Validation of Case Finding Algorithms for Hepatocellular Cancer From Administrative Data and Electronic Health Records Using Natural Language Processing.

PubMed

Sada, Yvonne; Hou, Jason; Richardson, Peter; El-Serag, Hashem; Davila, Jessica

2016-02-01

Accurate identification of hepatocellular cancer (HCC) cases from automated data is needed for efficient and valid quality improvement initiatives and research. We validated HCC International Classification of Diseases, 9th Revision (ICD-9) codes, and evaluated whether natural language processing by the Automated Retrieval Console (ARC) for document classification improves HCC identification. We identified a cohort of patients with ICD-9 codes for HCC during 2005-2010 from Veterans Affairs administrative data. Pathology and radiology reports were reviewed to confirm HCC. The positive predictive value (PPV), sensitivity, and specificity of ICD-9 codes were calculated. A split validation study of pathology and radiology reports was performed to develop and validate ARC algorithms. Reports were manually classified as diagnostic of HCC or not. ARC generated document classification algorithms using the Clinical Text Analysis and Knowledge Extraction System. ARC performance was compared with manual classification. PPV, sensitivity, and specificity of ARC were calculated. A total of 1138 patients with HCC were identified by ICD-9 codes. On the basis of manual review, 773 had HCC. The HCC ICD-9 code algorithm had a PPV of 0.67, sensitivity of 0.95, and specificity of 0.93. For a random subset of 619 patients, we identified 471 pathology reports for 323 patients and 943 radiology reports for 557 patients. The pathology ARC algorithm had PPV of 0.96, sensitivity of 0.96, and specificity of 0.97. The radiology ARC algorithm had PPV of 0.75, sensitivity of 0.94, and specificity of 0.68. A combined approach of ICD-9 codes and natural language processing of pathology and radiology reports improves HCC case identification in automated data.

A method for radiological characterization based on fluence conversion coefficients

NASA Astrophysics Data System (ADS)

Froeschl, Robert

2018-06-01

Radiological characterization of components in accelerator environments is often required to ensure adequate radiation protection during maintenance, transport and handling as well as for the selection of the proper disposal pathway. The relevant quantities are typical the weighted sums of specific activities with radionuclide-specific weighting coefficients. Traditional methods based on Monte Carlo simulations are radionuclide creation-event based or the particle fluences in the regions of interest are scored and then off-line weighted with radionuclide production cross sections. The presented method bases the radiological characterization on a set of fluence conversion coefficients. For a given irradiation profile and cool-down time, radionuclide production cross-sections, material composition and radionuclide-specific weighting coefficients, a set of particle type and energy dependent fluence conversion coefficients is computed. These fluence conversion coefficients can then be used in a Monte Carlo transport code to perform on-line weighting to directly obtain the desired radiological characterization, either by using built-in multiplier features such as in the PHITS code or by writing a dedicated user routine such as for the FLUKA code. The presented method has been validated against the standard event-based methods directly available in Monte Carlo transport codes.

Estimates of radiological risk from depleted uranium weapons in war scenarios.

PubMed

Durante, Marco; Pugliese, Mariagabriella

2002-01-01

Several weapons used during the recent conflict in Yugoslavia contain depleted uranium, including missiles and armor-piercing incendiary rounds. Health concern is related to the use of these weapons, because of the heavy-metal toxicity and radioactivity of uranium. Although chemical toxicity is considered the more important source of health risk related to uranium, radiation exposure has been allegedly related to cancers among veterans of the Balkan conflict, and uranium munitions are a possible source of contamination in the environment. Actual measurements of radioactive contamination are needed to assess the risk. In this paper, a computer simulation is proposed to estimate radiological risk related to different exposure scenarios. Dose caused by inhalation of radioactive aerosols and ground contamination induced by Tomahawk missile impact are simulated using a Gaussian plume model (HOTSPOT code). Environmental contamination and committed dose to the population resident in contaminated areas are predicted by a food-web model (RESRAD code). Small values of committed effective dose equivalent appear to be associated with missile impacts (50-y CEDE < 5 mSv), or population exposure by water-independent pathways (50-y CEDE < 80 mSv). The greatest hazard is related to the water contamination in conditions of effective leaching of uranium in the groundwater (50-y CEDE < 400 mSv). Even in this worst case scenario, the chemical toxicity largely predominates over radiological risk. These computer simulations suggest that little radiological risk is associated to the use of depleted uranium weapons.

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.

RESRAD model presentation

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

Yu, C.; Faillace, E.; Chen, S.Y.

RESRAD was one of the multimedia models selected by the US Nuclear Regulatory Commission (NRC) to include in its workshop on radiation dose modeling and demonstration of compliance with the radiological criteria for license termination. This paper is a summary of the presentation made at the workshop and focuses on the 10 questions the NRC distributed to all participants prior to the workshop. The code selection criteria, which were solicited by the NRC, for demonstrating compliance with the license termination rule are also included. Among the RESRAD family of codes, RESRAD and RESRAD-BUILD are designed for evaluating radiological contamination inmore » soils and in buildings. Many documents have been published to support the use of these codes. This paper focuses on these two codes. The pathways considered, the databases and parameters used, quality control and quality assurance, benchmarking, verification and validation of these codes, and capabilities as well as limitations of these codes are discussed in detail.« less

RESRAD for Radiological Risk Assessment. Comparison with EPA CERCLA Tools - PRG and DCC Calculators

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

Yu, C.; Cheng, J. -J.; Kamboj, S.

The purpose of this report is two-fold. First, the risk assessment methodology for both RESRAD and the EPA’s tools is reviewed. This includes a review of the EPA’s justification for 2 using a dose-to-risk conversion factor to reduce the dose-based protective ARAR from 15 to 12 mrem/yr. Second, the models and parameters used in RESRAD and the EPA PRG and DCC Calculators are compared in detail, and the results are summarized and discussed. Although there are suites of software tools in the RESRAD family of codes and the EPA Calculators, the scope of this report is limited to the RESRADmore » (onsite) code for soil contamination and the EPA’s PRG and DCC Calculators also for soil contamination.« less

Standard Anatomic Terminologies: Comparison for Use in a Health Information Exchange–Based Prior Computed Tomography (CT) Alerting System

PubMed Central

Lowry, Tina; Vreeman, Daniel J; Loo, George T; Delman, Bradley N; Thum, Frederick L; Slovis, Benjamin H; Shapiro, Jason S

2017-01-01

Background A health information exchange (HIE)–based prior computed tomography (CT) alerting system may reduce avoidable CT imaging by notifying ordering clinicians of prior relevant studies when a study is ordered. For maximal effectiveness, a system would alert not only for prior same CTs (exams mapped to the same code from an exam name terminology) but also for similar CTs (exams mapped to different exam name terminology codes but in the same anatomic region) and anatomically proximate CTs (exams in adjacent anatomic regions). Notification of previous same studies across an HIE requires mapping of local site CT codes to a standard terminology for exam names (such as Logical Observation Identifiers Names and Codes [LOINC]) to show that two studies with different local codes and descriptions are equivalent. Notifying of prior similar or proximate CTs requires an additional mapping of exam codes to anatomic regions, ideally coded by an anatomic terminology. Several anatomic terminologies exist, but no prior studies have evaluated how well they would support an alerting use case. Objective The aim of this study was to evaluate the fitness of five existing standard anatomic terminologies to support similar or proximate alerts of an HIE-based prior CT alerting system. Methods We compared five standard anatomic terminologies (Foundational Model of Anatomy, Systematized Nomenclature of Medicine Clinical Terms, RadLex, LOINC, and LOINC/Radiological Society of North America [RSNA] Radiology Playbook) to an anatomic framework created specifically for our use case (Simple ANatomic Ontology for Proximity or Similarity [SANOPS]), to determine whether the existing terminologies could support our use case without modification. On the basis of an assessment of optimal terminology features for our purpose, we developed an ordinal anatomic terminology utility classification. We mapped samples of 100 random and the 100 most frequent LOINC CT codes to anatomic regions in each terminology, assigned utility classes for each mapping, and statistically compared each terminology’s utility class rankings. We also constructed seven hypothetical alerting scenarios to illustrate the terminologies’ differences. Results Both RadLex and the LOINC/RSNA Radiology Playbook anatomic terminologies ranked significantly better (P<.001) than the other standard terminologies for the 100 most frequent CTs, but no terminology ranked significantly better than any other for 100 random CTs. Hypothetical scenarios illustrated instances where no standard terminology would support appropriate proximate or similar alerts, without modification. Conclusions LOINC/RSNA Radiology Playbook and RadLex’s anatomic terminologies appear well suited to support proximate or similar alerts for commonly ordered CTs, but for less commonly ordered tests, modification of the existing terminologies with concepts and relations from SANOPS would likely be required. Our findings suggest SANOPS may serve as a framework for enhancing anatomic terminologies in support of other similar use cases. PMID:29242174

Selected radionuclides important to low-level radioactive waste management

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

NONE

1996-11-01

The purpose of this document is to provide information to state representatives and developers of low level radioactive waste (LLW) management facilities about the radiological, chemical, and physical characteristics of selected radionuclides and their behavior in the environment. Extensive surveys of available literature provided information for this report. Certain radionuclides may contribute significantly to the dose estimated during a radiological performance assessment analysis of an LLW disposal facility. Among these are the radionuclides listed in Title 10 of the Code of Federal Regulations Part 61.55, Tables 1 and 2 (including alpha emitting transuranics with half-lives greater than 5 years). Thismore » report discusses these radionuclides and other radionuclides that may be significant during a radiological performance assessment analysis of an LLW disposal facility. This report not only includes essential information on each radionuclide, but also incorporates waste and disposal information on the radionuclide, and behavior of the radionuclide in the environment and in the human body. Radionuclides addressed in this document include technetium-99, carbon-14, iodine-129, tritium, cesium-137, strontium-90, nickel-59, plutonium-241, nickel-63, niobium-94, cobalt-60, curium -42, americium-241, uranium-238, and neptunium-237.« less

A digital library of radiology images.

PubMed

Kahn, Charles E

2006-01-01

A web-based virtual library of peer-reviewed radiological images was created for use in education and clinical decision support. Images were obtained from open-access content of five online radiology journals and one e-learning web site. Figure captions were indexed by Medical Subject Heading (MeSH) codes, imaging modality, and patient age and sex. This digital library provides a new, valuable online resource.

NOTE: Development of modified voxel phantoms for the numerical dosimetric reconstruction of radiological accidents involving external sources: implementation in SESAME tool

NASA Astrophysics Data System (ADS)

Courageot, Estelle; Sayah, Rima; Huet, Christelle

2010-05-01

Estimating the dose distribution in a victim's body is a relevant indicator in assessing biological damage from exposure in the event of a radiological accident caused by an external source. When the dose distribution is evaluated with a numerical anthropomorphic model, the posture and morphology of the victim have to be reproduced as realistically as possible. Several years ago, IRSN developed a specific software application, called the simulation of external source accident with medical images (SESAME), for the dosimetric reconstruction of radiological accidents by numerical simulation. This tool combines voxel geometry and the MCNP(X) Monte Carlo computer code for radiation-material interaction. This note presents a new functionality in this software that enables the modelling of a victim's posture and morphology based on non-uniform rational B-spline (NURBS) surfaces. The procedure for constructing the modified voxel phantoms is described, along with a numerical validation of this new functionality using a voxel phantom of the RANDO tissue-equivalent physical model.

Development of modified voxel phantoms for the numerical dosimetric reconstruction of radiological accidents involving external sources: implementation in SESAME tool.

PubMed

Courageot, Estelle; Sayah, Rima; Huet, Christelle

2010-05-07

Estimating the dose distribution in a victim's body is a relevant indicator in assessing biological damage from exposure in the event of a radiological accident caused by an external source. When the dose distribution is evaluated with a numerical anthropomorphic model, the posture and morphology of the victim have to be reproduced as realistically as possible. Several years ago, IRSN developed a specific software application, called the simulation of external source accident with medical images (SESAME), for the dosimetric reconstruction of radiological accidents by numerical simulation. This tool combines voxel geometry and the MCNP(X) Monte Carlo computer code for radiation-material interaction. This note presents a new functionality in this software that enables the modelling of a victim's posture and morphology based on non-uniform rational B-spline (NURBS) surfaces. The procedure for constructing the modified voxel phantoms is described, along with a numerical validation of this new functionality using a voxel phantom of the RANDO tissue-equivalent physical model.

CERISE, a French radioprotection code, to assess the radiological impact and acceptance criteria of installations for material handling, and recycling or disposal of very low-level radioactive waste

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

Santucci, P.; Guetat, P.

1993-12-31

This document describes the code CERISE, Code d`Evaluations Radiologiques Individuelles pour des Situations en Enterprise et dans l`Environnement. This code has been developed in the frame of European studies to establish acceptance criteria of very low-level radioactive waste and materials. This code is written in Fortran and runs on PC. It calculates doses received by the different pathways: external exposure, ingestion, inhalation and skin contamination. Twenty basic scenarios are already elaborated, which have been determined from previous studies. Calculations establish the relation between surface, specific and/or total activities, and doses. Results can be expressed as doses for an average activitymore » unit, or as average activity limits for a set of reference doses (defined for each scenario analyzed). In this last case, the minimal activity values and the corresponding limiting scenarios, are selected and summarized in a final table.« less

Society of Interventional Radiology

MedlinePlus

... GUIDELINES, CLINICAL TOPIC ACKNOWLEDGEMENTS MACRA MATTERS HEALTH POLICY, ECONOMICS, CODING REIMBURSEMENT AND APPEALS TOOLKITS UFE AWARENESS TOOLKIT ... GUIDELINES, CLINICAL TOPIC ACKNOWLEDGEMENTS MACRA MATTERS HEALTH POLICY, ECONOMICS, CODING REIMBURSEMENT AND APPEALS TOOLKITS UFE AWARENESS TOOLKIT ...

TRENCADIS--a WSRF grid MiddleWare for managing DICOM structured reporting objects.

PubMed

Blanquer, Ignacio; Hernandez, Vicente; Segrelles, Damià

2006-01-01

The adoption of the digital processing of medical data, especially on radiology, has leaded to the availability of millions of records (images and reports). However, this information is mainly used at patient level, being the extraction of information, organised according to administrative criteria, which make the extraction of knowledge difficult. Moreover, legal constraints make the direct integration of information systems complex or even impossible. On the other side, the widespread of the DICOM format has leaded to the inclusion of other information different from just radiological images. The possibility of coding radiology reports in a structured form, adding semantic information about the data contained in the DICOM objects, eases the process of structuring images according to content. DICOM Structured Reporting (DICOM-SR) is a specification of tags and sections to code and integrate radiology reports, with seamless references to findings and regions of interests of the associated images, movies, waveforms, signals, etc. The work presented in this paper aims at developing of a framework to efficiently and securely share medical images and radiology reports, as well as to provide high throughput processing services. This system is based on a previously developed architecture in the framework of the TRENCADIS project, and uses other components such as the security system and the Grid processing service developed in previous activities. The work presented here introduces a semantic structuring and an ontology framework, to organise medical images considering standard terminology and disease coding formats (SNOMED, ICD9, LOINC..).

ANEMOS: A computer code to estimate air concentrations and ground deposition rates for atmospheric nuclides emitted from multiple operating sources

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

Miller, C.W.; Sjoreen, A.L.; Begovich, C.L.

This code estimates concentrations in air and ground deposition rates for Atmospheric Nuclides Emitted from Multiple Operating Sources. ANEMOS is one component of an integrated Computerized Radiological Risk Investigation System (CRRIS) developed for the US Environmental Protection Agency (EPA) for use in performing radiological assessments and in developing radiation standards. The concentrations and deposition rates calculated by ANEMOS are used in subsequent portions of the CRRIS for estimating doses and risks to man. The calculations made in ANEMOS are based on the use of a straight-line Gaussian plume atmospheric dispersion model with both dry and wet deposition parameter options. Themore » code will accommodate a ground-level or elevated point and area source or windblown source. Adjustments may be made during the calculations for surface roughness, building wake effects, terrain height, wind speed at the height of release, the variation in plume rise as a function of downwind distance, and the in-growth and decay of daughter products in the plume as it travels downwind. ANEMOS can also accommodate multiple particle sizes and clearance classes, and it may be used to calculate the dose from a finite plume of gamma-ray-emitting radionuclides passing overhead. The output of this code is presented for 16 sectors of a circular grid. ANEMOS can calculate both the sector-average concentrations and deposition rates at a given set of downwind distances in each sector and the average of these quantities over an area within each sector bounded by two successive downwind distances. ANEMOS is designed to be used primarily for continuous, long-term radionuclide releases. This report describes the models used in the code, their computer implementation, the uncertainty associated with their use, and the use of ANEMOS in conjunction with other codes in the CRRIS. A listing of the code is included in Appendix C.« less

The Relative Value Unit: History, Current Use, and Controversies.

PubMed

Baadh, Amanjit; Peterkin, Yuri; Wegener, Melanie; Flug, Jonathan; Katz, Douglas; Hoffmann, Jason C

2016-01-01

The relative value unit (RVU) is an important measuring tool for the work performed by physicians, and is currently used in the United States to calculate physician reimbursement. An understanding of radiology RVUs and current procedural terminology codes is important for radiologists, trainees, radiology managers, and administrators, as this knowledge would help them to understand better their current productivity and reimbursement, as well as controversies regarding reimbursement, and permit them to adapt to reimbursement changes that may occur in the future. This article reviews the components of the RVU and how radiology payment is calculated, highlights trends in RVUs and resultant payment for diagnostic and therapeutic imaging and examinations, and discusses current issues involving RVU and current procedural terminology codes. Copyright © 2015 Mosby, Inc. All rights reserved.

Identification of Long Bone Fractures in Radiology Reports Using Natural Language Processing to support Healthcare Quality Improvement.

PubMed

Grundmeier, Robert W; Masino, Aaron J; Casper, T Charles; Dean, Jonathan M; Bell, Jamie; Enriquez, Rene; Deakyne, Sara; Chamberlain, James M; Alpern, Elizabeth R

2016-11-09

Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were developed. To implement and validate NLP tools to identify long bone fractures for pediatric emergency medicine quality improvement. Using freely available statistical software packages, we implemented NLP methods to identify long bone fractures from radiology reports. A sample of 1,000 radiology reports was used to construct three candidate classification models. A test set of 500 reports was used to validate the model performance. Blinded manual review of radiology reports by two independent physicians provided the reference standard. Each radiology report was segmented and word stem and bigram features were constructed. Common English "stop words" and rare features were excluded. We used 10-fold cross-validation to select optimal configuration parameters for each model. Accuracy, recall, precision and the F1 score were calculated. The final model was compared to the use of diagnosis codes for the identification of patients with long bone fractures. There were 329 unique word stems and 344 bigrams in the training documents. A support vector machine classifier with Gaussian kernel performed best on the test set with accuracy=0.958, recall=0.969, precision=0.940, and F1 score=0.954. Optimal parameters for this model were cost=4 and gamma=0.005. The three classification models that we tested all performed better than diagnosis codes in terms of accuracy, precision, and F1 score (diagnosis code accuracy=0.932, recall=0.960, precision=0.896, and F1 score=0.927). NLP methods using a corpus of 1,000 training documents accurately identified acute long bone fractures from radiology reports. Strategic use of straightforward NLP methods, implemented with freely available software, offers quality improvement teams new opportunities to extract information from narrative documents.

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

McKenzie-Carter, M.A.; Lyon, R.E.; Rope, S.K.

This report contains information to support the Environmental Assessment for the Burning Plasma Experiment (BPX) Project proposed for the Princeton Plasma Physics Laboratory (PPPL). The assumptions and methodology used to assess the impact to members of the public from operational and accidental releases of radioactive material from the proposed BPX during the operational period of the project are described. A description of the tracer release tests conducted at PPPL by NOAA is included; dispersion values from these tests are used in the dose calculations. Radiological releases, doses, and resulting health risks are calculated and summarized. The computer code AIRDOS- EPA,more » which is part of the computer code system CAP-88, is used to calculate the individual and population doses for routine releases; FUSCRAC3 is used to calculate doses resulting from off-normal releases where direct application of the NOAA tracer test data is not practical. Where applicable, doses are compared to regulatory limits and guideline values. 48 refs., 16 tabs.« less

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

Automated identification of patients with pulmonary nodules in an integrated health system using administrative health plan data, radiology reports, and natural language processing.

PubMed

Danforth, Kim N; Early, Megan I; Ngan, Sharon; Kosco, Anne E; Zheng, Chengyi; Gould, Michael K

2012-08-01

Lung nodules are commonly encountered in clinical practice, yet little is known about their management in community settings. An automated method for identifying patients with lung nodules would greatly facilitate research in this area. Using members of a large, community-based health plan from 2006 to 2010, we developed a method to identify patients with lung nodules, by combining five diagnostic codes, four procedural codes, and a natural language processing algorithm that performed free text searches of radiology transcripts. An experienced pulmonologist reviewed a random sample of 116 radiology transcripts, providing a reference standard for the natural language processing algorithm. With the use of an automated method, we identified 7112 unique members as having one or more incident lung nodules. The mean age of the patients was 65 years (standard deviation 14 years). There were slightly more women (54%) than men, and Hispanics and non-whites comprised 45% of the lung nodule cohort. Thirty-six percent were never smokers whereas 11% were current smokers. Fourteen percent of the patients were subsequently diagnosed with lung cancer. The sensitivity and specificity of the natural language processing algorithm for identifying the presence of lung nodules were 96% and 86%, respectively, compared with clinician review. Among the true positive transcripts in the validation sample, only 35% were solitary and unaccompanied by one or more associated findings, and 56% measured 8 to 30 mm in diameter. A combination of diagnostic codes, procedural codes, and a natural language processing algorithm for free text searching of radiology reports can accurately and efficiently identify patients with incident lung nodules, many of whom are subsequently diagnosed with lung cancer.

Identification of Long Bone Fractures in Radiology Reports Using Natural Language Processing to Support Healthcare Quality Improvement

PubMed Central

Masino, Aaron J.; Casper, T. Charles; Dean, Jonathan M.; Bell, Jamie; Enriquez, Rene; Deakyne, Sara; Chamberlain, James M.; Alpern, Elizabeth R.

2016-01-01

Summary Background Important information to support healthcare quality improvement is often recorded in free text documents such as radiology reports. Natural language processing (NLP) methods may help extract this information, but these methods have rarely been applied outside the research laboratories where they were developed. Objective To implement and validate NLP tools to identify long bone fractures for pediatric emergency medicine quality improvement. Methods Using freely available statistical software packages, we implemented NLP methods to identify long bone fractures from radiology reports. A sample of 1,000 radiology reports was used to construct three candidate classification models. A test set of 500 reports was used to validate the model performance. Blinded manual review of radiology reports by two independent physicians provided the reference standard. Each radiology report was segmented and word stem and bigram features were constructed. Common English “stop words” and rare features were excluded. We used 10-fold cross-validation to select optimal configuration parameters for each model. Accuracy, recall, precision and the F1 score were calculated. The final model was compared to the use of diagnosis codes for the identification of patients with long bone fractures. Results There were 329 unique word stems and 344 bigrams in the training documents. A support vector machine classifier with Gaussian kernel performed best on the test set with accuracy=0.958, recall=0.969, precision=0.940, and F1 score=0.954. Optimal parameters for this model were cost=4 and gamma=0.005. The three classification models that we tested all performed better than diagnosis codes in terms of accuracy, precision, and F1 score (diagnosis code accuracy=0.932, recall=0.960, precision=0.896, and F1 score=0.927). Conclusions NLP methods using a corpus of 1,000 training documents accurately identified acute long bone fractures from radiology reports. Strategic use of straightforward NLP methods, implemented with freely available software, offers quality improvement teams new opportunities to extract information from narrative documents. PMID:27826610

NaI(Tl) scintillator detectors stripping procedure for air kerma measurements of diagnostic X-ray beams

NASA Astrophysics Data System (ADS)

Oliveira, L. S. R.; Conti, C. C.; Amorim, A. S.; Balthar, M. C. V.

2013-03-01

Air kerma is an essential quantity for the calibration of national standards used in diagnostic radiology and the measurement of operating parameters used in radiation protection. Its measurement within the appropriate limits of accuracy, uncertainty and reproducibility is important for the characterization and control of the radiation field for the dosimetry of the patients submitted to diagnostic radiology and, also, for the assessment of the system which produces radiological images. Only the incident beam must be considered for the calculation of the air kerma. Therefore, for energy spectrum, counts apart the total energy deposition in the detector must be subtracted. It is necessary to establish a procedure to sort out the different contributions to the original spectrum and remove the counts representing scattered photons in the detector's materials, partial energy deposition due to the interactions in the detector active volume and, also, the escape peaks contributions. The main goal of this work is to present spectrum stripping procedure, using the MCNP Monte Carlo computer code, for NaI(Tl) scintillation detectors to calculate the air kerma due to an X-ray beam usually used in medical radiology. The comparison between the spectrum before stripping procedure against the reference value showed a discrepancy of more than 63%, while the comparison with the same spectrum after the stripping procedure showed a discrepancy of less than 0.2%.

Relative radiological risks derived from different TENORM wastes in Malaysia.

PubMed

Ismail, B; Teng, I L; Muhammad Samudi, Y

2011-11-01

In Malaysia technologically enhanced naturally occurring radioactive materials (TENORM) wastes are mainly the product of the oil and gas industry and mineral processing. Among these TENORM wastes are tin tailing, tin slag, gypsum and oil sludge. Mineral processing and oil and gas industries produce large volume of TENORM wastes that has become a radiological concern to the authorities. A study was carried out to assess the radiological risk related to workers working at these disposal sites and landfills as well as to the members of the public should these areas be developed for future land use. Radiological risk was assessed based on the magnitude of radiation hazard, effective dose rates and excess cancer risks. Effective dose rates and excess cancer risks were estimated using RESRAD 6.4 computer code. All data on the activity concentrations of NORM in wastes and sludges used in this study were obtained from the Atomic Energy Licensing Board, Malaysia, and they were collected over a period of between 5 and 10 y. Results obtained showed that there was a wide range in the total activity concentrations (TAC) of nuclides in the TENORM wastes. With the exception of tin slag and tin tailing-based TENORM wastes, all other TENORM wastes have TAC values comparable to that of Malaysia's soil. Occupational Effective Dose Rates estimated in all landfill areas were lower than the 20 mSv y(-1) permissible dose limit. The average Excess Cancer Risk Coefficient was estimated to be 2.77×10(-3) risk per mSv. The effective dose rates for residents living on gypsum and oil sludge-based TENORM wastes landfills were estimated to be lower than the permissible dose limit for members of the public, and was also comparable to that of the average Malaysia's ordinary soils. The average excess cancer risk coefficient was estimated to be 3.19×10(-3) risk per mSv. Results obtained suggest that gypsum and oil sludge-based TENORM wastes should be exempted from any radiological regulatory control and should be considered radiologically safe for future land use.

Validation of the DIFFAL, HPAC and HotSpot Dispersion Models Using the Full-Scale Radiological Dispersal Device (FSRDD) Field Trials Witness Plate Deposition Dataset.

PubMed

Purves, Murray; Parkes, David

2016-05-01

Three atmospheric dispersion models--DIFFAL, HPAC, and HotSpot--of differing complexities have been validated against the witness plate deposition dataset taken during the Full-Scale Radiological Dispersal Device (FSRDD) Field Trials. The small-scale nature of these trials in comparison to many other historical radiological dispersion trials provides a unique opportunity to evaluate the near-field performance of the models considered. This paper performs validation of these models using two graphical methods of comparison: deposition contour plots and hotline profile graphs. All of the models tested are assessed to perform well, especially considering that previous model developments and validations have been focused on larger-scale scenarios. Of the models, HPAC generally produced the most accurate results, especially at locations within ∼100 m of GZ. Features present within the observed data, such as hot spots, were not well modeled by any of the codes considered. Additionally, it was found that an increase in the complexity of the meteorological data input to the models did not necessarily lead to an improvement in model accuracy; this is potentially due to the small-scale nature of the trials.

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.

Dosimetric comparison of Monte Carlo codes (EGS4, MCNP, MCNPX) considering external and internal exposures of the Zubal phantom to electron and photon sources.

PubMed

Chiavassa, S; Lemosquet, A; Aubineau-Lanièce, I; de Carlan, L; Clairand, I; Ferrer, L; Bardiès, M; Franck, D; Zankl, M

2005-01-01

This paper aims at comparing dosimetric assessments performed with three Monte Carlo codes: EGS4, MCNP4c2 and MCNPX2.5e, using a realistic voxel phantom, namely the Zubal phantom, in two configurations of exposure. The first one deals with an external irradiation corresponding to the example of a radiological accident. The results are obtained using the EGS4 and the MCNP4c2 codes and expressed in terms of the mean absorbed dose (in Gy per source particle) for brain, lungs, liver and spleen. The second one deals with an internal exposure corresponding to the treatment of a medullary thyroid cancer by 131I-labelled radiopharmaceutical. The results are obtained by EGS4 and MCNPX2.5e and compared in terms of S-values (expressed in mGy per kBq and per hour) for liver, kidney, whole body and thyroid. The results of these two studies are presented and differences between the codes are analysed and discussed.

75 FR 20913 - Center for Devices and Radiological Health; New Address Information

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-22

... information for the Center for Devices and Radiological Health (CDRH). All filings and other documents that... components of the agency's CDRH. The changes are the result of the relocation of these offices to FDA's White... with FDA Form 3500A. You may obtain the coding manual from CDRH's Web site at http://www.fda.gov/Safety...

DXRaySMCS: a user-friendly interface developed for prediction of diagnostic radiology X-ray spectra produced by Monte Carlo (MCNP-4C) simulation.

PubMed

Bahreyni Toossi, M T; Moradi, H; Zare, H

2008-01-01

In this work, the general purpose Monte Carlo N-particle radiation transport computer code (MCNP-4C) was used for the simulation of X-ray spectra in diagnostic radiology. The electron's path in the target was followed until its energy was reduced to 10 keV. A user-friendly interface named 'diagnostic X-ray spectra by Monte Carlo simulation (DXRaySMCS)' was developed to facilitate the application of MCNP-4C code for diagnostic radiology spectrum prediction. The program provides a user-friendly interface for: (i) modifying the MCNP input file, (ii) launching the MCNP program to simulate electron and photon transport and (iii) processing the MCNP output file to yield a summary of the results (relative photon number per energy bin). In this article, the development and characteristics of DXRaySMCS are outlined. As part of the validation process, output spectra for 46 diagnostic radiology system settings produced by DXRaySMCS were compared with the corresponding IPEM78. Generally, there is a good agreement between the two sets of spectra. No statistically significant differences have been observed between IPEM78 reported spectra and the simulated spectra generated in this study.

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

Automatically inserted technical details improve radiology report accuracy.

PubMed

Abujudeh, Hani H; Govindan, Siddharth; Narin, Ozden; Johnson, Jamlik Omari; Thrall, James H; Rosenthal, Daniel I

2011-09-01

To assess the effect of automatically inserted technical details on the concordance of a radiology report header with the actual procedure performed. The study was IRB approved and informed consent was waived. We obtained radiology report audit data from the hospital's compliance office from the period of January 2005 through December 2009 spanning a total of 20 financial quarters. A "discordance percentage" was defined as the percentage of total studies in which a procedure code change was made during auditing. Using Chi-square analysis we compared discordance percentages between reports with manually inserted technical details (MITD) and automatically inserted technical details (AITD). The second quarter data of 2007 was not included in the analysis as the switch from MITD to AITD occurred during this quarter. The hospital's compliance office audited 9,110 studies from 2005-2009. Excluding the 564 studies in the second quarter of 2007, we analyzed a total of 8,546 studies, 3,948 with MITD and 4,598 with AITD. The discordance percentage in the MITD group was 3.95% (156/3,948, range per quarter, 1.5- 6.1%). The AITD discordance percentage was 1.37% (63/4,598, range per quarter, 0.0-2.6%). A Chi-square analysis determined a statistically significant difference between the 2 groups (P < 0.001). There was a statistically significant improvement in the concordance of a radiology report header with the performed procedure using automatically inserted technical details compared to manually inserted details. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

An empirical evaluation of supervised learning approaches in assigning diagnosis codes to electronic medical records

PubMed Central

Kavuluru, Ramakanth; Rios, Anthony; Lu, Yuan

2015-01-01

Background Diagnosis codes are assigned to medical records in healthcare facilities by trained coders by reviewing all physician authored documents associated with a patient's visit. This is a necessary and complex task involving coders adhering to coding guidelines and coding all assignable codes. With the popularity of electronic medical records (EMRs), computational approaches to code assignment have been proposed in the recent years. However, most efforts have focused on single and often short clinical narratives, while realistic scenarios warrant full EMR level analysis for code assignment. Objective We evaluate supervised learning approaches to automatically assign international classification of diseases (ninth revision) - clinical modification (ICD-9-CM) codes to EMRs by experimenting with a large realistic EMR dataset. The overall goal is to identify methods that offer superior performance in this task when considering such datasets. Methods We use a dataset of 71,463 EMRs corresponding to in-patient visits with discharge date falling in a two year period (2011–2012) from the University of Kentucky (UKY) Medical Center. We curate a smaller subset of this dataset and also use a third gold standard dataset of radiology reports. We conduct experiments using different problem transformation approaches with feature and data selection components and employing suitable label calibration and ranking methods with novel features involving code co-occurrence frequencies and latent code associations. Results Over all codes with at least 50 training examples we obtain a micro F-score of 0.48. On the set of codes that occur at least in 1% of the two year dataset, we achieve a micro F-score of 0.54. For the smaller radiology report dataset, the classifier chaining approach yields best results. For the smaller subset of the UKY dataset, feature selection, data selection, and label calibration offer best performance. Conclusions We show that datasets at different scale (size of the EMRs, number of distinct codes) and with different characteristics warrant different learning approaches. For shorter narratives pertaining to a particular medical subdomain (e.g., radiology, pathology), classifier chaining is ideal given the codes are highly related with each other. For realistic in-patient full EMRs, feature and data selection methods offer high performance for smaller datasets. However, for large EMR datasets, we observe that the binary relevance approach with learning-to-rank based code reranking offers the best performance. Regardless of the training dataset size, for general EMRs, label calibration to select the optimal number of labels is an indispensable final step. PMID:26054428

An empirical evaluation of supervised learning approaches in assigning diagnosis codes to electronic medical records.

PubMed

Kavuluru, Ramakanth; Rios, Anthony; Lu, Yuan

2015-10-01

Diagnosis codes are assigned to medical records in healthcare facilities by trained coders by reviewing all physician authored documents associated with a patient's visit. This is a necessary and complex task involving coders adhering to coding guidelines and coding all assignable codes. With the popularity of electronic medical records (EMRs), computational approaches to code assignment have been proposed in the recent years. However, most efforts have focused on single and often short clinical narratives, while realistic scenarios warrant full EMR level analysis for code assignment. We evaluate supervised learning approaches to automatically assign international classification of diseases (ninth revision) - clinical modification (ICD-9-CM) codes to EMRs by experimenting with a large realistic EMR dataset. The overall goal is to identify methods that offer superior performance in this task when considering such datasets. We use a dataset of 71,463 EMRs corresponding to in-patient visits with discharge date falling in a two year period (2011-2012) from the University of Kentucky (UKY) Medical Center. We curate a smaller subset of this dataset and also use a third gold standard dataset of radiology reports. We conduct experiments using different problem transformation approaches with feature and data selection components and employing suitable label calibration and ranking methods with novel features involving code co-occurrence frequencies and latent code associations. Over all codes with at least 50 training examples we obtain a micro F-score of 0.48. On the set of codes that occur at least in 1% of the two year dataset, we achieve a micro F-score of 0.54. For the smaller radiology report dataset, the classifier chaining approach yields best results. For the smaller subset of the UKY dataset, feature selection, data selection, and label calibration offer best performance. We show that datasets at different scale (size of the EMRs, number of distinct codes) and with different characteristics warrant different learning approaches. For shorter narratives pertaining to a particular medical subdomain (e.g., radiology, pathology), classifier chaining is ideal given the codes are highly related with each other. For realistic in-patient full EMRs, feature and data selection methods offer high performance for smaller datasets. However, for large EMR datasets, we observe that the binary relevance approach with learning-to-rank based code reranking offers the best performance. Regardless of the training dataset size, for general EMRs, label calibration to select the optimal number of labels is an indispensable final step. Copyright © 2015 Elsevier B.V. All rights reserved.

Coding for urologic office procedures.

PubMed

Dowling, Robert A; Painter, Mark

2013-11-01

This article summarizes current best practices for documenting, coding, and billing common office-based urologic procedures. Topics covered include general principles, basic and advanced urologic coding, creation of medical records that support compliant coding practices, bundled codes and unbundling, global periods, modifiers for procedure codes, when to bill for evaluation and management services during the same visit, coding for supplies, and laboratory and radiology procedures pertinent to urology practice. Detailed information is included for the most common urology office procedures, and suggested resources and references are provided. This information is of value to physicians, office managers, and their coding staff. Copyright © 2013 Elsevier Inc. All rights reserved.

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

Feasibility study for a realistic training dedicated to radiological protection improvement

NASA Astrophysics Data System (ADS)

Courageot, Estelle; Reinald, Kutschera; Gaillard-Lecanu, Emmanuelle; Sylvie, Jahan; Riedel, Alexandre; Therache, Benjamin

2014-06-01

Any personnel involved in activities within the controlled area of a nuclear facility must be provided with appropriate radiological protection training. An evident purpose of this training is to know the regulation dedicated to workplaces where ionizing radiation may be present, in order to properly carry out the radiation monitoring, to use suitable protective equipments and to behave correctly if unexpected working conditions happen. A major difficulty of this training consist in having the most realistic reading from the monitoring devices for a given exposure situation, but without using real radioactive sources. A new approach is developed at EDF R&D for radiological protection training. This approach combines different technologies, in an environment representative of the workplace but geographically separated from the nuclear power plant: a training area representative of a workplace, a Man Machine Interface used by the trainer to define the source configuration and the training scenario, a geolocalization system, fictive radiation monitoring devices and a particle transport code able to calculate in real time the dose map due to the virtual sources. In a first approach, our real-time particles transport code, called Moderato, used only an attenuation low in straight line. To improve the realism further, we would like to switch a code based on the Monte Carlo transport of particles method like Geant 4 or MCNPX instead of Moderato. The aim of our study is the evaluation of the code in our application, in particular, the possibility to keep a real time response of our architecture.

Coding for effective denial management.

PubMed

Miller, Jackie; Lineberry, Joe

2004-01-01

Nearly everyone will agree that accurate and consistent coding of diagnoses and procedures is the cornerstone for operating a compliant practice. The CPT or HCPCS procedure code tells the payor what service was performed and also (in most cases) determines the amount of payment. The ICD-9-CM diagnosis code, on the other hand, tells the payor why the service was performed. If the diagnosis code does not meet the payor's criteria for medical necessity, all payment for the service will be denied. Implementation of an effective denial management program can help "stop the bleeding." Denial management is a comprehensive process that works in two ways. First, it evaluates the cause of denials and takes steps to prevent them. Second, denial management creates specific procedures for refiling or appealing claims that are initially denied. Accurate, consistent and compliant coding is key to both of these functions. The process of proactively managing claim denials also reveals a practice's administrative strengths and weaknesses, enabling radiology business managers to streamline processes, eliminate duplicated efforts and shift a larger proportion of the staff's focus from paperwork to servicing patients--all of which are sure to enhance operations and improve practice management and office morale. Accurate coding requires a program of ongoing training and education in both CPT and ICD-9-CM coding. Radiology business managers must make education a top priority for their coding staff. Front office staff, technologists and radiologists should also be familiar with the types of information needed for accurate coding. A good staff training program will also cover the proper use of Advance Beneficiary Notices (ABNs). Registration and coding staff should understand how to determine whether the patient's clinical history meets criteria for Medicare coverage, and how to administer an ABN if the exam is likely to be denied. Staff should also understand the restrictions on use of ABNs and the compliance risks associated with improper use. Finally, training programs should include routine audits to monitor coders for competence and precision. Constantly changing codes and guidelines mean that a coder's skills can quickly become obsolete if not reinforced by ongoing training and monitoring. Comprehensive reporting and routine analysis of claim denials is without a doubt one of the greatest assets to a practice that is suffering from excessive claim denials and should be considered an investment capable of providing both short and long term ROIs. Some radiologists may lack the funding or human resources needed to implement truly effective coding programs for their staff members. In these circumstances, radiology business managers should consider outsourcing their coding.

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.

21 CFR 803.21 - Where can I find the reporting codes for adverse events that I use with medical device reports?

Code of Federal Regulations, 2010 CFR

2010-04-01

... the coding manual from CDRH's Web site at http://www.fda.gov/cdrh/mdr/mdr-forms.html; and from the... Radiological Health, 1350 Piccard Dr., Rockville, MD 20850, FAX: 240-276-3151, or e-mail to [email protected]CDRH.FDA.GOV...

137Cs Radiological risk estimation of NSD facility at Karawang site by using RESRAD onsite application: effect of cover thickness

NASA Astrophysics Data System (ADS)

Setiawan, B.; Prihastuti, S.; Moersidik, S. S.

2018-02-01

The operational of near surface disposal facility during waste packages loading activity into the facility, or in a monitoring activity around disposal facility at Karawang area is predicted to give a radiological risk to radiation workers. The thickness of disposal facility cover system affected the number of radiological risk of workers. Due to this reason, a radiological risk estimation needs to be considered. RESRAD onsite code is applied for this purpose by analyse the individual accepted dose and radiological risk data of radiation workers. The obtained results and then are compared with radiation protection reference in accordance with national regulation. In this case, the data from the experimental result of Karawang clay as host of disposal facility such as Kd value of 137Cs was used. Results showed that the thickness of the cover layer of disposal facility affected to the radiological risk which accepted by workers in a near surface disposal facility.

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

Sublet, J.-Ch., E-mail: jean-christophe.sublet@ukaea.uk; Eastwood, J.W.; Morgan, J.G.

Fispact-II is a code system and library database for modelling activation-transmutation processes, depletion-burn-up, time dependent inventory and radiation damage source terms caused by nuclear reactions and decays. The Fispact-II code, written in object-style Fortran, follows the evolution of material irradiated by neutrons, alphas, gammas, protons, or deuterons, and provides a wide range of derived radiological output quantities to satisfy most needs for nuclear applications. It can be used with any ENDF-compliant group library data for nuclear reactions, particle-induced and spontaneous fission yields, and radioactive decay (including but not limited to TENDL-2015, ENDF/B-VII.1, JEFF-3.2, JENDL-4.0u, CENDL-3.1 processed into fine-group-structure files, GEFY-5.2more » and UKDD-16), as well as resolved and unresolved resonance range probability tables for self-shielding corrections and updated radiological hazard indices. The code has many novel features including: extension of the energy range up to 1 GeV; additional neutron physics including self-shielding effects, temperature dependence, thin and thick target yields; pathway analysis; and sensitivity and uncertainty quantification and propagation using full covariance data. The latest ENDF libraries such as TENDL encompass thousands of target isotopes. Nuclear data libraries for Fispact-II are prepared from these using processing codes PREPRO, NJOY and CALENDF. These data include resonance parameters, cross sections with covariances, probability tables in the resonance ranges, PKA spectra, kerma, dpa, gas and radionuclide production and energy-dependent fission yields, supplemented with all 27 decay types. All such data for the five most important incident particles are provided in evaluated data tables. The Fispact-II simulation software is described in detail in this paper, together with the nuclear data libraries. The Fispact-II system also includes several utility programs for code-use optimisation, visualisation and production of secondary radiological quantities. Included in the paper are summaries of results from the suite of verification and validation reports available with the code.« less

FISPACT-II: An Advanced Simulation System for Activation, Transmutation and Material Modelling

NASA Astrophysics Data System (ADS)

Sublet, J.-Ch.; Eastwood, J. W.; Morgan, J. G.; Gilbert, M. R.; Fleming, M.; Arter, W.

2017-01-01

Fispact-II is a code system and library database for modelling activation-transmutation processes, depletion-burn-up, time dependent inventory and radiation damage source terms caused by nuclear reactions and decays. The Fispact-II code, written in object-style Fortran, follows the evolution of material irradiated by neutrons, alphas, gammas, protons, or deuterons, and provides a wide range of derived radiological output quantities to satisfy most needs for nuclear applications. It can be used with any ENDF-compliant group library data for nuclear reactions, particle-induced and spontaneous fission yields, and radioactive decay (including but not limited to TENDL-2015, ENDF/B-VII.1, JEFF-3.2, JENDL-4.0u, CENDL-3.1 processed into fine-group-structure files, GEFY-5.2 and UKDD-16), as well as resolved and unresolved resonance range probability tables for self-shielding corrections and updated radiological hazard indices. The code has many novel features including: extension of the energy range up to 1 GeV; additional neutron physics including self-shielding effects, temperature dependence, thin and thick target yields; pathway analysis; and sensitivity and uncertainty quantification and propagation using full covariance data. The latest ENDF libraries such as TENDL encompass thousands of target isotopes. Nuclear data libraries for Fispact-II are prepared from these using processing codes PREPRO, NJOY and CALENDF. These data include resonance parameters, cross sections with covariances, probability tables in the resonance ranges, PKA spectra, kerma, dpa, gas and radionuclide production and energy-dependent fission yields, supplemented with all 27 decay types. All such data for the five most important incident particles are provided in evaluated data tables. The Fispact-II simulation software is described in detail in this paper, together with the nuclear data libraries. The Fispact-II system also includes several utility programs for code-use optimisation, visualisation and production of secondary radiological quantities. Included in the paper are summaries of results from the suite of verification and validation reports available with the code.

Radiation Transport Calculation of the UGXR Collimators for the Jules Horowitz Reactor (JHR)

NASA Astrophysics Data System (ADS)

Chento, Yelko; Hueso, César; Zamora, Imanol; Fabbri, Marco; Fuente, Cristina De La; Larringan, Asier

2017-09-01

Jules Horowitz Reactor (JHR), a major infrastructure of European interest in the fission domain, will be built and operated in the framework of an international cooperation, including the development and qualification of materials and nuclear fuel used in nuclear industry. For this purpose UGXR Collimators, two multi slit gamma and X-ray collimation mechatronic systems, will be installed at the JHR pool and at the Irradiated Components Storage pool. Expected amounts of radiation produced by the spent fuel and X-ray accelerator implies diverse aspects need to be verified to ensure adequate radiological zoning and personnel radiation protection. A computational methodology was devised to validate the Collimators design by means of coupling different engineering codes. In summary, several assessments were performed by means of MCNP5v1.60 to fulfil all the radiological requirements in Nominal scenario (TEDE < 25µSv/h) and in Maintenance scenario (TEDE < 2mSv/h) among others, detailing the methodology, hypotheses and assumptions employed.

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

Detilleux, Michel; Centner, Baudouin

The paper describes different methodologies and tools developed in-house by Tractebel Engineering to facilitate the engineering works to be carried out especially in the frame of decommissioning projects. Three examples of tools with their corresponding results are presented: - The LLWAA-DECOM code, a software developed for the radiological characterization of contaminated systems and equipment. The code constitutes a specific module of more general software that was originally developed to characterize radioactive waste streams in order to be able to declare the radiological inventory of critical nuclides, in particular difficult-to-measure radionuclides, to the Authorities. In the case of LLWAA-DECOM, deposited activitiesmore » inside contaminated equipment (piping, tanks, heat exchangers...) and scaling factors between nuclides, at any given time of the decommissioning time schedule, are calculated on the basis of physical characteristics of the systems and of operational parameters of the nuclear power plant. This methodology was applied to assess decommissioning costs of Belgian NPPs, to characterize the primary system of Trino NPP in Italy, to characterize the equipment of miscellaneous circuits of Ignalina NPP and of Kozloduy unit 1 and, to calculate remaining dose rates around equipment in the frame of the preparation of decommissioning activities; - The VISIMODELLER tool, a user friendly CAD interface developed to ease the introduction of lay-out areas in a software named VISIPLAN. VISIPLAN is a 3D dose rate assessment tool for ALARA work planning, developed by the Belgian Nuclear Research Centre SCK.CEN. Both softwares were used for projects such as the steam generators replacements in Belgian NPPs or the preparation of the decommissioning of units 1 and 2 of Kozloduy NPP; - The DBS software, a software developed to manage the different kinds of activities that are part of the general time schedule of a decommissioning project. For each activity, when relevant, algorithms allow to estimate, on the basis of local inputs, radiological exposures of the operators (collective and individual doses), production of primary, secondary and tertiary waste and their characterization, production of conditioned waste, release of effluents,... and enable the calculation and the presentation (histograms) of the global results for all activities together. An example of application in the frame of the Ignalina decommissioning project is given. (authors)« less

Calculation of water equivalent thickness of materials of arbitrary density, elemental composition and thickness in proton beam irradiation

NASA Astrophysics Data System (ADS)

Zhang, Rui; Newhauser, Wayne D.

2009-03-01

In proton therapy, the radiological thickness of a material is commonly expressed in terms of water equivalent thickness (WET) or water equivalent ratio (WER). However, the WET calculations required either iterative numerical methods or approximate methods of unknown accuracy. The objective of this study was to develop a simple deterministic formula to calculate WET values with an accuracy of 1 mm for materials commonly used in proton radiation therapy. Several alternative formulas were derived in which the energy loss was calculated based on the Bragg-Kleeman rule (BK), the Bethe-Bloch equation (BB) or an empirical version of the Bethe-Bloch equation (EBB). Alternative approaches were developed for targets that were 'radiologically thin' or 'thick'. The accuracy of these methods was assessed by comparison to values from an iterative numerical method that utilized evaluated stopping power tables. In addition, we also tested the approximate formula given in the International Atomic Energy Agency's dosimetry code of practice (Technical Report Series No 398, 2000, IAEA, Vienna) and stopping power ratio approximation. The results of these comparisons revealed that most methods were accurate for cases involving thin or low-Z targets. However, only the thick-target formulas provided accurate WET values for targets that were radiologically thick and contained high-Z material.

Displaying radiologic images on personal computers: image storage and compression--Part 2.

PubMed

Gillespy, T; Rowberg, A H

1994-02-01

This is part 2 of our article on image storage and compression, the third article of our series for radiologists and imaging scientists on displaying, manipulating, and analyzing radiologic images on personal computers. Image compression is classified as lossless (nondestructive) or lossy (destructive). Common lossless compression algorithms include variable-length bit codes (Huffman codes and variants), dictionary-based compression (Lempel-Ziv variants), and arithmetic coding. Huffman codes and the Lempel-Ziv-Welch (LZW) algorithm are commonly used for image compression. All of these compression methods are enhanced if the image has been transformed into a differential image based on a differential pulse-code modulation (DPCM) algorithm. The LZW compression after the DPCM image transformation performed the best on our example images, and performed almost as well as the best of the three commercial compression programs tested. Lossy compression techniques are capable of much higher data compression, but reduced image quality and compression artifacts may be noticeable. Lossy compression is comprised of three steps: transformation, quantization, and coding. Two commonly used transformation methods are the discrete cosine transformation and discrete wavelet transformation. In both methods, most of the image information is contained in a relatively few of the transformation coefficients. The quantization step reduces many of the lower order coefficients to 0, which greatly improves the efficiency of the coding (compression) step. In fractal-based image compression, image patterns are stored as equations that can be reconstructed at different levels of resolution.

Recent Improvement of Measurement Instrumentation to Supervise Nuclear Operations and to Contribute Input Data to 3D Simulation Code - 13289

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

Mahe, Charly; Chabal, Caroline

2013-07-01

The CEA has developed many compact characterization tools to follow sensitive operations in a nuclear environment. Usually, these devices are made to carry out radiological inventories, to prepare nuclear interventions or to supervise some special operations. These in situ measurement techniques mainly take place at different stages of clean-up operations and decommissioning projects, but they are also in use to supervise sensitive operations when the nuclear plant is still operating. In addition to this, such tools are often associated with robots to access very highly radioactive areas, and thus can be used in accident situations. Last but not least, themore » radiological data collected can be entered in 3D calculation codes used to simulate the doses absorbed by workers in real time during operations in a nuclear environment. Faced with these ever-greater needs, nuclear measurement instrumentation always has to involve on-going improvement processes. Firstly, this paper will describe the latest developments and results obtained in both gamma and alpha imaging techniques. The gamma camera has been used by the CEA since the 1990's and several changes have made this device more sensitive, more compact and more competitive for nuclear plant operations. It is used to quickly identify hot spots, locating irradiating sources from 50 keV to 1500 keV. Several examples from a wide field of applications will be presented, together with the very latest developments. The alpha camera is a new camera used to see invisible alpha contamination on several kinds of surfaces. The latest results obtained allow real time supervision of a glove box cleaning operation (for {sup 241}Am contamination). The detection principle as well as the main trials and results obtained will be presented. Secondly, this paper will focus on in situ gamma spectrometry methods developed by the CEA with compact gamma spectrometry probes (CdZnTe, LaBr{sub 3}, NaI, etc.). The radiological data collected is used to quantify the activity of hot spots and can also then be entered in 3D models of nuclear plants to simulate intervention scenarios. Recent developments and results will be presented regarding this. Finally, thanks to a large amount of feedback, the interest of using complementary measurements will be discussed. In fact, the recent use of 3D simulation codes requires very accurate knowledge of nuclear plant radiological data. The use of coupled devices such as imaging devices, (gamma and alpha cameras), gamma spectrometry, dose rate mapping, collimated / un-collimated measurements and many other physical values gives an approach to the radiological knowledge of a process or plant with the lowest possible uncertainty. In line with this, the paper will conclude with the future developments and trials that could be assessed in that field of application. (authors)« less

32 CFR Appendix A to Part 195 - Programs to Which This Part Applies

Code of Federal Regulations, 2010 CFR

2010-07-01

...-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 Pt. 195, App. A Appendix A to Part 195—Programs to... Defense assistance to programs of adult education in civil defense subjects (50 United States Code App. 2281 (e), (f)). 6. Office of Civil Defense radiological instruments grants (50 United States Code App...

32 CFR Appendix A to Part 195 - Programs to Which This Part Applies

Code of Federal Regulations, 2011 CFR

2011-07-01

...-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 Pt. 195, App. A Appendix A to Part 195—Programs to... Defense assistance to programs of adult education in civil defense subjects (50 United States Code App. 2281 (e), (f)). 6. Office of Civil Defense radiological instruments grants (50 United States Code App...

Radiology Teacher: a free, Internet-based radiology teaching file server.

PubMed

Talanow, Roland

2009-12-01

Teaching files are an essential ingredient in residency education. The online program Radiology Teacher was developed to allow the creation of interactive and customized teaching files in real time. Online access makes it available anytime and anywhere, and it is free of charge, user tailored, and easy to use. No programming skills, additional plug-ins, or installations are needed, allowing its use even on protected intranets. Special effects for enhancing the learning experience as well as the linking and the source code are created automatically by the program. It may be used in different modes by individuals and institutions to share cases from multiple authors in a single database. Radiology Teacher is an easy-to-use automatic teaching file program that may enhance users' learning experiences by offering different modes of user-defined presentations.

Radiological control manual. Revision 1

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

Kloepping, R.

1996-05-01

This Lawrence Berkeley National Laboratory Radiological Control Manual (LBNL RCM) has been prepared to provide guidance for site-specific additions, supplements and interpretation of the DOE Radiological Control Manual. The guidance provided in this manual is one methodology to implement the requirements given in Title 10 Code of Federal Regulations Part 835 (10 CFR 835) and the DOE Radiological Control Manual. Information given in this manual is also intended to provide demonstration of compliance to specific requirements in 10 CFR 835. The LBNL RCM (Publication 3113) and LBNL Health and Safety Manual Publication-3000 form the technical basis for the LBNL RPPmore » and will be revised as necessary to ensure that current requirements from Rules and Orders are represented. The LBNL RCM will form the standard for excellence in the implementation of the LBNL RPP.« less

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

21 CFR 129.80 - Processes and controls.

Code of Federal Regulations, 2010 CFR

2010-04-01

... determine whether any of the coliform organisms are E. coli. (2) For chemical, physical, and radiological... bactericidal action to that required in paragraph (d)(3) of this section. (e) Unit package production code...

21 CFR 129.80 - Processes and controls.

Code of Federal Regulations, 2011 CFR

2011-04-01

... determine whether any of the coliform organisms are E. coli. (2) For chemical, physical, and radiological... bactericidal action to that required in paragraph (d)(3) of this section. (e) Unit package production code...

Mobile technology in radiology resident education.

PubMed

Korbage, Aiham C; Bedi, Harprit S

2012-06-01

The authors hypothesized that ownership of a mobile electronic device would result in more time spent learning radiology. Current trends in radiology residents' studying habits, their use of electronic and printed radiology learning resources, and how much of the funds allotted to them are being used toward printed vs electronic education tools were assessed in this study. A survey study was conducted among radiology residents across the United States from June 13 to July 5, 2011. Program directors listed in the Association of Program Directors in Radiology e-mail list server received an e-mail asking for residents to participate in an online survey. The questionnaire consisted of 12 questions and assessed the type of institution, the levels of training of the respondents, and book funds allocated to residents. It also assessed the residents' study habits, access to portable devices, and use of printed and electronic radiology resources. Radiology residents are adopters of new technologies, with 74% owning smart phones and 37% owning tablet devices. Respondents spend nearly an equal amount of time learning radiology from printed textbooks as they do from electronic resources. Eighty-one percent of respondents believe that they would spend more time learning radiology if provided with tablet devices. There is considerable use of online and electronic resources and mobile devices among the current generation of radiology residents. Benefits, such as more study time, may be obtained by radiology programs that incorporate tablet devices into the education of their residents. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

High Temperature Gas Reactors: Assessment of Applicable Codes and Standards

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

McDowell, Bruce K.; Nickolaus, James R.; Mitchell, Mark R.

2011-10-31

Current interest expressed by industry in HTGR plants, particularly modular plants with power up to about 600 MW(e) per unit, has prompted NRC to task PNNL with assessing the currently available literature related to codes and standards applicable to HTGR plants, the operating history of past and present HTGR plants, and with evaluating the proposed designs of RPV and associated piping for future plants. Considering these topics in the order they are arranged in the text, first the operational histories of five shut-down and two currently operating HTGR plants are reviewed, leading the authors to conclude that while small, simplemore » prototype HTGR plants operated reliably, some of the larger plants, particularly Fort St. Vrain, had poor availability. Safety and radiological performance of these plants has been considerably better than LWR plants. Petroleum processing plants provide some applicable experience with materials similar to those proposed for HTGR piping and vessels. At least one currently operating plant - HTR-10 - has performed and documented a leak before break analysis that appears to be applicable to proposed future US HTGR designs. Current codes and standards cover some HTGR materials, but not all materials are covered to the high temperatures envisioned for HTGR use. Codes and standards, particularly ASME Codes, are under development for proposed future US HTGR designs. A 'roadmap' document has been prepared for ASME Code development; a new subsection to section III of the ASME Code, ASME BPVC III-5, is scheduled to be published in October 2011. The question of terminology for the cross-duct structure between the RPV and power conversion vessel is discussed, considering the differences in regulatory requirements that apply depending on whether this structure is designated as a 'vessel' or as a 'pipe'. We conclude that designing this component as a 'pipe' is the more appropriate choice, but that the ASME BPVC allows the owner of the facility to select the preferred designation, and that either designation can be acceptable.« less

[Study on the indexes of forensic identification by the occlusal-facial digital radiology].

PubMed

Gao, Dong; Wang, Hu; Hu, Jin-liang; Xu, Zhe; Deng, Zhen-hua

2006-02-01

To discuss the coding of full dentition with 32 locations and measure the characteristics of some bony indexes in occlusal-facial digital radiology (DR). To select randomly three hundred DR orthopantomogram and code the full dentition, then analyze the diversity of dental patterns. To select randomly one hundred DR lateral cephalogram and measure six indexes (N-S,N-Me,Cd-Gn,Cd-Go,NP-SN,MP-SN) separately by one odontologist and one trained forensic graduate student, then calculate the coefficient variation (CV) of every index and take a correlation analysis for the consistency between two measurements. (1) The total diversity of 300 dental patterns was 75%.It was a very high value. (2)All six quantitative variables had comparatively high CV value.(3) After the linear correlation analysis between two measurements, all six coefficient correlations were close to 1. This indicated that the measurements were stable and consistent. The method of coding full dentition in DR orthopantomogram and measuring six bony indexes in DR lateral cephalogram can be used to forensic identification.

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.

Non-Ionizing Radiation Used in Microwave Ovens

MedlinePlus

... Human Services (HHS), U.S. Food and Drug Administration (FDA) FDA's Center for Devices and Radiological Health (CDRH) sets ... public health. These standards can be viewed on FDA's Code of Federal Regulations on Microwave Ovens . FDA ...

Environmental radiology assessment in Lahad Datu, Sabah

NASA Astrophysics Data System (ADS)

Siti Fharhana, Yusof; Wan Muhamad Saridan, Wan Hassan; Ahmad Termizi, Ramli; Mohd Hilmi, Sahini; Mohammad Syazwan, Mohd Sanusi; Nor Afifah, Basri; Nor Zati Hani, Abu Hanifah

2017-10-01

Monitoring terrestial gamma radiation is crucial to prepare a baseline data for environmental radiological protection. Radiological research was carried out in Lahad Datu, Sabah to obtain the radioactivity status and terrestrial gamma radiation level in the area. We measure the terrestrial gamma radiation dose rates and analyse the radioactivity concentration of primordial radionuclides for radiological risk assessment. We identified that the annual estimation of dose effective for public is below the public dose limit, 1 mSv per year. Public and environment safety and health are remain secure. The obtained data and results can be used as reference for environmental radiology protection.

Inpatient Complexity in Radiology-a Practical Application of the Case Mix Index Metric.

PubMed

Mabotuwana, Thusitha; Hall, Christopher S; Flacke, Sebastian; Thomas, Shiby; Wald, Christoph

2017-06-01

With ongoing healthcare payment reforms in the USA, radiology is moving from its current state of a revenue generating department to a new reality of a cost-center. Under bundled payment methods, radiology does not get reimbursed for each and every inpatient procedure, but rather, the hospital gets reimbursed for the entire hospital stay under an applicable diagnosis-related group code. The hospital case mix index (CMI) metric, as defined by the Centers for Medicare and Medicaid Services, has a significant impact on how much hospitals get reimbursed for an inpatient stay. Oftentimes, patients with the highest disease acuity are treated in tertiary care radiology departments. Therefore, the average hospital CMI based on the entire inpatient population may not be adequate to determine department-level resource utilization, such as the number of technologists and nurses, as case length and staffing intensity gets quite high for sicker patients. In this study, we determine CMI for the overall radiology department in a tertiary care setting based on inpatients undergoing radiology procedures. Between April and September 2015, CMI for radiology was 1.93. With an average of 2.81, interventional neuroradiology had the highest CMI out of the ten radiology sections. CMI was consistently higher across seven of the radiology sections than the average hospital CMI of 1.81. Our results suggest that inpatients undergoing radiology procedures were on average more complex in this hospital setting during the time period considered. This finding is relevant for accurate calculation of labor analytics and other predictive resource utilization tools.

Diagnostic x-ray dosimetry using Monte Carlo simulation.

PubMed

Ioppolo, J L; Price, R I; Tuchyna, T; Buckley, C E

2002-05-21

An Electron Gamma Shower version 4 (EGS4) based user code was developed to simulate the absorbed dose in humans during routine diagnostic radiological procedures. Measurements of absorbed dose using thermoluminescent dosimeters (TLDs) were compared directly with EGS4 simulations of absorbed dose in homogeneous, heterogeneous and anthropomorphic phantoms. Realistic voxel-based models characterizing the geometry of the phantoms were used as input to the EGS4 code. The voxel geometry of the anthropomorphic Rando phantom was derived from a CT scan of Rando. The 100 kVp diagnostic energy x-ray spectra of the apparatus used to irradiate the phantoms were measured, and provided as input to the EGS4 code. The TLDs were placed at evenly spaced points symmetrically about the central beam axis, which was perpendicular to the cathode-anode x-ray axis at a number of depths. The TLD measurements in the homogeneous and heterogenous phantoms were on average within 7% of the values calculated by EGS4. Estimates of effective dose with errors less than 10% required fewer numbers of photon histories (1 x 10(7)) than required for the calculation of dose profiles (1 x 10(9)). The EGS4 code was able to satisfactorily predict and thereby provide an instrument for reducing patient and staff effective dose imparted during radiological investigations.

Diagnostic x-ray dosimetry using Monte Carlo simulation

NASA Astrophysics Data System (ADS)

Ioppolo, J. L.; Price, R. I.; Tuchyna, T.; Buckley, C. E.

2002-05-01

An Electron Gamma Shower version 4 (EGS4) based user code was developed to simulate the absorbed dose in humans during routine diagnostic radiological procedures. Measurements of absorbed dose using thermoluminescent dosimeters (TLDs) were compared directly with EGS4 simulations of absorbed dose in homogeneous, heterogeneous and anthropomorphic phantoms. Realistic voxel-based models characterizing the geometry of the phantoms were used as input to the EGS4 code. The voxel geometry of the anthropomorphic Rando phantom was derived from a CT scan of Rando. The 100 kVp diagnostic energy x-ray spectra of the apparatus used to irradiate the phantoms were measured, and provided as input to the EGS4 code. The TLDs were placed at evenly spaced points symmetrically about the central beam axis, which was perpendicular to the cathode-anode x-ray axis at a number of depths. The TLD measurements in the homogeneous and heterogenous phantoms were on average within 7% of the values calculated by EGS4. Estimates of effective dose with errors less than 10% required fewer numbers of photon histories (1 × 107) than required for the calculation of dose profiles (1 × 109). The EGS4 code was able to satisfactorily predict and thereby provide an instrument for reducing patient and staff effective dose imparted during radiological investigations.

