The Effect of Frequent Quizzes on Short- and Long-Term Academic Performance.

ERIC Educational Resources Information Center

Geist, James R.; Soehren, Stephen E.

1997-01-01

This study examined effects of frequent quizzes on dental student performance in a course on introductory radiology. Results indicated the group (N=36) with frequent quizzes performed significantly better than the control group (n=35) on midterm and final examinations (but not post-tests), and assessed course content and instructor more…

A comparison of Chevron and Lindgren-Turan osteotomy techniques in hallux valgus surgery: a prospective randomized controlled study.

PubMed

Uygur, Esat; Özkan, Namık Kemal; Akan, Kaya; Çift, Hakan

2016-01-01

The aim of this prospective randomized controlled single-blind study was to compare the results of Chevron and Lindgren-Turan osteotomy techniques for treatment of moderate hallux valgus. A total of 66 female patients (34 in Chevron group, 32 Lindgren-Turan group) were recruited in this study and followed up for an average of 26.08 months. Operative procedures were performed by 2 surgeons, and patients were evaluated by an another researcher who was blinded to the surgical technique. The groups were compared for their radiological and clinical results. Both techniques was clinically and radiologically effective (p<0.01). However, no significant differences were found between the 2 groups regarding American Orthopaedic Foot and Ankle Society's clinical rating system, Painful Foot Evaluation scale of Maryland University scores, or radiologic evaluation (p>0.05). Compared to the Chevron group, the Lindgren-Turan group was found to have shorter surgical duration (p<0.05) and significantly more shortening at the first metatarsal (p<0.05). In moderate hallux valgus deformity, both the Chevron and Lindgren-Turan osteotomy techniques are clinically and radiologically safe, effective, and reliable alternatives. No superiority was detected in either technique. Although shortening at the first metatarsal in the Lindgren-Turan group was radiologically significant, the results were clinically tolerable.

RCT: Module 2.11, Radiological Work Coverage, Course 8777

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

Hillmer, Kurt T.

2017-07-20

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

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

Hillmer, Kurt T.

This course presents information on radiological work permits (RWPs), various types of postings used in radiological areas, radiological area setups, access controls, and releases of material from radiological areas. All of these are fundamental duties of RCTs. This course will prepare the student with the skills necessary for radiological control technician (RCT) qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and providing in-thefield skills.

Retrospective review of the performance standard for diagnostic x-ray equipment; availability of report--FDA. Notice; final rule-related.

PubMed

1985-11-12

The Food and Drug Administration (FDA) is announcing the availability of a report prepared by the X-Ray Standard Review Group (XSRG) in FDA's Center for Devices and Radiological Health (CDRH). The report contains the review group's assessment of the performance standard for diagnostic x-ray systems and their major components. It contains recommendations for changes in the standard with respect to the need to ensure that regulatory controls keep pace with developing technology and the needs of the radiological community. In addition, FDA is inviting interested persons to submit written comments, data, or information regarding the report for the agency's consideration in deciding whether to initiate any changes in the performance standard.

Creating an outpatient center of excellence in CT.

PubMed

Itri, Jason N; Bakow, Eric; Woods, Jordan

2014-12-01

CT examinations represent a substantial portion of the workload for many radiology departments, and optimizing service delivery is a critical function to ensure customer satisfaction. This article describes how the Six Sigma methodology was used in the radiology department at a large academic hospital to improve the patient experience and increase CT capacity while reducing waste and improving staff satisfaction. The 5 distinct phases of Six Sigma are reviewed as they apply to our CT Center of Excellence project: define, measure, analyze, improve, and control. Process metrics used in this project include the percentage of outpatient CT exams started within 5 minutes of the scheduled appointment time, and the number of studies with protocols selected >48 hours before the CT exam is performed. Outcome metrics include monthly department expense per scan and CT Press Ganey "standard test and treatment" mean scores. An approach to developing interventions is described based on identifying critical sources of variation, ranking these by creating risk prioritization numbers, performing root cause analysis, and utilizing the failure mode and effects analysis tool to prioritize possible solutions. Finally, the key features of action plans and a control plan are reviewed. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[Endovascular interventions for multiple trauma].

PubMed

Kinstner, C; Funovics, M

2014-09-01

In recent years interventional radiology has significantly changed the management of injured patients with multiple trauma. Currently nearly all vessels can be reached within a reasonably short time with the help of specially preshaped catheters and guide wires to achieve bleeding control of arterial und venous bleeding. Whereas bleeding control formerly required extensive open surgery, current interventional methods allow temporary vessel occlusion (occlusion balloons), permanent embolization and stenting. In injured patients with multiple trauma preinterventional procedural planning is performed with the help of multidetector computed tomography whenever possible. Interventional radiology not only allows minimization of therapeutic trauma but also a considerably shorter treatment time. Interventional bleeding control has developed into a standard method in the management of vascular trauma of the chest and abdomen as well as in vascular injuries of the upper and lower extremities when open surgical access is associated with increased risk. Additionally, pelvic trauma, vascular trauma of the superior thoracic aperture and parenchymal arterial lacerations of organs that can be at least partially preserved are primarily managed by interventional methods. In an interdisciplinary setting interventional radiology provides a safe and efficient means of rapid bleeding control in nearly all vascular territories in addition to open surgical access.

