) to provide weather support to CA personnel operating DTRA's CA tools, such as the Hazard Prediction and Assessment Capability (HPAC) tool. The meteorology team performs three main functions: 1) regular provision of meteorological data for use by personnel using HPAC, 2) determination of the best performing medium-range model forecast for the 12 - 48 hour timeframe and 3) provision of real-time help-desk support to users regarding acquisition and use of weather in HPAC CA applications. The normal meteorology team operations were expanded during a recent modeling project which took place during the 2006 Winter Olympic Games. The meteorology team took advantage of special weather observation datasets available in the domain of the Winter Olympic venues and undertook a project to improve weather modeling at high resolution. The varied and complex terrain provided a special challenge to the modelers on the meteorology team. Some of the Olympic venues were located in the mountains to the west of Torino, while the rest were located on the relatively flat plain in and around the cities of Pinerolo and Torino to the east. DTRA partners at Pennsylvania State University (PSU) and the U.S. National Center for Atmospheric Research (NCAR) established data collection and assimilation, and forecast modeling processes that used special weather station observations provided by the Area Previsione e Monitoraggio Ambientale of Italy's ARPA Piemonte. At PSU a version of the MM5 was especially prepared to use observation data to forecast weather in a four-nest configuration. Two other DTRA partners provided independent weather forecast models against which the PSU model data were compared. The U.S. Air Force Weather Agency provided its MM5 forecast model data and the U.S. National Oceanic and Atmospheric Administration's National Centers for Environmental Prediction provided data from a special version of their WRF model. The project produced many opportunities to improve the modeling and forecasting capability at DTRA. DTRA and its partners plan to expand upon this experience during upcoming field tests, and to further improve and expand the capability to provide accurate high-resolution weather forecast information to hazard and consequence assessment operations.

Experience-based consulting: the value proposition.

PubMed

Pliner, Nicole; Thrall, James; Boland, Giles; Palumbo, Denise

2004-11-01

Consulting is a profession universally accepted and well entrenched throughout the business world. Whether it is providing objective analysis, supplying a specific expertise, managing a project, or simply adding extra manpower, consultants can add value. However, what are the attributes of a good consultant? In health care, with the rapid pace of emerging technologies, economic intricacies, and the complexities of clinical care, hands-on experience is the key. Recognizing the power of consultants with hands-on experience, the Department of Radiology at Massachusetts General Hospital launched the Radiology Consulting Group, an "experience-based" model for consulting that may potentially shift the profession's paradigm.

Disruption of Radiologist Workflow.

PubMed

Kansagra, Akash P; Liu, Kevin; Yu, John-Paul J

2016-01-01

The effect of disruptions has been studied extensively in surgery and emergency medicine, and a number of solutions-such as preoperative checklists-have been implemented to enforce the integrity of critical safety-related workflows. Disruptions of the highly complex and cognitively demanding workflow of modern clinical radiology have only recently attracted attention as a potential safety hazard. In this article, we describe the variety of disruptions that arise in the reading room environment, review approaches that other specialties have taken to mitigate workflow disruption, and suggest possible solutions for workflow improvement in radiology. Copyright © 2015 Mosby, Inc. All rights reserved.

Patient-centered outcomes research in radiology: trends in funding and methodology.

PubMed

Lee, Christoph I; Jarvik, Jeffrey G

2014-09-01

The creation of the Patient-Centered Outcomes Research Trust Fund and the Patient-Centered Outcomes Research Institute (PCORI) through the Patient Protection and Affordable Care Act of 2010 presents new opportunities for funding patient-centered comparative effectiveness research (CER) in radiology. We provide an overview of the evolution of federal funding and priorities for CER with a focus on radiology-related priority topics over the last two decades, and discuss the funding processes and methodological standards outlined by PCORI. We introduce key paradigm shifts in research methodology that will be required on the part of radiology health services researchers to obtain competitive federal grant funding in patient-centered outcomes research. These paradigm shifts include direct engagement of patients and other stakeholders at every stage of the research process, from initial conception to dissemination of results. We will also discuss the increasing use of mixed methods and novel trial designs. One of these trial designs, the pragmatic trial, has the potential to be readily applied to evaluating the effectiveness of diagnostic imaging procedures and imaging-based interventions among diverse patient populations in real-world settings. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Improving financial performance by modeling and analysis of radiology procedure scheduling at a large community hospital.

PubMed

Lu, Lingbo; Li, Jingshan; Gisler, Paula

2011-06-01

Radiology tests, such as MRI, CT-scan, X-ray and ultrasound, are cost intensive and insurance pre-approvals are necessary to get reimbursement. In some cases, tests may be denied for payments by insurance companies due to lack of pre-approvals, inaccurate or missing necessary information. This can lead to substantial revenue losses for the hospital. In this paper, we present a simulation study of a centralized scheduling process for outpatient radiology tests at a large community hospital (Central Baptist Hospital in Lexington, Kentucky). Based on analysis of the central scheduling process, a simulation model of information flow in the process has been developed. Using such a model, the root causes of financial losses associated with errors and omissions in this process were identified and analyzed, and their impacts were quantified. In addition, "what-if" analysis was conducted to identify potential process improvement strategies in the form of recommendations to the hospital leadership. Such a model provides a quantitative tool for continuous improvement and process control in radiology outpatient test scheduling process to reduce financial losses associated with process error. This method of analysis is also applicable to other departments in the hospital.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carr, F. Jr.; Mahaffey, J.A.

The purpose of the DOE/OHER Chernobyl Database project is to create and maintain an information system to provide usable information for research studies related to the nuclear accident. The system is the official United States repository for information about the Chernobyl accident and its consequences, and currently includes an extensive bibliography and diverse radiological measurements with supporting information. PNL has established two resources: original (not summarized) measurement data, currently about 80,000 measurements, with ancillary information; and about 2,200 bibliographic citations, some including abstracts. Major organizations that have contributed radiological measurement data include the Washington State Department of Social and Healthmore » Services; United States Environmental Protection Agency (domestic and foreign data); United States Nuclear Regulatory Commission; Stone Webster; Brookhaven National Laboratory; Commissariat A L'energie Atomique in France; Ministry of Agriculture, Fisheries, and Food in the United Kingdom; Japan National Institute of Radiological Sciences; and the Finnish Centre For Radiation and Nuclear Safety (STUK). Scientists in Australia, Austria, Belgium, Canada, China, Denmark, England, Federal Republic of Germany, Finland, France, Ireland, Italy, Japan, the Netherlands, Romania, Scotland, Spain, Sweden, Switzerland, United States, Wales, and Yugoslavia have made contributions. Bibliographic materials have been obtained from scientists in the above countries that have replied to requests. In addition, literature searches have been conducted, including a search of the DOE Energy Database. The last search was conducted in January, 1989. This document lists the bibliographic information in the DOE/OHER Chernobyl Database at the current time.« less

Sample Based Unit Liter Dose Estimates

DOE Office of Scientific and Technical Information (OSTI.GOV)

JENSEN, L.

The Tank Waste Characterization Program has taken many core samples, grab samples, and auger samples from the single-shell and double-shell tanks during the past 10 years. Consequently, the amount of sample data available has increased, both in terms of quantity of sample results and the number of tanks characterized. More and better data is available than when the current radiological and toxicological source terms used in the Basis for Interim Operation (BIO) (FDH 1999a) and the Final Safety Analysis Report (FSAR) (FDH 1999b) were developed. The Nuclear Safety and Licensing (NS and L) organization wants to use the new datamore » to upgrade the radiological and toxicological source terms used in the BIO and FSAR. The NS and L organization requested assistance in producing a statistically based process for developing the source terms. This report describes the statistical techniques used and the assumptions made to support the development of a new radiological source term for liquid and solid wastes stored in single-shell and double-shell tanks. The results given in this report are a revision to similar results given in an earlier version of the document (Jensen and Wilmarth 1999). The main difference between the results in this document and the earlier version is that the dose conversion factors (DCF) for converting {mu}Ci/g or {mu}Ci/L to Sv/L (sieverts per liter) have changed. There are now two DCFs, one based on ICRP-68 and one based on ICW-71 (Brevick 2000).« less

The circulating transcriptome as a source of non-invasive cancer biomarkers: concepts and controversies of non-coding and coding RNA in body fluids

PubMed Central

Fernandez-Mercado, Marta; Manterola, Lorea; Larrea, Erika; Goicoechea, Ibai; Arestin, María; Armesto, María; Otaegui, David; Lawrie, Charles H

2015-01-01

The gold standard for cancer diagnosis remains the histological examination of affected tissue, obtained either by surgical excision, or radiologically guided biopsy. Such procedures however are expensive, not without risk to the patient, and require consistent evaluation by expert pathologists. Consequently, the search for non-invasive tools for the diagnosis and management of cancer has led to great interest in the field of circulating nucleic acids in plasma and serum. An additional benefit of blood-based testing is the ability to carry out screening and repeat sampling on patients undergoing therapy, or monitoring disease progression allowing for the development of a personalized approach to cancer patient management. Despite having been discovered over 60 years ago, the clear clinical potential of circulating nucleic acids, with the notable exception of prenatal diagnostic testing, has yet to translate into the clinic. The recent discovery of non-coding (nc) RNA (in particular micro(mi)RNAs) in the blood has provided fresh impetuous for the field. In this review, we discuss the potential of the circulating transcriptome (coding and ncRNA), as novel cancer biomarkers, the controversy surrounding their origin and biology, and most importantly the hurdles that remain to be overcome if they are really to become part of future clinical practice. PMID:26119132

Importance of an intact dura in management of compound elevated fractures; a short series and literature review.

PubMed

Mohindra, Sandeep; Singh, Harnarayan; Savardekar, Amey

2012-01-01

To describe compound elevated fractures (CEFs) of the skull vault, with radiological pictures, management problems and prognosticative factors. The authors describe three cases of CEFs of the cranium, their mode of injury, clinical findings, radiological images and management problems. The authors have reviewed the existing literature regarding epidemiological data, neurological status, dural breech, methods of management and final outcome, in respect of CEFs. The first case had no dural breech, the second case had completely shattered dura, with extruding brain matter from the wound, while the third case had an elevated bone flap in consequence to large extradural haematoma. The patients with intact dura had relatively favourable outcome, when compared to patients with shattered dura. Three cases are added to the existing 10 such cases described in English literature. The major cause of unfavourable outcome remains sepsis and the presence of intact dura places these cases in the relatively safe category, regarding infective complications. The authors attempt at highlighting the importance of intact dura with such an injury. The review of literature supports favourable outcomes in patients having no dural breech.

Using Social Media to Share Your Radiology Research: How Effective Is a Blog Post?

PubMed

Hoang, Jenny K; McCall, Jonathan; Dixon, Andrew F; Fitzgerald, Ryan T; Gaillard, Frank

2015-07-01

The aim of this study was to compare the volume of individuals who viewed online versions of research articles in 2 peer-reviewed radiology journals and a radiology blog promoted by social media. The authors performed a retrospective study comparing online analytic logs of research articles in the American Journal of Neuroradiology (AJNR) and the American Journal of Roentgenology (AJR) and a blog posting on Radiopaedia.org from April 2013 to September 2014. All 3 articles addressed the topic of reporting incidental thyroid nodules detected on CT and MRI. The total page views for the research articles and the blog article were compared, and trends in page views were observed. Factors potentially affecting trends were an AJNR podcast and promotion of the blog article on the social media platforms Facebook, Tumblr, and Twitter to followers of Radiopaedia.org in February 2014 and August 2014. The total numbers of page views during the study period were 2,421 for the AJNR article and 3,064 for the AJR article. The Radiopaedia.org blog received 32,675 page views, which was 13.6 and 10.7 times greater than AJNR and AJR page views, respectively, and 6.0 times greater than both journal articles combined. Months with activity above average for the blog and the AJNR article coincided with promotion by Radiopaedia.org on social media. Dissemination of scientific material on a radiology blog promoted on social media can substantially augment the reach of more traditional publication venues. Although peer-reviewed publication remains the most widely accepted measure of academic productivity, researchers in radiology should not ignore opportunities for increasing the impact of research findings via social media. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The role of initial radiologic and clinical manifestations in predicting the prognosis for pneumonia caused by H1N1 influenza virus.

PubMed

Göya, Cemil; Yavuz, Alpaslan; Hamidi, Cihad; Cetinçakmak, Mehmet Güli; Teke, Memik; Hattapoğlu, Salih; Duşak, Abdurrahim

2014-06-01

The aim of this study is to investigate the prognostic values of initial radiologic findings and preexisting medical conditions in pneumonia caused by H1N1 influenza virus that were obtained during the novel swine-origin influenza A (H1N1) virus (S-OIV) pandemic spread. Thirty-nine patients hospitalized due to H1N1 infection between September and December 2009 were retrospectively evaluated regarding the radiologic and clinical aspects. The thoracic computed tomography (CT) findings of all patients were assessed and accompanying conditions that may raise the morbidity were stated. The patients were divided into two groups as those who needed the intensive care unit administration and those treated with brief hospitalization; initial radiologic findings and preexisting medical situations of patients were compared among both groups respectively in terms of their prognostic value. In 39 patients with H1N1 infection (21 males and 18 females; mean age of 53.9±14 in range between 19 and 99 years); the necessity of intensive care was significantly higher in patients with solely chronic obstructive pulmonary disease (COPD) (P=0.008, Odds ratio: 27) or co-existence of COPD and malignity (Odds ratio: 13); however, no statistically significant difference between two groups was observed regarding the radiologic facts or other combinations of accompanying medical conditions in terms of any effects to the prognosis. In the H1N1 (S-OIV) pandemic, we observed that merely the contribution to the diagnostic process; the radiologic features have no significance as being prognostic indicator. Additionally; the superposition of H1N1 infection in patients with either COPD or COPD by malignity was stated to be a potential risk factor in terms of increased morbidity.

The Role of Artificial Intelligence in Diagnostic Radiology: A Survey at a Single Radiology Residency Training Program.

PubMed

Collado-Mesa, Fernando; Alvarez, Edilberto; Arheart, Kris

2018-02-21

Advances in artificial intelligence applied to diagnostic radiology are predicted to have a major impact on this medical specialty. With the goal of establishing a baseline upon which to build educational activities on this topic, a survey was conducted among trainees and attending radiologists at a single residency program. An anonymous questionnaire was distributed. Comparisons of categorical data between groups (trainees and attending radiologists) were made using Pearson χ 2 analysis or an exact analysis when required. Comparisons were made using the Wilcoxon rank sum test when the data were not normally distributed. An α level of 0.05 was used. The overall response rate was 66% (69 of 104). Thirty-six percent of participants (n = 25) reported not having read a scientific medical article on the topic of artificial intelligence during the past 12 months. Twenty-nine percent of respondents (n = 12) reported using artificial intelligence tools during their daily work. Trainees were more likely to express doubts on whether they would have pursued diagnostic radiology as a career had they known of the potential impact artificial intelligence is predicted to have on the specialty (P = .0254) and were also more likely to plan to learn about the topic (P = .0401). Radiologists lack exposure to current scientific medical articles on artificial intelligence. Trainees are concerned by the implications artificial intelligence may have on their jobs and desire to learn about the topic. There is a need to develop educational resources to help radiologists assume an active role in guiding and facilitating the development and implementation of artificial intelligence tools in diagnostic radiology. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Towards precision medicine: from quantitative imaging to radiomics

PubMed Central

Acharya, U. Rajendra; Hagiwara, Yuki; Sudarshan, Vidya K.; Chan, Wai Yee; Ng, Kwan Hoong

2018-01-01

Radiology (imaging) and imaging-guided interventions, which provide multi-parametric morphologic and functional information, are playing an increasingly significant role in precision medicine. Radiologists are trained to understand the imaging phenotypes, transcribe those observations (phenotypes) to correlate with underlying diseases and to characterize the images. However, in order to understand and characterize the molecular phenotype (to obtain genomic information) of solid heterogeneous tumours, the advanced sequencing of those tissues using biopsy is required. Thus, radiologists image the tissues from various views and angles in order to have the complete image phenotypes, thereby acquiring a huge amount of data. Deriving meaningful details from all these radiological data becomes challenging and raises the big data issues. Therefore, interest in the application of radiomics has been growing in recent years as it has the potential to provide significant interpretive and predictive information for decision support. Radiomics is a combination of conventional computer-aided diagnosis, deep learning methods, and human skills, and thus can be used for quantitative characterization of tumour phenotypes. This paper discusses the overview of radiomics workflow, the results of various radiomics-based studies conducted using various radiological images such as computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET), the challenges we are facing, and the potential contribution of radiomics towards precision medicine. PMID:29308604

Radiological environmental dose assessment methods and compliance dose results for 2015 operations at the Savannah River Site

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jannik, G. T.; Dixon, K. L.

This report presents the environmental dose assessment methods and the estimated potential doses to the offsite public from 2015 Savannah River Site (SRS) atmospheric and liquid radioactive releases. Also documented are potential doses from special-case exposure scenarios - such as the consumption of deer meat, fish, and goat milk.

Government of Canada Initiatives in Support of the Joint Convention

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, P.A.; Metcalfe, D.E.; Lojk, R.

The Government of Canada strongly supported international efforts to bring into force the Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management (the Joint Convention), and was the second country to ratify it. The Joint Convention places a number of obligations on Contracting Parties aimed at achieving and maintaining a high level of safety worldwide in spent fuel and radioactive waste management, ensuring that effective defenses against potential hazards are in place during all management stages, preventing accidents with radiological consequences and mitigating their consequences should they occur. In addition to establishingmore » and maintaining a modem regulatory framework and an independent regulatory body through the 2000 Nuclear Safety and Control Act, the Government of Canada has implemented a number of initiatives that address its responsibilities and serve to further enhance Canada's compliance with the Joint Convention. For nuclear fuel waste, the Government of Canada brought into force the Nuclear Fuel Waste Act in 2002 to require waste owners to develop, fund, organize and implement a long-term solution for Canada's nuclear fuel waste. The Act clearly reserves for Government the decision on the solution to be implemented in the best interests of Canadians, as well as oversight to ensure that waste owners are fulfilling their responsibilities. In the case of low-level radioactive waste, long-term solutions are being developed to ensure the protection of health, safety, and the environment, both now and in the future. Regarding uranium mine and mill tailings, current operators have state-of-the-art waste management facilities in place. The Government of Canada works with provincial governments to ensure that any potential abandoned or legacy mines sites where no owner can be held responsible are safely decommissioned and managed over the long term. (authors)« less

Radiological considerations for the operation of the Advanced Photon Source storage ring (revised).

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moe, H. J.