The Evolution of the Federal Monitoring and Assessment Center

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

NSTec Aerial Measurement System

2012-07-31

The Federal Radiological Monitoring and Assessment Center (FRMAC) is a federal emergency response asset whose assistance may be requested by the Department of Homeland Security (DHS), the Department of Defense (DoD), the Environmental Protection Agency (EPA), the Nuclear Regulatory Commission (NRC), and state and local agencies to respond to a nuclear or radiological incident. It is an interagency organization with representation from the Department of Energy’s National Nuclear Security Administration (DOE/NNSA), the Department of Defense (DoD), the Environmental Protection Agency (EPA), the Department of Health and Human Services (HHS), the Federal Bureau of Investigation (FBI), and other federal agencies. FRMAC,more » in its present form, was created in 1987 when the radiological support mission was assigned to the DOE’s Nevada Operations Office by DOE Headquarters. The FRMAC asset, including its predecessor entities, was created, grew, and evolved to function as a response to radiological incidents. Radiological emergency response exercises showed the need for a coordinated approach to managing federal emergency monitoring and assessment activities. The mission of FRMAC is to coordinate and manage all federal radiological environmental monitoring and assessment activities during a nuclear or radiological incident within the United States in support of state,local, tribal governments, DHS, and the federal coordinating agency. Radiological emergency response professionals with the DOE’s national laboratories support the Radiological Assistance Program (RAP), National Atmospheric Release Advisory Center (NARAC), the Aerial MeasuringSystem (AMS), and the Radiation Emergency Assistance Center/Training Site (REAC/TS). These teams support the FRMAC to provide: Atmospheric transport modeling; Radiation monitoring; Radiological analysis and data assessments; and Medical advice for radiation injuries In support of field operations, the FRMAC provides geographic information systems, communications, mechanical, electrical, logistics, and administrative support. The size of the FRMAC is tailored to the incident and is comprised of emergency response professionals drawn from across the federal government. State and local emergency response teams may also integrate their operations with FRMAC, but are not required to.« less

Impact assessment of ionizing radiation on human and non-human biota from the vicinity of a near-surface radioactive waste repository.

PubMed

Nedveckaite, T; Gudelis, A; Vives i Batlle, J

2013-05-01

This work describes the radiological assessment of the near-surface Maisiagala radioactive waste repository (Lithuania) over the period 2005-2012, with focus on water pathways and special emphasis on tritium. The study includes an assessment of the effect of post-closure upgrading, the durability of which is greater than 30 years. Both human and terrestrial non-human biota are considered, with local low-intensity forestry and small farms being the area of concern. The radiological exposure was evaluated using the RESRAD-OFFSITE, RESRAD-BIOTA and ERICA codes in combination with long-term data from a dedicated environmental monitoring programme. All measurements were performed at the Lithuanian Institute of Physics as part of this project. It is determined that, after repository upgrading, radiological exposure to humans are significantly lower than the human dose constraint of 0.2 mSv/year valid in the Republic of Lithuania. Likewise, for non-human biota, dose rates are below the ERICA/PROTECT screening levels. The potential annual effective inhalation dose that could be incurred by the highest-exposed human individual (which is due to tritiated water vapour airborne release over the most exposed area) does not exceed 0.1 μSv. Tritium-labelled drinking water appears to be the main pathway for human impact, representing about 83 % of the exposure. Annual committed effective dose (CED) values for members of the public consuming birch sap as medical practice are calculated to be several orders of magnitude below the CEDs for the same location associated with drinking of well water. The data presented here indicate that upper soil-layer samples may not provide a good indication of potential exposure to terrestrial deep-rooted trees, as demonstrated by an investigation of stratified (3)H in soil moisture, expressed on a wet soil mass basis, in an area with subsurface contamination.

Using computational modeling to compare X-ray tube Practical Peak Voltage for Dental Radiology

NASA Astrophysics Data System (ADS)

Holanda Cassiano, Deisemar; Arruda Correa, Samanda Cristine; de Souza, Edmilson Monteiro; da Silva, Ademir Xaxier; Pereira Peixoto, José Guilherme; Tadeu Lopes, Ricardo

2014-02-01

The Practical Peak Voltage-PPV has been adopted to measure the voltage applied to an X-ray tube. The PPV was recommended by the IEC document and accepted and published in the TRS no. 457 code of practice. The PPV is defined and applied to all forms of waves and is related to the spectral distribution of X-rays and to the properties of the image. The calibration of X-rays tubes was performed using the MCNPX Monte Carlo code. An X-ray tube for Dental Radiology (operated from a single phase power supply) and an X-ray tube used as a reference (supplied from a constant potential power supply) were used in simulations across the energy range of interest of 40 kV to 100 kV. Results obtained indicated a linear relationship between the tubes involved.

Survey Of Lossless Image Coding Techniques

NASA Astrophysics Data System (ADS)

Melnychuck, Paul W.; Rabbani, Majid

1989-04-01

Many image transmission/storage applications requiring some form of data compression additionally require that the decoded image be an exact replica of the original. Lossless image coding algorithms meet this requirement by generating a decoded image that is numerically identical to the original. Several lossless coding techniques are modifications of well-known lossy schemes, whereas others are new. Traditional Markov-based models and newer arithmetic coding techniques are applied to predictive coding, bit plane processing, and lossy plus residual coding. Generally speaking, the compression ratio offered by these techniques are in the area of 1.6:1 to 3:1 for 8-bit pictorial images. Compression ratios for 12-bit radiological images approach 3:1, as these images have less detailed structure, and hence, their higher pel correlation leads to a greater removal of image redundancy.

TERRA: a computer code for simulating the transport of environmentally released radionuclides through agriculture

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

Baes, C.F. III; Sharp, R.D.; Sjoreen, A.L.

1984-11-01

TERRA is a computer code which calculates concentrations of radionuclides and ingrowing daughters in surface and root-zone soil, produce and feed, beef, and milk from a given deposition rate at any location in the conterminous United States. The code is fully integrated with seven other computer codes which together comprise a Computerized Radiological Risk Investigation System, CRRIS. Output from either the long range (> 100 km) atmospheric dispersion code RETADD-II or the short range (<80 km) atmospheric dispersion code ANEMOS, in the form of radionuclide air concentrations and ground deposition rates by downwind location, serves as input to TERRA. User-definedmore » deposition rates and air concentrations may also be provided as input to TERRA through use of the PRIMUS computer code. The environmental concentrations of radionuclides predicted by TERRA serve as input to the ANDROS computer code which calculates population and individual intakes, exposures, doses, and risks. TERRA incorporates models to calculate uptake from soil and atmospheric deposition on four groups of produce for human consumption and four groups of livestock feeds. During the environmental transport simulation, intermediate calculations of interception fraction for leafy vegetables, produce directly exposed to atmospherically depositing material, pasture, hay, and silage are made based on location-specific estimates of standing crop biomass. Pasture productivity is estimated by a model which considers the number and types of cattle and sheep, pasture area, and annual production of other forages (hay and silage) at a given location. Calculations are made of the fraction of grain imported from outside the assessment area. TERRA output includes the above calculations and estimated radionuclide concentrations in plant produce, milk, and a beef composite by location.« less

Environmental Tools and Radiological Assessment

EPA Science Inventory

This presentation details two tools (SADA and FRAMES) available for use in environmental assessments of chemicals that can also be used for radiological assessments of the environment. Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporate...

Radiology Reports With Hyperlinks Improve Target Lesion Selection and Measurement Concordance in Cancer Trials.

PubMed

Machado, Laura B; Apolo, Andrea B; Steinberg, Seth M; Folio, Les R

2017-02-01

Radiology reports often lack the measurements of target lesions that are needed for oncology clinical trials. When available, the measurements in the radiology reports often do not match those in the records used to calculate therapeutic response. This study assessed the clinical value of hyperlinked tumor measurements in multimedia-enhanced radiology reports in the PACS and the inclusion of a radiologist assistant in the process of assessing tumor burden. We assessed 489 target lesions in 232 CT examinations of 71 patients with metastatic genitourinary cancer enrolled in two therapeutic trials. We analyzed target lesion selection and measurement concordance between oncology records (used to calculate therapeutic response) and two types of radiology reports in the PACS: multimedia-enhanced radiology reports and text-only reports. For statistical tests, we used the Wilcoxon signed rank, Wilcoxon rank sum test, and Fisher method to combine p values from the paired and unpaired results. The Fisher exact test was used to compare overall measurement concordance. Concordance on target lesion selection was greater for multimedia-enhanced radiology reports (78%) than the text-only reports (52%) (p = 0.0050). There was also improved overall measurement concordance with the multimedia-enhanced radiology reports (68%) compared with the text-only reports (38%) (p < 0.0001). Compared with text-only reports, hyperlinked multimedia-enhanced radiology reports improved concordance of target lesion selection and measurement with the measurements used to calculate therapeutic response.

Teaching and Assessing Professionalism in Radiology Resident Education.

PubMed

Kelly, Aine Marie; Gruppen, Larry D; Mullan, Patricia B

2017-05-01

Radiologists in teaching hospitals and in practices with residents rotating through are involved in the education of their residents. The Accreditation Council for Graduate Medical Education requires evidence that trainees are taught and demonstrate competency not only in medical knowledge and in patient care-the historic focus of radiology education-but also in the so-called non-interpretative core competencies, which include professionalism and interpersonal skills. In addition to accreditation agencies, the prominent assessment practices represented by the American Board of Radiology core and certifying examinations for trainees, as well as Maintenance of Certification for practitioners, are planning to feature more non-interpretative competency assessment, including professionalism to a greater extent. Because professionalism was incorporated as a required competency in medical education as a whole, more clarity about the justification and expected content for teaching about competence in professionalism, as well as greater understanding and evidence about appropriate and effective teaching and assessment methods, have emerged. This article summarizes justifications and expectations for teaching and assessing professionalism in radiology residents and best practices on how to teach and evaluate professionalism that can be used by busy radiology faculty in their everyday practice supervising radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Weld Repair of a Stamped Pressure Vessel in a Radiologically Controlled Zone

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

Cannell, Gary L.; Huth, Ralph J.; Hallum, Randall T.

2013-08-26

In September 2012 an ASME B&PVC Section VIII stamped pressure vessel located at the DOE Hanford Site Effluent Treatment Facility (ETF) developed a through-wall leak. The vessel, a steam/brine heat exchanger, operated in a radiologically controlled zone (by the CH2MHill PRC or CHPRC), had been in service for approximately 17 years. The heat exchanger is part of a single train evaporator process and its failure caused the entire system to be shut down, significantly impacting facility operations. This paper describes the activities associated with failure characterization, technical decision making/planning for repair by welding, logistical challenges associated with performing work inmore » a radiologically controlled zone, performing the repair, and administrative considerations related to ASME code requirements.« less

Correlations between serum adipocytokine concentrations, disease stage, radiological status and total body fat content in the patients with primary knee osteoarthritis.

PubMed

Richter, Magdalena; Trzeciak, Tomasz; Rybka, Jakub Dalibor; Suchorska, Wiktoria; Augustyniak, Ewelina; Lach, Michał; Kaczmarek, Małgorzata; Kaczmarczyk, Jacek

2017-05-01

The study was designed to investigate whether serum concentrations of leptin, resistin and adiponectin in obese and normal-weight patients with primary knee osteoarthritis (OA) correlate with clinical and radiological stages of the disease and percentage of total body fat. Seventy-three patients with knee OA, divided into obese and normal-weight groups, were clinically evaluated according to the Knee Society Score (KSS), and radiologically assessed using Kellgren and Lawrence scale. The percentage of total body fat and some anthropometric data were also given. Serum leptin, resistin and adiponectin concentrations were measured by Elisa and were correlated with the clinical, radiological and anthropometric parameters. Leptin concentrations were significantly higher (p = 0.001) in the obese patients and positively correlated (R = 0.63) with radiologically assessed OA grade, but only in the normal-weight group. Resistin and adiponectin concentrations were identical in obese and normal-weight patients and negatively correlated (R = -0.41) with the clinical status of obese patients. In both groups, percentage of total body fat positively correlated (R = 0.29 and R = 0.53 for obese and normal-weight respectively) with radiologically assessed OA grade. However, no correlations were found with clinical status of the patients. It was found that in the obese patients with knee OA, increased percentage of total body fat and elevated serum leptin concentration might favour the advancement of clinical but not radiologically assessed changes in the joint structures, while in normal-weight patients it correlates only with radiologically assessed changes but does not affect to an appreciable extent the clinical status of the patients.

The role of open-source software in innovation and standardization in radiology.

PubMed

Erickson, Bradley J; Langer, Steve; Nagy, Paul

2005-11-01

The use of open-source software (OSS), in which developers release the source code to applications they have developed, is popular in the software industry. This is done to allow others to modify and improve software (which may or may not be shared back to the community) and to allow others to learn from the software. Radiology was an early participant in this model, supporting OSS that implemented the ACR-National Electrical Manufacturers Association (now Digital Imaging and Communications in Medicine) standard for medical image communications. In radiology and in other fields, OSS has promoted innovation and the adoption of standards. Popular OSS is of high quality because access to source code allows many people to identify and resolve errors. Open-source software is analogous to the peer-review scientific process: one must be able to see and reproduce results to understand and promote what is shared. The authors emphasize that support for OSS need not threaten vendors; most vendors embrace and benefit from standards. Open-source development does not replace vendors but more clearly defines their roles, typically focusing on areas in which proprietary differentiators benefit customers and on professional services such as implementation planning and service. Continued support for OSS is essential for the success of our field.

A resident's primer of Medicare reimbursement in radiology.

PubMed

Lee, Ryan K

2006-01-01

After having completed medical school, residency, and in many cases specialized fellowships, radiologists are well equipped to practice clinical radiology. However, they receive little if any exposure to the business of radiology, such as coding, billing, and other administrative duties that maintain the financial well-being of any medical practice. Medicare insolvency, managed care, self-referral, and increasing imaging by nonradiology specialists are all issues creating a competitive and ever changing medical environment, and understanding the economic and business aspects of health care is becoming increasingly important for both academic and private practice radiologists. The intent of this paper is to provide new radiologists as well as radiologists in training an introduction to the reimbursement system, as well as to provide a generalized review of the process for practicing radiologists. In particular, this article addresses the fundamentals of the Medicare fee-for-service reimbursement process as well as the factors considered in arriving at the valuation of radiologic services by Medicare.

Use of Transportable Radiation Detection Instruments to Assess Internal Contamination from Intakes of Radionuclides Part II: Calibration Factors and ICAT Computer Program.

PubMed

Anigstein, Robert; Olsher, Richard H; Loomis, Donald A; Ansari, Armin

2016-12-01

The detonation of a radiological dispersion device or other radiological incidents could result in widespread releases of radioactive materials and intakes of radionuclides by affected individuals. Transportable radiation monitoring instruments could be used to measure radiation from gamma-emitting radionuclides in the body for triaging individuals and assigning priorities to their bioassay samples for in vitro assessments. The present study derived sets of calibration factors for four instruments: the Ludlum Model 44-2 gamma scintillator, a survey meter containing a 2.54 × 2.54-cm NaI(Tl) crystal; the Captus 3000 thyroid uptake probe, which contains a 5.08 × 5.08-cm NaI(Tl) crystal; the Transportable Portal Monitor Model TPM-903B, which contains two 3.81 × 7.62 × 182.9-cm polyvinyltoluene plastic scintillators; and a generic instrument, such as an ionization chamber, that measures exposure rates. The calibration factors enable these instruments to be used for assessing inhaled or ingested intakes of any of four radionuclides: Co, I, Cs, and Ir. The derivations used biokinetic models embodied in the DCAL computer software system developed by the Oak Ridge National Laboratory and Monte Carlo simulations using the MCNPX radiation transport code. The three physical instruments were represented by MCNP models that were developed previously. The affected individuals comprised children of five ages who were represented by the revised Oak Ridge National Laboratory pediatric phantoms, and adult men and adult women represented by the Adult Reference Computational Phantoms described in Publication 110 of the International Commission on Radiological Protection. These calibration factors can be used to calculate intakes; the intakes can be converted to committed doses by the use of tabulated dose coefficients. These calibration factors also constitute input data to the ICAT computer program, an interactive Microsoft Windows-based software package that estimates intakes of radionuclides and cumulative and committed effective doses, based on measurements made with these instruments. This program constitutes a convenient tool for assessing intakes and doses without consulting tabulated calibration factors and dose coefficients.

USE OF TRANSPORTABLE RADIATION DETECTION INSTRUMENTS TO ASSESS INTERNAL CONTAMINATION FROM INTAKES OF RADIONUCLIDES PART II: CALIBRATION FACTORS AND ICAT COMPUTER PROGRAM

PubMed Central

Anigstein, Robert; Olsher, Richard H.; Loomis, Donald A.; Ansari, Armin

2017-01-01

The detonation of a radiological dispersion device or other radiological incidents could result in widespread releases of radioactive materials and intakes of radionuclides by affected individuals. Transportable radiation monitoring instruments could be used to measure radiation from gamma-emitting radionuclides in the body for triaging individuals and assigning priorities to their bioassay samples for in vitro assessments. The present study derived sets of calibration factors for four instruments: the Ludlum Model 44-2 gamma scintillator, a survey meter containing a 2.54 × 2.54-cm NaI(Tl) crystal; the Captus 3000 thyroid uptake probe, which contains a 5.08 × 5.08-cm NaI(Tl) crystal; the Transportable Portal Monitor Model TPM-903B, which contains two 3.81 × 7.62 × 182.9-cm polyvinyltoluene plastic scintillators; and a generic instrument, such as an ionization chamber, that measures exposure rates. The calibration factors enable these instruments to be used for assessing inhaled or ingested intakes of any of four radionuclides: 60Co, 131I, 137Cs, and 192Ir. The derivations used biokinetic models embodied in the DCAL computer software system developed by the Oak Ridge National Laboratory and Monte Carlo simulations using the MCNPX radiation transport code. The three physical instruments were represented by MCNP models that were developed previously. The affected individuals comprised children of five ages who were represented by the revised Oak Ridge National Laboratory pediatric phantoms, and adult men and adult women represented by the Adult Reference Computational Phantoms described in Publication 110 of the International Commission on Radiological Protection. These calibration factors can be used to calculate intakes; the intakes can be converted to committed doses by the use of tabulated dose coefficients. These calibration factors also constitute input data to the ICAT computer program, an interactive Microsoft Windows-based software package that estimates intakes of radionuclides and cumulative and committed effective doses, based on measurements made with these instruments. This program constitutes a convenient tool for assessing intakes and doses without consulting tabulated calibration factors and dose coefficients. PMID:27798478

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 ...

Risk assessment during transport of radioactive materials through the Suez Canal

NASA Astrophysics Data System (ADS)

Sabek, M. G.; El-Shinawy, R. M. K.; Gomaa, M.

1997-03-01

In this paper a study for risk assessment of the impact of transporting radioactive materials, during the period 1986-1992, through the Suez Canal of Egypt is given. The code RADTRAN-IV was used for this study. The results of the code, for a normal case, show that the transportation of low activity materials such as uranium (U 3O 8) represent the main items that contribute significantly to the collective dose within the Suez Canal area (Port-Said, Ismailia and Suez). The values of the annual collective dose due to transportation of all radionuclide materials was found to be at a maximum in Suez town and is equal to 5.04 × 10 -8 Man-Sv for the whole populations. If we only consider the workder at the harbour (estimated to be 50 persons), the value of the annual collective dose is about 3.33 × 10 -4 Man-Sv. These values are less than the exemption value of 1 Man-Sv recommended by the IAEA. For the accident case, the following pathways are considered by the code: ground-shine, direct inhalation, inhalation of resuspended material and cloud-shine. The total values of the estimated risks for each radionuclide material are presented in table form and, in addition, health effects (genetic effects, GE, and latent cancer fatality), LCF) are discussed. The calculated values of the radiological risks are very low for the three towns, showing that no radiation-induced early deaths are to be expected.

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

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

McKenzie-Carter, M.A.; Lyon, R.E.

This report contains information to support the Environmental Assessment for the Compact Ignition Tokamak Project (CIT) proposed for Princeton Plasma Physics Laboratory (PPPL). The assumptions and methodology used to assess the impact to members of the public from operational and accidental releases of radioactive material from the proposed CIT during the operational period of the project are described. A description of the tracer release tests conducted at PPPL by NOAA is included; dispersion values from these tests are used in the dose calculation. Radiological releases, doses, and resulting health risks are calculated. The computer code AIRDOS-EPA is used to calculatemore » the individual and population doses for routine releases; FUSCRAC3 is used to calculate doses resulting from off-normal releases where direct application of the NOAA tracer test data is not practical. Where applicable, doses are compared to regulatory limits and guidelines values. 44 refs., 5 figs., 18 tabs.« less

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.

Addressing Uncertainty in the ISCORS Multimedia Radiological Dose Assessment of Municipal Sewage Sludge and Ash

NASA Astrophysics Data System (ADS)

Chiu, W. A.; Bachmaier, J.; Bastian, R.; Hogan, R.; Lenhart, T.; Schmidt, D.; Wolbarst, A.; Wood, R.; Yu, C.

2002-05-01

Managing municipal wastewater at publicly owned treatment works (POTWs) leads to the production of considerable amounts of residual solid material, which is known as sewage sludge or biosolids. If the wastewater entering a POTW contains radioactive material, then the treatment process may concentrate radionuclides in the sludge, leading to possible exposure of the general public or the POTW workers. The Sewage Sludge Subcommittee of the Interagency Steering Committee on Radiation Standards (ISCORS), which consists of representatives from the Environmental Protection Agency, the Nuclear Regulatory Commission, the Department of Energy, and several other federal, state, and local agencies, is developing guidance for POTWs on the management of sewage sludge that may contain radioactive materials. As part of this effort, they are conducting an assessment of potential radiation exposures using the Department of Energy's RESidual RADioactivity (RESRAD) family of computer codes developed by Argonne National Laboratory. This poster describes several approaches used by the Subcommittee to address the uncertainties associated with their assessment. For instance, uncertainties in the source term are addressed through a combination of analytic and deterministic computer code calculations. Uncertainties in the exposure pathways are addressed through the specification of a number of hypothetical scenarios, some of which can be scaled to address changes in exposure parameters. In addition, the uncertainty in some physical and behavioral parameters are addressed through probabilistic methods.

Comprehensive analysis of a Radiology Operations Management computer system.

PubMed

Arenson, R L; London, J W

1979-11-01

The Radiology Operations Management computer system at the Hospital of the University of Pennsylvania is discussed. The scheduling and file room modules are based on the system at Massachusetts General Hospital. Patient delays are indicated by the patient tracking module. A reporting module allows CRT/keyboard entry by transcriptionists, entry of standard reports by radiologists using bar code labels, and entry by radiologists using a specialty designed diagnostic reporting terminal. Time-flow analyses demonstrate a significant improvement in scheduling, patient waiting, retrieval of radiographs, and report delivery. Recovery of previously lost billing contributes to the proved cost effectiveness of this system.

Turbo FRMAC 2011

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

Fulton, John; Gallagher, Linda K.; Whitener, Dustin

The Turbo FRMAC (TF) software automates the calculations described in volumes 1-3 of "The Federal Manual for Assessing Environmental Data During a Radiological Emergency" (2010 version). This software automates the process of assessing radiological data during a Federal Radiological Emergency. The manual upon which the software is based is unclassified and freely available on the Internet. TF takes values generated by field samples or computer dispersion models and assesses the data in a way which is meaningful to a decision maker at a radiological emergency; such as, do radiation values exceed city, state, or federal limits; should the crops bemore » destroyed or can they be utilized; do residents need to be evacuated, sheltered in place, or should another action taken. The software also uses formulas generated by the EPA, FDA, and other federal agencies to generate field observable values specific to the radiological event that can be used to determine where regulatory limit values are exceeded. In addition to these calculations, TF calculates values which indicate how long an emergency worker can work in the contaminated area during a radiological emergency, the dose received from drinking contaminated water or milk, the dose from eating contaminated food, the does expected down or upwind of a given field sample, along with a significant number of other similar radiological health values.« less

Radiation dose to the global flying population.

PubMed

Alvarez, Luis E; Eastham, Sebastian D; Barrett, Steven R H

2016-03-01

Civil airliner passengers and crew are exposed to elevated levels of radiation relative to being at sea level. Previous studies have assessed the radiation dose received in particular cases or for cohort studies. Here we present the first estimate of the total radiation dose received by the worldwide civilian flying population. We simulated flights globally from 2000 to 2013 using schedule data, applying a radiation propagation code to estimate the dose associated with each flight. Passengers flying in Europe and North America exceed the International Commission on Radiological Protection annual dose limits at an annual average of 510 or 420 flight hours per year, respectively. However, this falls to 160 or 120 h on specific routes under maximum exposure conditions.

USE OF TRANSPORTABLE RADIATION DETECTION INSTRUMENTS TO ASSESS INTERNAL CONTAMINATION FROM INTAKES OF RADIONUCLIDES PART I: FIELD TESTS AND MONTE CARLO SIMULATIONS

PubMed Central

Anigstein, Robert; Erdman, Michael C.; Ansari, Armin

2017-01-01

The detonation of a radiological dispersion device or other radiological incidents could result in the dispersion of radioactive materials and intakes of radionuclides by affected individuals. Transportable radiation monitoring instruments could be used to measure photon radiation from radionuclides in the body for triaging individuals and assigning priorities to their bioassay samples for further assessments. Computer simulations and experimental measurements are required for these instruments to be used for assessing intakes of radionuclides. Count rates from calibrated sources of 60Co, 137Cs, and 241Am were measured on three instruments: a survey meter containing a 2.54 × 2.54-cm NaI(Tl) crystal, a thyroid probe using a 5.08 × 5.08-cm NaI(Tl) crystal, and a portal monitor incorporating two 3.81 × 7.62 × 182.9-cm polyvinyltoluene plastic scintillators. Computer models of the instruments and of the calibration sources were constructed, using engineering drawings and other data provided by the manufacturers. Count rates on the instruments were simulated using the Monte Carlo radiation transport code MCNPX. The computer simulations were within 16% of the measured count rates for all 20 measurements without using empirical radionuclide-dependent scaling factors, as reported by others. The weighted root-mean-square deviations (differences between measured and simulated count rates, added in quadrature and weighted by the variance of the difference) were 10.9% for the survey meter, 4.2% for the thyroid probe, and 0.9% for the portal monitor. These results validate earlier MCNPX models of these instruments that were used to develop calibration factors that enable these instruments to be used for assessing intakes and committed doses from several gamma-emitting radionuclides. PMID:27115229

Use of Transportable Radiation Detection Instruments to Assess Internal Contamination From Intakes of Radionuclides Part I: Field Tests and Monte Carlo Simulations.

PubMed

Anigstein, Robert; Erdman, Michael C; Ansari, Armin

2016-06-01

The detonation of a radiological dispersion device or other radiological incidents could result in the dispersion of radioactive materials and intakes of radionuclides by affected individuals. Transportable radiation monitoring instruments could be used to measure photon radiation from radionuclides in the body for triaging individuals and assigning priorities to their bioassay samples for further assessments. Computer simulations and experimental measurements are required for these instruments to be used for assessing intakes of radionuclides. Count rates from calibrated sources of Co, Cs, and Am were measured on three instruments: a survey meter containing a 2.54 × 2.54-cm NaI(Tl) crystal, a thyroid probe using a 5.08 × 5.08-cm NaI(Tl) crystal, and a portal monitor incorporating two 3.81 × 7.62 × 182.9-cm polyvinyltoluene plastic scintillators. Computer models of the instruments and of the calibration sources were constructed, using engineering drawings and other data provided by the manufacturers. Count rates on the instruments were simulated using the Monte Carlo radiation transport code MCNPX. The computer simulations were within 16% of the measured count rates for all 20 measurements without using empirical radionuclide-dependent scaling factors, as reported by others. The weighted root-mean-square deviations (differences between measured and simulated count rates, added in quadrature and weighted by the variance of the difference) were 10.9% for the survey meter, 4.2% for the thyroid probe, and 0.9% for the portal monitor. These results validate earlier MCNPX models of these instruments that were used to develop calibration factors that enable these instruments to be used for assessing intakes and committed doses from several gamma-emitting radionuclides.

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

Faillace, E.R.; Cheng, J.J.; Yu, C.

A series of benchmarking runs were conducted so that results obtained with the RESRAD code could be compared against those obtained with six pathway analysis models used to determine the radiation dose to an individual living on a radiologically contaminated site. The RESRAD computer code was benchmarked against five other computer codes - GENII-S, GENII, DECOM, PRESTO-EPA-CPG, and PATHRAE-EPA - and the uncodified methodology presented in the NUREG/CR-5512 report. Estimated doses for the external gamma pathway; the dust inhalation pathway; and the soil, food, and water ingestion pathways were calculated for each methodology by matching, to the extent possible, inputmore » parameters such as occupancy, shielding, and consumption factors.« less

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)

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.

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.

Color-coded visualization of magnetic resonance imaging multiparametric maps

NASA Astrophysics Data System (ADS)

Kather, Jakob Nikolas; Weidner, Anja; Attenberger, Ulrike; Bukschat, Yannick; Weis, Cleo-Aron; Weis, Meike; Schad, Lothar R.; Zöllner, Frank Gerrit

2017-01-01

Multiparametric magnetic resonance imaging (mpMRI) data are emergingly used in the clinic e.g. for the diagnosis of prostate cancer. In contrast to conventional MR imaging data, multiparametric data typically include functional measurements such as diffusion and perfusion imaging sequences. Conventionally, these measurements are visualized with a one-dimensional color scale, allowing only for one-dimensional information to be encoded. Yet, human perception places visual information in a three-dimensional color space. In theory, each dimension of this space can be utilized to encode visual information. We addressed this issue and developed a new method for tri-variate color-coded visualization of mpMRI data sets. We showed the usefulness of our method in a preclinical and in a clinical setting: In imaging data of a rat model of acute kidney injury, the method yielded characteristic visual patterns. In a clinical data set of N = 13 prostate cancer mpMRI data, we assessed diagnostic performance in a blinded study with N = 5 observers. Compared to conventional radiological evaluation, color-coded visualization was comparable in terms of positive and negative predictive values. Thus, we showed that human observers can successfully make use of the novel method. This method can be broadly applied to visualize different types of multivariate MRI data.

Applying ethical and legal principles to new technology: the University of Auckland Faculty of Medical and Health Sciences' policy 'Taking and Sharing Images of Patients.'

PubMed

Jonas, Monique; Malpas, Phillipa; Kersey, Kate; Merry, Alan; Bagg, Warwick

2017-01-27

To develop a policy governing the taking and sharing of photographic and radiological images by medical students. The Rules of the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers' Rights were applied to the taking, storing and sharing of photographic and radiological images by medical students. Stakeholders, including clinicians, medical students, lawyers at district health boards in the Auckland region, the Office of the Privacy Commissioner and the Health and Disability Commissioner were consulted and their recommendations incorporated. The policy 'Taking and Sharing Images of Patients' sets expectations of students in relation to: photographs taken for the purpose of providing care; photographs taken for educational or professional practice purposes and photographic or radiological images used for educational or professional practice purposes. In addition, it prohibits students from uploading images of patients onto image-sharing apps such as Figure 1. The policy has since been extended to apply to all students at the Faculty of Medical and Health Sciences at the University of Auckland. Technology-driven evolutions in practice necessitate regular review to ensure compliance with existing legal regulations and ethical frameworks. This policy offers a starting point for healthcare providers to review their own policies and practice, with a view to ensuring that patients' trust in the treatment that their health information receives is upheld.

Development of a rapidly deployed Department of Energy emergency response element.

PubMed

Tighe, R J; Riland, C A; Hopkins, R C

2000-02-01

The Federal Radiological Emergency Response Plan (FRERP) directs the Department of Energy (DOE) to maintain a viable, timely, and fully documented response option capable of supporting the responsible Lead Federal Agency in the event of a radiological emergency impacting any state or United States territory (e.g., CONUS). In addition, the DOE maintains a response option to support radiological emergencies outside the continental United States (OCONUS). While the OCONUS mission is not governed by the FRERP, this response is operationally similar to that assigned to the DOE by the FRERP The DOE is prepared to alert, activate, and deploy radiological response teams to augment the Radiological Assistance Program and/or local responders. The Radiological Monitoring and Assessment Center (RMAC) is a phased response that integrates with the Federal Radiological Monitoring and Assessment Center (FRMAC) in CONUS environments and represents a stand-alone DOE response for OCONUS environments. The FRMAC/RMAC Phase I was formally "stood up" as an operational element in April 1999. The FRMAC/RMAC Phase II proposed "stand-up" date is midyear 2000.

Academic Radiologist Subspecialty Identification Using a Novel Claims-Based Classification System.

PubMed

Rosenkrantz, Andrew B; Wang, Wenyi; Hughes, Danny R; Ginocchio, Luke A; Rosman, David A; Duszak, Richard

2017-06-01

The objective of the present study is to assess the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. Using a categorization scheme based on the Neiman Imaging Types of Service (NITOS) system, we mapped the Medicare Part B services billed by all radiologists from 2012 to 2014, assigning them to the following subspecialty categories: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, nuclear medicine, interventional radiology, and neuroradiology. The percentage of subspecialty work relative value units (RVUs) to total billed work RVUs was calculated for each radiologist nationwide. For radiologists at the top 20 academic departments funded by the National Institutes of Health, those percentages were compared with subspecialties designated on faculty websites. NITOS-based subspecialty assignments were also compared with the only radiologist subspecialty classifications currently recognized by Medicare (i.e., nuclear medicine and interventional radiology). Of 1012 academic radiologists studied, the median percentage of Medicare-billed NITOS-based subspecialty work RVUs matching the subspecialty designated on radiologists' own websites ranged from 71.3% (for nuclear medicine) to 98.9% (for neuroradiology). A NITOS-based work RVU threshold of 50% correctly classified 89.8% of radiologists (5.9% were not mapped to any subspecialty; subspecialty error rate, 4.2%). In contrast, existing Medicare provider codes identified only 46.7% of nuclear medicine physicians and 39.4% of interventional radiologists. Using a framework based on a recently established imaging health services research tool that maps service codes based on imaging modality and body region, Medicare claims data can be used to consistently identify academic radiologists by subspecialty in a manner not possible with the use of existing Medicare physician specialty identifiers. This method may facilitate more appropriate performance metrics for subspecialty academic physicians under emerging value-based payment models.

Radiological evaluation of dysphagia

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

Ott, D.J.; Gelfand, D.W.; Wu, W.C.

1986-11-21

Dysphagia is a common complaint in patients presenting for radiological or endoscopic examination of the esophagus and is usually due to functional or structural abnormalities of the esophageal body or esophagogastric region. The authors review the radiological evaluation of the esophagus and esophagogastric region in patients with esophageal dysphagia and discuss the roentgenographic techniques used, radiological efficacy for common structural disorders, and evaluation of esophageal motor function. Comparison is made with endoscopy in assessing dysphagia, with the conclusion that the radiological examination be used initially in patients with this complaint.

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.

Effects of soil water content on the external exposure of fauna to radioactive isotopes.

PubMed

Beaugelin-Seiller, K

2016-01-01

Within a recent model intercomparison about radiological risk assessment for contaminated wetlands, the influence of soil saturation conditions on external dose rates was evidenced. This issue joined concerns of assessors regarding the choice of the soil moisture value to input in radiological assessment tools such as the ERICA Tool. Does it really influence the assessment results and how? This question was investigated under IAEA's Modelling and Data for Radiological Impacts Assessments (MODARIA) programme via 42 scenarios for which the soil water content varied from 0 (dry soil) to 100% (saturated soil), in combination with other parameters that may influence the values of the external dose conversion coefficients (DCCs) calculated for terrestrial organisms exposed in soil. A set of α, β, and γ emitters was selected in order to cover the range of possible emission energies. The values of their external DCCs varied generally within a factor 1 to 1.5 with the soil water content, excepted for β emitters that appeared more sensitive (DCCs within a factor of about 3). This may be of importance for some specific cases or for upper tiers of radiological assessments, when refinement is required. But for the general purpose of screening assessment of radiological impact on fauna and flora, current approaches regarding the soil water content are relevant. Copyright © 2015 Elsevier Ltd. All rights reserved.

Online Radiology Reporting with Peer Review as a Learning and Feedback Tool in Radiology; Implementation, Validity, and Student Impressions.

PubMed

McEvoy, Fintan J; Shen, Nicholas W; Nielsen, Dorte H; Buelund, Lene E; Holm, Peter

2017-02-01

Communicating radiological reports to peers has pedagogical value. Students may be uneasy with the process due to a lack of communication and peer review skills or to their failure to see value in the process. We describe a communication exercise with peer review in an undergraduate veterinary radiology course. The computer code used to manage the course and deliver images online is reported, and we provide links to the executable files. We tested to see if undergraduate peer review of radiological reports has validity and describe student impressions of the learning process. Peer review scores for student-generated radiological reports were compared to scores obtained in the summative multiple choice (MCQ) examination for the course. Student satisfaction was measured using a bespoke questionnaire. There was a weak positive correlation (Pearson correlation coefficient = 0.32, p < 0.01) between peer review scores students received and the student scores obtained in the MCQ examination. The difference in peer review scores received by students grouped according to their level of course performance (high vs. low) was statistically significant (p < 0.05). No correlation was found between peer review scores awarded by the students and the scores they obtained in the MCQ examination (Pearson correlation coefficient = 0.17, p = 0.14). In conclusion, we have created a realistic radiology imaging exercise with readily available software. The peer review scores are valid in that to a limited degree they reflect student future performance in an examination. Students valued the process of learning to communicate radiological findings but do not fully appreciated the value of peer review.

ActiWiz 3 – an overview of the latest developments and their application

NASA Astrophysics Data System (ADS)

Vincke, H.; Theis, C.

2018-06-01

In 2011 the ActiWiz code was developed at CERN in order to optimize the choice of materials for accelerator equipment from a radiological point of view. Since then the code has been extended to allow for calculating complete nuclide inventories and provide evaluations with respect to radiotoxicity, inhalation doses, etc. Until now the software included only pre-defined radiation environments for CERN’s high-energy proton accelerators which were based on FLUKA Monte Carlo calculations. Eventually the decision was taken to invest into a major revamping of the code. Starting with version 3 the software is not limited anymore to pre-defined radiation fields but within a few seconds it can also treat arbitrary environments of which fluence spectra are available. This has become possible due to the use of ~100 CPU years’ worth of FLUKA Monte Carlo simulations as well as the JEFF cross-section library for neutrons < 20 MeV. Eventually the latest code version allowed for the efficient inclusion of 42 additional radiation environments of the LHC experiments as well as considerably more flexibility in view of characterizing also waste from CERN’s Large Electron Positron collider (LEP). New fully integrated analysis functionalities like automatic evaluation of difficult-to-measure nuclides, rapid assessment of the temporal evolution of quantities like radiotoxicity or dose-rates, etc. make the software a powerful tool for characterization complementary to general purpose MC codes like FLUKA. In this paper an overview of the capabilities will be given using recent examples from the domain of waste characterization as well as operational radiation protection.

Radioactive Waste Management Complex performance assessment: Draft

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

Case, M.J.; Maheras, S.J.; McKenzie-Carter, M.A.

1990-06-01

A radiological performance assessment of the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory was conducted to demonstrate compliance with appropriate radiological criteria of the US Department of Energy and the US Environmental Protection Agency for protection of the general public. The calculations involved modeling the transport of radionuclides from buried waste, to surface soil and subsurface media, and eventually to members of the general public via air, ground water, and food chain pathways. Projections of doses were made for both offsite receptors and individuals intruding onto the site after closure. In addition, uncertainty analyses were performed. Resultsmore » of calculations made using nominal data indicate that the radiological doses will be below appropriate radiological criteria throughout operations and after closure of the facility. Recommendations were made for future performance assessment calculations.« less

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

NSTec Environmental Restoration

Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, includingmore » acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the NIMS/ICS construct and Unified Command (UC) for management of a domestic incident. The NRP Nuclear/Radiological Incident Annex (NUC) further provides requirements and protocols for coordinating federal government capabilities to respond to nuclear/radiological Incidents of National Significance (INS) and other radiological incidents. When a FRMAC is established, it operates under the parameters of NIMS as defined in the NRP. FRMAC and its operations have been modified to reflect NIMS/ICS concepts and principles and to facilitate working in a Unified Command structure. FRMAC is established at or near the scene of the incident to coordinate radiological monitoring and assessment and is established in coordination with the U.S. Department of Homeland Security (DHS); the coordinating agency; other federal agencies; and state, local, and tribal authorities. However, regardless of the coordinating agency designation, U.S. Department of Energy (DOE) coordinates radiological monitoring and assessment activities for the initial phases of the offsite federal incident response through the Radiological Assistance Program (RAP) and FRMAC assets. Monitoring and assessment data are managed by FRMAC in an accountable, secure, and retrievable format. Monitoring data interpretations, including exposure rate contours, dose projections, and any requested radiological assessments are to be provided to the DHS; to the coordinating agency; and to state, local, and tribal government agencies.« less

Congenital intrahepatic portohepatic shunt managed by interventional radiologic occlusion: a case report and literature review.

PubMed

Grimaldi, Chiara; Monti, Lidia; Falappa, Piergiorgio; d'Ambrosio, Giuseppe; Manca, Antonio; de Ville de Goyet, Jean

2012-02-01

Congenital intrahepatic portosystemic shunts are rare hepatic vascular anomalies that often lead to severe secondary conditions. A 6-year-old boy was referred for assessment of severe hypoxia, and a large liver mass was diagnosed with such a malformation and was managed by direct closure of the venous fistula by interventional radiology. Follow-up assessment shows normalization of the respiratory condition and a progressive reduction of the vascular liver lesion. Review of literature suggests that radiologic interventions are currently the criterion standard for managing these conditions, with surgery reserved for patients who are not eligible for radiologic procedure and those requiring liver transplantation. Copyright © 2012 Elsevier Inc. All rights reserved.

COMPARE/Radiology, an interactive Web-based radiology teaching program evaluation of user response.

PubMed

Wagner, Matthias; Heckemann, Rolf A; Nömayr, Anton; Greess, Holger; Bautz, Werner A; Grunewald, Markus

2005-06-01

The aim of this study is to assess user benefits of COMPARE/Radiology, a highly interactive World Wide Web-based training program for radiology, as perceived by its users. COMPARE/Radiology (http://www.idr.med.uni-erlangen.de/compare.htm), an interactive training program based on 244 teaching cases, was created by the authors and made publicly available on the Internet. An anonymous survey was conducted among users to investigate the composition of the program's user base and assess the acceptance of the training program. In parallel, Web access data were collected and analyzed using descriptive statistics. The group of responding users (n = 1370) consisted of 201 preclinical medical students (14.7%), 314 clinical medical students (22.9%), 359 residents in radiology (26.2%), and 205 users of other professions (14.9%). A majority of respondents (1230; 89%) rated the interactivity of COMPARE/Radiology as good or excellent. Many respondents use COMPARE/Radiology for self-study (971; 70%) and for teaching others (600; 43%). Web access statistics show an increase in number of site visits from 1248 in December 2002 to 4651 in April 2004. Users appreciate the benefits of COMPARE/Radiology. The interactive instructional design was rated positively by responding users. The popularity of the site is growing, evidenced by the number of network accesses during the observation period.

44 CFR 354.4 - Assessment of fees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HOMELAND SECURITY PREPAREDNESS FEE FOR SERVICES TO SUPPORT FEMA'S OFFSITE RADIOLOGICAL EMERGENCY... CFR 50.54(q) requirements stating that offsite radiological emergency planning and preparedness are no... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Assessment of fees. 354.4...

Determination of spondylolisthesis in low back pain by clinical evaluation.

PubMed

Kalpakcioglu, Banu; Altinbilek, Turgay; Senel, Kazim

2009-01-01

Current guides recommend to evaluate the patients with low back pain complaints with initial clinical assessment and history, and to utilize radiological or other imaging technics, in case of possible diagnosis. The aim of this study was to compare the findings of radiological and clinical assessment, and validate the reliability of spondylolisthesis diagnosed with clinical assessment. This study is conducted on 100 patients with, and 30 patients without (control group) radiological diagnosis of spondylolisthesis, who had applied to Department of Physical Therapy and Rehabilitation, Haydarpasa Numune Hospital with low back pain complaints in one and a half year. Clinic assessment was consisted of 20 parameters including examinations of motor system such as, sign of slipping observed on palpation and inspection, extension of trunk and increase in lumbar lordosis. Antero-posterior, lateral, oblique and lateral flexion/extension radiographies were used for radiological assessment. Slipping degree and lumbar lordosis angle were measured. Women/men patients ratio was 91/9 in spondylolisthesis group and 22/8 in control group. Age of 69% of patients were 50 and over. In both groups, sciatalgia was observed in more than half of the patients, and no significant difference was detected in localization (p > 0.05). In clinical assessment, weak and drooping abdominal wall, paravertebral muscle hypertrophy, increase in lumbar lordosis, sign of slipping observed on palpation and inspection, hamstring muscle spasm, pain during lateral trunk flexion-extension tasks and during double leg raising task were found to be positively correlated with radiological assesment (p < 0.05). In our study, a systematic clinical assessment was proved to be useful in determination of possible spondylolisthesis cases. Radiological assessments are required in order to make the diagnosis clear and to determine the grade and prognosis of spondylolisthesis. Advanced imaging techniques like MRI and CT have to be used when neurological symptoms are present, and when surgical intervention is indicated.

Radiology education: a glimpse into the future.

PubMed

Scarsbrook, A F; Graham, R N J; Perriss, R W

2006-08-01

The digital revolution in radiology continues to advance rapidly. There are a number of interesting developments within radiology informatics which may have a significant impact on education and training of radiologists in the near future. These include extended functionality of handheld computers, web-based skill and knowledge assessment, standardization of radiological procedural training using simulated or virtual patients, worldwide videoconferencing via high-quality health networks such as Internet2 and global collaboration of radiological educational resources via comprehensive, multi-national databases such as the medical imaging resource centre initiative of the Radiological Society of North America. This article will explore the role of e-learning in radiology, highlight a number of useful web-based applications in this area, and explain how the current and future technological advances might best be incorporated into radiological training.

Development and initial evaluation of a training program for peripherally inserted central catheter (PICC) placement for radiology residents and technicians.

PubMed

Dabadie, A; Soussan, J; Mancini, J; Vidal, V; Bartoli, J M; Gorincour, G; Petit, P

2016-09-01

The goals of this study were to develop and evaluate a joint theoretical/practical training course for radiology residents and technicians and to start a collaborative practice agreement enabling radiology technicians to perform PICC placement under the responsibility of an interventional radiologist. A joint training session based on literature evidences and international recommendations was designed. Participants were assessed before and after training, and were also asked to evaluate the program one month after completion of the training course. Practical post-training mentoring guidelines were laid down for radiologists supervising technicians. From January to April 2014, 6 radiology residents and 12 radiology technicians from the two interventional radiology departments of the University hospitals in Marseille took part in the training program. For both residents and technicians, significant improvement was observed between pretraining and post-training assessment. The majority of participants were satisfied with the program. Our experience suggests that combined theoretical and practical training in PICC placement allows improving technical skill and yields high degrees of satisfaction for both radiology residents and technicians. A collaborative practice agreement is now formally established to enable radiologists to delegate PICC placement procedures to radiology technicians. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

The internal dosimetry code PLEIADES.

PubMed

Fell, T P; Phipps, A W; Smith, T J

2007-01-01

The International Commission on Radiological Protection (ICRP) has published dose coefficients for the ingestion or inhalation of radionuclides in a series of reports covering intakes by workers and members of the public, including children and pregnant or lactating women. The calculation of these coefficients divides naturally into two distinct parts-the biokinetic and dosimetric. This paper describes in detail the methods used to solve the biokinetic problem in the generation of dose coefficients on behalf of the ICRP, as implemented in the Health Protection Agency's internal dosimetry code PLEIADES. A summary of the dosimetric treatment is included.

Validation of the Proficiency Examination for Diagnostic Radiologic Technology. Final Report.

ERIC Educational Resources Information Center

Educational Testing Service, Princeton, NJ.

The validity of the Proficiency Examination for Diagnostic Radiologic Technology was investigated, using 140 radiologic technologists who took both the written Proficiency Examination and a performance test. As an additional criterion measure of job proficiency, supervisors' assessments were obtained for 128 of the technologists. The resulting…

United States Department of Energy National Nuclear Security Administration Sandia Field Office NESHAP Annual Report CY2014 for Sandia National Laboratories New Mexico

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

evelo, stacie; Miller, Mark L.

2015-05-01

This report provides a summary of the radionuclide releases from the United States (U.S.) Department of Energy (DOE) National Nuclear Security Administration facilities at Sandia National Laboratories, New Mexico (SNL/NM) during Calendar Year (CY) 2014, including the data, calculations, and supporting documentation for demonstrating compliance with 40 Code of Federal Regulation (CFR) 61, Subpart H--NATIONAL EMISSION STANDARDS FOR EMISSIONS OF RADIONUCLIDES OTHER THAN RADON FROM DEPARTMENT OF ENERGY FACILITIES. A description is given of the sources and their contributions to the overall dose assessment. In addition, the maximally exposed individual (MEI) radiological dose calculation and the population dose to localmore » and regional residents are discussed.« less

Diagnosis of cystocele--the correlation between clinical and radiological evaluation.

PubMed

Altman, Daniel; Mellgren, Anders; Kierkegaard, Jonas; Zetterström, Jan; Falconer, Christian; López, Annika

2004-01-01

In patients with genital prolapse involving several compartments simultaneously, radiologic investigation can be used to complement the clinical assessment. Contrast medium in the urinary bladder enables visualization of the bladder base at cystodefecoperitoneography (CDP). The aim of the present study was to evaluate the correlation between clinical examination using the Pelvic Organ Prolapse Quantification system (POP-Q) and CDP. Thirty-three women underwent clinical assessment and CDP. Statistical analysis using Pearson's correlation coefficient ( r) demonstrated a wide variability between the current definition of cystocele at CDP and POP-Q ( r=0.67). An attempt to provide an alternative definition of cystocele at CDP had a similar outcome ( r=0.63). The present study demonstrates a moderate correlation between clinical and radiologic findings in patients with anterior vaginal wall prolapse. It does not support the use of bladder contrast at radiologic investigation in the routine preoperative assessment of patients with genital prolapse.

Radioactive Waste Management Complex low-level waste radiological performance assessment

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

Maheras, S.J.; Rood, A.S.; Magnuson, S.O.

This report documents the projected radiological dose impacts associated with the disposal of radioactive low-level waste at the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory. This radiological performance assessment was conducted to evaluate compliance with applicable radiological criteria of the US Department of Energy and the US Environmental Protection Agency for protection of the public and the environment. The calculations involved modeling the transport of radionuclides from buried waste, to surface soil and subsurface media, and eventually to members of the public via air, groundwater, and food chain pathways. Projections of doses were made for both offsitemore » receptors and individuals inadvertently intruding onto the site after closure. In addition, uncertainty and sensitivity analyses were performed. The results of the analyses indicate compliance with established radiological criteria and provide reasonable assurance that public health and safety will be protected.« less

NATO Allied Joint Medical Publication 7: Allied Joint Medical Doctrine for Support to Chemical, Biological, Radiological, and Nuclear (CBRN) Defensive Operations, Final Draft

DTIC Science & Technology

2014-07-31

A-1 ANNEX B REFERENCES .................................................................................... B-1 ANNEX C GLOSSARY ... Occupational and environmental health surveillance consists of the assessment and accounting of physical, chemical, biological, and radiological...assessment is based on environmental health hazard and threat assessment, as well on environmental, occupational and disease surveillance information

Pediatric radiology malpractice claims - characteristics and comparison to adult radiology claims.

PubMed

Breen, Micheál A; Dwyer, Kathy; Yu-Moe, Winnie; Taylor, George A

2017-06-01

Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation. We hypothesize that the frequency, character and outcome of malpractice claims made against pediatric radiologists differ from those seen in general radiology practice. We searched the Controlled Risk Insurance Co. (CRICO) Strategies' Comparative Benchmarking System (CBS), a private repository of approximately 350,000 open and closed medical malpractice claims in the United States, for claims related to pediatric radiology. We further queried these cases for the major allegation, the clinical environment in which the claim arose, the clinical severity of the alleged injury, indemnity paid (if payment was made), primary imaging modality involved (if applicable) and primary International Classification of Diseases, 9th revision (ICD-9) diagnosis underlying the claim. There were a total of 27,056 fully coded claims of medical malpractice in the CBS database in the 5-year period between Jan. 1, 2010, and Dec. 31, 2014. Of these, 1,472 cases (5.4%) involved patients younger than 18 years. Radiology was the primary service responsible for 71/1,472 (4.8%) pediatric cases. There were statistically significant differences in average payout for pediatric radiology claims ($314,671) compared to adult radiology claims ($174,033). The allegations were primarily diagnosis-related in 70% of pediatric radiology claims. The most common imaging modality implicated in pediatric radiology claims was radiography. The highest payouts in pediatric radiology pertained to missed congenital and developmental anomalies (average $1,222,932) such as developmental dysplasia of the hip and congenital central nervous system anomalies. More than half of pediatric radiology claims arose in the ambulatory setting. Pediatric radiology is not immune from claims of medical malpractice and these claims result in high monetary payouts, particularly for missed diagnoses of congenital and developmental anomalies. Our data suggest that efforts to reduce diagnostic error in the outpatient radiology setting, in the interpretation of radiographs, and in the improved diagnosis of fractures and congenital and developmental anomalies would be of particular benefit to the pediatric radiology community.

A combination of traditional learning and e-learning can be more effective on radiological interpretation skills in medical students: a pre- and post-intervention study.

PubMed

Salajegheh, Ali; Jahangiri, Alborz; Dolan-Evans, Elliot; Pakneshan, Sahar

2016-02-03

The ability to interpret an X-Ray is a vital skill for graduating medical students which guides clinicians towards accurate diagnosis and treatment of the patient. However, research has suggested that radiological interpretation skills are less than satisfactory in not only medical students, but also in residents and consultants. This study investigated the effectiveness of e-learning for the development of X-ray interpretation skills in pre-clinical medical students. Competencies in clinical X-Ray interpretation were assessed by comparison of pre- and post-intervention scores and one year follow up assessment, where the e-learning course was the 'intervention'. Our results demonstrate improved knowledge and skills in X-ray interpretation in students. Assessment of the post training students showed significantly higher scores than the scores of control group of students undertaking the same assessment at the same time. The development of the Internet and advances in multimedia technologies has paved the way for computer-assisted education. As more rural clinical schools are established the electronic delivery of radiology teaching through websites will become a necessity. The use of e-learning to deliver radiology tuition to medical students represents an exciting alternative and is an effective method of developing competency in radiological interpretation for medical students.

Enhancing Public Access to Relevant and Valued Medical Information: Fresh Directions for RadiologyInfo.org.

PubMed

Rubin, Geoffrey D; Krishnaraj, Arun; Mahesh, Mahadevappa; Rajendran, Ramji R; Fishman, Elliot K

2017-05-01

RadiologyInfo.org is a public information portal designed to support patient care and broaden public awareness of the essential role radiology plays in overall patient health care. Over the past 14 years, RadiologyInfo.org has evolved considerably to provide access to more than 220 mixed-media descriptions of tests, treatments, and diseases through a spectrum of mobile and desktop platforms, social media, and downloadable documents in both English and Spanish. In 2014, the RSNA-ACR Public Information Website Committee, which stewards RadiologyInfo.org, developed 3- to 5-year strategic and implementation plans for the website. The process was informed by RadiologyInfo.org user surveys, formal stakeholder interviews, focus groups, and usability testing. Metrics were established as key performance indicators to assess progress toward the stated goals of (1) optimizing content to enhance patient-centeredness, (2) enhancing reach and engagement, and (3) maintaining sustainability. Major changes resulting from this process include a complete redesign of the website, the replacement of text-rich PowerPoint presentations with conversational videos, and the development of an affiliate network. Over the past year, visits to RadiologyInfo.org have increased by 60.27% to 1,424,523 in August 2016 from 235 countries and territories. Twenty-two organizations have affiliated with RadiologyInfo.org with new organizations being added on a monthly basis. RadiologyInfo provides a tangible demonstration of how radiologists can engage directly with the global public to educate them on the value of radiology in their health care and to allay concerns and dispel misconceptions. Regular self-assessment and responsive planning will ensure its continued growth and relevance. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Pediatric interventional radiology clinic - how are we doing?

PubMed

Rubenstein, Jonathan; Zettel, Julie C; Lee, Eric; Cote, Michelle; Aziza, Albert; Connolly, Bairbre L

2016-07-01

Development of a pediatric interventional radiology clinic is a necessary component of providing a pediatric interventional radiology service. Patient satisfaction is important when providing efficient, high-quality care. To analyze the care provided by a pediatric interventional radiology clinic from the perspective of efficiency and parent satisfaction, so as to identify areas for improvement. The prospective study was both quantitative and qualitative. The quantitative component measured clinic efficiency (waiting times, duration of clinic visit, nurse/physician time allocation and assessments performed; n = 91). The qualitative component assessed parental satisfaction with their experience with the pediatric interventional radiology clinic, using a questionnaire (5-point Likert scale) and optional free text section for feedback (n = 80). Questions explored the family's perception of relevance of information provided, consent process and overall satisfaction with their pediatric interventional radiology clinic experience. Families waited a mean of 11 and 10 min to meet the physician and nurse, respectively. Nurses and physicians spent a mean of 28 and 21 min with the families, respectively. The average duration of the pediatric interventional radiology clinic consultation was 56 min. Of 80 survey participants, 83% were satisfied with their experience and 94% said they believed providing consent before the day of the procedure was helpful. Only 5% of respondents were not satisfied with the time-efficiency of the interventional radiology clinic. Results show the majority of patients/parents are very satisfied with the pediatric interventional radiology clinic visit. The efficiency of the pediatric interventional radiology clinic is satisfactory; however, adherence to stricter scheduling can be improved.

Informatics in radiology: evaluation of an e-learning platform for teaching medical students competency in ordering radiologic examinations.

PubMed

Marshall, Nina L; Spooner, Muirne; Galvin, P Leo; Ti, Joanna P; McElvaney, N Gerald; Lee, Michael J

2011-01-01

A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P < .0001). In general, medical students lack the core knowledge that is needed for good-quality ordering of radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.

Inventory Uncertainty Quantification using TENDL Covariance Data in Fispact-II

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

Eastwood, J.W.; Morgan, J.G.; Sublet, J.-Ch., E-mail: jean-christophe.sublet@ccfe.ac.uk

2015-01-15

The new inventory code Fispact-II provides predictions of inventory, radiological quantities and their uncertainties using nuclear data covariance information. Central to the method is a novel fast pathways search algorithm using directed graphs. The pathways output provides (1) an aid to identifying important reactions, (2) fast estimates of uncertainties, (3) reduced models that retain important nuclides and reactions for use in the code's Monte Carlo sensitivity analysis module. Described are the methods that are being implemented for improving uncertainty predictions, quantification and propagation using the covariance data that the recent nuclear data libraries contain. In the TENDL library, above themore » upper energy of the resolved resonance range, a Monte Carlo method in which the covariance data come from uncertainties of the nuclear model calculations is used. The nuclear data files are read directly by FISPACT-II without any further intermediate processing. Variance and covariance data are processed and used by FISPACT-II to compute uncertainties in collapsed cross sections, and these are in turn used to predict uncertainties in inventories and all derived radiological data.« less

Assessment of effectiveness of geologic isolation systems. CIRMIS data system. Volume 4. Driller's logs, stratigraphic cross section and utility routines

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

Friedrichs, D.R.

1980-01-01

The Assessment of Effectiveness of Geologic Isolation Systems (AEGIS) Program is developing and applying the methodology for assessing the far-field, long-term post-closure safety of deep geologic nuclear waste repositories. AEGIS is being performed by Pacific Northwest Laboratory (PNL) under contract with the Office of Nuclear Waste Isolation (ONWI) for the Department of Energy (DOE). One task within AEGIS is the development of methodology for analysis of the consequences (water pathway) from loss of repository containment as defined by various release scenarios. Analysis of the long-term, far-field consequences of release scenarios requires the application of numerical codes which simulate the hydrologicmore » systems, model the transport of released radionuclides through the hydrologic systems to the biosphere, and, where applicable, assess the radiological dose to humans. The various input parameters required in the analysis are compiled in data systems. The data are organized and prepared by various input subroutines for use by the hydrologic and transport codes. The hydrologic models simulate the groundwater flow systems and provide water flow directions, rates, and velocities as inputs to the transport models. Outputs from the transport models are basically graphs of radionuclide concentration in the groundwater plotted against time. After dilution in the receiving surface-water body (e.g., lake, river, bay), these data are the input source terms for the dose models, if dose assessments are required. The dose models calculate radiation dose to individuals and populations. CIRMIS (Comprehensive Information Retrieval and Model Input Sequence) Data System is a storage and retrieval system for model input and output data, including graphical interpretation and display. This is the fourth of four volumes of the description of the CIRMIS Data System.« less

Review of Dangerous Radioisotopes: What is Available in Practice, What Should We be Concerned About?

DTIC Science & Technology

2015-06-01

of the credibility of a radioactive material as a radiological weapon to be applied to specific scenarios. • This does not replace the IAEA "AID...34 ratios, but more precisely applies this concept to assessments of interest. 7Jt#,�$ 2 IDA I Radiological Weapons • This analysis identified the...radiological weapons under seven different routes of exposure (or types of radiological weapons ), including external irradiation from a point source

Flow volume loops in patients with goiters.

PubMed Central

Geraghty, J G; Coveney, E C; Kiernan, M; O'Higgins, N J

1992-01-01

Plain radiology is the standard means of assessing upper airway obstruction in patients with goiters. Flow volume loop curves will provide additional information, because they allow a quantitative assessment of airflow dynamics in the respiratory cycle. Fifty-one patients had flow volume loops performed before and after thyroidectomy. There was a significant increase in the maximum inspiratory flow rate (3.9 +/- 0.2 versus 4.9 +/- 0.2 L/second, p less than 0.01) after thyroidectomy. Eight of twelve patients with normal tracheal radiology had improved airflow dynamics in the postoperative period. The flow volume loop curve is a simple noninvasive means of assessing airflow dynamics in patients with goiters and may be superior to conventional radiology. PMID:1731653

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.

Multi-Agency Radiological Laboratory Analytical Protocols Manual (MARLAP)

EPA Pesticide Factsheets

The Multi-Agency Radiological Laboratory Analytical Protocols Manual (MARLAP) provides guidance for the planning, implementation and assessment phases of projects that require laboratory analysis of radionuclides.

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.

Assessing the performance of LOINC® and RadLex for coverage of CT scans across three sites in a health information exchange.

PubMed

Beitia, Anton Oscar; Kuperman, Gilad; Delman, Bradley N; Shapiro, Jason S

2013-01-01

We evaluated the performance of LOINC® and RadLex standard terminologies for covering CT test names from three sites in a health information exchange (HIE) with the eventual goal of building an HIE-based clinical decision support system to alert providers of prior duplicate CTs. Given the goal, the most important parameter to assess was coverage for high frequency exams that were most likely to be repeated. We showed that both LOINC® and RadLex provided sufficient coverage for our use case through calculations of (a) high coverage of 90% and 94%, respectively for the subset of CTs accounting for 99% of exams performed and (b) high concept token coverage (total percentage of exams performed that map to terminologies) of 92% and 95%, respectively. With trends toward greater interoperability, this work may provide a framework for those wishing to map radiology site codes to a standard nomenclature for purposes of tracking resource utilization.

Case-oriented computer-based-training in radiology: concept, implementation and evaluation

PubMed Central

Dugas, Martin; Trumm, Christoph; Stäbler, Axel; Pander, Ernst; Hundt, Walter; Scheidler, Jurgen; Brüning, Roland; Helmberger, Thomas; Waggershauser, Tobias; Matzko, Matthias; Reiser, Maximillian

2001-01-01

Background Providing high-quality clinical cases is important for teaching radiology. We developed, implemented and evaluated a program for a university hospital to support this task. Methods The system was built with Intranet technology and connected to the Picture Archiving and Communications System (PACS). It contains cases for every user group from students to attendants and is structured according to the ACR-code (American College of Radiology) [2]. Each department member was given an individual account, could gather his teaching cases and put the completed cases into the common database. Results During 18 months 583 cases containing 4136 images involving all radiological techniques were compiled and 350 cases put into the common case repository. Workflow integration as well as individual interest influenced the personal efforts to participate but an increasing number of cases and minor modifications of the program improved user acceptance continuously. 101 students went through an evaluation which showed a high level of acceptance and a special interest in elaborate documentation. Conclusion Electronic access to reference cases for all department members anytime anywhere is feasible. Critical success factors are workflow integration, reliability, efficient retrieval strategies and incentives for case authoring. PMID:11686856

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

The Proposed MACRA/MIPS Threshold for Patient-Facing Encounters: What It Means for Radiologists.

PubMed

Rosenkrantz, Andrew B; Hirsch, Joshua A; Allen, Bibb; Wang, Wenyi; Hughes, Danny R; Nicola, Gregory N

2017-03-01

In implementing the Merit-Based Incentive Payment System (MIPS), CMS will provide special considerations to physicians with infrequent face-to-face patient encounters by reweighting MIPS performance categories to account for the unique circumstances facing these providers. The aim of this study was to determine the impact of varying criteria on the fraction of radiologists who are likely to receive special considerations for performance assessment under MIPS. Data from the 2014 Medicare Physician and Other Supplier file for 28,710 diagnostic radiologists were used to determine the fraction of radiologists meeting various proposed criteria for receiving special considerations. For each definition, the fraction of patient-facing encounters among all billed codes was determined for those radiologists not receiving special considerations. When using the criterion proposed by CMS that physicians will receive special considerations if billing ≤25 evaluation and management services or surgical codes, 72.0% of diagnostic radiologists would receive special considerations, though such encounters would represent only 2.1% of billed codes among remaining diagnostic radiologists without special considerations. If CMS were to apply an alternative criterion of billing ≤100 evaluation and management codes exclusively, 98.8% of diagnostic radiologists would receive special considerations. At this threshold, patient-facing encounters would represent approximately 10% of billed codes among remaining radiologists without special considerations. The current CMS proposed criterion for special considerations would result in a considerable fraction of radiologists being evaluated on the basis of measures that are not reflective of their practice and beyond their direct control. Alternative criteria could help ensure that radiologists are provided a fair opportunity for success in performance review under the MIPS. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

77 FR 73996 - Notice of Availability for the Draft Programmatic Environmental Assessment for the Recycling of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-12

... for the Recycling of Scrap Metals Originating From Radiological Areas AGENCY: Department of Energy... public review and comment of the Draft Programmatic Environmental Assessment (PEA) for the Recycling of... procedures). This Draft PEA for the Recycling of Scrap Metals Originating from Radiological Areas analyzes...