324 Building Baseline Radiological Characterization

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

R.J. Reeder, J.C. Cooper

This report documents the analysis of radiological data collected as part of the characterization study performed in 1998. The study was performed to create a baseline of the radiological conditions in the 324 Building.

Ongoing quality control in digital radiography: Report of AAPM Imaging Physics Committee Task Group 151.

PubMed

Jones, A Kyle; Heintz, Philip; Geiser, William; Goldman, Lee; Jerjian, Khachig; Martin, Melissa; Peck, Donald; Pfeiffer, Douglas; Ranger, Nicole; Yorkston, John

2015-11-01

Quality control (QC) in medical imaging is an ongoing process and not just a series of infrequent evaluations of medical imaging equipment. The QC process involves designing and implementing a QC program, collecting and analyzing data, investigating results that are outside the acceptance levels for the QC program, and taking corrective action to bring these results back to an acceptable level. The QC process involves key personnel in the imaging department, including the radiologist, radiologic technologist, and the qualified medical physicist (QMP). The QMP performs detailed equipment evaluations and helps with oversight of the QC program, the radiologic technologist is responsible for the day-to-day operation of the QC program. The continued need for ongoing QC in digital radiography has been highlighted in the scientific literature. The charge of this task group was to recommend consistency tests designed to be performed by a medical physicist or a radiologic technologist under the direction of a medical physicist to identify problems with an imaging system that need further evaluation by a medical physicist, including a fault tree to define actions that need to be taken when certain fault conditions are identified. The focus of this final report is the ongoing QC process, including rejected image analysis, exposure analysis, and artifact identification. These QC tasks are vital for the optimal operation of a department performing digital radiography.

Ongoing quality control in digital radiography: Report of AAPM Imaging Physics Committee Task Group 151

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

Jones, A. Kyle, E-mail: kyle.jones@mdanderson.org; Geiser, William; Heintz, Philip

Quality control (QC) in medical imaging is an ongoing process and not just a series of infrequent evaluations of medical imaging equipment. The QC process involves designing and implementing a QC program, collecting and analyzing data, investigating results that are outside the acceptance levels for the QC program, and taking corrective action to bring these results back to an acceptable level. The QC process involves key personnel in the imaging department, including the radiologist, radiologic technologist, and the qualified medical physicist (QMP). The QMP performs detailed equipment evaluations and helps with oversight of the QC program, the radiologic technologist ismore » responsible for the day-to-day operation of the QC program. The continued need for ongoing QC in digital radiography has been highlighted in the scientific literature. The charge of this task group was to recommend consistency tests designed to be performed by a medical physicist or a radiologic technologist under the direction of a medical physicist to identify problems with an imaging system that need further evaluation by a medical physicist, including a fault tree to define actions that need to be taken when certain fault conditions are identified. The focus of this final report is the ongoing QC process, including rejected image analysis, exposure analysis, and artifact identification. These QC tasks are vital for the optimal operation of a department performing digital radiography.« less

[Comparison of time-oriented cost accounting catalogs to control a department of radiology].

PubMed

Hackländer, T; Mertens, H; Cramer, B M

2005-03-01

Within a hospital, the radiology department has taken over the role of a cost center. Cost accounting can be applied to analyze the costs for the performance of services. By assigning the expenditures of resources to the service, the cash value can directly be distributed to the costs of equipment, material and rooms. Time-oriented catalogs of services are predefined to calculate the number of the employees for a radiology department. Using our own survey of time data, we examined whether such catalogs correctly represent the time consumed in a radiology department. Only services relevant for the turnover were compared. For 96 primary radiological services defined by the score-oriented German fee catalog for physicians (Gebuhrenordnung fur Arzte), a ranking list was made for the annual procedures in descending frequency order. According to the Pareto principle, the 11 services with the highest frequency were chosen and the time consumed for the technical and medical services was collected over a period of 2 months. This survey was compared with the time-oriented catalogs TARMED and EBM 2000plus. The included 11 relevant radiological services represented 80.3 % of the annual procedures of our radiology department. When comparing the technical services between the time-oriented catalogs and our own survey, TARMED gives a better description of the time consumed in 7 of the 11 services and EMB 2000plus in 3 services. When comparing the medical services, TARMED gives a better description of the time consumed in 6 of the 11 services and EBM 2000plus in 4 services. When averaging all the radiological services, TARMED overestimates the current number of physicians necessary for primary reading by a factor of 10.0 % and EBM 2000plus by a factor of 2.6 %. As to the time spent on performing the relevant radiological services, TARMED is slightly superior to describe the radiology department of a hospital than EBM 2000plus. For calculating the number of physicians necessary for primary reading, EBM 2000plus is superior to TARMED.