2002-05-02

This report deals with the radiological considerations of operations using 7700-MeV positron and electron beams in the storage ring (SR) tunnel. The radiological considerations addressed include the following: prompt secondary radiation (bremsstrahlung, giant resonance neutrons, medium and high energy neutrons, and muons) produced by electrons/positrons interacting in a beam stop or by particle losses in the component structures; skyshine radiation, which produces a radiation field in nearby areas and at the nearest off-site location; radioactive gases produced by neutron irradiation of air in the vicinity of a particle loss site; noxious gases (ozone and others) produced in air by themore » escaping bremsstrahlung radiation that results from absorbing particles in the components or by synchrotron radiation escaping into the tunnel; activation of the storage ring components that results in a residual radiation field in the vicinity of these materials following shutdown; potential activation of water used for cooling the magnets and other purposes in the SR tunnel; evaluation of the radiation fields due to escaping synchrotron radiation and gas bremsstrahlung. Estimated dose rates outside of the tunnel, in the early assembly area (EAA), and in the Experiment Hall for several modes of operation (including potential safety envelope beam power, normal beam power, and MCI (maximum credible incident) conditions) have been computed. Shielding in the first optics enclosure (FOE) and for the photon beamlines is discussed in ANL/APS/TB-7 (IPE 93), but additional radiological considerations for the ASD diagnostic beamlines are contained in Appendix C. Although the calculations refer to positrons, electron operation would produce essentially the same effects for the identical assumptions.« less

Inflammatory biomarkers and radiologic measurements in never-smokers with COPD: A cross-sectional study from the CODA cohort

PubMed Central

Lee, Hyun; Hong, Yoonki; Lim, Myoung Nam; Bak, So Hyeon; Kim, Min-Ji; Kim, Kyunga; Kim, Woo Jin; Park, Hye Yun

2017-01-01

Various biomarkers have emerged as potential surrogates to represent various subgroups of chronic obstructive pulmonary disease (COPD), which manifest with different phenotypes. However, the biomarkers representing never-smokers with COPD have not yet been well elucidated. The aim of this study was to evaluate the associations of certain serum and radiological biomarkers with the presence of COPD in never-smokers. To explore the associations of serum and radiological biomarkers with the presence of COPD in never-smokers, we conducted a cross-sectional patient cohort study composed of never-smokers from the COPD in Dusty Areas (CODA) cohort, consisting of subjects living in dusty areas near cement plants in South Korea. Of the 131 never-smokers in the cohort, 77 (58.8%) had COPD. There were no significant differences in the number of subjects with high levels of inflammatory biomarkers (>90th percentile of never-smokers without COPD), including white blood cell count, total bilirubin, interleukin (IL)-6, IL-8, and C-reactive protein, or radiologic measurements (including emphysema index and mean wall area percentage) between never-smokers with COPD and those without COPD. However, the number of subjects with high uric acid was significantly higher in never-smokers with COPD than never-smokers without COPD (31.2% (24/77) vs. 11.1% (6/54); p = 0.013). In addition, multivariate analysis revealed that high uric acid was significantly associated with the presence of COPD in never-smokers (adjusted relative risk: 1.63; 95% confidence interval: 1.21, 2.18; p = 0.001). Our study suggests that high serum levels of uric acid might be a potential biomarker for assessing the presence of COPD in never-smokers. PMID:29117798

Engineering tubular bone using mesenchymal stem cell sheets and coral particles

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geng, Wenxin; Ma, Dongyang; Yan, Xingrong

Highlights: • We developed a novel engineering strategy to solve the limitations of bone grafts. • We fabricated tubular constructs using cell sheets and coral particles. • The composite constructs showed high radiological density and compressive strength. • These characteristics were similar to those of native bone. -- Abstract: The development of bone tissue engineering has provided new solutions for bone defects. However, the cell-scaffold-based approaches currently in use have several limitations, including low cell seeding rates and poor bone formation capacity. In the present study, we developed a novel strategy to engineer bone grafts using mesenchymal stem cell sheetsmore » and coral particles. Rabbit bone marrow mesenchymal stem cells were continuously cultured to form a cell sheet with osteogenic potential and coral particles were integrated into the sheet. The composite sheet was then wrapped around a cylindrical mandrel to fabricate a tubular construct. The resultant tubular construct was cultured in a spinner-flask bioreactor and subsequently implanted into a subcutaneous pocket in a nude mouse for assessment of its histological characteristics, radiological density and mechanical property. A similar construct assembled from a cell sheet alone acted as a control. In vitro observations demonstrated that the composite construct maintained its tubular shape, and exhibited higher radiological density, compressive strength and greater extracellular matrix deposition than did the control construct. In vivo experiments further revealed that new bone formed ectopically on the composite constructs, so that the 8-week explants of the composite sheets displayed radiological density similar to that of native bone. These results indicate that the strategy of using a combination of a cell sheet and coral particles has great potential for bone tissue engineering and repairing bone defects.« less

Consensus Recommendations for Evaluation, Interpretation, and Utilization of Computed Tomography and Magnetic Resonance Enterography in Patients With Small Bowel Crohn's Disease.

PubMed

Bruining, David H; Zimmermann, Ellen M; Loftus, Edward V; Sandborn, William J; Sauer, Cary G; Strong, Scott A

2018-03-01

Computed tomography and magnetic resonance enterography have become routine small bowel imaging tests to evaluate patients with established or suspected Crohn's disease, but the interpretation and use of these imaging modalities can vary widely. A shared understanding of imaging findings, nomenclature, and utilization will improve the utility of these imaging techniques to guide treatment options, as well as assess for treatment response and complications. Representatives from the Society of Abdominal Radiology Crohn's Disease-Focused Panel, the Society of Pediatric Radiology, the American Gastroenterological Association, and other experts, systematically evaluated evidence for imaging findings associated with small bowel Crohn's disease enteric inflammation and established recommendations for the evaluation, interpretation, and use of computed tomography and magnetic resonance enterography in small bowel Crohn's disease. This work makes recommendations for imaging findings that indicate small bowel Crohn's disease, how inflammatory small bowel Crohn's disease and its complications should be described, elucidates potential extra-enteric findings that may be seen at imaging, and recommends that cross-sectional enterography should be performed at diagnosis of Crohn's disease and considered for small bowel Crohn's disease monitoring paradigms. A useful morphologic construct describing how imaging findings evolve with disease progression and response is described, and standard impressions for radiologic reports that convey meaningful information to gastroenterologists and surgeons are presented. © 2018, RSNA, AGA Institute, and Society of Abdominal Radiology This article is being published jointly in Radiology and Gastroenterology.

Principles on Radiological Characterization of the Unit 1 at Ignalina NPP for Decommissioning Purposes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Poskas, P.; Zujus, R.; Drumstas, G.

There is only one nuclear power plant in Lithuania - Ignalina NPP (INPP). The INPP operated two similar units with installed capacity of 1500 MW(each). They were commissioned in 12/1983 and 08/1987, and the original design lifetime was projected out to 2010 and 2015 respectively. But the first Unit of Ignalina NPP was shutdown December 31, 2004, and second Unit will be closed down before 2010 taking into consideration substantial long-term financial assistance from the EU, G7 and other states as well as international institutions. Implementation of dismantling activities requires detailed knowledge of the radiological situation at the Unit 1.more » General Programme of Radiological Survey for Ignalina NPP Unit 1 based on NUREG-1575 was prepared in 2005- 2006 by Consortium led by Lithuanian Energy Institute and approved by Regulatory Bodies. It includes such main steps as historical site assessment, scoping, characterization, remedial actions/decontamination support surveys and final status surveys. General Programme of Radiological Survey defines content and principles of the surveys, and preliminary survey considerations, including identification of the contaminants, establishment of the free release levels, principles on areas classification depending on contamination potential, identification of the final survey units, criteria for selection survey instrumentation, techniques and methods etc. So, in the paper information on these principles and the content of the different stages in General Programme of Radiological Survey is presented. (authors)« less

3D surface and body documentation in forensic medicine: 3-D/CAD Photogrammetry merged with 3D radiological scanning.

PubMed

Thali, Michael J; Braun, Marcel; Wirth, Joachim; Vock, Peter; Dirnhofer, Richard

2003-11-01

A main goal of forensic medicine is to document and to translate medical findings to a language and/or visualization that is readable and understandable for judicial persons and for medical laymen. Therefore, in addition to classical methods, scientific cutting-edge technologies can and should be used. Through the use of the Forensic, 3-D/CAD-supported Photogrammetric method the documentation of so-called "morphologic fingerprints" has been realized. Forensic, 3-D/CAD-supported Photogrammetry creates morphologic data models of the injury and of the suspected injury-causing instrument allowing the evaluation of a match between the injury and the instrument. In addition to the photogrammetric body surface registration, the radiological documentation provided by a volume scan (i.e., spiral, multi-detector CT, or MRI) registers the sub-surface injury, which is not visible to Photogrammetry. The new, combined method of merging Photogrammetry and Radiology data sets creates the potential to perform many kinds of reconstructions and postprocessing of (patterned) injuries in the realm of forensic medical case work. Using this merging method of colored photogrammetric surface and gray-scale radiological internal documentation, a great step towards a new kind of reality-based, high-tech wound documentation and visualization in forensic medicine is made. The combination of the methods of 3D/CAD Photogrammetry and Radiology has the advantage of being observer-independent, non-subjective, non-invasive, digitally storable over years or decades and even transferable over the web for second opinion.

Missed injuries during the initial assessment in a cohort of 1124 level-1 trauma patients.

PubMed

Giannakopoulos, G F; Saltzherr, T P; Beenen, L F M; Reitsma, J B; Bloemers, F W; Goslings, J C; Bakker, F C

2012-09-01

Despite the presence of diagnostic guidelines for the initial evaluation in trauma, the reported incidence of missed injuries is considerable. The aim of this study was to assess the missed injuries in a large cohort of trauma patients originating from two European Level-1 trauma centres. We analysed the 1124 patients included in the randomised REACT trial. Missed injuries were defined as injuries not diagnosed or suspected during initial clinical and radiological evaluation in the trauma room. We assessed the frequency, type, consequences and the phase in which the missed injuries were diagnosed and used univariate analysis to identify potential contributing factors. Eight hundred and three patients were male, median age was 38 years and 1079 patients sustained blunt trauma. Overall, 122 injuries were missed in 92 patients (8.2%). Most injuries concerned the extremities. Sixteen injuries had an AIS grade of ≥ 3. Patients with missed injuries had significantly higher injury severity scores (ISSs) (median of 15 versus 5, p<0.001). Factors associated with missed injuries were severe traumatic brain injury (GCS ≤ 8) and multitrauma (ISS ≥ 16). Seventy-two missed injuries remained undetected during tertiary survey (59%). In total, 31 operations were required for 26 initially missed injuries. Despite guidelines to avoid missed injuries, this problem is hard to prevent, especially in the severely injured. The present study showed that the rate of missed injuries was comparable with the literature and their consequences not severe. A high index of suspicion remains warranted, especially in multitrauma patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

Radiological monitoring plan for the Oak Ridge Y-12 Plant: Surface Water

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-10-01

The Y-12 Plant conducts a surface water monitoring program in response to DOE Orders and state of Tennessee requirements under the National Pollutant Discharge Elimination System (NPDES). The anticipated codification of DOE Order 5400.5 for radiation protection of the public and the environment (10 CFR Part 834) will require an environmental radiation protection plan (ERPP). The NPDES permit issued by the state of Tennessee requires a radiological monitoring plan (RMP) for Y-12 Plant surface waters. In a May 4, 1995 memo, the state of Tennessee, Division of Water Pollution Control, stated their desired needs and goals regarding the content ofmore » RMPs, associated documentation, and data resulting from the RMPs required under the NPDES permitting system (L. Bunting, General Discussion, Radiological Monitoring Plans, Tennessee Division of Water Pollution Control, May 4,1995). Appendix A provides an overview of how the Y-12 Plant will begin to address these needs and goals. It provides a more complete, documented basis for the current Y-12 Plant surface water monitoring program and is intended to supplement documentation provided in the Annual Site Environmental Reports (ASERs), NPDES reports, Groundwater Quality Assessment Reports, and studies conducted under the Y-12 Plant Environmental Restoration (ER) Program. The purpose of this update to the Y-12 Plant RMP is to satisfy the requirements of the current NPDES permit, DOE Order 5400.5, and 10 CFR Part 834, as current proposed, by defining the radiological monitoring plan for surface water for the Y-12 Plant. This plan includes initial storm water monitoring and data analysis. Related activities such as sanitary sewer and sediment monitoring are also summarized. The plan discusses monitoring goals necessary to determine background concentrations of radionuclides, to quantify releases, determine trends, satisfy regulatory requirements, support consequence assessments, and meet requirements that releases be ``as low as reasonably achievable`` (ALARA).« less

Renewal of radiological equipment.

PubMed

2014-10-01

In this century, medical imaging is at the heart of medical practice. Besides providing fast and accurate diagnosis, advances in radiology equipment offer new and previously non-existing options for treatment guidance with quite low morbidity, resulting in the improvement of health outcomes and quality of life for the patients. Although rapid technological development created new medical imaging modalities and methods, the same progress speed resulted in accelerated technical and functional obsolescence of the same medical imaging equipment, consequently creating a need for renewal. Older equipment has a high risk of failures and breakdowns, which might cause delays in diagnosis and treatment of the patient, and safety problems both for the patient and the medical staff. The European Society of Radiology is promoting the use of up-to-date equipment, especially in the context of the EuroSafe Imaging Campaign, as the use of up-to-date equipment will improve quality and safety in medical imaging. Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or renewal. This plan should look forward a minimum of 5 years, with annual updates. Teaching points • Radiological equipment has a definite life cycle span, resulting in unavoidable breakdown and decrease or loss of image quality which renders equipment useless after a certain time period.• Equipment older than 10 years is no longer state-of-the art equipment and replacement is essential. Operating costs of older equipment will be high when compared with new equipment, and sometimes maintenance will be impossible if no spare parts are available.• Older equipment has a high risk of failure and breakdown, causing delays in diagnosis and treatment of the patient and safety problems both for the patient and the medical staff.• Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or replacement. This plan should look forward a minimum of 5 years, with annual updating.

Is There Value in Having Radiology Provide a Second Reading in Pediatric Orthopaedic Clinic?

PubMed

Natarajan, Vivek; Bosch, Patrick; Dede, Ozgur; Deeney, Vincent; Mendelson, Stephen; Ward, Timothy; Brooks, Maria; Kenkre, Tanya; Roach, James

2017-06-01

The Joint Commission on Accreditation of Healthcare Organizations specifically mandates the dual interpretation of musculoskeletal radiographs by a radiologist in addition to the orthopaedist in all hospital-based orthopaedic clinics. Previous studies have questioned the utility of this practice. The purpose of this study was to further investigate the clinical significance of having the radiologist provide a second interpretation in a hospital-based pediatric orthopaedic clinic. A retrospective review was performed of all patients who had plain radiographs obtained in the pediatric orthopaedic clinic at an academic children's hospital over a 4-month period. For each radiographic series, the orthopaedist's note and the radiology interpretation were reviewed and a determination was made of whether the radiology read provided new clinically useful information and/or a new diagnosis, whether it recommended further imaging, or if it missed a diagnosis that was reflected in the orthopaedist's note. The hospital charges associated with the radiology read for each study were also quantified. The charts of 1570 consecutive clinic patients who were seen in the pediatric orthopaedic clinic from January to April, 2012 were reviewed. There were 2509 radiographic studies performed, of which 2264 had both a documented orthopaedist's note and radiologist's read. The radiologist's interpretation added new, clinically important information in 1.0% (23/2264) of these studies. In 1.7% (38/2264) of the studies, it was determined that the radiologist missed the diagnosis or clinically important information that could affect treatment. The total amount of the professional fees charged for the radiologists' interpretations was $87,362. On average, the hospital charges for each occurrence in which the radiologist's read provided an additional diagnosis or clinically important information beyond the orthopaedist's note were $3798. The results of this study suggest that eliminating the requirement to have the radiologist interpret radiographs in the pediatric orthopaedic clinic would have few clinical consequences. Level III-This is a diagnostic retrospective cohort study.

Diagnosis and Management of Transplanted Kidney Extrarenal Pseudoaneurysms: A Series of Four Cases and a Review of the Literature

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fananapazir, Ghaneh, E-mail: fananapazir@ucdavis.edu; Hannsun, Gemmy; Wright, Luke A.

Extrarenal pseudoaneurysms of transplanted kidneys are very rare but can have devastating consequences. In the past, these extrarenal pseudoaneurysms have often led to graft loss as well as significant morbidity and mortality. The role of advanced diagnostic imaging studies and of modern radiologic interventional management has not been studied. In this case series, we present four cases of extrarenal pseudoaneurysms of transplanted kidneys, describe the clinical scenarios and imaging that led to the angiographic diagnosis, and discuss the various endovascular and surgical approaches to management.

Automation of GIS-based population data-collection for transportation risk analysis

DOT National Transportation Integrated Search

1999-11-01

Estimation of the potential radiological risks associated with highway transport of radioactive : materials (RAM) requires input data describing population densities adjacent to all portions of : the route to be traveled. Previously, aggregated risks...

Pacific Northwest National Laboratory Potential Impact Categories for Radiological Air Emission Monitoring

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ballinger, Marcel Y.; Gervais, Todd L.; Barnett, J. Matthew

2012-06-05

In 2002, the EPA amended 40 CFR 61 Subpart H and 40 CFR 61 Appendix B Method 114 to include requirements from ANSI/HPS N13.1-1999 Sampling and Monitoring Releases of Airborne Radioactive Substances from the Stack and Ducts of Nuclear Facilities for major emission points. Additionally, the WDOH amended the Washington Administrative Code (WAC) 246-247 Radiation protection-air emissions to include ANSI/HPS N13.1-1999 requirements for major and minor emission points when new permitting actions are approved. A result of the amended regulations is the requirement to prepare a written technical basis for the radiological air emission sampling and monitoring program. A keymore » component of the technical basis is the Potential Impact Category (PIC) assigned to an emission point. This paper discusses the PIC assignments for the Pacific Northwest National Laboratory (PNNL) Integrated Laboratory emission units; this revision includes five PIC categories.« less

Agenesis of the gallbladder: A dangerously misdiagnosed malformation

PubMed Central

Peloponissios, Nicolas; Gillet, Michel; Cavin, René; Halkic, Nermin

2005-01-01

Isolated agenesis of the gallbladder is a rare anomaly, often asymptomatic. However, one patient out of four presented with right upper abdominal pain, nausea, and fatty food intolerance. The condition is frequently mistaken with an excluded or sclero-atrophic gallbladder, regardless of the imaging modality used. Consequently, AG often leads to unnecessary and potentially dangerous laparoscopic surgery as described in a few case reports over the last 10 years. The aim of this study is to clarify the diagnostic and therapeutic approach of this unusual pathology. Two cases seen in our institutions were retrospectively reviewed, together with a review of the American and European literature. During laparoscopy, the absence of normal anatomical structures and the impossibility of pulling on the gallbladder to expose and dissect the triangle of Callot increases the risk of iatrogenic injury to biliary or portal structures. Depending on the experiment of the surgeon in laparoscopic procedure, this has to be taken into account to decide a conversion to laparotomy. A high index of suspicion is necessary when interpreting the radiological images. In case of doubt, a MRI-cholangiography is mandatory. Because of possible inherited transmission, relatives with a history of biliary symptoms should be investigated. PMID:16273658

An Overview of Inflammatory Bowel Disease: General Consideration and Genetic Screening Approach in Diagnosis of Early Onset Subsets

PubMed Central

Nemati, Shahram; Teimourian, Shahram

2017-01-01

Inflammatory bowel disease (IBD) is the consequence of an aberrant hemostasis of the immune cells at the gut mucosal border. Based on clinical manifestation, laboratory tests, radiological studies, endoscopic and histological features, this disease is divided into three main types including Crohn’s disease (CD), Ulcerative colitis (UC), and IBDunclassified (IBD-U). IBD is frequently presented in adults, but about 20% of IBD cases are diagnosed during childhood called pediatric IBD (PIBD). Some patients in the latter group emerge the first symptoms during infancy or under 5 years of age named infantile and very early onset IBD (VEO-IBD), respectively. These subtypes make a small fraction of PIBD, but they have exclusive phenotypic and genetic characteristics such that they are accompanied by severe disease course and resistance to conventional therapy. In this context, understanding the underlying molecular pathology opens a promising field for individualized and effective treatment. Here, we describe current hypotheses on IBD pathophysiology then explain the new idea about genetic screening technology as a good potential approach to identify the causal variants early in the disease manifestation, which is especially important for the fast and accurate treatment of VEO-IBD. PMID:28638582

Managing nuclear power plant induced disasters.

PubMed

Kyne, Dean

2015-01-01

To understand the management process of nuclear power plant (NPP) induced disasters. The study shields light on phases and issues associated with the NPP induced disaster management. This study uses Palo Verde Nuclear Generation Station as study subject and Arizona State as study area. This study uses the Radiological Assessment System for Consequence Analysis (RASCAL) Source Term to Dose (STDose) of the Nuclear Regulatory Commission, a computer software to project and assess the source term dose and release pathway. This study also uses ArcGIS, a geographic information system to analyze geospatial data. A detailed case study of Palo Verde Nuclear Power Generation (PVNPG) Plant was conducted. The findings reveal that the NPP induced disaster management process is conducted by various stakeholders. To save lives and to minimize the impacts, it is vital to relate planning and process of the disaster management. Number of people who expose to the radioactive plume pathway and level of radioactivity could vary depending on the speed and direction of wind on the day the event takes place. This study findings show that there is a need to address the burning issue of different racial and ethnic groups' unequal exposure and unequal protection to potential risks associated with the NPPs.

Public Health Emergency Planning for Children in Chemical, Biological, Radiological, and Nuclear (CBRN) Disasters

PubMed Central

Bartenfeld, Michael T.; Peacock, Georgina; Griese, Stephanie E.

2015-01-01

Children represent nearly a quarter of the US population, but their unique needs in chemical, biological, radiological, and nuclear (CBRN) emergencies may not be well understood by public health and emergency management personnel or even clinicians. Children are different from adults physically, developmentally, and socially. These characteristics have implications for providing care in CBRN disasters, making resulting illness in children challenging to prevent, identify, and treat. This article discusses these distinct physical, developmental, and social traits and characteristics of children in the context of the science behind exposure to, health effects from, and treatment for the threat agents potentially present in CBRN incidents. PMID:25014894

The visual and radiological inspection of a pipeline using a teleoperated pipe crawler

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fogle, R.F.; Kuelske, K.; Kellner, R.A.