Analysis of fission and activation radionuclides produced by a uranium-fueled nuclear detonation and identification of the top dose-producing radionuclides.

PubMed

Kraus, Terry; Foster, Kevin

2014-08-01

The radiological assessment of the nuclear fallout (i.e., fission and neutron-activation radionuclides) from a nuclear detonation is complicated by the large number of fallout radionuclides. This paper provides the initial isotopic source term inventory of the fallout from a uranium-fueled nuclear detonation and identifies the significant and insignificant radiological dose producing radionuclides over 11 dose integration time periods (time phases) of interest. A primary goal of this work is to produce a set of consistent, time phase-dependent lists of the top dose-producing radionuclides that can be used to prepare radiological assessment calculations and data products (e.g., maps of areas that exceed protective action guidelines) in support of public and worker protection decisions. The ranked lists of top dose-producing radionuclides enable assessors to perform atmospheric dispersion modeling and radiological dose assessment modeling more quickly by using relatively short lists of radionuclides without significantly compromising the accuracy of the modeling and the dose projections. This paper also provides a superset-list of the top dose-producing fallout radionuclides from a uranium-fueled nuclear detonation that can be used to perform radiological assessments over any desired time phase. Furthermore, this paper provides information that may be useful to monitoring and sampling and laboratory analysis personnel to help understand which radionuclides are of primary concern. Finally, this paper may be useful to public protection decision makers because it shows the importance of quickly initiating public protection actions to minimize the radiological dose from fallout.

Changes in the market for diagnostic radiologists as measured through a help wanted index.

PubMed

Forman, H P; Kamin, D S; Covey, A M; Sunshine, J H

2000-04-01

We sought to create and validate a help wanted index for tracking changes in the radiology job market. All jobs advertised in Radiology and the American Journal of Roentgenology from January 1991 through December 1998 were tracked according to three separate parameters: academic versus private practice, subspecialty, and region. Statistical comparison was made between the first and second 48-month subperiods to identify changes. Thirteen thousand seven hundred one advertised positions were coded. A dramatic decrease in job advertisements was noted after December 1991, with advertisements falling to one eighth of their late 1991 peak. A recovery has occurred, with advertising now approaching peak levels. Shifts were seen toward more private practice, midwestern location, vascular and interventional, and mammography positions. Declines occurred in the share of positions in California, the Southwest, and several radiology subspecialties. Other trends were noted but were statistically less significant. A strong correlation (R = 0.98) was found between the annual number of positions advertised and radiologists' median incomes relative to those of all physicians. The job market in radiology, much as in other fields, can be tracked in a coincident manner with the use of a help wanted index. Changes in the makeup of radiology practice are important and are identified in a well-constructed index. These findings have validity and can be useful as an adjunct to other information for policy and planning purposes.

Chart-stimulated Recall as a Learning Tool for Improving Radiology Residents' Reports.

PubMed

Nadeem, Naila; Zafar, Abdul Mueed; Haider, Sonia; Zuberi, Rukhsana W; Ahmad, Muhammad Nadeem; Ojili, Vijayanadh

2017-08-01

Workplace-based assessments gauge the highest tier of clinical competence. Chart-stimulated recall (CSR) is a workplace-based assessment method that complements chart audit with an interview based on the residents' notes. It allows evaluation of the residents' knowledge and heuristics while providing opportunities for feedback and self-reflection. We evaluated the utility of CSR for improving the radiology residents' reporting skills. Residents in each year of training were randomly assigned to an intervention group (n = 12) or a control group (n = 13). Five pre-intervention and five post-intervention reports of each resident were independently evaluated by three blinded reviewers using a modified Bristol Radiology Report Assessment Tool. The study intervention comprised a CSR interview tailored to each individual resident's learning needs based on the pre-intervention assessment. The CSR process focused on the clinical relevance of the radiology reports. Student's t test (P < .05) was used to compare pre- and post-intervention scores of each group. A total of 125 pre-intervention and 125 post-intervention reports were evaluated (total 750 assessments). The Cronbach's alpha for the study tool was 0.865. A significant improvement was seen in the cumulative 19-item score (66% versus 73%, P < .001) and the global rating score (59% versus 72%, P < .001) of the intervention group after the CSR. The reports of the control group did not demonstrate any significant improvement. CSR is a feasible workplace-based assessment method for improving reporting skills of the radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Radiation Transport and Shielding for Space Exploration and High Speed Flight Transportation

NASA Technical Reports Server (NTRS)

Maung, Khin Maung; Trapathi, R. K.

1997-01-01

Transportation of ions and neutrons in matter is of direct interest in several technologically important and scientific areas, including space radiation, cosmic ray propagation studies in galactic medium, nuclear power plants and radiological effects that impact industrial and public health. For the proper assessment of radiation exposure, both reliable transport codes and accurate data are needed. Nuclear cross section data is one of the essential inputs into the transport codes. In order to obtain an accurate parametrization of cross section data, theoretical input is indispensable especially for processes where there is little or no experimental data available. In this grant period work has been done on the studies of the use of relativistic equations and their one-body limits. The results will be useful in choosing appropriate effective one-body equation for reaction calculations. Work has also been done to improve upon the data base needed for the transport codes used in the studies of radiation transport and shielding for space exploration and high speed flight transportation. A phenomenological model was developed for the total absorption cross sections valid for any system of charged and/or uncharged collision pairs for the entire energy range. The success of the model is gratifying. It is being used by other federal agencies, national labs and universities. A list of publications based on the work during the grant period is given below and copies are enclosed with this report.

Using probabilistic criteria in an assessment of the potential radiological consequences of the decommissioning of a nuclear research reactor

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

Wallner, Christian; Rall, Anna-Maria; Thummerer, Severin

In order to assess the risk of radiological consequences of incidents and accidents in nuclear facilities it is important to contemplate their frequency of occurrence. It has to be shown that incidents and accidents occur sufficiently seldom according to their radiological consequences i. e. the occurrence frequency of radiological doses has to be limited. This is even demanded by the German radiation protection ordinance (StrlSchV), which says that in nuclear facilities other than nuclear power plants (NPP) in operation and for decommissioning, the occurrence frequency of incidents and accidents shall be contemplated in order to prove the design of safetymore » measures and safety installations. Based on the ideas of the ICRP64, we developed a risk based assessment concept for nuclear facilities, which fulfils the requirements of the German regulations concerning dose limits in normal operation and design basis accidents. The general use of the concept is dedicated to nuclear facilities other than nuclear power plants (NPP) in operation and for decommissioning, where the regulation of risk assessment is less sophisticated. The concept specifies occurrence frequency limits for radiation exposure dose ranges, i. e. the occurrence frequency of incidents and accidents has to be limited according to their radiological effects. To apply this concept, scenarios of incidents and accidents are grouped in exposition classes according to their resulting potential effective dose to members of the general public. The occurrence frequencies of the incidents and accidents are summarized in each exposition class whereas the sum must not exceed the frequency limits mentioned above. In the following we introduce the application of this concept in the assessment of the potential radiological consequences of the decommissioning of a nuclear research reactor. We carried out this assessment for the licensing process of the decommissioning on behalf of German authorities. (authors)« less

Public transparency Web sites for radiology practices: prevalence of price, clinical quality, and service quality information.

PubMed

Rosenkrantz, Andrew B; Doshi, Ankur M

2016-01-01

To assess information regarding radiology practices on public transparency Web sites. Eight Web sites comparing radiology centers' price and quality were identified. Web site content was assessed. Six of eight Web sites reported examination prices. Other reported information included hours of operation (4/8), patient satisfaction (2/8), American College of Radiology (ACR) accreditation (3/8), on-site radiologists (2/8), as well as parking, accessibility, waiting area amenities, same/next-day reports, mammography follow-up rates, examination appropriateness, radiation dose, fellowship-trained radiologists, and advanced technologies (1/8 each). Transparency Web sites had a preponderance of price (and to a lesser extent service quality) information, risking fostering price-based competition at the expense of clinical quality. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical operations management in radiology.

PubMed

Ondategui-Parra, Silvia; Gill, Ileana E; Bhagwat, Jui G; Intrieri, Lisa A; Gogate, Adheet; Zou, Kelly H; Nathanson, Eric; Seltzer, Steven E; Ros, Pablo R

2004-09-01

Providing radiology services is a complex and technically demanding enterprise in which the application of operations management (OM) tools can play a substantial role in process management and improvement. This paper considers the benefits of an OM process in a radiology setting. Available techniques and concepts of OM are addressed, along with gains and benefits that can be derived from these processes. A reference framework for the radiology processes is described, distinguishing two phases in the initial assessment of a unit: the diagnostic phase and the redesign phase.

Anismus, Physiology, Radiology: Is It Time for Some Pragmatism? A Comparative Study of Radiological and Anorectal Physiology Findings in Patients With Anismus.

PubMed

Pisano, Umberto; Irvine, Lesley; Szczachor, Justina; Jawad, Ahsin; MacLeod, Andrew; Lim, Michael

2016-10-01

Anismus is a functional disorder featuring obstructive symptoms and paradoxical contractions of the pelvic floor. This study aims to establish diagnosis agreement between physiology and radiology, associate anismus with morphological outlet obstruction, and explore the role of sphincteric pressure and rectal volumes in the radiological diagnosis of anismus. Consecutive patients were evaluated by using magnetic resonance imaging proctography/fluoroscopic defecography and anorectal physiology. Morphological radiological features were associated with physiology tests. A categorical analysis was performed using the chi-square test, and agreement was assessed via the kappa coefficient. A Mann-Whitney test was used to assess rectal volumes and sphincterial pressure distributions between groups of patients. A P-value of <0.05 was significant. Forty-three patients (42 female patients) underwent anorectal physiology and radiology imaging. The median age was 54 years (interquartile range, 41.5-60 years). Anismus was seen radiologically and physiologically in 18 (41.8%) and 12 patients (27.9%), respectively. The agreement between modalities was 0.298 (P = 0.04). Using physiology as a reference, radiology had positive and negative predictive values of 44% and 84%, respectively. Rectoceles, cystoceles, enteroceles and pathological pelvic floor descent were not physiologically predictive of animus (P > 0.05). The sphincterial straining pressure was 71 mmHg in the anismus group versus 12 mmHg. Radiology was likely to identify anismus when the straining pressure exceeded 50% of the resting pressure (P = 0.08). Radiological techniques detect pelvic morphological abnormalities, but lead to overdiagnoses of anismus. No proctographic pathological feature predicts anismus reliably. A stronger pelvic floor paradoxical contraction is associated with a greater likelihood of detection by proctography.

Anismus, Physiology, Radiology: Is It Time for Some Pragmatism? A Comparative Study of Radiological and Anorectal Physiology Findings in Patients With Anismus

PubMed Central

Irvine, Lesley; Szczachor, Justina; Jawad, Ahsin; MacLeod, Andrew; Lim, Michael

2016-01-01

Purpose Anismus is a functional disorder featuring obstructive symptoms and paradoxical contractions of the pelvic floor. This study aims to establish diagnosis agreement between physiology and radiology, associate anismus with morphological outlet obstruction, and explore the role of sphincteric pressure and rectal volumes in the radiological diagnosis of anismus. Methods Consecutive patients were evaluated by using magnetic resonance imaging proctography/fluoroscopic defecography and anorectal physiology. Morphological radiological features were associated with physiology tests. A categorical analysis was performed using the chi-square test, and agreement was assessed via the kappa coefficient. A Mann-Whitney test was used to assess rectal volumes and sphincterial pressure distributions between groups of patients. A P-value of <0.05 was significant. Results Forty-three patients (42 female patients) underwent anorectal physiology and radiology imaging. The median age was 54 years (interquartile range, 41.5–60 years). Anismus was seen radiologically and physiologically in 18 (41.8%) and 12 patients (27.9%), respectively. The agreement between modalities was 0.298 (P = 0.04). Using physiology as a reference, radiology had positive and negative predictive values of 44% and 84%, respectively. Rectoceles, cystoceles, enteroceles and pathological pelvic floor descent were not physiologically predictive of animus (P > 0.05). The sphincterial straining pressure was 71 mmHg in the anismus group versus 12 mmHg. Radiology was likely to identify anismus when the straining pressure exceeded 50% of the resting pressure (P = 0.08). Conclusion Radiological techniques detect pelvic morphological abnormalities, but lead to overdiagnoses of anismus. No proctographic pathological feature predicts anismus reliably. A stronger pelvic floor paradoxical contraction is associated with a greater likelihood of detection by proctography. PMID:27847787

Development of a Standardized Kalamazoo Communication Skills Assessment Tool for Radiologists: Validation, Multisource Reliability, and Lessons Learned.

PubMed

Brown, Stephen D; Rider, Elizabeth A; Jamieson, Katherine; Meyer, Elaine C; Callahan, Michael J; DeBenedectis, Carolynn M; Bixby, Sarah D; Walters, Michele; Forman, Sara F; Varrin, Pamela H; Forbes, Peter; Roussin, Christopher J

2017-08-01

The purpose of this study was to develop and test a standardized communication skills assessment instrument for radiology. The Delphi method was used to validate the Kalamazoo Communication Skills Assessment instrument for radiology by revising and achieving consensus on the 43 items of the preexisting instrument among an interdisciplinary team of experts consisting of five radiologists and four nonradiologists (two men, seven women). Reviewers assessed the applicability of the instrument to evaluation of conversations between radiology trainees and trained actors portraying concerned parents in enactments about bad news, radiation risks, and diagnostic errors that were video recorded during a communication workshop. Interrater reliability was assessed by use of the revised instrument to rate a series of enactments between trainees and actors video recorded in a hospital-based simulator center. Eight raters evaluated each of seven different video-recorded interactions between physicians and parent-actors. The final instrument contained 43 items. After three review rounds, 42 of 43 (98%) items had an average rating of relevant or very relevant for bad news conversations. All items were rated as relevant or very relevant for conversations about error disclosure and radiation risk. Reliability and rater agreement measures were moderate. The intraclass correlation coefficient range was 0.07-0.58; mean, 0.30; SD, 0.13; and median, 0.30. The range of weighted kappa values was 0.03-0.47; mean, 0.23; SD, 0.12; and median, 0.22. Ratings varied significantly among conversations (χ 2 6 = 1186; p < 0.0001) and varied significantly by viewing order, rater type, and rater sex. The adapted communication skills assessment instrument is highly relevant for radiology, having moderate interrater reliability. These findings have important implications for assessing the relational competencies of radiology trainees.

Association of study quality with completeness of reporting: have completeness of reporting and quality of systematic reviews and meta-analyses in major radiology journals changed since publication of the PRISMA statement?

PubMed

Tunis, Adam S; McInnes, Matthew D F; Hanna, Ramez; Esmail, Kaisra

2013-11-01

To evaluate whether completeness of reporting of systematic reviews and meta-analyses in major radiology journals has changed since publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement; a secondary objective is to evaluate whether completeness of reporting (ie, PRISMA) is associated with study quality (ie, Assessing the Methodological Quality of Systematic Reviews [AMSTAR]). Systematic reviews and meta-analyses published in major radiology journals between January 2007 and December 2011 were identified by searching MEDLINE with the modified Montori method. Studies were reviewed independently by two investigators and assessed for adherence to the AMSTAR and PRISMA checklists. The average results were analyzed to assess for change in mean score before and after PRISMA publication and to assess results over time; a Pearson correlation coefficient was calculated to assess for any association between PRISMA and AMSTAR results. Included were 130 studies from 11 journals. Average PRISMA and AMSTAR results were 21.8 of 27 and 7.2 of 11, respectively. The average result was higher after publication of PRISMA, and PRISMA-reported items were 22.6 of 27 after publication of PRISMA versus 20.9 of 27 before publication of PRISMA; AMSTAR results were 7.7 of 11 after publication of PRISMA versus 6.7 of 11 before publication of PRISMA. There was a strong positive correlation (r = 0.86) between the PRISMA and AMSTAR results. There was high variability between journals. Radiology had the highest PRISMA reported items (24.7 of 27), and American Journal of Neuroradiology had the lowest (19.6 of 27). Two major areas for improvement include study protocol registration and assessment of risk of bias across studies (ie, publication bias). In major radiology journal studies, there was modest improvement in completeness of reporting of systematic reviews and meta-analyses, assessed by PRISMA, which was strongly associated with higher study quality, assessed by AMSTAR. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.13130273/-/DC1. RSNA, 2013

Monte Carlo simulation of x-ray spectra in diagnostic radiology and mammography using MCNP4C

NASA Astrophysics Data System (ADS)

Ay, M. R.; Shahriari, M.; Sarkar, S.; Adib, M.; Zaidi, H.

2004-11-01

The general purpose Monte Carlo N-particle radiation transport computer code (MCNP4C) was used for the simulation of x-ray spectra in diagnostic radiology and mammography. The electrons were transported until they slow down and stop in the target. Both bremsstrahlung and characteristic x-ray production were considered in this work. We focus on the simulation of various target/filter combinations to investigate the effect of tube voltage, target material and filter thickness on x-ray spectra in the diagnostic radiology and mammography energy ranges. The simulated x-ray spectra were compared with experimental measurements and spectra calculated by IPEM report number 78. In addition, the anode heel effect and off-axis x-ray spectra were assessed for different anode angles and target materials and the results were compared with EGS4-based Monte Carlo simulations and measured data. Quantitative evaluation of the differences between our Monte Carlo simulated and comparison spectra was performed using student's t-test statistical analysis. Generally, there is a good agreement between the simulated x-ray and comparison spectra, although there are systematic differences between the simulated and reference spectra especially in the K-characteristic x-rays intensity. Nevertheless, no statistically significant differences have been observed between IPEM spectra and the simulated spectra. It has been shown that the difference between MCNP simulated spectra and IPEM spectra in the low energy range is the result of the overestimation of characteristic photons following the normalization procedure. The transmission curves produced by MCNP4C have good agreement with the IPEM report especially for tube voltages of 50 kV and 80 kV. The systematic discrepancy for higher tube voltages is the result of systematic differences between the corresponding spectra.

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.

Findings in 2002 from a help wanted index of job advertisements: is the job-market shortage of diagnostic radiologists easing?

PubMed

Saketkhoo, Daniel D; Sunshine, Jonathan H; Covey, Anne M; Forman, Howard P

2003-08-01

The goal of this study is to present the most recent data on the diagnostic radiology job market in the United States using a help wanted index of job advertisements. All diagnostic radiology positions advertised in the American Journal of Roentgenology and Radiology from January through December 2002 were coded by practice type, geographic location, and subspecialty. Data were compared with the previously published results from 1991 through 2001. From January through December 2002, 5117 positions were advertised for diagnostic radiologists, representing a 10.4% decrease from 2001. The 12-month rolling average of job advertisements peaked at 488 in February 2002 and dropped to 432 by December 2002, a level not seen since August 2000. In 2002, 42.7% of positions advertised were academic, representing a steady increase from 34.0% in 1999. When comparing the 4-year periods 1999-2002 and 1995-1998, a statistically significant proportional increase was found for positions advertised in the Midwest. Statistically significant relative increases were also observed for the subspecialties of abdominal radiology, mammography, neuroradiology, pediatric radiology, chest radiology, and nuclear medicine. Statistically significant relative decreases were seen in general and vascular and interventional positions. The absolute demand for diagnostic radiologists nationwide appears to have stabilized during 2002, albeit at a level much higher than in previous years, and may be decreasing. A split seems to have appeared in the market between academia and private practice. Current policy should be directed toward increasing the supply of diagnostic radiologists, especially academicians.

Radiological Protection and Nuclear Engineering Studies in Multi-MW Target Systems

NASA Astrophysics Data System (ADS)

Luis, Raul Fernandes

Several innovative projects involving nuclear technology have emerged around the world in recent years, for applications such as spallation neutron sources, accelerator-driven systems for the transmutation of nuclear waste and radioactive ion beam (RIB) production. While the available neutron Wuxes from nuclear reactors did not increase substantially in intensity over the past three decades, the intensities of neutron sources produced in spallation targets have increased steadily, and should continue to do so during the 21st century. Innovative projects like ESS, MYRRHA and EURISOL lie at the forefront of the ongoing pursuit for increasingly bright neutron sources; driven by proton beams with energies up to 2 GeV and intensities up to several mA, the construction of their proposed facilities involves complex Nuclear Technology and Radiological Protection design studies executed by multidisciplinary teams of scientists and engineers from diUerent branches of Science. The intense neutron Wuxes foreseen for those facilities can be used in several scientiVc research Velds, such as Nuclear Physics and Astrophysics, Medicine and Materials Science. In this work, the target systems of two facilitites for the production of RIBs using the Isotope Separation On-Line (ISOL) method were studied in detail: ISOLDE, operating at CERN since 1967, and EURISOL, the next-generation ISOL facility to be built in Europe. For the EURISOL multi-MW target station, a detailed study of Radiological Protection was carried out using the Monte Carlo code FLUKA. Simulations were done to assess neutron Wuences, Vssion rates, ambient dose equivalent rates during operation and after shutdown and the production of radioactive nuclei in the targets and surrounding materials. DiUerent materials were discussed for diUerent components of the target system, aiming at improving its neutronics performance while keeping the residual activities resulting from material activation as low as possible. The second goal of this work was to perform an optimisation study for the ISOLDE neutron converter and Vssion target system. The target system was simulated using FLUKA and the cross section codes TALYS and ABRABLA, with the objective of maximising the performance of the system for the production of pure beams of neutron-rich isotopes, suppressing the contaminations by undesired neutron-deficient isobars. Two alternative target systems were proposed in the optimisation studies; the simplest of the two, with some modiVcations, was built as a prototype and tested at ISOLDE. The experimental results clearly show that it is possible, with simple changes in the layouts of the target systems, to produce purer beams of neutron-rich isotopes around the doubly magic nuclei 78Ni and 132Sn. A study of Radiological Protection was also performed, comparing the performances of the prototype target system and the standard ISOLDE target system. None

Final Radiological Assessment of External Exposure for CLEAR-Line Americium Recovery Operations

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

Davis, Adam C.; Belooussova, Olga N.; Hetrick, Lucas Duane

2014-11-12

Los Alamos National Laboratory is currently planning to implement an americium recovery program. The americium, ordinarily isotopically pure 241Am, would be extracted from existing Pu materials, converted to an oxide and shipped to support fabrication of americium oxide-beryllium neutron sources. These operations would occur in the currently proposed Chloride Extraction and Actinide Recovery (CLEAR) line of glove boxes. This glove box line would be collocated with the currently-operational Experimental Chloride Extraction Line (EXCEL). The focus of this document is to provide an in-depth assessment of the currently planned radiation protection measures and to determine whether or not further design workmore » is required to satisfy design-goal and ALARA requirements. Further, this document presents a history of americium recovery operations in the Department of Energy and high-level descriptions of the CLEAR line operations to provide a basis of comparison. Under the working assumptions adopted by this study, it was found that the evaluated design appears to mitigate doses to a level that satisfies the ALARA-in-design requirements of 10 CFR 835 as implemented by the Los Alamos National Laboratory procedure P121. The analyses indicate that extremity doses would also meet design requirements. Dose-rate calculations were performed using the radiation transport code MCNP5 and doses were estimated using a time-motion study developed in consort with the subject matter expert. A copy of this report and all supporting documentation are located on the Radiological Engineering server at Y:\\Rad Engineering\\2013 PROJECTS\\TA-55 Clear Line.« less

77 FR 125 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Device Classification...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-03

... medical devices regulated by the Center for Devices and Radiological Health (CDRH) and the Center for... assist that office in processing your request, or fax your request to CDRH at (301) 847-8149. The draft... parts 862 through 892)) have been the basis for the CDRH's Classification Product Code structure and...

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.

Assessing Medical Student Knowledge of Imaging Modality Selection Before and After a General Radiology Elective: A Comparison of MS-IIs, MS-IIIs, and MS-IVs.

PubMed

Gispen, Fiona E; Magid, Donna

2016-05-01

Correct selection of imaging tests is essential f or clinicians but until recently has been largely neglected in medical education. How and when students acquire such non-interpretive skills are unknown. This study will assess student knowledge of imaging test selection before and after a general radiology elective. Between 2008 and 2015, an unannounced 13-item test was administered to second, third, and fourth-year students on the first and last days of the Johns Hopkins School of Medicine radiology elective. Scores (0–13) were based on the American College of Radiology Appropriateness Criteria. Pre- and posttest means were compared using paired samples t tests. Whether performance on the pretest and posttest differed by class year was assessed using analysis of variance and Kruskal-Wallis, respectively, and whether year was associated with posttest score after controlling for pretest score was assessed using analysis of covariance. Posttest means were significantly higher than pretest means for students in all years (P values <.0001). Pretest scores differed by year (F(2, 360) = 66.85, P <.0001): fourth-year students scored highest (mean = 9.96 of 13) and second-year students scored lowest (mean = 7.01 of 13). Posttest scores did not differ (χ2(2, 270) = 0.348, P = .841). Year in school had no independent effect on posttest score (F(2, 239) = 0.45, P = .637). Knowledge of modality selection increases with clinical training, but room for improvement remains. A general radiology elective increases this knowledge. Second-year students improve most, suggesting that taking radiology early is efficient, but further research to evaluate retention of this knowledge is needed. Medical student education in radiology must increasingly recognize and address non-interpretive skills and intelligent imaging utilization.

Radiology liability update: review of claims, trends, high-risk conditions and practices, and tort reform alternatives.

PubMed

Thomson, Norman B; Patel, Mohini

2012-10-01

Radiology liability claims data are reviewed to explore the risk for suit and adverse judgments or settlements among radiologists, assess high-risk imaging conditions, and identify high-risk practice issues. Possible medical malpractice tort reform options are reviewed. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

De Blas, Alfredo; Tapia, Carlos; Riego, Albert

pGamma is a code developed by the NERG group of the Technical University of Catalonia - Barcelona Tech for the analysis of gamma spectra generated by the Equipment for the Continuous Measurement and Identification of Gamma Radioactivity on Aerosols with Paper Filter developed for our group and Raditel Servies company. Nowadays the code is in the process of adaptation for the monitors of the Environmental Radiological Surveillance Network of the Local Government of Catalonia (Generalitat of Catalonia), Spain. The code is a Spectrum Analysis System, it identifies the gamma emitters on the spectrum, determines its Concentration of Activity, generates alarmsmore » depending on the Activity of the emitters and generates a report. The Spectrum Analysis System includes a library with emitters of interest, NORM and artificial. The code is being used on the three stations with the aerosol monitor of the Network (Asco and Vandellos, near both Nuclear Power Plants and Barcelona). (authors)« less

Magnetic resonance image compression using scalar-vector quantization

NASA Astrophysics Data System (ADS)

Mohsenian, Nader; Shahri, Homayoun

1995-12-01

A new coding scheme based on the scalar-vector quantizer (SVQ) is developed for compression of medical images. SVQ is a fixed-rate encoder and its rate-distortion performance is close to that of optimal entropy-constrained scalar quantizers (ECSQs) for memoryless sources. The use of a fixed-rate quantizer is expected to eliminate some of the complexity issues of using variable-length scalar quantizers. When transmission of images over noisy channels is considered, our coding scheme does not suffer from error propagation which is typical of coding schemes which use variable-length codes. For a set of magnetic resonance (MR) images, coding results obtained from SVQ and ECSQ at low bit-rates are indistinguishable. Furthermore, our encoded images are perceptually indistinguishable from the original, when displayed on a monitor. This makes our SVQ based coder an attractive compression scheme for picture archiving and communication systems (PACS), currently under consideration for an all digital radiology environment in hospitals, where reliable transmission, storage, and high fidelity reconstruction of images are desired.

Radiological Medical Device Innovation: Approvals via the Premarket Approval Pathway From 2000 to 2015.

PubMed

Ghobadi, Comeron W; Hayman, Emily L; Finkle, Joshua H; Walter, Jessica R; Xu, Shuai

2017-01-01

The aim of this study was to critically assess the clinical evidence leading to radiologic medical device approvals via the premarket approval pathway from 2000 to 2015. This study used the publically available FDA premarket database for radiologic device approvals over the past 15 years (September 1, 2000, to August 31, 2015). Approval characteristics were collected for each device, and statistical analysis was performed on the data for each pivotal trial. Additionally, methodological quality of the pivotal trial was determined using the Quality Assessment of Diagnostic Accuracy Studies tool. Twenty-three class III radiologic device approvals were identified, with breast imaging accounting for 16 (70%) and computer-aided detection software accounting for 9 (39%) approvals. The median premarket approval time was 475 days (range, 180-1,116). Twenty-one devices were approved on the basis of multireader, multicenter studies, one on the basis of a randomized controlled trial, and one on the basis of a preclinical technical equivalence trial. The median number of patients per pivotal trial was 201 (range, 25-3,946). Twenty-six of the 34 pivotal trials (76%) had at least one methodologic bias. Breast imaging devices had a greater number of patients per pivotal trial (P = .009) and more prospective studies. With regard to all modalities, increased time to device approval correlated with weaker trial quality (r = 0.600, P < .001). Radiologic devices are largely approved by multireader, multicenter studies, the recommended standard for assessing diagnostic technologies. Given that radiologic devices play a key role in modern medicine, further efforts should be made to increase transparency of clinical data leading to approval. Copyright © 2016 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.

CIRMIS Data system. Volume 2. Program listings

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

Friedrichs, D.R.

1980-01-01

The Assessment of Effectiveness of Geologic Isolation Systems (AEGIS) Program is developing and applying the methodology for assessing the far-field, long-term post-closure safety of deep geologic nuclear waste repositories. AEGIS is being performed by Pacific Northwest Laboratory (PNL) under contract with the Office of Nuclear Waste Isolation (OWNI) for the Department of Energy (DOE). One task within AEGIS is the development of methodology for analysis of the consequences (water pathway) from loss of repository containment as defined by various release scenarios. Analysis of the long-term, far-field consequences of release scenarios requires the application of numerical codes which simulate the hydrologicmore » systems, model the transport of released radionuclides through the hydrologic systems, model the transport of released radionuclides through the hydrologic systems to the biosphere, and, where applicable, assess the radiological dose to humans. The various input parameters required in the analysis are compiled in data systems. The data are organized and prepared by various input subroutines for utilization by the hydraulic and transport codes. The hydrologic models simulate the groundwater flow systems and provide water flow directions, rates, and velocities as inputs to the transport models. Outputs from the transport models are basically graphs of radionuclide concentration in the groundwater plotted against time. After dilution in the receiving surface-water body (e.g., lake, river, bay), these data are the input source terms for the dose models, if dose assessments are required.The dose models calculate radiation dose to individuals and populations. CIRMIS (Comprehensive Information Retrieval and Model Input Sequence) Data System is a storage and retrieval system for model input and output data, including graphical interpretation and display. This is the second of four volumes of the description of the CIRMIS Data System.« less

Determining procedures for simulation-based training in radiology: a nationwide needs assessment.

PubMed

Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth; Bachmann Nielsen, Michael; Paltved, Charlotte; Lindorff-Larsen, Karen Gilboe; Nielsen, Bjørn Ulrik; Konge, Lars

2018-06-01

New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored frequency of procedure, number of radiologists performing the procedure, risk and/or discomfort for patients, and feasibility for simulation. Round 3 was elimination and prioritization of procedures. Response rates were 67 %, 70 % and 66 %, respectively. In Round 1, 22 technical procedures were included. Round 2 resulted in pre-prioritization of procedures. In round 3, 13 procedures were included in the final prioritized list. The three highly prioritized procedures were ultrasound-guided (US) histological biopsy and fine-needle aspiration, US-guided needle puncture and catheter drainage, and basic abdominal ultrasound. A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. • Simulation-based training can supplement training on patients in radiology. • Development of simulation-based training should follow a structured approach. • The CAMES Needs Assessment Formula explores needs for simulation training. • A national Delphi study identified and prioritized procedures suitable for simulation training. • The prioritized list serves as guide for development of courses in radiology.

Radiological characteristics of MRI-based VIP polymer gel under carbon beam irradiation

NASA Astrophysics Data System (ADS)

Maeyama, T.; Fukunishi, N.; Ishikawa, K. L.; Furuta, T.; Fukasaku, K.; Takagi, S.; Noda, S.; Himeno, R.; Fukuda, S.

2015-02-01

We study the radiological characteristics of VIP polymer gel dosimeters under carbon beam irradiation with energy of 135 and 290 AMeV. To evaluate dose response of VIP polymer gels, the transverse (or spin-spin) relaxation rate R2 of the dosimeters measured by magnetic resonance imaging (MRI) as a function of linear energy transfer (LET), rather than penetration depth, as is usually done in previous reports. LET is evaluated by use of the particle transport simulation code PHITS. Our results reveal that the dose response decreases with increasing dose-averaged LET and that the dose response-LET relation also varies with incident carbon beam energy. The latter can be explained by taking into account the contribution from fragmentation products.

Real frequency of ordinary and atypical sub-trochanteric and diaphyseal fractures in France based on X-rays and medical file analysis.

PubMed

Beaudouin-Bazire, Constance; Dalmas, Noémie; Bourgeois, Julie; Babinet, Antoine; Anract, Philippe; Chantelot, Christophe; Farizon, Frédéric; Chopin, Florence; Briot, Karine; Roux, Christian; Cortet, Bernard; Thomas, Thierry

2013-03-01

Atypical sub-trochanteric and femoral shaft fractures have been reported in patients treated with bisphosphonates. Their incidence has been determined from registered data analysis using international codes. Therefore, the aim of our study was to estimate the real frequency of typical and atypical sub-trochanteric or diaphyseal fractures, based on radiological and clinical data compared to registered data. In the registers of three large French University Hospitals, patients identified with International Classification of Diseases, 10th Revision diagnosis codes for sub-trochanteric or diaphyseal fracture were selected. Frequencies of ordinary and atypical fractures were calculated after both registered data, radiological and clinical files analysis. Among the 4592 patients hospitalized for a femoral fracture over 5 years, 574 were identified to have had a sub-trochanteric or femoral shaft fracture. 47.7% of the sub-trochanteric and femoral shaft fractures were misclassified, predominantly in the sub-trochanteric fractures subset. 12 patients had an atypical fracture (4% of the sub-trochanteric and femoral shaft fractures) and 11 fractures presented radiological features of atypical fractures, whereas clinical files analysis revealed they were pathological or traumatic fractures. Atypical fractures frequency is very low. Because of their low frequency and the unreliability of registered databases, the risk of atypical fractures is very difficult to estimate retrospectively. A prospective study is needed to clarify the risk factors associated with these fractures. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. 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.

Role of follow-up endoscopic examination in treatment response assessment for patients with gastric diffuse large B cell lymphoma.

PubMed

Yoon, Seung Bae; Lee, In Seok; Lee, Ha Ni; Kim, Eunyoung; Kim, Woohyeon; Lee, Han Hee; Lee, Bo-In; Choi, Myung-Gyu; Jung, Seung Eun; Choi, Byung Ock; Park, Gyeong Sin; Cho, Seok-Goo

2016-09-01

According to lymphoma guidelines, gastric diffuse large B cell lymphoma (DLBCL) patients should undergo regular computed tomography (CT) and/or positron emission tomography (PET) examinations to assess treatment response. Endoscopic examinations are not indicated in the guidelines. The aim of this study was to investigate the utility of endoscopic examinations during and after treatment for DLBCL. We reviewed the patients diagnosed with gastric DLBCL at Seoul St. Mary's Hospital. All patients underwent endoscopy and radiologic examinations at every follow-up appointment. Radiologic response was defined according to World Health Organization criteria and endoscopic response was determined based on the Groupe d'Etude des Lymphomes de l'Adult grading system that is widely used in post-treatment evaluation of gastric MALT lymphoma. Forty-five patients were analyzed. Within a median follow-up period of 34 months, 35 patients achieved both radiologic and endoscopic complete remission (CR). The median times to endoscopic and radiologic CR were not significantly different (21 versus 16 weeks, p = 0.118). However, in 25 patients with stage I disease, endoscopic CR [median (range), 20 (11-36)] was achieved later than radiologic CR [median (range), 13 (8-36)] (p = 0.027). Among 40 patients who achieved radiologic CR, 35 patients who also achieved endoscopic CR maintained remission during the follow-up. Two of the five patients who achieved radiologic CR without endoscopic CR experienced recurrence. In gastric DLBCL patients, endoscopic response does not always correlate with radiologic response and might predict disease recurrence. We suggest that follow-up endoscopic examination with biopsy should be performed in addition to radiologic examination.

Evidence-Based Imaging Guidelines and Medicare Payment Policy

PubMed Central

Sistrom, Christopher L; McKay, Niccie L

2008-01-01

Objective This study examines the relationship between evidence-based appropriateness criteria for neurologic imaging procedures and Medicare payment determinations. The primary research question is whether Medicare is more likely to pay for imaging procedures as the level of appropriateness increases. Data Sources The American College of Radiology Appropriateness Criteria (ACRAC) for neurological imaging, ICD-9-CM codes, CPT codes, and payment determinations by the Medicare Part B carrier for Florida and Connecticut. Study Design Cross-sectional study of appropriateness criteria and Medicare Part B payment policy for neurological imaging. In addition to descriptive and bivariate statistics, multivariate logistic regression on payment determination (yes or no) was performed. Data Collection Methods The American College of Radiology Appropriateness Criteria (ACRAC) documents specific to neurological imaging, ICD-9-CM codes, and CPT codes were used to create 2,510 medical condition/imaging procedure combinations, with associated appropriateness scores (coded as low/middle/high). Principal Findings As the level of appropriateness increased, more medical condition/imaging procedure combinations were payable (low = 61 percent, middle = 70 percent, and high = 74 percent). Logistic regression indicated that the odds of a medical condition/imaging procedure combination with a middle level of appropriateness being payable was 48 percent higher than for an otherwise similar combination with a low appropriateness score (95 percent CI on odds ratio=1.19–1.84). The odds ratio for being payable between high and low levels of appropriateness was 2.25 (95 percent CI: 1.66–3.04). Conclusions Medicare could improve its payment determinations by taking advantage of existing clinical guidelines, appropriateness criteria, and other authoritative resources for evidence-based practice. Such an approach would give providers a financial incentive that is aligned with best-practice medicine. In particular, Medicare should review and update its payment policies to reflect current information on the appropriateness of alternative imaging procedures for the same medical condition. PMID:18454778

REDUCED PROTECTIVE CLOTHING DETERMINATIONS

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

BROWN, R.L.

2003-06-13

This technical basis document defines conditions where reduced protective clothing can be allowed, defines reduced protective clothing, and documents the regulatory review that determines the process is compliant with the Tank Farm Radiological Control Manual (TFRCM) and Title 10, Part 835, of the Code of Federal Regulations (10CFR835). The criteria, standards, and requirements contained in this document apply only to Tank Farm Contractor (TFC) facilities.

Operation ARGUS 1958.

DTIC Science & Technology

1982-04-30

Nuclear Test Operations South Atlantic ARGUS Christofilos Theory FLORAL ARGUS Effect JASON Van Allen Belts Nuclear Test Personnel Review (MTPR) MIDAS ...precluded radiological exposure. Project 7.3 -- Surface Measurements (Project MIDAS ) Agencies: This project, code-named MIDAS for security reasons, was...weapon casings, but these personnel were badged and equipped with ten self-reading pocket dosimeters as well as alpha-detection equipment provided by the

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.

Modes of information delivery in radiologic anatomy education: Impact on student performance.

PubMed

Ketelsen, Dominik; Schrödl, Falk; Knickenberg, Inés; Heckemann, Rolf A; Hothorn, Torsten; Neuhuber, Winfried; Bautz, Werner A L; Grunewald, Markus

2007-01-01

This study provides a systematic assessment of different methods of delivering radiologic teaching content (lecture, printed text, and digital content delivery) under standard conditions, enabling comparison of the effectiveness of these methods. A printed atlas of sectional anatomy was used as a standard. Digital content was developed on the basis of the printed atlas. Lecturers used both the printed and the digital content to prepare lectures. Standardized teaching material thus created was presented to second-term undergraduate students who had attended the school's anatomy course, but had not received any radiology teaching. Multiple choice examinations were used to assess the students' ability to recognize anatomical structures in known as well as unknown images. In a survey, the students' subjective experience of the learning process was assessed. No difference was seen between the groups regarding examination results. Students preferred a combination of digital media and lectures by enthusiastic teachers. The shortage of teachers requires a compromise concerning the delivery of radiologic anatomy content in a medical school setting. Based on our results, we recommend a combined approach of lecture and digital content delivery.

JOURNAL CLUB: Redefining the Radiology Curriculum in Medical School: Vertical Integration and Global Accessibility.

PubMed

Retrouvey, Michele; Trace, Anthony Paul; Goodmurphy, Craig W; Shaves, Sarah

2018-01-01

Radiology interconnects medical disciplines given that a working understanding of imaging is essential to clinicians of every specialty. Using online education, we created a globally accessible, web-based undergraduate medical radiology curriculum modeled after the National Medical Student Curriculum in Radiology program of the Alliance of Medical Student Educators in Radiology. Seventy-four radiology faculty-mentored video modules were produced, 50 of which were integrated into the 1st-year anatomy course. We administered tests to medical students before and after students saw the videos to assess the effectiveness of the modules. We surveyed students on their interests in pursuing radiology as a career before and after participating in this curriculum. On the preexamination questions, the mean score was 58.0%, which increased to 83.6% on the pair-matched imaging-related questions on the actual examination. Before participating in the new curriculum, 88% of students did not express an interest in radiology, and 9% were undecided about radiology as a future career. There was an increase in students who reported that they would definitely or most likely pursue a career in radiology (7%) after they had viewed the lectures. Radiology education is now available to a greater number of multidisciplinary learners worldwide. This project produced a comprehensive, globally accessible radiology curriculum in a self-paced, flexible learning format for new generations of physicians.

Teaching and Assessing Professionalism in Radiology: Resources and Scholarly Opportunities to Contribute to Required Expectations.

PubMed

Kelly, Aine Marie; Mullan, Patricia B

2018-05-01

Teaching and assessing trainees' professionalism now represents an explicit expectation for Accreditation Council Graduate Medical Education-accredited radiology programs. Challenges to meeting this expectation include variability in defining the construct of professionalism; limits of traditional teaching and assessment methods, used for competencies historically more prominent in medical education, for professionalism; and emerging expectations for credible and feasible professionalism teaching and assessment practices in the current context of health-care training and practice. This article identifies promising teaching resources and methods that can be used strategically to augment traditional teaching of the cognitive basis for professionalism, including role modeling, case-based scenarios, debriefing, simulations, narrative medicine (storytelling), guided discussions, peer-assisted learning, and reflective practice. This article also summarizes assessment practices intended to promote learning, as well as to inform how and when to assess trainees as their professional identities develop over time, settings, and autonomous practice, particularly in terms of measurable behaviors. This includes assessment tools (including mini observations, critical incident reports, and appreciative inquiry) for authentic assessment in the workplace; engaging multiple sources (self-, peer, other health professionals, and patients) in assessment; and intentional practices for trainees to take responsibility for seeking our actionable feedback and reflection. This article examines the emerging evidence of the feasibility and value added of assessment of medical competency milestones, including professionalism, coordinated by the Accreditation Council Graduate Medical Education in radiology and other medical specialties. Radiology has a strategic opportunity to contribute to scholarship and inform policies in professionalism teaching and assessment practices. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Should radiology residents be taught evidence-based radiology? An experiment with "the EBR Journal Club".

PubMed

Heilbrun, Marta E

2009-12-01

Introduce radiology residents to evidence-based radiology (EBR) using a journal club format based on the Radiology Alliance for Health Services Research/American Alliance of Academic Chief Residents in Radiology (RAHSR/A3CR2) Critical Thinking Skills sessions and EBR series of articles published in Radiology in 2007. The club began with a presentation outlining the process that would occur in an alternating format, with topics and articles chosen by residents. In session A, questions were rephrased in a Patient/Population, Intervention, Comparison, Outcome format, and a literature search was performed. Articles were discussed in session B, with residents assigned by year to the tasks of article summary, technology assessment, and comparison to checklists (Standards for Reporting of Diagnostic Accuracy, Consolidated Standards of Reporting Trials, or Quality of Reporting of Meta-analysis). The residents collectively assigned a level of evidence to each article, and a scribe provided a summary. Twenty-two residents participated, with 12/22 (55%) of residents submitting any question, 6/22 (27.3%) submitting more than one question, and 4 residents submitting questions in more than one session. Topics included radiation risk, emergency radiology, screening examinations, modality comparisons, and technology assessment. Of the 31 articles submitted for review, 15 were in radiology journals and 5 were published before 2000. For 2/9 topics searched, no single article that the residents selected was available through our library's subscription service. The maximum level of evidence assigned by residents was level III, "limited evidence." In each session, the residents concluded that they became less confident in the "right answer." They proposed that future reading recommendations come from attendings rather than literature searches. A journal club format is an effective tool to teach radiology residents EBR principles. Resistance comes from the difficulty in accessing good literature for review and in constructing good review questions.

Development and validation of a questionnaire to evaluate infection control in oral radiology.

PubMed

da Costa, Eliana D; Pinelli, Camila; da Silva Tagliaferro, Elaine P; Corrente, José E; Ambrosano, Glaucia M B

2017-04-01

To create and validate a questionnaire to evaluate infection control in oral radiology. The questionnaire was developed after review of the literature, which included published articles and the biosafety protocols available from healthcare agencies. The initial version of the questionnaire was composed of 14 multiple choice questions and was divided into 3 domains on handwashing, disinfection/protection of surfaces and disinfectant used. Content validity was assessed by two expert committees, which reviewed the content and scope of the questionnaire and the relevance of each item, respectively. Reliability was evaluated using test-retest and internal consistency methods with 115 undergraduate dentistry students. Construct validity was assessed using the known-groups technique and factor analysis. The known-groups technique involved 641 undergraduate dentistry students, 20 PhD students and 15 oral radiology professors. In the factor analysis, 3 radiology technicians also participated in addition to the 641 undergraduates, 20 PhD students and 15 oral radiology professors. The content validity results were found to be satisfactory to excellent for the ordinal variables (intraclass correlation coefficient = 0.722-1.000) and good to great for the yes/no questions (kappa = 0.662-0.913) in terms of reliability and good internal consistency (Cronbach's alpha = 0.88). After a factor analysis, some questions were excluded, and the questions were grouped into new domains. Significant differences were observed between answers from different groups. The final version of the questionnaire was composed of nine domains. The questionnaire created was found to exhibit good psychometric properties for assessing infection control in oral radiology.

Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

PubMed

Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

2017-01-01

Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Characteristics and quality of published animal research in the field of radiology.

PubMed

Yoon, Soo Jeong; Yoon, Dae Young; Cho, Young Kwon; Baek, Sora; Lim, Kyoung Ja; Seo, Young Lan; Yun, Eun Joo

2017-06-01

Background Animal research has played an important role in the field of radiology. Purpose To evaluate the characteristics and quality of published radiological animal research. Material and Methods A PubMed search was performed for radiological animal research articles (defined as studies using animal models with a radiologist as the first author) published in 1994, 2004, and 2014. The following information was extracted from each article: journal name, radiological subspecialty, imaging technique, animal species, number of animals used, number of authors, declared funding, country of origin, methodological quality, and ethical quality. Methodological and ethical quality of studies were assessed with seven-item (sample size calculation, animal age, animal sex, animal weight, inclusion and exclusion criteria, randomization, and blinded outcome assessment) and four-item (ethical review committee approval, anesthesia, pain control, and euthanasia) scales, respectively. Results The numbers of radiological animal studies markedly increased, from 91 in 1994 to 163 in 2004 and to 305 in 2014. One hundred and sixty-two (29.0%) articles focused on the neuroradiology/head and neck subspecialty, 233 (41.7%) used magnetic resonance imaging (MRI), 190 (34.0%) used mice, 254 (45.4%) used 10-30 animals, 297 (53.1%) had 4-7 authors, 392 (70.1%) were funded, and 222 (39.7%) were from the USA. Six of 7 methodological and 3/4 ethical quality items significantly improved over time. Conclusion The quantity and quality of radiological animal research has increased over the last two decades; however, methodological and ethical quality remains suboptimal.

A Checklist to Improve Patient Safety in Interventional Radiology

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

Koetser, Inge C. J.; Vries, Eefje N. de; Delden, Otto M. van

2013-04-15

To develop a specific RADiological Patient Safety System (RADPASS) checklist for interventional radiology and to assess the effect of this checklist on health care processes of radiological interventions. On the basis of available literature and expert opinion, a prototype checklist was developed. The checklist was adapted on the basis of observation of daily practice in a tertiary referral centre and evaluation by users. To assess the effect of RADPASS, in a series of radiological interventions, all deviations from optimal care were registered before and after implementation of the checklist. In addition, the checklist and its use were evaluated by interviewingmore » all users. The RADPASS checklist has two parts: A (Planning and Preparation) and B (Procedure). The latter part comprises checks just before starting a procedure (B1) and checks concerning the postprocedural care immediately after completion of the procedure (B2). Two cohorts of, respectively, 94 and 101 radiological interventions were observed; the mean percentage of deviations of the optimal process per intervention decreased from 24 % before implementation to 5 % after implementation (p < 0.001). Postponements and cancellations of interventions decreased from 10 % before implementation to 0 % after implementation. Most users agreed that the checklist was user-friendly and increased patient safety awareness and efficiency. The first validated patient safety checklist for interventional radiology was developed. The use of the RADPASS checklist reduced deviations from the optimal process by three quarters and was associated with less procedure postponements.« less

Radiology Resident Supply and Demand: A Regional Perspective.

PubMed

Pfeifer, Cory M

2017-09-01

Radiology was subject to crippling deficits in the number of jobs available to graduates of training programs from 2012 through 2015. As the specialty transitions to the assimilation of osteopathic training programs and the welcoming of direct competition from new integrated interventional radiology programs, the assessment of growth in radiology training positions over the 10 years preceding this pivotal time will serve to characterize the genesis of the crisis while inspiring stakeholders to avoid similar negative fluctuations in the future. The number of per capita radiology trainees in each region was derived from data published by the National Resident Matching Program, as were annual match statistics over the years 2012 through 2016. Data regarding new interventional radiology and diagnostic radiology enrollees were also obtained from the National Resident Matching Program. The seven states with the most per capita radiology residents were in the Mid-Atlantic and Northeastern United States in both 2006 and 2016, and three of these seven also showed the greatest per capita growth over the course of the 10 years studied. New radiology programs were accredited during the peak of the job shortage. Integrated interventional radiology training created 24 de novo radiology residents in the 2017 match. Fill rates are weakly positively correlated with program size. Unregulated radiology program growth persisted during the decade leading up to 2016. The region with the fewest jobs available since 2012 is also home to the greatest number of per capita radiology residents. Numerous published opinions during the crisis did not result in enforced policy change. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Functional Testing of SLC26A4 Variants—Clinical and Molecular Analysis of a Cohort with Enlarged Vestibular Aqueduct from Austria

PubMed Central

Bernardinelli, Emanuele; Nofziger, Charity; Patsch, Wolfgang; Rasp, Gerd; Paulmichl, Markus; Dossena, Silvia

2018-01-01

The prevalence and spectrum of sequence alterations in the SLC26A4 gene, which codes for the anion exchanger pendrin, are population-specific and account for at least 50% of cases of non-syndromic hearing loss associated with an enlarged vestibular aqueduct. A cohort of nineteen patients from Austria with hearing loss and a radiological alteration of the vestibular aqueduct underwent Sanger sequencing of SLC26A4 and GJB2, coding for connexin 26. The pathogenicity of sequence alterations detected was assessed by determining ion transport and molecular features of the corresponding SLC26A4 protein variants. In this group, four uncharacterized sequence alterations within the SLC26A4 coding region were found. Three of these lead to protein variants with abnormal functional and molecular features, while one should be considered with no pathogenic potential. Pathogenic SLC26A4 sequence alterations were only found in 12% of patients. SLC26A4 sequence alterations commonly found in other Caucasian populations were not detected. This survey represents the first study on the prevalence and spectrum of SLC26A4 sequence alterations in an Austrian cohort and further suggests that genetic testing should always be integrated with functional characterization and determination of the molecular features of protein variants in order to unequivocally identify or exclude a causal link between genotype and phenotype. PMID:29320412

Validation of Rapid Radiochemical Method for Californium ...

EPA Pesticide Factsheets

Technical Brief In the event of a radiological/nuclear contamination event, the response community would need tools and methodologies to rapidly assess the nature and the extent of contamination. To characterize a radiologically contaminated outdoor area and to inform risk assessment, large numbers of environmental samples would be collected and analyzed over a short period of time. To address the challenge of quickly providing analytical results to the field, the U.S. EPA developed a robust analytical method. This method allows response officials to characterize contaminated areas and to assess the effectiveness of remediation efforts, both rapidly and accurately, in the intermediate and late phases of environmental cleanup. Improvement in sample processing and analysis leads to increased laboratory capacity to handle the analysis of a large number of samples following the intentional or unintentional release of a radiological/nuclear contaminant.

Cellular track model of biological damage to mammalian cell cultures from galactic cosmic rays

NASA Technical Reports Server (NTRS)

Cucinotta, Francis A.; Katz, Robert; Wilson, John W.; Townsend, Lawrence W.; Nealy, John E.; Shinn, Judy L.

1991-01-01

The assessment of biological damage from the galactic cosmic rays (GCR) is a current interest for exploratory class space missions where the highly ionizing, high-energy, high-charge ions (HZE) particles are the major concern. The relative biological effectiveness (RBE) values determined by ground-based experiments with HZE particles are well described by a parametric track theory of cell inactivation. Using the track model and a deterministic GCR transport code, the biological damage to mammalian cell cultures is considered for 1 year in free space at solar minimum for typical spacecraft shielding. Included are the effects of projectile and target fragmentation. The RBE values for the GCR spectrum which are fluence-dependent in the track model are found to be more severe than the quality factors identified by the International Commission on Radiological Protection publication 26 and seem to obey a simple scaling law with the duration period in free space.

Lateral sesamoid position in hallux valgus: correlation with the conventional radiological assessment.

PubMed

Agrawal, Yuvraj; Desai, Aravind; Mehta, Jaysheel

2011-12-01

We aimed to quantify the severity of the hallux valgus based on the lateral sesamoid position and to establish a correlation of our simple assessment method with the conventional radiological assessments. We reviewed one hundred and twenty two dorso-plantar weight bearing radiographs of feet. The intermetatarsal and hallux valgus angles were measured by the conventional methods; and the position of lateral sesamoid in relation to first metatarsal neck was assessed by our new and simple method. Significant correlation was noted between intermetatarsal angle and lateral sesamoid position (Rho 0.74, p < 0.0001); lateral sesamoid position and hallux valgus angle (Rho 0.56, p < 0.0001). Similar trends were noted in different grades of severity of hallux valgus in all the three methods of assessment. Our method of assessing hallux valgus deformity based on the lateral sesamoid position is simple, less time consuming and has statistically significant correlation with that of the established conventional radiological measurements. Copyright © 2011 European Foot and Ankle Society. Published by Elsevier Ltd. 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.

Image splitting and remapping method for radiological image compression

NASA Astrophysics Data System (ADS)

Lo, Shih-Chung B.; Shen, Ellen L.; Mun, Seong K.

1990-07-01

A new decomposition method using image splitting and gray-level remapping has been proposed for image compression, particularly for images with high contrast resolution. The effects of this method are especially evident in our radiological image compression study. In our experiments, we tested the impact of this decomposition method on image compression by employing it with two coding techniques on a set of clinically used CT images and several laser film digitized chest radiographs. One of the compression techniques used was full-frame bit-allocation in the discrete cosine transform domain, which has been proven to be an effective technique for radiological image compression. The other compression technique used was vector quantization with pruned tree-structured encoding, which through recent research has also been found to produce a low mean-square-error and a high compression ratio. The parameters we used in this study were mean-square-error and the bit rate required for the compressed file. In addition to these parameters, the difference between the original and reconstructed images will be presented so that the specific artifacts generated by both techniques can be discerned by visual perception.

PDA-phone-based instant transmission of radiological images over a CDMA network by combining the PACS screen with a Bluetooth-interfaced local wireless link.

PubMed

Kim, Dong Keun; Yoo, Sun K; Park, Jeong Jin; Kim, Sun Ho

2007-06-01

Remote teleconsultation by specialists is important for timely, correct, and specialized emergency surgical and medical decision making. In this paper, we designed a new personal digital assistant (PDA)-phone-based emergency teleradiology system by combining cellular communication with Bluetooth-interfaced local wireless links. The mobility and portability resulting from the use of PDAs and wireless communication can provide a more effective means of emergency teleconsultation without requiring the user to be limited to a fixed location. Moreover, it enables synchronized radiological image sharing between the attending physician in the emergency room and the remote specialist on picture archiving and communication system terminals without distorted image acquisition. To enable rapid and fine-quality radiological image transmission over a cellular network in a secure manner, progressive compression and security mechanisms have been incorporated. The proposed system is tested over a code division Multiple Access 1x-Evolution Data-Only network to evaluate the performance and to demonstrate the feasibility of this system in a real-world setting.

Radiation dose reduction: comparative assessment of publication volume between interventional and diagnostic radiology.

PubMed

Hansmann, Jan; Henzler, Thomas; Gaba, Ron C; Morelli, John N

2017-01-01

We aimed to quantify and compare awareness regarding radiation dose reduction within the interventional radiology and diagnostic radiology communities. Abstracts accepted to the annual meetings of the Society of Interventional Radiology (SIR), the Cardiovascular and Interventional Radiological Society of Europe (CIRSE), the Radiological Society of North America (RSNA), and the European Congress of Radiology (ECR) between 2005 and 2015 were analyzed using the search terms "interventional/computed tomography" and "radiation dose/radiation dose reduction." A PubMed query using the above-mentioned search terms for the years of 2005-2015 was performed. Between 2005 and 2015, a total of 14 520 abstracts (mean, 660±297 abstracts) and 80 614 abstracts (mean, 3664±1025 abstracts) were presented at interventional and diagnostic radiology meetings, respectively. Significantly fewer abstracts related to radiation dose were presented at the interventional radiology meetings compared with the diagnostic radiology meetings (162 abstracts [1% of total] vs. 2706 [3% of total]; P < 0.001). On average 15±7 interventional radiology abstracts (range, 6-27) and 246±105 diagnostic radiology abstracts (range, 112-389) pertaining to radiation dose were presented at each meeting. The PubMed query revealed an average of 124±39 publications (range, 79-187) and 1205±307 publications (range, 829-1672) related to interventional and diagnostic radiology dose reduction per year, respectively (P < 0.001). The observed increase in the number of abstracts regarding radiation dose reduction in the interventional radiology community over the past 10 years has not mirrored the increased volume seen within diagnostic radiology, suggesting that increased education and discussion about this topic may be warranted.

Radiation dose reduction: comparative assessment of publication volume between interventional and diagnostic radiology

PubMed Central

Hansmann, Jan; Henzler, Thomas; Gaba, Ron C.; Morelli, John N.

2017-01-01

PURPOSE We aimed to quantify and compare awareness regarding radiation dose reduction within the interventional radiology and diagnostic radiology communities. METHODS Abstracts accepted to the annual meetings of the Society of Interventional Radiology (SIR), the Cardiovascular and Interventional Radiological Society of Europe (CIRSE), the Radiological Society of North America (RSNA), and the European Congress of Radiology (ECR) between 2005 and 2015 were analyzed using the search terms “interventional/computed tomography” and “radiation dose/radiation dose reduction.” A PubMed query using the above-mentioned search terms for the years of 2005–2015 was performed. RESULTS Between 2005 and 2015, a total of 14 520 abstracts (mean, 660±297 abstracts) and 80 614 abstracts (mean, 3664±1025 abstracts) were presented at interventional and diagnostic radiology meetings, respectively. Significantly fewer abstracts related to radiation dose were presented at the interventional radiology meetings compared with the diagnostic radiology meetings (162 abstracts [1% of total] vs. 2706 [3% of total]; P < 0.001). On average 15±7 interventional radiology abstracts (range, 6–27) and 246±105 diagnostic radiology abstracts (range, 112–389) pertaining to radiation dose were presented at each meeting. The PubMed query revealed an average of 124±39 publications (range, 79–187) and 1205±307 publications (range, 829–1672) related to interventional and diagnostic radiology dose reduction per year, respectively (P < 0.001). CONCLUSION The observed increase in the number of abstracts regarding radiation dose reduction in the interventional radiology community over the past 10 years has not mirrored the increased volume seen within diagnostic radiology, suggesting that increased education and discussion about this topic may be warranted. PMID:28287072

Interpretation of Brain CT Scans in the Field by Critical Care Physicians in a Mobile Stroke Unit

PubMed Central

Zakariassen, Erik; Lindner, Thomas; Nome, Terje; Bache, Kristi G.; Røislien, Jo; Gleditsch, Jostein; Solyga, Volker; Russell, David; Lund, Christian G.

2017-01-01

ABSTRACT BACKGROUND AND PURPOSE In acute stroke, thromboembolism or spontaneous hemorrhage abruptly reduces blood flow to a part of the brain. To limit necrosis, rapid radiological identification of the pathological mechanism must be conducted to allow the initiation of targeted treatment. The aim of the Norwegian Acute Stroke Prehospital Project is to determine if anesthesiologists, trained in prehospital critical care, may accurately assess cerebral computed tomography (CT) scans in a mobile stroke unit (MSU). METHODS In this pilot study, 13 anesthesiologists assessed unselected acute stroke patients with a cerebral CT scan in an MSU. The scans were simultaneously available by teleradiology at the receiving hospital and the on‐call radiologist. CT scan interpretation was focused on the radiological diagnosis of acute stroke and contraindications for thrombolysis. The aim of this study was to find inter‐rater agreement between the pre‐ and in‐hospital radiological assessments. A neuroradiologist evaluated all CT scans retrospectively. Statistical analysis of inter‐rater agreement was analyzed with Cohen's kappa. RESULTS Fifty‐one cerebral CT scans from the MSU were included. Inter‐rater agreement between prehospital anesthesiologists and the in‐hospital on‐call radiologists was excellent in finding radiological selection for thrombolysis (kappa .87). Prehospital CT scans were conducted in median 10 minutes (7 and 14 minutes) in the MSU, and median 39 minutes (31 and 48 minutes) before arrival at the receiving hospital. CONCLUSION This pilot study shows that anesthesiologists trained in prehospital critical care may effectively assess cerebral CT scans in an MSU, and determine if there are radiological contraindications for thrombolysis. PMID:28766306

New Nuclear Emergency Prognosis system in Korea

NASA Astrophysics Data System (ADS)

Lee, Hyun-Ha; Jeong, Seung-Young; Park, Sang-Hyun; Lee, Kwan-Hee

2016-04-01

This paper reviews the status of assessment and prognosis system for nuclear emergency response in Korea, especially atmospheric dispersion model. The Korea Institute of Nuclear Safety (KINS) performs the regulation and radiological emergency preparedness of the nuclear facilities and radiation utilizations. Also, KINS has set up the "Radiological Emergency Technical Advisory Plan" and the associated procedures such as an emergency response manual in consideration of the IAEA Safety Standards GS-R-2, GS-G-2.0, and GS-G-2.1. The Radiological Emergency Technical Advisory Center (RETAC) organized in an emergency situation provides the technical advice on radiological emergency response. The "Atomic Computerized Technical Advisory System for nuclear emergency" (AtomCARE) has been developed to implement assessment and prognosis by RETAC. KINS developed Accident Dose Assessment and Monitoring (ADAMO) system in 2015 to reflect the lessons learned from Fukushima accident. It incorporates (1) the dose assessment on the entire Korean peninsula, Asia region, and global region, (2) multi-units accident assessment (3) applying new methodology of dose rate assessment and the source term estimation with inverse modeling, (4) dose assessment and monitoring with the environmental measurements result. The ADAMO is the renovated version of current FADAS of AtomCARE. The ADAMO increases the accuracy of the radioactive material dispersion with applying the LDAPS(Local Data Assimilation Prediction System, Spatial resolution: 1.5 km) and RDAPS(Regional Data Assimilation Prediction System, Spatial resolution: 12km) of weather prediction data, and performing the data assimilation of automatic weather system (AWS) data from Korea Meteorological Administration (KMA) and data from the weather observation tower at NPP site. The prediction model of the radiological material dispersion is based on the set of the Lagrangian Particle model and Lagrangian Puff model. The dose estimation methodology incorporate the dose assessment methods of IAEA, WHO, and USNRC. The dose assessment result will express on the GIS (GIS (Geographic Information System) to provide to the local- governments and the central government. Acknowledgements This research has been supported by the Nuclear Safety and Security Commission [Reference No.1305020-0315-SB110

Radiology and social media: are private practice radiology groups more social than academic radiology departments?