Air and smear sample calculational tool for Fluor Hanford Radiological control

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

BAUMANN, B.L.

2003-07-11

A spreadsheet calculation tool was developed to automate the calculations performed for determining the concentration of airborne radioactivity and smear counting as outlined in HNF-13536, Section 5.2.7, ''Analyzing Air and Smear Samples''. This document reports on the design and testing of the calculation tool. Radiological Control Technicians (RCTs) will save time and reduce hand written and calculation errors by using an electronic form for documenting and calculating work place air samples. Current expectations are RCTs will perform an air sample and collect the filter or perform a smear for surface contamination. RCTs will then survey the filter for gross alphamore » and beta/gamma radioactivity and with the gross counts utilize either hand calculation method or a calculator to determine activity on the filter. The electronic form will allow the RCT with a few key strokes to document the individual's name, payroll, gross counts, instrument identifiers; produce an error free record. This productivity gain is realized by the enhanced ability to perform mathematical calculations electronically (reducing errors) and at the same time, documenting the air sample.« less

Integrated Fellowship in Vascular Surgery and Intervention Radiology

PubMed Central

Messina, Louis M.; Schneider, Darren B.; Chuter, Timothy A. M.; Reilly, Linda M.; Kerlan, Robert K.; LaBerge, Jeane M.; Wilson, Mark W.; Ring, Ernest J.; Gordon, Roy L.

2002-01-01

Objective To evaluate an integrated fellowship in vascular surgery and interventional radiology initiated to train vascular surgeons in endovascular techniques and to train radiology fellows in clinical aspects of vascular diseases. Summary Background Data The rapid evolution of endovascular techniques for the treatment of vascular diseases requires that vascular surgeons develop proficiency in these techniques and that interventional radiologists develop proficiency in the clinical evaluation and management of patients who are best treated with endovascular techniques. In response to this need the authors initiated an integrated fellowship in vascular surgery and interventional radiology and now report their interim results. Methods Since 1999 vascular fellows and radiology fellows performed an identical year-long fellowship in interventional radiology. During the fellowship, vascular surgery and radiology fellows perform both vascular and nonvascular interventional procedures. Both vascular surgery and radiology-based fellows spend one quarter of the year on the vascular service performing endovascular aortic aneurysm repairs and acquiring clinical experience in the vascular surgery inpatient and outpatient services. Vascular surgery fellows then complete an additional year-long fellowship in vascular surgery. To evaluate the type and number of interventional radiology procedures, the authors analyzed records of cases performed by all interventional radiology and vascular surgery fellows from a prospectively maintained database. The attitudes of vascular surgery and interventional radiology faculty and fellows toward the integrated fellowship were surveyed using a formal questionnaire. Results During the fellowship each fellow performed an average of 1,201 procedures, including 808 vascular procedures (236 diagnostic angiograms, 70 arterial interventions, 59 diagnostic venograms, 475 venous interventions, and 43 hemodialysis graft interventions) and 393 nonvascular procedures. On average fellows performed 20 endovascular aortic aneurysm repairs per year. There was no significant difference between the vascular surgery and radiology fellows in either the spectrum or number of cases performed. Eighty-eight percent (23/26) of the questionnaires were completed and returned. Both interventional radiologists and vascular surgeons strongly supported the integrated fellowship model and favored continuation of the integrated program. Vascular surgery and interventional radiology faculty members wanted additional training in clinical vascular surgery for the radiology-based fellows. With the exception of the radiology fellows there was uniform agreement that vascular surgery fellows benefit from training in nonvascular aspects of interventional radiology. Conclusions Integration of vascular surgery and interventional radiology fellowships is feasible and is mutually beneficial to both disciplines. Furthermore, the integrated fellowship provides exceptional training for vascular surgery and interventional radiology fellows in all catheter-based techniques that far exceeds the minimum requirements for credentialing suggested by various professional societies. There is a clear need for cooperation and active involvement on the parts of the American Board of Radiology and the American Board of Surgery and its Vascular Board to create hybrid training programs that meet mutually agreed-on criteria that document sufficient acquisition of both the cognitive and technical skills required to manage patients undergoing endovascular procedures safely and effectively. PMID:12368668

Implementation of quality assurance in diagnostic radiology in Bosnia and Herzegovina (Republic of Srpska).