1996-07-01

In the 1950s the Savannah River Site built an open, unlined retention basin for temporary storage of potentially radionuclide-contaminated cooling water form a chemical separations process and storm water drainage from a nearby waste management facility which stored large quantities of nuclear fission by-products in carbon steel tanks. An underground process pipeline lead to the basin. Once the closure of the basin in 1972, further assessment has been required. A visual and radiological inspection of the pipeline was necessary to aid in the decision about further remediation. This article describes the inspection using a teleoperated pipe crawler. 5 figs.

The novel application of Benford's second order analysis for monitoring radiation output in interventional radiology.

PubMed

Cournane, S; Sheehy, N; Cooke, J

2014-06-01

Benford's law is an empirical observation which predicts the expected frequency of digits in naturally occurring datasets spanning multiple orders of magnitude, with the law having been most successfully applied as an audit tool in accountancy. This study investigated the sensitivity of the technique in identifying system output changes using simulated changes in interventional radiology Dose-Area-Product (DAP) data, with any deviations from Benford's distribution identified using z-statistics. The radiation output for interventional radiology X-ray equipment is monitored annually during quality control testing; however, for a considerable portion of the year an increased output of the system, potentially caused by engineering adjustments or spontaneous system faults may go unnoticed, leading to a potential increase in the radiation dose to patients. In normal operation recorded examination radiation outputs vary over multiple orders of magnitude rendering the application of normal statistics ineffective for detecting systematic changes in the output. In this work, the annual DAP datasets complied with Benford's first order law for first, second and combinations of the first and second digits. Further, a continuous 'rolling' second order technique was devised for trending simulated changes over shorter timescales. This distribution analysis, the first employment of the method for radiation output trending, detected significant changes simulated on the original data, proving the technique useful in this case. The potential is demonstrated for implementation of this novel analysis for monitoring and identifying change in suitable datasets for the purpose of system process control. Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Reducing Bottlenecks to Improve the Efficiency of the Lung Cancer Care Delivery Process: A Process Engineering Modeling Approach to Patient-Centered Care.

PubMed

Ju, Feng; Lee, Hyo Kyung; Yu, Xinhua; Faris, Nicholas R; Rugless, Fedoria; Jiang, Shan; Li, Jingshan; Osarogiagbon, Raymond U

2017-12-01

The process of lung cancer care from initial lesion detection to treatment is complex, involving multiple steps, each introducing the potential for substantial delays. Identifying the steps with the greatest delays enables a focused effort to improve the timeliness of care-delivery, without sacrificing quality. We retrospectively reviewed clinical events from initial detection, through histologic diagnosis, radiologic and invasive staging, and medical clearance, to surgery for all patients who had an attempted resection of a suspected lung cancer in a community healthcare system. We used a computer process modeling approach to evaluate delays in care delivery, in order to identify potential 'bottlenecks' in waiting time, the reduction of which could produce greater care efficiency. We also conducted 'what-if' analyses to predict the relative impact of simulated changes in the care delivery process to determine the most efficient pathways to surgery. The waiting time between radiologic lesion detection and diagnostic biopsy, and the waiting time from radiologic staging to surgery were the two most critical bottlenecks impeding efficient care delivery (more than 3 times larger compared to reducing other waiting times). Additionally, instituting surgical consultation prior to cardiac consultation for medical clearance and decreasing the waiting time between CT scans and diagnostic biopsies, were potentially the most impactful measures to reduce care delays before surgery. Rigorous computer simulation modeling, using clinical data, can provide useful information to identify areas for improving the efficiency of care delivery by process engineering, for patients who receive surgery for lung cancer.

Proposal of a New Adverse Event Classification by the Society of Interventional Radiology Standards of Practice Committee.

PubMed

Khalilzadeh, Omid; Baerlocher, Mark O; Shyn, Paul B; Connolly, Bairbre L; Devane, A Michael; Morris, Christopher S; Cohen, Alan M; Midia, Mehran; Thornton, Raymond H; Gross, Kathleen; Caplin, Drew M; Aeron, Gunjan; Misra, Sanjay; Patel, Nilesh H; Walker, T Gregory; Martinez-Salazar, Gloria; Silberzweig, James E; Nikolic, Boris

2017-10-01

To develop a new adverse event (AE) classification for the interventional radiology (IR) procedures and evaluate its clinical, research, and educational value compared with the existing Society of Interventional Radiology (SIR) classification via an SIR member survey. A new AE classification was developed by members of the Standards of Practice Committee of the SIR. Subsequently, a survey was created by a group of 18 members from the SIR Standards of Practice Committee and Service Lines. Twelve clinical AE case scenarios were generated that encompassed a broad spectrum of IR procedures and potential AEs. Survey questions were designed to evaluate the following domains: educational and research values, accountability for intraprocedural challenges, consistency of AE reporting, unambiguity, and potential for incorporation into existing quality-assurance framework. For each AE scenario, the survey participants were instructed to answer questions about the proposed and existing SIR classifications. SIR members were invited via online survey links, and 68 members participated among 140 surveyed. Answers on new and existing classifications were evaluated and compared statistically. Overall comparison between the two surveys was performed by generalized linear modeling. The proposed AE classification received superior evaluations in terms of consistency of reporting (P < .05) and potential for incorporation into existing quality-assurance framework (P < .05). Respondents gave a higher overall rating to the educational and research value of the new compared with the existing classification (P < .05). This study proposed an AE classification system that outperformed the existing SIR classification in the studied domains. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

The potential for gaming techniques in radiology education and practice.

PubMed

Reiner, Bruce; Siegel, Eliot

2008-02-01

Traditional means of communication, education and training, and research have been dramatically transformed with the advent of computerized medicine, and no other medical specialty has been more greatly affected than radiology. Of the myriad of newer computer applications currently available, computer gaming stands out for its unique potential to enhance end-user performance and job satisfaction. Research in other disciplines has demonstrated computer gaming to offer the potential for enhanced decision making, resource management, visual acuity, memory, and motor skills. Within medical imaging, video gaming provides a novel means to enhance radiologist and technologist performance and visual perception by increasing attentional capacity, visual field of view, and visual-motor coordination. These enhancements take on heightened importance with the increasing size and complexity of three-dimensional imaging datasets. Although these operational gains are important in themselves, psychologic gains intrinsic to video gaming offer the potential to reduce stress and improve job satisfaction by creating a fun and engaging means of spirited competition. By creating customized gaming programs and rewards systems, video game applications can be customized to the skill levels and preferences of individual users, thereby creating a comprehensive means to improve individual and collective job performance.

Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination.

PubMed

Grayson, James; Basciano, Peter; Rawson, James V; Klein, Kandace

2015-12-01

The aim of this study was to examine the referral pattern of imaging studies requested in a single state compared with the potential location of interpretation. Analysis of Medicare patients in a DocGraph data set was performed to identify sequential different physician services claims for the same patient for which the second claim was for services provided by a radiologist. In the 2011 Medicare population, radiology referrals from physicians practicing in Georgia resulted in 76.5% of radiology interpretations by radiologists inside the state of Georgia. The states bordering Georgia accounted for 11.6% of interpretations in the Georgia market. The remaining interpretations were distributed throughout the remainder of the country. A significant proportion of routine imaging interpretation occurs outside the state in which an examination is performed. Additional studies are needed to identify complex drivers of imaging referral patterns, such as patient geographic location and demographics, radiologist workforce distribution, contractual obligations, and social relationships. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Postmortem computed tomography (PMCT) and disaster victim identification.

PubMed

Brough, A L; Morgan, B; Rutty, G N

2015-09-01

Radiography has been used for identification since 1927, and established a role in mass fatality investigations in 1949. More recently, postmortem computed tomography (PMCT) has been used for disaster victim identification (DVI). PMCT offers several advantages compared with fluoroscopy, plain film and dental X-rays, including: speed, reducing the number of on-site personnel and imaging modalities required, making it potentially more efficient. However, there are limitations that inhibit the international adoption of PMCT into routine practice. One particular problem is that due to the fact that forensic radiology is a relatively new sub-speciality, there are no internationally established standards for image acquisition, image interpretation and archiving. This is reflected by the current INTERPOL DVI form, which does not contain a PMCT section. The DVI working group of the International Society of Forensic Radiology and Imaging supports the use of imaging in mass fatality response and has published positional statements in this area. This review will discuss forensic radiology, PMCT, and its role in disaster victim identification.

Radioactive decay data tables: A handbook of decay data for application to radiation dosimetry and radiological assessments

NASA Astrophysics Data System (ADS)

Kocher, D. C.; Smith, J. S.

Decay data are presented for approximately 500 radionuclides including those occurring naturally in the environment, those of potential importance in routine or accidental releases from the nuclear fuel cycle, those of current interest in nuclear medicine and fusion reactor technology, and some of those of interest to Committee 2 of the International Commission on Radiological Protection for the estimation of annual limits on intake via inhalation and ingestion for occupationally exposed individuals. Physical processes involved in radioactive decay which produce the different types of radiation observed, methods used to prepare the decay data sets for each radionuclide in the format of the computerized evaluated nuclear structure data file, the tables of radioactive decay data, and the computer code MEDLIST used to produce the tables are described. Applications of the data to problems of interest in radiation dosimetry and radiological assessments are considered as well as the calculations of the activity of a daughter radionuclide relative to the activity of its parent in a radioactive decay chain.

[Posterior reversible encephalopathy syndrome induced by a cough and cold drug containing pseudoephedrine].

PubMed

Ebbo, M; Benarous, L; Thomas, G; Jourde, N; Genot, S; Bernit, E; Veit, V; Harlé, J-R; Schleinitz, N

2010-06-01

Posterior reversible encephalopathy syndrome is a clinico-radiological entity characterized by neurologic symptoms in association with usually reversible bilateral posterior hemispheric oedema on neuroimaging. Many pathological conditions and treatments have been associated with this syndrome. We report a 19-year-old woman, followed-up for hypocomplementemic urticarial vasculitis, who presented with a posterior reversible encephalopathy syndrome induced by the intake of an over-the-counter cold remedy containing pseudoephedrine. Clinical manifestations and radiological abnormalities resolved after anti-hypertensive therapy and withdrawal of sympathomimetic drug. The diagnosis of posterior reversible encephalopathy syndrome should be considered in patients with compatible clinical and radiological presentation because of its potential reversibility with an appropriate management. Intake of drugs, including over-the-counter cough and cold drugs, should be looked for in the history as well as autoimmune disorders. Copyright 2010 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

The American Board of Radiology Perspective on Maintenance of Certification: Part IV: Practice quality improvement in radiologic physics.

PubMed

Frey, G Donald; Ibbott, Geoffrey S; Morin, Richard L; Paliwal, Bhudatt R; Thomas, Stephen R; Bosma, Jennifer

2007-11-01

Recent initiatives of the American Board of Medical Specialties (ABMS) in the area of maintenance of certification (MOC) have been reflective of the response of the medical community to address public concerns regarding quality of care, medical error reduction, and patient safety. In March 2000, the 24 member boards of the ABMS representing all medical subspecialties in the USA agreed to initiate specialty-specific maintenance of certification (MOC) programs. The American Board of Radiology (ABR) MOC program for diagnostic radiology, radiation oncology, and radiologic physics has been developed, approved by the ABMS, and initiated with full implementation for all three disciplines beginning in 2007. The overriding objective of MOC is to improve the quality of health care through diplomate-initiated learning and quality improvement. The four component parts to the MOC process are: Part I: Professional standing, Part II: Evidence of life long learning and periodic self-assessment, Part III: Cognitive expertise, and Part IV: Evaluation of performance in practice (with the latter being the focus of this paper). The key components of Part IV require a physicist-based response to demonstrate commitment to practice quality improvement (PQI) and progress in continuing individual competence in practice. Diplomates of radiologic physics must select a project to be completed over the ten-year cycle that potentially can improve the quality of the diplomate's individual or systems practice and enhance the quality of care. Five categories have been created from which an individual radiologic physics diplomate can select one required PQI project: (1) Safety for patients, employees, and the public, (2) accuracy of analyses and calculations, (3) report turnaround time and communication issues, (4) practice guidelines and technical standards, and (5) surveys (including peer review of self-assessment reports). Each diplomate may select a project appropriate for an individual, participate in a project within a clinical department, participate in a peer review of a self-assessment report, or choose a qualified national project sponsored by a society. Once a project has been selected, the steps are: (1) Collect baseline data relevant to the chosen project, (2) review and analyze the data, (3) create and implement an improvement plan, (4) remeasure and track, and (5) report participation to the ABR, using the template provided by the ABR. These steps begin in Year 2, following training in Year 1. Specific examples of individual PQI projects for each of the three disciplines of radiologic physics are provided. Now, through the MOC programs, the relationship between the radiologic physicist and the ABR will be continuous through the diplomate's professional career. The ABR is committed to providing an effective infrastructure that will promote and assist the process of continuing professional development including the enhancement of practice quality improvement for radiologic physicists.

Value-Based Assessment of Radiology Reporting Using Radiologist-Referring Physician Two-Way Feedback System-a Design Thinking-Based Approach.

PubMed

Shaikh, Faiq; Hendrata, Kenneth; Kolowitz, Brian; Awan, Omer; Shrestha, Rasu; Deible, Christopher

2017-06-01

In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study. These new dimensions of value measurement will directly impact the cascade of further medical management. We share our continued experience with this project that had two components: RESP (Referrer Evaluation System Pilot) and FRACI (Feedback from Radiologist Addressing Confounding Issues), which were introduced to the clinical radiology workflow in order to capture referrer-based and radiologist-based feedback on radiology reporting. We also share our insight into the principles of design thinking as applied in its planning and execution.

Informatics in radiology: automated structured reporting of imaging findings using the AIM standard and XML.

PubMed

Zimmerman, Stefan L; Kim, Woojin; Boonn, William W

2011-01-01

Quantitative and descriptive imaging data are a vital component of the radiology report and are frequently of paramount importance to the ordering physician. Unfortunately, current methods of recording these data in the report are both inefficient and error prone. In addition, the free-text, unstructured format of a radiology report makes aggregate analysis of data from multiple reports difficult or even impossible without manual intervention. A structured reporting work flow has been developed that allows quantitative data created at an advanced imaging workstation to be seamlessly integrated into the radiology report with minimal radiologist intervention. As an intermediary step between the workstation and the reporting software, quantitative and descriptive data are converted into an extensible markup language (XML) file in a standardized format specified by the Annotation and Image Markup (AIM) project of the National Institutes of Health Cancer Biomedical Informatics Grid. The AIM standard was created to allow image annotation data to be stored in a uniform machine-readable format. These XML files containing imaging data can also be stored on a local database for data mining and analysis. This structured work flow solution has the potential to improve radiologist efficiency, reduce errors, and facilitate storage of quantitative and descriptive imaging data for research. Copyright © RSNA, 2011.

Quantitative Stratification of Diffuse Parenchymal Lung Diseases

PubMed Central

Raghunath, Sushravya; Rajagopalan, Srinivasan; Karwoski, Ronald A.; Maldonado, Fabien; Peikert, Tobias; Moua, Teng; Ryu, Jay H.; Bartholmai, Brian J.; Robb, Richard A.

2014-01-01

Diffuse parenchymal lung diseases (DPLDs) are characterized by widespread pathological changes within the pulmonary tissue that impair the elasticity and gas exchange properties of the lungs. Clinical-radiological diagnosis of these diseases remains challenging and their clinical course is characterized by variable disease progression. These challenges have hindered the introduction of robust objective biomarkers for patient-specific prediction based on specific phenotypes in clinical practice for patients with DPLD. Therefore, strategies facilitating individualized clinical management, staging and identification of specific phenotypes linked to clinical disease outcomes or therapeutic responses are urgently needed. A classification schema consistently reflecting the radiological, clinical (lung function and clinical outcomes) and pathological features of a disease represents a critical need in modern pulmonary medicine. Herein, we report a quantitative stratification paradigm to identify subsets of DPLD patients with characteristic radiologic patterns in an unsupervised manner and demonstrate significant correlation of these self-organized disease groups with clinically accepted surrogate endpoints. The proposed consistent and reproducible technique could potentially transform diagnostic staging, clinical management and prognostication of DPLD patients as well as facilitate patient selection for clinical trials beyond the ability of current radiological tools. In addition, the sequential quantitative stratification of the type and extent of parenchymal process may allow standardized and objective monitoring of disease, early assessment of treatment response and mortality prediction for DPLD patients. PMID:24676019

Active pixel as dosimetric device for interventional radiology

NASA Astrophysics Data System (ADS)

Servoli, L.; Baldaccini, F.; Biasini, M.; Checcucci, B.; Chiocchini, S.; Cicioni, R.; Conti, E.; Di Lorenzo, R.; Dipilato, A. C.; Esposito, A.; Fanó, L.; Paolucci, M.; Passeri, D.; Pentiricci, A.; Placidi, P.

2013-08-01

Interventional Radiology (IR) is a subspecialty of radiology comprehensive of all minimally invasive diagnostic and therapeutic procedures performed using radiological devices to obtain image guidance. The interventional procedures are potentially harmful for interventional radiologists and medical staff due to the X-ray diffusion by the patient's body. The characteristic energy range of the diffused photons spans few tens of keV. In this work we will present a proposal for a new X-ray sensing element in the energy range of interest for IR procedures. The sensing element will then be assembled in a dosimeter prototype, capable of real-time measurement, packaged in a small form-factor, with wireless communication and no external power supply to be used for individual operators dosimetry for IR procedures. For the sensor, which is the heart of the system, we considered three different Active Pixel Sensors (APS). They have shown a good capability as single X-ray photon detectors, up to several tens keV photon energy. Two dosimetric quantities have been considered, the number of detected photons and the measured energy deposition. Both observables have a linear dependence with the dose, as measured by commercial dosimeters. The uncertainties in the measurement are dominated by statistic and can be pushed at ˜5% for all the sensors under test.

Anesthesia Practices for Interventional Radiology in Europe.

PubMed

Vari, Alessandra; Gangi, Afshin

2017-06-01

The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology. Predictable differences between countries and national regulations were confirmed, showing how significantly many "local" factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care. Significant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.

Environmental impacts of the release of a transuranic actinide, americium-241, from a contaminated facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Want, J.; Merry-Libby, P.

1985-10-29

Americium-241 is widely used as a radiation source, but it also has some potential risk if taken into the body because of its high dose conversion factor. Although the radiotoxicity of americium-241 is small compared to other transuranic actinides, its effects on the reproductive system and on development of the placenta are more damaging than the effects of plutonium-239. In Ohio, a gemologist's laboratory was contaminated with americium-241. Prior to decontamination of the laboratory, potential radiological impacts to the surrounding environment were assessed. A hypothetical fire accident resulting in a unit release (1 curie) was assumed. Potential radiological impacts weremore » simulated using an atmospheric dispersion and dosimetry model with local meteorological data, population census data, and detailed information regarding the neighborhood. The results indicate that there could have been a significant impact on nearby residents from americium-241 via atmospheric dispersion if a major catastrophic release had occurred prior to contamination and decommissioning of the laboratory. 14 refs., 3 figs., 2 tabs.« less

The Japanese tsunami and resulting nuclear emergency at the Fukushima Daiichi power facility: technical, radiologic, and response perspectives.

PubMed

Dauer, Lawrence T; Zanzonico, Pat; Tuttle, R Michael; Quinn, Dennis M; Strauss, H William

2011-09-01

The Fukushima Daiichi nuclear power facility, in the Futaba District of the Fukushima Prefecture in Japan, was severely damaged by the earthquake and ensuing tsunami that struck off the northern coast of the island of Honshu on March 11, 2011. The resulting structural damage to the plant disabled the reactor's cooling systems and led to significant, ongoing environmental releases of radioactivity, triggering a mandatory evacuation of a large area surrounding the plant. The status of the facility continues to change, and permanent control of its radioactive inventory has not yet been achieved. The purpose of this educational article is to summarize the short-term chronology, radiologic consequences, emergency responses, and long-term challenges associated with this event. Although there is ongoing debate on preparedness before the event and the candor of responsible entities in recognizing and disclosing its severity, it largely appears that appropriate key actions were taken by the Japanese authorities during the event that should mitigate any radiologic health impact. These actions include an organized evacuation of over 200,000 inhabitants from the vicinity of the site and areas early in the emergency; monitoring of food and water and placement of radiation limits on such foodstuffs; distribution of stable potassium iodide; and systematic scanning of evacuees. However, the risk of additional fuel damage and of further, perhaps substantial, releases persists. The situation at the Fukushima Daiichi nuclear facility remains fluid, and the long-term environmental and health impact will likely take years to fully delineate.