PubMed

Glover, McKinley; Choy, Garry; Boland, Giles W; Saini, Sanjay; Prabhakar, Anand M

2015-05-01

This study assesses the prevalence of use of the most commonly used social media sites among private radiology groups (PRGs) and academic radiology departments (ARDs). The 50 largest PRGs and the 50 ARDs with the highest level of funding from the National Institutes of Health were assessed for presence of a radiology-specific social media account on Facebook, Twitter, Instagram, Pinterest, YouTube, and LinkedIn. Measures of organizational activity and end-user activity were collected, including the number of posts and followers, as appropriate; between-group comparisons were performed. PRGs adopted Facebook 12 months earlier (P = .02) and Twitter 18 months earlier (P = .02) than did ARDs. A total of 76% of PRGs maintained ≥1 account on the social media sites included in the study, compared with 28% of ARDs (P < .0001). The prevalence of having an account on the social media sites for PRGs was: Facebook, 66%; LinkedIn, 56%; Twitter, 42%; YouTube, 20%; Pinterest, 4%; and Instagram, 2%. The prevalence of radiology-specific social media accounts for ARDs was: Facebook, 18%; LinkedIn, 0%; Twitter, 24%; YouTube, 6%; Pinterest, 0%; and Instagram, 0%. There was no significant difference between ARDs and PRGs in measures of end-user or organizational activity on Facebook or Twitter. Use of social media in health care is emerging as mainstream, with PRGs being early adopters of Facebook and Twitter in comparison with ARDs. Competitive environments and institutional policies may be strong factors that influence how social media is used by radiologists at the group and department levels. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Image processing of angiograms: A pilot study

NASA Technical Reports Server (NTRS)

Larsen, L. E.; Evans, R. A.; Roehm, J. O., Jr.

1974-01-01

The technology transfer application this report describes is the result of a pilot study of image-processing methods applied to the image enhancement, coding, and analysis of arteriograms. Angiography is a subspecialty of radiology that employs the introduction of media with high X-ray absorption into arteries in order to study vessel pathology as well as to infer disease of the organs supplied by the vessel in question.

Simulation for Teaching and Assessment of Nodule Perception on Chest Radiography in Nonradiology Health Care Trainees.

PubMed

Auffermann, William F; Henry, Travis S; Little, Brent P; Tigges, Stefan; Tridandapani, Srini

2015-11-01

Simulation has been used as an educational and assessment tool in several fields, generally involving training of physical skills. To date, simulation has found limited application in teaching and assessment of skills related to image perception and interpretation. The goal of this pilot study was to evaluate the feasibility of simulation as a tool for teaching and assessment of skills related to perception of nodules on chest radiography. This study received an exemption from the institutional review board. Subjects consisted of nonradiology health care trainees. Subjects underwent training and assessment of pulmonary nodule identification skills on chest radiographs at simulated radiology workstations. Subject performance was quantified by changes in area under the localization receiver operating characteristic curve. At the conclusion of the study, all subjects were given a questionnaire with five questions comparing learning at a simulated workstation with training using conventional materials. Statistical significance for questionnaire responses was tested using the Wilcoxon signed rank test. Subjects demonstrated statistically significant improvement in nodule identification after training at a simulated radiology workstation (change in area under the curve, 0.1079; P = .015). Subjects indicated that training on simulated radiology workstations was preferable to conventional training methods for all questions; P values for all questions were less than .01. Simulation may be a useful tool for teaching and assessment of skills related to medical image perception and interpretation. Further study is needed to determine which skills and trainee populations may be most amenable to training and assessment using simulation. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The potential radiological impact from a Brazilian phosphate facility.

PubMed

Glória dos Reis, Rócio; da Costa Lauria, Dejanira

2014-10-01

In the semiarid region of Brazil, a facility for the production of phosphoric acid for fertilizer is in the last stages of the planning phase. The raw feedstock of Santa Quiteria has a very high level of uranium associated with the phosphate in form of apatite. The reaction by which phosphoric acid is produced generates phosphogypsum (PG) as a by-product. The ratio of phosphogypsum to phosphoric acid is approximately 5 to 1. After all of the phosphate has been extracted and processed, it is expected that some 37 million tons of phosphogypsum will be produced, containing 13 Bq/g of (226)Ra and 11 Bq/g of (210)Pb. To assess the potential impact of this PG stack on the surrounding inhabitants, a generic impact assessment was performed using a modeling approach. We estimated the amount and shape of the residue stack and used computational codes for assessing the radiological impact in a prospective risk assessment. A hypothetical farmer scenario was used to calculate two potential doses, one near the site boundary and another directly over the stack piles after the project is shut down. Using a conservative approach, the potential public dose was estimated to be 2.8 mSv/y. This study identified the rainfall erosion index, dissolution rate of PG, radionuclide distribution coefficients and fish consumption rate as parameters where improved information could enhance the quality of the dose assessment. The disposal and shape of the stack is of major concern, since the PG erosion might be the main pathway for the environmental contamination; therefore, studies should be carried out to determine a suitable shape and disposal of the stack. Furthermore, containment barriers should be evaluated for their potential to reduce or avoid environmental contamination by runoff. In addition, the onsite public dose underscores the importance of a planning for remediation of the area after the plant is shut down to assure that neither the public nor the environmental health will be affected by the presence of the PG stack. Copyright © 2014 Elsevier Ltd. All rights reserved.

Potential Offsite Radiological Doses Estimated for the Proposed Divine Strake Experiment, Nevada Test Site

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

Ron Warren

2006-12-01

An assessment of the potential radiation dose that residents offsite of the Nevada Test Site (NTS) might receive from the proposed Divine Strake experiment was made to determine compliance with Subpart H of Part 61 of Title 40 of the Code of Federal Regulations, National Emission Standards for Emissions of Radionuclides Other than Radon from Department of Energy Facilities. The Divine Strake experiment, proposed by the Defense Threat Reduction Agency, consists of a detonation of 700 tons of heavy ammonium nitrate fuel oil-emulsion above the U16b Tunnel complex in Area 16 of the NTS. Both natural radionuclides suspended, and historicmore » fallout radionuclides resuspended from the detonation, have potential to be transported outside the NTS boundary by wind. They may, therefore, contribute radiological dose to the public. Subpart H states ''Emissions of radionuclides to the ambient air from Department of Energy facilities shall not exceed those amounts that would cause any member of the public to receive in any year an effective dose equivalent of 10 mrem/yr'' (Title 40 of the Code of Federal Regulations [CFR] 61.92) where mrem/yr is millirem per year. Furthermore, application for U.S. Environmental Protection Agency (EPA) approval of construction of a new source or modification of an existing source is required if the effective dose equivalent, caused by all emissions from the new construction or modification, is greater than or equal to 0.1 mrem/yr (40 CFR 61.96). In accordance with Section 61.93, a dose assessment was conducted with the computer model CAP88-PC, Version 3.0. In addition to this model, a dose assessment was also conducted by the National Atmospheric Release Advisory Center (NARAC) at the Lawrence Livermore National Laboratory. This modeling was conducted to obtain dose estimates from a model designed for acute releases and which addresses terrain effects and uses meteorology from multiple locations. Potential radiation dose to a hypothetical maximally exposed individual at the closest NTS boundary to the proposed Divine Strake experiment, as estimated by the CAP88-PC model, was 0.005 mrem with wind blowing directly towards that location. Boundary dose, as modeled by NARAC, ranged from about 0.006 to 0.007 mrem. Potential doses to actual offsite populated locations were generally two to five times lower still, or about 40 to 100 times lower then the 0.1 mrem level at which EPA approval is required pursuant to Section 61.96.« less

Does leaching of naturally occurring radionuclides from roadway pavements stabilised with coal fly ash have negative impacts on groundwater quality and human health?

PubMed

Almahayni, T; Vanhoudt, N

2018-05-05

We assessed the potential impact of using coal fly ash to stabilise roadway pavements on groundwater quality and human health. The leaching potential of naturally occurring radionuclides (NORs) typically present in the fly ash was assessed with the HYDRUS-1D code and data representative of a segment of the Wisconsin State Trunk Highway 60 as a case study. Our assessment suggests that the impact would be mainly from the chemical toxicity of uranium (U). In our particular case study, U concentration in the leachate exceeded the maximum contaminant level for this element (MCL = 30 μg L -1 ) in almost all the scenarios. In the groundwater, the MCL was only exceeded under conditions of high leaching and low dilution in the aquifer. The radiological toxicity from the consumption of the contaminated groundwater by a hypothetical adult, however, was at maximum 43% of the individual dose criterion (IDC = 0.1 mSv y -1 ). The results also highlight the need to consider site-specific conditions such as climate and hydrogeology when assessing the environmental impacts of utilising fly ash in roadway construction applications since they could have profound effects on the assessment findings. There is also a pressing need for reliable and representative data to support realistic assessments. Copyright © 2018 Elsevier B.V. All rights reserved.

Comparison of EGS4 and MCNP Monte Carlo codes when calculating radiotherapy depth doses.

PubMed

Love, P A; Lewis, D G; Al-Affan, I A; Smith, C W

1998-05-01

The Monte Carlo codes EGS4 and MCNP have been compared when calculating radiotherapy depth doses in water. The aims of the work were to study (i) the differences between calculated depth doses in water for a range of monoenergetic photon energies and (ii) the relative efficiency of the two codes for different electron transport energy cut-offs. The depth doses from the two codes agree with each other within the statistical uncertainties of the calculations (1-2%). The relative depth doses also agree with data tabulated in the British Journal of Radiology Supplement 25. A discrepancy in the dose build-up region may by attributed to the different electron transport algorithims used by EGS4 and MCNP. This discrepancy is considerably reduced when the improved electron transport routines are used in the latest (4B) version of MCNP. Timing calculations show that EGS4 is at least 50% faster than MCNP for the geometries used in the simulations.

Quantitative computed tomography (QCT) as a radiology reporting tool by using optical character recognition (OCR) and macro program.

PubMed

Lee, Young Han; Song, Ho-Taek; Suh, Jin-Suck

2012-12-01

The objectives are (1) to introduce a new concept of making a quantitative computed tomography (QCT) reporting system by using optical character recognition (OCR) and macro program and (2) to illustrate the practical usages of the QCT reporting system in radiology reading environment. This reporting system was created as a development tool by using an open-source OCR software and an open-source macro program. The main module was designed for OCR to report QCT images in radiology reading process. The principal processes are as follows: (1) to save a QCT report as a graphic file, (2) to recognize the characters from an image as a text, (3) to extract the T scores from the text, (4) to perform error correction, (5) to reformat the values into QCT radiology reporting template, and (6) to paste the reports into the electronic medical record (EMR) or picture archiving and communicating system (PACS). The accuracy test of OCR was performed on randomly selected QCTs. QCT as a radiology reporting tool successfully acted as OCR of QCT. The diagnosis of normal, osteopenia, or osteoporosis is also determined. Error correction of OCR is done with AutoHotkey-coded module. The results of T scores of femoral neck and lumbar vertebrae had an accuracy of 100 and 95.4 %, respectively. A convenient QCT reporting system could be established by utilizing open-source OCR software and open-source macro program. This method can be easily adapted for other QCT applications and PACS/EMR.

Updated findings from a help wanted index of job advertisements and an analysis of the policy implications: is the job-market shortage for diagnostic radiologists stabilizing?

PubMed

Saketkhoo, Daniel D; Covey, Anne M; Sunshine, Jonathan; Forman, Howard P

2002-10-01

The goal of our study is to present the most recent data on the diagnostic radiology job market in the United States using a help wanted index of job advertisements. All diagnostic radiology jobs advertised in the American Journal of Roentgenology and Radiology between January 2000 and December 2001 were coded by practice type, geographic location, and subspecialty and were compared with the previously published results from 1991 through 1999. From January 1999 through December 2001, 15,205 positions were advertised for diagnostic radiologists, representing a 284% average per-month increase as compared with the previous 4-year period. The 12-month rolling average of job advertisements peaked in June 2001 at 476 and has since stabilized. Thirty-six percent of positions advertised were academic, identical to the proportion found from 1995 to 1998. A statistically significant relative increase in jobs advertised was noted in the Midwest, and relative decreases were seen in the Northeast, Northwest, Southwest, and (most recently) California. Statistically significant relative decreases were also observed in the number of general radiology, vascular and interventional, and emergency radiology positions. The demand for mammographers, pediatric radiologists, neuroradiologists, abdominal imagers, and chest radiologists all exhibited statistically significant relative increases. The absolute demand for both private and academic radiologists continued to grow throughout the country and in all subspecialties, but the pace of increase has slowed dramatically during the past 12 months, especially in the western United States. Current policy should be directed toward training for the areas of greatest need.

Incidence of Radiologically Isolated Syndrome: A Population-Based Study.

PubMed

Forslin, Y; Granberg, T; Jumah, A Antwan; Shams, S; Aspelin, P; Kristoffersen-Wiberg, M; Martola, J; Fredrikson, S

2016-06-01

Incidental MR imaging findings resembling MS in asymptomatic individuals, fulfilling the Okuda criteria, are termed "radiologically isolated syndrome." Those with radiologically isolated syndrome are at high risk of their condition converting to MS. The epidemiology of radiologically isolated syndrome remains largely unknown, and there are no population-based studies, to our knowledge. Our aim was to study the population-based incidence of radiologically isolated syndrome in a high-incidence region for MS and to evaluate the effect on radiologically isolated syndrome incidence when revising the original radiologically isolated syndrome criteria by using the latest radiologic classification for dissemination in space. All 2272 brain MR imaging scans in 1907 persons obtained during 2013 in the Swedish county of Västmanland, with a population of 259,000 inhabitants, were blindly evaluated by a senior radiologist and a senior neuroradiologist. The Okuda criteria for radiologically isolated syndrome were applied by using both the Barkhof and Swanton classifications for dissemination in space. Assessments of clinical data were performed by a radiology resident and a senior neurologist. The cumulative incidence of radiologically isolated syndrome was 2 patients (0.1%), equaling an incidence rate of 0.8 cases per 100,000 person-years, in a region with an incidence rate of MS of 10.2 cases per 100,000 person-years. There was no difference in the radiologically isolated syndrome incidence rate when applying a modified version of the Okuda criteria by using the newer Swanton classification for dissemination in space. Radiologically isolated syndrome is uncommon in a high-incidence region for MS. Adapting the Okuda criteria to use the dissemination in space-Swanton classification may be feasible. Future studies on radiologically isolated syndrome may benefit from a collaborative approach to ensure adequate numbers of participants. © 2016 by American Journal of Neuroradiology.

Clinico-radiological diagnosis and grading of rapidly progressive osteoarthritis of the hip.

PubMed

Zazgyva, Ancuţa; Gurzu, Simona; Gergely, István; Jung, Ioan; Roman, Ciprian O; Pop, Tudor S

2017-03-01

Due to the current lack of standard definitions for rapidly progressive osteoarthritis of the hip (RPOH) in the literature, this observational study aimed to describe new diagnostic criteria and a grading system for the disease.From a consecutive series of patients undergoing total hip replacement, 2 groups were selected: 1 with RPOH and 1 with primary hip osteoarthritis (POH), and their clinical, paraclinical, and demographic data were compared. The newly proposed clinico-radiological diagnostic criteria are based on characteristics of pain, joint mobility, and radiological assessment. The radiological grading system's inter- and intraobserver reliability was assessed through serial evaluations by 2 blinded reviewers.From the total 863 cases, 82 cases (9.5%) of RPOH were identified and compared with 107 cases of POH. Mean age and disease bilaterality were similar, with a predominance of female patients in the RPOH group (P = 0.03). There were significant differences between the 2 groups in disease onset and aggravation, and intraoperative blood loss. The grading system showed significant inter- and intraobserver agreement (weighted kappa 0.93, and 0.89).Our study presents distinctive, easily recognizable clinico-radiological characteristics of RPOH and confirmed the inter- and intraobserver reliability of the newly proposed grading system.

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.

Assessment of natural radioactivity and associated radiological risks from tiles used in Kajang, Malaysia

NASA Astrophysics Data System (ADS)

Abdullahi, S.; Ismail, A. F.; Samat, S. B.; Yasir, M. S.

2018-04-01

The activity concentration and radiological risk of commonly used flooring materials (tiles) in Malaysia were studied. The natural radionuclide concentrations of 226Ra, 232Th and 40K were measured using high-purity germanium detector. The average concentration of 226Ra, 232Th and 40K in the samples were 65.75±1.1 Bq kg-1, 61.92±1.43 Bq kg-1 and 617.77±6.72 Bq kg-1 respectively. The mean concentration of radium equivalent activity, absorbed dose rate, external and internal hazard indices and annual effective dose equivalent were 195.21±2.88 Bq kg-1, 92.75±1.27 nGy h-1, 0.53±0.01, 0.7±0.01 and 0.44±0.0 mSv y-1 respectively. The aim was to assess the possible radiological risks attributed from the tile materials. Even though, the activity concentrations were higher than worldwide average values, but none of the radiological impact parameters exceeded the maximum recommended values. Hence, it was concluded that, contribution of tiles to radiation exposure is negligible and therefore, radiologically safe to use as building materials.

Gender and the radiology workforce: results of the 2014 ACR workforce survey.

PubMed

Bluth, Edward I; Bansal, Swati; Macura, Katarzyna J; Fielding, Julia; Truong, Hang

2015-02-01

As part of the 2014 ACR Human Resources Commission Workforce Survey, an assessment of the gender of the U.S. radiologist workforce was undertaken. Radiologist gender in relation to type of practice, work location, leadership roles, and full- versus part-time employment have not previously been assessed by this survey. The survey was completed by group leaders in radiology identified through the Practice of Radiology Environment Database. The response rate to the survey was 22%, representing 35% of all practicing radiologists. The survey found that 78% of the radiology workforce is male, and 22% female. Among the men, 58% work in private practice, and 18% in the academic/university environment; among women, percentages were 43% and 31%, respectively. Of all physician leads, 85% are men, 15% women. Of the full-time radiologists, 15% of men are practice leaders compared with 11% of women. Fewer women than men are in private practice. More women than men practice in academic/university environments. Among part-time radiologists, there are more men than women, but significantly more women work part time than men. Women are in the minority among practice leaders. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiological threat assessment and the Federal Response Plan--a gap analysis.

PubMed

Conklin, W Craig; Liotta, Philip L

2005-11-01

The ability of the federal government to effectively and efficiently respond to nuclear or radiological terrorist attacks has been the subject of intense discussion and analysis for many years. Because of recent terrorist activities and intelligence information, there is strong sentiment that it is not a question of if, but when, a radiological or nuclear terrorist attack will occur. As a result, there is considerable concern that the federal government may not be adequately prepared to respond to an attack involving a radiological dispersal device or improvised nuclear device. In response to these concerns, federal departments and agencies have initiated actions to develop a better understanding of the magnitude of the radiological/nuclear terrorist threat, assess the ability of the federal government to support state and local responses to such attacks, and improve the Nation's ability to prepare for, respond to, and recover from these types of attacks. In an era of limited fiscal growth and competing priorities, the federal government will have to enhance its collaboration with state and local governments, the private sector, and academia to ensure that the Nation is capable of responding to a terrorist attack involving radioactive or nuclear material.

[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.

Most Common Publication Types in Radiology Journals:: What is the Level of Evidence?

PubMed

Rosenkrantz, Andrew B; Pinnamaneni, Niveditha; Babb, James S; Doshi, Ankur M

2016-05-01

This study aimed to assess the most common publication types in radiology journals, as well as temporal trends and association with citation frequency. PubMed was searched to extract all published articles having the following "Publication Type" indices: "validation studies," "meta-analysis," "clinical trial," "comparative study," "evaluation study," "guideline," "multicenter study," "randomized study," "review," "editorial," "case report," and "technical report." The percentage of articles within each category published within clinical radiology journals was computed. Normalized percentages for each category were also computed on an annual basis. Citation counts within a 2-year window following publication were obtained using Web of Science. Overall trends were assessed. Publication types with the highest fraction in radiology journals were technical reports, evaluation studies, and case reports (4.8% to 5.8%). Publication types with the lowest fraction in radiology journals were randomized trials, multicenter studies, and meta-analyses (0.8% to 1.5%). Case reports showed a significant decrease since 1999, with accelerating decline since 2007 (P = 0.002). Publication types with highest citation counts were meta-analyses, guidelines, and multicenter studies (8.1 ± 10.7 to 12.9 ± 5.1). Publication types with lowest citation counts were case reports, editorials, and technical reports (1.4 ± 2.4 to 2.9 ± 4.3). The representation in radiology journals and citation frequency of the publication types showed weak inverse correlation (r = -0.372). Radiology journals have historically had relatively greater representation of less frequently cited publication types. Various strategies, including methodological training, multidisciplinary collaboration, national support networks, as well as encouragement of higher level of evidence by funding agencies and radiology journals themselves, are warranted to improve the impact of radiological research. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Capabilities of the RENEB network for research and large scale radiological and nuclear emergency situations.

PubMed

Monteiro Gil, Octávia; Vaz, Pedro; Romm, Horst; De Angelis, Cinzia; Antunes, Ana Catarina; Barquinero, Joan-Francesc; Beinke, Christina; Bortolin, Emanuela; Burbidge, Christopher Ian; Cucu, Alexandra; Della Monaca, Sara; Domene, Mercedes Moreno; Fattibene, Paola; Gregoire, Eric; Hadjidekova, Valeria; Kulka, Ulrike; Lindholm, Carita; Meschini, Roberta; M'Kacher, Radhia; Moquet, Jayne; Oestreicher, Ursula; Palitti, Fabrizio; Pantelias, Gabriel; Montoro Pastor, Alegria; Popescu, Irina-Anca; Quattrini, Maria Cristina; Ricoul, Michelle; Rothkamm, Kai; Sabatier, Laure; Sebastià, Natividad; Sommer, Sylwester; Terzoudi, Georgia; Testa, Antonella; Trompier, François; Vral, Anne

2017-01-01

To identify and assess, among the participants in the RENEB (Realizing the European Network of Biodosimetry) project, the emergency preparedness, response capabilities and resources that can be deployed in the event of a radiological or nuclear accident/incident affecting a large number of individuals. These capabilities include available biodosimetry techniques, infrastructure, human resources (existing trained staff), financial and organizational resources (including the role of national contact points and their articulation with other stakeholders in emergency response) as well as robust quality control/assurance systems. A survey was prepared and sent to the RENEB partners in order to acquire information about the existing, operational techniques and infrastructure in the laboratories of the different RENEB countries and to assess the capacity of response in the event of radiological or nuclear accident involving mass casualties. The survey focused on several main areas: laboratory's general information, country and staff involved in biological and physical dosimetry; retrospective assays used, the number of assays available per laboratory and other information related to biodosimetry and emergency preparedness. Following technical intercomparisons amongst RENEB members, an update of the survey was performed one year later concerning the staff and the available assays. The analysis of RENEB questionnaires allowed a detailed assessment of existing capacity of the RENEB network to respond to nuclear and radiological emergencies. This highlighted the key importance of international cooperation in order to guarantee an effective and timely response in the event of radiological or nuclear accidents involving a considerable number of casualties. The deployment of the scientific and technical capabilities existing within the RENEB network members seems mandatory, to help other countries with less or no capacity for biological or physical dosimetry, or countries overwhelmed in case of a radiological or nuclear accident involving a large number of individuals.

Development and validation of a questionnaire to evaluate infection control in oral radiology

PubMed Central

Pinelli, Camila; da Silva Tagliaferro, Elaine P; Corrente, José E; Ambrosano, Glaucia M B

2017-01-01

Objectives: To create and validate a questionnaire to evaluate infection control in oral radiology. Methods: The questionnaire was developed after review of the literature, which included published articles and the biosafety protocols available from healthcare agencies. The initial version of the questionnaire was composed of 14 multiple choice questions and was divided into 3 domains on handwashing, disinfection/protection of surfaces and disinfectant used. Content validity was assessed by two expert committees, which reviewed the content and scope of the questionnaire and the relevance of each item, respectively. Reliability was evaluated using test–retest and internal consistency methods with 115 undergraduate dentistry students. Construct validity was assessed using the known-groups technique and factor analysis. The known-groups technique involved 641 undergraduate dentistry students, 20 PhD students and 15 oral radiology professors. In the factor analysis, 3 radiology technicians also participated in addition to the 641 undergraduates, 20 PhD students and 15 oral radiology professors. Results: The content validity results were found to be satisfactory to excellent for the ordinal variables (intraclass correlation coefficient = 0.722–1.000) and good to great for the yes/no questions (kappa = 0.662–0.913) in terms of reliability and good internal consistency (Cronbach's alpha = 0.88). After a factor analysis, some questions were excluded, and the questions were grouped into new domains. Significant differences were observed between answers from different groups. The final version of the questionnaire was composed of nine domains. Conclusions: The questionnaire created was found to exhibit good psychometric properties for assessing infection control in oral radiology. PMID:28112553

Radiology of Osteogenesis Imperfecta, Rickets and Other Bony Fragility States.

PubMed

Calder, Alistair D

2015-01-01

This section gives an overview of radiological findings in bony fragility states, with a special focus on osteogenesis imperfecta (OI) and rickets. Conventional radiological assessment of bone density is inaccurate and imprecise and only reliably detects severe osteopaenia. However, other aspects of bone structure and morphology can be assessed, and it is possible to distinguish between osteopaenic and osteomalacic states. OI is a heterogeneous group of disorders of type 1 collagen formation and processing that are characterised by varying degrees of bony fragility, with presentations varying from perinatal lethality to asymptomatic. Radiological diagnosis of severe forms is usually straightforward, but that of milder disease may be challenging because specific features are often absent. However, a multidisciplinary approach is usually successful. Features of OI, including Wormian bones, skull base deformities, vertebral involvement and long bone fractures and deformities, are reviewed in this section. Rickets is best defined as a disorder of the growth plate characterised by the impaired apoptosis of hypertrophied chondrocytes. Vitamin D deficiency is a common cause of rickets. The patho-anatomical basis of radiological findings in rickets is reviewed and illustrated. Rickets is frequently accompanied by hyperparathyroidism and osteomalacia. Rickets used to be classified as calciopaenic or phosphopaenic but is now referred to as parathyroid hormone or fibroblast growth factor 23 mediated, respectively [1]. The radiological features of the two forms are reviewed. © 2015 S. Karger AG, Basel.

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.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Consoles in the Radiological Control Center at NASA's Kennedy Space Center are seen during ceremonies to name the facility in honor of Randy Scott. A professional health physicist of more than 40 years, Scott served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016. Located in the Neil Armstrong Operations and Checkout building, the Randall E. Scott Radiological Control Center is staffed by technical and radiological experts from NASA, the U.S. Department of Energy, the U.S. Air Force 45th Space Wing and the state of Florida. The group performs data collection and assessment functions supporting launch site and field data collection activities.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

A portion of the Radiological Control Center at NASA's Kennedy Space Center is seen during ceremonies to name the facility in honor of Randy Scott. A professional health physicist of more than 40 years, Scott served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016. Located in the Neil Armstrong Operations and Checkout building, the Randall E. Scott Radiological Control Center is staffed by technical and radiological experts from NASA, the U.S. Department of Energy, the U.S. Air Force 45th Space Wing and the state of Florida. The group performs data collection and assessment functions supporting launch site and field data collection activities.

Contrast reaction training in US radiology residencies: a COARDRI study.

PubMed

LeBedis, Christina A; Rosenkrantz, Andrew B; Otero, Hansel J; Decker, Summer J; Ward, Robert J

To perform a survey-based assessment of current contrast reaction training in US diagnostic radiology residency programs. An electronic survey was distributed to radiology residency program directors from 9/2015-11/2015. 25.7% of programs responded. 95.7% of those who responded provide contrast reaction management training. 89.4% provide didactic lectures (occurring yearly in 71.4%). 37.8% provide hands-on simulation training (occurring yearly in 82.3%; attended by both faculty and trainees in 52.9%). Wide variability in contrast reaction education in US diagnostic radiology residency programs reveals an opportunity to develop and implement a national curriculum. Copyright © 2017 Elsevier Inc. All rights reserved.

REACTOR PHYSICS MODELING OF SPENT RESEARCH REACTOR FUEL FOR TECHNICAL NUCLEAR FORENSICS

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

Nichols, T.; Beals, D.; Sternat, M.

2011-07-18

Technical nuclear forensics (TNF) refers to the collection, analysis and evaluation of pre- and post-detonation radiological or nuclear materials, devices, and/or debris. TNF is an integral component, complementing traditional forensics and investigative work, to help enable the attribution of discovered radiological or nuclear material. Research is needed to improve the capabilities of TNF. One research area of interest is determining the isotopic signatures of research reactors. Research reactors are a potential source of both radiological and nuclear material. Research reactors are often the least safeguarded type of reactor; they vary greatly in size, fuel type, enrichment, power, and burn-up. Manymore » research reactors are fueled with highly-enriched uranium (HEU), up to {approx}93% {sup 235}U, which could potentially be used as weapons material. All of them have significant amounts of radiological material with which a radioactive dispersal device (RDD) could be built. Therefore, the ability to attribute if material originated from or was produced in a specific research reactor is an important tool in providing for the security of the United States. Currently there are approximately 237 operating research reactors worldwide, another 12 are in temporary shutdown and 224 research reactors are reported as shut down. Little is currently known about the isotopic signatures of spent research reactor fuel. An effort is underway at Savannah River National Laboratory (SRNL) to analyze spent research reactor fuel to determine these signatures. Computer models, using reactor physics codes, are being compared to the measured analytes in the spent fuel. This allows for improving the reactor physics codes in modeling research reactors for the purpose of nuclear forensics. Currently the Oak Ridge Research reactor (ORR) is being modeled and fuel samples are being analyzed for comparison. Samples of an ORR spent fuel assembly were taken by SRNL for analytical and radiochemical analysis. The fuel assembly was modeled using MONTEBURNS(MCNP5/ ORIGEN2.2) and MCNPX/CINDER90. The results from the models have been compared to each other and to the measured data.« less

77 FR 39498 - Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-03

...] Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection Devices Applied... Clinical Performance Assessment: Considerations for Computer-Assisted Detection Devices Applied to... guidance, entitled ``Computer-Assisted Detection Devices Applied to Radiology Images and Radiology Device...

The Importance of Curriculum-Based Training and Assessment in Interventional Radiology

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

Belli, Anna-Maria, E-mail: anna.belli@stgeorges.nhs.uk; Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl; Lee, Michael, E-mail: mlee@rcsi.ie

Physician performance and outcomes are being scrutinised by health care providers to improve patient safety and cost efficiency. Patients are best served by physicians who have undergone appropriate specialist training and assessment and perform large numbers of cases to maintain their skills. The Cardiovascular and Interventional Radiological Society of Europe has put into place a curriculum for training in interventional radiology (IR) and a syllabus with an examination, the European Board of Interventional Radiology, providing evidence of attainment of an appropriate and satisfactory skill set for the safe practice of IR. This curriculum is appropriate for IR where there ismore » a high volume of image-guided procedures in vascular and nonvascular organ systems with cross-use of minimally invasive techniques in patients with a variety of disease processes. Other specialties may require different, longer, and more focused training if their experience is “diluted” by the need to master a different skill set.« less

Quantitative evaluation of Iranian radiology papers and its comparison with selected countries.

PubMed

Ghafoori, Mahyar; Emami, Hasan; Sedaghat, Abdolrasoul; Ghiasi, Mohammad; Shakiba, Madjid; Alavi, Manijeh

2014-01-01

Recent technological developments in medicine, including modern radiology have promoted the impact of scientific researches on social life. The scientific outputs such as article and patents are products that show the scientists' attempt to access these achievements. In the current study, we evaluate the current situation of Iranian scientists in the field of radiology and compare it with the selected countries in terms of scientific papers. For this purpose, we used scientometric tools to quantitatively assess the scientific papers in the field of radiology. Radiology papers were evaluated in the context of medical field audit using retrospective model. We used the related databases of biomedical sciences for extraction of articles related to radiology. In the next step, the situation of radiology scientific products of the country were determined with respect to the under study regional countries. Results of the current study showed a ratio of 0.19% for Iranian papers in PubMed database published in 2009. In addition, in 2009, Iranian papers constituted 0.29% of the Scopus scientific database. The proportion of Iranian papers in the understudy region was 7.6%. To diminish the gap between Iranian scientific radiology papers and other competitor countries in the region and achievement of document 2025 goals, multifold effort of the society of radiology is necessary.

Utility of rapid database searching for quality assurance: 'detective work' in uncovering radiology coding and billing errors

NASA Astrophysics Data System (ADS)

Horii, Steven C.; Kim, Woojin; Boonn, William; Iyoob, Christopher; Maston, Keith; Coleman, Beverly G.

2011-03-01

When the first quarter of 2010 Department of Radiology statistics were provided to the Section Chiefs, the authors (SH, BC) were alarmed to discover that Ultrasound showed a decrease of 2.5 percent in billed examinations. This seemed to be in direct contradistinction to the experience of the ultrasound faculty members and sonographers. Their experience was that they were far busier than during the same quarter of 2009. The one exception that all acknowledged was the month of February, 2010 when several major winter storms resulted in a much decreased Hospital admission and Emergency Department visit rate. Since these statistics in part help establish priorities for capital budget items, professional and technical staffing levels, and levels of incentive salary, they are taken very seriously. The availability of a desktop, Web-based RIS database search tool developed by two of the authors (WK, WB) and built-in database functions of the ultrasound miniPACS, made it possible for us very rapidly to develop and test hypotheses for why the number of billable examinations was declining in the face of what experience told the authors was an increasing number of examinations being performed. Within a short time, we identified the major cause as errors on the part of the company retained to verify billable Current Procedural Terminology (CPT) codes against ultrasound reports. This information is being used going forward to recover unbilled examinations and take measures to reduce or eliminate the types of coding errors that resulted in the problem.

Can radiological results be surrogate markers of functional outcome in distal radial extra-articular fractures?

PubMed

Kumar, Skand; Penematsa, Subbaraju; Sadri, Maziar; Deshmukh, Subodh C

2008-08-01

The purpose of this study was to evaluate the relationship between radiological and functional results in patients with extra-articular fractures of the distal radius. We conducted a prospective study of radiological and functional assessment in 95 consecutively selected extra-articular distal radius fractures. There were two patient groups: more than 60 and less than 60 years of age. The final fracture union radiographs were analysed for their functional outcome using the Michigan Hand Outcomes Questionnaire (MHQ) and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. In patients with acceptable radiological results, 62% (MHQ group) and 72% (DASH group) of patients had satisfactory functional outcome. Analysing patients with satisfactory functional results, 56% (MHQ group) and 59% (DASH group) had satisfactory radiological results. There was a higher proportion of patients with better functional results, despite poor radiological results, in both of the age groups. There was a statistically significant correlation between satisfactory radial tilt and functional outcome in the younger patients. In the older age group, patients with satisfactory radiological results had satisfactory functional outcome (p<0.05). However, in the older age group, satisfactory functional results were achieved, despite unsatisfactory radiological results.

Contribution for new genetic markers of rheumatoid arthritis activity and severity: sequencing of the tumor necrosis factor-alpha gene promoter.

PubMed

Fonseca, João Eurico; Cavaleiro, João; Teles, José; Sousa, Elsa; Andreozzi, Valeska L; Antunes, Marília; Amaral-Turkman, Maria A; Canhão, Helena; Mourão, Ana F; Lopes, Joana; Caetano-Lopes, Joana; Weinmann, Pamela; Sobral, Marta; Nero, Patrícia; Saavedra, Maria J; Malcata, Armando; Cruz, Margarida; Melo, Rui; Braña, Araceli; Miranda, Luis; Patto, José V; Barcelos, Anabela; da Silva, José Canas; Santos, Luís M; Figueiredo, Guilherme; Rodrigues, Mário; Jesus, Herberto; Quintal, Alberto; Carvalho, Teresa; da Silva, José A Pereira; Branco, Jaime; Queiroz, Mário Viana

2007-01-01

The objective of this study was to assess whether clinical measures of rheumatoid arthritis activity and severity were influenced by tumor necrosis factor-alpha (TNF-alpha) promoter genotype/haplotype markers. Each patient's disease activity was assessed by the disease activity score using 28 joint counts (DAS28) and functional capacity by the Health Assessment Questionnaire (HAQ) score. Systemic manifestations, radiological damage evaluated by the Sharp/van der Heijde (SvdH) score, disease-modifying anti-rheumatic drug use, joint surgeries, and work disability were also assessed. The promoter region of the TNF-alpha gene, between nucleotides -1,318 and +49, was sequenced using an automated platform. Five hundred fifty-four patients were evaluated and genotyped for 10 single-nucleotide polymorphism (SNP) markers, but 5 of these markers were excluded due to failure to fall within Hardy-Weinberg equilibrium or to monomorphism. Patients with more than 10 years of disease duration (DD) presented significant associations between the -857 SNP and systemic manifestations, as well as joint surgeries. Associations were also found between the -308 SNP and work disability in patients with more than 2 years of DD and radiological damage in patients with less than 10 years of DD. A borderline effect was found between the -238 SNP and HAQ score and radiological damage in patients with 2 to 10 years of DD. An association was also found between haplotypes and the SvdH score for those with more than 10 years of DD. An association was found between some TNF-alpha promoter SNPs and systemic manifestations, radiological progression, HAQ score, work disability, and joint surgeries, particularly in some classes of DD and between haplotypes and radiological progression for those with more than 10 years of DD.

Contribution for new genetic markers of rheumatoid arthritis activity and severity: sequencing of the tumor necrosis factor-alpha gene promoter

PubMed Central

Fonseca, João Eurico; Cavaleiro, João; Teles, José; Sousa, Elsa; Andreozzi, Valeska L; Antunes, Marília; Amaral-Turkman, Maria A; Canhão, Helena; Mourão, Ana F; Lopes, Joana; Caetano-Lopes, Joana; Weinmann, Pamela; Sobral, Marta; Nero, Patrícia; Saavedra, Maria J; Malcata, Armando; Cruz, Margarida; Melo, Rui; Braña, Araceli; Miranda, Luis; Patto, José V; Barcelos, Anabela; da Silva, José Canas; Santos, Luís M; Figueiredo, Guilherme; Rodrigues, Mário; Jesus, Herberto; Quintal, Alberto; Carvalho, Teresa; da Silva, José A Pereira; Branco, Jaime; Queiroz, Mário Viana

2007-01-01

The objective of this study was to assess whether clinical measures of rheumatoid arthritis activity and severity were influenced by tumor necrosis factor-alpha (TNF-α) promoter genotype/haplotype markers. Each patient's disease activity was assessed by the disease activity score using 28 joint counts (DAS28) and functional capacity by the Health Assessment Questionnaire (HAQ) score. Systemic manifestations, radiological damage evaluated by the Sharp/van der Heijde (SvdH) score, disease-modifying anti-rheumatic drug use, joint surgeries, and work disability were also assessed. The promoter region of the TNF-α gene, between nucleotides -1,318 and +49, was sequenced using an automated platform. Five hundred fifty-four patients were evaluated and genotyped for 10 single-nucleotide polymorphism (SNP) markers, but 5 of these markers were excluded due to failure to fall within Hardy-Weinberg equilibrium or to monomorphism. Patients with more than 10 years of disease duration (DD) presented significant associations between the -857 SNP and systemic manifestations, as well as joint surgeries. Associations were also found between the -308 SNP and work disability in patients with more than 2 years of DD and radiological damage in patients with less than 10 years of DD. A borderline effect was found between the -238 SNP and HAQ score and radiological damage in patients with 2 to 10 years of DD. An association was also found between haplotypes and the SvdH score for those with more than 10 years of DD. An association was found between some TNF-α promoter SNPs and systemic manifestations, radiological progression, HAQ score, work disability, and joint surgeries, particularly in some classes of DD and between haplotypes and radiological progression for those with more than 10 years of DD. PMID:17408492

Sacred Cows and Stubborn Mules: The Imperative to Reform the US Code

DTIC Science & Technology

2013-02-14

National Guard have also added specialized domestic military missions like the Chemical, Biological , Radiological and Nuclear (CBRN) Response Enterprise...lists cyber and EMP as exigent future threats, adding that the most predictable future megatrend is empowerment. “Individuals and small groups will...and include a Defense CBRN Response Force (DCRF) and two CBRN Response Elements (CRE). The US Marines also maintain two Chemical, Biological Incident

Development of an IHE MRRT-compliant open-source web-based reporting platform.

PubMed

Pinto Dos Santos, Daniel; Klos, G; Kloeckner, R; Oberle, R; Dueber, C; Mildenberger, P

2017-01-01

To develop a platform that uses structured reporting templates according to the IHE Management of Radiology Report Templates (MRRT) profile, and to implement this platform into clinical routine. The reporting platform uses standard web technologies (HTML / JavaScript and PHP / MySQL) only. Several freely available external libraries were used to simplify the programming. The platform runs on a standard web server, connects with the radiology information system (RIS) and PACS, and is easily accessible via a standard web browser. A prototype platform that allows structured reporting to be easily incorporated into the clinical routine was developed and successfully tested. To date, 797 reports were generated using IHE MRRT-compliant templates (many of them downloaded from the RSNA's radreport.org website). Reports are stored in a MySQL database and are easily accessible for further analyses. Development of an IHE MRRT-compliant platform for structured reporting is feasible using only standard web technologies. All source code will be made available upon request under a free license, and the participation of other institutions in further development is welcome. • A platform for structured reporting using IHE MRRT-compliant templates is presented. • Incorporating structured reporting into clinical routine is feasible. • Full source code will be provided upon request under a free license.

Development of a reliable estimation procedure of radioactivity inventory in a BWR plant due to neutron irradiation for decommissioning

NASA Astrophysics Data System (ADS)

Tanaka, Ken-ichi; Ueno, Jun

2017-09-01

Reliable information of radioactivity inventory resulted from the radiological characterization is important in order to plan decommissioning planning and is also crucial in order to promote decommissioning in effectiveness and in safe. The information is referred to by planning of decommissioning strategy and by an application to regulator. Reliable information of radioactivity inventory can be used to optimize the decommissioning processes. In order to perform the radiological characterization reliably, we improved a procedure of an evaluation of neutron-activated materials for a Boiling Water Reactor (BWR). Neutron-activated materials are calculated with calculation codes and their validity should be verified with measurements. The evaluation of neutron-activated materials can be divided into two processes. One is a distribution calculation of neutron-flux. Another is an activation calculation of materials. The distribution calculation of neutron-flux is performed with neutron transport calculation codes with appropriate cross section library to simulate neutron transport phenomena well. Using the distribution of neutron-flux, we perform distribution calculations of radioactivity concentration. We also estimate a time dependent distribution of radioactivity classification and a radioactive-waste classification. The information obtained from the evaluation is utilized by other tasks in the preparatory tasks to make the decommissioning plan and the activity safe and rational.

Differential Motivations for Pursuing Diagnostic Radiology by Gender: Implications for Residency Recruitment.

PubMed

Grimm, Lars J; Lowell, Dorothy A; Cater, Sarah W; Yoon, Sora C

2017-10-01

The purpose of this study is to determine how the motivations to pursue a career in radiology differ by gender. In addition, the influence of medical school radiology education will be assessed. Radiology applicants to our institution from the 2015-2016 interview season were offered an online survey in February 2016. Respondents scored the influence of 24 aspects of radiology on their decision to pursue radiology. Comparisons were made between male and female respondents. Respondents were also asked the type of medical school radiology education they received and to score the influence this experience had on their decision to pursue radiology. There were 202 total respondents (202/657) including 47 women and 155 men. Compared to men, the following factors had a more negative impact on women: flexible work hours (P = 0.04), work environment (P = 0.04), lifestyle (P = 0.04), impact on patient care (P = 0.05), high current debt load (P = 0.02), gender distribution of the field (P = 0.04), and use of emerging/advanced technology (P = 0.02). In contrast, women felt more favorably about the opportunities for leadership (P = 0.04) and research (P < 0.01). Dedicated radiology exposure was as follows: 20% (n = 20) none, 48% (n = 96) preclinical exposure, 55% (n = 111) elective rotation, and 18% (n = 37) core rotation. More intensive radiology exposure via a core rotation had a significantly positive impact on the decision to pursue radiology (P < 0.01). Male and female radiology applicants are motivated by different aspects of radiology, which may influence residency recruitment practices. In addition, more intensive radiology exposure has a net positive impact on the decision to pursue radiology. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Radiological Modeling for Determination of Derived Concentration Levels of an Area with Uranium Residual Material - 13533

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

Perez-Sanchez, Danyl

As a result of a pilot project developed at the old Spanish 'Junta de Energia Nuclear' to extract uranium from ores, tailings materials were generated. Most of these residual materials were sent back to different uranium mines, but a small amount of it was mixed with conventional building materials and deposited near the old plant until the surrounding ground was flattened. The affected land is included in an area under institutional control and used as recreational area. At the time of processing, uranium isotopes were separated but other radionuclides of the uranium decay series as Th-230, Ra-226 and daughters remainmore » in the residue. Recently, the analyses of samples taken at different ground's depths confirmed their presence. This paper presents the methodology used to calculate the derived concentration level to ensure that the reference dose level of 0.1 mSv y-1 used as radiological criteria. In this study, a radiological impact assessment was performed modeling the area as recreational scenario. The modelization study was carried out with the code RESRAD considering as exposure pathways, external irradiation, inadvertent ingestion of soil, inhalation of resuspended particles, and inhalation of radon (Rn-222). As result was concluded that, if the concentration of Ra-226 in the first 15 cm of soil is lower than, 0.34 Bq g{sup -1}, the dose would not exceed the reference dose. Applying this value as a derived concentration level and comparing with the results of measurements on the ground, some areas with a concentration of activity slightly higher than latter were found. In these zones the remediation proposal has been to cover with a layer of 15 cm of clean material. This action represents a reduction of 85% of the dose and ensures compliance with the reference dose. (authors)« less

SU-E-T-41: Analysis of GI Dose Variability Due to Intrafraction Setup Variance

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

Phillips, J; Wolfgang, J

2014-06-01

Purpose: Proton SBRT (stereotactic body radiation therapy) can be an effective modality for treatment of gastrointestinal tumors, but limited in practice due to sensitivity with respect to variation in the RPL (radiological path length). Small, intrafractional shifts in patient anatomy can lead to significant changes in the dose distribution. This study describes a tool designed to visualize uncertainties in radiological depth in patient CT's and aid in treatment plan design. Methods: This project utilizes the Shadie toolkit, a GPU-based framework that allows for real-time interactive calculations for volume visualization. Current SBRT simulation practice consists of a serial CT acquisition formore » the assessment of inter- and intra-fractional motion utilizing patient specific immobilization systems. Shadie was used to visualize potential uncertainties, including RPL variance and changes in gastric content. Input for this procedure consisted of two patient CT sets, contours of the desired organ, and a pre-calculated dose. In this study, we performed rigid registrations between sets of 4DCT's obtained from a patient with varying setup conditions. Custom visualizations are written by the user in Shadie, permitting one to create color-coded displays derived from a calculation along each ray. Results: Serial CT data acquired on subsequent days was analyzed for variation in RPB and gastric content. Specific shaders were created to visualize clinically relevant features, including RPL (radiological path length) integrated up to organs of interest. Using pre-calculated dose distributions and utilizing segmentation masks as additional input allowed us to further refine the display output from Shadie and create tools suitable for clinical usage. Conclusion: We have demonstrated a method to visualize potential uncertainty for intrafractional proton radiotherapy. We believe this software could prove a useful tool to guide those looking to design treatment plans least insensitive to motion for patients undergoing proton SBRT in the GI tract.« less

Experimental Fuels Facility Re-categorization Based on Facility Segmentation

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

Reiss, Troy P.; Andrus, Jason

The Experimental Fuels Facility (EFF) (MFC-794) at the Materials and Fuels Complex (MFC) located on the Idaho National Laboratory (INL) Site was originally constructed to provide controlled-access, indoor storage for radiological contaminated equipment. Use of the facility was expanded to provide a controlled environment for repairing contaminated equipment and characterizing, repackaging, and treating waste. The EFF facility is also used for research and development services, including fuel fabrication. EFF was originally categorized as a LTHC-3 radiological facility based on facility operations and facility radiological inventories. Newly planned program activities identified the need to receive quantities of fissionable materials in excessmore » of the single parameter subcritical limit in ANSI/ANS-8.1, “Nuclear Criticality Safety in Operations with Fissionable Materials Outside Reactors” (identified as “criticality list” quantities in DOE-STD-1027-92, “Hazard Categorization and Accident Analysis Techniques for Compliance with DOE Order 5480.23, Nuclear Safety Analysis Reports,” Attachment 1, Table A.1). Since the proposed inventory of fissionable materials inside EFF may be greater than the single parameter sub-critical limit of 700 g of U-235 equivalent, the initial re-categorization is Hazard Category (HC) 2 based upon a potential criticality hazard. This paper details the facility hazard categorization performed for the EFF. The categorization was necessary to determine (a) the need for further safety analysis in accordance with LWP-10802, “INL Facility Categorization,” and (b) compliance with 10 Code of Federal Regulations (CFR) 830, Subpart B, “Safety Basis Requirements.” Based on the segmentation argument presented in this paper, the final hazard categorization for the facility is LTHC-3. Department of Energy Idaho (DOE-ID) approval of the final hazard categorization determined by this hazard assessment document (HAD) was required per the DOE-ID Supplemental Guidance for DOE-STD-1027-92 based on the proposed downgrade of the initial facility categorization of Hazard Category 2.« less

What Does Competence Entail in Interventional Radiology?

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

Ahmed, Kamran, E-mail: k.ahmed@imperial.ac.u; Keeling, Aoife N.; Khan, Reenam S.

2010-02-15

Interventional radiology is a relatively new speciality and may be referred to as 'image-guided surgery without a scalpel.' Training and accreditation bodies regard interventional radiology training as being 'different' from general radiology because of the additional need for dexterity and clinical acumen. Due to the multidimensional role of an interventional radiologist, a practitioner in this discipline must have a number of the competencies of anesthetists, surgeons, and radiologists. The attributes required of an interventional radiologist are akin to those required of a surgeon. This paper gives an overview of the skills required to be a competent interventional radiologist along withmore » a succinct introduction to methods of assessment of technical and non-technical skills.« less

Feasibility and validation of virtual autopsy for dental identification using the Interpol dental codes.

PubMed

Franco, Ademir; Thevissen, Patrick; Coudyzer, Walter; Develter, Wim; Van de Voorde, Wim; Oyen, Raymond; Vandermeulen, Dirk; Jacobs, Reinhilde; Willems, Guy

2013-05-01

Virtual autopsy is a medical imaging technique, using full body computed tomography (CT), allowing for a noninvasive and permanent observation of all body parts. For dental identification clinically and radiologically observed ante-mortem (AM) and post-mortem (PM) oral identifiers are compared. The study aimed to verify if a PM dental charting can be performed on virtual reconstructions of full-body CT's using the Interpol dental codes. A sample of 103 PM full-body CT's was collected from the forensic autopsy files of the Department of Forensic Medicine University Hospitals, KU Leuven, Belgium. For validation purposes, 3 of these bodies underwent a complete dental autopsy, a dental radiological and a full-body CT examination. The bodies were scanned in a Siemens Definition Flash CT Scanner (Siemens Medical Solutions, Germany). The images were examined on 8- and 12-bit screen resolution as three-dimensional (3D) reconstructions and as axial, coronal and sagittal slices. InSpace(®) (Siemens Medical Solutions, Germany) software was used for 3D reconstruction. The dental identifiers were charted on pink PM Interpol forms (F1, F2), using the related dental codes. Optimal dental charting was obtained by combining observations on 3D reconstructions and CT slices. It was not feasible to differentiate between different kinds of dental restoration materials. The 12-bit resolution enabled to collect more detailed evidences, mainly related to positions within a tooth. Oral identifiers, not implemented in the Interpol dental coding were observed. Amongst these, the observed (3D) morphological features of dental and maxillofacial structures are important identifiers. The latter can become particularly more relevant towards the future, not only because of the inherent spatial features, yet also because of the increasing preventive dental treatment, and the decreasing application of dental restorations. In conclusion, PM full-body CT examinations need to be implemented in the PM dental charting protocols and the Interpol dental codes should be adapted accordingly. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

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.

Resident iPad use: has it really changed the game?

PubMed

Berkowitz, Seth J; Kung, Justin W; Eisenberg, Ronald L; Donohoe, Kevin; Tsai, Leo L; Slanetz, Priscilla J

2014-02-01

The purpose of this study was to assess residents' usage patterns and opinions of the iPad as a tool for radiology education and clinical practice at an academic medical center. All 38 radiology residents in our radiology program (postgraduate years 2 to 5) were provided with iPad 2 tablets and subscriptions to e-Anatomy and STATdx. After 6 months of device use, residents were surveyed to assess their opinions regarding the technology as a tool for education and clinical practice. A total of 36 residents (95%) completed the survey. Eighty-six percent reported daily iPad use. Radiology-specific applications, particularly e-Anatomy, were used weekly or daily by 88% of respondents. Most preferred to read journal articles on the iPad (70%), but the number of respondents preferring to read textbooks on the iPad (48.5%) compared with the traditional bound form (48.5%) was evenly divided. Residents were also divided on the clinical utility of the iPad. Most had not used the iPad to view radiologic examinations (75%). Fewer than half (47%) used their iPads during readout. Finally, only 12% had used the iPad to edit dictated reports. The iPad has generated excitement within the radiology community, particularly among resident educators, who are increasingly recognizing the unique needs of "millennial learners." This study showed that the majority of residents at the authors' institution have incorporated the iPad as an educational tool and use it as a learning aid. Incorporation of the iPad into clinical workflow has been less pronounced. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Short-term Automated Quantification of Radiologic Changes in the Characterization of Idiopathic Pulmonary Fibrosis Versus Nonspecific Interstitial Pneumonia and Prediction of Long-term Survival.

PubMed

De Giacomi, Federica; Raghunath, Sushravya; Karwoski, Ronald; Bartholmai, Brian J; Moua, Teng

2018-03-01

Fibrotic interstitial lung diseases presenting with nonspecific and overlapping radiologic findings may be difficult to diagnose without surgical biopsy. We hypothesized that baseline quantifiable radiologic features and their short-term interval change may be predictive of underlying histologic diagnosis as well as long-term survival in idiopathic pulmonary fibrosis (IPF) presenting without honeycombing versus nonspecific interstitial pneumonia (NSIP). Forty biopsy-confirmed IPF and 20 biopsy-confirmed NSIP patients with available high-resolution chest computed tomography 4 to 24 months apart were studied. CALIPER software was used for the automated characterization and quantification of radiologic findings. IPF subjects were older (66 vs. 48; P<0.0001) with lower diffusion capacity for carbon monoxide and higher volumes of baseline reticulation (193 vs. 83 mL; P<0.0001). Over the interval period, compared with NSIP, IPF patients experienced greater functional decline (forced vital capacity, -6.3% vs. -1.7%; P=0.02) and radiologic progression, as noted by greater increase in reticulation volume (24 vs. 1.74 mL; P=0.048), and decrease in normal (-220 vs. -37.7 mL; P=0.045) and total lung volumes (-198 vs. 58.1 mL; P=0.03). Older age, male gender, higher reticulation volumes at baseline, and greater interval decrease in normal lung volumes were predictive of IPF. Both baseline and short-term changes in quantitative radiologic findings were predictive of mortality. Baseline quantitative radiologic findings and assessment of short-term disease progression may help characterize underlying IPF versus NSIP in those with difficult to differentiate clinicoradiologic presentations. Our study supports the possible utility of assessing serial quantifiable high-resolution chest computed tomographic findings for disease differentiation in these 2 entities.

Swollen joint count in psoriatic arthritis is associated with progressive radiological damage in hands and feet.

PubMed

Simon, P; Pfoehler, C; Bergner, R; Schreiber, M; Pfreundschuh, M; Assmann, G

2012-01-01

Psoriatic arthritis (PsA) may progress to joint damage. Determining clinical predictors of joint damage assessed by radiography is important. The aim of this study was to determine clinical factors as possible predictors for radiological damage in hands and feet of PsA patients with a 12-month follow-up. We conducted a retrospective study on 53 PsA patients who were taking disease-modifying anti-rheumatic drugs (DMARDs) and/or tumour necrosis factor (TNF)-alpha-blockers at a fixed dosage. The patients were observed in 118 follow-up visits (intervals of 12 months ± 3 months), according to a clinical and radiological protocol which included the documentation of the number of swollen and tender joints in hands and feet, the applied therapy, psoriasis, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and global health assessment. Outcome was defined as radiographic damage of hands and feet (Ratingen score). For the statistical analysis the Chi-Square test for 2x2 crosstables (with Fisher's correction, as required) was used. Progressive radiological damage was more frequent among patients with an increasing swollen joint count (8 of 26 visits; 30.8%) than among those with a stable or decreased number of swollen joints (5 of 89 visits; 5.6%; p=0.001). The analysis of the patients stratified into the different treatment modalities resulted in a significant higher rate of radiological progress (20.8%) in patients on DMARD therapy compared with TNF-alpha blocking agents (0%) (p=0.009). During a 12-month follow-up of PsA patients, an increasing number of swollen joints heralds progression of radiological damage. TNF-alpha-blocker therapy appears to be superior to DMARDs in the protection from radiological progress.

Assessment of four midcarpal radiologic determinations.

PubMed

Cho, Mickey S; Battista, Vincent; Dubin, Norman H; Pirela-Cruz, Miguel

2006-03-01

Several radiologic measurement methods have been described for determining static carpal alignment of the wrist. These include the scapholunate, radiolunate, and capitolunate angles. The triangulation method is an alternative radiologic measurement which we believe is easier to use and more reproducible and reliable than the above mentioned methods. The purpose of this study is to assess the intraobserver reproducibility and interobserver reliability of the triangulation method, scapholunate, radiolunate, and capitolunate angles. Twenty orthopaedic residents and staff at varying levels of training made four radiologic measurements including the scapholunate, radiolunate and capitolunate angles as well as the triangulation method on five different lateral, digitized radiographs of the wrist and forearm in neutral radioulnar deviation. Thirty days after the initial measurements, the participants repeated the four radiologic measurements using the same radiographs. The triangulation method had the best intra-and-interobserver agreement of the four methods tested. This agreement was significantly better than the capitolunate and radiolunate angles. The scapholunate angle had the next best intraobserver reproducibility and interobserver reliability. The triangulation method has the best overall observer agreement when compared to the scapholunate, radiolunate, and capitolunate angles in determining static midcarpal alignment. No comment can be made on the validity of the measurements since there is no radiographic gold standard in determining static carpal alignment.

How Secure Is Your Radiology Department? Mapping Digital Radiology Adoption and Security Worldwide.

PubMed

Stites, Mark; Pianykh, Oleg S

2016-04-01

Despite the long history of digital radiology, one of its most critical aspects--information security--still remains extremely underdeveloped and poorly standardized. To study the current state of radiology security, we explored the worldwide security of medical image archives. Using the DICOM data-transmitting standard, we implemented a highly parallel application to scan the entire World Wide Web of networked computers and devices, locating open and unprotected radiology servers. We used only legal and radiology-compliant tools. Our security-probing application initiated a standard DICOM handshake to remote computer or device addresses, and then assessed their security posture on the basis of handshake replies. The scan discovered a total of 2774 unprotected radiology or DICOM servers worldwide. Of those, 719 were fully open to patient data communications. Geolocation was used to analyze and rank our findings according to country utilization. As a result, we built maps and world ranking of clinical security, suggesting that even the most radiology-advanced countries have hospitals with serious security gaps. Despite more than two decades of active development and implementation, our radiology data still remains insecure. The results provided should be applied to raise awareness and begin an earnest dialogue toward elimination of the problem. The application we designed and the novel scanning approach we developed can be used to identify security breaches and to eliminate them before they are compromised.

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 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.

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.

Trends in Publications in Radiology Journals Designated as Relating to Patient-Centered Care.

PubMed

Rosenkrantz, Andrew B; Rawson, James V

2017-05-01

To assess trends in publications in radiology journals designated as dealing with patient-centered care. PubMed was searched for articles in radiology journals for which the article's record referenced patient-centered/patient-centric care. Among these, original research articles were identified and assigned major themes. Trends were assessed descriptively. A total of 115 articles in radiology journals designated as dealing with patient-centered care were identified, including 40 original research articles. The number of articles annually ranged from 0 to 4 in 2000-2008, 5 to 9 in 2010-2012, 14 to 15 in 2013-2014, and 25 in 2015. Only four radiology journals had published more than one of the original research articles. Original research articles' most common themes were: optimization of patients' access to reports and images (n=7); patients' examination experience (5); image evaluation (n=4); radiologists meeting with patients (n=4); improving patients' knowledge of imaging (n=3); examination wait times/efficiency (n=3); examination utilization/appropriateness (n=3); and IT enhancements (n=3). A total of 13 of 40 original research articles solicited opinions from patients. One study involved patients in educating trainees regarding patient-centered care. No study involved patients in system-level decisions regarding health care design and delivery. Articles dealing with patient-centered care in radiology are increasing, though they remain concentrated in a limited number of journals. Though major themes included image/report access, patient experiences, and radiologists meeting with patients, many studies dealt with less clearly patient-centric topics such as examination interpretation, while inclusion of patients in systems design was lacking. Further research in radiology is encouraged to target a broader range of ideals of patient-centered care, such as diversity, autonomy, and compassion, and to incorporate greater patient engagement. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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.

Metrics for Radiologists in the Era of Value-based Health Care Delivery.

PubMed

Sarwar, Ammar; Boland, Giles; Monks, Annamarie; Kruskal, Jonathan B

2015-01-01

Accelerated by the Patient Protection and Affordable Care Act of 2010, health care delivery in the United States is poised to move from a model that rewards the volume of services provided to one that rewards the value provided by such services. Radiology department operations are currently managed by an array of metrics that assess various departmental missions, but many of these metrics do not measure value. Regulators and other stakeholders also influence what metrics are used to assess medical imaging. Metrics such as the Physician Quality Reporting System are increasingly being linked to financial penalties. In addition, metrics assessing radiology's contribution to cost or outcomes are currently lacking. In fact, radiology is widely viewed as a contributor to health care costs without an adequate understanding of its contribution to downstream cost savings or improvement in patient outcomes. The new value-based system of health care delivery and reimbursement will measure a provider's contribution to reducing costs and improving patient outcomes with the intention of making reimbursement commensurate with adherence to these metrics. The authors describe existing metrics and their application to the practice of radiology, discuss the so-called value equation, and suggest possible metrics that will be useful for demonstrating the value of radiologists' services to their patients. (©)RSNA, 2015.

Radiation safety and medical education: development and integration of a dedicated educational module into a radiology clerkship, outcomes assessment, and survey of medical students' perceptions.

PubMed

Koontz, Nicholas A; Gunderman, Richard B

2012-04-01

This study assesses the effect on medical student understanding of a new radiobiology and radiation safety module in a fourth-year radiology clerkship. A dedicated radiobiology and radiation safety module was incorporated into the fourth-year medical school radiology clerkship at our institution. Student understanding of the material was assessed via pretest and posttest. Statistical analysis was performed to assess significance of changes in student performance. In addition, we surveyed student perceptions of the importance of this material in medical education and practice. Monthly pretest mean scores ranged from 47.8% to 55.6%, with an average monthly pretest score of 50.3%. Monthly posttest mean scores ranged from 77.3% to 91.2%, with an average monthly posttest score of 83.9%. The improvement in exam scores after the educational intervention was statistically significant (all P < .01). The introduction of a new educational module can significantly improve medical student understanding of radiobiology and radiation safety. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

User's Guide for RESRAD-OFFSITE

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

Gnanapragasam, E.; Yu, C.

2015-04-01

The RESRAD-OFFSITE code can be used to model the radiological dose or risk to an offsite receptor. This User’s Guide for RESRAD-OFFSITE Version 3.1 is an update of the User’s Guide for RESRAD-OFFSITE Version 2 contained in the Appendix A of the User’s Manual for RESRAD-OFFSITE Version 2 (ANL/EVS/TM/07-1, DOE/HS-0005, NUREG/CR-6937). This user’s guide presents the basic information necessary to use Version 3.1 of the code. It also points to the help file and other documents that provide more detailed information about the inputs, the input forms and features/tools in the code; two of the features (overriding the source termmore » and computing area factors) are discussed in the appendices to this guide. Section 2 describes how to download and install the code and then verify the installation of the code. Section 3 shows ways to navigate through the input screens to simulate various exposure scenarios and to view the results in graphics and text reports. Section 4 has screen shots of each input form in the code and provides basic information about each parameter to increase the user’s understanding of the code. Section 5 outlines the contents of all the text reports and the graphical output. It also describes the commands in the two output viewers. Section 6 deals with the probabilistic and sensitivity analysis tools available in the code. Section 7 details the various ways of obtaining help in the code.« less

MO-DE-201-03: This course presents a review of radiologic anatomy and physiology as it applies to projection radiography, fluoroscopy, CT, MRI, U/S, and nuclear medicine

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

Fahey, F.

Fundamental knowledge of radiologic anatomy and physiology is critical for medical physicists. Many physicists are exposed to this topic only in graduate school, and knowledge is seldom formally evaluated or assessed after Part I of the ABR exam. Successful interactions with clinicians, including surgeons, radiologists, and oncologists requires that the medical physicist possess this knowledge. This course presents a review of radiologic anatomy and physiology as it applies to projection radiography, fluoroscopy, CT, MRI, U/S, and nuclear medicine. We will review structural anatomy, manipulation of tissue contrast, the marriage between anatomy and physiology, and explore how medical imaging exploits normalmore » and pathological processes in the body to generate contrast. Learning Objectives: Review radiologic anatomy. Examine techniques to manipulate tissue contrast in radiology. Integrate anatomy and physiology in molecular imaging.« less

Task Descriptions in Diagnostic Radiology. Research Report No. 7. Volume 4, Index of Tasks by Code Number and Extended Name.

ERIC Educational Resources Information Center

Gilpatrick, Eleanor

The fourth of four volumes in Research Report No. 7 of the Health Services Mobility Study (HSMS), this book contains the extended task names of all the tasks whose descriptions can be found in the three prior volumes. It serves as an index to all the tasks by listing the volume in which each task description appears. Chapter 1 of this volume…

Degenerative lumbar spinal stenosis: correlation with Oswestry Disability Index and MR imaging.