PubMed

Bosnjak, J; Ciraj-Bjelac, O; Strbac, B

2008-01-01

Application of a quality control (QC) programme is very important when optimisation of image quality and reduction of patient exposure is desired. QC surveys of diagnostics imaging equipment in Republic of Srpska (entity of Bosnia and Herzegovina) has been systematically performed since 2001. The presented results are mostly related to the QC test results of X-ray tubes and generators for diagnostic radiology units in 92 radiology departments. In addition, results include workplace monitoring and usage of personal protective devices for staff and patients. Presented results showed the improvements in the implementation of the QC programme within the period 2001--2005. Also, more attention is given to appropriate maintenance of imaging equipment, which was one of the main problems in the past. Implementation of a QC programme is a continuous and complex process. To achieve good performance of imaging equipment, additional tests are to be introduced, along with image quality assessment and patient dosimetry. Training is very important in order to achieve these goals.

A four-alternative forced choice (4AFC) software for observer performance evaluation in radiology

NASA Astrophysics Data System (ADS)

Zhang, Guozhi; Cockmartin, Lesley; Bosmans, Hilde

2016-03-01

Four-alternative forced choice (4AFC) test is a psychophysical method that can be adopted for observer performance evaluation in radiological studies. While the concept of this method is well established, difficulties to handle large image data, perform unbiased sampling, and keep track of the choice made by the observer have restricted its application in practice. In this work, we propose an easy-to-use software that can help perform 4AFC tests with DICOM images. The software suits for any experimental design that follows the 4AFC approach. It has a powerful image viewing system that favorably simulates the clinical reading environment. The graphical interface allows the observer to adjust various viewing parameters and perform the selection with very simple operations. The sampling process involved in 4AFC as well as the speed and accuracy of the choice made by the observer is precisely monitored in the background and can be easily exported for test analysis. The software has also a defensive mechanism for data management and operation control that minimizes the possibility of mistakes from user during the test. This software can largely facilitate the use of 4AFC approach in radiological observer studies and is expected to have widespread applicability.

Formation of an environmental restoration user group for radiological controls

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

Morris, R.L.

1993-12-31

An Environmental Restoration User Group for Radiological Controls will be proposed. Article 116 of the Radiological Control Manual encourages contractors to establish informal working associations that promote dialogue among similar facilities. Chem-Nuclear Geotech, Inc., is willing to initially organize and lead a users group to work on common problems, define standard methods, publish a Radiological Work Practices Handbook, and recommend regulatory changes to make environmental restoration programs more cost effective without compromising radiological control. A charter for the users group will be proposed. A questionnaire will be distributed to interested persons to assist in development of focus groups and agendamore » items for the first meeting. The first meeting is planned for May 25-26, 1993, in Grand Junction Colorado. All interested persons are welcome to attend.« less

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.

EVALUATING ROBOT TECHNOLOGIES AS TOOLS TO EXPLORE RADIOLOGICAL AND OTHER HAZARDOUS ENVIRONMENTS

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

Curtis W. Nielsen; David I. Gertman; David J. Bruemmer

2008-03-01

There is a general consensus that robots could be beneficial in performing tasks within hazardous radiological environments. Most control of robots in hazardous environments involves master-slave or teleoperation relationships between the human and the robot. While teleoperation-based solutions keep humans out of harms way, they also change the training requirements to accomplish a task. In this paper we present a research methodology that allowed scientists at Idaho National Laboratory to identify, develop, and prove a semi-autonomous robot solution for search and characterization tasks within a hazardous environment. Two experiments are summarized that validated the use of semi-autonomy and show thatmore » robot autonomy can help mitigate some of the performance differences between operators who have different levels of robot experience, and can improve performance over teleoperated systems.« less

The efficacy of a continuous quality improvement (CQI) method in a radiological department. Comparison with non-CQI control material.

PubMed

Laurila, J; Standertskjöld-Nordenstam, C G; Suramo, I; Tolppanen, E M; Tervonen, O; Korhola, O; Brommels, M

2001-01-01

To study the efficacy of continuous quality improvement (CQI) compared to ordinary management in an on-duty radiology department. Because of complaints regarding delivery of on-duty radiological services, an improvement was initiated simultaneously at two hospitals, at the HUCH (Helsinki University Central Hospital) utilising the CQI-method, and at the OUH (Oulu University Hospital) with a traditional management process. For the CQI project, a team was formed to evaluate the process with flow-charts, cause and effect diagrams, Pareto analysis and control charts. Interventions to improve the process were based on the results of these analyses. The team at the HUCH implemented the following changes: A radiologist was added to the evening shift between 15:00-22:00 and a radiographer was moved from the morning shift to 15:00-22:00. A clear improvement was achieved in the turn-around time, but in the follow-up some of the gains were lost. Only minimal changes were achieved at the OUH, where the intervention was based on traditional management processes. CQI was an effective method for improving the quality of performance of a radiology department compared with ordinary management methods, but some of this improvement may be subsequently lost without a continuous measurement system.