Radiological/Nuclear Human Monitoring Tabletop Exercise: Recommendations and Lessons Identified.

PubMed

Chauhan, Vinita; Duncan, Devin; Wilkins, Ruth C

2017-06-01

Health Canada is the lead department for coordinating the federal response to a Canadian nuclear emergency event. The framework to manage a radiological consequence is outlined in the Federal Nuclear Emergency Plan (FNEP). In 2014, a full scale exercise (FSX) was held to test the capacity of the federal government to handle a nuclear facility emergency disaster in Canada. The FSX provided a means to demonstrate the integration of various departments and agencies in response to such an event, and although a number of task teams within FNEP were tested, the capacity to monitor humans for exposure post-event was not played out fully. To address this, a table top exercise (TTX) was held in 2015 that brought together experts from human monitoring groups (HMGs) in partnership with Provincial and Municipal emergency response organizations. The TTX took the form of a facilitated discussion centered around two types of radiological/nuclear (RN) emergency scenarios that commenced post-release. The purpose of the exercise was to integrate these communities and identify knowledge gaps in policies and concepts of operations pertaining to the human monitoring aspects of RN events including biodosimetry, bioassay, portal monitors, whole body counting, and the provision of personal dosimetry. It also tested the interoperability between first responders/receivers and Federal, Provincial, and Municipal emergency response organizations. The end outcome was the identification of clear knowledge gaps in existing and newly developed concepts of operation in the human population monitoring response to an RN emergency in Canada; these and possible recommendations are captured in this report.

Radiation protection recommendations as applied to the disposal of long-lived solid radioactive waste. A report of The International Commission on Radiological Protection.

PubMed

1998-01-01

(79) Waste, by definition, has no benefit. It should be viewed as one aspect of the beneficial practice that gave rise to it. Furthermore, radioactive waste management should be placed in the context of the management of society's waste in general. (80) A major issue in evaluating the acceptability of a disposal system for long-lived solid radioactive waste is that doses or risks may arise from exposures in the distant future. There is uncertainty surrounding any estimate of these doses or risks due to lack of knowledge about future conditions. Such exposures are treated as potential exposures as their magnitude depends on future processes and conditions that have probabilities associated with them. (81) Nevertheless, the Commission recognises a basic principle that individuals and populations in the future should be afforded at least the same level of protection from the action of disposing of radioactive waste today as is the current generation. This implies use of the current quantitative dose and risk criteria derived from considering associated health detriment. Therefore, protection of future generations should be achieved by applying these dose or risk criteria to the estimated future doses or risks in appropriately defined critical groups. These estimates should not be regarded as measures of health detriment beyond times of around several hundreds of years into the future. In the case of these longer time periods, they represent indicators of the protection afforded by the disposal system. (82 Constrained optimisation is the central approach to evaluating the radiological acceptability of a waste disposal system; dose or risk constraints are used rather than dose or risk limits. By this transition from limitation to optimisation, the needs of practical application of the radiological protection system to the disposal of long-lived solid waste disposal are met: determination of acceptability now for exposures that may occur in the distant future. Optimisation should be applied in an iterative manner during the disposal system development process and should particularly cover both site selection and repository design. (83) Two broad categories of exposure situations should be considered: natural processes and human intrusion. The latter only refers to intrusion that is inadvertent. The radiological implications of deliberate intrusion into a repository are the responsibility of the intruder. Assessed doses or risks arising from natural processes should be compared with a dose constraint of 0.3 mSv per year or its risk equivalent of around 10(-5) per year. With regard to human intrusion, the consequences from one or more plausible stylized scenarios should be considered in order to evaluate the resilience of the repository to such events. (84) The Commission considers that in circumstances where human intrusion could lead to doses to those living around the site sufficiently high that intervention on current criteria would almost always be justified, reasonable efforts should be made at the repository development stage to reduce the probability of human intrusion or to limit its consequences. In this respect, the Commission has previously advised that an existing annual dose of around 10 mSv per year may be used as a generic reference level below which intervention is not likely to be justifiable. Conversely, an existing annual dose of around 100 mSv per year may be used as a generic reference level above which intervention should be considered almost always justifiable. Similar considerations apply in situations where the thresholds for deterministic effects in relevant organs are exceeded. (85) Compliance with the constraints can be assessed by utilising either an aggregated risk-oriented approach, with a risk constraint, or a disaggregated dose/probability approach, with a dose constraint, or a combination of both. A similar level of protection can be achieved by any of these approaches; however, more information may

Radiology research in mainland China in the past 10 years: a survey of original articles published in Radiology and European Radiology.

PubMed

Zhang, Long Jiang; Wang, Yun Fei; Yang, Zhen Lu; Schoepf, U Joseph; Xu, Jiaqian; Lu, Guang Ming; Li, Enzhong

2017-10-01

To evaluate the features and trends of Radiology research in Mainland China through bibliometric analysis of the original articles published in Radiology and European Radiology (ER) between 2006 and 2015. We reviewed the original articles published in Radiology and ER between 2006 and 2015. The following information was abstracted: imaging subspecialty, imaging technique(s) used, research type, sample size, study design, statistical analysis, study results, funding declarations, international collaborations, number of authors, department and province of the first author. All variables were examined longitudinally over time. Radiology research in Mainland China saw a substantial increase in original research articles published, especially in the last 5 years (P < 0.001). Within Mainland China's Radiology research, neuroradiology, vascular/interventional Radiology, and abdominal Radiology were the most productive fields; MR imaging was the most used modality, and a distinct geographic provenience was observed for articles published in Radiology and ER. Radiology research in Mainland China has seen substantial growth in the past 5 years with neuroradiology, vascular/interventional Radiology, and abdominal Radiology as the most productive fields. MR imaging is the most used modality. Article provenience shows a distinct geographical pattern. • Radiology research in Mainland China saw a substantial increase. • Neuroradiology, vascular/interventional Radiology, and abdominal Radiology are the most productive fields. • MRI is the most used modality in Mainland China's Radiology research. • Guangdong, Shanghai, and Beijing are the most productive provinces.

Estimates of the radiological dose to people living on Bikini Island for two weeks while diving in and around the sunken ships in Bikini Lagoon

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robison, W.L.

1990-09-01

Bikini Island and Bikini Lagoon were contaminated by fallout from nuclear weapons tests conducted at the atoll by the United States from 1946 to 1958. The second test, Baker, of the Crossroads series was an underwater detonation in 1946 that sank several ships in the lagoon, including the USS Saratoga and the Japanese battleship Nagato. The ships received high-intensity gamma-ray and neutron bombardment from the Baker test, which induced radioactivity in the metal structures. Some of the tests conducted after the Baker shot (there were 21 tests in all) injected contaminated carbonate particles into the air, some of which weremore » deposited across the lagoon surface. Most of this contaminated soil then settled onto the ships` decks and other structures and on the lagoon bottom. These sunken ships provide an interesting location for divers. Recreational diving and swimming in and around the ships raises the question of the potential radiological dose from the radionuclides present in or on the ships and in the lagoon sediments. The purpose of this paper, therefore, is to present an analysis of the potential radiological dose to persons who would dive near the sunken ships and live on Bikini Island for a short period of time.« less

Estimates of the radiological dose to people living on Bikini Island for two weeks while diving in and around the sunken ships in Bikini Lagoon

DOE Office of Scientific and Technical Information (OSTI.GOV)

Robison, W.L.

1990-09-01

Bikini Island and Bikini Lagoon were contaminated by fallout from nuclear weapons tests conducted at the atoll by the United States from 1946 to 1958. The second test, Baker, of the Crossroads series was an underwater detonation in 1946 that sank several ships in the lagoon, including the USS Saratoga and the Japanese battleship Nagato. The ships received high-intensity gamma-ray and neutron bombardment from the Baker test, which induced radioactivity in the metal structures. Some of the tests conducted after the Baker shot (there were 21 tests in all) injected contaminated carbonate particles into the air, some of which weremore » deposited across the lagoon surface. Most of this contaminated soil then settled onto the ships' decks and other structures and on the lagoon bottom. These sunken ships provide an interesting location for divers. Recreational diving and swimming in and around the ships raises the question of the potential radiological dose from the radionuclides present in or on the ships and in the lagoon sediments. The purpose of this paper, therefore, is to present an analysis of the potential radiological dose to persons who would dive near the sunken ships and live on Bikini Island for a short period of time.« less

A Perspective of the future of nuclear medicine training and certification

PubMed Central

Arevalo-Perez, Julio; Paris, Manuel; Graham, Michael M.; Osborne, Joseph R.

2016-01-01

Nuclear Medicine has evolved from a medical subspecialty using quite basic tests to one using elaborate methods to image organ physiology and has truly become “Molecular Imaging”. Concurrently, there has also been a timely debate about who has to be responsible for keeping pace with all of the components of the developmental cycle; imaging, radiopharmaceuticals and instrumentation. Since the foundation of the ABNM, the practice of Nuclear Medicine and the process toward certification have undergone major revisions. At present, the debate is focused on the inevitable future convergence of Radiology and Nuclear Medicine. The potential for further cooperation or fusion of the American Board of Radiology (ABR) and the American Board of Nuclear Medicine (ABNM) is likely to bring about a new path for Nuclear Medicine and Molecular Imaging training. If the merger is done carefully, respecting the strengths of both partners equally, there is an excellent potential to create a hybrid Nuclear Medicine – Radiology specialty that combines Physiology and Molecular Biology with detailed anatomic imaging that will sustain the innovation that has been central to nuclear medicine residency and practice. Herein, we also introduce a few basic trends in imaging utilization in the United States. These trends do not predict future utilization, but highlight the need for an appropriately credentialed practitioner to interpret these examinations and provide value to the healthcare system. PMID:26687859

Questionnaire surveys of dentists on radiology

PubMed Central

Shelley, AM; Brunton, P; Horner, K

2012-01-01

Objectives Survey by questionnaire is a widely used research method in dental radiology. A major concern in reviews of questionnaires is non-response. The objectives of this study were to review questionnaire studies in dental radiology with regard to potential survey errors and to develop recommendations to assist future researchers. Methods A literature search with the software search package PubMed was used to obtain internet-based access to Medline through the website www.ncbi.nlm.nih.gov/pubmed. A search of the English language peer-reviewed literature was conducted of all published studies, with no restriction on date. The search strategy found articles with dates from 1983 to 2010. The medical subject heading terms used were “questionnaire”, “dental radiology” and “dental radiography”. The reference sections of articles retrieved by this method were hand-searched in order to identify further relevant papers. Reviews, commentaries and relevant studies from the wider literature were also included. Results 53 questionnaire studies were identified in the dental literature that concerned dental radiography and included a report of response rate. These were all published between 1983 and 2010. In total, 87 articles are referred to in this review, including the 53 dental radiology studies. Other cited articles include reviews, commentaries and examples of studies outside dental radiology where they are germane to the arguments presented. Conclusions Non-response is only one of four broad areas of error to which questionnaire surveys are subject. This review considers coverage, sampling and measurement, as well as non-response. Recommendations are made to assist future research that uses questionnaire surveys. PMID:22517994

A Planning Tool for Estimating Waste Generated by a Radiological Incident and Subsequent Decontamination Efforts - 13569

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boe, Timothy; Lemieux, Paul; Schultheisz, Daniel

2013-07-01

Management of debris and waste from a wide-area radiological incident would probably constitute a significant percentage of the total remediation cost and effort. The U.S. Environmental Protection Agency's (EPA's) Waste Estimation Support Tool (WEST) is a unique planning tool for estimating the potential volume and radioactivity levels of waste generated by a radiological incident and subsequent decontamination efforts. The WEST was developed to support planners and decision makers by generating a first-order estimate of the quantity and characteristics of waste resulting from a radiological incident. The tool then allows the user to evaluate the impact of various decontamination/demolition strategies onmore » the waste types and volumes generated. WEST consists of a suite of standalone applications and Esri{sup R} ArcGIS{sup R} scripts for rapidly estimating waste inventories and levels of radioactivity generated from a radiological contamination incident as a function of user-defined decontamination and demolition approaches. WEST accepts Geographic Information System (GIS) shape-files defining contaminated areas and extent of contamination. Building stock information, including square footage, building counts, and building composition estimates are then generated using the Federal Emergency Management Agency's (FEMA's) Hazus{sup R}-MH software. WEST then identifies outdoor surfaces based on the application of pattern recognition to overhead aerial imagery. The results from the GIS calculations are then fed into a Microsoft Excel{sup R} 2007 spreadsheet with a custom graphical user interface where the user can examine the impact of various decontamination/demolition scenarios on the quantity, characteristics, and residual radioactivity of the resulting waste streams. (authors)« less

Thirteenth Annual Warren K. Sinclair Keynote Address: Where Are the Radiation Professionals (WARP)?

PubMed

Toohey, Richard E

2017-02-01

In July 2013, the National Council on Radiation Protection and Measurements convened a workshop for representatives from government, professional organizations, academia, and the private sector to discuss a potential shortage of radiation protection professionals in the not-too-distant future. This shortage manifests itself in declining membership of professional societies, decreasing enrollment in university programs in the radiological sciences, and perhaps most importantly, the imminent retirement of the largest birth cohort in American history, the so-called "baby boomer" generation. Consensus emerged that shortages already are, or soon will be, felt in government agencies (including state radiation control programs); membership in professional societies is declining precipitously; and student enrollments and university support for radiological disciplines are decreasing with no reversals expected. The supply of medical physicists appears to be adequate at least in the near term, although a shortage of available slots in accredited clinical training programs looms large. In general, the private sector appears stable, due in part to retirees joining the consultant ranks. However, it is clear that a severe problem exists with the lack of an adequate surge capacity to respond to a large-scale reactor accident or radiological terrorism attack in the United States. The workshop produced a number of recommendations, including increased funding of both fellowships and research in the radiological sciences, as well as creation of internships, practicums, and post-doctoral positions. A federal joint program support office that would more efficiently manage the careers of radiological professionals in the civil service would enhance recruiting and development, and increase the flexibility of the various agencies to manage their staffing needs.

Classification of visual signs in abdominal CT image figures in biomedical literature

NASA Astrophysics Data System (ADS)

Xue, Zhiyun; You, Daekeun; Antani, Sameer; Long, L. Rodney; Demner-Fushman, Dina; Thoma, George R.

2014-03-01

"Imaging signs" are a critical part of radiology's language. They not only are important for conveying diagnosis, but may also aid in indexing radiology literature and retrieving relevant cases and images. Here we report our work towards representing and categorizing imaging signs of abdominal abnormalities in figures in the radiology literature. Given a region-of-interest (ROI) from a figure, our goal was to assign a correct imaging sign label to that ROI from the following seven: accordion, comb, ring, sandwich, small bowel feces, target, or whirl. As training and test data, we created our own "gold standard" dataset of regions containing imaging signs. We computed 2997 feature attributes to represent imaging sign characteristics for each ROI in training and test sets. Following feature selection they were reduced to 70 attributes and were input to a Support Vector Machine classifier. We applied image-enhancement methods to compensate for variable quality of the images in radiology articles. In particular we developed a method for automatic detection and removal of pointers/markers (arrows, arrowheads, and asterisk symbols) on the images. These pointers/markers are valuable for approximately locating ROIs; however, they degrade the classification because they are often (partially) included in the training ROIs. On a test set of 283 ROIs, our method achieved an overall accuracy of 70% in labeling the seven signs, which we believe is a promising result for using imaging signs to search/retrieve radiology literature. This work is also potentially valuable for the creation of a visual ontology of biomedical imaging entities.

Use of the ICRP system for the protection of marine ecosystems.

PubMed

Telleria, D; Cabianca, T; Proehl, G; Kliaus, V; Brown, J; Bossio, C; Van der Wolf, J; Bonchuk, I; Nilsen, M

2015-06-01

The International Commission on Radiological Protection (ICRP) recently reinforced the international system of radiological protection, initially focused on humans, by identifying principles of environmental protection and proposing a framework for assessing impacts of ionising radiation on non-human species, based on a reference flora and fauna approach. For this purpose, ICRP developed dosimetric models for a set of Reference Animals and Plants, which are representative of flora and fauna in different environments (terrestrial, freshwater, marine), and produced criteria based on information on radiation effects, with the aim of evaluating the level of potential or actual radiological impacts, and as an input for decision making. The approach developed by ICRP for flora and fauna is consistent with the approach used to protect humans. The International Atomic Energy Agency (IAEA) includes considerations on the protection of the environment in its safety standards, and is currently developing guidelines to assess radiological impacts based on the aforementioned ICRP approach. This paper presents the method developed by IAEA, in a series of meetings with international experts, to enable assessment of the radiological impact to the marine environment in connection with the Convention on the Prevention of Marine Pollution by Dumping of Wastes and Other Matter 1972 (London Convention 1972). This method is based on IAEA's safety standards and ICRP's recommendations, and was presented in 2013 for consideration by representatives of the contracting parties of the London Convention 1972; it was approved for inclusion in its procedures, and is in the process of being incorporated into guidelines. © The International Society for Prosthetics and Orthotics Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Radiation Protection Knowledge, Attitude, and Practice (KAP) in Interventional Radiology

PubMed Central

Shabani, Fatemeh; Hasanzadeh, Hadi; Emadi, Alireza; Mirmohammadkhani, Majid; Bitarafan-Rajabi, Ahmad; Abedelahi, Ali; Bokharaeian, Mitra; Masoumi, Hamed; Seifi, Danial; Khani, Tahereh; Sanchooli, Mohamad; Moshfegh, Shima; Ziari, Abbas

2018-01-01

Objectives Due to increasing cardiac disease and its mortality rate, the frequency of cardiac imaging has grown and, as a result, interventional cardiologists potentially receive high radiation doses in cardiac examinations. This study aimed to assess the knowledge, attitude, and practice (KAP) level of radiation protection (RP) among interventional radiology staff in Iranian health care centers across the country. Methods We used a validated questionnaire survey consisting of 30 multiple-choice questions to perform a cross-sectional study. Participants were healthcare personnel working professionally with radiation at different levels (i.e., secretary, radiology technologists, nurse, and physician). The questionnaire was divided into three sections to assess KAP regarding RP. Results Significant differences exist in RP KAP mean scores based on educational age (p < 0.050). There was no significant difference in RP KAP mean scores when looking at sex, practice age, and hospital type (p > 0.050). We found a significant difference between RP KAP mean scores and different regions (p < 0.050). Conclusions Educational and practice age, sex, type of hospital, and geographical region affect he KAP of interventional radiology staff regarding RP. Since many of the subjective radiation harms for both medical team and patients, this can be easily controlled and prevented; a checkup for personnel of interventional radiology departments, considering samples from different parts of the country with different levels of education, continuous training, and practical courses may help map the status of KAP. The results of this study may also help authorized health physics officers design strategic plans to enhance the quality of such services in radiation departments. PMID:29657683

Radiation Protection Knowledge, Attitude, and Practice (KAP) in Interventional Radiology.

PubMed

Shabani, Fatemeh; Hasanzadeh, Hadi; Emadi, Alireza; Mirmohammadkhani, Majid; Bitarafan-Rajabi, Ahmad; Abedelahi, Ali; Bokharaeian, Mitra; Masoumi, Hamed; Seifi, Danial; Khani, Tahereh; Sanchooli, Mohamad; Moshfegh, Shima; Ziari, Abbas

2018-03-01

Due to increasing cardiac disease and its mortality rate, the frequency of cardiac imaging has grown and, as a result, interventional cardiologists potentially receive high radiation doses in cardiac examinations. This study aimed to assess the knowledge, attitude, and practice (KAP) level of radiation protection (RP) among interventional radiology staff in Iranian health care centers across the country. We used a validated questionnaire survey consisting of 30 multiple-choice questions to perform a cross-sectional study. Participants were healthcare personnel working professionally with radiation at different levels (i.e., secretary, radiology technologists, nurse, and physician). The questionnaire was divided into three sections to assess KAP regarding RP. Significant differences exist in RP KAP mean scores based on educational age (p < 0.050). There was no significant difference in RP KAP mean scores when looking at sex, practice age, and hospital type (p > 0.050). We found a significant difference between RP KAP mean scores and different regions (p < 0.050). Educational and practice age, sex, type of hospital, and geographical region affect he KAP of interventional radiology staff regarding RP. Since many of the subjective radiation harms for both medical team and patients, this can be easily controlled and prevented; a checkup for personnel of interventional radiology departments, considering samples from different parts of the country with different levels of education, continuous training, and practical courses may help map the status of KAP. The results of this study may also help authorized health physics officers design strategic plans to enhance the quality of such services in radiation departments.