PubMed

Sirvanci, Mustafa; Bhatia, Mona; Ganiyusufoglu, Kursat Ali; Duran, Cihan; Tezer, Mehmet; Ozturk, Cagatay; Aydogan, Mehmet; Hamzaoglu, Azmi

2008-05-01

Because neither the degree of constriction of the spinal canal considered to be symptomatic for lumbar spinal stenosis nor the relationship between the clinical appearance and the degree of a radiologically verified constriction is clear, a correlation of patient's disability level and radiographic constriction of the lumbar spinal canal is of interest. The aim of this study was to establish a relationship between the degree of radiologically established anatomical stenosis and the severity of self-assessed Oswestry Disability Index in patients undergoing surgery for degenerative lumbar spinal stenosis. Sixty-three consecutive patients with degenerative lumbar spinal stenosis who were scheduled for elective surgery were enrolled in the study. All patients underwent preoperative magnetic resonance imaging and completed a self-assessment Oswestry Disability Index questionnaire. Quantitative image evaluation for lumbar spinal stenosis included the dural sac cross-sectional area, and qualitative evaluation of the lateral recess and foraminal stenosis were also performed. Every patient subsequently answered the national translation of the Oswestry Disability Index questionnaire and the percentage disability was calculated. Statistical analysis of the data was performed to seek a relationship between radiological stenosis and percentage disability recorded by the Oswestry Disability Index. Upon radiological assessment, 27 of the 63 patients evaluated had severe and 33 patients had moderate central dural sac stenosis; 11 had grade 3 and 27 had grade 2 nerve root compromise in the lateral recess; 22 had grade 3 and 37 had grade 2 foraminal stenosis. On the basis of the percentage disability score, of the 63 patients, 10 patients demonstrated mild disability, 13 patients moderate disability, 25 patients severe disability, 12 patients were crippled and three patients were bedridden. Radiologically, eight patients with severe central stenosis and nine patients with moderate lateral stenosis demonstrated only minimal disability on percentage Oswestry Disability Index scores. Statistical evaluation of central and lateral radiological stenosis versus Oswestry Disability Index percentage scores showed no significant correlation. In conclusion, lumbar spinal stenosis remains a clinico-radiological syndrome, and both the clinical picture and the magnetic resonance imaging findings are important when evaluating and discussing surgery with patients having this diagnosis. MR imaging has to be used to determine the levels to be decompressed.

Technology Assessment and Roadmap for the Emergency Radiation Dose Assessment Program

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

Turteltaub, K W; Hartman-Siantar, C; Easterly, C

2005-10-03

A Joint Interagency Working Group (JIWG) under the auspices of the Department of Homeland Security Office of Research and Development conducted a technology assessment of emergency radiological dose assessment capabilities as part of the overall need for rapid emergency medical response in the event of a radiological terrorist event in the United States. The goal of the evaluation is to identify gaps and recommend general research and development needs to better prepare the Country for mitigating the effects of such an event. Given the capabilities and roles for responding to a radiological event extend across many agencies, a consensus ofmore » gaps and suggested development plans was a major goal of this evaluation and road-mapping effort. The working group consisted of experts representing the Departments of Homeland Security, Health and Human Services (Centers for Disease Control and the National Institutes of Health), Food and Drug Administration, Department of Defense and the Department of Energy's National Laboratories (see appendix A for participants). The specific goals of this Technology Assessment and Roadmap were to: (1) Describe the general context for deployment of emergency radiation dose assessment tools following terrorist use of a radiological or nuclear device; (2) Assess current and emerging dose assessment technologies; and (3) Put forward a consensus high-level technology roadmap for interagency research and development in this area. This report provides a summary of the consensus of needs, gaps and recommendations for a research program in the area of radiation dosimetry for early response, followed by a summary of the technologies available and on the near-term horizon. We then present a roadmap for a research program to bring present and emerging near-term technologies to bear on the gaps in radiation dose assessment and triage. Finally we present detailed supporting discussion on the nature of the threats we considered, the status of technology today, promising emerging technologies and references for further reading.« less

Evidence-based radiology: how to quickly assess the validity and strength of publications in the diagnostic radiology literature.

PubMed

Dodd, Jonathan D; MacEneaney, Peter M; Malone, Dermot E

2004-05-01

The aim of this study was to show how evidence-based medicine (EBM) techniques can be applied to the appraisal of diagnostic radiology publications. A clinical scenario is described: a gastroenterologist has questioned the diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) in a patient who may have common bile duct (CBD) stones. His opinion was based on an article on MRCP published in "Gut." The principles of EBM are described and then applied to the critical appraisal of this paper. Another paper on the same subject was obtained from the radiology literature and was also critically appraised using explicit EBM criteria. The principles for assessing the validity and strength of both studies are outlined. All statistical parameters were generated quickly using a spreadsheet in Excel format. The results of EBM assessment of both papers are presented. The calculation and application of confidence intervals (CIs) and likelihood ratios (LRs) for both studies are described. These statistical results are applied to individual patient scenarios using graphs of conditional probability (GCP). Basic EBM principles are described and additional points relevant to radiologists discussed. Online resources for EBR practice are identified. The principles of EBM and their application to radiology are discussed. It is emphasized that sensitivity and specificity are point estimates of the "true" characteristics of a test in clinical practice. A spreadsheet can be used to quickly calculate CIs, LRs and GCPs. These give the radiologist a better understanding of the meaning of diagnostic test results in any patient or population of patients.

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.

Medical Student Assessment of Videotape for Teaching in Diagnostic Radiology

ERIC Educational Resources Information Center

Moss, J. R.; McLachlan, M. S. F.

1976-01-01

A series of six recordings that describe some aspects of the radiology of the chest, using only radiographs, were viewed by a small group of final year medical students. Their scores for factual questions immediately afterwards were compared with their attitudes to the learning experience; higher scores correlated with positive attitudes. (LBH)

Assessment of posterior vaginal wall prolapse: comparison of physical findings to cystodefecoperitoneography.

PubMed

Altman, Daniel; López, Annika; Kierkegaard, Jonas; Zetterström, Jan; Falconer, Christian; Pollack, Johan; Mellgren, Anders

2005-01-01

The aim of the present study was to compare clinical and radiological findings when assessing posterior vaginal wall prolapse. Defecography can be used to complement the clinical evaluation in patients with posterior vaginal wall prolapse. Further development of the defecography technique, using contrast medium in the urinary bladder and intraperitoneally, have resulted in cystodefecoperitoneography (CDP). Thirty-eight women underwent clinical examination using the pelvic organ prolapse quantification system (POP-Q) followed by CDP. All patients answered a standardized bowel function questionnaire. Statistical analysis measuring correlation between POP-Q and CDP using Pearson's correlation coefficient (r) and Spearman's rank order correlation coefficient (rs) demonstrated a poor to moderate correlation, r=0.49 and rs=0.55. Although there was a strong association between large rectoceles (>3 cm) at CDP and symptoms of rectal emptying difficulties (p<0.001), severity and prevalence of bowel dysfunction showed poor coherence with clinical prolapse staging and findings at radiological imaging. Vaginal topography and POP-Q staging predict neither radiological size nor visceral involvement in posterior vaginal wall prolapse. Radiological evaluation may therefore be a useful complement in selected patients.

Assessing the radiological load on the environment in the middle Danube river basin on the basis of a study of the Kopački Rit Nature Park, Croatia.

PubMed

Petrinec, Branko; Sovilj, Marina Poje; Babić, Dinko; Meštrović, Tomislav; Miklavčić, Igor; Radolić, Vanja; Stanić, Denis; Vuković, Branko; Šoštarić, Marko

2018-06-05

A study of the environmental radioactivity in the Kopački Rit Nature Park, Croatia, is presented. This wildlife reserve is part of the Middle Danube River Basin, and it is exposed to various pollutants due to a number of human activities in the surroundings, where there is a nuclear power plant and also urban centres and areas of intense agricultural production. Results for the activity concentrations of soil and surface water samples do not indicate any elevated radioactivity level, which is confirmed by on-site measurements of ambient dose rate equivalent. An assessment of the radiological load on the local biota, carried out using the ERICA tool, implies an overall low radiological risk even if conservative values of the risk quotient are used. Therefore, human activities do not have a significant effect on the radiological load on the Kopački Rit area. A similar conclusion might be made with regard to numerous similar environments in the Middle Danube River Basin.

A data-driven approach for quality assessment of radiologic interpretations.

PubMed

Hsu, William; Han, Simon X; Arnold, Corey W; Bui, Alex At; Enzmann, Dieter R

2016-04-01

Given the increasing emphasis on delivering high-quality, cost-efficient healthcare, improved methodologies are needed to measure the accuracy and utility of ordered diagnostic examinations in achieving the appropriate diagnosis. Here, we present a data-driven approach for performing automated quality assessment of radiologic interpretations using other clinical information (e.g., pathology) as a reference standard for individual radiologists, subspecialty sections, imaging modalities, and entire departments. Downstream diagnostic conclusions from the electronic medical record are utilized as "truth" to which upstream diagnoses generated by radiology are compared. The described system automatically extracts and compares patient medical data to characterize concordance between clinical sources. Initial results are presented in the context of breast imaging, matching 18 101 radiologic interpretations with 301 pathology diagnoses and achieving a precision and recall of 84% and 92%, respectively. The presented data-driven method highlights the challenges of integrating multiple data sources and the application of information extraction tools to facilitate healthcare quality improvement. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Variable thickness transient ground-water flow model. Volume 3. Program listings

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

Reisenauer, A.E.

1979-12-01

The Assessment of Effectiveness of Geologic Isolation Systems (AEGIS) Program is developing and applying the methodology for assessing the far-field, long-term post-closure safety of deep geologic nuclear waste repositories. AEGIS is being performed by Pacific Northwest Laboratory (PNL) under contract with the Office of Nuclear Waste Isolation (OWNI) for the Department of Energy (DOE). One task within AEGIS is the development of methodology for analysis of the consequences (water pathway) from loss of repository containment as defined by various release scenarios. Analysis of the long-term, far-field consequences of release scenarios requires the application of numerical codes which simulate the hydrologicmore » systems, model the transport of released radionuclides through the hydrologic systems to the biosphere, and, where applicable, assess the radiological dose to humans. Hydrologic and transport models are available at several levels of complexity or sophistication. Model selection and use are determined by the quantity and quality of input data. Model development under AEGIS and related programs provides three levels of hydrologic models, two levels of transport models, and one level of dose models (with several separate models). This is the third of 3 volumes of the description of the VTT (Variable Thickness Transient) Groundwater Hydrologic Model - second level (intermediate complexity) two-dimensional saturated groundwater flow.« less

Volumetric image interpretation in radiology: scroll behavior and cognitive processes.

PubMed

den Boer, Larissa; van der Schaaf, Marieke F; Vincken, Koen L; Mol, Chris P; Stuijfzand, Bobby G; van der Gijp, Anouk

2018-05-16

The interpretation of medical images is a primary task for radiologists. Besides two-dimensional (2D) images, current imaging technologies allow for volumetric display of medical images. Whereas current radiology practice increasingly uses volumetric images, the majority of studies on medical image interpretation is conducted on 2D images. The current study aimed to gain deeper insight into the volumetric image interpretation process by examining this process in twenty radiology trainees who all completed four volumetric image cases. Two types of data were obtained concerning scroll behaviors and think-aloud data. Types of scroll behavior concerned oscillations, half runs, full runs, image manipulations, and interruptions. Think-aloud data were coded by a framework of knowledge and skills in radiology including three cognitive processes: perception, analysis, and synthesis. Relating scroll behavior to cognitive processes showed that oscillations and half runs coincided more often with analysis and synthesis than full runs, whereas full runs coincided more often with perception than oscillations and half runs. Interruptions were characterized by synthesis and image manipulations by perception. In addition, we investigated relations between cognitive processes and found an overall bottom-up way of reasoning with dynamic interactions between cognitive processes, especially between perception and analysis. In sum, our results highlight the dynamic interactions between these processes and the grounding of cognitive processes in scroll behavior. It suggests, that the types of scroll behavior are relevant to describe how radiologists interact with and manipulate volumetric images.

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

Prepopulated radiology report templates: a prospective analysis of error rate and turnaround time.

PubMed

Hawkins, C M; Hall, S; Hardin, J; Salisbury, S; Towbin, A J

2012-08-01

Current speech recognition software allows exam-specific standard reports to be prepopulated into the dictation field based on the radiology information system procedure code. While it is thought that prepopulating reports can decrease the time required to dictate a study and the overall number of errors in the final report, this hypothesis has not been studied in a clinical setting. A prospective study was performed. During the first week, radiologists dictated all studies using prepopulated standard reports. During the second week, all studies were dictated after prepopulated reports had been disabled. Final radiology reports were evaluated for 11 different types of errors. Each error within a report was classified individually. The median time required to dictate an exam was compared between the 2 weeks. There were 12,387 reports dictated during the study, of which, 1,173 randomly distributed reports were analyzed for errors. There was no difference in the number of errors per report between the 2 weeks; however, radiologists overwhelmingly preferred using a standard report both weeks. Grammatical errors were by far the most common error type, followed by missense errors and errors of omission. There was no significant difference in the median dictation time when comparing studies performed each week. The use of prepopulated reports does not alone affect the error rate or dictation time of radiology reports. While it is a useful feature for radiologists, it must be coupled with other strategies in order to decrease errors.

Introducing DeBRa: a detailed breast model for radiological studies

NASA Astrophysics Data System (ADS)

Ma, Andy K. W.; Gunn, Spencer; Darambara, Dimitra G.

2009-07-01

Currently, x-ray mammography is the method of choice in breast cancer screening programmes. As the mammography technology moves from 2D imaging modalities to 3D, conventional computational phantoms do not have sufficient detail to support the studies of these advanced imaging systems. Studies of these 3D imaging systems call for a realistic and sophisticated computational model of the breast. DeBRa (Detailed Breast model for Radiological studies) is the most advanced, detailed, 3D computational model of the breast developed recently for breast imaging studies. A DeBRa phantom can be constructed to model a compressed breast, as in film/screen, digital mammography and digital breast tomosynthesis studies, or a non-compressed breast as in positron emission mammography and breast CT studies. Both the cranial-caudal and mediolateral oblique views can be modelled. The anatomical details inside the phantom include the lactiferous duct system, the Cooper ligaments and the pectoral muscle. The fibroglandular tissues are also modelled realistically. In addition, abnormalities such as microcalcifications, irregular tumours and spiculated tumours are inserted into the phantom. Existing sophisticated breast models require specialized simulation codes. Unlike its predecessors, DeBRa has elemental compositions and densities incorporated into its voxels including those of the explicitly modelled anatomical structures and the noise-like fibroglandular tissues. The voxel dimensions are specified as needed by any study and the microcalcifications are embedded into the voxels so that the microcalcification sizes are not limited by the voxel dimensions. Therefore, DeBRa works with general-purpose Monte Carlo codes. Furthermore, general-purpose Monte Carlo codes allow different types of imaging modalities and detector characteristics to be simulated with ease. DeBRa is a versatile and multipurpose model specifically designed for both x-ray and γ-ray imaging studies.

Unsupervised Extraction of Diagnosis Codes from EMRs Using Knowledge-Based and Extractive Text Summarization Techniques

PubMed Central

Kavuluru, Ramakanth; Han, Sifei; Harris, Daniel

2017-01-01

Diagnosis codes are extracted from medical records for billing and reimbursement and for secondary uses such as quality control and cohort identification. In the US, these codes come from the standard terminology ICD-9-CM derived from the international classification of diseases (ICD). ICD-9 codes are generally extracted by trained human coders by reading all artifacts available in a patient’s medical record following specific coding guidelines. To assist coders in this manual process, this paper proposes an unsupervised ensemble approach to automatically extract ICD-9 diagnosis codes from textual narratives included in electronic medical records (EMRs). Earlier attempts on automatic extraction focused on individual documents such as radiology reports and discharge summaries. Here we use a more realistic dataset and extract ICD-9 codes from EMRs of 1000 inpatient visits at the University of Kentucky Medical Center. Using named entity recognition (NER), graph-based concept-mapping of medical concepts, and extractive text summarization techniques, we achieve an example based average recall of 0.42 with average precision 0.47; compared with a baseline of using only NER, we notice a 12% improvement in recall with the graph-based approach and a 7% improvement in precision using the extractive text summarization approach. Although diagnosis codes are complex concepts often expressed in text with significant long range non-local dependencies, our present work shows the potential of unsupervised methods in extracting a portion of codes. As such, our findings are especially relevant for code extraction tasks where obtaining large amounts of training data is difficult. PMID:28748227

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

Nuclear security and radiological preparedness for the olympic games, athens 2004: lessons learned for organizing major public events.

PubMed

Kamenopoulou, Vassiliki; Dimitriou, Panayiotis; Hourdakis, Constantine J; Maltezos, Antonios; Matikas, Theodore; Potiriadis, Constantinos; Camarinopoulos, Leonidas

2006-10-01

In light of the exceptional circumstances that arose from hosting the Olympic Games in Athens in 2004 and from recent terrorist events internationally, Greece attributes the highest priority to security issues. According to its statutory role, the Greek Atomic Energy Commission is responsible for emergency preparedness and response in case of nuclear and radiological events, and advises the Government on the measures and interventions necessary to protect the public. In this context, the Commission participated in the Nuclear, Radiological, Biological, and Chemical Threat National Emergency Plan, specially developed for the Olympic Games, and coordinated by the Olympic Games Security Division. The objective of this paper is to share the experience gained during the organization of the Olympic Games and to present the nuclear security program implemented prior to, during, and beyond the Games, in order to prevent, detect, assess, and respond to the threat of nuclear terrorism. This program adopted a multi-area coverage of nuclear security, including physical protection of nuclear and radiological facilities, prevention of smuggling of radioactive materials through borders, prevention of dispersion of these materials into the Olympic venues, enhancement of emergency preparedness and response to radiological events, upgrading of the technical infrastructure, establishment of new procedures for assessing the threat and responding to radiological incidents, and training personnel belonging to several organizations involved in the National Emergency Response Plan. Finally, the close cooperation of Greek Authorities with the International Atomic Energy Agency and the U.S. Department of Energy, under the coordination of the Greek Atomic Energy Commission, is also discussed.

Radiological interpretation of images displayed on tablet computers: a systematic review.

PubMed

Caffery, L J; Armfield, N R; Smith, A C

2015-06-01

To review the published evidence and to determine if radiological diagnostic accuracy is compromised when images are displayed on a tablet computer and thereby inform practice on using tablet computers for radiological interpretation by on-call radiologists. We searched the PubMed and EMBASE databases for studies on the diagnostic accuracy or diagnostic reliability of images interpreted on tablet computers. Studies were screened for inclusion based on pre-determined inclusion and exclusion criteria. Studies were assessed for quality and risk of bias using Quality Appraisal of Diagnostic Reliability Studies or the revised Quality Assessment of Diagnostic Accuracy Studies tool. Treatment of studies was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). 11 studies met the inclusion criteria. 10 of these studies tested the Apple iPad(®) (Apple, Cupertino, CA). The included studies reported high sensitivity (84-98%), specificity (74-100%) and accuracy rates (98-100%) for radiological diagnosis. There was no statistically significant difference in accuracy between a tablet computer and a digital imaging and communication in medicine-calibrated control display. There was a near complete consensus from authors on the non-inferiority of diagnostic accuracy of images displayed on a tablet computer. All of the included studies were judged to be at risk of bias. Our findings suggest that the diagnostic accuracy of radiological interpretation is not compromised by using a tablet computer. This result is only relevant to the Apple iPad and to the modalities of CT, MRI and plain radiography. The iPad may be appropriate for an on-call radiologist to use for radiological interpretation.

The Future of Mammography: Radiology Residents’ Experiences, Attitudes, and Opinions

PubMed Central

Baxi, Shrujal S.; Snow, Jacqueline G.; Liberman, Laura; Elkin, Elena B.

2011-01-01

OBJECTIVE The objective of our study was to assess the experiences and preferences of radiology residents with respect to breast imaging. MATERIALS AND METHODS We surveyed radiology residents at 26 programs in New York and New Jersey. Survey topics included plans for subspecialty training, beliefs, and attitudes toward breast imaging and breast cancer screening and the likelihood of interpreting mammography in the future. RESULTS Three hundred forty-four residents completed the survey (response rate, 62%). The length of time spent training in breast imaging varied from no dedicated time (37%) to 1–8 weeks (40%) to more than 9 weeks (23%). Most respondents (97%) agreed that mammography is important to women’s health. More than 85% of residents believed that mammography should be interpreted by breast imaging specialists. Respondents shared negative views about mammography, agreeing with statements that the field was associated with a high risk of malpractice (99%), stress (94%), and low reimbursement (68%). Respondents endorsed several positive attributes of mammography, including job availability (97%), flexible work schedules (94%), and few calls or emergencies (93%). Most radiology residents (93%) said that they were likely to pursue subspecialty training, and 7% expressed interest in breast imaging fellowships. CONCLUSION Radiology residents’ negative and positive views about mammography seem to be independent of time spent training in mammography and of future plans to pursue fellowship training in breast imaging. Systematic assessment of the plans and preferences of radiology residents can facilitate the development of strategies to attract trainees to careers in breast imaging. PMID:20489113

Comparison of work and time estimates by chiropractic physicians with those of medical and osteopathic providers.

PubMed

Hess, J A; Mootz, R D

1999-06-01

Resource-based relative value scales (RBRVS) have become a standard method for identifying costs and determining reimbursement for physician services. Development of RBRVS systems and methods are reviewed, and the RBRVS concept of physician "work" is defined. Results of work and time inputs from chiropractic physicians are compared with those reported by osteopathic and medical specialties. Last, implications for reimbursement of chiropractic fee services are discussed. Total work, intraservice work, and time inputs for clinical vignettes reported by chiropractic, osteopathic, and medical physicians are compared. Data for chiropractic work and time reports were drawn from a national random sample of chiropractors conducted as part of a 1997 workers' compensation chiropractic fee schedule development project. Medical and osteopathic inputs were drawn from RBRVS research conducted at Harvard University under a federal contract reported in 1990. Both data sets used the same or similar clinical vignettes and similar methods. Comparisons of work and time inputs are made for clinical vignettes to assess whether work reported by chiropractors is of similar magnitude and variability as work reported by other specialties. Chiropractic inputs for vignettes related to evaluation and management services are similar to those reported by medical specialists and osteopathic physicians. The range of variation between chiropractic work input and other specialties is of similar magnitude to that within other specialties. Chiropractors report greater work input for radiologic interpretation and lower work input for manipulation services. Chiropractors seem to perform similar total "work" for evaluation and management services as other specialties. No basis exists for excluding chiropractors from using evaluation and management codes for reimbursement purposes on grounds of dissimilar physician time or work estimates. Greater work input by chiropractors in radiology interpretation may be related to a greater importance placed on findings in care planning. Consistently higher reports for osteopathic work input on manipulation are likely attributable to differences in reference vignettes used in the respective populations. Research with a common reference vignette used for manipulation providers is recommended, as is development of a single generic approach to coding for manipulation services.

Cloud immersion building shielding factors for US residential structures.

PubMed

Dickson, E D; Hamby, D M

2014-12-01

This paper presents validated building shielding factors designed for contemporary US housing-stock under an idealized, yet realistic, exposure scenario within a semi-infinite cloud of radioactive material. The building shielding factors are intended for use in emergency planning and level three probabilistic risk assessments for a variety of postulated radiological events in which a realistic assessment is necessary to better understand the potential risks for accident mitigation and emergency response planning. Factors are calculated from detailed computational housing-units models using the general-purpose Monte Carlo N-Particle computational code, MCNP5, and are benchmarked from a series of narrow- and broad-beam measurements analyzing the shielding effectiveness of ten common general-purpose construction materials and ten shielding models representing the primary weather barriers (walls and roofs) of likely US housing-stock. Each model was designed to scale based on common residential construction practices and include, to the extent practical, all structurally significant components important for shielding against ionizing radiation. Calculations were performed for floor-specific locations as well as for computing a weighted-average representative building shielding factor for single- and multi-story detached homes, both with and without basement, as well for single-wide manufactured housing-units.

The Radiology Resident iPad Toolbox: an educational and clinical tool for radiology residents.

PubMed

Sharpe, Emerson E; Kendrick, Michael; Strickland, Colin; Dodd, Gerald D

2013-07-01

Tablet computing and mobile resources are the hot topics in technology today, with that interest spilling into the medical field. To improve resident education, a fully configured iPad, referred to as the "Radiology Resident iPad Toolbox," was created and implemented at the University of Colorado. The goal was to create a portable device with comprehensive educational, clinical, and communication tools that would contain all necessary resources for an entire 4-year radiology residency. The device was distributed to a total of 34 radiology residents (8 first-year residents, 8 second-year residents, 9 third-year residents, and 9 fourth-year residents). This article describes the process used to develop and deploy the device, provides a distillation of useful applications and resources decided upon after extensive evaluation, and assesses the impact this device had on resident education. The Radiology Resident iPad Toolbox is a cost-effective, portable, educational instrument that has increased studying efficiency; improved access to study materials such as books, radiology cases, lectures, and web-based resources; and increased interactivity in educational conferences and lectures through the use of audience-response software, with questions geared toward the new ABR board format. This preconfigured tablet fully embraces the technology shift into mobile computing and represents a paradigm shift in educational strategy. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

ORNL necessary and sufficient standards for environment, safety, and health. Final report of the Identification Team for other industrial, radiological, and non-radiological hazard facilities

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

NONE

1998-07-01

This Necessary and Sufficient (N and S) set of standards is for Other Industrial, Radiological, and Non-Radiological Hazard Facilities at Oak Ridge National Laboratory (ORNL). These facility classifications are based on a laboratory-wide approach to classify facilities by hazard category. An analysis of the hazards associated with the facilities at ORNL was conducted in 1993. To identify standards appropriate for these Other Industrial, Radiological, and Non-Radiological Hazard Facilities, the activities conducted in these facilities were assessed, and the hazards associated with the activities were identified. A preliminary hazards list was distributed to all ORNL organizations. The hazards identified in priormore » hazard analyses are contained in the list, and a category of other was provided in each general hazard area. A workshop to assist organizations in properly completing the list was held. Completed hazard screening lists were compiled for each ORNL division, and a master list was compiled for all Other Industrial, Radiological Hazard, and Non-Radiological facilities and activities. The master list was compared against the results of prior hazard analyses by research and development and environment, safety, and health personnel to ensure completeness. This list, which served as a basis for identifying applicable environment, safety, and health standards, appears in Appendix A.« less

Evaluation of the use of intra-operative radiology for open placement of lag screws for the stabilization of sacroiliac luxation in cats.

PubMed

Silveira, Francisco; Quinn, Robert J; Adrian, Anna M; Owen, Martin R; Bush, Mark A

2017-01-16

To assess the effect of intra-operative radiology on the quality of lag screw insertion for the management of sacroiliac joint luxations in cats. In this retrospective single-centre study, the surgical, anaesthetic and imaging records of 40 screws (32 cats) placed with lag effect for management of sacroiliac luxation were reviewed. Postoperative radiographs were assessed for sacroiliac joint reduction, screw position, and sacral width purchased by each screw. Cases were divided into two groups according to the use of (IOR) or the absence of intra-operative radiology (NIOR). A total of 23 lag screws were placed with the aid of intra-operative radiology and 17 without. Three of the 23 screws placed in the IOR group exited the sacrum as opposed to eight of 17 screws in the NIOR group (p = 0.03). Mean sacral width purchased by the screws in the IOR group (70.8%) was also significantly higher (p = 0.002) than in the NIOR group (54.6%). Mean general anaesthetic times for unilateral and bilateral screw placement for the IOR group and NIOR group were not significantly different. The use of intra-operative radiology can significantly improve the quality of lag screw insertion for the stabilization of sacroiliac luxations in cats, which should lead to a reduced incidence of postoperative screw loosening.

Comparison of delayed complications of central venous catheters placed surgically or radiologically in pediatric oncology patients.

PubMed

Basford, Tavis J; Poenaru, Dan; Silva, Mariana

2003-05-01

Pediatric central venous catheters (CVCs) traditionally have been placed surgically, guided by anatomic landmarks. Increasingly, interventional radiology services are inserting CVCs using ultrasound image guidance. This study compares the frequency of delayed complications in CVCs placed surgically or radiologically in a pediatric oncology population. Data on CVCs placed in one academic institution over 10 years were collected and analyzed retrospectively. Main outcomes assessed were infectious complications, mechanical complications, and premature catheter removal. Ninety-eight CVCs-comprising 52 external tunneled catheters (ETCs) and 46 subcutaneous ports-were assessed in 67 patients. Median patient age was 6.1 years for children with external catheters and 7.8 years for those with ports. Both infectious and mechanical complications were significantly more common among surgically placed ETCs than those placed radiologically (P <.05). Complications per 1,000 catheter days and premature removal showed a trend toward greater frequency among surgical ETCs, although this did not reach statistical significance. No consistent trends were seen in complications among ports. Pediatric patients with CVCs, especially those with external catheters, experience frequent delayed complications. Patients with radiologically inserted ETCs may encounter fewer complications than those with surgically placed ones. This corroborates previous reports in the literature suggesting image-guided CVC placement as a preferable alternative to traditional techniques. Copyright 2003 Elsevier Inc. All rights reserved.

Turbo FRMAC 2016 v. 7.3.0

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

Madrid, Gregory J.; Whitener, Dustin Heath; Folz, Wesley

2017-05-27

The Turbo FRMAC (TF) software program is the software implementation of the science and methodologies utilized in the Federal Radiological Monitoring and Assessment Center (FRMAC). The software automates the calculations described in volumes 1 of "The Federal Manual for Assessing Environmental Data during a Radiological Emergency" (2015 version). In the event of the intentional or accidental release of radioactive material, the software is used to guide and govern the response of the Federal, State, Local, and Tribal governments. The manual, upon which the software is based, is unclassified and freely available on the Internet.

Turbo FRMAC 2018

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

Fulton, John; Gallagher, Linda; Gonzales, Alejandro

The Turbo FRMAC (TF) software program is the software implementation of the science and methodologies utilized in the Federal Radiological Monitoring and Assessment Center (FRMAC). The software automates the calculations described in volumes 1 of "The Federal Manual for Assessing Environmental Data during a Radiological Emergency" (2015 version). In the event of the intentional or accidental release of radioactive material, the software is used to guide and govern the response of the Federal, State, Local, and Tribal governments. The manual, upon which the software is based, is unclassified and freely available on the Internet.

Turbo FRMAC 2016 Version 7.1.0

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

Fulton, John; Gallagher, Linda K.; Madrid, Gregory J.

2016-08-01

The Turbo FRMAC (TF) software program is the software implementation of the science and methodologies utilized in the Federal Radiological Monitoring and Assessment Center (FRMAC). The software automates the calculations described in volumes 1 of "The Federal Manual for Assessing Environmental Data during a Radiological Emergency" (2015 version). In the event of the intentional or accidental release of radioactive material, the software is used to guide and govern the response of the Federal, State, Local, and Tribal governments. The manual, upon which the software is based, is unclassified and freely available on the Internet.

Turbo FRMAC 2016 v. 7.2.0

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

Madrid, Gregory J.; Whitener, Dustin Heath; Folz, Wesley

2017-02-27

The Turbo FRMAC (TF) software program is the software implementation of the science and methodologies utilized in the Federal Radiological Monitoring and Assessment Center (FRMAC). The software automates the calculations described in volumes 1 of "The Federal Manual for Assessing Environmental Data during a Radiological Emergency" (2015 version). In the event of the intentional or accidental release of radioactive material, the software is used to guide and govern the response of the Federal, State, Local, and Tribal governments. The manual, upon which the software is based, is unclassified and freely available on the Internet.

Radiological performance assessment for the E-Area Vaults Disposal Facility

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

Cook, J.R.

This report is the first revision to ``Radiological Performance Assessment for the E-Area Vaults Disposal Facility, Revision 0'', which was issued in April 1994 and received conditional DOE approval in September 1994. The title of this report has been changed to conform to the current name of the facility. The revision incorporates improved groundwater modeling methodology, which includes a large data base of site specific geotechnical data, and special Analyses on disposal of cement-based wasteforms and naval wastes, issued after publication of Revision 0.

Bosniak Classification for Complex Renal Cysts Reevaluated: A Systematic Review.

PubMed

Schoots, Ivo G; Zaccai, Keren; Hunink, Myriam G; Verhagen, Paul C M S

2017-07-01

We systematically evaluated the Bosniak classification system with malignancy rates of each Bosniak category, and assessed the effectiveness related to surgical treatment and oncologic outcome based on recurrence and/or metastasis. In a systematic review according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) criteria, we selected 39 publications for inclusion in this analysis and categorized them into 1) surgical cohorts-all cysts treated surgically and 2) radiological cohorts-cysts with surgical treatment or radiological followup. A total of 3,036 complex renal cysts were categorized into Bosniak II, IIF, III and IV. In surgical and radiological cohorts pooled estimates showed a malignancy prevalence of 0.51 (0.44, 0.58) in Bosniak III and 0.89 (0.83, 0.92) in Bosniak IV cysts, respectively. Stable Bosniak IIF cysts showed a malignancy rate of less than 1% during radiological followup (surveillance). Bosniak IIF cysts, which showed reclassification to the Bosniak III/IV category during radiological followup (12%), showed malignancy in 85%, comparable to Bosniak IV cysts. The estimated surgical number needed to treat to avoid metastatic disease of Bosniak III and IV cysts was 140 and 40, respectively. The effectiveness of the Bosniak classification system for complex renal cysts was high in categories II, IIF and IV, but low in category III, and 49% of Bosniak III cysts was overtreated because of a benign outcome. This surgical overtreatment combined with the excellent outcome for Bosniak III cysts may suggest that surveillance is a rational alternative to surgery. This will require further study to assess whether surveillance of Bosniak III cysts will prove safe. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Readability of Online Patient Education Materials Related to IR.

PubMed

McEnteggart, Gregory E; Naeem, Muhammad; Skierkowski, Dorothy; Baird, Grayson L; Ahn, Sun H; Soares, Gregory

2015-08-01

To assess the readability of online patient education materials (OPEM) related to common diseases treated by and procedures performed by interventional radiology (IR). The following websites were chosen based on their average Google search return for each IR OPEM content area examined in this study: Society of Interventional Radiology (SIR), Cardiovascular and Interventional Radiological Society of Europe (CIRSE), National Library of Medicine, RadiologyInfo, Mayo Clinic, WebMD, and Wikipedia. IR OPEM content area was assessed for the following: peripheral arterial disease, central venous catheter, varicocele, uterine artery embolization, vertebroplasty, transjugular intrahepatic portosystemic shunt, and deep vein thrombosis. The following algorithms were used to estimate and compare readability levels: Flesch-Kincaid Grade Formula, Flesch Reading Ease Score, Gunning Frequency of Gobbledygook, Simple Measure of Gobbledygook, and Coleman-Liau Index. Data were analyzed using general mixed modeling. On average, online sources that required beyond high school grade-level readability were Wikipedia (15.0), SIR (14.2), and RadiologyInfo (12.4); sources that required high school grade-level readability were CIRSE (11.3), Mayo Clinic (11.0), WebMD (10.6), and National Library of Medicine (9.0). On average, OPEM on uterine artery embolization, vertebroplasty, varicocele, and peripheral arterial disease required the highest level of readability (12.5, 12.3, 12.3, and 12.2, respectively). The IR OPEM assessed in this study were written above the recommended sixth-grade reading level and the health literacy level of the average American adult. Many patients in the general public may not have the ability to read and understand health information in IR OPEM. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

Using SAFRAN Software to Assess Radiological Hazards from Dismantling of Tammuz-2 Reactor Core at Al-tuwaitha Nuclear Site

NASA Astrophysics Data System (ADS)

Abed Gatea, Mezher; Ahmed, Anwar A.; jundee kadhum, Saad; Ali, Hasan Mohammed; Hussein Muheisn, Abbas

2018-05-01

The Safety Assessment Framework (SAFRAN) software has implemented here for radiological safety analysis; to verify that the dose acceptance criteria and safety goals are met with a high degree of confidence for dismantling of Tammuz-2 reactor core at Al-tuwaitha nuclear site. The activities characterizing, dismantling and packaging were practiced to manage the generated radioactive waste. Dose to the worker was considered an endpoint-scenario while dose to the public has neglected due to that Tammuz-2 facility is located in a restricted zone and 30m berm surrounded Al-tuwaitha site. Safety assessment for dismantling worker endpoint-scenario based on maximum external dose at component position level in the reactor pool and internal dose via airborne activity while, for characterizing and packaging worker endpoints scenarios have been done via external dose only because no evidence for airborne radioactivity hazards outside the reactor pool. The in-situ measurements approved that reactor core components are radiologically activated by Co-60 radioisotope. SAFRAN results showed that the maximum received dose for workers are (1.85, 0.64 and 1.3mSv/y) for activities dismantling, characterizing and packaging of reactor core components respectively. Hence, the radiological hazards remain below the low level hazard and within the acceptable annual dose for workers in radiation field

Cost accounting in radiology: new directions and importance for policy.

PubMed

Muchantef, Karl; Forman, Howard P

2005-12-01

The purpose of this article is to promote insight into radiology costs through improvements in assessing patient-level cost data. Accurate patient costing is a prerequisite for establishing a proper payment system-one where the price paid for a service approximates the cost of delivering that service. In the absence of an accurate payment scheme, margins can vary significantly from one patient to the next. The resulting financial incentives skew the radiology marketplace away from the provision of efficient and appropriate care toward the selection of patients whose costs are low relative to reimbursements.

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

Early radiological and functional outcomes for a cementless press-fit design modular femoral stem revision system.

PubMed

Hancock, Douglas S; Sharplin, Paul K; Larsen, Peter D; Phillips, Fredrick Ts

2018-05-01

To assess early radiological and functional outcomes of revision hip surgery with a cementless press-fit design femoral stem. A retrospective review of 48 consecutive revision total hip replacements using the RECLAIM revision hip system, between October 2012 and August 2015. Radiographic assessment was undertaken with serial anteroposterior (AP) X-rays of the pelvis. Risk factors for subsidence were evaluated. Prospective clinical follow up was performed on 21 patients to assess functional outcomes. Mean stem subsidence was 1.1 mm (95% confidence interval[CI]: 0.63-1.57). Median follow up of 12 months. An inverse relationship was observed between level of subsidence and femoral stem diameter r = -0.45, p = 0.001. Subsidence at the time of follow-up assessment was correlated with initial subsidence (correlation coefficient rho 0.69, p = 0.001). The mean Merle d'Aubigne score at the latest follow up was 14.2 (range 8-17). The mean OHS was 34.1 (range 15-48). Early radiological and functional outcomes for the RECLAIM revision system showed very low levels of subsidence and good functional outcomes. There was an association with smaller diameter femoral stems and greater levels of subsidence.

RELIABILITY AND VALIDITY OF SUBJECTIVE ASSESSMENT OF LUMBAR LORDOSIS IN CONVENTIONAL RADIOGRAPHY.

PubMed

Ruhinda, E; Byanyima, R K; Mugerwa, H

2014-10-01

Reliability and validity studies of different lumbar curvature analysis and measurement techniques have been documented however there is limited literature on the reliability and validity of subjective visual analysis. Radiological assessment of lumbar lordotic curve aids in early diagnosis of conditions even before neurologic changes set in. To ascertain the level of reliability and validity of subjective assessment of lumbar lordosis in conventional radiography. A blinded, repeated-measures diagnostic test was carried out on lumbar spine x-ray radiographs. Radiology Department at Joint Clinical Research Centre (JCRC), Mengo-Kampala-Uganda. Seventy (70) lateral lumbar x-ray films were used for this study and were obtained from the archive of JCRC radiology department at Butikiro house, Mengo-Kampala. Poor observer agreement, both inter- and intra-observer, with kappa values of 0.16 was found. Inter-observer agreement was poorer than intra-observer agreement. Kappa values significantly rose when the lumbar lordosis was clustered into four categories without grading each abnormality. The results confirm that subjective assessment of lumbar lordosis has low reliability and validity. Film quality has limited influence on the observer reliability. This study further shows that fewer scale categories of lordosis abnormalities produce better observer reliability.

Artificial intelligence in radiology.

PubMed

Hosny, Ahmed; Parmar, Chintan; Quackenbush, John; Schwartz, Lawrence H; Aerts, Hugo J W L

2018-05-17

Artificial intelligence (AI) algorithms, particularly deep learning, have demonstrated remarkable progress in image-recognition tasks. Methods ranging from convolutional neural networks to variational autoencoders have found myriad applications in the medical image analysis field, propelling it forward at a rapid pace. Historically, in radiology practice, trained physicians visually assessed medical images for the detection, characterization and monitoring of diseases. AI methods excel at automatically recognizing complex patterns in imaging data and providing quantitative, rather than qualitative, assessments of radiographic characteristics. In this Opinion article, we establish a general understanding of AI methods, particularly those pertaining to image-based tasks. We explore how these methods could impact multiple facets of radiology, with a general focus on applications in oncology, and demonstrate ways in which these methods are advancing the field. Finally, we discuss the challenges facing clinical implementation and provide our perspective on how the domain could be advanced.

Radiation risk assessment in professionals working in dental radiology area using buccal micronucleus cytome assay.

PubMed

Sadatullah, Syed; Dawasaz, Ali Azhar; Luqman, Master; Assiry, Ali A; Almeshari, Ahmed A; Togoo, Rafi Ahmad

2013-11-01

The aim of this study was to assess the incidence of micronuclei (MN) in buccal mucosal cells of professionals working in radiology area to determine the risk of stochastic effects of radiation. All the professionals and students working in King Khalid University - College of Dentistry radiology area were included in the Risk Group (RG = 27). The Control Group (CG = 27) comprised of healthy individual matching the gender and age of the RG. Buccal mucosal scraping from all the 54 subjects of RG and CG were stained with Papanicolaou stain and observed under oil immersion lens (×100) for the presence of micronuclei (MN) in the exfoliated epithelial cells. There was no significant difference between the incidence of MN in RG and CG (p = >0.05) using t-test. Routine radiation protection protocol does minimize the risk of radiation induced cytotoxicity, however, screening of professionals should be carried out at regular intervals.

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.

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.

Experimental approaches to assessing the impact of a cesium chloride radiological dispersal device

USGS Publications Warehouse

Lee, S.; Gibb, Snyder E.; Barzyk, J.; McGee, J.; Koenig, A.

2008-01-01

The US EPA, as a part of the Chemical, Biological, Radiological-Nuclear, and Explosives (CBRNE) Research and Technology Initiative (CRTI) project team, is currently working to assess the impacts of an urban radiological dispersion device (RDD) and to develop containment and decontamination strategies. Three efforts in this area are currently underway: development of a laboratory-scale cesium chloride deposition method to mimic a RDD; assessment of cesium (Cs) penetration depth and pathways in urban materials using two dimensional (2-D) mapping laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS); and experimental determination of distribution coefficients (kd) for Cs in water-building material systems. It is critical that, when performing laboratory-scale experiments to assess the fate of Cs from an RDD, the Cs particle deposition method mimics the RDD deposition. Once Cs particles are deposited onto urban surfaces, 2-D mapping of Cs concentrations using LA-ICP-MS is a critical tool for determining Cs transport pathways through these materials. Lastly, distribution coefficients are critical for understanding the transport of Cs in urban settings when direct measurements of its penetration depth are unavailable. An assessment of the newly developed deposition method along with preliminary results from the penetration experiments are presented in this paper.

Ethnic and Gender Diversity in Radiology Fellowships.

PubMed

West, Derek L; Nguyen, HaiThuy

2017-06-01

The purpose of the study is to assess ethnic and gender diversity in US radiology fellowship programs from 2006 to 2013. Data for this study was obtained from Journal of the American Medical Association supplements publications from 2005 to 2006 to 2012-2013 (Gonzalez-Moreno, Innov Manag Policy Pract. 15(2):149, 2013; Nivet, Acad Med. 86(12):1487-9, 2011; Reede, Health Aff. 22(4):91-3, 2003; Chapman et al., Radiology 270(1):232-40, 2014; Getto, 2005; Rivo and Satcher, JAMA 270(9):1074-8, 1993; Schwartz et al., Otolaryngol Head Neck Surg. 149(1):71-6, 2013; Simon, Clin Orthop Relat Res. 360:253-9, 1999) and the US census 2010. For each year, Fisher's exact test was used to compare the percentage of women and under-represented minorities in each Accreditation Council for Graduate Medical Education (ACGME)-certified radiology fellowship to the percentage of women and under-represented minorities in (1) all ACGME-certified radiology fellowships combined, (2) radiology residents, (3) ACGME-certified fellows in all of medicine combined, (4) ACGME-certified residents in all of medicine combined, and (5) graduating medical students. Chi-Squared test was used to compare the percentage of women and under-represented minorities and the 2010 US census. p < 0.05 was used as indicator of significance. Interventional radiology and neuroradiology demonstrated the highest levels of disparities, compared to every level of medical education. Abdominal and musculoskeletal radiology fellowships demonstrated disparity patterns consistent with lack of female and URM medical graduates entering into radiology residency. All radiology fellowships demonstrated variable levels of gender and ethnic disparities. Outreach efforts, pipeline programs, and mentoring may be helpful in addressing this issue.

Rapid Acute Dose Assessment Using MCNP6

NASA Astrophysics Data System (ADS)

Owens, Andrew Steven

Acute radiation doses due to physical contact with a high-activity radioactive source have proven to be an occupational hazard. Multiple radiation injuries have been reported due to manipulating a radioactive source with bare hands or by placing a radioactive source inside a shirt or pants pocket. An effort to reconstruct the radiation dose must be performed to properly assess and medically manage the potential biological effects from such doses. Using the reference computational phantoms defined by the International Commission on Radiological Protection (ICRP) and the Monte Carlo N-Particle transport code (MCNP6), dose rate coefficients are calculated to assess doses for common acute doses due to beta and photon radiation sources. The research investigates doses due to having a radioactive source in either a breast pocket or pants back pocket. The dose rate coefficients are calculated for discrete energies and can be used to interpolate for any given energy of photon or beta emission. The dose rate coefficients allow for quick calculation of whole-body dose, organ dose, and/or skin dose if the source, activity, and time of exposure are known. Doses are calculated with the dose rate coefficients and compared to results from the International Atomic Energy Agency (IAEA) reports from accidents that occurred in Gilan, Iran and Yanango, Peru. Skin and organ doses calculated with the dose rate coefficients appear to agree, but there is a large discrepancy when comparing whole-body doses assessed using biodosimetry and whole-body doses assessed using the dose rate coefficients.

Preoperative tumour staging with multidisciplinary team assessment improves the outcome in locally advanced primary rectal cancer.

PubMed

Palmer, G; Martling, A; Cedermark, B; Holm, T

2011-12-01

Multidisciplinary team meetings have been introduced as a result of developments in preoperative radiological tumour staging and neoadjuvant treatment. Multidisciplinary team recommendations will influence treatment decisions but their effect on patient outcome is unknown. The aim of this study was to assess outcome in relation to preoperative local and distant staging, with or without multidisciplinary team assessment. A population-based registry of all patients with rectal cancer, treated in the Stockholm region from 1995 to 2004, identified 303 patients with locally advanced primary rectal cancer. The patients were classified into three groups: group 1, preoperative local and distant radiological tumour staging with discussion at a multidisciplinary team meeting; group 2, preoperative staging but no multidisciplinary team assessment; and group 3, no proper preoperative radiological staging. Neoadjuvant treatment was more prevalent in groups 1 and 2 than in group 3. The incidence of R0 resection differed significantly between the groups (52% in group 1, 43% in group 2 and 21% in group 3; P < 0.001). Local tumour control was achieved in 57%, 36%, and 19% of patients in groups 1, 2 and 3, respectively (P < 0.001). The estimated overall 5-year survival of patients was 30%, 28% and 12% in groups 1, 2 and 3, respectively. Preoperative radiological tumour staging in patients with locally advanced primary rectal cancer and discussion at a multidisciplinary team meeting increases the proportion of patients receiving neoadjuvant treatment and cancer-specific end-points. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

Alternative Metrics ("Altmetrics") for Assessing Article Impact in Popular General Radiology Journals.

PubMed

Rosenkrantz, Andrew B; Ayoola, Abimbola; Singh, Kush; Duszak, Richard

2017-07-01

Emerging alternative metrics leverage social media and other online platforms to provide immediate measures of biomedical articles' reach among diverse public audiences. We aimed to compare traditional citation and alternative impact metrics for articles in popular general radiology journals. All 892 original investigations published in 2013 issues of Academic Radiology, American Journal of Roentgenology, Journal of the American College of Radiology, and Radiology were included. Each article's content was classified as imaging vs nonimaging. Traditional journal citations to articles were obtained from Web of Science. Each article's Altmetric Attention Score (Altmetric), representing weighted mentions across a variety of online platforms, was obtained from Altmetric.com. Statistical assessment included the McNemar test, the Mann-Whitney test, and the Pearson correlation. Mean and median traditional citation counts were 10.7 ± 15.4 and 5 vs 3.3 ± 13.3 and 0 for Altmetric. Among all articles, 96.4% had ≥1 traditional citation vs 41.8% for Altmetric (P < 0.001). Online platforms for which at least 5% of the articles were represented included Mendeley (42.8%), Twitter (34.2%), Facebook (10.7%), and news outlets (8.4%). Citations and Altmetric were weakly correlated (r = 0.20), with only a 25.0% overlap in terms of articles within their top 10th percentiles. Traditional citations were higher for articles with imaging vs nonimaging content (11.5 ± 16.2 vs 6.9 ± 9.8, P < 0.001), but Altmetric scores were higher in articles with nonimaging content (5.1 ± 11.1 vs 2.8 ± 13.7, P = 0.006). Although overall online attention to radiology journal content was low, alternative metrics exhibited unique trends, particularly for nonclinical articles, and may provide a complementary measure of radiology research impact compared to traditional citation counts. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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.

A Poor Man's Nuclear Deterrent: Assessing the Value of Radiological Weapons for State Actors

NASA Astrophysics Data System (ADS)

Donohue, Nathan

The threat of weapons of mass destruction is an issue which remains at the forefront on national security. Nuclear, chemical, and biological weapons are all considered very dangerous by both state and non-state actors. Radiological weapons exist in that same category yet are not held in the same regard; the reason that is given is that these types of weapons are not the weapons of mass destruction that the other three are. Instead, radiological weapons are better considered weapons of mass disruption. Accordingly, in the academic and policy literature there has been very little perceived value associated with such weapons for use by state actors. However the historical focus on the military efficacy of radiological weapons has obscured the obvious truth that they may pose significant value for state actors. What this research shows is that the explosion of a radiological weapon could disrupt a target area in ways which could cripple the economy of an adversary state and promote widespread fear concerning exposure to radiation. Any such attack would not only necessitate large scale evacuation, but cleanup, decontamination, demolition, territory exclusion, and relocation. Moreover, the effects of such an attack would be unlikely to remain an isolated event as evacuated and displaced citizens spread across the nation carrying both fear and residual radiation. All of these factors would only be compounded by a state actor's ability to not only develop such weapons, but to manufacture them in such a composition that contemporary examples of such weapons grossly underestimate their impact. Accordingly, radiological weapons could hold great value for any state actor wishing to pursue their development and to threaten their use. Moreover, "while RDDs may not be well suited as "military weapons" in the classic sense, the use of RDDs could be powerfully coercive."1 In that sense, state actors could even acquire radiological weapons for their deterrent value. 1James L. Ford, "Radiological Dispersal Devices: Assessing the Transnational Threat," Strategic Forum, No. 136, (March 1998), March 29, 2012, http://www.au.af.mil/au/awc/awcgate/ndu/forum136.htm.

Study of EPR/ESR Dosimetry in Fingernails as a Method for Assessing Dose of Victims of Radiological Accidents/Incidents

DTIC Science & Technology

2008-06-17

dosimeters . .............................................................................................. 117 Figure 4-2. Flow chart illustrating...alanine, various sugars, quartz in rocks and sulfates, as EPR dosimeters [15]. Alternatively, radiation-induced EPR signals have been detected using...the medical response to radiological accidents, as a method for estimating radiation dose without the use of physical dosimeters and using exposed

Technology Readiness Assessment (TRA) Deskbook

DTIC Science & Technology

2009-07-01

Document CDER Center for Drug Evaluation and Research CDR Critical Design Review CDRH Center for Devices and Radiologic Health CFD computational fluid...gational Device Exemption (IDE) meeting is held with Center for Devices and Radiological Health ( CDRH ) for proposed Class III devices, and the IDE...is prepared and submitted to CDRH . For a 510(k), determine substantially equivalent devices and their classification, validate func- tioning model

Radiologists' preferences for just-in-time learning.

PubMed

Kahn, Charles E; Ehlers, Kevin C; Wood, Beverly P

2006-09-01

Effective learning can occur at the point of care, when opportunities arise to acquire information and apply it to a clinical problem. To assess interest in point-of-care learning, we conducted a survey to explore radiologists' attitudes and preferences regarding the use of just-in-time learning (JITL) in radiology. Following Institutional Review Board approval, we invited 104 current radiology residents and 86 radiologists in practice to participate in a 12-item Internet-based survey to assess their attitudes toward just-in-time learning. Voluntary participation in the survey was solicited by e-mail; respondents completed the survey on a web-based form. Seventy-nine physicians completed the questionnaire, including 47 radiology residents and 32 radiologists in practice; the overall response rate was 42%. Respondents generally expressed a strong interest for JITL: 96% indicated a willingness to try such a system, and 38% indicated that they definitely would use a JITL system. They expressed a preference for learning interventions of 5-10 min in length. Current and recent radiology trainees have expressed a strong interest in just-in-time learning. The information from this survey should be useful in pursuing the design of learning interventions and systems for delivering just-in-time learning to radiologists.

Radiology in Medical Education: A Pediatric Radiology Elective as a Template for Other Radiology Courses.

PubMed

Hilmes, Melissa A; Hyatt, Eddie; Penrod, Cody H; Fleming, Amy E; Singh, Sudha P

2016-03-01

Traditionally, the pediatric radiology elective for medical students and pediatric residents constituted a morning teaching session focused mainly on radiography and fluoroscopy. A more structured elective was desired to broaden the exposure to more imaging modalities, create a more uniform educational experience, and include assessment tools. In 2012, an introductory e-mail and formal syllabus, including required reading assignments, were sent to participants before the start date. A rotating weekly schedule was expanded to include cross-sectional imaging (ultrasound, CT, MR) and nuclear medicine. The schedule could accommodate specific goals of the pediatric resident or medical student, as requested. Starting in 2013, an online pre-test and post-test were developed, as well as an online end-of-rotation survey specific to the pediatric radiology elective. Taking the Image Gently pledge was required. A scavenger hunt tool, cue cards, and electronic modules were added. Pre-test and post-test scores, averaged over 2 years, showed improvement in radiology knowledge, with scores increasing by 27% for medical students and 21% for pediatric residents. Surveys at the end of the elective were overwhelmingly positive, with constructive criticism and complimentary comments. We have successfully created an elective experience in radiology that dedicates time to education while preserving the workflow of radiologists. We have developed tools to provide a customized experience with many self-directed learning opportunities. Our tools and techniques are easily translatable to a general or adult radiology elective. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology compared with xenon—133 scanning and bronchoscopic lobar sampling as methods for assessing regional lung function in patients with emphysema

PubMed Central

Barter, C. E.; Hugh-Jones, P.; Laws, J. W.; Crosbie, W. A.

1973-01-01

Regional lung function was assessed by radiographic methods, by regional function studies using xenon-133 scans, and by lobar sampling with a mass spectrometer flow-meter at bronchoscopy in 12 patients who subsequently had bullae resected at operation. The information given by these three methods of regional assessment was subsequently compared with the findings at operation. When only one lobe was abnormal on the radiographs, these alone were adequate to locate the major site of the emphysema and the regional tests gave relatively little extra information. The xenon scan was sometimes helpful in assessing the state of the remaining lung, but this information could be deduced from the radiographs and overall lung function tests, especially the carbon monoxide transfer and mechanical measurements. Bronchoscopic sampling was helpful in determining whether the affected lobe was acting as a ventilated dead-space. When more than one lobe was affected the regional function tests supplemented the radiographs in defining the site of bullous change as well as locating dead space. Xenon scans, although widely employed for such preoperative assessments, added little to the topographical information obtained by careful radiology. The combination of radiology, lobar sampling, and overall function tests is recommended for assessing which emphysematous patients are likely to benefit from surgery. Images PMID:4685209

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

Radiological interpretation of images displayed on tablet computers: a systematic review

PubMed Central

Armfield, N R; Smith, A C

2015-01-01

Objective: To review the published evidence and to determine if radiological diagnostic accuracy is compromised when images are displayed on a tablet computer and thereby inform practice on using tablet computers for radiological interpretation by on-call radiologists. Methods: We searched the PubMed and EMBASE databases for studies on the diagnostic accuracy or diagnostic reliability of images interpreted on tablet computers. Studies were screened for inclusion based on pre-determined inclusion and exclusion criteria. Studies were assessed for quality and risk of bias using Quality Appraisal of Diagnostic Reliability Studies or the revised Quality Assessment of Diagnostic Accuracy Studies tool. Treatment of studies was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: 11 studies met the inclusion criteria. 10 of these studies tested the Apple iPad® (Apple, Cupertino, CA). The included studies reported high sensitivity (84–98%), specificity (74–100%) and accuracy rates (98–100%) for radiological diagnosis. There was no statistically significant difference in accuracy between a tablet computer and a digital imaging and communication in medicine-calibrated control display. There was a near complete consensus from authors on the non-inferiority of diagnostic accuracy of images displayed on a tablet computer. All of the included studies were judged to be at risk of bias. Conclusion: Our findings suggest that the diagnostic accuracy of radiological interpretation is not compromised by using a tablet computer. This result is only relevant to the Apple iPad and to the modalities of CT, MRI and plain radiography. Advances in knowledge: The iPad may be appropriate for an on-call radiologist to use for radiological interpretation. PMID:25882691

[Assessment of the correlation between histological degeneration and radiological and clinical parameters in a series of patients who underwent lumbar disc herniation surgery].

PubMed

Munarriz, Pablo M; Paredes, Igor; Alén, José F; Castaño-Leon, Ana M; Cepeda, Santiago; Hernandez-Lain, Aurelio; Lagares, Alfonso

The use of histological degeneration scores in surgically-treated herniated lumbar discs is not common in clinical practice and its use has been primarily restricted to research. The objective of this study is to evaluate if there is an association between a higher grade of histological degeneration when compared with clinical or radiological parameters. Retrospective consecutive analysis of 122 patients who underwent single-segment lumbar disc herniation surgery. Clinical information was available on all patients, while the histological study and preoperative magnetic resonance imaging were also retrieved for 75 patients. Clinical variables included age, duration of symptoms, neurological deficits, or affected deep tendon reflex. The preoperative magnetic resonance imaging was evaluated using Modic and Pfirrmann scores for the affected segment by 2 independent observers. Histological degeneration was evaluated using Weiler's score; the presence of inflammatory infiltrates and neovascularization, not included in the score, were also studied. Correlation and chi-square tests were used to assess the association between histological variables and clinical or radiological variables. Interobserver agreement was also evaluated for the MRI variables using weighted kappa. No statistically significant correlation was found between histological variables (histological degeneration score, inflammatory infiltrates or neovascularization) and clinical or radiological variables. Interobserver agreement for radiological scores resulted in a kappa of 0.79 for the Pfirrmann scale and 0.65 for the Modic scale, both statistically significant. In our series of patients, we could not demonstrate any correlation between the degree of histological degeneration or the presence of inflammatory infiltrates when compared with radiological degeneration scales or clinical variables such as the patient's age or duration of symptoms. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

Radiology resident teaching skills improvement: impact of a resident teacher training program.

PubMed

Donovan, Andrea

2011-04-01

Teaching is considered an essential competency for residents to achieve during their training. Instruction in teaching skills may assist radiology residents in becoming more effective teachers and increase their overall satisfaction with teaching. The purposes of this study were to survey radiology residents' teaching experiences during residency and to assess perceived benefits following participation in a teaching skills development course. Study participants were radiology residents with membership in the American Alliance of Academic Chief Residents in Radiology or the Siemens AUR Radiology Resident Academic Development Program who participated in a 1.5-hour workshop on teaching skills development at the 2010 Association of University Radiologists meeting. Participants completed a self-administered, precourse questionnaire that addressed their current teaching strategies, as well as the prevalence and structure of teaching skills training opportunities at their institutions. A second postcourse questionnaire enabled residents to evaluate the seminar and assessed new knowledge and skill acquisition. Seventy-eight residents completed the precourse and postcourse questionnaires. The vast majority of respondents indicated that they taught medical students (72 of 78 [92.3%]). Approximately 20% of residency programs (17 of 78) provided residents with formal didactic programs on teaching skills. Fewer than half (46.8%) of the resident respondents indicated that they received feedback on their teaching from attending physicians (36 of 77), and only 18% (13 of 78) routinely gave feedback to their own learners. All of the course participants agreed or strongly agreed that this workshop was helpful to them as teachers. Few residency programs had instituted resident teacher training curricula. A resident teacher training workshop was perceived as beneficial by the residents, and they reported improvement in their teaching skills. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Use of DandD for dose assessment under NRC`s radiological criteria for license termination rule

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

Gallegos, D.P.; Brown, T.J.; Davis, P.A.

The Decontamination and Decommissioning (DandD) software package has been developed by Sandia National Laboratories for the Nuclear Regulatory Commission (NRC) specifically for the purpose of providing a user-friendly analytical tool to address the dose criteria contained in NRC`s Radiological Criteria for License Termination rule (10 CFR Part 20 Subpart E; NRC, 1997). Specifically, DandD embodies the NRC`s screening methodology to allow licensees to convert residual radioactivity contamination levels at their site to annual dose, in a manner consistent with both 10 CFR Part 20 and the corresponding implementation guidance developed by NRC. The screening methodology employs reasonably conservative scenarios, fatemore » and transport models, and default parameter values that have been developed to allow the NRC to quantitatively estimate the risk of releasing a site given only information about the level of contamination. Therefore, a licensee has the option of specifying only the level of contamination and running the code with the default parameter values, or in the case where site specific information is available to alter the appropriate parameter values and then calculate dose. DandD can evaluate dose for fur different scenarios: residential, building occupancy, building renovation, or drinking water. The screening methodology and DandD are part of a larger decision framework that allows and encourages licensees to optimize decisions on choice of alternative actions at their site, including collection of additional data and information. This decision framework is integrated into and documented in NRC`s technical guidance for decommissioning.« less

Development of a computer code to calculate the distribution of radionuclides within the human body by the biokinetic models of the ICRP.

PubMed

Matsumoto, Masaki; Yamanaka, Tsuneyasu; Hayakawa, Nobuhiro; Iwai, Satoshi; Sugiura, Nobuyuki

2015-03-01

This paper describes the Basic Radionuclide vAlue for Internal Dosimetry (BRAID) code, which was developed to calculate the time-dependent activity distribution in each organ and tissue characterised by the biokinetic compartmental models provided by the International Commission on Radiological Protection (ICRP). Translocation from one compartment to the next is taken to be governed by first-order kinetics, which is formulated by the first-order differential equations. In the source program of this code, the conservation equations are solved for the mass balance that describes the transfer of a radionuclide between compartments. This code is applicable to the evaluation of the radioactivity of nuclides in an organ or tissue without modification of the source program. It is also possible to handle easily the cases of the revision of the biokinetic model or the application of a uniquely defined model by a user, because this code is designed so that all information on the biokinetic model structure is imported from an input file. The sample calculations are performed with the ICRP model, and the results are compared with the analytic solutions using simple models. It is suggested that this code provides sufficient result for the dose estimation and interpretation of monitoring data. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Radiological Environmental Protection for LCLS-II High Power Operation

NASA Astrophysics Data System (ADS)

Liu, James; Blaha, Jan; Cimeno, Maranda; Mao, Stan; Nicolas, Ludovic; Rokni, Sayed; Santana, Mario; Tran, Henry

2017-09-01

The LCLS-II superconducting electron accelerator at SLAC plans to operate at up to 4 GeV and 240 kW average power, which would create higher radiological impacts particularly near the beam loss points such as beam dumps and halo collimators. The main hazards to the public and environment include direct or skyshine radiation, effluent of radioactive air such as 13N, 15O and 41Ar, and activation of groundwater creating tritium. These hazards were evaluated using analytic methods and FLUKA Monte Carlo code. The controls (mainly extensive bulk shielding and local shielding around high loss points) and monitoring (neutron/photon detectors with detection capabilities below natural background at site boundary, site-wide radioactive air monitors, and groundwater wells) were designed to meet the U.S. DOE and EPA, as well as SLAC requirements. The radiological design and controls for the LCW systems [including concrete housing shielding for 15O and 11C circulating in LCW, 7Be and erosion/corrosion products (22Na, 54Mn, 60Co, 65Zn, etc.) captured in resin and filters, leak detection and containment of LCW with 3H and its waste water discharge; explosion from H2 build-up in surge tank and release of radionuclides] associated with the high power beam dumps are also presented.

Inventory simulation tools: Separating nuclide contributions to radiological quantities

NASA Astrophysics Data System (ADS)

Gilbert, Mark R.; Fleming, Michael; Sublet, Jean-Christophe

2017-09-01

The activation response of a material is a primary factor considered when evaluating its suitability for a nuclear application. Various radiological quantities, such as total (becquerel) activity, decay heat, and γ dose, can be readily predicted via inventory simulations, which numerically evolve in time the composition of a material under exposure to neutron irradiation. However, the resulting data sets can be very complex, often necessarily resulting in an over-simplification of the results - most commonly by just considering total response metrics. A number of different techniques for disseminating more completely the vast amount of data output from, in particular, the FISPACT-II inventory code system, including importance diagrams, nuclide maps, and primary knock-on atom (PKA) spectra, have been developed and used in scoping studies to produce database reports for the periodic table of elements. This paper introduces the latest addition to this arsenal - standardised and automated plotting of the time evolution in a radiological quantity for a given material separated by contributions from dominant radionuclides. Examples for relevant materials under predicted fusion reactor conditions, and for bench-marking studies against decay-heat measurements, demonstrate the usefulness and power of these radionuclide-separated activation plots. Note to the reader: the pdf file has been changed on September 22, 2017.