Interventional Radiologic Treatment for Idiopathic Portal Hypertension

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

Hirota, Shozo; Ichikawa, Satoshi; Matsumoto, Shinichi

1999-07-15

Purpose: To evaluate the usefulness of interventional radiological treatment for idiopathic portal hypertension. Methods: Between 1995 and 1998, we performed an interventional radiological treatment in five patients with idiopathic portal hypertension, four of whom had refused surgery and one of whom had undergone surgery. Three patients with gastroesophageal varices (GEV) were treated by partial splenic embolization (PSE), one patient with esophageal varices (EV) and massive ascites by transjugular intrahepatic portosytemic shunt (TIPS) and PSE, and one patient with GEV by percutaneous transhepatic obliteration (PTO). Midterm results were analyzed in terms of the effect on esophageal and/or gastric varices. Results: Inmore » one woman with severe GEV who underwent three sessions of PSE, there was endoscopic confirmation that the GEV had disappeared. In one man his EV shrunk markedly after two sessions of PSE. In two patients slight reduction of the EV was obtained with one application of PSE combined with endoscopic variceal ligation therapy. PTO for GV in one patient resulted in good control of the varices. All patients have survived for 16-42 months since the first interventional treatment, and varices are well controlled. Conclusion: Interventional radiological treatment is effective for patients with idiopathic portal hypertension, whether or not they have undergone surgery.« less

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.

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

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

Film labels: a new look.

PubMed

Hunter, T B

1994-02-01

Every diagnostic image should be properly labeled. To improve the labeling of radiographs in the Department of Radiology at the University Medical Center, Tucson, Arizona, a special computer program was written to control the printing of the department's film flashcards. This program captures patient data from the hospital's radiology information system and uses it to create a film flashcard that contains the patient's name, hospital number, date of birth, age, the time the patient checked into the radiology department, and the date of the examination. The resulting film labels are legible and aesthetically pleasing. Having the patient's age and date of birth on the labels is a useful quality assurance measure to make certain the proper study has been performed on the correct patient. All diagnostic imaging departments should institute measures to assure their film labeling is as legible and informative as possible.

Influence of 1800 MHz GSM-like electromagnetic radiation exposure on fracture healing.

PubMed

Aslan, Ahmet; Kırdemır, Vecihi; Kocak, Ahmet; Atay, Tolga; Baydar, Metin Lütfi; Özerdemoglu, Remzi Arif; Aydogan, Nevres Hürriyet

2014-02-01

In this study, we aimed to investigate whether 1800 MHz frequency electromagnetic radiation (EMR) has an effect on bone healing. A total of 30 Wistar albino rats were divided into two equal groups. Fractures were created in the right tibias of all rats; next, intramedullary fixations with K-wire were performed. A control group (Group I) was kept under the same experimental conditions except without EMR exposure. Rats in Group II were exposed to an 1800 MHz frequency EMR for 30 min a day for 5 days a week. Next, radiological, mechanical, and histological examinations were performed to evaluate tibial fracture healing. Radiological, histological and mechanical scores were not significantly different between groups (respectively, p = 0.114, p = 0.184 and p = 0.083), and all of these scores were lower than those of the controls. EMR at 1800 MHz frequency emitted from cellular phones has no effect on bone fracture healing. Copyright © 2014 IMSS. 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.

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

Shourbaji, AA

Oak Ridge National Laboratory conducted field radiological measurements at two port locations at the request of the Environmental Protection Agency (EPA). The radiological measurements were performed on five radiation detection systems at the port of Darrow, Louisiana and three systems at the port of Charleston, South Carolina. Darrow was visited on January 20-23, 2004 and Charleston on May 25, 2004. All tested systems are designed to detect radioactive material that might be present in scrap metals as the scrap is being unloaded from ships. All eight systems are commercially known as the Cricket and manufactured by RAD/COMM Systems. Each radiationmore » detection system consists of a detector with two channels and a wireless transmitter, both mounted on the grapple, and a controller located in the crane cab. The cranes at both locations are operated by the Cooper T. Smith Company. The purpose of the radiological measurements was to evaluate the performance of the radiation detection systems in terms of their ability to detect elevated radiation levels, and to develop a routine testing method for all EPA Cricket systems.« less

Pannus inflammation in sacroiliitis following immune pathological injury and radiological structural damage: a study of 193 patients with spondyloarthritis.