Digital video applications in radiologic education: theory, technique, and applications.

PubMed

Hennessey, J G; Fishman, E K; Ney, D R

1994-05-01

Computer-assisted instruction (CAI) has great potential in medical education. The recent explosion of multimedia platforms provides an environment for the seemless integration of text, images, and sound into a single program. This article discusses the role of digital video in the current educational environment as well as its future potential. An indepth review of the technical decisions of this new technology is also presented.

Financial ratios in diagnostic radiology practices: variability and trends.

PubMed

Hogan, Christopher; Sunshine, Jonathan H

2004-03-01

To evaluate variation in financial ratios for radiology practices nationwide and trends in these ratios and in payments. In 1999, the American College of Radiology surveyed radiology practices by mail. The final response rate was 66%. Weighting was used to make responses representative of all radiology practices in the United States. Self-reported financial ratios (payments, charges, accounts receivable turnover) were analyzed; 449 responses had usable data on these ratios. Comparison with results of a similar 1992 survey and combined analysis with Medicare data on billed charges provided information on trends. All measures of payment collections declined sharply from 1992 to 1999, with the gross collections rate (revenues as percentage of billed charges) decreasing from 71% to 55%. Average payment for a typical radiology service decreased approximately 4% in dollar terms or approximately 19% in inflation-adjusted terms. In 1999, nonmetropolitan practices appeared to fare better than others. Among insurers, Medicaid stood out as a low and slow payer, but neither managed care nor Medicare had a consistent effect on financial ratios. The gross collections rate varied substantially across geographic areas, as did, in an inverse pattern, the level of billed charges. One-quarter of practices had accounts receivable equal to 90 or more days of billings. The opposing geographic pattern of billed charges and gross collection rate suggests that geographic variation in the latter is driven more by variation in billed charges than by variation in payment levels. Radiologists saw a substantial decrease in the real (inflation-adjusted) value of payment per service during the 1990s. The large fraction of practices with accounts receivable of 90 or more days of billings-a level considered potentially imprudent by financial management advisors-suggests that many practices should improve financial management and that state prompt-payment laws have not had a substantial positive effect. Copyright RSNA, 2004

The RADCAT-3 system for closing the loop on important non-urgent radiology findings: a multidisciplinary system-wide approach.

PubMed

Dibble, Elizabeth H; Swenson, David W; Cobb, Cynthia; Paul, Timothy J; Karn, Andrew E; Portelli, David C; Movson, Jonathan S

2017-04-01

The goal of this project was to create a system that was easy for radiologists to use and that could reliably identify, communicate, and track communication of important but non-urgent radiology findings to providers and patients. Prior to 2012, our workflow for communicating important non-urgent diagnostic imaging results was cumbersome, rarely used by our radiologists, and resulted in delays in report turnaround time. In 2012, we developed a new system to communicate important non-urgent findings (the RADiology CATegorization 3 (RADCAT-3) system) that was easy for radiologists to use and documented communication of results in the electronic medical record. To evaluate the performance of the new system, we reviewed our radiology reports before (June 2011-June 2012) and after (June 2012-June 2014) the implementation of the new system to compare utilization by the radiologists and success in communicating these findings. During the 12 months prior to implementation, 250 radiology reports (0.06 % of all reports) entered our workflow for communicating important non-urgent findings. One-hundred percent were successfully communicated. During the 24 months after implementation, 13,158 radiology reports (1.4 % of all reports) entered our new RADCAT-3 workflow (3995 (0.8 % of all reports) during year 1 and 9163 (1.9 % of all reports) during year 2). 99.7 % of those reports were successfully communicated. We created a reliable system to ensure communication of important but non-urgent findings with providers and/or patients and to document that communication in the electronic medical record. The rapid adoption of the new system by radiologists suggests that they found it easy to use and had confidence in its integrity. This system has the potential to improve patient care by improving the likelihood of appropriate follow-up for important non-urgent findings that could become life threatening.

Teaching Primary Health Care: An Interdisciplinary Approach.

ERIC Educational Resources Information Center

Bezzina, Paul; Keogh, Johann J.; Keogh, Mariana

1998-01-01

Nursing and radiology students (n=15) at the University of Malta who completed an interdisciplinary module on primary health care reported they found the theoretical material applicable to practice; the module enabled them to learn about their potential role in primary health care. (SK)

Anatomy of an incident

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cournoyer, Michael E.; Trujillo, Stanley; Lawton, Cindy M.

A traditional view of incidents is that they are caused by shortcomings in human competence, attention, or attitude. It may be under the label of “loss of situational awareness,” procedure “violation,” or “poor” management. A different view is that human error is not the cause of failure, but a symptom of failure – trouble deeper inside the system. In this perspective, human error is not the conclusion, but rather the starting point of investigations. During an investigation, three types of information are gathered: physical, documentary, and human (recall/experience). Through the causal analysis process, apparent cause or apparent causes are identifiedmore » as the most probable cause or causes of an incident or condition that management has the control to fix and for which effective recommendations for corrective actions can be generated. A causal analysis identifies relevant human performance factors. In the following presentation, the anatomy of a radiological incident is discussed, and one case study is presented. We analyzed the contributing factors that caused a radiological incident. When underlying conditions, decisions, actions, and inactions that contribute to the incident are identified. This includes weaknesses that may warrant improvements that tolerate error. Measures that reduce consequences or likelihood of recurrence are discussed.« less

Anatomy of an incident

DOE PAGES

Cournoyer, Michael E.; Trujillo, Stanley; Lawton, Cindy M.; ...

2016-03-23

A traditional view of incidents is that they are caused by shortcomings in human competence, attention, or attitude. It may be under the label of “loss of situational awareness,” procedure “violation,” or “poor” management. A different view is that human error is not the cause of failure, but a symptom of failure – trouble deeper inside the system. In this perspective, human error is not the conclusion, but rather the starting point of investigations. During an investigation, three types of information are gathered: physical, documentary, and human (recall/experience). Through the causal analysis process, apparent cause or apparent causes are identifiedmore » as the most probable cause or causes of an incident or condition that management has the control to fix and for which effective recommendations for corrective actions can be generated. A causal analysis identifies relevant human performance factors. In the following presentation, the anatomy of a radiological incident is discussed, and one case study is presented. We analyzed the contributing factors that caused a radiological incident. When underlying conditions, decisions, actions, and inactions that contribute to the incident are identified. This includes weaknesses that may warrant improvements that tolerate error. Measures that reduce consequences or likelihood of recurrence are discussed.« less

Biomarker Development for Intraductal Papillary Mucinous Neoplasms Using Multiple Reaction Monitoring Mass Spectrometry.

PubMed

Kim, Yikwon; Kang, MeeJoo; Han, Dohyun; Kim, Hyunsoo; Lee, KyoungBun; Kim, Sun-Whe; Kim, Yongkang; Park, Taesung; Jang, Jin-Young; Kim, Youngsoo

2016-01-04

Intraductal papillary mucinous neoplasm (IPMN) is a common precursor of pancreatic cancer (PC). Much clinical attention has been directed toward IPMNs due to the increase in the prevalence of PC. The diagnosis of IPMN depends primarily on a radiological examination, but the diagnostic accuracy of this tool is not satisfactory, necessitating the development of accurate diagnostic biomarkers for IPMN to prevent PC. Recently, high-throughput targeted proteomic quantification methods have accelerated the discovery of biomarkers, rendering them powerful platforms for the evolution of IPMN diagnostic biomarkers. In this study, a robust multiple reaction monitoring (MRM) pipeline was applied to discovery and verify IPMN biomarker candidates in a large cohort of plasma samples. Through highly reproducible MRM assays and a stringent statistical analysis, 11 proteins were selected as IPMN marker candidates with high confidence in 184 plasma samples, comprising a training (n = 84) and test set (n = 100). To improve the discriminatory power, we constructed a six-protein panel by combining marker candidates. The multimarker panel had high discriminatory power in distinguishing between IPMN and controls, including other benign diseases. Consequently, the diagnostic accuracy of IPMN can be improved dramatically with this novel plasma-based panel in combination with a radiological examination.

Who owns the image? Archiving and retention issues in the digital age.

PubMed

Mezrich, Jonathan L; Siegel, Eliot

2014-04-01

Patients are often confused with respect to the ownership of radiologic images and the extent to which they may exert rights over their own imaging. In general, a facility that generates imaging maintains "ownership" rights. Patients have a right to inspect their images and obtain copies but they may not have the images or reports modified or stricken. Facilities may use images not only for treatment purposes but also have rights to use images with respect to educational training, quality control, and research, subject to HIPAA requirements. A facility has statutory obligations with respect to record retention and may face financial penalty and malpractice consequences for failure to retain images. Bankruptcy and state laws address issues of transfer of ownership of a patient's images in cases in which a facility goes out of business. Future questions remain as to whether the length of time a facility maintains images should increase as digital storage media improve and whether the use of inter-facility image sharing via "cloud" technology should alter obligations with respect to which facility must retain the images. Copyright © 2014 American College of Radiology. All rights reserved.

[Neuromuscular deficits in chronic ankle instability. Frequency and significance - multicenter study].

PubMed

Schmidt, R; Becker, H P; Rauhut, F; Tannheimer, M

2014-08-01

The peroneal reaction time (PRT) is used in the assessment of neuromuscular deficits in chronic functional ankle instability. Powered by the Editorial Manager and Preprint Manager from Aries Systems Corporation the present study was conducted to determine the PRT in a large collective of patients with chronic ankle instability because it is unclear if this parameter of neuromuscular deficit is prolonged. In this study 186 patients underwent a diagnostic algorithm consisting of anamnesis, clinical examination, X-ray and determination of the PRT on a tilting platform. A prolonged PRT as a manifestation of a neuromuscular deficit could be detected in the majority of the patients (n = 143, 77%). Comparing the affected and healthy legs 77 patients (41%) showed a significant difference in talar shift (p = 0.002) and talar tilt (p = 0.04) in the radiological stress views. Of these 77 patients only 15 (8%) showed radiological evidence of a mechanical problem. As a consequence of recurring ankle sprains a post-traumatic deficit in proprioception has to be expected in most cases. In general a conservative therapy approach should be followed including specific training to improve neuromuscular and proprioceptive deficits.

Stratification of risk to the surgical team in removal of small arms ammunition implanted in the craniofacial region: case report.

PubMed

Forbes, Jonathan A; Laughlin, Ian; Newberry, Shane; Ryhn, Michael; Pasley, Jason; Newberry, Travis

2016-09-01

In cases of penetrating injury with implantation of small arms ammunition, it can often be difficult to tell the difference between simple ballistics and ballistics associated with unexploded ordnances (UXOs). In the operative environment, where highly flammable substances are often close to the surgical site, detonation of UXOs could have catastrophic consequences for both the patient and surgical team. There is a paucity of information in the literature regarding how to evaluate whether an implanted munition contains explosive material. This report describes a patient who presented during Operation Enduring Freedom with an implanted munition suspicious for a UXO and the subsequent workup organized by Explosive Ordnance Disposal (EOD) Company prior to surgical removal. Clinical risk factors for UXOs include assassination attempts and/or wartime settings. Specific radiological features suggestive of a UXO include projectile size greater than 7.62-mm caliber, alterations in density of the tip, as well as radiological evidence of a hollowed-out core. If an implanted UXO is suspected, risks to the surgical and anesthesia teams can be minimized by notifying the nearest military installation with EOD capabilities and following clinical practice guidelines set forth by the Joint Theater Trauma System.

Farewell TID-14844; hello SECY-92-127

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lahti, G.P.; Johnson, W.J.

This year, 1992, marks the 50th anniversary of the first sustained nuclear reaction in the pile at the University of Chicago's Stagg Field. But it also marks the 30th anniversary of the publication of TID-14844, which has served as the design-basis source term for radiological assessments supporting the licensing of nuclear power plants in the United States since its inception. The conservative TID-14844 model assumes that 100% of the noble gases and 50% of the iodines are instantaneously released to the containment and are available for leakage to the environment. TID-14844 is formally embodied in the US Nuclear Regulatory Commission'smore » (NRC's) regulations in parts 10CFR100 (siting) and 10CFR50 (review of control room habitability, postaccident shielding and sampling systems). It is also embodied in a host of NRC Regulatory Guides and NUREG reports that address off-site consequences of releases of radioactivity, equipment qualification, and other postaccident radiological concerns. On April 20, 1992, the NRC staff presented to the NRC commissioners the draft Revised Accident Source Terms for Light-Water Nuclear Power Plants.' This effort is documented in SECY-92-127 and provides the first official position of the NRC in this matter.« less

Population dose near the Semipalatinsk test site.

PubMed

Hille, R; Hill, P; Bouisset, P; Calmet, D; Kluson, J; Seisebaev, A; Smagulov, S

1998-10-01

To determine the consequences of atmospheric atomic bomb tests for the population in the surroundings of the former nuclear weapons test site near Semipalatinsk in Kazakhstan, a pilot study was performed by an international cooperation between Kazakh, French, Czech and German institutions at two villages, Mostik and Maisk. Together with Kazakh scientists, eight experts from Europe carried out a field mission in September 1995 to assess, within the framework of a NATO supported project, the radiological situation as far as external doses, environmental contamination and body burden of man were concerned. A summary of the results obtained is presented. The actual radiological situation near the test site is characterized by fallout contaminations. Cs was found in upper soil layers in concentrations similar to those of the global fallout. Also Sr, Am and Co were observed. The resulting present dose to the population is low. Mean external doses from soil contamination for Maisk and Mostik (0.60-0.63 mSv/year) presently correspond to mean external doses in normal environments. Mean values of the annual internal doses observed in these two villages are below 2 microSv/year for 90Sr. For other radionuclides the internal doses are also negligible.

Transportation of radionuclides in urban environs: draft environmental assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Finley, N.C.; Aldrich, D.C.; Daniel, S.L.

1980-07-01

This report assesses the environmental consequences of the transportation of radioactive materials in densely populated urban areas, including estimates of the radiological, nonradiological, and social impacts arising from this process. The chapters of the report and the appendices which follow detail the methodology and results for each of four causative event categories: incident free transport, vehicular accidents, human errors or deviations from accepted quality assurance practices, and sabotage or malevolent acts. The numerical results are expressed in terms of the expected radiological and economic impacts from each. Following these discussions, alternatives to the current transport practice are considered. Then, themore » detailed analysis is extended from a limited area of New York city to other urban areas. The appendices contain the data bases and specific models used to evaluate these impacts, as well as discussions of chemical toxicity and the social impacts of radioactive material transport in urban areas. The latter are evaluated for each causative event category in terms of psychological, sociological, political, legal, and organizational impacts. The report is followed by an extensive bibliography covering the many fields of study which were required in performing the analysis.« less

[Total hip replacement with isoelastic prosthesis in animals (author's transl)].

PubMed

Muhr, O; Stockhusen, H; Müller, O

1976-10-08

Uncemented fixation and low-fraction materials are the basis of this experiment. Plastics with an elasticity similar to the bone ("isoelasticity") show very propitious material qualities. The direct cementless incorporation of test bodies must be checked. In 63 sheep isoelastic total hip joints were implanted. After 2 till 51 weeks the animals were sacrificed and 44 specimen of hips and organs were explored macroscopically, radiologically, spherimetrically and histologically. The result was: 1. Plastic hip prosthesis are incorporated in the bone, but the boundary layer is built by a collagenous fiber tissue. 2. Loosening brings resoption of the bone and expansion of the structural changed soft tissue. 3. The transformation of the femoral cortex to osteoporosis is considered possibly as the consequence of an insufficient biological transfer of the weight. 4. Fractures of the femoral prosthesis-stem could not be observed. 5. The radiology allows at the pelvis prosthesis a concret statement concerning stability, on the femoral part a probable one. 6. The abrasion is minimal, the tissue reaction to abrasion products is unessential. 7. Small abrasion particles are carried of by the lymph tract and stored in the first regional gland. A more distant spreading is not demonstrable.

Transverse maxillary distraction with a bone-anchored appliance: dento-periodontal effects and clinical and radiological results.

PubMed

Ramieri, G A; Spada, M C; Austa, M; Bianchi, S D; Berrone, S

2005-06-01

In 29 adult patients presenting with maxillary deficiency, a bone-anchored palatal distractor (Surgi-Tec NV, Brugge, Belgium) was applied after osteotomy of the anterolateral walls of the maxillary sinuses, midpalatal suture, and, eventually, separation of the pterygomaxillary sutures. Expansion proceeded at a rate of 0.33-0.66 mm per day and the device was retained for 4-6 months for consolidation. Active orthodontic therapy was started after 8-10 weeks. The increment of arch width and the perimeter were evaluated using dental casts. Tooth thermal sensitivity and the periodontal side effects of treatment were monitored clinically after distraction, at device removal, and after 1 year. Bone healing was also investigated during the procedure using conventional radiological techniques. This experience confirms that transverse maxillary distraction is an effective technique in adult patients, leading to the formation of new bone. There were no noticeable intraoperative complications, but postsurgical periodontal side effects were documented. The procedure offers advantages over traditional teeth-borne appliances in terms of rapidity of treatment and the absence of mechanical forces acting on the teeth. Further evaluation is required to assess the long-term stability and periodontal consequences of this technique.

Thermoluminescence characteristics of Israeli household salts for retrospective dosimetry in radiological events

NASA Astrophysics Data System (ADS)

Druzhyna, S.; Datz, H.; Horowitz, Y. S.; Oster, L.; Orion, I.

2016-06-01

Following a nuclear accident or terror attack involving the dispersal of radioactive substances, radiation dose assessment to first responders and the members of the public is essential. The need for a retrospective assessment of the radiation dose to those possibly affected is, therefore, obligatory. The present study examines the potential use of Israeli household salt as a retrospective dosimeter (RD). The experiments were carried out on Israeli salt samples (NaCl) following a Nielsen market track survey based on scanning data representing the barcoded market, including organized and independent retail chains and a sample of private minimarkets and supermarkets. The technique used was thermoluminescence (TL) dosimetry. Salt samples were exposed to levels of dose from 0.5 mGy to 300 Gy at the Israeli Secondary Standard Dosimetry Laboratory of the Soreq Nuclear Research Center using a calibrated 137Cs source. Our emphasis has been on a detailed investigation of the basic dosimetric characteristics of the salts including: (i) glow curve analysis (ii) individual glow peak dose response (iii) reproducibility (iv) estimation of minimal measurable dose (v) effect of nitrogen readout, (vi) influence of humidity during pre-irradiation storage and (vii) light induced fading. The results are sufficiently favorable to lead to the conclusion that the Israeli household salts can serve as a pragmatic potential candidate for RD under certain restricted conditions. Occasional pre-calibration of the major salt brands in a dedicated laboratory may be essential depending on the required accuracy in the estimation of dose and consequent clinical evaluation.

Metabolomic applications in radiation biodosimetry: exploring radiation effects through small molecules.

PubMed

Pannkuk, Evan L; Fornace, Albert J; Laiakis, Evagelia C

2017-10-01

Exposure of the general population to ionizing radiation has increased in the past decades, primarily due to long distance travel and medical procedures. On the other hand, accidental exposures, nuclear accidents, and elevated threats of terrorism with the potential detonation of a radiological dispersal device or improvised nuclear device in a major city, all have led to increased needs for rapid biodosimetry and assessment of exposure to different radiation qualities and scenarios. Metabolomics, the qualitative and quantitative assessment of small molecules in a given biological specimen, has emerged as a promising technology to allow for rapid determination of an individual's exposure level and metabolic phenotype. Advancements in mass spectrometry techniques have led to untargeted (discovery phase, global assessment) and targeted (quantitative phase) methods not only to identify biomarkers of radiation exposure, but also to assess general perturbations of metabolism with potential long-term consequences, such as cancer, cardiovascular, and pulmonary disease. Metabolomics of radiation exposure has provided a highly informative snapshot of metabolic dysregulation. Biomarkers in easily accessible biofluids and biospecimens (urine, blood, saliva, sebum, fecal material) from mouse, rat, and minipig models, to non-human primates and humans have provided the basis for determination of a radiation signature to assess the need for medical intervention. Here we provide a comprehensive description of the current status of radiation metabolomic studies for the purpose of rapid high-throughput radiation biodosimetry in easily accessible biofluids and discuss future directions of radiation metabolomics research.