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.

Applications of the microdosimetric function implemented in the macroscopic particle transport simulation code PHITS.

PubMed

Sato, Tatsuhiko; Watanabe, Ritsuko; Sihver, Lembit; Niita, Koji

2012-01-01

Microdosimetric quantities such as lineal energy are generally considered to be better indices than linear energy transfer (LET) for expressing the relative biological effectiveness (RBE) of high charge and energy particles. To calculate their probability densities (PD) in macroscopic matter, it is necessary to integrate microdosimetric tools such as track-structure simulation codes with macroscopic particle transport simulation codes. As an integration approach, the mathematical model for calculating the PD of microdosimetric quantities developed based on track-structure simulations was incorporated into the macroscopic particle transport simulation code PHITS (Particle and Heavy Ion Transport code System). The improved PHITS enables the PD in macroscopic matter to be calculated within a reasonable computation time, while taking their stochastic nature into account. The microdosimetric function of PHITS was applied to biological dose estimation for charged-particle therapy and risk estimation for astronauts. The former application was performed in combination with the microdosimetric kinetic model, while the latter employed the radiation quality factor expressed as a function of lineal energy. Owing to the unique features of the microdosimetric function, the improved PHITS has the potential to establish more sophisticated systems for radiological protection in space as well as for the treatment planning of charged-particle therapy.

Educational Impact of Trainee-Facilitated Head and Neck Radiology-Pathology Correlation Conferences.

PubMed

Ginat, Daniel Thomas; Cipriani, Nicole A; Christoforidis, Gregory

2018-05-17

The goal of this study was to evaluate the benefits of resident and fellow-facilitated radiology-pathology head and neck conferences. A total of seven resident-facilitated and six fellow-facilitated head and neck radiology-pathology cases were presented as part of the radiology department conference series. The radiology residents were surveyed regarding the perceived quality and effectiveness of the fellow-facilitated sessions. The number of publications yielded from all the cases presented was tracked. Overall, the residents assessed the quality of the fellow-facilitated conferences with an average score of 3.9 out of 5 and the overall helpfulness with an average of 3.5 out of 5. The overall average level of resident understanding among the residents for the topics presented to them by the fellows at baseline was 2.5 out of 5 and 3.4 out of 5 after the presentations, which was a significant increase (p-value < 0.01). There were three peer-reviewed publications generated from the resident presentations and four peer-reviewed publications generated from the fellow presentations, which represents a 54% publication rate collectively. Therefore, trainee-facilitated head and neck radiology-pathology conferences at our institution provide added learning and scholarly activity opportunities.

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.

[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 .

The job market in diagnostic radiology 1999: updated findings from a help wanted index of job advertisements.

PubMed

Covey, A M; Sunshine, J; Forman, H P

2000-10-01

The purpose of this article is to report 1999 data on the job market in diagnostic radiology detected using a help wanted index of job advertisements and to profile trends in practice type, location, and subspecialty using our previously published data as a basis for comparison. Each advertised job for a diagnostic radiologist in the American Journal of Roentgenology and RADIOLOGY: between January 1991 and December 1999 was coded by practice type, location, and subspecialty. In 1999, 3926 positions were advertised for diagnostic radiologists, representing a 75% increase from 1998. Private practice jobs, which represented 53% of advertisements from 1991 through 1994 and 64% of ads from 1995 through 1998, increased to 66% of ads in 1999. Geographic trends in 1999 were characterized by a relative increase of jobs in the Midwest and California and a decrease in percentage (but increase in total number of ads) in the Northeast and Southwest. The demand for subspecialists continued in 1999, with only 34% of ads placed for general radiologists. A relative increase in demand for neuroradiologists, mammographers, and abdominal imagers was also seen in 1999 in comparison with previously published data from 1995 through 1998. The demand for diagnostic radiologists continues to rise, with more ads placed in 1999 than any other year from 1991 through 1998. Using a help wanted index of job advertisements, we have created an indicator of changes in the diagnostic radiology job market with specific reference to practice type, geographic location, and subspecialty training.

Monte Carlo determination of the conversion coefficients Hp(3)/Ka in a right cylinder phantom with 'PENELOPE' code. Comparison with 'MCNP' simulations.

PubMed

Daures, J; Gouriou, J; Bordy, J M

2011-03-01

This work has been performed within the frame of the European Union ORAMED project (Optimisation of RAdiation protection for MEDical staff). The main goal of the project is to improve standards of protection for medical staff for procedures resulting in potentially high exposures and to develop methodologies for better assessing and for reducing, exposures to medical staff. The Work Package WP2 is involved in the development of practical eye-lens dosimetry in interventional radiology. This study is complementary of the part of the ENEA report concerning the calculations with the MCNP-4C code of the conversion factors related to the operational quantity H(p)(3). In this study, a set of energy- and angular-dependent conversion coefficients (H(p)(3)/K(a)), in the newly proposed square cylindrical phantom made of ICRU tissue, have been calculated with the Monte-Carlo code PENELOPE and MCNP5. The H(p)(3) values have been determined in terms of absorbed dose, according to the definition of this quantity, and also with the kerma approximation as formerly reported in ICRU reports. At a low-photon energy (up to 1 MeV), the two results obtained with the two methods are consistent. Nevertheless, large differences are showed at a higher energy. This is mainly due to the lack of electronic equilibrium, especially for small angle incidences. The values of the conversion coefficients obtained with the MCNP-4C code published by ENEA quite agree with the kerma approximation calculations obtained with PENELOPE. We also performed the same calculations with the code MCNP5 with two types of tallies: F6 for kerma approximation and *F8 for estimating the absorbed dose that is, as known, due to secondary electrons. PENELOPE and MCNP5 results agree for the kerma approximation and for the absorbed dose calculation of H(p)(3) and prove that, for photon energies larger than 1 MeV, the transport of the secondary electrons has to be taken into account.

Protracted Hypofractionated Radiotherapy for Graves' Ophthalmopathy: A Pilot Study of Clinical and Radiologic Response

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

Casimiro de Deus Cardoso, Cejana; Giordani, Adelmo Jose; Borri Wolosker, Angela Maria

Purpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation. Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. Of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptomsmore » of the disease. Radiologic response was assessed by magnetic resonance imaging. Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy. Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy.« less

Breast intraductal papillomas without atypia in radiologic-pathologic concordant core-needle biopsies: Rate of upgrade to carcinoma at excision.

PubMed

Pareja, Fresia; Corben, Adriana D; Brennan, Sandra B; Murray, Melissa P; Bowser, Zenica L; Jakate, Kiran; Sebastiano, Christopher; Morrow, Monica; Morris, Elizabeth A; Brogi, Edi

2016-09-15

The surgical management of mammary intraductal papilloma without atypia (IDP) identified at core-needle biopsy (CNB) is controversial. This study assessed the rate of upgrade to carcinoma at surgical excision (EXC). This study identified women with a CNB diagnosis of intraductal papilloma without atypia or carcinoma at a cancer center between 2003 and 2013. Radiologic-pathologic concordance was assessed for all cases, and discordant cases were excluded. The radiologic and clinicopathologic features of patients with a CNB diagnosis of IDP were correlated with an upgrade to carcinoma at EXC. The study population consists of 189 women with 196 IDPs; 166 women (171 IDPs) underwent EXC. The upgrade rate was 2.3% (4 of 171). The upgraded lesions were 2 invasive lobular carcinomas and 2 cases of ductal carcinoma in situ (DCIS). One case of DCIS involved the residual IDP, whereas the other 3 carcinomas were ≥ 8 mm away. Twenty-four women (25 IDPs) did not undergo EXC and had stable imaging on follow-up (median, 23.5 months). The upgrade rate at EXC for IDPs diagnosed at CNB with radiologic-pathologic concordance was 2.3%. These findings suggest that observation is appropriate for patients with radiologic-pathologic concordant CNB yielding IDP, regardless of its size. Cancer 2016. © 2016 American Cancer Society. Cancer 2016;122:2819-2827. © 2016 American Cancer Society. © 2016 American Cancer Society.

A New modified anthropometric haller index obtained without radiological exposure.

PubMed

Sonaglioni, Andrea; Baravelli, Massimo; Vincenti, Antonio; Trevisan, Roberta; Zompatori, Maurizio; Nicolosi, Gian Luigi; Lombardo, Michele; Anzà, Claudio

2018-05-15

To validate a new modified method for measuring the anthropometric Haller index (HI), obtained without radiological exposure. This new method was based on the use of a rigid ruler and of a 2.5 MHz ultrasound transducer for the assessment of latero-lateral and antero-posterior chest diameters, respectively. We enrolled 100 consecutive patients (mean age 67.9 ± 14.5 years, 55% males), who underwent a two-plane CXR, for any clinical indication, over a four-month period. In all patients, the same radiologist calculated the conventional radiological HI (mean value 1.93 ± 0.35) and the same cardiologist used the above described new technique to measure the modified HI (mean value 1.99 ± 0.26). The Bland-Altman analysis showed tight limits of agreement (+ 0.37; - 0.51) between the two measurement methods, with a mild systematic overestimation of the new method as compared to the standard radiological HI. The Pearson's correlation analysis highlighted a strong correlation between the two methods (r = 0.81, p < 0.0001), while the Student's t test demonstrated a not statistically difference between the means (p = 0.12). The modified HI might allow a quick description of the chest conformation without radiological exposure and a more immediate comprehension of its possible influence on the cardiac kinetics and function, as assessed by echocardiography or other imaging modalities.

Assessment of radiation protection awareness and knowledge about radiological examination doses among Italian radiographers.

PubMed

Paolicchi, F; Miniati, F; Bastiani, L; Faggioni, L; Ciaramella, A; Creonti, I; Sottocornola, C; Dionisi, C; Caramella, D

2016-04-01

To evaluate radiation protection basic knowledge and dose assessment for radiological procedures among Italian radiographers A validated questionnaire was distributed to 780 participants with balanced demographic characteristics and geographic distribution. Only 12.1 % of participants attended radiation protection courses on a regular basis. Despite 90 % of radiographers stating to have sufficient awareness of radiation protection issues, most of them underestimated the radiation dose of almost all radiological procedures. About 5 % and 4 % of the participants, respectively, claimed that pelvis magnetic resonance imaging and abdominal ultrasound exposed patients to radiation. On the contrary, 7.0 % of the radiographers stated that mammography does not use ionising radiation. About half of participants believed that radiation-induced cancer is not dependent on age or gender and were not able to differentiate between deterministic and stochastic effects. Young radiographers (with less than 3 years of experience) showed a higher level of knowledge compared with the more experienced radiographers. There is a substantial need for radiographers to improve their awareness of radiation protection issues and their knowledge of radiological procedures. Specific actions such as regular training courses for both undergraduate and postgraduate students as well as for working radiographers must be considered in order to assure patient safety during radiological examinations. • Radiographers should improve their knowledge on radiation protection issues. • Only 12.1 % of participants attended radiation protection courses on a regular basis. • Specific actions must be considered in order to increase knowledge and awareness.

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

Assessment of Musculoskeletal Function and its Correlation with Radiological Joint Score in Children with Hemophilia A.

PubMed

Gupta, Samriti; Garg, Kapil; Singh, Jagdish

2015-12-01

To evaluate the functional independence of children with hemophilia A and its correlation to radiological joint score. The present cross sectional study was conducted at SPMCHI, SMS Medical College, Jaipur, India. Children in the age group of 4-18 y affected with severe, moderate and mild hemophilia A and with a history of hemarthrosis who attended the OPD, emergency or got admitted in wards of SPMCHI, SMS Medical College were examined. Musculoskeletal function was measured in 98 patients using Functional Independence Score in Hemophilia (FISH) and index joints (joints most commonly affected with repeated bleeding) were assessed radiologically with plain X rays using Pettersson score. The mean FISH score was 28.07 ± 3.90 (range 17-32) with squatting, running and step climbing as most affected tasks. The mean Pettersson score was 3.8 ± 3.2. A significant correlation was found between mean Pettersson score and FISH (r = -0.875, P < 0.001) with knee and elbow having r = -0.810 and -0.861 respectively, but not in case of ankle with r = -0.420 (P 0.174). The FISH and radiological joint (Pettersson's) scores may be extremely useful in the clinical practice in the absence of magnetic resonance imaging (MRI), which is considered very sensitive to detect early joint damage, but at a cost that makes it relatively inaccessible. FISH seems to be a reliable tool for assessment of functional independence in patients with hemophilia A.

Use of Low-Fidelity Simulation Laboratory Training for Teaching Radiology Residents CT-Guided Procedures.

PubMed

Picard, Melissa; Nelson, Rachel; Roebel, John; Collins, Heather; Anderson, M Bret

2016-11-01

To determine the benefit of the addition of low-fidelity simulation-based training to the standard didactic-based training in teaching radiology residents common CT-guided procedures. This was a prospective study involving 24 radiology residents across all years in a university program. All residents underwent standard didactic lecture followed by low-fidelity simulation-based training on three common CT-guided procedures: random liver biopsy, lung nodule biopsy, and drain placement. Baseline knowledge, confidence, and performance assessments were obtained after the didactic session and before the simulation training session. Approximately 2 months later, all residents participated in a simulation-based training session covering all three of these procedures. Knowledge, confidence, and performance data were obtained afterward. These assessments covered topics related to preprocedure workup, intraprocedure steps, and postprocedure management. Knowledge data were collected based on a 15-question assessment. Confidence data were obtained based on a 5-point Likert-like scale. Performance data were obtained based on successful completion of predefined critical steps. There was significant improvement in knowledge (P = .005), confidence (P < .008), and tested performance (P < .043) after the addition of simulation-based training to the standard didactic curriculum for all procedures. This study suggests that the addition of low-fidelity simulation-based training to a standard didactic-based curriculum is beneficial in improving resident knowledge, confidence, and tested performance of common CT-guided procedures. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Preliminary radiological safety assessment for decommissioning of thoria dissolver of the ²³³U pilot plant, Trombay.

PubMed

Priya, S; Srinivasan, P; Gopalakrishnan, R K

2012-01-01

The thoria dissolver, used for separation of (233)U from reactor-irradiated thorium metal and thorium oxide rods, is no longer operational. It was decided to carry out assessment of the radiological status of the dissolver cell for planning of the future decommissioning/dismantling operations. The dissolver interiors are expected to be contaminated with the dissolution remains of irradiated thorium oxide rods in addition to some of the partially dissolved thoria pellets. Hence, (220)Rn, a daughter product of (228)Th is of major radiological concern. Airborne activity of thoron daughters (212)Pb (Th-B) and (212)Bi (Th-C) was estimated by air sampling followed by high-resolution gamma spectrometry of filter papers. By measuring the full-energy peaks counts in the energy windows of (212)Pb, (212)Bi and (208)Tl, concentrations of thoron progeny in the sampled air were estimated by applying the respective intrinsic peak efficiency factors and suitable correction factors for the equilibration effects of (212)Pb and (212)Bi in the filter paper during the delay between sampling and counting. Then the thoron working level (TWL) was evaluated using the International Commission on Radiological Protection (ICRP) methodology. Finally, the potential effective dose to the workers, due to inhalation of thoron and its progeny during dismantling operations was assessed by using dose conversion factors recommended by ICRP. Analysis of filter papers showed a maximum airborne thoron progeny concentration of 30 TWLs inside the dissolver.

Distribution of scholarly publications among academic radiology departments.

PubMed

Morelli, John N; Bokhari, Danial

2013-03-01

The aim of this study was to determine whether the distribution of publications among academic radiology departments in the United States is Gaussian (ie, the bell curve) or Paretian. The search affiliation feature of the PubMed database was used to search for publications in 3 general radiology journals with high Impact Factors, originating at radiology departments in the United States affiliated with residency training programs. The distribution of the number of publications among departments was examined using χ(2) test statistics to determine whether it followed a Pareto or a Gaussian distribution more closely. A total of 14,219 publications contributed since 1987 by faculty members in 163 departments with residency programs were available for assessment. The data acquired were more consistent with a Pareto (χ(2) = 80.4) than a Gaussian (χ(2) = 659.5) distribution. The mean number of publications for departments was 79.9 ± 146 (range, 0-943). The median number of publications was 16.5. The majority (>50%) of major radiology publications from academic departments with residency programs originated in <10% (n = 15 of 178) of such departments. Fifteen programs likewise produced no publications in the surveyed journals. The number of publications in journals with high Impact Factors published by academic radiology departments more closely fits a Pareto rather than a normal distribution. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

RADIOPROTECTION CAMPAIGN AND CARD: EDUCATIONAL STRATEGIES THAT REDUCE CHILDREN'S EXCESSIVE EXPOSURE TO RADIOLOGICAL EXAMS.

PubMed

Bernardo, Mônica Oliveira; Almeida, Fernando Antonio de; Morgado, Flavio

2017-01-01

To analyze the results of an initiative aimed at improving the reasonable use of radiological examinations, ensuring their technical quality, implementing a radioprotection campaign that includes training of the professional team, and introducing the radioprotection card for children under 12 years old as a tool for parents and doctors to control children's exposure to radiation. The study was held in a health care insurance system covering 140,000 people. A radioprotection campaign was implemented according to Image Gently • protocols, ensuring the lowest dose of radiation and the quality of examinations, and the radioprotection card was implemented. To assess the effectiveness of these actions, the number of radiological examinations performed at the pediatric emergency room in a period of one year preceding the campaign was compared with the number of radiological examinations performed one year after the campaign. The campaign was well accepted by all professionals, families, and patients involved. In the year following the implementation of radioprotection strategies, there was a 22% reduction of radiological examinations performed at the pediatric emergency room. There was also a 29% reduction in the request of two or more radiological examinations for the same child or examinations with two or more incidences. The campaign and the radioprotection card for children under 12 years old proved to be feasible strategies and correlated with a reduction in radiological examinations requested and performed at the pediatric emergency room.

The American Board of Radiology Maintenance of Certification (MOC) Program in Radiologic Physics

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

Thomas, Stephen R.; Hendee, William R.; Paliwal, Bhudatt R.

2005-01-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document the professional development of each diplomate of The American Board of Radiology (ABR) through its focus on the essential elements of quality care in Diagnostic Radiology and its subspecialties, and in the specialties of Radiation Oncology and Radiologic Physics. The initial elements of the ABR-MOC have been developed in accord with guidelines of The American Board of Medical Specialties. All diplomates with a ten-year,more » time-limited primary certificate in Diagnostic Radiologic Physics, Therapeutic Radiologic Physics, or Medical Nuclear Physics who wish to maintain certification must successfully complete the requirements of the appropriate ABR-MOC program for their specialty. Holders of multiple certificates must meet ABR-MOC requirements specific to the certificates held. Diplomates with lifelong certificates are not required to participate in the MOC, but are strongly encouraged to do so. MOC is based on documentation of individual participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Within these components, MOC addresses six competencies: medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice.« less

Nevada National Security Site Radiological Control Manual

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

Radiological Control Managers’ Council

2012-03-26

This document supersedes DOE/NV/25946--801, 'Nevada Test Site Radiological Control Manual,' Revision 1 issued in February 2010. Brief Description of Revision: A complete revision to reflect a recent change in name for the NTS; changes in name for some tenant organizations; and to update references to current DOE policies, orders, and guidance documents. Article 237.2 was deleted. Appendix 3B was updated. Article 411.2 was modified. Article 422 was re-written to reflect the wording of DOE O 458.1. Article 431.6.d was modified. The glossary was updated. This manual contains the radiological control requirements to be used for all radiological activities conducted bymore » programs under the purview of the U.S. Department of Energy (DOE) and the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO). Compliance with these requirements will ensure compliance with Title 10 Code of Federal Regulations (CFR) Part 835, 'Occupational Radiation Protection.' Programs covered by this manual are located at the Nevada National Security Site (NNSS); Nellis Air Force Base and North Las Vegas, Nevada; Santa Barbara and Livermore, California; and Andrews Air Force Base, Maryland. In addition, fieldwork by NNSA/NSO at other locations is covered by this manual. Current activities at NNSS include operating low-level radioactive and mixed waste disposal facilities for United States defense-generated waste, assembly and execution of subcritical experiments, assembly/disassembly of special experiments, the storage and use of special nuclear materials, performing criticality experiments, emergency responder training, surface cleanup and site characterization of contaminated land areas, environmental activity by the University system, and nonnuclear test operations, such as controlled spills of hazardous materials at the Hazardous Materials Spill Center. Currently, the major potential for occupational radiation exposure is associated with the burial of low-level radioactive waste and the handling of radioactive sources. Remediation of contaminated land areas may also result in radiological exposures.« less

Osteoporosis

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

Riggs, B.L. Melton III, L.J.

This book contains 20 chapters. Some of the titles are: Radiology of asteoporosis; Quantitative computed tomography in assessment of osteoporosis; Nuclear medicine and densitometry; Assessment of bone turnover by histormorphometry in osteoporosis; and The biochemistry of bone.

Teaching medical management and operations engineering for systems-based practice to radiology residents.

PubMed

Brandon, Catherine J; Mullan, Patricia B

2013-03-01

To better prepare radiology residents for providing care within the context of the larger health care system, this study evaluated the feasibility and impact of a curriculum to enhance radiology residents' understanding and ability to apply concepts from medical management and industrial and operational engineering to systems-based practice problems in radiology practice. A multiprofessional team including radiology, medical education, and industrial and operational engineering professionals collaborated in developing a seven-module curriculum, including didactic lectures, interactive large-group analysis, and small-group discussions with case-based radiology examples, which illustrated real-life management issues and the roles physicians held. Residents and faculty participated in topic selection. Pre- and post-instruction formative assessments were administered, and results were shared with residents during teaching sessions. Attendance and participation in case-based scenario resolutions indicate the feasibility and impact of the interactive curriculum on residents' interest and ability to apply curricular concepts to systems-based practice in radiology. Paired t test analyses (P < .05) and effect sizes showed residents significantly increased their knowledge and ability to apply concepts to systems-based practice issues in radiology. Our iterative curriculum development and implementation process demonstrated need and support for a multiprofessional team approach to teach management and operational engineering concepts. Curriculum topics are congruent with Accreditation Council for Graduate Medical Education requirements for systems-based practice. The case-based curriculum using a mixed educational format of didactic lectures and small-group discussion and problem analysis could be adopted for other radiology programs, for both residents and continuing medical education applications. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Association between bacterial infection and radiologically confirmed pneumonia among children.

PubMed

Nascimento-Carvalho, Cristiana M; Araújo-Neto, César A; Ruuskanen, Olli

2015-05-01

The role of chest radiograph (CXR) among children with community-acquired pneumonia is controversial. We aimed to assess if there is association between a specific etiology and radiologically confirmed pneumonia. This was a prospective cross-sectional study. Based on report of respiratory complaints and fever/difficulty breathing plus the detection of pulmonary infiltrate/pleural effusion on the CXR taken upon admission read by the pediatrician on duty, children <5-year-old hospitalized with community-acquired pneumonia were enrolled. On admission, clinical data and biological samples were collected to investigate 19 etiological agents (11 viruses and 8 bacteria). CXR taken upon admission was independently read by a pediatric radiologist blinded to clinical data. The study group comprised 209 cases with evaluated CXR and establishment of a probable etiology. Radiologically confirmed pneumonia, normal CXR and other radiographic diagnoses were described for 165 (79.0%), 36 (17.2%) and 8 (3.8%) patients, respectively. Viral infection was significantly more common among patients without radiologically confirmed pneumonia (68.2% vs. 47.9%; P = 0.02), particularly among those with normal CXR (66.7% vs. 47.9%; P = 0.04) when compared with patients with radiologically confirmed pneumonia. Bacterial infection was more frequent among cases with radiologically confirmed pneumonia (52.1% vs. 31.8%; P = 0.02). Likewise, pneumococcal infection was more frequently detected among children with radiologically confirmed pneumonia in regard to children with normal CXR (24.2% vs. 8.3%; P = 0.04). Sensitivity (95% confidence interval) of radiologically confirmed pneumonia for pneumococcal infection was 93% (80-98%), and negative predictive value (95% confidence interval) of normal CXR for pneumococcal infection was 92% (77-98%). Bacterial infection, especially pneumococcal one, is associated with radiologically confirmed pneumonia.

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.

Emergency Department Patient Perceptions of Transvaginal Ultrasound for Complications of First-Trimester Pregnancy.

PubMed

Panebianco, Nova; Shofer, Frances; O'Conor, Katie; Wihbey, Tristan; Mulugeta, Lakeisha; Baston, Cameron M; Suzuki, Evan; Alghamdi, Adel; Dean, Anthony

2018-01-30

Emergency department (ED) transvaginal ultrasound (US) is underused in clinical practice. This study assessed pregnant women's perceptions of ED transvaginal US in terms of pain, embarrassment, anxiety, and willingness to receive the procedure. Secondary variables include physicians' perceptions of patients' experiences. Women undergoing US examinations for complications of first-trimester pregnancy were prospectively surveyed before any US and after ED and/or radiology transvaginal US. Patients' and physicians' assessments of pain, embarrassment, and anxiety were measured with visual analog scales (0-100). A total of 398 women were enrolled. In the pre-US survey, the median anxiety score was 14 (interquartile range, 3-51), and 96% of patients were willing to have an ED transvaginal US if necessary. Of those who had ED transvaginal US, 96% would agree to have another examination. Patients reported minimal pain/embarrassment, and there was no difference if performed in the ED versus radiology (median pain, 11.5 versus 13; P = .433; median embarrassment, 7 versus 4; P = .345). Of the 48 who had both ED and radiology transvaginal US, 85% thought the ED transvaginal US was worthwhile. Physicians accurately assessed patient's embarrassment and pain (mean differences, 3.5 and -1.9, respectively; P > .25 for both); however, they overestimated them relative to the pelvic examination (mean difference for embarrassment, 12.8; P < .0001; pain, 8.0; P = .01). Pregnant ED patients report low levels of anxiety, pain, and embarrassment, and after ED transvaginal US, 96% would agree to have the examination again. There is no difference in pain/embarrassment between ED and radiology transvaginal US. Emergency department physicians accurately assessed patients' pain and embarrassment with ED transvaginal US but overestimated them compared to the pelvic examination. © 2018 by the American Institute of Ultrasound in Medicine.

Finite-element three-dimensional ground-water (FE3DGW) flow model - formulation, program listings and users' manual

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

Gupta, S.K.; Cole, C.R.; Bond, F.W.

1979-12-01

The Assessment of Effectiveness of Geologic Isolation Systems (AEGIS) Program is developing and applying the methodology for assessing the far-field, long-term post-closure safety of deep geologic nuclear waste repositories. AEGIS is being performed by Pacific Northwest Laboratory (PNL) under contract with the Office of Nuclear Waste Isolation (OWNI) for the Department of Energy (DOE). One task within AEGIS is the development of methodology for analysis of the consequences (water pathway) from loss of repository containment as defined by various release scenarios. Analysis of the long-term, far-field consequences of release scenarios requires the application of numerical codes which simulate the hydrologicmore » systems, model the transport of released radionuclides through the hydrologic systems to the biosphere, and, where applicable, assess the radiological dose to humans. Hydrologic and transport models are available at several levels of complexity or sophistication. Model selection and use are determined by the quantity and quality of input data. Model development under AEGIS and related programs provides three levels of hydrologic models, two levels of transport models, and one level of dose models (with several separate models). This document consists of the description of the FE3DGW (Finite Element, Three-Dimensional Groundwater) Hydrologic model third level (high complexity) three-dimensional, finite element approach (Galerkin formulation) for saturated groundwater flow.« less

Skeletal and radiological manifestations of child abuse: Implications for study in past populations.

PubMed

Ross, Ann H; Juarez, Chelsey A

2016-10-01

Child abuse in its various types such as physical, emotional, sexual, and neglect has been document throughout history. However, before the mid-20th century, inflicted injuries to children was overlooked in part because children were often viewed as property. According to the World Health Organization, 57,000 children were the victims of homicide in the year 2000. In this paper we present the skeletal and radiological manifestation of physical abuse and fatal neglect and provide recommendations to assess child maltreatment from past populations. Pediatric biomechanical factors and healing are discussed as it is important to keep in mind that children are not just small adults. Skeletal and radiological indicators of nonaccidental or inflicted injuries are reviewed from the literature. Inflicted injuries are presented based on specificity to identify child abuse. In addition, skeletal indicators that could help assess fatal starvation are also reviewed and metabolic diseases are proposed as potential evidence of neglect. A recent child homicide is presented and used to illustrate the difficulty in assessing child maltreatment. Present-day clinical child abuse protocols are used to provide recommendations to assess child abuse in a bioarchaeological context. Clin. Anat. 29:844-853, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Automatically pairing measured findings across narrative abdomen CT reports.

PubMed

Sevenster, Merlijn; Bozeman, Jeffrey; Cowhy, Andrea; Trost, William

2013-01-01

Radiological measurements are one of the key variables in widely adopted guidelines (WHO, RECIST) that standardize and objectivize response assessment in oncology care. Measurements are typically described in free-text, narrative radiology reports. We present a natural language processing pipeline that extracts measurements from radiology reports and pairs them with extracted measurements from prior reports of the same clinical finding, e.g., lymph node or mass. A ground truth was created by manually pairing measurements in the abdomen CT reports of 50 patients. A Random Forest classifier trained on 15 features achieved superior results in an end-to-end evaluation of the pipeline on the extraction and pairing task: precision 0.910, recall 0.878, F-measure 0.894, AUC 0.988. Representing the narrative content in terms of UMLS concepts did not improve results. Applications of the proposed technology include data mining, advanced search and workflow support for healthcare professionals managing radiological measurements.

Collaborative learning in radiologic science education.

PubMed

Yates, Jennifer L

2006-01-01

Radiologic science is a complex health profession, requiring the competent use of technology as well as the ability to function as part of a team, think critically, exercise independent judgment, solve problems creatively and communicate effectively. This article presents a review of literature in support of the relevance of collaborative learning to radiologic science education. In addition, strategies for effective design, facilitation and authentic assessment of activities are provided for educators wishing to incorporate collaborative techniques into their program curriculum. The connection between the benefits of collaborative learning and necessary workplace skills, particularly in the areas of critical thinking, creative problem solving and communication skills, suggests that collaborative learning techniques may be particularly useful in the education of future radiologic technologists. This article summarizes research identifying the benefits of collaborative learning for adult education and identifying the link between these benefits and the necessary characteristics of medical imaging technologists.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

A Mars Science Laboratory cap is displayed in the Randall E. Scott Radiological Control Center at NASA's Kennedy Space Center. The facility was recently named in honor of Randy Scott, a professional health physicist of more than 40 years. He served as the Florida spaceport's Radiation Protection Officer for 14 years until his death June 17, 2016. Launched Nov. 26, 2011, the Mars Science Laboratory with the Curiosity lander was powered by a radioisotope thermalelectric generator. Located in the Neil Armstrong Operations and Checkout building, the Randall E. Scott Radiological Control Center is staffed by technical and radiological experts from NASA, the U.S. Department of Energy, the U.S. Air Force 45th Space Wing and the state of Florida. The group performs data collection and assessment functions supporting launch site and field data collection activities during launces involving plutonium-powered spacecraft such as the Mars Science Laboratory.

Fast Running Urban Dispersion Model for Radiological Dispersal Device (RDD) Releases: Model Description and Validation

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

Gowardhan, Akshay; Neuscamman, Stephanie; Donetti, John

Aeolus is an efficient three-dimensional computational fluid dynamics code based on finite volume method developed for predicting transport and dispersion of contaminants in a complex urban area. It solves the time dependent incompressible Navier-Stokes equation on a regular Cartesian staggered grid using a fractional step method. It also solves a scalar transport equation for temperature and using the Boussinesq approximation. The model also includes a Lagrangian dispersion model for predicting the transport and dispersion of atmospheric contaminants. The model can be run in an efficient Reynolds Average Navier-Stokes (RANS) mode with a run time of several minutes, or a moremore » detailed Large Eddy Simulation (LES) mode with run time of hours for a typical simulation. This report describes the model components, including details on the physics models used in the code, as well as several model validation efforts. Aeolus wind and dispersion predictions are compared to field data from the Joint Urban Field Trials 2003 conducted in Oklahoma City (Allwine et al 2004) including both continuous and instantaneous releases. Newly implemented Aeolus capabilities include a decay chain model and an explosive Radiological Dispersal Device (RDD) source term; these capabilities are described. Aeolus predictions using the buoyant explosive RDD source are validated against two experimental data sets: the Green Field explosive cloud rise experiments conducted in Israel (Sharon et al 2012) and the Full-Scale RDD Field Trials conducted in Canada (Green et al 2016).« less

How are the costs of care for medical falls distributed? The costs of medical falls by component of cost, timing, and injury severity.

PubMed

Bohl, Alex A; Phelan, Elizabeth A; Fishman, Paul A; Harris, Jeffrey R

2012-10-01

To examine the components of cost that drive increased total costs after a medical fall over time, stratified by injury severity. We used 2004-2007 cost and utilization data for persons enrolled in an integrated care delivery system. We used a longitudinal cohort study design, where each individual provides 2-3 years of administrative data grouped into 3-month intervals relative to an index date. We identified 8,969 medical fallers through International Classification of Diseases, 9th Revision, codes and E-Codes and used 8,956 nonfaller controls, identified through age and gender frequency matching. Total costs were partitioned into 7 components: inpatient, outpatient, emergency, radiology, pharmacy, postacute care, and "other." The large increase in costs after a hospitalized fall is mainly associated with inpatient and postacute care components. The spike in costs after a nonhospitalized fall is attributable to outpatient and "other" (e.g., ambulatory surgery or community health services) components. Hospitalized fallers' inpatient, emergency, postacute care, outpatient, and radiology costs are not always greater than those for nonhospitalized fallers. Components associated with increased costs after a medical fall vary over time and by injury severity. Future studies should compare if delivering certain acute and postacute health services improve health and reduce cost trajectories after a medical fall more than others. Additionally, since the older adult population and the problem of falls are growing, health care delivery systems should develop standardized methodology to monitor medical fall rates.

Radiological assessment of the sinus tympani: temporal bone HRCT analyses and surgically related findings.

PubMed

Marchioni, Daniele; Valerini, Sara; Mattioli, Francesco; Alicandri-Ciufelli, Matteo; Presutti, Livio

2015-05-01

To evaluate the morphology of the sinus tympani (ST) based on computed tomography (CT) scans (axial view), describing the findings in a cohort of 148 patients (296 ears), and classifying the prevalence according to our ST classification. To evaluate the surgical prevalence based on the type of ST. To calculate the sensibility and positive predictive value (PPV) of high-resolution computed tomography (HRCT) scans for ST involvement by cholesteatoma. Retrospective review of the radiologic database and surgical reports. In total, 98/296 (33.1%) middle ears presented a radiologic morphology Type A; 185/296 (62.5%) middle ears presented a radiologic morphology Type B; 13/296 (4.4%) middle ears presented a radiologic morphology Type C; HRCT showed a sensibility of 91%, specificity of 65%, PPV of 68% and negative predictive value (NPV) of 90%. ST shape and depth can influence surgical preference in cholesteatoma surgery. In the case of a shallower ST, an exclusive endoscopic exploration is chosen; whereas in the case of a deeper ST, a retrofacial approach is usually preferred. HRCT scans demonstrated high sensibility and NPV for ST involvement by cholesteatoma.

How Turkish radiology residents access information related to their profession in this social media and smartphone era.

PubMed

Ozutemiz, Can; Dicle, Oguz; Koremezli, Nevin

2015-01-01

To evaluate the frequency of mobile technology and social media usage among radiology residents and their access to professional information. A questionnaire consisting of 24 questions prepared using Google Drive was sent via e-mail to 550 radiology residents throughout the country. Of the 176 participating residents, 74 completed the survey via the internet, and 102 completed it at three different national radiology meetings. Response rates and its relationship with responses given to different questions were assessed. Hundred two male and 74 female residents participated in the survey. 141 (81.3%) residents thought that they had appropriate internet access in their department. The number of residents using a smartphone was 153 (86.9%). The android operating system (70, 45.8%) was the preferred operating system of respondants. Only 24 (15.7%) of the smartphone users thought that there were enough radiology related applications. "Radiology assistant" (18.9%), "Radiopedia" (7.8%) and "Radiographics" (7.8%) were the most utilized applications. Of the smartphone users, 87(56.9%) stated that they used cell phones in order to find radiological information, and the most used web pages were Google (165, 93.8%), Radiopaedia.org (129, 73.3%), Radiologyassistant.nl (135, 76.7%), and Pubmed (114, 64.8%). Social media usages were as follows: None (10, 5.7%), Facebook (139, 79%), Twitter (55, 31.3%), Google + (51, 29%) and YouTube (44, 25%). While smartphone usage rates among the residents were high, the use of radiology specific applications was not common. Social media usage was very common among residents.

Relationship Between Dental Hygiene Students' Performance in an Oral Radiology Course and the National Board Dental Hygiene Examination: A Retrospective Study.

PubMed

Liang, Hui; DeWald, Janice P; Solomon, Eric S

2018-02-01

Dental hygiene students' performance in oral radiology courses may give an early indication of their readiness prior to taking the National Board Dental Hygiene Examination (NBDHE). The aim of this study was to determine the relationship between dental hygiene students' performance in an oral radiology lecture course and their performance on the NBDHE. Data were collected for all 117 dental hygiene students at Texas A&M University College of Dentistry from 2006 to 2009 who took the NBDHE during their second year of the program. Their final grades and scores on three written section examinations in an oral radiology course taken in their first year were compared with their overall NBDHE scores and raw scores on the oral radiology and case study sections. Moderate correlations (0.3

Data analysis and review of radiology services at Glasgow 2014 Commonwealth Games.

PubMed

Bethapudi, Sarath; Ritchie, David; Bongale, Santosh; Gordon, Jonny; MacLean, John; Mendl, Liz

2015-10-01

Medical services at the Glasgow 2014 Commonwealth Games (CWG) were provided though a purpose-built medical polyclinic, which had a fully equipped radiology department along with other services, set up within the main Games Village. Data analysis of radiology services offered at CWG has not been published before. Imaging services within the polyclinic, Athletes Village, Glasgow 2014 CWG. The aim of the paper is to analyse data on radiological investigations and assess the demand and distribution of workload on imaging services at CWG 2014. Data on radiology investigations at the CWG 2014 was retrieved from the Carestream picture archiving and communication system (PACS) and Pharmasys (CWG official centralised electronic database system) and analysed. Six hundred ninety-seven diagnostic and interventional procedures were performed. Of these 37.9% were magnetic resonance imaging (MRI) scans, 22% were diagnostic ultrasound (US) examinations, 33.1% were radiographs, 4.3% were computed tomography (CT) scans and 2.7% were imaging-guided interventional procedures. 88% of imaging was performed on athletes and the remainder were performed on team officials and workforce. Demand on radiology services gradually picked up through the pre-competition period and peaked half way through the CWG. Radiology played a vital role in the successful provision of medical services at the Glasgow 2014 CWG. High demand on imaging services can be expected at major international sporting events and therefore pre-event planning is vital. Having back-up facilities in case of technical failure should be given due importance when planning radiology services at future CWG events.

Experimental Approaches to Assessing the Impact of a ...

EPA Pesticide Factsheets

Symposium Paper The US EPA, as part of the CRTI project team, is currently working to assess the impacts of an urban radiological dispersion device (RDD) and develop containment and decontamination strategies.

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.

A filmless radiology department in a full digital regional hospital: quantitative evaluation of the increased quality and efficiency.

PubMed

Nitrosi, Andrea; Borasi, Giovanni; Nicoli, Franco; Modigliani, Gino; Botti, Andrea; Bertolini, Marco; Notari, Pietro

2007-06-01

Reggio Emilia hospital installed Picture Archiving and Communications Systems (PACS) as the final step towards a completely digital clinical environment completing the HIS/EMR and 1,400 web/terminals for patient information access. Financial benefits throughout the hospital were assessed upfront and measured periodically. Key indicators (radiology exam turnaround time, number of radiology procedures performed, inpatients length of stay before and after the PACS implementation, etc.) were analyzed and values were statistically tested to assess workflow and productivity improvements. The hospital went "filmless" in 28 weeks. Between the half of 2004 and the respective period in 2003, overall Radiology Department productivity increased by 12%, TAT improved by more than 60%. Timelier patient care resulted in decreased lengths of stay. Neurology alone experienced a 12% improvement in average patient stay. To quantify the impact of PACS on the average hospital stays and the expected productivity benefits to inpatient productivity were used a "high level" and a "detailed" business model. Annual financial upsides have exceeded $1.9 millions/year. A well-planned PACS deployment simplifies imaging workflow and improves patient care throughout the hospital while delivering substantial financial benefits. Staff buy-in was the key in this process and on-going training and process monitoring are a must.

Brain Tumor Database, a free relational database for collection and analysis of brain tumor patient information.

PubMed

Bergamino, Maurizio; Hamilton, David J; Castelletti, Lara; Barletta, Laura; Castellan, Lucio

2015-03-01

In this study, we describe the development and utilization of a relational database designed to manage the clinical and radiological data of patients with brain tumors. The Brain Tumor Database was implemented using MySQL v.5.0, while the graphical user interface was created using PHP and HTML, thus making it easily accessible through a web browser. This web-based approach allows for multiple institutions to potentially access the database. The BT Database can record brain tumor patient information (e.g. clinical features, anatomical attributes, and radiological characteristics) and be used for clinical and research purposes. Analytic tools to automatically generate statistics and different plots are provided. The BT Database is a free and powerful user-friendly tool with a wide range of possible clinical and research applications in neurology and neurosurgery. The BT Database graphical user interface source code and manual are freely available at http://tumorsdatabase.altervista.org. © The Author(s) 2013.

Assessing the possible radiological impact of routine radiological discharges from proposed nuclear power stations in England and Wales.

PubMed

Jones, Alison; Jones, Kelly; Holmes, Sheila; Ewers, Leon; Cabianca, Tiberio

2013-03-01

The aim of this work is to assess the possible radiological impact on the population of the United Kingdom (UK) from new nuclear power stations proposed for up to eight sites in England and Wales. The radiological impact was measured in terms of collective dose to the UK, European and world populations from a single year's discharge integrated to 500 and 100 000 years and the annual dose to an average member of the UK population (known as the per-caput dose). The doses were calculated for two reactor types, UK EPR™ and AP1000™, using the annual expected discharges estimated by the designers of the reactors and assuming two reactors per site. In addition, typical individual doses to adults living close to the sites were calculated on the basis of continuous discharges for 60 years (the assumed lifetime of the reactors). The dose to a representative person (previously known as the critical group) was not calculated, as this has been done elsewhere. The assessments were carried out using the software program PC-CREAM 08(®) which implements the updated European Commission methodology for assessing the radiological impact of routine releases of radionuclides to the environment. The collective dose truncated to 500 years to the UK population was estimated to be 0.5 manSv assuming UK EPR reactors on all sites and 0.6 manSv assuming AP1000s on three sites with UK EPRs on the other sites. The most significant contribution to the collective dose to the UK population is due to the global circulation of carbon-14 released to the atmosphere. The annual dose to an average member of the UK population from all sites was calculated to be around 10 nSv y(-1) and would therefore contribute little to an individual's total radiation dose. All the calculated doses to a typical adult living near the sites assuming continuous discharges for 60 years were found to be below 1 μSv y(-1).

Assessing the Gap in Female Authorship in Radiology: Trends Over the Past Two Decades.

PubMed

Liang, Teresa; Zhang, Cathy; Khara, Rohan M; Harris, Alison C

2015-07-01

The aim of this study was to retrospectively identify trends in the representation of female authorship in prominent general radiology journals over the past 2 decades. A comprehensive search was conducted for all articles published in 1993, 2003, and 2013 in Radiology, the American Journal of Roentgenology (AJR), European Radiology, and Investigative Radiology. The genders of the first and last authors were collected. Chi-square tests were used for statistical analysis, and P values < .05 were considered to indicate statistical significance. A total of 3,786 articles were reviewed. Overall, women constituted 20.0% authorship, 24.7% of first authors, and 15.2% of senior authors. The average overall female first and senior authorship grew from 19.7% to 32.1% and from 13.6% to 19.1%, respectively from 1993 to 2013. Female first authorship grew over the past 2 decades in the journals reviewed, with significant growth in AJR and Radiology (P < .0001). Female first authorship in the individual journals grew from 16.4%-29.1% in 1993, to 29.1%-34.8% in 2013. Female senior authorship also demonstrated growth in the past 2 decades, growing from 4.3%-17.5% in 1993 to 15.5%-23.2% in 2013. There was significant growth in senior female authorship in Radiology (from 12.1% to 19.2%, P = .004) and European Radiology (from 4.3% to 15.5%, P = .0433). Female senior authorship remained significantly lower than first authorship over the past 2 decades (P = .002, P < .001, and P < .0001). Although women's growth in first authorship in radiology literature is proportional to their growth in the specialty, they continue to remain a minority, especially in senior authorship, and demonstrate similar participation to other medical specialties. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Methodology, status and plans for development and assessment of Cathare code

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

Bestion, D.; Barre, F.; Faydide, B.

1997-07-01

This paper presents the methodology, status and plans for the development, assessment and uncertainty evaluation of the Cathare code. Cathare is a thermalhydraulic code developed by CEA (DRN), IPSN, EDF and FRAMATOME for PWR safety analysis. First, the status of the code development and assessment is presented. The general strategy used for the development and the assessment of the code is presented. Analytical experiments with separate effect tests, and component tests are used for the development and the validation of closure laws. Successive Revisions of constitutive laws are implemented in successive Versions of the code and assessed. System tests ormore » integral tests are used to validate the general consistency of the Revision. Each delivery of a code Version + Revision is fully assessed and documented. A methodology is being developed to determine the uncertainty on all constitutive laws of the code using calculations of many analytical tests and applying the Discrete Adjoint Sensitivity Method (DASM). At last, the plans for the future developments of the code are presented. They concern the optimization of the code performance through parallel computing - the code will be used for real time full scope plant simulators - the coupling with many other codes (neutronic codes, severe accident codes), the application of the code for containment thermalhydraulics. Also, physical improvements are required in the field of low pressure transients and in the modeling for the 3-D model.« less

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.

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures.

PubMed

López, P Ortiz; Dauer, L T; Loose, R; Martin, C J; Miller, D L; Vañó, E; Doruff, M; Padovani, R; Massera, G; Yoder, C

2018-03-01

In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

Hands-on Physics Education of Residents in Diagnostic Radiology.

PubMed

Zhang, Jie; Hardy, Peter A; DiSantis, David J; Oates, M Elizabeth

2017-06-01

The American Board of Radiology Core Examination integrates assessment of physics knowledge into its overall testing of clinical radiology, with an emphasis on understanding image quality and artifacts, radiation dose, and patient safety for each modality or subspecialty organ system. Accordingly, achieving a holistic approach to physics education of radiology residents is a huge challenge. The traditional teaching of radiological physics-simply through didactic lectures-was not designed for such a holistic approach. Admittedly, time constraints and clinical demands can make incorporation of physics teaching into clinical practice problematic. We created and implemented a week-long, intensive physics rotation for fledgling radiology residents and evaluated its effectiveness. The dedicated physics rotation is held for 1 week during the first month of radiology residency. It comprises three components: introductory lectures, hands-on practical clinical physics operations, and observation of clinical image production. A brief introduction of the physics pertinent to each modality is given at the beginning of each session. Hands-on experimental demonstrations are emphasized, receiving the greatest allotment of time. The residents perform experiments such as measuring radiation dose, studying the relationship between patient dose and clinical practice (eg, fluoroscopy technique), investigating the influence of acquisition parameters (kV, mAs) on radiographs, and evaluating image quality using computed tomography, magnetic resonance imaging, ultrasound, and gamma camera/single-photon emission computed tomography/positron emission tomography phantoms. Quantitative assessment of the effectiveness of the rotation is based on an examination that tests the residents' grasp of basic medical physics concepts along with written course evaluations provided by each resident. The pre- and post-rotation tests show that after the physics rotation, the average correct score of 25 questions improved from 13.6 ± 2.4 to 19 ± 1.2. The survey shows that the physics rotation during the first week of residency is favored by all residents and that 1 week's duration is appropriate. All residents are of the opinion that the intensive workshop would benefit them in upcoming clinical rotations. Residents acknowledge becoming more comfortable regarding the use of radiation and providing counsel regarding radiation during pregnancy. An immersive, short-duration, clinically oriented physics rotation is well received by new or less experienced radiology trainees, correlates basic physics concepts with their relevance to clinical imaging, and more closely parallels expectations of the American Board of Radiology Core Examination. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Pinworm infection masquerading as colorectal liver metastasis.

PubMed

Roberts, K J; Hubscher, S; Mangat, K; Sutcliffe, R; Marudanayagam, R

2012-09-01

Enterobius vermicularis is responsible for a variety of diseases but rarely affects the liver. Accurate characterisation of suspected liver metastases is essential to avoid unnecessary surgery. In the presented case, following a diagnosis of rectal cancer, a solitary liver nodule was diagnosed as a liver metastasis due to typical radiological features and subsequently resected. At pathological assessment, however, a necrotic nodule containing E. vermicularis was identified. Solitary necrotic nodules of the liver are usually benign but misdiagnosed frequently as malignant due to radiological features. It is standard practice to diagnose colorectal liver metastases solely on radiological evidence. Without obtaining tissue prior to liver resection, misdiagnosis of solitary necrotic nodules of the liver will continue to occur.

Pinworm infection masquerading as colorectal liver metastasis

PubMed Central

Roberts, KJ; Hubscher, S; Mangat, K; Sutcliffe, R; Marudanayagam, R

2012-01-01

Enterobius vermicularis is responsible for a variety of diseases but rarely affects the liver. Accurate characterisation of suspected liver metastases is essential to avoid unnecessary surgery. In the presented case, following a diagnosis of rectal cancer, a solitary liver nodule was diagnosed as a liver metastasis due to typical radiological features and subsequently resected. At pathological assessment, however, a necrotic nodule containing E vermicularis was identified. Solitary necrotic nodules of the liver are usually benign but misdiagnosed frequently as malignant due to radiological features. It is standard practice to diagnose colorectal liver metastases solely on radiological evidence. Without obtaining tissue prior to liver resection, misdiagnosis of solitary necrotic nodules of the liver will continue to occur. PMID:22943320

Radiological impact of airborne effluents of coal and nuclear plants.

PubMed

McBride, J P; Moore, R E; Witherspoon, J P; Blanco, R E

1978-12-08

Radiation doses from airborne effluents of model coal-fired and nuclear power plants (1000 megawatts electric) are compared. Assuming a 1 percent ash release to the atmosphere (Environmental Protection Agency regulation) and 1 part per million of uranium and 2 parts per million of thorium in the coal (approximately the U.S. average), population doses from the coal plant are typically higher than those from pressurized-water or boiling-water reactors that meet government regulations. Higher radionuclide contents and ash releases are common and would result in increased doses from the coal plant. The study does not assess the impact of non-radiological pollutants or the total radiological impacts of a coal versus a nuclear economy.

Radiology Physician Extenders: A Literature Review of the History and Current Roles of Physician Extenders in Medical Imaging.

PubMed

Sanders, Vicki L; Flanagan, Jennifer

2015-01-01

The purpose of the literature review was to assess the origins of radiology physician extenders and examine the current roles found in the literature of advanced practice physician extenders within medical imaging. Twenty-six articles relating to physician assistants (PAs), nurse practitioners (NPs), radiologist assistants (RAs), and nuclear medicine advanced associates (NMAAs) were reviewed to discern similarities and differences in history, scope of practice, and roles in the medical imaging field. The literature showed PAs and NPs are working mostly in interventional radiology. PAs, NPs, and RAs perform similar tasks in radiology, including history and physicals, evaluation and management, preprocedure work-up, obtaining informed consent, initial observations/reports, and post-procedure follow-up. NPs and PAs perform a variety of procedures but most commonly vascular access, paracentesis, and thoracentesis. RAs perform gastrointestinal, genitourinary, nonvascular invasive fluoroscopy procedures, and vascular access procedures. The review revealed NMAAs are working in an advanced role, but no specific performances of procedures was found in the literature, only suggested tasks and clinical competencies. PAs, NPs, and RAs are currently the three main midlevel providers used in medical imaging. These midlevel providers are being used in a variety of ways to increase the efficiency of the radiologist and provide diagnostic and therapeutic radiologic procedures to patients. NMAAs are being used in medical imaging but little literature is available on current roles in clinical practice. More research is needed to assess the exact procedures and duties being performed by these medical imaging physician extenders.

Radiology resident dictation instruction: effectiveness of the didactic lecture.

PubMed

Woodfield, Courtney A; Mainiero, Martha B

2008-07-01

The study's purpose was to determine the effectiveness of a didactic lecture for teaching and evaluating radiology resident dictation skills. A 23-question test was created to assess resident knowledge of the American College of Radiology practice guidelines for reporting and our institution-specific requirements for communication of diagnostic imaging results. The test was administered to 23 residents before and after a 40-minute didactic lecture covering the structure of radiology reports and requirements for communication of imaging findings. The pre- and postlecture tests were graded on the basis of the number of correct answers. Data were analyzed using the mixed linear model for repeated measures and the Holm test for group comparisons. Mean pre- and postlecture test scores were 74.6% +/- 2.73% and 94.6% +/- 5.94% for postgraduate year (PGY) 2, 88.1% +/- 5.55% and 95.6% +/- 4.50% for PGY 3, 94.8% +/- 2.5% and 100% +/- 0% for PGY 4, and 96.8% +/- 1.79% and 98.4% +/- 2.19% for PGY 5, respectively. The increase of pre- to postlecture test scores was statistically significant for PGY 2, PGY 3, and PGY 4 residents (P < .005). Pre- to postlecture test improvement was greatest for PGY 2 residents. Test performance of PGY 2 residents compared with PGY 5 residents was statistically different. Test scores for PGY 2 to PGY 4 residents significantly increased after didactic instruction on the reporting and communication of diagnostic imaging results. These findings suggest that a lecture and test format can be used to teach and assess radiology resident reporting and communication skills.

Sensitivity of autopsy and radiological examination in detecting bone fractures in an animal model: implications for the assessment of fatal child physical abuse.

PubMed

Cattaneo, C; Marinelli, E; Di Giancamillo, A; Di Giancamillo, M; Travetti, O; Vigano', L; Poppa, P; Porta, D; Gentilomo, A; Grandi, M

2006-12-20

Skeletal injuries are often strong indicators of child abuse and their detection is therefore crucial. The aim of this study was to compare the sensitivity of three diagnostic approaches, namely autopsy, traditional (conventional) radiology, and computed tomography on "battered" piglets, in order to verify the sensitivity of each method, with respect to the true number of bone fractures assessed once the piglet was skeletonised (osteological control). Four newborn cadaver piglets who had died from natural causes were severely beaten post-mortem in every district of the body. Traditional radiography, computed tomography (CT) and autopsy were performed. The piglet was then macerated until skeletonised and the number of all fractures present recorded (osteological control). On the cranium, traditional radiology revealed only 35% circa of actual fractures, autopsy detected only 31% (P<0.01 for both comparisons versus osteological control), whereas CT imaging detected all fractures actually present. For ribs, radiology detected only 47% of all fractures present, and autopsy 65% circa (P>0.05 for both comparisons versus osteological control), while CT scans detected 34% (P<0.01). In suspected cases of fatal child abuse, we suggest that the bones of specific districts be directly analysed either at autopsy or by collecting specific diagnostic sites, such as parts of the rib cage, and subjecting them to maceration. The removed areas could be replaced with artificial material for cosmetic purposes. The authors stress the importance of combined radiological, CT scan, autopsy and osteological survey in the detection of perimortem bone fractures.

Long-Term Outcomes of Vestibular Schwannomas Treated With Fractionated Stereotactic Radiotherapy: An Institutional Experience

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

Kapoor, Sumit; Batra, Sachin; Carson, Kathryn

2011-11-01

Purpose: We assessed clinical outcome and long-term tumor control after fractionated stereotactic radiotherapy (FSRT) for unilateral schwannoma. Methods and Materials: Between 1995 and 2007, 496 patients were treated with fractionated stereotactic radiotherapy at Johns Hopkins Hospital (Baltimore, MD); 385 patients had radiologic follow-up that met the inclusion criteria. The primary endpoint was treatment failure. Secondary endpoints were radiologic progression and clinical outcome. Logistic regression analysis assessed the association of age, race, tumor side, sex, and pretreatment symptoms. Results: In 11 patients (3%) treatment failed, and they required salvage (microsurgical) treatment. Radiologic progression was observed in 116 patients (30.0%), including 35more » patients (9%) in whom the treatment volume more than doubled during the follow-up period, although none required surgical resection. Tumors with baseline volumes of less than 1 cm{sup 3} were 18.02 times more likely to progress than those with tumor volumes of 1 cm{sup 3} or greater (odds ratio, 18.02; 95% confidence interval, 4.25-76.32). Treatment-induced neurologic morbidity included 8 patients (1.6%) with new facial weakness, 12 patients (2.8%) with new trigeminal paresthesias, 4 patients (0.9%) with hydrocephalus (1 communicating and 3 obstructive), and 2 patients (0.5%) with possibly radiation-induced neoplasia. Conclusions: Although the rate of treatment failure is low (3%), careful follow-up shows that radiologic progression occurs frequently. When reporting outcome, the 'no salvage surgery needed' and 'no additional treatment needed' criteria for treatment success need to be complemented by the radiologic data.« less

Vascular extravasation of contrast medium in radiological examinations: University of California San Diego Health System Experience.

PubMed

Niv, Galia; Costa, Matthew; Kicak, Patricia; Richman, Katherine

2014-06-01

Extravasation is a well-recognized complication estimated to be between 0.1% and 0.9% of contrast medium administrations. According to the UC San Diego (UCSD) health system policy, all contrast medium extravasation (CME) reports are reviewed by the department of Risk Management, and the appropriate action is taken. Despite this strategy, a decrease in the incidence of CME could not be demonstrated. The aims of this study were to determine the frequency, management, and outcome of CME in UC San Diego patients and to assess the knowledge regarding CME among radiology technologists based on policy and guidelines. The secondary aim was to assess the manual ability of the radiology technologists in the performance of the procedure. The study has 2 parts; the first was retrospective, including data collection and interpretation of all radiology procedures using intravenous contrast medium injection between January 1, 2010, and September 30, 2011, and the second was prospective, including proactive observations and knowledge questionnaire. There were 83 (0.48%) cases of CME of 17,200 patients, 54 women (0.64%) and 29 men (0.33%), P = 0.005. The patients with CME were older, and their cannula was inserted in other departments than Radiology Department, P < 0.000. There was a gap between the high theoretical knowledge that was found in the knowledge questionnaire and its implementation that was demonstrated in the proactive observation. Our data demonstrate that sex, age, and where the cannula was inserted are predictive factors for CME. We believe that CME could be prevented by proper educational program and establishment of efficient strategy.

Critique of the transitional year internship and its relationship to radiology residency.

PubMed

Baker, Stephen R; Tilak, Gauri S; Thakur, Uma

2008-05-01

The purpose of the study is to determine if transitional year program (TYP) requirements foster realization of standards of excellence and clinical relevance for future radiologists and to explore demographic and economic factors pertinent to TYPs. A list of accredited TYPs were obtained from the American Medical Association's Graduate Medical Education (ACGME) Directory 2006-2007. Specialty distribution of TYP graduates was examined from statistics provided by the ACGME, and data from the 2007 Main Residency Match was analyzed. Data derived from a concurrent survey of the perception of the value of internship sent to all current radiology residents and fellows was assessed. The institutional costs of employing TYP interns versus physician assistants were also calculated. Forty-one of the 125 TYPs lack residencies in internal medicine (IM), general surgery (GS), or both, and approximately two-third of these lack full medical school affiliation. The interns who will graduate from these 41 programs account for 103 of the 1,128 radiology residents in their post-graduate year 2. Despite the longest elective time offered in TYPs compared to conventional preliminary programs, current radiology trainees who had participated in preliminary IM or GS internships were more satisfied compared to trainees completing TYPs. The requirements of the transitional internship and compliance with them need to be carefully assessed to determine their efficacy. Despite the strong economic impetus for hiring TYP interns, the availability of open slots in existing preliminary programs in IM and GS, coupled with radiology residents' greater level of satisfaction with traditional over transitional internships, makes the existence of TYPs less compelling.

Misrepresentation of publications by radiology residency applicants: is it really a problem?

PubMed

Eisenberg, Ronald L; Cunningham, Meredith; Kung, Justin W; Slanetz, Priscilla J

2013-03-01

The aim of this study was to determine whether the previous relatively high rate of misrepresentation of publications is still a problem with current applicants for radiology residency. The publications submitted by a sample of 300 applicants for a radiology residency in 2011 were assessed using PubMed and an extensive Internet search to verify whether the articles were in print and had the applicants listed as authors and in the same positions of authorship. Whether the applicants graduated from US or international medical schools was recorded. Of the 138 applicants (46.0%) who cited 1 or more publications, there were 5 misrepresentations (3.6%). These included 1 article not found in the cited journal, 1 journal that could not be found, 1 article in which the applicant was not listed as an author, and 2 instances in which the applicants were not in the same positions of authorship (listed as lead authors but actually second authors). The misrepresentation rate was 1.9% among US graduates and 8.8% among graduates of international medical schools. The low rate of misrepresentation of publications, especially among graduates of US medical schools, does not seem to warrant spending the time to check the citations of journal articles of all applicants for radiology residency positions. Nevertheless, it is reasonable to request that applicants bring to their interviews a copy of each cited article and to assess their knowledge of all other listed research activities. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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.

"Flipping" the introductory clerkship in radiology: impact on medical student performance and perceptions.

PubMed

Belfi, Lily M; Bartolotta, Roger J; Giambrone, Ashley E; Davi, Caryn; Min, Robert J

2015-06-01

Among methods of "blended learning" (ie, combining online modules with in-class instruction), the "flipped classroom" involves student preclass review of material while reserving class time for interactive knowledge application. We integrated blended learning methodology in a "flipped" introductory clerkship in radiology, and assessed the impact of this approach on the student educational experience (performance and perception). In preparation for the "flipped clerkship," radiology faculty and residents created e-learning modules that were uploaded to an open-source website. The clerkship's 101 rising third-year medical students were exposed to different teaching methods during the course, such as blended learning, traditional lecture learning, and independent learning. Students completed precourse and postcourse knowledge assessments and surveys. Student knowledge improved overall as a result of taking the course. Blended learning achieved greater pretest to post-test improvement of high statistical significance (P value, .0060) compared to lecture learning alone. Blended learning also achieved greater pretest to post-test improvement of borderline statistical significance (P value, .0855) in comparison to independent learning alone. The difference in effectiveness of independent learning versus lecture learning was not statistically significant (P value, .2730). Student perceptions of the online modules used in blended learning portions of the course were very positive. They specifically enjoyed the self-paced interactivity and the ability to return to the modules in the future. Blended learning can be successfully applied to the introductory clerkship in radiology. This teaching method offers educators an innovative and efficient approach to medical student education in radiology. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

SiNC: Saliency-injected neural codes for representation and efficient retrieval of medical radiographs

PubMed Central

Sajjad, Muhammad; Mehmood, Irfan; Baik, Sung Wook

2017-01-01

Medical image collections contain a wealth of information which can assist radiologists and medical experts in diagnosis and disease detection for making well-informed decisions. However, this objective can only be realized if efficient access is provided to semantically relevant cases from the ever-growing medical image repositories. In this paper, we present an efficient method for representing medical images by incorporating visual saliency and deep features obtained from a fine-tuned convolutional neural network (CNN) pre-trained on natural images. Saliency detector is employed to automatically identify regions of interest like tumors, fractures, and calcified spots in images prior to feature extraction. Neuronal activation features termed as neural codes from different CNN layers are comprehensively studied to identify most appropriate features for representing radiographs. This study revealed that neural codes from the last fully connected layer of the fine-tuned CNN are found to be the most suitable for representing medical images. The neural codes extracted from the entire image and salient part of the image are fused to obtain the saliency-injected neural codes (SiNC) descriptor which is used for indexing and retrieval. Finally, locality sensitive hashing techniques are applied on the SiNC descriptor to acquire short binary codes for allowing efficient retrieval in large scale image collections. Comprehensive experimental evaluations on the radiology images dataset reveal that the proposed framework achieves high retrieval accuracy and efficiency for scalable image retrieval applications and compares favorably with existing approaches. PMID:28771497

An Integrated Interactive-Spaced Education Radiology Curriculum for Preclinical Students.

PubMed

Tshibwabwa, Eli; Mallin, Robert; Fraser, Madeleine; Tshibwabwa, Martin; Sanii, Reza; Rice, James; Cannon, Jenifer

2017-01-01

The objective of this study is to determine whether a radiology module, together with online spaced education, helps students of an integrated problem-based learning (PBL) curriculum increase their radiology knowledge and long-term retention. Second-year students at the American University of Antigua College of Medicine participated in small groups of ten students each into two 2 h of radiology laboratories. The study comprised two cohorts: winter and fall 2013 students (control group) and 2014 students (experimental group). Both groups used face-to-face PBL. The students of the experimental group received additional online-spaced education. The skills were assessed for both groups before the beginning of laboratories and 4 weeks and 7 months after laboratories. There was no significant difference on pretest between the control and experimental groups. On completion of the radiology laboratories, comparison of test results before and after training showed net improvement for both groups. The corresponding difference for the experimental group was higher compared to the one for the control group (7.83 vs. 6.21, P < 0.001). The difference between the scores on delayed test and pretest showed that the students of both groups demonstrated average knowledge improvement even though their level of performance was slightly below the posttest. The corresponding difference for the experimental group did not differ much from the posttest ( P > 0.05), and no significant difference of scores was observed 7 months later for either group. Further, a higher percentage of the students in the experimental group strongly agreed that their learning objectives were met (92% vs. 71%, P > 0.001), and this trend persisted throughout the study. Online spaced education combined to a face-to-face PBL enhances not only the student's knowledge of basic radiology along with his/her self-assessment skills but also the long-term retention of radiology material and satisfaction with the integrated interactive system-based module. Future research is needed to see if medical students in need of additional education support may benefit from spaced education in the field of remediation.

Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners.

PubMed

Carlos, Ruth C; Sicks, JoRean D; Chang, George J; Lyss, Alan P; Stewart, Teresa L; Sung, Lillian; Weaver, Kathryn E

2017-12-01

Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties, such as primary care, radiology, and oncology. From the program's inception, the National Cancer Institute Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational, and social factors, including care transitions that determine patient outcomes. The aim of this study is to describe the capacity of the NCORP to conduct multidisciplinary CCDR that includes radiology and primary care practices. The NCORP includes 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites, composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group, defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Eighty-seven percent of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. Seventy-nine percent had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice, and ownership by large regional or multistate health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly different between the community and the minority and underserved community sites. Research relationships exist between the majority of community oncology sites and affiliated radiology practices. Research relationships with affiliated primary care practices lagged. NCORP as a whole has the opportunity to encourage continued and expanded engagement where relationships exist. Where no relationship exists, the NCORP can encourage recruitment, particularly of primary care practices as partners. Copyright © 2017. Published by Elsevier Inc.

Contaminant deposition building shielding factors for US residential structures.

PubMed

Dickson, Elijah; Hamby, David; Eckerman, Keith

2017-10-10

This paper presents validated building shielding factors designed for contemporary US housing-stock under an idealized, yet realistic, exposure scenario from contaminant deposition on the roof and surrounding surfaces. The building shielding factors are intended for use in emergency planning and level three probabilistic risk assessments for a variety of postulated radiological events in which a realistic assessment is necessary to better understand the potential risks for accident mitigation and emergency response planning. Factors are calculated from detailed computational housing-units models using the general-purpose Monte Carlo N-Particle computational code, MCNP5, and are benchmarked from a series of narrow- and broad-beam measurements analyzing the shielding effectiveness of ten common general-purpose construction materials and ten shielding models representing the primary weather barriers (walls and roofs) of likely US housing-stock. Each model was designed to scale based on common residential construction practices and include, to the extent practical, all structurally significant components important for shielding against ionizing radiation. Calculations were performed for floor-specific locations from contaminant deposition on the roof and surrounding ground as well as for computing a weighted-average representative building shielding factor for single- and multi-story detached homes, both with and without basement as well for single-wide manufactured housing-unit. © 2017 IOP Publishing Ltd.

Contaminant deposition building shielding factors for US residential structures.

PubMed

Dickson, E D; Hamby, D M; Eckerman, K F

2015-06-01

This paper presents validated building shielding factors designed for contemporary US housing-stock under an idealized, yet realistic, exposure scenario from contaminant deposition on the roof and surrounding surfaces. The building shielding factors are intended for use in emergency planning and level three probabilistic risk assessments for a variety of postulated radiological events in which a realistic assessment is necessary to better understand the potential risks for accident mitigation and emergency response planning. Factors are calculated from detailed computational housing-units models using the general-purpose Monte Carlo N-Particle computational code, MCNP5, and are benchmarked from a series of narrow- and broad-beam measurements analyzing the shielding effectiveness of ten common general-purpose construction materials and ten shielding models representing the primary weather barriers (walls and roofs) of likely US housing-stock. Each model was designed to scale based on common residential construction practices and include, to the extent practical, all structurally significant components important for shielding against ionizing radiation. Calculations were performed for floor-specific locations from contaminant deposition on the roof and surrounding ground as well as for computing a weighted-average representative building shielding factor for single- and multi-story detached homes, both with and without basement as well for single-wide manufactured housing-unit.

An Assessment of Radiology Residency Program Websites.

PubMed

Hansberry, David R; Bornstein, Jonathan; Agarwal, Nitin; McClure, Kristen E; Deshmukh, Sandeep P; Long, Suzanne

2018-04-01

When prospective radiology residents decide where to apply to residency, many will use the Internet as a resource to garner information. Therefore, it is important for residency programs to produce and maintain an informative and comprehensive website. Here, we review 179 radiology residency program websites for 19 criteria including various aspects related to the residency application process, benefits, didactics, research, clinical training, and faculty leadership. We evaluated 179 radiology residency program websites for the inclusion of 19 different criteria. Criteria for information not available directly on the website and links with no information were considered not present. Only 12 of the 179 (6.7%) program websites had at least 80% of the 19 criteria. In addition, 41 programs (23%) had less than 50% of the criteria listed on their websites. Websites ranged from having 16% of the criteria to as much as 95%. Although previous studies have shown that prospective radiology resident applicants are influenced by intangibles like current resident satisfaction and academic reputation, they have also shown that applicants are influenced by the educational curriculum, clinical training, program resources, research opportunities, and quality of faculty. Therefore, it is imperative to provide online resources for prospective candidates in an attempt for residency programs to remain competitive in recruiting high-quality US medical student graduates. These findings suggest there is room for improving the comprehensiveness of information provided on radiology residency program websites. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Spatial Approaches for Ecological Screening and Exposure Assessment of Chemicals and Radionclides

EPA Science Inventory

This presentation details a tool, SADA, available for use in environmental assessments of chemicals that can also be used for radiological assessments of the environment. Spatial Analysis and Decision Assistance (SADA) is a Windows freeware program that incorporates tools from e...

Value of audits in breast cancer screening quality assurance programmes.

PubMed

Geertse, Tanya D; Holland, Roland; Timmers, Janine M H; Paap, Ellen; Pijnappel, Ruud M; Broeders, Mireille J M; den Heeten, Gerard J

2015-11-01

Our aim was to retrospectively evaluate the results of all audits performed in the past and to assess their value in the quality assurance of the Dutch breast cancer screening programme. The audit team of the Dutch Reference Centre for Screening (LRCB) conducts triennial audits of all 17 reading units. During audits, screening outcomes like recall rates and detection rates are assessed and a radiological review is performed. This study investigates and compares the results of four audit series: 1996-2000, 2001-2005, 2003-2007 and 2010-2013. The analysis shows increased recall rates (from 0.66%, 1.07%, 1.22% to 1.58%), increased detection rates (from 3.3, 4.5, 4.8 to 5.4 per 1000) and increased sensitivity (from 64.5%, 68.7%, 70.5% to 71.6%), over the four audit series. The percentage of 'missed cancers' among interval cancers and advanced screen-detected cancers did not change (p = 0.4). Our audits not only provide an opportunity for assessing screening outcomes, but also provide moments of self-reflection with peers. For radiologists, an accurate understanding of their performance is essential to identify points of improvement. We therefore recommend a radiological review of screening examinations and immediate feedback as part of an audit. • Radiological review and immediate feedback are recommended as part of an audit. • For breast screening radiologists, audits provide moments of self-reflection with peers. • Radiological review of screening examinations provides insights in recall behaviour. • Accurate understanding of radiologists' performance is essential to identify points of improvement.

User's Manual for RESRAD-OFFSITE Version 2.

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

Yu, C.; Gnanapragasam, E.; Biwer, B. M.

2007-09-05

The RESRAD-OFFSITE code is an extension of the RESRAD (onsite) code, which has been widely used for calculating doses and risks from exposure to radioactively contaminated soils. The development of RESRAD-OFFSITE started more than 10 years ago, but new models and methodologies have been developed, tested, and incorporated since then. Some of the new models have been benchmarked against other independently developed (international) models. The databases used have also expanded to include all the radionuclides (more than 830) contained in the International Commission on Radiological Protection (ICRP) 38 database. This manual provides detailed information on the design and application ofmore » the RESRAD-OFFSITE code. It describes in detail the new models used in the code, such as the three-dimensional dispersion groundwater flow and radionuclide transport model, the Gaussian plume model for atmospheric dispersion, and the deposition model used to estimate the accumulation of radionuclides in offsite locations and in foods. Potential exposure pathways and exposure scenarios that can be modeled by the RESRAD-OFFSITE code are also discussed. A user's guide is included in Appendix A of this manual. The default parameter values and parameter distributions are presented in Appendix B, along with a discussion on the statistical distributions for probabilistic analysis. A detailed discussion on how to reduce run time, especially when conducting probabilistic (uncertainty) analysis, is presented in Appendix C of this manual.« less

NV/YMP radiological control manual, Revision 2

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

Gile, A.L.

The Nevada Test Site (NTS) and the adjacent Yucca Mountain Project (YMP) are located in Nye County, Nevada. The NTS has been the primary location for testing nuclear explosives in the continental US since 1951. Current activities include operating low-level radioactive and mixed waste disposal facilities for US defense-generated waste, assembly/disassembly of special experiments, surface cleanup and site characterization of contaminated land areas, and non-nuclear test operations such as controlled spills of hazardous materials at the hazardous Materials (HAZMAT) Spill Center (HSC). Currently, the major potential for occupational radiation exposure is associated with the burial of low-level nuclear waste andmore » the handling of radioactive sources. Planned future remediation of contaminated land areas may also result in radiological exposures. The NV/YMP Radiological Control Manual, Revision 2, represents DOE-accepted guidelines and best practices for implementing Nevada Test Site and Yucca Mountain Project Radiation Protection Programs in accordance with the requirements of Title 10 Code of Federal Regulations Part 835, Occupational Radiation Protection. These programs provide protection for approximately 3,000 employees and visitors annually and include coverage for the on-site activities for both personnel and the environment. The personnel protection effort includes a DOE Laboratory Accreditation Program accredited dosimetry and personnel bioassay programs including in-vivo counting, routine workplace air sampling, personnel monitoring, and programmatic and job-specific As Low as Reasonably Achievable considerations.« less

Phenotypic comparison of individuals with homozygous or heterozygous mutation of NOTCH3 in a large CADASIL family.

PubMed

Abou Al-Shaar, Hussam; Qadi, Najeeb; Al-Hamed, Mohamed H; Meyer, Brian F; Bohlega, Saeed

2016-08-15

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary microangiopathy caused by mutations in NOTCH3, very rarely homoallelic. To describe the clinical, radiological, and neuropsychological features in an extended CADASIL family including members with either a homozygous or heterozygous NOTCH3 R1231C mutation. The pedigree included 3 generations of a family with 13 affected individuals. The patients were examined clinically and radiologically. Neuropsychological testing was performed on the proband. Sequencing of the entire coding DNA sequence (CDS) and flanking regions of NOTCH3 was undertaken using PCR amplification and direct Sanger sequencing. Homozygous C3769T mutation, predicting R1231C in exon 22 of NOTCH3 was found in 7 family members. Six other family members harbored the same in the heterozygous state. Homozygous individuals showed a slightly more severe clinical and radiological phenotype of earlier onset compared to their heterozygous counterparts. This study reports the largest number of patients with homozygous NOTCH3 mutation. The phenotype and imaging features of homozygous individuals is within the spectrum of CADASIL, although slightly at the severe end when compared to heterozygotes carrying the same mutation. Both genetic modifiers and environmental factors may play an essential role in modification and alteration of the clinical phenotype and white matter changes among CADASIL patients. Copyright © 2016 Elsevier B.V. All rights reserved.

The importance of biochemical and genetic findings in the diagnosis of atypical Norrie disease.

PubMed

Rodríguez-Muñoz, Ana; García-García, Gema; Menor, Francisco; Millán, José M; Tomás-Vila, Miguel; Jaijo, Teresa

2018-01-26

Norrie disease (ND) is a rare X-linked disorder characterized by bilateral congenital blindness. ND is caused by a mutation in the Norrie disease pseudoglioma (NDP) gene, which encodes a 133-amino acid protein called norrin. Intragenic deletions including NDP and adjacent genes have been identified in ND patients with a more severe neurologic phenotype. We report the biochemical, molecular, clinical and radiological features of two unrelated affected males with a deletion including NDP and MAO genes. Biochemical and genetic analyses were performed to understand the atypical phenotype and radiological findings. Biogenic amines in cerebrospinal fluid (CSF) were measured by high-performance liquid chromatography. The coding exons of NDP gene were amplified by polymerase chain reaction. Multiplex ligation-dependent probe amplification and chromosomal microarray were carried out on both affected males. Computed tomography and magnetic resonance imaging were performed on the two patients. In one patient, the serotonin and catecholamine metabolite levels in CSF were virtually undetectable. In both patients, genetic studies revealed microdeletions in the Xp11.3 region, involving the NDP, MAOA and MAOB genes. Radiological examination demonstrated brain and cerebellar atrophy. We suggest that alterations caused by MAO deficit may remain during the first years of life. Clinical phenotype, biochemical findings and neuroimaging can guide the genetic study in patients with atypical ND and help us to a better understanding of this disease.

Quality of life assessment in interventional radiology.

PubMed

Monsky, Wayne L; Khorsand, Derek; Nolan, Timothy; Douglas, David; Khanna, Pavan

2014-03-01

The aim of this review was to describe quality of life (QoL) questionnaires relevant to interventional radiology. Interventional radiologists perform a large number of palliative procedures. The effect of these therapies on QoL is important. This is particularly true for cancer therapies where procedures with marginal survival benefits may result in tremendous QoL benefits. Image-guided minimally invasive procedures should be compared to invasive procedures, with respect to QoL, as part of comparative effectiveness assessment. A large number of questionnaires have been validated for measurement of overall and disease-specific quality of life. Use of applicable QoL assessments can aid in evaluating clinical outcomes and help to further substantiate the need for minimally invasive image-guided procedures. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Evaluation of echocardiography in the management of elderly patients with heart failure.

PubMed

Hendry, A; Hacking, L; Langhorne, P; Vallance, R; MacDonald, J

1999-09-01

To determine the validity of a clinical diagnosis of systolic dysfunction in elderly patients with heart failure and assess the contribution of echocardiography to their management. 61 elderly patients with a diagnosis of heart failure in a geriatric assessment unit setting. Prospective study determining sensitivity, specificity and predictive values of a clinical and radiological diagnosis compared with echocardiographic standard. Proposed management was compared before and after echocardiography. Clinical assessment was highly sensitive (93%) but lacked specificity (32%). Combining radiological and clinical diagnoses increased specificity to 58%. Echocardiography revised the lead cardiac diagnosis for 28% of patients and influenced patient management plans for 41%. For elderly patients with heart failure, echocardiography improves diagnostic accuracy and identifies those patients with potential to benefit from angiotensin-converting enzyme inhibitors.

Soils Project Risk-Based Corrective Action Evaluation Process with ROTC 1 and ROTC 2, Revision 0

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

Matthews, Patrick; Sloop, Christina

2012-04-01

This document formally defines and clarifies the NDEP-approved process the NNSA/NSO Soils Activity uses to fulfill the requirements of the FFACO and state regulations. This process is used to establish FALs in accordance with the risk-based corrective action (RBCA) process stipulated in Chapter 445 of the Nevada Administrative Code (NAC) as described in the ASTM International (ASTM) Method E1739-95 (NAC, 2008; ASTM, 1995). It is designed to provide a set of consistent standards for chemical and radiological corrective actions.

Comparison of fluence-to-dose conversion coefficients for deuterons, tritons and helions.

PubMed

Copeland, Kyle; Friedberg, Wallace; Sato, Tatsuhiko; Niita, Koji

2012-02-01

Secondary radiation in aircraft and spacecraft includes deuterons, tritons and helions. Two sets of fluence-to-effective dose conversion coefficients for isotropic exposure to these particles were compared: one used the particle and heavy ion transport code system (PHITS) radiation transport code coupled with the International Commission on Radiological Protection (ICRP) reference phantoms (PHITS-ICRP) and the other the Monte Carlo N-Particle eXtended (MCNPX) radiation transport code coupled with modified BodyBuilder™ phantoms (MCNPX-BB). Also, two sets of fluence-to-effective dose equivalent conversion coefficients calculated using the PHITS-ICRP combination were compared: one used quality factors based on linear energy transfer; the other used quality factors based on lineal energy (y). Finally, PHITS-ICRP effective dose coefficients were compared with PHITS-ICRP effective dose equivalent coefficients. The PHITS-ICRP and MCNPX-BB effective dose coefficients were similar, except at high energies, where MCNPX-BB coefficients were higher. For helions, at most energies effective dose coefficients were much greater than effective dose equivalent coefficients. For deuterons and tritons, coefficients were similar when their radiation weighting factor was set to 2.

Knowledge management: Role of the the Radiation Safety Information Computational Center (RSICC)

NASA Astrophysics Data System (ADS)

Valentine, Timothy

2017-09-01

The Radiation Safety Information Computational Center (RSICC) at Oak Ridge National Laboratory (ORNL) is an information analysis center that collects, archives, evaluates, synthesizes and distributes information, data and codes that are used in various nuclear technology applications. RSICC retains more than 2,000 software packages that have been provided by code developers from various federal and international agencies. RSICC's customers (scientists, engineers, and students from around the world) obtain access to such computing codes (source and/or executable versions) and processed nuclear data files to promote on-going research, to ensure nuclear and radiological safety, and to advance nuclear technology. The role of such information analysis centers is critical for supporting and sustaining nuclear education and training programs both domestically and internationally, as the majority of RSICC's customers are students attending U.S. universities. Additionally, RSICC operates a secure CLOUD computing system to provide access to sensitive export-controlled modeling and simulation (M&S) tools that support both domestic and international activities. This presentation will provide a general review of RSICC's activities, services, and systems that support knowledge management and education and training in the nuclear field.

Chronic comorbidity in patients with early rheumatoid arthritis: a descriptive study.

PubMed

Kroot, E J; van Gestel, A M; Swinkels, H L; Albers, M M; van de Putte, L B; van Riel, P L

2001-07-01

To study the presence of chronic coexisting diseases in patients with rheumatoid arthritis (RA) and its effect on RA treatment, disease course, and outcome during the first years of the disease. From January 1985 to December 1990, 186 patients with recent onset RA were enrolled in a prospective longitudinal study. Between January 1991 and November 1992 patients were interviewed on the basis of a comorbidity questionnaire. For analysis the diseases were coded according to the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) medical diagnoses. Disease activity during the period of followup was measured by the Disease Activity Score. Outcome in terms of physical disability (Health Assessment Questionnaire) and radiological damage (Sharp's modified version) over 3 and 6 year periods was determined. In the group of 186 patients, with mean disease duration of 4.3 years at January 1991, 50 patients (27%) reported at least one chronic coexisting disease. The most frequently reported coexisting diseases were of cardiovascular (29%), respiratory (18%), or dermatological (11%) origin. For the major part (66%) chronic coexisting diseases were already present before onset of RA. No statistically significant differences in use of disease modifying antirheumatic drugs or corticosteroids were observed between RA patients with and without chronic coexisting diseases. No statistically significant differences were found in disease activity or in outcome in terms of physical disability and radiological damage over 3 and 6 year periods between the 2 groups with RA. The results showed that about 27% of patients with RA in this inception cohort had at least one chronic coexisting disease. Treatment, disease course, and outcome did not differ between patients with and without chronic coexisting diseases during the first years of the disease.

The assessment of ionising radiation impact on the cooling pond freshwater ecosystem non-human biota from the Ignalina NPP operation beginning to shut down and initial decommissioning.

PubMed

Mazeika, J; Marciulioniene, D; Nedveckaite, T; Jefanova, O

2016-01-01

The radiological doses to non-human biota of freshwater ecosystem in the Ignalina NPP cooling pond - Lake Druksiai were evaluated for several cases including the plant's operation period and initial decommissioning activities, using the ERICA 1.2 code with IAEA SRS-19 models integrated approach and tool. Among the Lake Druksiai freshwater ecosystem reference organisms investigated the highest exposure dose rate was determined for bottom fauna - benthic organisms (mollusc-bivalves, crustaceans, mollusc-gastropods, insect larvae), and among the other reference organisms - for vascular plants. The mean and maximum total dose rate values due to anthropogenic radionuclide ionising radiation impact in all investigated cases were lower than the ERICA screening dose rate value of 10 μGy/h. The main exposure of reference organisms as a result of Ignalina NPP former effluent to Lake Druksiai is due to ionizing radiation of radionuclides (60)Co and (137)Cs, of predicted releases to Lake Druksiai during initial decommissioning period - due to radionuclides (60)Co, (134)Cs and (137)Cs, and as a result of predicted releases to Lake Druksiai from low- and intermediate-level short-lived radioactive waste disposal site in 30-100 year period - due to radionuclides (99)Tc and (3)H. The risk quotient expected values in all investigated cases were <1, and therefore the risk to non-human biota can be considered negligible with the exception of a conservative risk quotient for insect larvae. Radiological protection of non-human biota in Lake Druksiai, the Ignalina NPP cooling pond, is both feasible and acceptable. Copyright © 2015 Elsevier Ltd. All rights reserved.

User Instructions for the Systems Assessment Capability, Rev. 1, Computer Codes Volume 3: Utility Codes

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

Eslinger, Paul W.; Aaberg, Rosanne L.; Lopresti, Charles A.

2004-09-14

This document contains detailed user instructions for a suite of utility codes developed for Rev. 1 of the Systems Assessment Capability. The suite of computer codes for Rev. 1 of Systems Assessment Capability performs many functions.

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.

Radiology Reporting System Data Exchange With the Electronic Health Record System: A Case Study in Iran.

PubMed

Ahmadi, Maryam; Ghazisaeidi, Marjan; Bashiri, Azadeh

2015-03-18

In order to better designing of electronic health record system in Iran, integration of health information systems based on a common language must be done to interpret and exchange this information with this system is required. This study provides a conceptual model of radiology reporting system using unified modeling language. The proposed model can solve the problem of integration this information system with the electronic health record system. By using this model and design its service based, easily connect to electronic health record in Iran and facilitate transfer radiology report data. This is a cross-sectional study that was conducted in 2013. The study population was 22 experts that working at the Imaging Center in Imam Khomeini Hospital in Tehran and the sample was accorded with the community. Research tool was a questionnaire that prepared by the researcher to determine the information requirements. Content validity and test-retest method was used to measure validity and reliability of questioner respectively. Data analyzed with average index, using SPSS. Also Visual Paradigm software was used to design a conceptual model. Based on the requirements assessment of experts and related texts, administrative, demographic and clinical data and radiological examination results and if the anesthesia procedure performed, anesthesia data suggested as minimum data set for radiology report and based it class diagram designed. Also by identifying radiology reporting system process, use case was drawn. According to the application of radiology reports in electronic health record system for diagnosing and managing of clinical problem of the patient, with providing the conceptual Model for radiology reporting system; in order to systematically design it, the problem of data sharing between these systems and electronic health records system would eliminate.

Geographic Patterns of Radiology Referrals in the United States: A Descriptive Network Analysis.

PubMed

Liao, Geraldine J; Liao, Joshua M; Cook, Tessa S

2018-06-01

To provide a nationwide description of radiology referral patterns for Medicare beneficiaries and network-based measures that can describe and monitor shifts in referral patterns. We linked publicly available Medicare data with the National Plan and Provider Enumeration System data set to analyze 3,925,366 encounters representing referrals from nonradiology referrers to diagnostic radiology providers in 2015. We assessed per-state referral volume as well as in-state and in-region referrals and the correlation between state referral volume and in-state referrals. Additionally, we applied the conceptual framework of networks to create two measures to evaluate referrer-radiologist connections within each state: number of referrer relationships and referral density index (RDI). In 2015, there was considerable variation in in-state referrals across states, and the correlation between state referral volume and in-state referrals was low (0.18). Across census regions, in-region referrals were high (84.3% in the South to 89.2% in the Midwest). Across states, the mean number of referrer relationships ranged from 7.0 in Utah to 25.0 in California, and the number of referrer relationships varied significantly within states. Radiology provider RDI also varied both within and across states, with mean radiology provider RDI spanning from 0.05 in Kansas to 0.25 in Hawaii. In a nationwide description of geographic patterns in radiology referrals among Medicare beneficiaries, we demonstrate wide variation in radiology referral patterns and utilized network methods to develop two measures that can be used in the future to monitor shifts in referral patterns. Copyright © 2018 American College of Radiology. All rights reserved.

Radiology education in Europe: Analysis of results from 22 European countries

PubMed Central

Rehani, Bhavya; Zhang, Yi C; Rehani, Madan M; Palkó, András; Lau, Lawrence; Lette, Miriam N Mikhail; Dillon, William P

2017-01-01

AIM To assess the state of radiology education across Europe by means of a survey study. METHODS A comprehensive 23-item radiology survey was distributed via email to the International Society of Radiology members, national radiological societies, radiologists and medical physicists. Reminders to complete the survey were sent and the results were analyzed over a period of 4 mo (January-April 2016). Survey questions include length of medical school and residency training; availability of fellowship and subspecialty training; number of residency programs in each country; accreditation pathways; research training; and medical physics education. Descriptive statistics were used to analyze and summarize data. RESULTS Radiology residency training ranges from 2-6 years with a median of 5 years, and follows 1 year of internship training in 55% (12 out of 22) European countries. Subspecialty fellowship training is offered in 55% (12 out of 22) European countries. Availability for specialization training by national societies is limited to eight countries. For nearly all respondents, less than fifty percent of radiologists travel abroad for specialization. Nine of 22 (41%) European countries have research requirements during residency. The types of certifying exam show variation where 64% (14 out of 22) European countries require both written and oral boards, 23% (5 out of 22) require oral examinations only, and 5% (1 out of 22) require written examinations only. A degree in medical physics is offered in 59% (13 out of 22) European countries and is predominantly taught by medical physicists. Nearly all respondents report that formal examinations in medical physics are required. CONCLUSION Comparative learning experiences across the continent will help guide the development of comprehensive yet pragmatic infrastructures for radiology education and collaborations in radiology education worldwide. PMID:28298965

Citation Impact of Collaboration in Radiology Research.

PubMed

Rosenkrantz, Andrew B; Parikh, Ujas; Duszak, Richard

2018-02-01

Team science involving multidisciplinary and multi-institutional collaboration is increasingly recognized as a means of strengthening the quality of scientific research. The aim of this study was to assess associations between various forms of collaboration and the citation impact of published radiology research. In 2010, 876 original research articles published in Academic Radiology, the American Journal of Roentgenology, JACR, and Radiology were identified with at least one radiology-affiliated author. All articles were manually reviewed to extract features related to all authors' disciplines and institutions. Citations to these articles through September 2016 were extracted from Thomson Reuters Web of Science. Subsequent journal article citation counts were significantly higher (P < .05) for original research articles with at least seven versus six or fewer authors (26.2 ± 30.8 versus 20.3 ± 23.1, respectively), with authors from multiple countries versus from a single country (32.3 ± 39.2 versus 22.0 ± 25.0, respectively), with rather than without a nonuniversity collaborator (28.7 ± 38.6 versus 22.4 ± 24.9, respectively), and with rather than without a nonclinical collaborator (26.5 ± 33.1 versus 21.9 ± 24.4, respectively). On multivariate regression analysis, the strongest independent predictors of the number of citations were authors from multiple countries (β = 9.14, P = .002), a nonuniversity collaborator (β = 4.80, P = .082), and at least seven authors (β = 4.11, P = .038). With respect to subsequent journal article citations, various forms of collaboration are associated with greater scholarly impact of published radiology research. To enhance the relevance of their research, radiology investigators are encouraged to pursue collaboration across traditional disciplinary, institutional, and geographic boundaries. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Familiarity with current practices of granting and maintaining privileges in pediatric interventional radiology--a worldwide survey of the members of the Society for Pediatric Interventional Radiology (SPIR).

PubMed

Harned, Roger K

2012-11-01

Physician credentialing is a complex process driven by the demand for quality improvement in health care. In the U.S., the Joint Commission Standard of 2007 has tied hospital accreditation to credentialing through mandated use of the Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE). To assess pediatric interventional radiologists' knowledge of how institutions grant them privileges. Members of the Society for Pediatric Interventional Radiology (SPIR) were sent a web-based survey regarding credentialing. Of 122 members from 19 countries, 81 (66%) responded, and of these 81, 59 (73%) were familiar with their hospital's privileging process. Of 49 U.S. respondents and 32 non-U.S. respondents, 37 (76%) and 17 (53%), respectively, stated that interventional radiology credentialing was different from diagnostic radiology credentialing. Of the 49 U.S. respondents, 24 (49%) reported an OPPE, and of the 32 non-U.S. respondents, 8 (25%) reported an ongoing evaluation. The U.S. OPPE is performed at shorter intervals than its international equivalent. Four years after the Joint Commission defined the FPPE and OPPE, separate credentialing of pediatric interventional radiology from pediatric diagnostic radiology is more likely in the U.S. than internationally, and U.S. pediatric interventional radiologists are more likely to have a defined ongoing professional evaluation and to be evaluated every 6 months or more frequently. There are many SPIR members who do not know how they obtain privileges and/or are not knowingly subject to an OPPE. This lack of knowledge may affect future education of interventional radiologists as well as the definition of pediatric interventional radiology practices within individual institutions.

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

Jeremy Gwin and Douglas Frenette

This document contains process knowledge and radiological data and analysis to support approval for release of the 25-ton locomotive, Serial Number 21547, at the Area 25 Engine Maintenance, Assembly, and Disassembly (EMAD) Facility, located on the Nevada Test Site (NTS). The 25-ton locomotive is a small, one-of-a-kind locomotive used to move railcars in support of the Nuclear Engine for Rocket Vehicle Application project. This locomotive was identified as having significant historical value by the Nevada State Railroad Museum in Boulder City, Nevada, where it will be used as a display piece. A substantial effort to characterize the radiological conditions ofmore » the locomotive was undertaken by the NTS Management and Operations Contractor, National Security Technologies, LLC (NSTec). During this characterization process, seven small areas on the locomotive had contamination levels that exceeded the NTS release criteria (limits consistent with U.S. Department of Energy [DOE] Order DOE O 5400.5, “Radiation Protection of the Public and the Environment”). The decision was made to perform radiological decontamination of these known accessible impacted areas to further the release process. On February 9, 2010, NSTec personnel completed decontamination of these seven areas to within the NTS release criteria. Although all accessible areas of the locomotive had been successfully decontaminated to within NTS release criteria, it was plausible that inaccessible areas of the locomotive (i.e., those areas on the locomotive where it was not possible to perform radiological surveys) could potentially have contamination above unrestricted release limits. To access the majority of these inaccessible areas, the locomotive would have to be disassembled. A complete disassembly for a full radiological survey could have permanently destroyed parts and would have ruined the historical value of the locomotive. Complete disassembly would also add an unreasonable financial burden for the contractor. A decision was reached between the NTS regulator and NSTec, opting for alternative authorized limits from DOE Headquarters. In doing so, NSTec personnel performed a dose model using the DOE-approved modeling code RESRAD-BUILD v3.5 to evaluate scenarios. The parameters used in the dose model were conservative. NSTec’s Radiological Engineering Calculation, REC-2010-001, “Public Dose Estimate from the EMAD 25 Ton Locomotive,” concluded that the four scenarios evaluated were below the 25-millirem per year limit, the “likely” dose scenarios met the “few millirem in a year” criteria, and that the EMAD 25-ton locomotive met the radiological requirements to be released with residual radioactivity to the public.« less

Diagnostic workstation for digital hand atlas in bone age assessment

NASA Astrophysics Data System (ADS)

Cao, Fei; Huang, H. K.; Pietka, Ewa; Gilsanz, Vicente; Ominsky, Steven

1998-06-01

Bone age assessment by a radiological examination of a hand and wrist image is a procedure frequently performed in pediatric patients to evaluate growth disorders, determine growth potential in children and monitor therapy effects. The assessment method currently used in radiological diagnosis is based on atlas matching of the diagnosed hand image with the reference set of atlas patterns, which was developed in 1950s and is not fully applicable for children of today. We intent to implement a diagnostic workstation for creating a new reference set of clinically normal images which will serve as a digital atlas and can be used for a computer-assisted bone age assessment. In this paper, we present the initial data- collection and system setup phase of this five-year research program. We describe the system design, user interface implementation and software tool development for collection, visualization, management and processing of clinically normal hand and wrist images.

Automatic identification of IASLC-defined mediastinal lymph node stations on CT scans using multi-atlas organ segmentation

NASA Astrophysics Data System (ADS)

Hoffman, Joanne; Liu, Jiamin; Turkbey, Evrim; Kim, Lauren; Summers, Ronald M.

2015-03-01

Station-labeling of mediastinal lymph nodes is typically performed to identify the location of enlarged nodes for cancer staging. Stations are usually assigned in clinical radiology practice manually by qualitative visual assessment on CT scans, which is time consuming and highly variable. In this paper, we developed a method that automatically recognizes the lymph node stations in thoracic CT scans based on the anatomical organs in the mediastinum. First, the trachea, lungs, and spines are automatically segmented to locate the mediastinum region. Then, eight more anatomical organs are simultaneously identified by multi-atlas segmentation. Finally, with the segmentation of those anatomical organs, we convert the text definitions of the International Association for the Study of Lung Cancer (IASLC) lymph node map into patient-specific color-coded CT image maps. Thus, a lymph node station is automatically assigned to each lymph node. We applied this system to CT scans of 86 patients with 336 mediastinal lymph nodes measuring equal or greater than 10 mm. 84.8% of mediastinal lymph nodes were correctly mapped to their stations.

Improving the coding and classification of ambulance data through the application of International Classification of Disease 10th revision.

PubMed

Cantwell, Kate; Morgans, Amee; Smith, Karen; Livingston, Michael; Dietze, Paul

2014-02-01

This paper aims to examine whether an adaptation of the International Classification of Disease (ICD) coding system can be applied retrospectively to final paramedic assessment data in an ambulance dataset with a view to developing more fine-grained, clinically relevant case definitions than are available through point-of-call data. Over 1.2 million case records were extracted from the Ambulance Victoria data warehouse. Data fields included dispatch code, cause (CN) and final primary assessment (FPA). Each FPA was converted to an ICD-10-AM code using word matching or best fit. ICD-10-AM codes were then converted into Major Diagnostic Categories (MDC). CN was aligned with the ICD-10-AM codes for external cause of morbidity and mortality. The most accurate results were obtained when ICD-10-AM codes were assigned using information from both FPA and CN. Comparison of cases coded as unconscious at point-of-call with the associated paramedic assessment highlighted the extra clinical detail obtained when paramedic assessment data are used. Ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Coding of ambulance data using ICD-10-AM allows for comparison of not only ambulance service users but also with other population groups. WHAT IS KNOWN ABOUT THE TOPIC? There is no reliable and standard coding and categorising system for paramedic assessment data contained in ambulance service databases. WHAT DOES THIS PAPER ADD? This study demonstrates that ambulance paramedic assessment data can be aligned with ICD-10-AM and MDC with relative ease, allowing retrospective coding of large datasets. Representation of ambulance case types using ICD-10-AM-coded information obtained after paramedic assessment is more fine grained and clinically relevant than point-of-call data, which uses caller information before ambulance attendance. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? This paper describes a model of coding using an internationally recognised standard coding and categorising system to support analysis of paramedic assessment. Ambulance data coded using ICD-10-AM allows for reliable reporting and comparison within the prehospital setting and across the healthcare industry.

Regulatory experience in applying a radiological environmental protection framework for existing and planned nuclear facilities.

PubMed

Mihok, S; Thompson, P

2012-01-01

Frameworks and methods for the radiological protection of non-human biota have been evolving rapidly at the International Commission on Radiological Protection and through various European initiatives. The International Atomic Energy Agency has incorporated a requirement for environmental protection in the latest revision of its Basic Safety Standards. In Canada, the Canadian Nuclear Safety Commission has been legally obligated to prevent unreasonable risk to the environment since 2000. Licensees have therefore been meeting generic legal requirements to demonstrate adequate control of releases of radioactive substances for the protection of both people and biota for many years. In the USA, in addition to the generic requirements of the Environmental Protection Agency and the Nuclear Regulatory Commission, Department of Energy facilities have also had to comply with specific dose limits after a standard assessment methodology was finalised in 2002. Canadian regulators developed a similar framework for biota dose assessment through a regulatory assessment under the Canadian Environmental Protection Act in the late 1990s. Since then, this framework has been applied extensively to satisfy legal requirements under the Canadian Environmental Assessment Act and the Nuclear Safety and Control Act. After approximately a decade of experience in applying these methods, it is clear that simple methods are fit for purpose, and can be used for making regulatory decisions for existing and planned nuclear facilities. Copyright © 2012. Published by Elsevier Ltd.

Using technology assessment as the picture archiving and communication system spreads outside radiology to the enterprise.

PubMed

Maliff, R P; Launders, J

2000-05-01

Picture archiving and communication systems (PACS) are being implemented within radiology departments, and many facilities are entering the next stage of PACS use by deploying PACS to departments outside of radiology and to other facilities located at a distance. Many PACS vendors and department administrators have based cost-justification analyses on the anticipated savings from expanding PACS to these areas. However, many of these cost-savings analyses can be highly suspect in their assumptions and findings. Technology assessment (TA) at the hospital/health system level is an organized, systematic approach to examining the efficacy of a technology in relation to the health system's mission and clinical needs. It can be an organized and unifying approach to aid in the distribution of limited capital resources. As extra-radiology PACS deployment is a costly endeavor, TA may be used to plan for PACS implementation throughout the enterprise. In many organizations, PACS is thought of as a radiology domain as its first uses were centered on this image-producing service. Now, as PACS technology spreads to other service areas, such as cardiology, dermatology, pathology, orthopedics, obstetrics, etc, the need to incorporate other viewpoints in a system-based PACS is necessary to avoid having independent PACS that may duplicate archives and may not communicate with each other. How to meet the diverse PACS needs of clinical services can be a challenging task; a TA program has been demonstrated to effectively handle the clinical needs, demands, and timeframes of PACS planning and support throughout hospitals and health systems. A hospital-based TA program can assist health care organizations to present PACS as a system-wide need and program rather than a radiology-based program gobbling up the capital budget. Submitting PACS to the TA review process can identify essential elements in planning and help avoid many of the pitfalls of PACS implementation and operations. Thorough cost and/or return on investment analyses, phasing decisions, workflow re-engineering, and outcomes assessment programs are a few of the issues that a TA program can address to help in the transition to a complete electronic image environment. The TA process includes clinician selection, evaluation criteria and their selection for technologies under review, a policy for review/authorization/denial, and measurement of expected outcomes.

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.

Curriculum in radiology for residents: what, why, how, when, and where.

PubMed

Collins, J

2000-02-01

Developing a curriculum in chest radiology should follow the same general principles that are used when developing a curriculum in any subspecialty area of radiology. A curriculum is more than a "list of topics" with which a resident should be familiar after 4 years of training. It includes objectives and goals, content, faculty, methods, and evaluation. Numerous resources are available for those who are charged with developing a curriculum in chest radiology. In addition to faculty members in the department, whose input during development can ensure successful implementation of the curriculum, organizations (i.e., ACR, APDR, STR) already have begun to develop "model" curricula. Attending the annual meeting of the Association of American Medical Colleges is a way to meet and hear from professionals who develop and oversee curriculum development at their medical schools, and another important resource available at some medical schools is the Office of Medical Education. The faculty within such offices are uniquely qualified to assist with curriculum and faculty development, especially for those areas in which radiology faculty traditionally are less experienced, such as development of valid and reliable assessment forms and construction of behaviorally based objectives.

The total value equation: a suggested framework for understanding value creation in diagnostic radiology.

PubMed

Heller, Richard E

2014-01-01

As a result of macroeconomic forces necessitating fundamental changes in health care delivery systems, value has become a popular term in the medical industry. Much has been written recently about the idea of value as it relates to health care services in general and the practice of radiology in particular. Of course, cost, value, and cost-effectiveness are not new topics of conversation in radiology. Not only is value one of the most frequently used and complex words in management, entire classes in business school are taught around the concept of understanding and maximizing value. But what is value, and when speaking of value creation strategies, what is it exactly that is meant? For the leader of a radiology department, either private or academic, value creation is a core function. This article provides a deeper examination of what value is, what drives value creation, and how practices and departments can evaluate their own value creation efficiencies. An equation, referred to as the Total Value Equation, is presented as a framework to assess value creation activities and strategies. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Outcome of transforaminal lumbar interbody fusion in spondylolisthesis-A clinico-radiological correlation.

PubMed

Balasubramanian, Vijay Anand; Douraiswami, Balaji; Subramani, Suresh

2018-06-01

Lumbar spondylolisthesis is a common cause of morbidity in middle aged individuals. Spinal fusion with instrumentation has become the gold standard for lumbar segmental instability. Studies which correlate the improvement in radiology postoperatively with functional outcome show contrasting reports. This study is aimed at finding the correlation between clinical and radiological outcomes after surgery with transforaminal lumbar interbody fusion. A retrospective study in 35 patients who underwent transforaminal lumbar interbody fusion in a period of 1 year was done. Preoperative pain (VAS Score), functional ability (ODI), radiological parameters (slip angle, slip grade, disc height, foraminal height, lumbar lordosis) were compared with postoperative recordings at the last followup. Functional improvement (Macnab's criteria) and fusion (Lee's fusion criteria) were assessed. Statistical analysis was done with student's paired t -test and Pearson's correlation coefficient. VAS score, ODI improved from 8 to 2 and 70 to 15 respectively. Slip angle improved from 23°to 5° on an average. 80% patients showed fusion and 85% showed good clinical outcome at 1 year followup. Analyzing with Pearson correlation coefficient showed no significant relation between pain scores and radiological parameters. But there was statistically significant relation between radiological fusion and the final clinical outcome. TLIF produces spinal fusion in most individuals. Strong spinal fusion is essential for good clinical outcome in spondylolisthesis patients who undergo TLIF. Reduction in slip is not necessary for all patients with listhesis.

Can D-Dimer Measurement Reduce the Frequency of Radiological Assessment in Patients Receiving Palliative Imatinib for Gastrointestinal Stromal Tumor (GIST)?

PubMed

Afshar, Mehran; Hamilton, Patrick; Seligmann, Jenny; Lord, Simon; Baxter, Paul; Marples, Maria; Stark, Dan; Hall, Peter S

2015-01-01

Imatinib therapy has improved outcomes in advanced GISTs. Current guidelines suggest monitoring with CT scanning every 12 weeks. There are no validated biomarkers to assist disease evaluation. We identified 50 patients treated with imatinib for GIST in a single tertiary center. We assessed the prognostic value of D-dimers by Cox regression, and the utility as a biomarker for radiological progression (rPD) using receiver-operator curve (ROC) analysis. In asymptomatic patients with D-dimer levels <1,000 and falling levels, the negative predictive value for rPD was 92%. D-dimers may reduce the burden of CT scanning in a proportion of patients in this setting.

Analysis of dose-LET distribution in the human body irradiated by high energy hadrons.

PubMed

Sato, T; Tsuda, S; Sakamoto, Y; Yamaguchi, Y; Niita, K

2003-01-01

For the purposes of radiological protection, it is important to analyse profiles of the particle field inside a human body irradiated by high energy hadrons, since they can produce a variety of secondary particles which play an important role in the energy deposition process, and characterise their radiation qualities. Therefore Monte Carlo calculations were performed to evaluate dose distributions in terms of the linear energy transfer of ionising particles (dose-LET distribution) using a newly developed particle transport code (Particle and Heavy Ion Transport code System, PHITS) for incidences of neutrons, protons and pions with energies from 100 MeV to 200 GeV. Based on these calculations, it was found that more than 80% and 90% of the total deposition energies are attributed to ionisation by particles with LET below 10 keV microm(-1) for the irradiations of neutrons and the charged particles, respectively.

Patients' satisfaction towards radiological service and associated factors in Hawassa University Teaching and referral hospital, Southern Ethiopia.

PubMed

Mulisa, Teshome; Tessema, Fasil; Merga, Hailu

2017-06-26

Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21. The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11-0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007-0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4-11.62) were factors associated with patients satisfaction. This study found that majority of respondents was satisfied with the radiological services. Respondent's education level, occupation as well as duration of time taken to enter into examination room were important factors influencing the satisfaction condition. Hence, concerted effort is needed to constantly improve on patient satisfaction to better radiology returns arising from improved patient patronage. It is recommended to give great care and attention to clients during radiological examination procedure and also suggested that the department should decrease time taken to enter into examination room. On the other hand, the reasons behind more educated clients were less satisfied with radiologic service than more educated respondents need further investigation.

The Patient Experience in Radiology: Observations From Over 3,500 Patient Feedback Reports in a Single Institution.

PubMed

Rosenkrantz, Andrew B; Pysarenko, Kristine

2016-11-01

To identify factors associated with the patient experience in radiology based on patient feedback reports from a single institution. In a departmental patient experience committee initiative, all imaging outpatients are provided names and roles of all departmental employees with whom they interact, along with contact information for providing feedback after their appointment. All resulting feedback was recorded in a web-based database. A total of 3,675 patient comments over a 3-year period were assessed in terms of major themes. Roles of employees recognized within the patient comments were also assessed. Patient feedback comments most commonly related to professional staff behavior (74.5%) and wait times (11.9%), and less commonly related to a spectrum of other issues (comfort during the exam, quality of the facilities, access to information regarding the exam, patient privacy, medical records, the radiology report, billing). The most common attributes relating to staff behavior involved patients' perceptions of staff caring, professionalism, pleasantness, helpfulness, and efficiency. Employees most commonly recognized by the comments were the technologist (50.2%) and receptionist (31.6%) and much less often the radiologist (2.2%). No radiologist was in the top 10% of employees in terms of the number of comments received. Patients' comments regarding their experiences in undergoing radiologic imaging were largely influenced by staff behavior and communication (particularly relating to technologists and receptionists), as well as wait times, with radiologists having a far lesser immediate impact. Radiologists are encouraged to engage in activities that promote direct visibility to their patients and thereby combat risks of the perceived "invisible" radiologist. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Interventional Radiology Clinical Practice Guideline Recommendations for Neurovascular Disorders Are Not Based on High-Quality Systematic Reviews.

PubMed

Chong, A B; Taylor, M; Schubert, G; Vassar, M

2017-04-01

In recent years, clinical practice guidelines have been criticized for biased interpretations of research evidence, and interventional radiology is no exception. Our aim was to evaluate the methodologic quality and transparency of reporting in systematic reviews used as evidence in interventional radiology clinical practice guidelines for neurovascular disorders from the Society of Interventional Radiology. Our sources were 9 neurovascular disorder clinical practice guidelines from the Society of Interventional Radiology. We selected 65 systematic reviews and meta-analyses. A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) tools were used to assess the methodologic quality and reporting transparency of systematic reviews. Radial plots were created on the basis of average scores for PRISMA and AMSTAR items. On the basis of AMSTAR scores, 3 (4.62%) reviews were high-quality, 28 reviews (43.08%) were moderate-quality, and 34 reviews (52.31%) were low-quality, with an average quality score of 3.66 (34.32%; minimum, 0%; maximum, 81.82%). The average PRISMA score was 18.18 (69.41%). We were unable to obtain previous versions for 8 reviews, 7 of which were from the Cochrane Database of Systematic Reviews. The methodologic quality of systematic reviews needs to be improved. Although reporting clarity was much better than the methodologic quality, it still has room for improvement. The methodologic quality and transparency of reporting did not vary much among clinical practice guidelines. This study can also be applied to other medical specialties to examine the quality of studies used as evidence in their own clinical practice guidelines. © 2017 by American Journal of Neuroradiology.

Honorary authorship in radiologic research articles: assessment of frequency and associated factors.

PubMed

Eisenberg, Ronald L; Ngo, Long; Boiselle, Philip M; Bankier, Alexander A

2011-05-01

To quantify the frequency of perceived honorary authorship in radiologic journals and to identify specific factors that increase its prevalence. This study qualified for exempt status by the institutional review board. An electronic survey was sent to first authors of all original research articles published in Radiology and European Radiology over 3 years. Questions included guidelines used for determining authorship, contributions of coauthors, the perception of honorary authorship, and demographic information. Univariable analysis of sample proportions was performed by using χ(2) tests. Multivariable logistic regression models were used to assess the independent factors that were associated with the probability of perceiving honorary authorship. Of the 392 (29.3%) of 1338 first authors who responded to the survey, 102 (26.0%) perceived that one or more coauthors did not make sufficient contributions to merit being included as an author. Of the 392 respondents, 231 (58.9%) stated that one or more coauthors performed only "nonauthor" tasks according to International Committee of Medical Journal Editors criteria. Factors associated with an increased first-author perception of honorary authorship included lower academic rank (adjusted odds ratio [OR]: 2.89; 95% confidence interval [CI]: 1.66, 5.06), as well as working in an environment in which the section or department head was automatically listed as an author (adjusted OR: 3.80; 95% CI: 2.13, 6.79). The percentage of honorary authorship was significantly higher (P = .019) among respondents who did not follow journal requirements for authorship. The rate of perceived honorary authorship (overall, 26.0%) was substantially more frequent among respondents of lower academic rank and in those working in an environment in which their section or department head was automatically listed as an author. http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101500/-/DC1. RSNA, 2011

University of Saskatchewan Radiology Courseware (USRC): an assessment of its utility for teaching diagnostic imaging in the medical school curriculum.

PubMed

Burbridge, Brent; Kalra, Neil; Malin, Greg; Trinder, Krista; Pinelle, David

2015-01-01

We have found it very challenging to integrate images from our radiology digital imaging repository into the curriculum of our local medical school. Thus, it has been difficult to convey important knowledge related to viewing and interpreting diagnostic radiology images. We sought to determine if we could create a solution for this problem and evaluate whether students exposed to this solution were able to learn imaging concepts pertinent to medical practice. We developed University of Saskatchewan Radiology Courseware (USRC), a novel interactive web application that enables preclinical medical students to acquire image interpretation skills fundamental to clinical practice. This web application reformats content stored in Medical Imaging Resource Center teaching cases for BlackBoard Learn™, a popular learning management system. We have deployed this solution for 2 successive years in a 1st-year basic sciences medical school course at the College of Medicine, University of Saskatchewan. The "courseware" content covers both normal anatomy and common clinical pathologies in five distinct modules. We created two cohorts of learners consisting of an intervention cohort of students who had used USRC for their 1st academic year, whereas the nonintervention cohort was students who had not been exposed to this learning opportunity. To assess the learning experience of the users we designed an online questionnaire and image review quiz delivered to both of the student groups. Comparisons between the groups revealed statistically significant differences in both confidence with image interpretation and the ability to answer knowledge-based questions. Students were satisfied with the overall usability, functions, and capabilities of USRC. USRC is an innovative technology that provides integration between Medical Imaging Resource Center, a teaching solution used in radiology, and a Learning Management System.

Characterization of optically stimulated luminescence dosemeters to measure organ doses in diagnostic radiology

PubMed Central

Endo, A; Katoh, T; Kobayashi, I; Joshi, R; Sur, J; Okano, T

2012-01-01

Objective The aim of this study was to assess the characteristics of an optically stimulated luminescence dosemeter (OSLD) for use in diagnostic radiology and to apply the OSLD in measuring the organ doses by panoramic radiography. Methods The dose linearity, energy dependency and angular dependency of aluminium oxide-based OSLDs were examined using an X-ray generator to simulate various exposure settings in diagnostic radiology. The organ doses were then measured by inserting the dosemeters into an anthropomorphic phantom while using three panoramic machines. Results The dosemeters demonstrated consistent dose linearity (coefficient of variation<1.5%) and no significant energy dependency (coefficient of variation<1.5%) under the applied exposure conditions. They also exhibited negligible angular dependency (≤10%). The organ doses of the X-ray as a result of panoramic imaging by three machines were calculated using the dosemeters. Conclusion OSLDs can be utilized to measure the organ doses in diagnostic radiology. The availability of these dosemeters in strip form proves to be reliably advantageous. PMID:22116136

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.

Issues around radiological protection of the environment and its integration with protection of humans: promoting debate on the way forward.

PubMed

Brownless, G P

2007-12-01

This paper explores issues to consider around integrating direct, explicit protection of the environment into the current system of radiological protection, which is focused on the protection of humans. Many issues around environmental radiological protection have been discussed, and ready-to-use toolboxes have been constructed for assessing harm to non-human biota, but it is not clear how (or even if) these should be fitted into the current system of protection. Starting from the position that the current approach to protecting the environment (namely that it follows from adequately protecting humans) is generally effective, this paper considers how explicit radiological protection of the environment can be integrated with the current system, through developing a 'worked example' of how this could be done and highlighting issues peculiar to protection of the environment. The aim of the paper is to promote debate on this topic, with the ultimate aim of ensuring that any changes to the system are consensual and robust.

Decision support systems for clinical radiological practice — towards the next generation

PubMed Central

Stivaros, S M; Gledson, A; Nenadic, G; Zeng, X-J; Keane, J; Jackson, A

2010-01-01

The huge amount of information that needs to be assimilated in order to keep pace with the continued advances in modern medical practice can form an insurmountable obstacle to the individual clinician. Within radiology, the recent development of quantitative imaging techniques, such as perfusion imaging, and the development of imaging-based biomarkers in modern therapeutic assessment has highlighted the need for computer systems to provide the radiological community with support for academic as well as clinical/translational applications. This article provides an overview of the underlying design and functionality of radiological decision support systems with examples tracing the development and evolution of such systems over the past 40 years. More importantly, we discuss the specific design, performance and usage characteristics that previous systems have highlighted as being necessary for clinical uptake and routine use. Additionally, we have identified particular failings in our current methodologies for data dissemination within the medical domain that must be overcome if the next generation of decision support systems is to be implemented successfully. PMID:20965900

Toward Data-Driven Radiology Education-Early Experience Building Multi-Institutional Academic Trainee Interpretation Log Database (MATILDA).

PubMed

Chen, Po-Hao; Loehfelm, Thomas W; Kamer, Aaron P; Lemmon, Andrew B; Cook, Tessa S; Kohli, Marc D

2016-12-01

The residency review committee of the Accreditation Council of Graduate Medical Education (ACGME) collects data on resident exam volume and sets minimum requirements. However, this data is not made readily available, and the ACGME does not share their tools or methodology. It is therefore difficult to assess the integrity of the data and determine if it truly reflects relevant aspects of the resident experience. This manuscript describes our experience creating a multi-institutional case log, incorporating data from three American diagnostic radiology residency programs. Each of the three sites independently established automated query pipelines from the various radiology information systems in their respective hospital groups, thereby creating a resident-specific database. Then, the three institutional resident case log databases were aggregated into a single centralized database schema. Three hundred thirty residents and 2,905,923 radiologic examinations over a 4-year span were catalogued using 11 ACGME categories. Our experience highlights big data challenges including internal data heterogeneity and external data discrepancies faced by informatics researchers.

Bulgarian experience in the establishment of reference dose levels and implementation of a quality control system in diagnostic radiology.

PubMed

Vassileva, J; Dimov, A; Slavchev, A; Karadjov, A

2005-01-01

Results from a Bulgarian patient dose survey in diagnostic radiology are presented. Reference levels for entrance surface dose (ESD) were 0.9 mGy for chest radiography (PA), 30 mGy for lumbar spine (Lat), 10 mGy for pelvis, 5 mGy for skull (AP), 3 mGy for skull (Lat) and 13 mGy for mammography. Quality control (QC) programmes were proposed for various areas of diagnostic radiology. Film processing QC warranted special attention. Proposed QC programmes included parameters to be tested, level of expertise needed and two action levels: remedial and suspension. Programmes were tested under clinical conditions to assess initial results and draw conclusions for further QC system development. On the basis of international experience, measurement protocols were developed for all parameters tested. QC equipment was provided as part of the PHARE project. A future problem for QC programme implementation may be the small number of medical physics experts in diagnostic radiology.

Managing a Multisite Academic-Private Radiology Practice Reading Environment: Impact of IT Downtimes on Enterprise Efficiency.

PubMed

Becker, Murray; Goldszal, Alberto; Detal, Julie; Gronlund-Jacob, Judith; Epstein, Robert

2015-06-01

The aim of this study was to assess whether the complex radiology IT infrastructures needed for large, geographically diversified, radiology practices are inherently stable with respect to system downtimes, and to characterize the nature of the downtimes to better understand their impact on radiology department workflow. All radiology IT unplanned downtimes over a 12-month period in a hybrid academic-private practice that performs all interpretations in-house (no commercial "nighthawk" services) for approximately 900,000 studies per year, originating at 6 hospitals, 10 outpatient imaging centers, and multiple low-volume off-hours sites, were logged and characterized using 5 downtime metrics: duration, etiology, failure type, extent, and severity. In 12 consecutive months, 117 unplanned downtimes occurred with the following characteristics: duration: median time = 3.5 hours with 34% <1.5 hours and 30% >12 hours; etiology: 87% were due to software malfunctions, and 13% to hardware malfunctions; failure type: 88% were transient component failures, 12% were complete component failures; extent: all sites experienced downtimes, but downtimes were always localized to a subset of sites, and no system-wide downtimes occurred; severity (impact on radiologist workflow): 47% had minimal impact, 50% moderate impact, and 3% severe impact. In the complex radiology IT system that was studied, downtimes were common; they were usually a result of transient software malfunctions; the geographic extent was always localized rather than system wide; and most often, the impacts on radiologist workflow were modest. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Improving Novice Radiology Trainees' Perception Using Fine Art.

PubMed

Goodman, Thomas Rob; Kelleher, Michael

2017-10-01

To determine if fine art perception training improved performance in novice radiology trainees. On the first day of their residency, 15 radiology residents underwent a basic radiology perception test in which they were shown 15 different radiographs that each had a significant abnormality. This was followed by a focused session of interpretation training at a local art gallery where art experts taught the trainees how to thoroughly analyze a painting. After this fine art session, the residents were once again shown 15 different radiographs and asked, in the same manner as before, to identify the location of the abnormality. The results of both radiograph assessments were then compared. The 15 residents correctly identified the areas of abnormality on 35 of 225 cases pre-art training with a mean score of 2.33 and a SD of 1.4. After art training, the figure for correctly identifying the area of abnormality rose to 94 of 225 cases with a mean score of 6.27 and a SD of 1.79 (P < .0001). The implementation of a focused teaching session on perception improved first-year residents' ability to localize imaging abnormalities. This improvement was significant (P < .0001). Most errors in radiology occur due to failures of perception rather than failures to correctly interpret a finding and, as such, it behooves the profession to ensure that perception training is adequately addressed as part of a radiology training curriculum. Using an art gallery may be a novel, effective transitional starting point for novice radiology trainees. Copyright © 2017. Published by Elsevier Inc.

[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.

Student performance and course evaluations before and after use of the Classroom Performance System ™ in a third-year veterinary radiology course.

PubMed

Hecht, Silke; Adams, W H; Cunningham, M A; Lane, I F; Howell, N E

2013-01-01

Effective teaching of veterinary radiology can be challenging in a traditional classroom environment. Audience response systems, colloquially known as "clickers," provide a means of encouraging student interaction. The purpose of this study was to compare student performance and course evaluations before and after using the Classroom Performance System™ in the third-year (fifth semester) didactic radiology course at the University of Tennessee College of Veterinary Medicine. Overall student performance was assessed by comparing median numeric final course grades (%) between years without and with use of the Classroom Performance System™. Grades of students were determined for individual instructors' sections. Student evaluations of the radiology course were compared for the years available (2007-2010). Student interactions were also evaluated subjectively by instructors who used the Classroom Performance System™. There was a significant difference (p = 0.009) between the median student grade before (2005 - 2008, median 82.2%; interquartile range 77.6-85.7%; range 61.9-95.5%) and after use of the classroom performance system (2009-2010, median 83.6%; interquartile range 79.9-87.9%; range 68.2-93.2%). There was no statistically significant difference in median student grades for individual instructors over the study period. The radiology course student evaluation scores were significantly higher in years where the Classroom Performance System™ was used in comparison to previous years (P = 0.019). Subjectively, students appeared more involved when using clickers. Findings indicated that the Classroom Performance System™ may be a useful tool for enhancing veterinary radiology education. © 2012 Veterinary Radiology & Ultrasound.

Evaluation of two selection tests for recruitment into radiology specialty training.

PubMed

Patterson, Fiona; Knight, Alec; McKnight, Liam; Booth, Thomas C

2016-07-11

This study evaluated whether two selection tests previously validated for primary care General Practice (GP) trainee selection could provide a valid shortlisting selection method for entry into specialty training for the secondary care specialty of radiology. We conducted a retrospective analysis of data from radiology applicants who also applied to UK GP specialty training or Core Medical Training. The psychometric properties of the two selection tests, a clinical problem solving (CPS) test and situational judgement test (SJT), were analysed to evaluate their reliability. Predictive validity of the tests was analysed by comparing them with the current radiology selection assessments, and the licensure examination results taken after the first stage of training (Fellowship of the Royal College of Radiologists (FRCR) Part 1). The internal reliability of the two selection tests in the radiology applicant sample was good (α ≥ 0.80). The average correlation with radiology shortlisting selection scores was r = 0.26 for the CPS (with p < 0.05 in 5 of 11 shortlisting centres), r = 0.15 for the SJT (with p < 0.05 in 2 of 11 shortlisting centres) and r = 0.25 (with p < 0.05 in 5 of 11 shortlisting centres) for the two tests combined. The CPS test scores significantly correlated with performance in both components of the FRCR Part 1 examinations (r = 0.5 anatomy; r = 0.4 physics; p < 0.05 for both). The SJT did not correlate with either component of the examination. The current CPS test may be an appropriate selection method for shortlisting in radiology but would benefit from further refinement for use in radiology to ensure that the test specification is relevant. The evidence on whether the SJT may be appropriate for shortlisting in radiology is limited. However, these results may be expected to some extent since the SJT is designed to measure non-academic attributes. Further validation work (e.g. with non-academic outcome variables) is required to evaluate whether an SJT will add value in recruitment for radiology specialty training and will further inform construct validity of SJTs as a selection methodology.

Dental radiographic indicators, a key to age estimation

PubMed Central

Panchbhai, AS

2011-01-01

Objective The present review article is aimed at describing the radiological methods utilized for human age identification. Methods The application and importance of radiological methods in human age assessment was discussed through the literature survey. Results Following a literature search, 46 articles were included in the study and the relevant information is depicted in the article. Dental tissue is often preserved indefinitely after death. Implementation of radiography is based on the assessment of the extent of calcification of teeth and in turn the degree of formation of crown and root structures, along with the sequence and the stages of eruption. Several radiological techniques can be used to assist in both individual and general identification, including determination of gender, ethnic group and age. The radiographic method is a simpler and cheaper method of age identification compared with histological and biochemical methods. Radiographic and tomographic images have become an essential aid for human identification in forensic dentistry, particularly with the refinement of techniques and the incorporation of information technology resources. Conclusion Based on an appropriate knowledge of the available methods, forensic dentists can choose the most appropriate since the validity of age estimation crucially depends on the method used and its proper application. The multifactorial approach will lead to optimum age assessment. The legal requirements also have to be considered. PMID:21493876

Non-invasive diagnosis of advanced fibrosis and cirrhosis

PubMed Central

Sharma, Suraj; Khalili, Korosh; Nguyen, Geoffrey Christopher

2014-01-01

Liver cirrhosis is a common and growing public health problem globally. The diagnosis of cirrhosis portends an increased risk of morbidity and mortality. Liver biopsy is considered the gold standard for diagnosis of cirrhosis and staging of fibrosis. However, despite its universal use, liver biopsy is an invasive and inaccurate gold standard with numerous drawbacks. In order to overcome the limitations of liver biopsy, a number of non-invasive techniques have been investigated for the assessment of cirrhosis. This review will focus on currently available non-invasive markers of cirrhosis. The evidence behind the use of these markers will be highlighted, along with an assessment of diagnostic accuracy and performance characteristics of each test. Non-invasive markers of cirrhosis can be radiologic or serum-based. Radiologic techniques based on ultrasound, magnetic resonance imaging and elastography have been used to assess liver fibrosis. Serum-based biomarkers of cirrhosis have also been developed. These are broadly classified into indirect and direct markers. Indirect biomarkers reflect liver function, which may decline with the onset of cirrhosis. Direct biomarkers, reflect extracellular matrix turnover, and include molecules involved in hepatic fibrogenesis. On the whole, radiologic and serum markers of fibrosis correlate well with biopsy scores, especially when excluding cirrhosis or excluding fibrosis. This feature is certainly clinically useful, and avoids liver biopsy in many cases. PMID:25492996

Automated multi-radionuclide separation and analysis with combined detection capability

NASA Astrophysics Data System (ADS)

Plionis, Alexander Asterios

The radiological dispersal device (RDD) is a weapon of great concern to those agencies responsible for protecting the public from the modern age of terrorism. In order to effectively respond to an RDD event, these agencies need to possess the capability to rapidly identify the radiological agents involved in the incident and assess the uptake of each individual victim. Since medical treatment for internal radiation poisoning is radionuclide-specific, it is critical to identify and quantify the radiological uptake of each individual victim. This dissertation describes the development of automated analytical components that could be used to determine and quantify multiple radionuclides in human urine bioassays. This is accomplished through the use of extraction chromatography that is plumbed in-line with one of a variety of detection instruments. Flow scintillation analysis is used for 90Sr and 210Po determination, flow gamma analysis is used assess 60 Co and 137Cs, and inductively coupled plasma mass spectrometry is used to determine actinides. Detection limits for these analytes were determined for the appropriate technique and related to their implications for health physics.

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

Assessment of a press-fit proximal femoral modular reconstruction implant (PFMR®) at 14.5 years. A 48-case series with a disturbing rate of implant fracture.