PubMed

Wang, Dan Min; Lin, Ling; Peng, Jian Hua; Gong, Yao; Hou, Zhi Duo; Chen, Su Biao; Xiao, Zheng Yu

2018-06-08

The pathogenesis of sacroiliitis is unclear; therefore, we aimed to systematically study the immunopathology of sacroiliitis in patients with axial spondyloarthritis (axSpA), and explore the relationship between pannus formation, inflammation, and the structural damage caused by sacroiliitis. Fine needle aspiration biopsy of the sacroiliac joint (SIJ) was performed in 193 patients with axSpA. Clinical, laboratory, and imaging data were collected at baseline and during the follow up. Immunohistochemistry analysis was performed to detect CD34+ microvessels, CD68+ osteoclasts/macrophages, vascular endothelial growth factor (VEGF), metalloproteinase-3 (MMP-3), tumor necrosis factor-α (TNF-α), and caspase-3. Autopsy subjects were used as controls. In early sacroiliitis (grade 0-1) all pathological features could be observed, with the most common being subchondral pannus formation. Among the 193 patients, 98 were followed up for 1-13 years (mean 3.6 years); 63.3% had radiological progression at the endpoint. Multiple regression analysis showed that cartilage pannus invasion (OR 2.99, P = 0.010) and endochondral ossification (OR 3.97, P = 0.049) at baseline were risk factors for radiological structural damage. Compared to SIJ controls, the subchondral microvessel density, number of CD68+ multinuclear osteoclasts, and the levels of VEGF, caspase-3, MMP-3, and TNF-α expressed at the interface of the bone and cartilage were significantly higher in patients with sacroiliitis. Subchondral fibrovascular tissue formation is the most important pathological feature in early sacroiliitis. The existence of cartilage pannus invasion or endochondral ossification at baseline can predict radiological structural damage during the follow up.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Space Center, presents Myrna Scott, widow of Randy Scott, with a replica of the emblem noting that the spaceport's Radiological Control Center has been named in honor of her husband who died last year. The ceremony in the center's Radiological Control Center honored the extensive contributions 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.

The common cold in patients with a history of recurrent sinusitis: increased symptoms and radiologic sinusitislike findings.

PubMed

Alho, O P; Ylitalo, K; Jokinen, K; Laitinen, J; Suramo, I; Tuokko, H; Koskela, M; Uhari, M

2001-01-01

We evaluated whether the symptoms and signs and radiologic findings during a common cold are similar in patients who have and have not suffered from recurrent sinusitis. We recruited 2 series of volunteer cases from February 1, 1996, to December 31, 1996. Twenty-three adults who claimed to have suffered from recurrent sinusitis and 25 who had never had sinusitis were examined during the period of a self-diagnosed cold of 48 to 96 hours' duration and again after 21 days. Symptom scores were recorded, nasoendoscopy and computed tomography scans were performed, and viral and bacterial specimens were taken. The patients with a history of sinusitis had significantly higher symptom scores than the control patients (P=.04) and had radiologic sinusitislike changes more often (65% [15] vs 36% [9]; difference 29% [95% confidence interval, 2%-56%]; P=.04). The viral etiology of the common cold (verified in 67% of the episodes) was similar in both groups. Pathogenic bacteria were isolated from the middle meatus in 24% (6) of the control patients and only 9% (2) of the sinusitis-prone patients (P=.15). On the basis of the symptomatology, radiologic findings, and bacterial cultures only 2 patients in the sinusitis-prone group should have been treated with antimicrobials. Some patients are susceptible to both sinusitislike symptoms and radiologic findings during viral common colds. This may cause them to consult their physicians earlier and more often during viral colds, which may result in unnecessary antibiotic treatments. Nasopharyngeal bacteriological cultures may prove to be useful in ruling out bacterial sinusitis.

Moving beyond quality control in diagnostic radiology and the role of the clinically qualified medical physicist.

PubMed

Delis, H; Christaki, K; Healy, B; Loreti, G; Poli, G L; Toroi, P; Meghzifene, A

2017-09-01

Quality control (QC), according to ISO definitions, represents the most basic level of quality. It is considered to be the snapshot of the performance or the characteristics of a product or service, in order to verify that it complies with the requirements. Although it is usually believed that "the role of medical physicists in Diagnostic Radiology is QC", this, not only limits the contribution of medical physicists, but is also no longer adequate to meet the needs of Diagnostic Radiology in terms of Quality. In order to assure quality practices more organized activities and efforts are required in the modern era of diagnostic radiology. The complete system of QC is just one element of a comprehensive quality assurance (QA) program that aims at ensuring that the requirements of quality of a product or service will consistently be fulfilled. A comprehensive Quality system, starts even before the procurement of any equipment, as the need analysis and the development of specifications are important components under the QA framework. Further expanding this framework of QA, a comprehensive Quality Management System can provide additional benefits to a Diagnostic Radiology service. Harmonized policies and procedures and elements such as mission statement or job descriptions can provide clarity and consistency in the services provided, enhancing the outcome and representing a solid platform for quality improvement. The International Atomic Energy Agency (IAEA) promotes this comprehensive quality approach in diagnostic imaging and especially supports the field of comprehensive clinical audits as a tool for quality improvement. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Effect of low-intensity pulsed ultrasound on bone regeneration: biochemical and radiologic analyses.