Department of Homeland Security national planning scenarios: a spectrum of imaging findings to educate the radiologists.

PubMed

Burch, Heather; Kitley, Charles A; Naeem, Mohammed

2010-07-01

Following the events of the September 11th attack, there has been an increasing concern about the possibility of a future attack on our homeland. In response, the United States Department of Homeland Defense has planned for a future attack by formulating multiple scenarios which may occur in the event of such a disaster. Radiology will play a key role in each of these scenarios, assisting with triage, diagnosis, and therapy of the large populations which potentially could be involved. This article describes some of these scenarios as well the response which will be expected of the radiology community in the event of such a disaster.

Pre-reading mammograms by specialised breast technologists: legal implications for technologist and radiologist in The Netherlands.

PubMed

van den Biggelaar, F J H M; Flobbe, K; van Engelshoven, J M A; de Bijl, N P Y M

2009-09-01

This paper focuses on the legal implications in terms of duties and responsibilities for radiologists and radiologic technologists of independent pre-reading of mammograms by radiologic technologists, so patients could be discharged without being seen by a radiologist. Pre-reading could be effectuated when preconditions are met to perform reserved procedures by unauthorised professionals as stated in the Individual Health Care Professions (IHCP) Act. Furthermore, compliance with a protocol or code of conduct in combination with adequate training and supervision should be sufficient to disprove potential claims. For a wide implementation, pre-reading should be well-embedded in legal rules and should answer the professional standard of care.

[The balanced scorecard--applications in a radiology department].

PubMed

Maurer, M H; Teichgräber, U; Kröncke, T J; Hamm, B; Lemke, A J

2012-12-01

The balanced scorecard (BSC) represents a comprehensive management tool for organizations with the aim to focus all activities on a chosen strategy. Targets for various perspectives of the environment such as the customer, financial, process, and potential perspective are linked with concrete measures, and cause-effect relationships between the objectives are analyzed. This article shows that the BSC can also be used for the comprehensive control of a radiology department and thus provides a meaningful contribution in organizing the various diagnostic and treatment services, the management of complex clinical environment and can be of help with the tasks in research and teaching. © Georg Thieme Verlag KG Stuttgart · New York.

Instagram as a Vehicle for Education: What Radiology Educators Need to Know.

PubMed

Shafer, Serena; Johnson, Michael B; Thomas, Rachel B; Johnson, Pamela T; Fishman, Elliot K

2018-06-01

Since its inception in 2010, Instagram has rapidly grown into one of the world's largest social media forums, with over 700 million registered users. In the field of medicine, Instagram has been used for professional development and is also being added to the armamentarium of social media vehicles for education. Utilization of Instagram for medical education lags behind Facebook and Twitter, as many educators may not recognize the potential role. The purpose of this manuscript is to describe unique features of Instagram that are not found on Facebook and Twitter, with the aim of facilitating use of Instagram for radiology education. Copyright © 2018. Published by Elsevier Inc.

Should radiology IT be owned by the chief information officer?

PubMed

Channin, David S; Bowers, George; Nagy, Paul

2009-06-01

Considerable debate within the medical community has focused on the optimal location of information technology (IT) support groups on the organizational chart. The challenge has been to marry local accountability and physician acceptance of IT with the benefits gained by the economies of scale achieved by centralized knowledge and system best practices. In the picture archiving and communication systems (PACS) industry, a slight shift has recently occurred toward centralized control. Radiology departments, however, have begun to realize that no physicians in any other discipline are as dependent on IT as radiologists are on their PACS. The potential strengths and weaknesses of centralized control of the PACS is the topic of discussion for this month's Point/Counterpoint.

Multiple magnet ingestion: is there a role for early surgical intervention?

PubMed

Salimi, Amrollah; Kooraki, Soheil; Esfahani, Shadi Abdar; Mehdizadeh, Mehrzad

2012-01-01

Children often swallow foreign bodies. Multiple magnet ingestion is rare, but can result in serious complications. This study presents three unique cases of multiple magnet ingestion: one case an 8-year-old boy with multiple magnet ingestion resulting in gastric obstruction and the other two cases with intestinal perforations due to multiple magnet intake. History and physical examination are unreliable in children who swallow multiple magnets. Sometimes radiological findings are not conclusive, whether one magnet is swallowed or more. If magnets are not moved in sequential radiology images, we recommend early surgical intervention before gastrointestinal complications develop. Toy companies, parents, physicians, and radiologists should be warned about the potential complications of such toys.

Proceedings of the 21st DOE/NRC Nuclear Air Cleaning Conference; Sessions 1--8

DOE Office of Scientific and Technical Information (OSTI.GOV)

First, M.W.

1991-02-01

Separate abstracts have been prepared for the papers presented at the meeting on nuclear facility air cleaning technology in the following specific areas of interest: air cleaning technologies for the management and disposal of radioactive wastes; Canadian waste management program; radiological health effects models for nuclear power plant accident consequence analysis; filter testing; US standard codes on nuclear air and gas treatment; European community nuclear codes and standards; chemical processing off-gas cleaning; incineration and vitrification; adsorbents; nuclear codes and standards; mathematical modeling techniques; filter technology; safety; containment system venting; and nuclear air cleaning programs around the world. (MB)

Imaging and Diagnosis of Physical Child Abuse.

PubMed

Johnson, Marlene M

2017-09-01

Child abuse involves grave and disturbing acts of violence that can have lasting physical and emotional consequences for children and their families. The diagnosis of child abuse is emotionally difficult for those involved, and an error in judgment either way can have a detrimental effect on the health and safety of the child. Physicians rely on the skills of the imaging team to produce high-quality images that assist in differentiating inflicted injuries from accidental trauma. This article explores the significance of imaging in child abuse by discussing the types of injuries that occur and the imaging studies that aid in diagnosing physical child abuse. ©2017 American Society of Radiologic Technologists.

Requirements for estimation of doses from contaminants dispersed by a 'dirty bomb' explosion in an urban area.

PubMed

Andersson, K G; Mikkelsen, T; Astrup, P; Thykier-Nielsen, S; Jacobsen, L H; Hoe, S C; Nielsen, S P

2009-12-01

The ARGOS decision support system is currently being extended to enable estimation of the consequences of terror attacks involving chemical, biological, nuclear and radiological substances. This paper presents elements of the framework that will be applied in ARGOS to calculate the dose contributions from contaminants dispersed in the atmosphere after a 'dirty bomb' explosion. Conceptual methodologies are presented which describe the various dose components on the basis of knowledge of time-integrated contaminant air concentrations. Also the aerosolisation and atmospheric dispersion in a city of different types of conceivable contaminants from a 'dirty bomb' are discussed.

Filgrastim for the treatment of hematopoietic acute radiation syndrome.

PubMed

Farese, A M; MacVittie, T J

2015-09-01

The U.S. Food and Drug Administration (FDA) recently approved Neupogen(®) (filgrastim) for the treatment of patients with radiation-induced myelosuppression following a radiological/nuclear incident. It is the first medical countermeasure currently approved by the FDA for this indication under the criteria of the FDA "animal rule". This article summarizes the consequences of high-dose radiation exposure, a description of the hematopoietic acute radiation syndrome (H-ARS), the use of hematopoietic growth factors in radiation accident victims and current available treatments for H-ARS with an emphasis on the use of Neupogen in this scenario. Copyright 2015 Prous Science, S.A.U. or its licensors. All rights reserved.

Imaging and radiology

MedlinePlus

Interventional radiology; Diagnostic radiology; X-ray imaging ... DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care professionals see structures inside your body. Doctors that specialize in the interpretation ...

Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report.

PubMed

Blumfield, Einat; Moore, Michael M; Drake, Mary K; Goodman, Thomas R; Lewis, Kristopher N; Meyer, Laura T; Ngo, Thang D; Sammet, Christina; Stanescu, Arta Luana; Swenson, David W; Slovis, Thomas L; Iyer, Ramesh S

2017-05-01

Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children. For this reason, the Society (SPR) for Pediatric Radiology Quality and Safety committee conducted a survey to evaluate the current status of GBCAs usage among pediatric radiologists. To assess the usage of GBCAs among SPR members. An online 15-question survey was distributed to SPR members. Survey questions pertained to the type of GBCAs used, protocoling workflow, requirement of renal function or pregnancy tests, and various clinical indications for contrast-enhanced MRI examinations. A total of 163 survey responses were compiled (11.1% of survey invitations), the majority of these from academic institutions in the United States. Ninety-four percent reported that MR studies are always or usually protocoled by pediatric radiologists. The most common GBCA utilized by survey respondents were Eovist (60.7%), Ablavar (45.4%), Gadovist (38.7%), Magnevist (34.4%) and Dotarem (32.5%). For several clinical indications, survey responses regarding GBCA administration were concordant with American College of Radiology (ACR) Appropriateness Criteria, including seizures, headache and osteomyelitis. For other indications, including growth hormone deficiency and suspected vascular ring, survey responses revealed potential overutilization of GBCAs when compared to ACR recommendations. Survey results demonstrate that GBCAs are administered judiciously in children, yet there is an opportunity to improve their utilization with the goal of reducing potential future adverse effects.

Predicted cancer risks induced by computed tomography examinations during childhood, by a quantitative risk assessment approach.

PubMed

Journy, Neige; Ancelet, Sophie; Rehel, Jean-Luc; Mezzarobba, Myriam; Aubert, Bernard; Laurier, Dominique; Bernier, Marie-Odile

2014-03-01

The potential adverse effects associated with exposure to ionizing radiation from computed tomography (CT) in pediatrics must be characterized in relation to their expected clinical benefits. Additional epidemiological data are, however, still awaited for providing a lifelong overview of potential cancer risks. This paper gives predictions of potential lifetime risks of cancer incidence that would be induced by CT examinations during childhood in French routine practices in pediatrics. Organ doses were estimated from standard radiological protocols in 15 hospitals. Excess risks of leukemia, brain/central nervous system, breast and thyroid cancers were predicted from dose-response models estimated in the Japanese atomic bomb survivors' dataset and studies of medical exposures. Uncertainty in predictions was quantified using Monte Carlo simulations. This approach predicts that 100,000 skull/brain scans in 5-year-old children would result in eight (90 % uncertainty interval (UI) 1-55) brain/CNS cancers and four (90 % UI 1-14) cases of leukemia and that 100,000 chest scans would lead to 31 (90 % UI 9-101) thyroid cancers, 55 (90 % UI 20-158) breast cancers, and one (90 % UI <0.1-4) leukemia case (all in excess of risks without exposure). Compared to background risks, radiation-induced risks would be low for individuals throughout life, but relative risks would be highest in the first decades of life. Heterogeneity in the radiological protocols across the hospitals implies that 5-10 % of CT examinations would be related to risks 1.4-3.6 times higher than those for the median doses. Overall excess relative risks in exposed populations would be 1-10 % depending on the site of cancer and the duration of follow-up. The results emphasize the potential risks of cancer specifically from standard CT examinations in pediatrics and underline the necessity of optimization of radiological protocols.

500 E Illinois St, June 2013, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

In the immediatevicinity of the area of the potential contamination the surface gamma readings were 8,400 to 9,500 cpm.The unshielded Ludlum threshold value equivalent to the USEPA cleanup value of 7.1 pCi/g total radiumwas 17,920 cpm.

18 CFR 12.22 - Contents of emergency action plan.

Code of Federal Regulations, 2012 CFR

2012-04-01

... action plan. 12.22 Section 12.22 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... plans for notifying potentially affected persons, appropriate Federal, state, and local agencies... nuclear power plants—1) Radiological response plan. If the personnel operating any powerhouse or any...

18 CFR 12.22 - Contents of emergency action plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... action plan. 12.22 Section 12.22 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... plans for notifying potentially affected persons, appropriate Federal, state, and local agencies... nuclear power plants—1) Radiological response plan. If the personnel operating any powerhouse or any...

18 CFR 12.22 - Contents of emergency action plan.

Code of Federal Regulations, 2014 CFR

2014-04-01

... action plan. 12.22 Section 12.22 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... plans for notifying potentially affected persons, appropriate Federal, state, and local agencies... nuclear power plants—1) Radiological response plan. If the personnel operating any powerhouse or any...

18 CFR 12.22 - Contents of emergency action plan.

Code of Federal Regulations, 2013 CFR

2013-04-01

... action plan. 12.22 Section 12.22 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY... plans for notifying potentially affected persons, appropriate Federal, state, and local agencies... nuclear power plants—1) Radiological response plan. If the personnel operating any powerhouse or any...

76 FR 42074 - Consideration of Rulemaking To Address Prompt Remediation of Residual Radioactivity During...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

... Address Prompt Remediation of Residual Radioactivity During Operations AGENCY: Nuclear Regulatory... States, and other stakeholders on a potential rulemaking to address prompt remediation of residual... DPR does not have a mandatory requirement for licensees to conduct radiological remediation during...

Understanding patient satisfaction ratings for radiology services.

PubMed

Lang, Elvira V; Yuh, William T C; Ajam, Amna; Kelly, Ronda; Macadam, Luke; Potts, Richard; Mayr, Nina A

2013-12-01

Under the Hospital Value-Based Purchasing Program of the Centers for Medicare & Medicaid Services, patient satisfaction accounts for 30% of the measures of and payments for quality of care. Understanding what drives patient satisfaction data and how the data are obtained, converted into scores, and formulated into rankings is increasingly critical for imaging departments. The objectives of this article are to describe the potential impact of patient satisfaction ratings on institutions and individuals, explain how patient satisfaction is rated and ranked, identify drivers that affect the ratings and rankings, and probe the resulting challenges unique to radiology departments. Research results indicate that training providers to make simple modifications in their language and behavior during patient care can significantly impact patient satisfaction, which, in turn, can impact both quality-of-care ratings and the bottom line of hospitals. Training providers is a simple and cost-effective way to potentiate the clinical expression of compassion into improvement of patient satisfaction and financial reward, a national trend that no one in the game can afford to ignore.

Lateral epicondylitis and beyond: imaging of lateral elbow pain with clinical-radiologic correlation.

PubMed

Kotnis, Nikhil A; Chiavaras, Mary M; Harish, Srinivasan

2012-04-01

The diagnosis of lateral epicondylitis is often straightforward and can be made on the basis of clinical findings. However, radiological assessment is valuable where the clinical picture is less clear or where symptoms are refractory to treatment. Demographics, aspects of clinical history, or certain physical signs may suggest an alternate diagnosis. Knowledge of the typical clinical presentation and imaging findings of lateral epicondylitis, in addition to other potential causes of lateral elbow pain, is necessary. These include entrapment of the posterior interosseous and lateral antebrachial cutaneous nerves, posterolateral rotatory instability, posterolateral plica syndrome, Panner's disease, osteochondritis dissecans of the capitellum, radiocapitellar overload syndrome, occult fractures and chondral-osseous impaction injuries, and radiocapitellar arthritis. Knowledge of these potential masquerades of lateral epicondylitis and their characteristic clinical and imaging features is essential for accurate diagnosis. The goal of this review is to provide an approach to the imaging of lateral elbow pain, discussing the relevant anatomy, various causes, and discriminating factors, which will allow for an accurate diagnosis.

Image degradation by glare in radiologic display devices

NASA Astrophysics Data System (ADS)

Badano, Aldo; Flynn, Michael J.

1997-05-01

No electronic devices are currently available that can display digital radiographs without loss of visual information compared to traditional transilluminated film. Light scattering within the glass faceplate of cathode-ray tube (CRT) devices causes excessive glare that reduces image contrast. This glare, along with ambient light reflection, has been recognized as a significant limitation for radiologic applications. Efforts to control the effect of glare and ambient light reflection in CRTs include the use of absorptive glass and thin film coatings. In the near future, flat panel displays (FPD) with thin emissive structures should provide very low glare, high performance devices. We have used an optical Monte Carlo simulation to evaluate the effect of glare on image quality for typical CRT and flat panel display devices. The trade-off between display brightness and image contrast is described. For CRT systems, achieving good glare ratio requires a reduction of brightness to 30-40 percent of the maximum potential brightness. For FPD systems, similar glare performance can be achieved while maintaining 80 percent of the maximum potential brightness.

An Updated Comprehensive Risk Analysis for Radioisotopes Identified of High Risk to National Security in the Event of a Radiological Dispersion Device Scenario

NASA Astrophysics Data System (ADS)

Robinson, Alexandra R.

An updated global survey of radioisotope production and distribution was completed and subjected to a revised "down-selection methodology" to determine those radioisotopes that should be classified as potential national security risks based on availability and key physical characteristics that could be exploited in a hypothetical radiological dispersion device. The potential at-risk radioisotopes then were used in a modeling software suite known as Turbo FRMAC, developed by Sandia National Laboratories, to characterize plausible contamination maps known as Protective Action Guideline Zone Maps. This software also was used to calculate the whole body dose equivalent for exposed individuals based on various dispersion parameters and scenarios. Derived Response Levels then were determined for each radioisotope using: 1) target doses to members of the public provided by the U.S. EPA, and 2) occupational dose limits provided by the U.S. Nuclear Regulatory Commission. The limiting Derived Response Level for each radioisotope also was determined.

The role of interventional radiology in the treatment of intrahepatic cholangiocarcinoma.

PubMed

Ierardi, Anna Maria; Angileri, Salvatore Alessio; Patella, Francesca; Panella, Silvia; Lucchina, Natalie; Petre, Elena N; Pinto, Antonio; Franceschelli, Giuseppe; Carrafiello, Gianpaolo; Cornalba, Gianpaolo; Sofocleous, Constantinos T

2017-01-01

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy after hepatocellular carcinoma. Complete surgical resection remains the only potentially curative option for patients with ICC. However, until now, early diagnosis with potential surgical intervention has been the exception rather than the rule with only 30% of patients qualifying for attempted surgical cure. Many patients are unresectable because of disease stage, anatomic conditions, medical comorbidities, and small future remnant liver. Interventional radiology procedures are available for these types of patients with intra-arterial therapies and/or ablative treatments both for curative and for palliative treatment. The goals of interventional therapy are to control local tumor growth, to relieve symptoms, and to improve and preserve quality of life. The choice of treatment depends largely on tumor extent and patient performance. No randomized studies exist to compare treatments. The present review describes the current evidence of the interventional treatments in the management of the ICC. Moreover, interventional procedures available to increase the future liver reserve before surgery were analyzed.

Anesthesia Practices for Interventional Radiology in Europe

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vari, Alessandra, E-mail: alessandra.vari@uniroma1.it; Gangi, Afshin, E-mail: gangi@unistra.fr

PurposeThe Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe.MethodsAnonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology.ResultsPredictable differences betweenmore » countries and national regulations were confirmed, showing how significantly many “local” factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care.ConclusionSignificant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.« less

The Fukushima Dai-ichi accident: additional lessons from a radiological emergency assistance mission.

PubMed

Becker, Steven M

2013-11-01

In response to the March 2011 earthquake-tsunami disaster and the Fukushima Dai-ichi nuclear accident, a special nongovernmental Radiological Emergency Assistance Mission flew to Japan from the United States. Invited by one of Japan's largest hospital and healthcare groups and facilitated by a New York-based international disaster relief organization, the mission included an emergency physician, a health physicist, and a disaster management specialist. During the 10 d mission, team members conducted fieldwork in areas affected by the earthquake, tsunami, and nuclear accident; went to cities and towns in the 20-30 km Emergency Evacuation Preparation Zone around the damaged nuclear plant; visited other communities affected by the nuclear accident; went to evacuation shelters; met with mayors and other local officials; met with central government officials; exchanged observations, experiences, and information with Japanese medical, emergency response, and disaster management colleagues; and provided radiological information and training to more than 1,100 Japanese hospital and healthcare personnel and first responders. The mission produced many insights with potential relevance for radiological/nuclear emergency preparedness and response. The first "lessons learned" were published in December 2011. Since that time, additional broad insights from the mission and mission followup have been identified. Five of these new lessons, which focus primarily on community impacts and responses and public communication issues, are presented and discussed in this article.

Design requirements for radiology workstations.