PubMed

Dumoulin, Q; Sabau, S; Goetzmann, T; Jacquot, A; Sirveaux, F; Mole, D; Roche, O

2018-05-01

The PFMR ® proximal femoral modular reconstruction implant (Protek, Sulzer Orthopedics, Switzerland) is a straight modular stem in sanded titanium with press-fit anchorage, intended to achieve spontaneous bone reconstruction following Wagner's principle. The aim of the present study was to analyze long-term clinical and radiological outcome. A single-center retrospective study included 48 PFMR stems implanted in 47 patients between 1998 and 2002. Results in this series were previously reported at 7 years' follow-up. Clinical assessment used PMA and Harris scores. Radiologic assessment focused on stem stability and osseointegration, and bone stock following Le Béguec. Twenty-three patients were seen at a mean 14.5 years' follow-up (13 deceased, 11 lost to follow-up), including 1 with bilateral implants, i.e., 24 stems. PMA and Harris scores, stem stability and osseointegration and bone stock were stable with respect to the 7-year findings. Radiology found 7 stem fractures in the Morse taper, i.e., in 29% of implants. Two of these cases required femoral implant replacement; 5 were asymptomatic. Long-term outcome for PFMR stems was clinically and radiologically satisfactory for the 16 patients free of mechanical complications. The Morse taper fracture rate was high, and higher than reported elsewhere. The usual risk factors for implant fracture were not found in the present series. The modular design of the press-fit revision implant is its weak point; monoblock implants should be used in patients with good life-expectancy. IV (retrospective study). Copyright © 2018 Elsevier Masson SAS. All rights reserved.

An assessment of the feasibility and effectiveness of an e-learning module in delivering a curriculum in radiation protection to undergraduate medical students.

PubMed

Leong, Sum; Mc Laughlin, Patrick; O'Connor, Owen J; O'Flynn, Siun; Maher, Michael M

2012-03-01

Integrating radiation protection (RP) education in the undergraduate medical curriculum is gaining importance and is mandatory in certain jurisdictions. An e-learning module for RP was developed at the authors' medical school and was integrated into year 4 of the 5-year undergraduate medical program. The aim of this study was to investigate its impact on RP knowledge, student preferences for various teaching methods, self-assessment of RP knowledge, and perceptions of career prospects in radiology. Likert-type 5-point scale evaluations and general comments about the RP module and various methods of teaching were also obtained. An e-learning module in RP was designed and presented to year 4 medical undergraduates. All students were required to complete premodule and postmodule questionnaires. Eighty-nine percent (n = 113) and 99% (n = 126) of the 127 medical students successfully completed and returned the premodule and postmodule questionnaires, respectively. After the e-learning module, students' postmodule RP knowledge had improved significantly. Analysis of postmodule RP knowledge suggested that a favorable self-assessment of knowledge of RP, perception of career prospects in radiology, and completion of the e-learning module with an increased number of sessions were factors predictive of improved RP knowledge. Students expressed a preference for didactic lectures and clinical attachment for instruction in RP over e-learning. The development of an e-learning module in RP is feasible and results in improved knowledge of RP among medical undergraduates. Combining e-learning and more traditional educational programs such as a clinical radiology rotation is likely to improve student experience. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Sellar reconstruction without intrasellar packing after endoscopic surgery of pituitary macroadenomas is better than its reputation.

PubMed

Ismail, Mostafa; Fares, Abd Alla; Abdelhak, Balegh; D'Haens, Jean; Michel, Olaf

2016-01-01

Sellar reconstruction with intrasellar packing following endoscopic resection of pituitary macroadenomas remains a subject of clinical and radiological discussion particularly, when an intraoperative cerebrospinal fluid (CSF) leakage is absent. This study was conducted to contribute our experience with sellar reconstruction after a standard endoscopic surgery of pituitary macroadenomas without intraoperative CSF leakage to the ongoing discussion between techniques with and without intrasellar packing. A consecutive series of 47 pituitary macroadenomas undergoing excision via a standard endoscopic endonasal transsphenoidal surgery (EETS) without evident intraoperative CSF leakage were retrospectively evaluated over a 10-months mean follow-up period. According to the sellar reconstruction technique, three groups could be identified: Group A - with no intrasellar packing, Group B - with haemostatic materials packing, and Group C - with abdominal fat packing. Postoperative clinical and radiological assessments of the three groups were documented and analyzed for differences in outcome. Postoperative clinical assessment did not differ significantly between the three groups. In group A, postoperative CSF leakage, sphenoid sinusitis and empty sella syndrome were not observed. However, a significant difference in radiological assessment could be identified; the interpretation of sellar contents in postoperative MRI of group A succeeded earlier and more reliably than in other groups with intrasellar packing. There is no difference in the incidence of postoperative CSF leakage and empty sella syndrome among the various reconstructive techniques with and without intrasellar packing, irrespective of size and extension of the pituitary adenoma. Sellar reconstruction without intrasellar packing following a standard EETS is not inferior to other techniques with packing and even shows more radiological advantages, which made it our preferred technique, at least if no intraoperative CSF leakage is evident.

Do Clinical and Radiological Assessments Contribute to the Understanding of Biomaterials? Results From a Prospective Randomized Sinus Augmentation Split-Mouth Trial.

PubMed

Lorenz, Jonas; Korzinskas, Tadas; Chia, Poju; Maawi, Sarah Al; Eichler, Katrin; Sader, Robert A; Ghanaati, Shahram

2018-02-01

The present prospective randomized split-mouth trial reports on the 3-year clinical and radiological follow-up investigation of implants placed 7 months after sinus augmentation with 2 different bone substitute materials. The aim of the study was to complete the histologic observation of cellular reactions by analyses of the implants and the volumetric changes of the augmented bone substitute materials. A sinus augmentation split-mouth trial was performed in 14 patients with the synthetic bone substitute material Nanobone (NB) and the xenogeneic Bio-Oss (BO). Changes in volume and density of the augmented biomaterials were investigated by analysis of computed tomography scans, taken immediately after augmentation and after 7 months. Clinical implant parameters were assessed after 3 years of loading. Both bone substitute materials underwent nonsignificant volume reduction and significant increase in bone density over an integration period of 7 months. No significant differences concerning volume and bone density were observed between the groups. Three years after loading, 51 of 53 implants were in situ with no peri-implant infections, and only a few soft-tissue variations were present. The present prospective randomized study showed that no differences could be observed clinically and radiologically. Accordingly, it seems that both biomaterials, independent of their physicochemical composition, enable clinical success and long-time stability for dental implants. Interestingly, the histological results showed distinct differences in cellular reactions: While the xenogeneic BO induced a mild tissue reaction with only few multinucleated giant cells and comparably low vascularization, the synthetic NB induced a multinucleated giant cell-triggered tissue reaction with an increase of vascularization. Thus, the present study showed that a combination analysis-histological, clinical, and radiological-is necessary for a detailed assessment of a biomaterial's quality for clinical application.

Dental Faculty Accuracy When Using Diagnostic Codes: A Pilot Study.

PubMed

Sutton, Jeanne C; Fay, Rose-Marie; Huynh, Carolyn P; Johnson, Cleverick D; Zhu, Liang; Quock, Ryan L

2017-05-01

The aim of this study was to examine the accuracy of dental faculty members' utilization of diagnostic codes and resulting treatment planning based on radiographic interproximal tooth radiolucencies. In 2015, 50 full-time and part-time general dentistry faculty members at one U.S. dental school were shown a sequence of 15 bitewing radiographs; one interproximal radiolucency was highlighted on each bitewing. For each radiographic lesion, participants were asked to choose the most appropriate diagnostic code (from a concise list of five codes, corresponding to lesion progression to outer/inner halves of enamel and outer/middle/pulpal thirds of dentin), acute treatment (attempt to arrest/remineralize non-invasively, operative intervention, or no treatment), and level of confidence in choices. Diagnostic and treatment choices of participants were compared to "gold standard" correct responses, as determined by expert radiology and operative faculty members, respectively. The majority of the participants selected the correct diagnostic code for lesions in the outer one-third of dentin (p<0.0001) and the pulpal one-third of dentin (p<0.0001). For lesions in the outer and inner halves of enamel and the middle one-third of dentin, the correct rates were moderate. However, the majority of the participants chose correct treatments on all types of lesions (correct rate 63.6-100%). Faculty members' confidence in their responses was generally high for all lesions, all above 90%. Diagnostic codes were appropriately assigned by participants for the very deepest lesions, but they were not assigned accurately for more incipient lesions (limited to enamel). Paradoxically, treatment choices were generally correct, regardless of diagnostic choices. Further calibration is needed to improve faculty use and teaching of diagnostic codes.

U.S. national response assets for radiological incidents.

PubMed

Remick, Alan L; Crapo, John L; Woodruff, Charles R

2005-11-01

The federal government has had the ability to respond to incidents of national significance for decades. Since 11 September 2001, there have been enhancements to existing federal assets and the creation of new federal assets. This presentation will provide an overview of the more significant federal assets. Pivotal to a response of national significance is the U.S. Department of Energy (DOE) Federal Radiological Monitoring and Assessment Center, which organizes and coordinates federal agency monitoring activities during an emergency. DOE manages the Federal Radiological Monitoring and Assessment Center during the emergency phase, and the Environmental Protection Agency (EPA) manages the response during the recovery phase once the emergency is terminated. EPA monitoring teams provide support during both the emergency and recovery phases of an emergency. Other DOE teams are available to respond to major nuclear power plant events, transportation accidents, or terrorism events involving the use of radiological materials, including the Radiological Assistance Program, the Aerial Measuring System, the National Atmospheric Release Advisory Center, and the Radiation Emergency Assistance Center/Training Site. For incidents involving a nuclear weapon, an improvised nuclear device, or a radiological dispersal device, DOE assets such as the Nuclear Emergency Support Team and the Accident Response Group could provide capabilities for weapon or device search, recovery, and removal. The Radiological Triage System harnesses the weapons scientists and engineers at the DOE national laboratories to provide gamma spectroscopy interpretation for agencies responding to an incident. In recent years, National Guard Weapons of Mass Destruction-Civil Support Teams have been created to support state and local response to terrorism events. The Civil Support Teams normally come under direct control of the state and can respond without requiring authorization from the U.S. Department of Defense (DoD). Changes brought about by the events of September 11 also extend to changing federal response policy and planning. Therefore, the Catastrophic Incident Response Annex to the National Response Plan is discussed. DoD also provides specifically designated radiological response capabilities that can be utilized within the guidelines of the National Response Plan. While optimally designed to support military missions, these resources also help provide for a well-equipped set of national assets to temporarily support and augment the local, state, and federal civil agencies that have primary authority and responsibility for domestic disaster assistance. The military's role in domestic emergencies is well defined in military regulations, as well as the national plan.

Evaluation in industry of a draft code of practice for manual handling.

PubMed

Ashby, Liz; Tappin, David; Bentley, Tim

2004-05-01

This paper reports findings from a study which evaluated the draft New Zealand Code of Practice for Manual Handling. The evaluation assessed the ease of use, applicability and validity of the Code and in particular the associated manual handling hazard assessment tools, within New Zealand industry. The Code was studied in a sample of eight companies from four sectors of industry. Subjective feedback and objective findings indicated that the Code was useful, applicable and informative. The manual handling hazard assessment tools incorporated in the Code could be adequately applied by most users, with risk assessment outcomes largely consistent with the findings of researchers using more specific ergonomics methodologies. However, some changes were recommended to the risk assessment tools to improve usability and validity. The evaluation concluded that both the Code and the tools within it would benefit from simplification, improved typography and layout, and industry-specific information on manual handling hazards.

A Single-Center Experience With Isolated Limb Infusion: An Interventional Oncology Opportunity.

PubMed

DeFoe, Adam; Heckman, Andrew; Slater, Dick; Silva-Lopez, Edibaldo; Foster, Jason; Bowden, Thom; Vargo, Christopher

2017-03-01

This retrospective review details our experience with isolated limb infusion for the treatment of melanoma, squamous cell carcinoma, and sarcoma in-transit metastases performed entirely in the interventional radiology suite. Eleven patients were treated over a 3-year period. Treatment response was assessed clinically and with PET/CT. Eight patients had either complete or partial response, giving an overall response rate of 72%. Isolated limb infusion can efficiently be performed entirely in the interventional radiology suite.

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

Code manual for CONTAIN 2.0: A computer code for nuclear reactor containment analysis

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

Murata, K.K.; Williams, D.C.; Griffith, R.O.

1997-12-01

The CONTAIN 2.0 computer code is an integrated analysis tool used for predicting the physical conditions, chemical compositions, and distributions of radiological materials inside a containment building following the release of material from the primary system in a light-water reactor accident. It can also predict the source term to the environment. CONTAIN 2.0 is intended to replace the earlier CONTAIN 1.12, which was released in 1991. The purpose of this Code Manual is to provide full documentation of the features and models in CONTAIN 2.0. Besides complete descriptions of the models, this Code Manual provides a complete description of themore » input and output from the code. CONTAIN 2.0 is a highly flexible and modular code that can run problems that are either quite simple or highly complex. An important aspect of CONTAIN is that the interactions among thermal-hydraulic phenomena, aerosol behavior, and fission product behavior are taken into account. The code includes atmospheric models for steam/air thermodynamics, intercell flows, condensation/evaporation on structures and aerosols, aerosol behavior, and gas combustion. It also includes models for reactor cavity phenomena such as core-concrete interactions and coolant pool boiling. Heat conduction in structures, fission product decay and transport, radioactive decay heating, and the thermal-hydraulic and fission product decontamination effects of engineered safety features are also modeled. To the extent possible, the best available models for severe accident phenomena have been incorporated into CONTAIN, but it is intrinsic to the nature of accident analysis that significant uncertainty exists regarding numerous phenomena. In those cases, sensitivity studies can be performed with CONTAIN by means of user-specified input parameters. Thus, the code can be viewed as a tool designed to assist the knowledge reactor safety analyst in evaluating the consequences of specific modeling assumptions.« less

Ward nurses' knowledge of computed tomography scanning.

PubMed

Majeed, M A; Nayeemuddin, M; Christie, M

Patients benefit from and are reassured by advance information on procedures that they are to undergo. Ward nurses should have adequate knowledge of radiological investigations to ensure proper patient preparation and good interdepartmental communication to avoid delays and cancellations. This study was conducted to assess the ward nurses' knowledge of the process of computed tomography (CT) scanning. One hundred and twenty qualified nurses were asked to complete a questionnaire regarding CT scanning. The findings revealed a suboptimal level of awareness about the process. This is probably due to lack of formal teaching for nurses on the wards in regards the different radiological procedures and patient preparation. There is a strong case for better educational talks on rapidly changing radiological techniques for ward staff to ensure high-quality patient care.

Potential presence of metals in patients treated with metal-metal coupling prostheses for hip arthroplasty at 7 and 10 years of follow-up.

PubMed

Sessa, Giuseppe; Testa, Gianluca; Gioitta Iachino, Salvatore; Costarella, Luciano; Puma Pagliarello, Calogero; Ferrante, Margherita; Grasso, Alfina; Pavone, Vito

2018-05-01

Beginning in 2008, metal-on-metal prostheses have been in the spotlight owing to much higher revision rates than expected. Adverse local tissue reactions have been well described in the literature as potential complications. Between 2012 and 2013, 13 patients with metal-on-metal total hip replacements were evaluated clinically and radiologically and with laboratory samples. The same tests were repeated between 2015 and 2016 on eight patients to assess any changes. In the laboratory assessment, we searched for chromium, cobalt, molybdenum, and nickel in blood and urine samples over 24 h. Clinical assessment has shown good score in all patients except one. On a second examination, between 2015 and 2016, all patients obtained results similar to those obtained in the first assessment, except a patient, who reported a recent fall. In the radiological assessment between 2012 and 2013, results were optimal, apart from a case of aseptic mobilization. The patients reassessed 3 years after the first examination showed radiological results similar to those previously obtained, apart from a patient, who showed signals of mobilization. Metal levels found in their blood decreased in most cases after 3 years. Urine levels of nickel increased in five subjects, and chromium levels increased in four, but levels of cobalt and molybdenum decreased in four patients. It could be hypothesized that the decreasing trend of metal ion levels is associated with a stable wear status. On the contrary, a progressive increase in metal ion levels must be considered as early proof of implant loosening.

Development of the voxel computational phantoms of pediatric patients and their application to organ dose assessment

NASA Astrophysics Data System (ADS)

Lee, Choonik

A series of realistic voxel computational phantoms of pediatric patients were developed and then used for the radiation risk assessment for various exposure scenarios. The high-resolution computed tomographic images of live patients were utilized for the development of the five voxel phantoms of pediatric patients, 9-month male, 4-year female, 8-year female, 11-year male, and 14-year male. The phantoms were first developed as head and torso phantoms and then extended into whole body phantoms by utilizing computed tomographic images of a healthy adult volunteer. The whole body phantom series was modified to have the same anthropometrics with the most recent reference data reported by the international commission on radiological protection. The phantoms, named as the University of Florida series B, are the first complete set of the pediatric voxel phantoms having reference organ masses and total heights. As part of the dosimetry study, the investigation on skeletal tissue dosimetry methods was performed for better understanding of the radiation dose to the active bone marrow and bone endosteum. All of the currently available methodologies were inter-compared and benchmarked with the paired-image radiation transport model. The dosimetric characteristics of the phantoms were investigated by using Monte Carlo simulation of the broad parallel beams of external phantom in anterior-posterior, posterior-anterior, left lateral, right lateral, rotational, and isotropic angles. Organ dose conversion coefficients were calculated for extensive photon energies and compared with the conventional stylized pediatric phantoms of Oak Ridge National Laboratory. The multi-slice helical computed tomography exams were simulated using Monte Carlo simulation code for various exams protocols, head, chest, abdomen, pelvis, and chest-abdomen-pelvis studies. Results have found realistic estimates of the effective doses for frequently used protocols in pediatric radiology. The results were very crucial in understanding the radiation risks of the patients undergoing computed tomography. Finally, nuclear medicine simulations were performed by calculating specific absorbed fractions for multiple target-source organ pairs via Monte Carlo simulations. Specific absorbed fractions were calculated for both photon and electron so that they can be used to calculated radionuclide S-values. All of the results were tabulated for future uses and example dose assessment was performed for selected nuclides administered in nuclear medicine.

Management of cosmic radiation exposure for aircraft crew in Japan.

PubMed

Yasuda, Hiroshi; Sato, Tatsuhiko; Yonehara, Hidenori; Kosako, Toshiso; Fujitaka, Kazunobu; Sasaki, Yasuhito

2011-07-01

The International Commission on Radiological Protection has recommended that cosmic radiation exposure of crew in commercial jet aircraft be considered as occupational exposure. In Japan, the Radiation Council of the government has established a guideline that requests domestic airlines to voluntarily keep the effective dose of cosmic radiation for aircraft crew below 5 mSv y(-1). The guideline also gives some advice and policies regarding the method of cosmic radiation dosimetry, the necessity of explanation and education about this issue, a way to view and record dose data, and the necessity of medical examination for crew. The National Institute of Radiological Sciences helps the airlines to follow the guideline, particularly for the determination of aviation route doses by numerical simulation. The calculation is performed using an original, easy-to-use program package called 'JISCARD EX' coupled with a PHITS-based analytical model and a GEANT4-based particle tracing code. The new radiation weighting factors recommended in 2007 are employed for effective dose determination. The annual individual doses of aircraft crew were estimated using this program.

Using the Monte Carlo technique to calculate dose conversion coefficients for medical professionals in interventional radiology

NASA Astrophysics Data System (ADS)

Santos, W. S.; Carvalho, A. B., Jr.; Hunt, J. G.; Maia, A. F.

2014-02-01

The objective of this study was to estimate doses in the physician and the nurse assistant at different positions during interventional radiology procedures. In this study, effective doses obtained for the physician and at points occupied by other workers were normalised by air kerma-area product (KAP). The simulations were performed for two X-ray spectra (70 kVp and 87 kVp) using the radiation transport code MCNPX (version 2.7.0), and a pair of anthropomorphic voxel phantoms (MASH/FASH) used to represent both the patient and the medical professional at positions from 7 cm to 47 cm from the patient. The X-ray tube was represented by a point source positioned in the anterior posterior (AP) and posterior anterior (PA) projections. The CC can be useful to calculate effective doses, which in turn are related to stochastic effects. With the knowledge of the values of CCs and KAP measured in an X-ray equipment, at a similar exposure, medical professionals will be able to know their own effective dose.

Non-destructive in-situ method and apparatus for determining radionuclide depth in media

DOEpatents

Xu, X. George; Naessens, Edward P.

2003-01-01

A non-destructive method and apparatus which is based on in-situ gamma spectroscopy is used to determine the depth of radiological contamination in media such as concrete. An algorithm, Gamma Penetration Depth Unfolding Algorithm (GPDUA), uses point kernel techniques to predict the depth of contamination based on the results of uncollided peak information from the in-situ gamma spectroscopy. The invention is better, faster, safer, and/cheaper than the current practice in decontamination and decommissioning of facilities that are slow, rough and unsafe. The invention uses a priori knowledge of the contaminant source distribution. The applicable radiological contaminants of interest are any isotopes that emit two or more gamma rays per disintegration or isotopes that emit a single gamma ray but have gamma-emitting progeny in secular equilibrium with its parent (e.g., .sup.60 Co, .sup.235 U, and .sup.137 Cs to name a few). The predicted depths from the GPDUA algorithm using Monte Carlo N-Particle Transport Code (MCNP) simulations and laboratory experiments using .sup.60 Co have consistently produced predicted depths within 20% of the actual or known depth.

Validation of a physically based catchment model for application in post-closure radiological safety assessments of deep geological repositories for solid radioactive wastes.

PubMed

Thorne, M C; Degnan, P; Ewen, J; Parkin, G

2000-12-01

The physically based river catchment modelling system SHETRAN incorporates components representing water flow, sediment transport and radionuclide transport both in solution and bound to sediments. The system has been applied to simulate hypothetical future catchments in the context of post-closure radiological safety assessments of a potential site for a deep geological disposal facility for intermediate and certain low-level radioactive wastes at Sellafield, west Cumbria. In order to have confidence in the application of SHETRAN for this purpose, various blind validation studies have been undertaken. In earlier studies, the validation was undertaken against uncertainty bounds in model output predictions set by the modelling team on the basis of how well they expected the model to perform. However, validation can also be carried out with bounds set on the basis of how well the model is required to perform in order to constitute a useful assessment tool. Herein, such an assessment-based validation exercise is reported. This exercise related to a field plot experiment conducted at Calder Hollow, west Cumbria, in which the migration of strontium and lanthanum in subsurface Quaternary deposits was studied on a length scale of a few metres. Blind predictions of tracer migration were compared with experimental results using bounds set by a small group of assessment experts independent of the modelling team. Overall, the SHETRAN system performed well, failing only two out of seven of the imposed tests. Furthermore, of the five tests that were not failed, three were positively passed even when a pessimistic view was taken as to how measurement errors should be taken into account. It is concluded that the SHETRAN system, which is still being developed further, is a powerful tool for application in post-closure radiological safety assessments.

A web based Foundations of Radiological Physics for diagnostic radiology residents.

PubMed

Blackmon, Kevin N; Huda, Walter; Lewis, Madelene C; Tipnis, Sameer; Mah, Eugene; Frey, Donald G

2013-03-01

RATIONALE AND OBJECTS: We describe a new web-based physics course for radiology residents preparing for the Exam of the Future (EOF). A course was developed with a total of 12 web-based modules. Six modules were focused on "imaging" and six on "radiation." A module was subdivided into nine short "nuggets." Traditional lectures were replaced by modules using prerecorded lectures (Tegrity) to a secure website (WebCT). Each module was accompanied by three quizzes, each consisting of ten questions designed to reinforce covered materials. All online modules were accompanied by a noon conference that employed an Audience Response System (Turning Point). Seventeen first-year residents over 2 consecutive years beginning in July 2010 took this new course, and participated in an anonymous online follow-up survey (Survey Monkey). The recorded 12 modules had an overall average duration of 72 ± 19 minutes. Ten of 17 residents expressed a preference of 15 minutes for nugget duration. Highest personal assessment scores of each resident's understanding were obtained in human radiation risks and radiation protection. Residents considered supplemental noon conferences to be important for learning radiological physics. Satisfaction level was largely positive, with five residents highly satisfied, nine residents somewhat satisfied, two residents neutral, and only one resident somewhat dissatisfied. Our Foundations of Radiological Physics course was well received and served as the springboard for mastering x-ray-based imaging modalities of radiography, mammography, fluoroscopy, interventional radiology, and computed tomography. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

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.

A reference standard-based quality assurance program for radiology.

PubMed

Liu, Patrick T; Johnson, C Daniel; Miranda, Rafael; Patel, Maitray D; Phillips, Carrie J

2010-01-01

The authors have developed a comprehensive radiology quality assurance (QA) program that evaluates radiology interpretations and procedures by comparing them with reference standards. Performance metrics are calculated and then compared with benchmarks or goals on the basis of published multicenter data and meta-analyses. Additional workload for physicians is kept to a minimum by having trained allied health staff members perform the comparisons of radiology reports with the reference standards. The performance metrics tracked by the QA program include the accuracy of CT colonography for detecting polyps, the false-negative rate for mammographic detection of breast cancer, the accuracy of CT angiography detection of coronary artery stenosis, the accuracy of meniscal tear detection on MRI, the accuracy of carotid artery stenosis detection on MR angiography, the accuracy of parathyroid adenoma detection by parathyroid scintigraphy, the success rate for obtaining cortical tissue on ultrasound-guided core biopsies of pelvic renal transplants, and the technical success rate for peripheral arterial angioplasty procedures. In contrast with peer-review programs, this reference standard-based QA program minimizes the possibilities of reviewer bias and erroneous second reviewer interpretations. The more objective assessment of performance afforded by the QA program will provide data that can easily be used for education and management conferences, research projects, and multicenter evaluations. Additionally, such performance data could be used by radiology departments to demonstrate their value over nonradiology competitors to referring clinicians, hospitals, patients, and third-party payers. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Fourteen years of progress testing in radiology residency training: experiences from The Netherlands.

PubMed

Rutgers, D R; van Raamt, F; van Lankeren, W; Ravesloot, C J; van der Gijp, A; Ten Cate, Th J; van Schaik, J P J

2018-05-01

To describe the development of the Dutch Radiology Progress Test (DRPT) for knowledge testing in radiology residency training in The Netherlands from its start in 2003 up to 2016. We reviewed all DRPTs conducted since 2003. We assessed key changes and events in the test throughout the years, as well as resident participation and dispensation for the DRPT, test reliability and discriminative power of test items. The DRPT has been conducted semi-annually since 2003, except for 2015 when one digital DRPT failed. Key changes in these years were improvements in test analysis and feedback, test digitalization (2013) and inclusion of test items on nuclear medicine (2016). From 2003 to 2016, resident dispensation rates increased (Pearson's correlation coefficient 0.74, P-value <0.01) to maximally 16 %. Cronbach´s alpha for test reliability varied between 0.83 and 0.93. The percentage of DRPT test items with negative item-rest-correlations, indicating relatively poor discriminative power, varied between 4 % and 11 %. Progress testing has proven feasible and sustainable in Dutch radiology residency training, keeping up with innovations in the radiological profession. Test reliability and discriminative power of test items have remained fair over the years, while resident dispensation rates have increased. • Progress testing allows for monitoring knowledge development from novice to senior trainee. • In postgraduate medical training, progress testing is used infrequently. • Progress testing is feasible and sustainable in radiology residency training.

Radioactive dispersion analysis for hypothetical nuclear power plant (NPP) candidate site in Perak state, Malaysia

NASA Astrophysics Data System (ADS)

Shamsuddin, Shazmeen Daniar; Basri, Nor Afifah; Omar, Nurlyana; Koh, Meng-Hock; Ramli, Ahmad Termizi; Saridan Wan Hassan, Wan Muhamad

2017-10-01

Malaysia is planning to build a nuclear power plant (NPP) by 2030 to diversify the national electricity supply and resources. Selection of an NPP site must consider various factors, especially nuclear safety consideration to fulfil the nuclear safety objectives. Environmental Risk Assessment Analysis is a part of safety requirements by the International Atomic Energy Agency (IAEA) prior to the NPP commissioning process. Risk Assessments Analysis (RIA) is compulsory for the NPP site evaluation. One of RIA methods are Radioactive Dispersion Analysis using probabilistic risk analysis software. It is also important to perform studies to estimate the impact to the neighbouring population in the case of a nuclear accident at the power plant. In the present work, aimed to study the impact of a hypothetical nuclear accident by simulating the dispersion pattern of radionuclides originated from a candidate site at Manjung, Perak. The work has been performed using the HotSpot Health Physics codes. Two types of radionuclides have been considered namely 137Cs and 131I. In calculations, the initial concentration of radioactive materials of Fukushima Daiichi accident data are used which are 2.06 x 1016 Bq and 1.68 x 1017 Bq respectively for the two radionuclides. The result shows that the dispersion distance obtained from both software are not the same. It shows that 137Cs and 131I can be dispersed as far as 16 km and 80 km away from the site during radiological accident respectively, reaching major towns in Perak. Using HOTSPOT, the estimated total effective dose equivalent (TEDE) for 137Cs and 131I at major towns in Perak such as Lumut and Sitiawan are 1.2 mSv and 9.9 mSv. As for Taiping, Ipoh, Kampar, and Teluk Intan the estimated TEDE is around 0.2 mSv and 1.6 mSv respectively. In conclusion, the dispersion can reach as far as 80 km from the site. However, estimated annual effective dose is not more than 1 mSv limit, which is considered acceptable in the point of view of radiological health risk for human and the environment.

Assessment of environmental public exposure from a hypothetical nuclear accident for Unit-1 Bushehr nuclear power plant.

PubMed

Sohrabi, M; Ghasemi, M; Amrollahi, R; Khamooshi, C; Parsouzi, Z

2013-05-01

Unit-1 of the Bushehr nuclear power plant (BNPP-1) is a VVER-type reactor with 1,000-MWe power constructed near Bushehr city at the coast of the Persian Gulf, Iran. The reactor has been recently operational to near its full power. The radiological impact of nuclear power plant (NPP) accidents is of public concern, and the assessment of radiological consequences of any hypothetical nuclear accident on public exposure is vital. The hypothetical accident scenario considered in this paper is a design-basis accident, that is, a primary coolant leakage to the secondary circuit. This scenario was selected in order to compare and verify the results obtained in the present paper with those reported in the Final Safety Analysis Report (FSAR 2007) of the BNPP-1 and to develop a well-proven methodology that can be used to study other and more severe hypothetical accident scenarios for this reactor. In the present study, the version 2.01 of the PC COSYMA code was applied. In the early phase of the accidental releases, effective doses (from external and internal exposures) as well as individual and collective doses (due to the late phase of accidental releases) were evaluated. The surrounding area of the BNPP-1 within a radius of 80 km was subdivided into seven concentric rings and 16 sectors, and distribution of population and agricultural products was calculated for this grid. The results show that during the first year following the modeled hypothetical accident, the effective doses do not exceed the limit of 5 mSv, for the considered distances from the BNPP-1. The results obtained in this study are in good agreement with those in the FSAR-2007 report. The agreement obtained is in light of many inherent uncertainties and variables existing in the two modeling procedures applied and proves that the methodology applied here can also be used to model other severe hypothetical accident scenarios of the BNPP-1 such as a small and large break in the reactor coolant system as well as beyond design-basis accidents. Such scenarios are planned to be studied in the near future, for this reactor.

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.

Experimental Design and Data Analysis in Receiver Operating Characteristic Studies: Lessons Learned from Reports in Radiology from 1997 to 20061

PubMed Central

Shiraishi, Junji; Pesce, Lorenzo L.; Metz, Charles E.; Doi, Kunio

2009-01-01

Purpose: To provide a broad perspective concerning the recent use of receiver operating characteristic (ROC) analysis in medical imaging by reviewing ROC studies published in Radiology between 1997 and 2006 for experimental design, imaging modality, medical condition, and ROC paradigm. Materials and Methods: Two hundred ninety-five studies were obtained by conducting a literature search with PubMed with two criteria: publication in Radiology between 1997 and 2006 and occurrence of the phrase “receiver operating characteristic.” Studies returned by the query that were not diagnostic imaging procedure performance evaluations were excluded. Characteristics of the remaining studies were tabulated. Results: Two hundred thirty-three (79.0%) of the 295 studies reported findings based on observers' diagnostic judgments or objective measurements. Forty-three (14.6%) did not include human observers, with most of these reporting an evaluation of a computer-aided diagnosis system or functional data obtained with computed tomography (CT) or magnetic resonance (MR) imaging. The remaining 19 (6.4%) studies were classified as reviews or meta-analyses and were excluded from our subsequent analysis. Among the various imaging modalities, MR imaging (46.0%) and CT (25.7%) were investigated most frequently. Approximately 60% (144 of 233) of ROC studies with human observers published in Radiology included three or fewer observers. Conclusion: ROC analysis is widely used in radiologic research, confirming its fundamental role in assessing diagnostic performance. However, the ROC studies reported in Radiology were not always adequate to support clear and clinically relevant conclusions. © RSNA, 2009 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.2533081632/-/DC1 PMID:19864510

Calibration and performance of a real-time gamma-ray spectrometry water monitor using a LaBr3(Ce) detector

NASA Astrophysics Data System (ADS)

Prieto, E.; Casanovas, R.; Salvadó, M.

2018-03-01

A scintillation gamma-ray spectrometry water monitor with a 2″ × 2″ LaBr3(Ce) detector was characterized in this study. This monitor measures gamma-ray spectra of river water. Energy and resolution calibrations were performed experimentally, whereas the detector efficiency was determined using Monte Carlo simulations with EGS5 code system. Values of the minimum detectable activity concentrations for 131I and 137Cs were calculated for different integration times. As an example of the monitor performance after calibration, a radiological increment during a rainfall episode was studied.

Radiological assessment for bauxite mining and alumina refining.

PubMed

O'Connor, Brian H; Donoghue, A Michael; Manning, Timothy J H; Chesson, Barry J

2013-01-01

Two international benchmarks assess whether the mining and processing of ores containing Naturally Occurring Radioactive Material (NORM) require management under radiological regulations set by local jurisdictions. First, the 1 Bq/g benchmark for radionuclide head of chain activity concentration determines whether materials may be excluded from radiological regulation. Second, processes may be exempted from radiological regulation where occupational above-background exposures for members of the workforce do not exceed 1 mSv/year. This is also the upper-limit of exposure prescribed for members of the public. Alcoa of Australia Limited (Alcoa) has undertaken radiological evaluations of the mining and processing of bauxite from the Darling Range of Western Australia since the 1980s. Short-term monitoring projects have demonstrated that above-background exposures for workers do not exceed 1 mSv/year. A whole-of-year evaluation of above-background, occupational radiological doses for bauxite mining, alumina refining and residue operations was conducted during 2008/2009 as part of the Alcoa NORM Quality Assurance System (NQAS). The NQAS has been guided by publications from the International Commission on Radiological Protection (ICRP), the International Atomic Energy Agency (IAEA) and the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA). The NQAS has been developed specifically in response to implementation of the Australian National Directory on Radiation Protection (NDRP). Positional monitoring was undertaken to increase the accuracy of natural background levels required for correction of occupational exposures. This is important in view of the small increments in exposure that occur in bauxite mining, alumina refining and residue operations relative to natural background. Positional monitoring was also undertaken to assess the potential for exposure in operating locations. Personal monitoring was undertaken to characterise exposures in Similar Exposure Groups (SEGs). The monitoring was undertaken over 12 months, to provide annual average assessments of above-background doses, thereby reducing temporal variations, especially for radon exposures. The monitoring program concentrated on gamma and radon exposures, rather than gross alpha exposures, as past studies have shown that gross alpha exposures from inhalable dust for most of the workforce are small in comparison to combined gamma and radon exposures. The natural background determinations were consistent with data in the literature for localities near Alcoa's mining, refining and residue operations in Western Australia, and also with UNSCEAR global data. Within the mining operations, there was further consistency between the above-background dose estimates and the local geochemistry, with slight elevation of dose levels in mining pits. Conservative estimates of above-background levels for the workforce have been made using an assumption of 100% occupancy (1920 hours per year) for the SEGs considered. Total incremental composite doses for individuals were clearly less than 1.0 mSv/year when gamma, radon progeny and gross alpha exposures were considered. This is despite the activity concentration of some materials being slightly higher than the benchmark of 1 Bq/g. The results are consistent with previous monitoring and demonstrate compliance with the 1 mSv/year exemption level within mining, refining and residue operations. These results will be of value to bauxite mines and alumina refineries elsewhere in the world.

Cracking the Code: Assessing Institutional Compliance with the Australian Code for the Responsible Conduct of Research

ERIC Educational Resources Information Center

Morris, Suzanne E.

2010-01-01

This paper provides a review of institutional authorship policies as required by the "Australian Code for the Responsible Conduct of Research" (the "Code") (National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC) & Universities Australia (UA) 2007), and assesses them for Code compliance.…

Automated assessment and tracking of human body thermal variations using unsupervised clustering.

PubMed

Yousefi, Bardia; Fleuret, Julien; Zhang, Hai; Maldague, Xavier P V; Watt, Raymond; Klein, Matthieu

2016-12-01

The presented approach addresses a review of the overheating that occurs during radiological examinations, such as magnetic resonance imaging, and a series of thermal experiments to determine a thermally suitable fabric material that should be used for radiological gowns. Moreover, an automatic system for detecting and tracking of the thermal fluctuation is presented. It applies hue-saturated-value-based kernelled k-means clustering, which initializes and controls the points that lie on the region-of-interest (ROI) boundary. Afterward, a particle filter tracks the targeted ROI during the video sequence independently of previous locations of overheating spots. The proposed approach was tested during experiments and under conditions very similar to those used during real radiology exams. Six subjects have voluntarily participated in these experiments. To simulate the hot spots occurring during radiology, a controllable heat source was utilized near the subject's body. The results indicate promising accuracy for the proposed approach to track hot spots. Some approximations were used regarding the transmittance of the atmosphere, and emissivity of the fabric could be neglected because of the independence of the proposed approach for these parameters. The approach can track the heating spots continuously and correctly, even for moving subjects, and provides considerable robustness against motion artifact, which occurs during most medical radiology procedures.

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.

Tumor response evaluation after neoadjuvant chemotherapy in locally advanced gastric adenocarcinoma: a prospective, multi-center cohort study

PubMed Central

De Martini, Paolo; Ceresoli, Marco; Mari, Giulio M.; Costanzi, Andrea; Maggioni, Dario; Pugliese, Raffaele; Ferrari, Giovanni

2017-01-01

Background To verify the prognostic value of the pathologic and radiological tumor response after neoadjuvant chemotherapy in the treatment of locally advanced gastric adenocarcinoma. Methods A total of 67 patients with locally advanced gastric cancer (clinical ≥ T2 or nodal disease and without evidence of distant metastases) underwent perioperative chemotherapy (ECF or ECX regimen) from December 2009 through June 2015 in two surgical units. Histopathological and radiological response to chemotherapy were evaluated by using tumor regression grade (TRG) (Becker’s criteria) and volume change assessed by CT. Results Fifty-one (86%) patients completed all chemotherapy scheduled cycles successfully and surgery was curative (R0) in 64 (97%) subjects. The histopathological analysis showed 19 (29%) specimens with TRG1 (less than 10% of vital tumor left) and 25 (37%) patients had partial or complete response (CR) assessed by CT scan. Median disease free survival (DFS) and overall survival (OS) were 25.70 months (range, 14.52–36.80 months) and 36.60 months (range, 24.3–52.9 months), respectively. The median follow up was 27 months (range, 5.00–68.00 months). Radiological response and TRG were found to be a prognostic factor for OS and DFS, while tumor histology was not significantly related to survival. Conclusions Both radiological response and TRG have been shown as promising survival markers in patients treated with perioperative chemotherapy for locally advanced gastric cancer. Other predictive markers of response to chemotherapy are strongly required. PMID:29299362

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.

Assessment of eye lens doses for workers during interventional radiology procedures.

PubMed

Urboniene, A; Sadzeviciene, E; Ziliukas, J

2015-07-01

The assessment of eye lens doses for workers during interventional radiology (IR) procedures was performed using a new eye lens dosemeter. In parallel, the results of routine individual monitoring were analysed and compared with the results obtained from measurements with a new eye lens dosemeter. The eye lens doses were assessed using Hp(3) measured at the level of the eyes and were compared with Hp(10) measured with the whole-body dosemeter above the lead collar. The information about use of protective measures, the number of performed interventional procedures per month and their fluoroscopy time was also collected. The assessment of doses to the lens of the eye was done for 50 IR workers at 9 Lithuanian hospitals for the period of 2012-2013. If the use of lead glasses is not taken into account, the estimated maximum annual dose equivalent to the lens of the eye was 82 mSv. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Toxicology profiles of chemical and radiological contaminants at Hanford

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

Harper, B.L.; Strenge, D.L.; Stenner, R.D.

1995-07-01

This document summarizes toxicology information required under Section 3.3 (Toxicity Assessment) of HSRAM, and can also be used to develop the short toxicology profiles required in site assessments (described in HSRAM, Section 3.3.5). Toxicology information is used in the dose-response step of the risk assessment process. The dose-response assessment describes the quantitative relationship between the amount of exposure to a substance and the extent of toxic injury or disease. Data are derived from animal studies or, less frequently, from studies in exposed human populations. The risks of a substance cannot be ascertained with any degree of confidence unless dose-response relationsmore » are quantified. This document summarizes dose-response information available from the US Environmental Protection Agency (EPA). The contaminants selected for inclusion in this document represent most of the contaminants found at Hanford (both radiological and chemical), based on sampling and analysis performed during site investigations, and historical information on waste disposal practices at the Hanford Site.« less

Technology assessment of medical devices at the Center for Devices and Radiological Health.

PubMed

Kessler, L; Richter, K

1998-09-25

We reviewed the Food and Drug Administration's regulatory process for medical devices and described the issues that arise in assessing device safety and effectiveness during the postmarket period. The Center for Devices and Radiological Health (CDRH), an organization within the Food and Drug Administration, has the legal authority and responsibility for ensuring that medical devices marketed in the United States are both reasonably safe and effective for their intended use. This is an enormous challenge given the diversity of medical devices and the large number of different types of devices on the market. Many scientific and regulatory activities are necessary to ensure device safety and effectiveness, including technology assessment, albeit in a manner quite different from that of conventional technology assessment. The basic approach taken at the CDRH to ensure device safety and effectiveness is to develop an understanding of the way in which a medical device works and how it will perform in clinical situations.

Exploration of association rule mining for coding consistency and completeness assessment in inpatient administrative health data.

PubMed

Peng, Mingkai; Sundararajan, Vijaya; Williamson, Tyler; Minty, Evan P; Smith, Tony C; Doktorchik, Chelsea T A; Quan, Hude

2018-03-01

Data quality assessment is a challenging facet for research using coded administrative health data. Current assessment approaches are time and resource intensive. We explored whether association rule mining (ARM) can be used to develop rules for assessing data quality. We extracted 2013 and 2014 records from the hospital discharge abstract database (DAD) for patients between the ages of 55 and 65 from five acute care hospitals in Alberta, Canada. The ARM was conducted using the 2013 DAD to extract rules with support ≥0.0019 and confidence ≥0.5 using the bootstrap technique, and tested in the 2014 DAD. The rules were compared against the method of coding frequency and assessed for their ability to detect error introduced by two kinds of data manipulation: random permutation and random deletion. The association rules generally had clear clinical meanings. Comparing 2014 data to 2013 data (both original), there were 3 rules with a confidence difference >0.1, while coding frequency difference of codes in the right hand of rules was less than 0.004. After random permutation of 50% of codes in the 2014 data, average rule confidence dropped from 0.72 to 0.27 while coding frequency remained unchanged. Rule confidence decreased with the increase of coding deletion, as expected. Rule confidence was more sensitive to code deletion compared to coding frequency, with slope of change ranging from 1.7 to 184.9 with a median of 9.1. The ARM is a promising technique to assess data quality. It offers a systematic way to derive coding association rules hidden in data, and potentially provides a sensitive and efficient method of assessing data quality compared to standard methods. Copyright © 2018 Elsevier Inc. All rights reserved.

Radiological and clinical predictors of long-term outcome in rotator cuff calcific tendinitis.

PubMed

de Witte, Pieter Bas; van Adrichem, Raymond A; Selten, Jasmijn W; Nagels, Jochem; Reijnierse, M; Nelissen, Rob G H H

2016-10-01

Knowledge on the epidemiology and long-term course of rotator cuff calcific tendinitis (RCCT) is scarce. We assessed demographics, radiological characteristics, and their association with long-term outcomes in a large patient group. Baseline demographics, radiological characteristics and treatment were recorded in 342 patients. Interobserver agreement of radiological measures was analyzed. Long-term outcome was evaluated with questionnaires (WORC, DASH). The association of baseline characteristics with outcome was assessed. Mean age was 49.0 (SD = 10.0), and 59.5 % were female. The dominant arm was affected in 66.0 %, and 21.3 % had bilateral disease. Calcifications were on average 18.7 mm (SD = 10.1, ICC = 0.84 (p < 0.001)) and located 10.1 mm (SD = 11.8) medially to the acromion (ICC = 0.77 (p < 0.001)). Gärtner type I calcifications were found in 32.1 % (Kappa = 0.47 (p < 0.001)). After 14 years (SD = 7.1) of follow-up, median WORC was 72.5 (range, 3.0-100.0; WORC < 60 in 42 %) and median DASH 17.0 (range, 0.0-82.0). Female gender, dominant arm involvement, bilateral disease, longer duration of symptoms, and multiple calcifications were associated with inferior WORC. DASH results were similar. Many subjects have persisting shoulder complaints years after diagnosis, regardless of treatment. Female gender, dominant arm involvement, bilateral disease, longer duration of symptoms, and multiple calcifications were associated with inferior outcome. Radiological measures had moderate-to-good reliability and no prognostic value. • Most RCCT studies report on short-term outcome and/or small patients groups. • In this large, long-term observational study, RCCT appeared to not be self-limiting in many subjects. • Negative prognostic factors included female gender, more calcifications, dominant arm affected, and longer duration of symptoms. • Interobserver agreement of general radiological RCCT measures is moderate to good. • More rigorous diagnostics and treatment might be needed in specific RCCT cases.

FDA adverse Event Problem Codes: standardizing the classification of device and patient problems associated with medical device use.

PubMed

Reed, Terrie L; Kaufman-Rivi, Diana

2010-01-01

The broad array of medical devices and the potential for device failures, malfunctions, and other adverse events associated with each device creates a challenge for public health device surveillance programs. Coding reported events by type of device problem provides one method for identifying a potential signal of a larger device issue. The Food and Drug Administration's (FDA) Center for Devices and Radiological Health (CDRH) Event Problem Codes that are used to report adverse events previously lacked a structured set of controls for code development and maintenance. Over time this led to inconsistent, ambiguous, and duplicative concepts being added to the code set on an ad-hoc basis. Recognizing the limitation of its coding system the FDA set out to update the system to improve its usefulness within FDA and as a basis of a global standard to identify important patient and device outcomes throughout the medical community. In 2004, FDA and the National Cancer Institute (NCI) signed a Memorandum of Understanding (MOU) whereby NCI agreed to provide terminology development and maintenance services to all FDA Centers. Under this MOU, CDRH's Office of Surveillance and Biometrics (OSB) convened a cross-Center workgroup and collaborated with staff at NCI Enterprise Vocabulary Service (EVS) to streamline the Patient and Device Problem Codes and integrate them into the NCI Thesaurus and Meta-Thesaurus. This initiative included many enhancements to the Event Problem Codes aimed at improving code selection as well as improving adverse event report analysis. LIMITATIONS & RECOMMENDATIONS: Staff resources, database concerns, and limited collaboration with external groups in the initial phases of the project are discussed. Adverse events associated with medical device use can be better understood when they are reported using a consistent and well-defined code set. This FDA initiative was an attempt to improve the structure and add control mechanisms to an existing code set, improve analysis tools that will better identify device safety trends, and improve the ability to prevent or mitigate effects of adverse events associated with medical device use.

Calculation of the Phenix end-of-life test 'Control Rod Withdrawal' with the ERANOS code

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

Tiberi, V.

2012-07-01

The Inst. of Radiological Protection and Nuclear Safety (IRSN) acts as technical support to French public authorities. As such, IRSN is in charge of safety assessment of operating and under construction reactors, as well as future projects. In this framework, one current objective of IRSN is to evaluate the ability and accuracy of numerical tools to foresee consequences of accidents. Neutronic studies step in the safety assessment from different points of view among which the core design and its protection system. They are necessary to evaluate the core behavior in case of accident in order to assess the integrity ofmore » the first barrier and the absence of a prompt criticality risk. To reach this objective one main physical quantity has to be evaluated accurately: the neutronic power distribution in core during whole reactor lifetime. Phenix end of life tests, carried out in 2009, aim at increasing the experience feedback on sodium cooled fast reactors. These experiments have been done in the framework of the development of the 4. generation of nuclear reactors. Ten tests have been carried out: 6 on neutronic and fuel aspects, 2 on thermal hydraulics and 2 for the emergency shutdown. Two of them have been chosen for an international exercise on thermal hydraulics and neutronics in the frame of an IAEA Coordinated Research Project. Concerning neutronics, the Control Rod Withdrawal test is relevant for safety because it allows evaluating the capability of calculation tools to compute the radial power distribution on fast reactors core configurations in which the flux field is very deformed. IRSN participated to this benchmark with the ERANOS code developed by CEA for fast reactors studies. This paper presents the results obtained in the framework of the benchmark activity. A relatively good agreement was found with available measures considering the approximations done in the modeling. The work underlines the importance of burn-up calculations in order to have a fine core concentrations mesh for the calculation of the power distribution. (authors)« less

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

Hardin, Ernest; Su, Jiann-Cherng; Peretz, Fred

The primary purpose of the preclosure radiological safety assessment (that this document supports) is to identify risk factors for disposal operations, to aid in design for the deep borehole field test (DBFT) engineering demonstration.

A Strategy to Overcome the Radiology Lottery in the Staging of Head and Neck Cancer: An Aid to Attaining the 30-Day Rule

PubMed Central

Elloy, Marianne; Jarvis, Sara; Davis, Anne

2009-01-01

INTRODUCTION Rapid access to radiological services is essential, if the British Association of Otolaryngologists – Head and Neck Surgeons Minimum Temporal Standards are to be met in the management of head and neck cancer patients. This study assesses a new initiative whereby the multidisciplinary team prioritises allocated imaging appointments rather than using the traditional radiological triage system. PATIENTS AND METHODS This study was a prospective audit of all patients referred over a 3-month period with suspected head and neck cancer. The main outcome measures were: (i) median interval in days from general practitioner (GP) referral to staging scan; and (ii) median interval in days from first clinic appointment to staging scan. RESULTS The new multidisciplinary team booking system led to a statistically significant reduction in the ‘request-to-scan time’ (from 12 days to 5 days). The time from ‘GP to scan’ also improved. CONCLUSIONS This new multidisciplinary team-led booking system, could, in the future, speed up access to radiology services lead and neck cancer patients, allowing earlier definitive treatment. PMID:19126338

Radiological impact of natural radioactivity in Egyptian phosphate rocks, phosphogypsum and phosphate fertilizers.

PubMed

El-Bahi, S M; Sroor, A; Mohamed, Gehan Y; El-Gendy, N S

2017-05-01

In this study, the activity concentrations of the natural radionuclides in phosphate rocks and its products were measured using a high- purity germanium detector (HPGe). The obtained activity results show remarkable wide variation in the radioactive contents for the different phosphate samples. The average activity concentration of 235 U, 238 U, 226 Ra, 232 Th and 40 K was found as (45, 1031, 786, 85 and 765Bq/kg) for phosphate rocks, (28, 1234, 457, 123 and 819Bq/kg) for phosphate fertilizers, (47, 663, 550, 79 and 870Bq/kg) for phosphogypsum and (25, 543, 409, 54 and 897Bq/kg) for single super phosphate respectively. Based on the measured activities, the radiological parameters (activity concentration index, absorbed gamma dose rate in outdoor and indoor and the corresponding annual effective dose rates and total excess lifetime cancer risk) were estimated to assess the radiological hazards. The total excess lifetime cancer risk (ELCR) has been calculated and found to be high in all samples, which related to high radioactivity, representing radiological risk for the health of the population. Copyright © 2017 Elsevier Ltd. All rights reserved.

75 FR 20867 - DTE Energy; Enrico Fermi Atomic Power Plant, Unit 1

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-21

... Power Plant, Unit 1 Environmental Assessment and Finding of No Significant Impact for an Exemption From... County, Michigan. Environmental Assessment Identification of Proposed Action The proposed action is in... the Michigan Department of Natural Resources and the Environment, Radiological Protection and Medical...

Assessment for the management of NORM wastes in conventional hazardous and nonhazardous waste landfills.

PubMed

Mora, Juan C; Baeza, Antonio; Robles, Beatriz; Sanz, Javier

2016-06-05

Naturally Occurring Radioactive Materials (NORM) wastes are generated in huge quantities in several industries and their management has been carried out under considerations of industrial non-radioactive wastes, before the concern on the radioactivity content was included in the legislation. Therefore these wastes were conditioned using conventional methods and the waste disposals were designed to isolate toxic elements from the environment for long periods of time. Spanish regulation for these conventional toxic waste disposals includes conditions that assure adequate isolation to minimize the impact of the wastes to the environment in present and future conditions. After 1996 the radiological impact of the management of NORM wastes is considered and all the aspects related with natural radiations and the radiological control regarding the management of residues from NORM industries were developed in the new regulation. One option to be assessed is the disposal of NORM wastes in hazardous and non-hazardous waste disposals, as was done before this new regulation. This work analyses the management of NORM wastes in these landfills to derive the masses that can be disposed without considerable radiological impact. Generic dose assessments were carried out under highly conservative hypothesis and a discussion on the uncertainty and variability sources was included to provide consistency to the calculations. Copyright © 2016 Elsevier B.V. All rights reserved.

An assessment of the relationship between congenital transverse deficiency of the forearm and symbrachydactyly.

PubMed

Kallemeier, Patricia M; Manske, Paul R; Davis, Benjamin; Goldfarb, Charles A

2007-11-01

A relationship between symbrachydactyly and transverse deficiency has been suggested but has not been critically investigated or established by scientific studies. The purpose of this investigation was to evaluate a large group of patients with transverse deficiency of the forearm for clinical and radiologic features typically seen in patients with symbrachydactyly. A retrospective review of the medical records of 291 patients with a diagnosis of upper-extremity transverse deficiency at the level of the forearm was performed. Patient charts, photographs, and radiographs were evaluated for manifestations of symbrachydactyly; specifically, we clinically assessed for the presence of nubbins and skin invaginations and radiologically assessed for hypoplasia of the proximal radius and ulna. Two hundred seven patients had soft tissue nubbins at the end of their amputation stumps including 38 with the additional finding of skin invagination at the distal end. Another 36 extremities had a skin invagination alone. Twenty-nine of the extremities without nubbins or skin invaginations had hypoplasia of the proximal radius and ulna. Thus, 272 of the 291 extremities with transverse deficiency had manifestations of symbrachydactyly. The majority of patients with the diagnosis of transverse deficiency have soft tissue nubbins, skin invaginations, or hypoplasia of the proximal radius and ulna at the end of their amputation stumps. These clinical and radiologic features support the concept that transverse deficiency through the forearm represents a proximal continuum of symbrachydactyly.

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

Analysis of the influence of the heat transfer phenomena on the late phase of the ThAI Iod-12 test

NASA Astrophysics Data System (ADS)

Gonfiotti, B.; Paci, S.

2014-11-01

Iodine is one of the major contributors to the source term during a severe accident in a Nuclear Power Plant for its volatility and high radiological consequences. Therefore, large efforts have been made to describe the Iodine behaviour during an accident, especially in the containment system. Due to the lack of experimental data, in the last years many attempts were carried out to fill the gaps on the knowledge of Iodine behaviour. In this framework, two tests (ThAI Iod-11 and Iod-12) were carried out inside a multi-compartment steel vessel. A quite complex transient characterizes these two tests; therefore they are also suitable for thermal- hydraulic benchmarks. The two tests were originally released for a benchmark exercise during the SARNET2 EU Project. At the end of this benchmark a report covering the main findings was issued, stating that the common codes employed in SA studies were able to simulate the tests but with large discrepancies. The present work is then related to the application of the new versions of ASTEC and MELCOR codes with the aim of carry out a new code-to-code comparison vs. ThAI Iod-12 experimental data, focusing on the influence of the heat exchanges with the outer environment, which seems to be one of the most challenging issues to cope with.

NTS radiological assessment project: comparison of delta-surface interpolation with kriging for the Frenchman Lake region of area 5

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

Foley, T.A. Jr.

The primary objective of this report is to compare the results of delta surface interpolation with kriging on four large sets of radiological data sampled in the Frenchman Lake region at the Nevada Test Site. The results of kriging, described in Barnes, Giacomini, Reiman, and Elliott, are very similar to those using the delta surface interpolant. The other topic studied is in reducing the number of sample points and obtaining results similar to those using all of the data. The positive results here suggest that great savings of time and money can be made. Furthermore, the delta surface interpolant ismore » viewed as a contour map and as a three dimensional surface. These graphical representations help in the analysis of the large sets of radiological data.« less

Characterizing Contamination and Assessing Exposure, Risk and Resilience

EPA Pesticide Factsheets

EPA supports its responders' ability to characterize site contamination by developing sampling protocols, sample preparation methods, and analytical methods for chemicals, biotoxins, microbial pathogens, and radiological agents.

Odontogenic Cysts - An Overview.

PubMed

Nayyer, Namita V; Macluskey, Michaelina; Keys, William

2015-01-01

This article aims to discuss the clinical features, radiological assessment, histopathology and management of a variety of odontogenic cysts. It also highlights the reclassification of odontogenic keratocysts to keratocystic odontogenic tumours.

Radiological assessment of the breast following enhancement with Macrolane: Managing the challenges.

PubMed

Scaperrotta, Gianfranco; Satchithananda, Keshtra; Tengvar, Magnus; Post, Karin; Lim, Adrian K; Panizza, Pietro; Wesolowska, Ewa; Inglefield, Christopher J

2017-01-01

Macrolane VRF ® , a biodegradable, stabilized hyaluronic acid gel, was used for breast enhancement 2008-2012. Similar to permanent implants, the presence of Macrolane gel may interfere with interpretation of mammography. This short communication aims to provide a guide to the appearance of Macrolane on radiology examination (including mammography, ultrasound and magnetic resonance imaging) and aid selection of the most appropriate imaging modality to facilitate breast examination in women who have undergone Macrolane breast enhancement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 2: Patient Preparation and Medications)

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

Taslakian, Bedros, E-mail: btaslakian@gmail.com; Sebaaly, Mikhael Georges, E-mail: ms246@aub.edu.lb; Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb

2016-04-15

Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care. Patient care before and after an interventional procedure, identification, and management of early and delayed complications of various procedures are equal in importance to the procedure itself. In this second part, we complete the comprehensive, methodical review of pre-procedural care and patient preparation before vascular and interventional radiology procedures.

Ebola virus disease: radiology preparedness.

PubMed

Bluemke, David A; Meltzer, Carolyn C

2015-02-01

At present, there is a major emphasis on Ebola virus disease (EVD) preparedness training at medical facilities throughout the United States. Failure to have proper EVD procedures in place was cited as a major reason for infection of medical personnel in the United States. Medical imaging does not provide diagnosis of EVD, but patient assessment in the emergency department and treatment isolation care unit is likely to require imaging services. The purpose of this article is to present an overview of relevant aspects of EVD disease and preparedness relevant to the radiologic community. © RSNA, 2014.

Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 2: Patient Preparation and Medications).

PubMed

Taslakian, Bedros; Sebaaly, Mikhael Georges; Al-Kutoubi, Aghiad

2016-04-01

Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care. Patient care before and after an interventional procedure, identification, and management of early and delayed complications of various procedures are equal in importance to the procedure itself. In this second part, we complete the comprehensive, methodical review of pre-procedural care and patient preparation before vascular and interventional radiology procedures.

Radiological progression and its predictive risk factors in silicosis

PubMed Central

Lee, H; Phoon, W; Ng, T

2001-01-01

OBJECTIVES—To investigate the risk factors predicting radiological progression in silicosis in a prospective cohort study of patients with silicosis who were previously exposed to silica from granite dust.
METHODS—From among a total of 260 patients with silicosis contracted from granite work, 141 with available serial chest x ray films of acceptable quality taken over a period of 2 to 17 (mean 7.5) years, were selected for study. Ninety four (66.7%) had ended exposure 5 or more years perviously (mean 10.1 years, maximum 28 years). Radiological progression was assessed by paired comparison of the initial and most recent radiographs, with two or more steps of increase in profusion of small opacities according to the 12 point scale of the International Labour Organisation (ILO) classification of radiographs of pneumoconiosis, taken from the majority reading by a panel of three independent readers.
RESULTS—Overall, 37% of patients with silicosis had radiological evidence of progression. From the initial radiographs, 24 (31.6%) of those with radiological profusion category 1, 15 (37.5%) of those with radiological profusion category 2, and 13 (52%) of those with complicated silicosis (including all seven with category 3 profusion of small opacities) showed radiological progression. As expected, progression was more likely to be found after longer periods of follow up (the interval between the two chest x ray films) with a 20% increased odds of progression for every additional year of follow up. After adjustment for varying intervals of follow up, the probability of radiological progression was found to be significant if large opacities were present in the initial chest x ray film. Progression was also less likely to be found among those who had ended exposure to silica longer ago, although the result was of borderline significance (p=0.07). Tuberculosis was also associated with increased likelihood of progression (borderline significance).
CONCLUSIONS—There is a high probability of radiological progression in silicosis after high levels of exposure to granite dust among workers who were followed up for up to 17 years. A significant risk factor is the extent of radiological opacities in the initial chest x ray film. The probability of progression is also likely to be reduced with longer periods after the end of exposure.


Keywords: silicosis; radiological progression; granite quarry PMID:11404452

Methodology, status, and plans for development and assessment of the RELAP5 code

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

Johnson, G.W.; Riemke, R.A.

1997-07-01

RELAP/MOD3 is a computer code used for the simulation of transients and accidents in light-water nuclear power plants. The objective of the program to develop and maintain RELAP5 was and is to provide the U.S. Nuclear Regulatory Commission with an independent tool for assessing reactor safety. This paper describes code requirements, models, solution scheme, language and structure, user interface validation, and documentation. The paper also describes the current and near term development program and provides an assessment of the code`s strengths and limitations.

A web implementation: the good and the not-so-good.

PubMed

Bergsneider, C; Piraino, D; Fuerst, M

2001-06-01

E-commerce, e-mail, e-greeting, e-this, and e-that everywhere you turn there is a new "e" word for an internet or Web application. We, at the Cleveland Clinic Foundation, have been "e-nlightened" and will discuss in this report the implementation of a web-based radiology information system (RIS) in our radiology division or "e-radiology" division. The application, IDXRad Version 10.0 from IDX Corp, Burlington, VT, is in use at the Cleveland Clinic Foundation and has both intranet (for use in Radiology) and internet (referring physician viewing) modules. We will concentrate on the features of using a web browser for the application's front-end, including easy prototyping for screen review, easier mock-ups of demonstrations by vendors and developers, and easier training as more people become web-addicted. Project communication can be facilitated with an internal project web page, and use of the web browser can accommodate quicker turnaround of software upgrades as the software code is centrally located. Compared with other technologies, including client/server, there is a smaller roll out cost when using a standard web browser. However, the new technology requires a change and changes are never implemented without challenges. A seasoned technologist using a legacy system can enter data quicker using function keys than using a graphical user interface and pointing and clicking through a series of pop-up windows. Also, effective use of a web browser depends on intuitive design for it to be easily implemented and accepted by the user. Some software packages will not work on both of the popular web browsers and then are tailored to specific release levels. As computer-based patient records become a standard, patient confidentiality must be enforced. The technical design and application security features that support the web-based software package will be discussed. Also web technologies have their own implementation issues.

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.

Study on vertical distribution of radionuclides ({sup 40}K, Th and U) in soil collected from Manjung district

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

Zainal, Fetri; Hamzah, Zaini; Wood, Khalik

2016-01-22

The accumulation of radionuclides in soil is a greatest concerns due to their toxicity. This study investigated the vertical distribution of radionuclides and radiological assessment in a soil profile were collected in three different directions [North (N), North-East (NE) and South-East (SE)] within 40 km from Manjung district. All profile samples were collected down to 45cm at 7.5cm interval using hand auger. Soil density and radionuclides ({sup 40}K, Th and U) concentrations were determined by gravimetric method and Energy Dispersive X-Ray Fluorescence (EDXRF) technique, respectively. The radionuclides concentrations was in decreasing order of {sup 40}K > Th > U. Soil qualitymore » assessment was carried out using Enrichment Factor (EF), Pollution Index (PI) and Geoaccumulation Index (I {sub geo}) where all radionuclides show significant enrichment (5 < EF < 20), PI classified as middle pollution classes and 0 < Igeo < 1, indicating moderately polluted, respectively. From the concentration of radionuclides, the radiological risk was calculated and the present result show external hazard index (H{sub ex}) is below than unity indicate low radiological risk.« less

Assessment of the radiological impact of oil refining industry.

PubMed

Bakr, W F

2010-03-01

The field of radiation protection and corresponding national and international regulations has evolved to ensure safety in the use of radioactive materials. Oil and gas production processing operations have been known to cause naturally occurring radioactive materials (NORMs) to accumulate at elevated concentrations as by-product waste streams. A comprehensive radiological study on the oil refining industry in Egypt was carried out to assess the radiological impact of this industry on the workers. Scales, sludge, water and crude oil samples were collected at each stage of the refining process. The activity concentration of (226)Ra, (232)Th and (40)K were determined using high-resolution gamma spectrometry. The average activity concentrations of the determined isotopes are lower than the IAEA exempt activity levels for NORM isotopes. Different exposure scenarios were studied. The average annual effective dose for workers due to direct exposure to gamma radiation and dust inhalation found to be 0.6 microSv and 3.2 mSv, respectively. Based on the ALARA principle, the results indicate that special care must be taken during cleaning operations in order to reduce the personnel's exposure due to maintenance as well as to avoid contamination of the environment. 2009 Elsevier Ltd. All rights reserved.