PubMed

Pomini, Karina T; Andreo, Jesus C; Rodrigues, Antonio de C; de O Gonçalves, Jéssica B; Daré, Letícia R; German, Iris J S; Rosa, Geraldo M; Buchaim, Rogerio L

2014-04-01

The purpose of this study was to evaluate the effects of low-intensity pulsed ultrasound at 1.0 MHz on the healing process of fractures with bone loss in the rat fibula by alkaline phosphate level measurement and radiologic analyses. Thirty 70-day-old male Wistar rats underwent a bone resection of 2.5 to 3.0 mm between the proximal and middle third of the right fibular diaphysis. The animals were randomly divided into 3 experimental groups: reference (uninjured), control (injured only), and treated (injured and treated with 5 applications of ultrasound, interspersed by 2 days of rest, beginning 24 hours after the osteotomy). Euthanasia was performed at experimental periods of 7 and 14 days. The right hind limb was removed for radiologic analysis. The blood was collected via cardiac puncture to determine the serum alkaline phosphatase activity. The bone fractures had not been completely consolidated in the treated and control group when analysis of the bone took place. At day 7, the serum alkaline phosphatase activity was higher in the treated group (mean ± SD, 72.17 ± 7.02 U/L) compared to the control (65.26 ± 8.41 U/L) and reference (67.21 ± 7.86 U/L) groups. At day 14, higher alkaline phosphatase activity was seen in the control group (68.96 ± 8.12 U/L) compared to the treated (66.09 ± 8.46 U/L) and reference (67.14 ± 7.96 U/L) groups. The biochemical and radiologic results suggest that low-intensity pulsed ultrasound can be used as an auxiliary method to consolidate fractures and probably reduces the bone healing time, offering clinical benefits.

Congenital Portosystemic Shunts: Clinic Heterogeneity Requires an Individual Management of the Patient.

PubMed

Chocarro, Gloria; Amesty, María Virginia; Encinas, Jose Luis; Vilanova Sánchez, Alejandra; Hernandez, Francisco; Andres, Ane M; Gamez, Manolo; Tovar, Juan Antonio; Lopez Santamaria, Manuel

2016-02-01

Congenital portosystemic shunt (CPSS) is a rare entity without insufficiency in treatment issues. The aim of this article is to show our experience in the heterogeneity of this condition. A retrospective study of 25 CPSS in the period 1995 to 2014 was conducted. Description of the morphology, clinical impact, and treatment is given. According to the imaging techniques (IT), the shunt was apparently intrahepatic in 14 patients, extrahepatic in 10 patients, and mixed in 1 patient. In 14 children, IT showed hepatic portal circulation. In total shunts in which radiological examination was performed, invasive radiological techniques were able to demonstrate intrahepatic portal vein. In other patients, it was not investigated as they are asymptomatic. A child presented multiorgan failure with fulminant hepatic failure at birth. The shunt was radiologically closed and clinical impairment reversed rapidly. He is now asymptomatic with no longer images of CPSS in ultrasound scan controls. Also, seven children are asymptomatic at this time and are monitored periodically. Seven children had prenatal diagnosis, in five the shunt closed spontaneously. Nine children were symptomatic in their evolution (hyperammonemia, regenerative nodules, cholestasis, gastrointestinal bleeding). Of these, in five we performed balloon test occlusion, tolerated in all patients, followed by radiological closure. In our experience, the advancement of interventional radiology techniques avoided surgery to close the shunt. Morphologically, the CPSS is extremely heterogeneous, with multiple possible connections established. CPSS has multiple clinical presentations, from asymptomatic patients to acute liver failure. The therapeutic approach should be individualized and therefore held in overspecialized centers. Georg Thieme Verlag KG Stuttgart · New York.

Automated classification of radiology reports to facilitate retrospective study in radiology.