PubMed

Moise, Adrian; Atkins, M Stella

2004-06-01

This article stresses the importance of capturing feedback from representative users in the early stages of product development. We present our solution to producing quality requirement specifications for radiology workstations, specifications that remain valid over time because we successfully anticipated the industry trends and the user's needs. We present the results from a user study performed in December 1999 in a radiology clinic equipped with state-of-the-art Picture Archiving and Communications Systems (PACS) and imaging scanners. The study involved eight radiologists who answered questions and provided comments on three complementary research topics. First, we asked our subjects to enumerate the advantages and the disadvantages for both softcopy and hardcopy reading. We identified the two major factors for productivity improvement through the use of PACS workstations: workflow re-engineering and process automation. Second, we collected radiologist feedback on the use of hanging protocols (HPs). The results indicated the high importance of automatic image organization through HPs, with the potential effect of reducing the interpretation time by 10-20%. Our subjects estimated that 10-15 HPs would cover about 85%-95% of the regular radiological examinations. Third, we investigated the impact of the display devices on the radiologist's workflow. Our results indicated that the number and the properties of the monitors is a modality-specific requirement. The main results from this study on key functional requirements for softcopy interpretation only recently were incorporated in most of the current, successful PACS workstations.

Agribusiness: Industry Study Final Report, AY 2003-2004, Seminar 1

DTIC Science & Technology

2004-01-01

vulnerability of our nation’s food supply to a potential biological attack, primarily due to inadequate governmental oversight. He states, "The Food and Drug...national laboratory system to assist with chemical, biological , and radiological agent identification and analysis. Following the passage of the...Genetically Modified Foods,” June 2003. Chalk, Peter, “Hitting America’s Soft Underbelly: The Potential Threat of Deliberate Biological Attacks

Radiological safety status and quality assurance audit of medical X-ray diagnostic installations in India.

PubMed

Sonawane, A U; Singh, Meghraj; Sunil Kumar, J V K; Kulkarni, Arti; Shirva, V K; Pradhan, A S

2010-10-01

We conducted a radiological safety and quality assurance (QA) audit of 118 medical X-ray diagnostic machines installed in 45 major hospitals in India. The main objective of the audit was to verify compliance with the regulatory requirements stipulated by the national regulatory body. The audit mainly covered accuracy check of accelerating potential (kVp), linearity of tube current (mA station) and timer, congruence of radiation and optical field, and total filtration; in addition, we also reviewed medical X-ray diagnostic installations with reference to room layout of X-ray machines and conduct of radiological protection survey. A QA kit consisting of a kVp Test-O-Meter (ToM) (Model RAD/FLU-9001), dose Test-O-Meter (ToM) (Model 6001), ionization chamber-based radiation survey meter model Gun Monitor and other standard accessories were used for the required measurements. The important areas where there was noncompliance with the national safety code were: inaccuracy of kVp calibration (23%), lack of congruence of radiation and optical field (23%), nonlinearity of mA station (16%) and timer (9%), improper collimator/diaphragm (19.6%), faulty adjustor knob for alignment of field size (4%), nonavailability of warning light (red light) at the entrance of the X-ray room (29%), and use of mobile protective barriers without lead glass viewing window (14%). The present study on the radiological safety status of diagnostic X-ray installations may be a reasonably good representation of the situation in the country as a whole. The study contributes significantly to the improvement of radiological safety by the way of the steps already taken and by providing a vital feed back to the national regulatory body.

The U.S. Radiologist Workforce: An Analysis of Temporal and Geographic Variation by Using Large National Datasets.

PubMed

Rosenkrantz, Andrew B; Hughes, Danny R; Duszak, Richard

2016-04-01

To determine recent trends related to temporal as well as national and statewide geographic variation in the U.S. radiologist and radiology resident workforce. This retrospective HIPAA-compliant study was exempted from the internal review board. Federal Area Health Resources Files and Medicare 5% research identifiable files were used to compute parameters related to the radiologist workforce. Geographic variation and annual temporal trends were analyzed. Pearson and Spearman correlations were assessed. Nationally, the number of radiology trainees increased 84.2% from a nadir in 1997 (3080 trainees) to 2011 (5674 trainees) and showed high state-to-state variation (range, 0-678 trainees in 2011). However, total radiologists nationally increased 39.2% from 1995 (27 906 radiologists) to 2011 (38 875 radiologists), and radiologists per 100 000 population nationally increased by 7.5% from 1995 (10.62%) to 2011 (11.42%), while showing high state-to-state variation (highest-to-lowest state ratio of 4.3). Radiologists' share of the overall physician workforce declined nationally by 8.8% from 1995 (4.0%) to 2011 (3.7%), with moderate state-to-state variation (highest-to-lowest state ratio of 1.7). Radiology trainee numbers exhibited weak-to-moderate positive state-by-state correlation with radiologists per 100 000 population (r = 0.292-0.532), but moderate-to-strong inverse correlation with the percentage of radiologists in rural practice (r = -0.464 to -0.635). Although the number of radiology trainees dramatically increased, radiologists per 100 000 population increased only slightly, and radiologists' share of the overall physician workforce declined. State-to-state variations in radiologist and radiology resident workforces are high, which suggests a potential role for geographic redistribution rather than changes in the overall workforce size.

A peek into the future of radiology using big data applications.

PubMed

Kharat, Amit T; Singhal, Shubham

2017-01-01

Big data is extremely large amount of data which is available in the radiology department. Big data is identified by four Vs - Volume, Velocity, Variety, and Veracity. By applying different algorithmic tools and converting raw data to transformed data in such large datasets, there is a possibility of understanding and using radiology data for gaining new knowledge and insights. Big data analytics consists of 6Cs - Connection, Cloud, Cyber, Content, Community, and Customization. The global technological prowess and per-capita capacity to save digital information has roughly doubled every 40 months since the 1980's. By using big data, the planning and implementation of radiological procedures in radiology departments can be given a great boost. Potential applications of big data in the future are scheduling of scans, creating patient-specific personalized scanning protocols, radiologist decision support, emergency reporting, virtual quality assurance for the radiologist, etc. Targeted use of big data applications can be done for images by supporting the analytic process. Screening software tools designed on big data can be used to highlight a region of interest, such as subtle changes in parenchymal density, solitary pulmonary nodule, or focal hepatic lesions, by plotting its multidimensional anatomy. Following this, we can run more complex applications such as three-dimensional multi planar reconstructions (MPR), volumetric rendering (VR), and curved planar reconstruction, which consume higher system resources on targeted data subsets rather than querying the complete cross-sectional imaging dataset. This pre-emptive selection of dataset can substantially reduce the system requirements such as system memory, server load and provide prompt results. However, a word of caution, "big data should not become "dump data" due to inadequate and poor analysis and non-structured improperly stored data. In the near future, big data can ring in the era of personalized and individualized healthcare.

The effects of expanding outpatient and inpatient evaluation and management services in a pediatric interventional radiology practice.

PubMed

Edalat, Faramarz; Lindquester, Will S; Gill, Anne E; Simoneaux, Stephen F; Gaines, Jennifer; Hawkins, C Matthew

2017-03-01

Despite a continuing emphasis on evaluation and management clinical services in adult interventional radiology (IR) practice, the peer-reviewed literature addressing these services - and their potential economic benefits - is lacking in pediatric IR practice. To measure the effects of expanding evaluation and management (E&M) services through the establishment of a dedicated pediatric interventional radiology outpatient clinic and inpatient E&M reporting system. We collected and analyzed E&M current procedural terminology (CPT) codes from all patients seen in a pediatric interventional radiology outpatient clinic between November 2014 and August 2015. We also calculated the number of new patients seen in the clinic who had a subsequent procedure (procedural conversion rate). For comparison, we used historical data comprising pediatric patients seen in a general interventional radiology (IR) clinic for the 2 years immediately prior. An inpatient E&M reporting system was implemented and all inpatient E&M (and subsequent procedural) services between July 2015 and September 2015 were collected and analyzed. We estimated revenue for both outpatient and inpatient services using the Medicare Physician Fee Schedule global non-facility price as a surrogate. Following inception of a pediatric IR clinic, the number of new outpatients (5.5/month; +112%), procedural conversion rate (74.5%; +19%), estimated E&M revenue (+158%), and estimated procedural revenue from new outpatients (+228%) all increased. Following implementation of an inpatient clinic reporting system, there were 8.3 consults and 7.3 subsequent hospital encounters per month, with a procedural conversion rate of 88%. Growth was observed in all meaningful metrics following expansion of outpatient and inpatient pediatric IR E&M services.

Radiology Undergraduate and Resident Curricula: A Narrative Review of the Literature

PubMed Central

Linaker, Kathleen L.

2015-01-01

Objective The purpose of this study was to examine the literature regarding radiology curricula for both undergraduates and residents. Methods A review of the literature was performed using relevant key words. Articles were retrieved through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references. Results Of the 4716 unique abstracts reviewed by the author, 142 were found to be relevant to the purpose of this study. Undergraduate radiology education, radiology curriculum, and radiology pedagogy vary widely between disciplines and between colleges within disciplines. Formal radiology education is not taught at all medical programs and little radiology training is incorporated into non-radiology residencies. This results in some medical graduates not being taught how to interpret basic radiology images and not learning contraindications and indications for ordering diagnostic imaging tests. There are no definitive studies examining how to incorporate radiology into the curriculum, how to teach radiology to either undergraduates or residents, or how to assess this clinical competency. Conclusions This review shows that radiology education is perceived to be important in undergraduate and residency programs. However, some programs do not include radiology training, thus graduates from those programs do not learn radiology essentials. PMID:26770172

Assessment of Natural Radioactivity Levels and Potential Radiological Risks of Common Building Materials Used in Bangladeshi Dwellings.

PubMed

Asaduzzaman, Khandoker; Mannan, Farhana; Khandaker, Mayeen Uddin; Farook, Mohideen Salihu; Elkezza, Aeman; Amin, Yusoff Bin Mohd; Sharma, Sailesh; Abu Kassim, Hasan Bin

2015-01-01

The concentrations of primordial radionuclides (226Ra, 232Th and 40K) in commonly used building materials (brick, cement and sand), the raw materials of cement and the by-products of coal-fired power plants (fly ash) collected from various manufacturers and suppliers in Bangladesh were determined via gamma-ray spectrometry using an HPGe detector. The results showed that the mean concentrations of 226Ra, 232Th and 40K in all studied samples slightly exceeded the typical world average values of 50 Bq kg(-1), 50 Bq kg(-1) and 500 Bq kg(-1), respectively. The activity concentrations (especially 226Ra) of fly-ash-containing cement in this study were found to be higher than those of fly-ash-free cement. To evaluate the potential radiological risk to individuals associated with these building materials, various radiological hazard indicators were calculated. The radium equivalent activity values for all samples were found to be lower than the recommended limit for building materials of 370 Bq kg(-1), with the exception of the fly ash. For most samples, the values of the alpha index and the radiological hazard (external and internal) indices were found to be within the safe limit of 1. The mean indoor absorbed dose rate was observed to be higher than the population-weighted world average of 84 nGy h(-1), and the corresponding annual effective dose for most samples fell below the recommended upper dose limit of 1 mSv y(-1). For all investigated materials, the values of the gamma index were found to be greater than 0.5 but less than 1, indicating that the gamma dose contribution from the studied building materials exceeds the exemption dose criterion of 0.3 mSv y(-1) but complies with the upper dose principle of 1 mSv y(-1).

Assessment of Natural Radioactivity Levels and Potential Radiological Risks of Common Building Materials Used in Bangladeshi Dwellings

PubMed Central

Asaduzzaman, Khandoker; Mannan, Farhana; Khandaker, Mayeen Uddin; Farook, Mohideen Salihu; Elkezza, Aeman; Amin, Yusoff Bin Mohd; Sharma, Sailesh; Abu Kassim, Hasan Bin

2015-01-01

The concentrations of primordial radionuclides (226Ra, 232Th and 40K) in commonly used building materials (brick, cement and sand), the raw materials of cement and the by-products of coal-fired power plants (fly ash) collected from various manufacturers and suppliers in Bangladesh were determined via gamma-ray spectrometry using an HPGe detector. The results showed that the mean concentrations of 226Ra, 232Th and 40K in all studied samples slightly exceeded the typical world average values of 50 Bq kg−1, 50 Bq kg−1 and 500 Bq kg−1, respectively. The activity concentrations (especially 226Ra) of fly-ash-containing cement in this study were found to be higher than those of fly-ash-free cement. To evaluate the potential radiological risk to individuals associated with these building materials, various radiological hazard indicators were calculated. The radium equivalent activity values for all samples were found to be lower than the recommended limit for building materials of 370 Bq kg-1, with the exception of the fly ash. For most samples, the values of the alpha index and the radiological hazard (external and internal) indices were found to be within the safe limit of 1. The mean indoor absorbed dose rate was observed to be higher than the population-weighted world average of 84 nGy h–1, and the corresponding annual effective dose for most samples fell below the recommended upper dose limit of 1 mSv y–1. For all investigated materials, the values of the gamma index were found to be greater than 0.5 but less than 1, indicating that the gamma dose contribution from the studied building materials exceeds the exemption dose criterion of 0.3 mSv y-1 but complies with the upper dose principle of 1 mSv y−1. PMID:26473957

Incidence of intraoperative seizures during motor evoked potential monitoring in a large cohort of patients undergoing different surgical procedures.

PubMed

Ulkatan, Sedat; Jaramillo, Ana Maria; Téllez, Maria J; Kim, Jinu; Deletis, Vedran; Seidel, Kathleen

2017-04-01

OBJECTIVE The purpose of this study was to investigate the incidence of seizures during the intraoperative monitoring of motor evoked potentials (MEPs) elicited by electrical brain stimulation in a wide spectrum of surgeries such as those of the orthopedic spine, spinal cord, and peripheral nerves, interventional radiology procedures, and craniotomies for supra- and infratentorial tumors and vascular lesions. METHODS The authors retrospectively analyzed data from 4179 consecutive patients who underwent surgery or an interventional radiology procedure with MEP monitoring. RESULTS Of 4179 patients, only 32 (0.8%) had 1 or more intraoperative seizures. The incidence of seizures in cranial procedures, including craniotomies and interventional neuroradiology, was 1.8%. In craniotomies in which transcranial electrical stimulation (TES) was applied to elicit MEPs, the incidence of seizures was 0.7% (6/850). When direct cortical stimulation was additionally applied, the incidence of seizures increased to 5.4% (23/422). Patients undergoing craniotomies for the excision of extraaxial brain tumors, particularly meningiomas (15 patients), exhibited the highest risk of developing an intraoperative seizure (16 patients). The incidence of seizures in orthopedic spine surgeries was 0.2% (3/1664). None of the patients who underwent surgery for conditions of the spinal cord, neck, or peripheral nerves or who underwent cranial or noncranial interventional radiology procedures had intraoperative seizures elicited by TES during MEP monitoring. CONCLUSIONS In this largest such study to date, the authors report the incidence of intraoperative seizures in patients who underwent MEP monitoring during a wide spectrum of surgeries such as those of the orthopedic spine, spinal cord, and peripheral nerves, interventional radiology procedures, and craniotomies for supra- and infratentorial tumors and vascular lesions. The low incidence of seizures induced by electrical brain stimulation, particularly short-train TES, demonstrates that MEP monitoring is a safe technique that should not be avoided due to the risk of inducing seizures.

The Impact Factor of Radiological Journals: Associations with Journal Content and Other Characteristics Over a Recent 12-Year Period.

PubMed

Rosenkrantz, Andrew B; Ayoola, Abimbola

2016-06-01

The aim of this study was to evaluate the trends in the impact factor (IF) of radiological journals over a recent 12-year period, including associations between IF and journal topic. Journal Citation Reports (JCR) was used to identify all biomedical journals and all radiological journals (assigned a JCR category of "Radiology, Nuclear Medicine, & Medical Imaging"), along with journal IF, in 2003 and 2014. Radiological journals were manually classified by topic. Trends in median IF (mIF) were assessed. The number of radiological journals increased from 83 (2003) to 125 (2014) (all biomedical journals: 5907 to 8718, respectively). mIF of radiological journals increased from 1.42 (2003) to 1.75 (2014) (all biomedical journals: 0.93 to 1.46, respectively). The most common topic among new radiological journals was general (nonspecialized) radiology (8). Five new radiological journals in 2014 were in topics (cancer imaging and molecular imaging) having no journals in 2003. mIF of general radiological journals was 1.49. Topics having highest mIF were cardiac imaging (2.94), optics (2.86), molecular imaging (2.77), radiation oncology (2.60), and neuroradiology (2.25). Topics with lowest mIF were ultrasound (1.19) and interventional radiology (1.44). Topics with the largest increase in mIF were cardiac imaging (from 1.17 to 2.94) and neuroradiology (from 1.07 to 2.25). Radiological journals exhibited higher mIF than biomedical journals overall. Among radiological journals, subspecialty journals had highest mIF. While a considerable number of new radiological journals since 2003 were general radiology journals having relatively low IF, there were also new journal topics representing emerging areas of subspecialized radiological research. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Asian Radiology Forum 2016 for Promoting Radiology Together in the Asian-Oceanian Region: Roles of the Asian-Oceanian Society of Radiology and Its Member Societies

PubMed Central

Kim, Ho Sung; Choi, Jung-Ah

2018-01-01

According to the reports presented at the second Asian Radiology Forum (ARF) 2016, organized by the Korean Society of Radiology (KSR) during the Korean Congress of Radiology (KCR) in September 2016 in Seoul, there is an increasing need for the Asian-Oceanian Society of Radiology (AOSR) and its member societies to promote radiology together in the Asian-Oceanian region. In ARF 2016, the national delegates of the Asian-Oceanian radiological partner societies primarily discussed their societies' activities and contributions in international and regional societies including AOSR, expectations for AOSR, recommendations and suggestions for AOSR, and their societies' support of AOSR. PMID:29520175

ICRP PUBLICATION 122: radiological protection in geological disposal of long-lived solid radioactive waste.

PubMed

Weiss, W; Larsson, C-M; McKenney, C; Minon, J-P; Mobbs, S; Schneider, T; Umeki, H; Hilden, W; Pescatore, C; Vesterlind, M

2013-06-01

This report updates and consolidates previous recommendations of the International Commission on Radiological Protection (ICRP) related to solid waste disposal (ICRP, 1985, 1997b, 1998). The recommendations given apply specifically to geological disposal of long-lived solid radioactive waste. The report explains how the ICRP system of radiological protection described in Publication 103 (ICRP, 2007) can be applied in the context of the geological disposal of long-lived solid radioactive waste. Although the report is written as a standalone document, previous ICRP recommendations not dealt with in depth in the report are still valid. The 2007 ICRP system of radiological protection evolves from the previous process-based protection approach relying on the distinction between practices and interventions by moving to an approach based on the distinction between three types of exposure situation: planned, emergency and existing. The Recommendations maintains the Commission's three fundamental principles of radiological protection namely: justification, optimisation of protection and the application of dose limits. They also maintain the current individual dose limits for effective dose and equivalent dose from all regulated sources in planned exposure situations. They re-enforce the principle of optimisation of radiological protection, which applies in a similar way to all exposure situations, subject to restrictions on individual doses: constraints for planned exposure situations, and reference levels for emergency and existing exposure situations. The Recommendations also include an approach for developing a framework to demonstrate radiological protection of the environment. This report describes the different stages in the life time of a geological disposal facility, and addresses the application of relevant radiological protection principles for each stage depending on the various exposure situations that can be encountered. In particular, the crucial factor that influences the application of the protection system over the different phases in the life time of a disposal facility is the level of oversight or 'watchful care' that is present. The level of oversight affects the capability to control the source, i.e. the waste and the repository, and to avoid or reduce potential exposures. Three main time frames are considered: time of direct oversight, when the disposal facility is being implemented and is under active supervision; time of indirect oversight, when the disposal facility is sealed and oversight is being exercised by regulators or special administrative bodies or society at large to provide additional assurance on behalf of society; and time of no oversight, when oversight is no longer exercised in case memory of the disposal facility is lost. Copyright © 2013. Published by Elsevier Ltd.

Radiological and toxicological assessment of an external heat (burn) test of the 105MM cartridge, APFSDS-T, XM-744

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gilchrist, R.L.; Parker, G.B.; Mishima, J.

1978-03-01

The potential radiological and toxicological hazard of depleted uranium aerosol release was investigated. This type of release might arise from accidents with XM-774 ammunition involving great heat. Twelve rounds of packaged ammunition were subjected to an external heat (burn) test. Examination of the site on the day following the test revealed that all 12 depleted uranium penetrators were completely intact. Oxidation of the penetrators was not apparent, even on the most severely burned projectile located at ground zero. Eleven of the 12 projectiles were recovered with the sabots intact; some sabots appeared charred. It was concluded that no airborne releasemore » of depleted uranium had occurred and subsequently there had been no radiological or toxicological hazard from DU during this test. However, this conclusion may not apply to the release of depleted uranium in other types of fires involving this ammunition because other factors may affect the fire. These factors include type of fuel, number of ammunition rounds, and type of structure housing the ammunition.« less

Using Standardized Lexicons for Report Template Validation with LexMap, a Web-based Application.

PubMed

Hostetter, Jason; Wang, Kenneth; Siegel, Eliot; Durack, Jeremy; Morrison, James J

2015-06-01

An enormous amount of data exists in unstructured diagnostic and interventional radiology reports. Free text or non-standardized terminologies limit the ability to parse, extract, and analyze these report data elements. Medical lexicons and ontologies contain standardized terms for relevant concepts including disease entities, radiographic technique, and findings. The use of standardized terms offers the potential to improve reporting consistency and facilitate computer analysis. The purpose of this project was to implement an interface to aid in the creation of standards-compliant reporting templates for use in interventional radiology. Non-standardized procedure report text was analyzed and referenced to RadLex, SNOMED-CT, and LOINC. Using JavaScript, a web application was developed which determined whether exact terms or synonyms in reports existed within these three reference resources. The NCBO BioPortal Annotator web service was used to map terms, and output from this application was used to create an interactive annotated version of the original report. The application was successfully used to analyze and modify five distinct reports for the Society of Interventional Radiology's standardized reporting project.

A review of existing and potential computer user interfaces for modern radiology.

PubMed

Iannessi, Antoine; Marcy, Pierre-Yves; Clatz, Olivier; Bertrand, Anne-Sophie; Sugimoto, Maki

2018-05-16

The digitalization of modern imaging has led radiologists to become very familiar with computers and their user interfaces (UI). New options for display and command offer expanded possibilities, but the mouse and keyboard remain the most commonly utilized, for usability reasons. In this work, we review and discuss different UI and their possible application in radiology. We consider two-dimensional and three-dimensional imaging displays in the context of interventional radiology, and discuss interest in touchscreens, kinetic sensors, eye detection, and augmented or virtual reality. We show that UI design specifically for radiologists is key for future use and adoption of such new interfaces. Next-generation UI must fulfil professional needs, while considering contextual constraints. • The mouse and keyboard remain the most utilized user interfaces for radiologists. • Touchscreen, holographic, kinetic sensors and eye tracking offer new possibilities for interaction. • 3D and 2D imaging require specific user interfaces. • Holographic display and augmented reality provide a third dimension to volume imaging. • Good usability is essential for adoption of new user interfaces by radiologists.

Source Recertification, Refurbishment, and Transfer Logistics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gastelum, Zoe N.; Duckworth, Leesa L.; Greenfield, Bryce A.

2013-09-01

The 2012 Gap Analysis of Department of Energy Radiological Sealed Sources, Standards, and Materials for Safeguards Technology Development [1] report, and the subsequent Reconciliation of Source Needs and Surpluses across the U.S. Department of Energy National Laboratory Complex [2] report, resulted in the identification of 33 requests for nuclear or radiological sealed sources for which there was potentially available, suitable material from within the U.S. Department of Energy (DOE) complex to fill the source need. Available, suitable material was defined by DOE laboratories as material slated for excess, or that required recertification or refurbishment before being used for safeguards technologymore » development. This report begins by outlining the logistical considerations required for the shipment of nuclear and radiological materials between DOE laboratories. Then, because of the limited need for transfer of matching sources, the report also offers considerations for an alternative approach – the shipment of safeguards equipment between DOE laboratories or technology testing centers. Finally, this report addresses repackaging needs for the two source requests for which there was available, suitable material within the DOE complex.« less

Embedded importance watermarking for image verification in radiology

NASA Astrophysics Data System (ADS)

Osborne, Domininc; Rogers, D.; Sorell, M.; Abbott, Derek

2004-03-01

Digital medical images used in radiology are quite different to everyday continuous tone images. Radiology images require that all detailed diagnostic information can be extracted, which traditionally constrains digital medical images to be of large size and stored without loss of information. In order to transmit diagnostic images over a narrowband wireless communication link for remote diagnosis, lossy compression schemes must be used. This involves discarding detailed information and compressing the data, making it more susceptible to error. The loss of image detail and incidental degradation occurring during transmission have potential legal accountability issues, especially in the case of the null diagnosis of a tumor. The work proposed here investigates techniques for verifying the voracity of medical images - in particular, detailing the use of embedded watermarking as an objective means to ensure that important parts of the medical image can be verified. We propose a result to show how embedded watermarking can be used to differentiate contextual from detailed information. The type of images that will be used include spiral hairline fractures and small tumors, which contain the essential diagnostic high spatial frequency information.

Benefits of an automatic patient dose registry system for interventional radiology and cardiology at five hospitals of the Madrid area.

PubMed

Fernandez-Soto, J M; Ten, J I; Sanchez, R M; España, M; Pifarre, X; Vano, E

2015-07-01

The purpose of this article is to present the results of connecting the interventional radiology and cardiology laboratories of five university hospitals to a unique server using an automatic patient dose registry system (Dose On Line for Interventional Radiology, DOLIR) developed in-house, and to evaluate its feasibility more than a year after its introduction. The system receives and stores demographic and dosimetric parameters included in the MPPS DICOM objects sent by the modalities to a database. A web service provides a graphical interface to analyse the information received. During 2013, the system processed 10 788 procedures (6874 cardiac, 2906 vascular and 1008 neuro interventional). The percentages of patients requiring clinical follow-up due to potential tissue reactions before and after the use of DOLIR are presented. The system allowed users to verify in real-time, if diagnostic (or interventional) reference levels are fulfilled. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Radiological input during paediatric multidisciplinary team meetings and its influence on clinical patient management.

PubMed

Llewellyn-Jones, Glyn; Pereira, John

2016-04-01

There is little information about the role of the radiologist at multidisciplinary team meetings; in particular their influence on patient management. To evaluate the influence of radiologists on clinical patient management during multidisciplinary meetings. Prospective data were collected over a 5-week period from multidisciplinary team meetings across four paediatric clinical domains. Radiological input was recorded for each case discussion, including the type of influence and its potential effect on clinical patient management. One hundred and forty paediatric cases were reviewed. Radiological advice was requested from the radiologist for 25.7% (N = 36) of cases. In 17.9% (N = 25) this advice was judged to have influenced clinical patient management. There were two cases where new imaging findings were discovered. Radiologists influence clinical patient management during multidisciplinary team meetings primarily by providing differential diagnoses and guidance regarding future imaging, with respect to both the necessity and the modality. Occasionally, when imaging is reviewed at these meetings, new findings are discovered that impact on patient management. © 2016 The Royal Australian and New Zealand College of Radiologists.

NOTE: Investigating the potential of polymer gel dosimetry for interventional radiology: first results

NASA Astrophysics Data System (ADS)

Antoniou, P. E.; Bousbouras, P.; Sandaltzopoulos, R.; Kaldoudi, E.

2008-04-01

Complex interventional radiology (IR) procedures contribute an increasing percentage of the overall medical radiation exposure of the population making accurate dosimetry a challenge. Magnetic resonance (MR) based polymer gel dosimetry has been widely employed in complex dosimetric problems in radiotherapy. The aim of this note is to investigate the feasibility of normoxic gel dosimetry in IR. Dose response, energy dependence and dose rate dependence were investigated in irradiation set-ups relevant to IR for a particular normoxic gel, based on methacrylic acid (MAA) as the monomer and including tetrakis-hydroxy-methyl-phosphonium chloride (THPC) as antioxidant. The gel presents a linear dose response beyond a 25 cGy threshold. No significant energy dependence was observed in the useful range of interventional radiology (80-110 kVp). A linear correlation between the gel response and dose rate was observed in the range of dose rates relevant to IR (5-8 cGy min-1). These results demonstrate a reduction of gel sensitivity at very low dose rate levels. A possible explanation of this effect is suggested.

Comprehensive Health Care Economics Curriculum and Training in Radiology Residency.

PubMed

Keiper, Mark; Donovan, Timothy; DeVries, Matthew

2018-06-01

To investigate the ability to successfully develop and institute a comprehensive health care economics skills curriculum in radiology residency training utilizing didactic lectures, case scenario exercises, and residency miniretreats. A comprehensive health care economics skills curriculum was developed to significantly expand upon the basic ACGME radiology residency milestone System-Based Practice, SBP2: Health Care Economics requirements and include additional education in business and contract negotiation, radiology sales and marketing, and governmental and private payers' influence in the practice of radiology. A health care economics curriculum for radiology residents incorporating three phases of education was developed and implemented. Phase 1 of the curriculum constituted basic education through didactic lectures covering System-Based Practice, SBP2: Health Care Economics requirements. Phase 2 constituted further, more advanced didactic lectures on radiology sales and marketing techniques as well as government and private insurers' role in the business of radiology. Phase 3 applied knowledge attained from the initial two phases to real-life case scenario exercises and radiology department business miniretreats with the remainder of the radiology department. A health care economics skills curriculum in radiology residency is attainable and essential in the education of future radiology residents in the ever-changing climate of health care economics. Institution of more comprehensive programs will likely maximize the long-term success of radiology as a specialty by identifying and educating future leaders in the field of radiology. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A practical description and student perspective of the integration of radiology into lower limb musculoskeletal anatomy.

PubMed

Davy, S; O'Keeffe, G W; Mahony, N; Phelan, N; Barry, D S

2017-05-01

Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need. We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions. The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions. Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool. The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice.

Emerging Technologies and Techniques for Wide Area Radiological Survey and Remediation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sutton, M.; Zhao, P.

2016-03-24

Technologies to survey and decontaminate wide-area contamination and process the subsequent radioactive waste have been developed and implemented following the Chernobyl nuclear power plant release and the breach of a radiological source resulting in contamination in Goiania, Brazil. These civilian examples of radioactive material releases provided some of the first examples of urban radiological remediation. Many emerging technologies have recently been developed and demonstrated in Japan following the release of radioactive cesium isotopes (Cs-134 and Cs-137) from the Fukushima Dai-ichi nuclear power plant in 2011. Information on technologies reported by several Japanese government agencies, such as the Japan Atomic Energymore » Agency (JAEA), the Ministry of the Environment (MOE) and the National Institute for Environmental Science (NIES), together with academic institutions and industry are summarized and compared to recently developed, deployed and available technologies in the United States. The technologies and techniques presented in this report may be deployed in response to a wide area contamination event in the United States. In some cases, additional research and testing is needed to adequately validate the technology effectiveness over wide areas. Survey techniques can be deployed on the ground or from the air, allowing a range of coverage rates and sensitivities. Survey technologies also include those useful in measuring decontamination progress and mapping contamination. Decontamination technologies and techniques range from non-destructive (e.g., high pressure washing) and minimally destructive (plowing), to fully destructive (surface removal or demolition). Waste minimization techniques can greatly impact the long-term environmental consequences and cost following remediation efforts. Recommendations on technical improvements to address technology gaps are presented together with observations on remediation in Japan.« less

Medical response to a radiologic/nuclear event: integrated plan from the Office of the Assistant Secretary for Preparedness and Response, Department of Health and Human Services.

PubMed

Coleman, C Norman; Hrdina, Chad; Bader, Judith L; Norwood, Ann; Hayhurst, Robert; Forsha, Joseph; Yeskey, Kevin; Knebel, Ann

2009-02-01

The end of the Cold War led to a reduced concern for a major nuclear event. However, the current threats from terrorism make a radiologic (dispersal or use of radioactive material) or nuclear (improvised nuclear device) event a possibility. The specter and enormousness of the catastrophe resulting from a state-sponsored nuclear attack and a sense of nihilism about the effectiveness of a response were such that there had been limited civilian medical response planning. Although the consequences of a radiologic dispersal device are substantial, and the detonation of a modest-sized (10 kiloton) improvised nuclear device is catastrophic, it is both possible and imperative that a medical response be planned. To meet this need, the Office of the Assistant Secretary for Preparedness and Response in the Department of Health and Human Services, in collaboration within government and with nongovernment partners, has developed a scientifically based comprehensive planning framework and Web-based "just-in-time" medical response information called Radiation Event Medical Management (available at http://www.remm.nlm.gov). The response plan includes (1) underpinnings from basic radiation biology, (2) tailored medical responses, (3) delivery of medical countermeasures for postevent mitigation and treatment, (4) referral to expert centers for acute treatment, and (5) long-term follow-up. Although continuing to evolve and increase in scope and capacity, current response planning is sufficiently mature that planners and responders should be aware of the basic premises, tools, and resources available. An effective response will require coordination, communication, and cooperation at an unprecedented level. The logic behind and components of this response are presented to allow for active collaboration among emergency planners and responders and federal, state, local, and tribal governments.

Acromioclavicular joint dislocations: radiological correlation between Rockwood classification system and injury patterns in human cadaver species.

PubMed

Eschler, Anica; Rösler, Klaus; Rotter, Robert; Gradl, Georg; Mittlmeier, Thomas; Gierer, Philip

2014-09-01

The classification system of Rockwood and Young is a commonly used classification for acromioclavicular joint separations subdividing types I-VI. This classification hypothesizes specific lesions to anatomical structures (acromioclavicular and coracoclavicular ligaments, capsule, attached muscles) leading to the injury. In recent literature, our understanding for anatomical correlates leading to the radiological-based Rockwood classification is questioned. The goal of this experimental-based investigation was to approve the correlation between the anatomical injury pattern and the Rockwood classification. In four human cadavers (seven shoulders), the acromioclavicular and coracoclavicular ligaments were transected stepwise. Radiological correlates were recorded (Zanca view) with 15-kg longitudinal tension applied at the wrist. The resulting acromio- and coracoclavicular distances were measured. Radiographs after acromioclavicular ligament transection showed joint space enlargement (8.6 ± 0.3 vs. 3.1 ± 0.5 mm, p < 0.05) and no significant change in coracoclavicular distance (10.4 ± 0.9 vs. 10.0 ± 0.8 mm). According to the Rockwood classification only type I and II lesions occurred. After additional coracoclavicular ligament cut, the acromioclavicular joint space width increased to 16.7 ± 2.7 vs. 8.6 ± 0.3 mm, p < 0.05. The mean coracoclavicular distance increased to 20.6 ± 2.1 mm resulting in type III-V lesions concerning the Rockwood classification. Trauma with intact coracoclavicular ligaments did not result in acromioclavicular joint lesions higher than Rockwood type I and II. The clinical consequence for reconstruction of low-grade injuries might be a solely surgical approach for the acromioclavicular ligaments or conservative treatment. High-grade injuries were always based on additional structural damage to the coracoclavicular ligaments. Rockwood type V lesions occurred while muscle attachments were intact.

Open Source: Potential in Latin America for Radiological Weapons

DTIC Science & Technology

2010-03-01

Limos Project,” The NEFA Foundation, http://www.nefafoundation.org/miscellaneous/Barot/GasLimos.pdf (accessed 18 March 2010), 31. 44 Dhiren, “Rough...March 2010). Barot, Dhiren. "Rough Presentation for Gas Limos Project." The NEFA Foundation. http://www.nefafoundation.org/miscellaneous/Barot

Computational Approach for Securing Radiology-Diagnostic Data in Connected Health Network using High-Performance GPU-Accelerated AES.

PubMed

Adeshina, A M; Hashim, R

2017-03-01

Diagnostic radiology is a core and integral part of modern medicine, paving ways for the primary care physicians in the disease diagnoses, treatments and therapy managements. Obviously, all recent standard healthcare procedures have immensely benefitted from the contemporary information technology revolutions, apparently revolutionizing those approaches to acquiring, storing and sharing of diagnostic data for efficient and timely diagnosis of diseases. Connected health network was introduced as an alternative to the ageing traditional concept in healthcare system, improving hospital-physician connectivity and clinical collaborations. Undoubtedly, the modern medicinal approach has drastically improved healthcare but at the expense of high computational cost and possible breach of diagnosis privacy. Consequently, a number of cryptographical techniques are recently being applied to clinical applications, but the challenges of not being able to successfully encrypt both the image and the textual data persist. Furthermore, processing time of encryption-decryption of medical datasets, within a considerable lower computational cost without jeopardizing the required security strength of the encryption algorithm, still remains as an outstanding issue. This study proposes a secured radiology-diagnostic data framework for connected health network using high-performance GPU-accelerated Advanced Encryption Standard. The study was evaluated with radiology image datasets consisting of brain MR and CT datasets obtained from the department of Surgery, University of North Carolina, USA, and the Swedish National Infrastructure for Computing. Sample patients' notes from the University of North Carolina, School of medicine at Chapel Hill were also used to evaluate the framework for its strength in encrypting-decrypting textual data in the form of medical report. Significantly, the framework is not only able to accurately encrypt and decrypt medical image datasets, but it also successfully encrypts and decrypts textual data in Microsoft Word document, Microsoft Excel and Portable Document Formats which are the conventional format of documenting medical records. Interestingly, the entire encryption and decryption procedures were achieved at a lower computational cost using regular hardware and software resources without compromising neither the quality of the decrypted data nor the security level of the algorithms.

Saving Lives and Preventing Injuries From Unjustified Protective Actions-Method for Developing a Comprehensive Public Protective Action Strategy for a Severe NPP Emergency.

PubMed

Callen, J; McKenna, T

2018-05-01

During the response to the Fukushima Daiichi nuclear power plant (FDNPP) emergency, about 50 patients died during or shortly after an evacuation when they were not provided with the needed medical support. In addition, it has been shown that during the FDNPP emergency there were increases in mortality rates among the elderly due to long-term dislocation as a result of evacuation and relocation orders and an inability to stay in areas where residents were advised to shelter for extended periods. These deaths occurred even though the possible radiation exposure to the public was too low to result in radiation-induced deaths, injuries, or a meaningful increase in the cancer rate, even if no protective actions had been taken. These problems are not unique to the FDNPP emergency and would be expected if the recommendations of many organizations were followed. Neither the International Commission on Radiological Protection (ICRP), the U.S. Nuclear Regulatory Commission (NRC) nor the U.S Environmental Protection Agency (EPA) adequately take into consideration in their recommendations and analysis the non-radiological health impacts, such as deaths and injuries, that could result from protective actions. Furthermore, ICRP, NRC, EPA, and the U.S. Department of Homeland Security (DHS) call for taking protective actions at doses lower than those resulting in meaningful adverse radiation-induced health effects and do not state the doses at which such effects would be seen. Consequently, it would be impossible for decision makers and the public to balance all the hazards both from radiation exposure and protective actions when deciding whether a protective action is justified. What is needed, as is presented in this paper, is a method for developing a comprehensive protective action strategy that allows the public, decision makers, and others who must work together to balance the radiological with the non-radiological health hazards posed by protective actions, and to counter the exaggerated fear of radiation exposure that could lead to taking unjustified protective actions and adverse psychological, sociological, and other effects.

Radiological controls integrated into design

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kindred, G.W.

1995-03-01

Radiological controls are required by law in the design of commercial nuclear power reactor facilities. These controls can be relatively minor or significant, relative to cost. To ensure that radiological controls are designed into a project, the health physicist (radiological engineer) must be involved from the beginning. This is especially true regarding keeping costs down. For every radiological engineer at a nuclear power plant there must be fifty engineers of other disciplines. The radiological engineer cannot be an expert on every discipline of engineering. However, he must be knowledgeable to the degree of how a design will impact the facilitymore » from a radiological perspective. This paper will address how to effectively perform radiological analyses with the goal of radiological controls integrated into the design package.« less

Necrotising otitis externa in the immunocompetent patient: case series.

PubMed

Unadkat, S; Kanzara, T; Watters, G

2018-01-01

Necrotising otitis externa can be a devastating form of otitis externa. It typically tends to affect patients who are immunocompromised or diabetic. To date, there is very little in the literature about necrotising otitis externa in the immunocompetent patient population. The present paper discusses both the clinical and radiological findings in three cases of necrotising otitis externa in an immunocompetent patient cohort. The common factor among all three patients was their advanced age. Diagnosing necrotising otitis externa can be challenging because of the potentially non-specific symptoms and the absence of early radiological signs, particularly if patients are neither immunocompromised nor diabetic. Elderly patients should be considered in the same light as immunocompromised and diabetic patients in the context of necrotising otitis externa.