PubMed

Zhou, Yihua; Amundson, Per K; Yu, Fang; Kessler, Marcus M; Benzinger, Tammie L S; Wippold, Franz J

2014-12-01

Retrospective research is an import tool in radiology. Identifying imaging examinations appropriate for a given research question from the unstructured radiology reports is extremely useful, but labor-intensive. Using the machine learning text-mining methods implemented in LingPipe [1], we evaluated the performance of the dynamic language model (DLM) and the Naïve Bayesian (NB) classifiers in classifying radiology reports to facilitate identification of radiological examinations for research projects. The training dataset consisted of 14,325 sentences from 11,432 radiology reports randomly selected from a database of 5,104,594 reports in all disciplines of radiology. The training sentences were categorized manually into six categories (Positive, Differential, Post Treatment, Negative, Normal, and History). A 10-fold cross-validation [2] was used to evaluate the performance of the models, which were tested in classification of radiology reports for cases of sellar or suprasellar masses and colloid cysts. The average accuracies for the DLM and NB classifiers were 88.5% with 95% confidence interval (CI) of 1.9% and 85.9% with 95% CI of 2.0%, respectively. The DLM performed slightly better and was used to classify 1,397 radiology reports containing the keywords "sellar or suprasellar mass", or "colloid cyst". The DLM model produced an accuracy of 88.2% with 95% CI of 2.1% for 959 reports that contain "sellar or suprasellar mass" and an accuracy of 86.3% with 95% CI of 2.5% for 437 reports of "colloid cyst". We conclude that automated classification of radiology reports using machine learning techniques can effectively facilitate the identification of cases suitable for retrospective research.

Interventional Radiology in Paediatrics.

PubMed

Chippington, Samantha J; Goodwin, Susie J

2015-01-01

As in adult practice, there is a growing role for paediatric interventional radiology expertise in the management of paediatric pathologies. This review is targeted for clinicians who may refer their patients to paediatric interventional radiology services, or who are responsible for patients who are undergoing paediatric interventional radiology procedures. The article includes a brief overview of the indications for intervention, techniques involved and the commonest complications. Although some of the procedures described are most commonly performed in a tertiary paediatric centre, many are performed in most Children's hospitals.

[Interventional radiology: current problems and new directions].

PubMed

Santos Martín, E; Crespo Vallejo, E

2014-01-01

In recent years, vascular and interventional radiology has become one of the fastest growing diagnostic and therapeutic specialties. This growth has been based on a fundamental concept: performing minimally invasive procedures under imaging guidance. This attractive combination has led to the interest of professionals from other clinical specialties outside radiology in performing this type of intervention. The future of vascular and interventional radiology, although uncertain, must be linked to clinical practice and multidisciplinary teamwork. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

[Marketing mix in a radiology department: challenges for future radiologists in management].

PubMed

Claikens, B

1998-08-01

Radiology has gained an enviable position among medial specialities. Developments in new technology expand its horizons and the volume of radiologic imaging techniques and procedures increase far more than the overall growth in health care services. In this position radiology has become a prime target for restrictions, cutbacks, controlled financing in an area of managed care and new national health care policy based on partially fixed budgets. Future health care takers have to choose the best available diagnostic and therapeutic techniques. Evidence based medicine, cost-utility analysis, diagnostic performance analysis, patient outcome analysis, technology assessment and guidelines for practice are means to guide us through our obligatory choice. Our major objective is to use the most performant available imaging technique or intervention to achieve the best possible outcome for our patient at lower possible costs. A strategic response from radiologists is required to meet the imperatives of this new management situation. They must do far more than interpret imaging procedures. They must work as efficient managers of imaging resources, organise their practices and define their marketing-strategies using the different, so-called, marketing-mix elements. The challenges will be great but the rewards are worth our best efforts. In this article we highlight the marketing responsibilities of future radiologists and their clinical practice in this new socio-economic environment and we present different useful marketing tools.

Microbiology for Radiologists: How to Minimize Infection Transmission in the Radiology Department.

PubMed

Mirza, Sobia K; Tragon, Tyson R; Fukui, Melanie B; Hartman, Matthew S; Hartman, Amy L

2015-01-01

The implementation of standardized infection control and prevention practices is increasingly relevant as modern radiology practice evolves into its more clinical role. Current Centers for Disease Control and Prevention, National Institutes of Health, and World Health Organization guidelines for the proper use of personal protective equipment, decontamination of reusable medical equipment, and appropriate management of bloodborne pathogen exposures will be reviewed. Standard precautions apply to all patients at all times and are the mainstay of infection control. Proper hand hygiene includes washing hands with soap and water when exposed to certain infectious particles, such as Clostridium difficile spores, which are not inactivated by alcohol-based hand rubs. The appropriate use of personal protective equipment in accordance with recommendations from the Centers for Disease Control and Prevention includes wearing a surgical mask during lumbar puncture. Because radiologists may perform lumbar punctures for patients with prion disease, it is important to appreciate that incineration is the most effective method of inactivating prion proteins. However, there is currently no consensus recommendation on the decontamination of prion-contaminated reusable items associated with lumbar puncture, and institutional policies should be consulted for directed management. In the event of a needlestick injury, radiology staff must be able to quickly provide appropriate initial management and seek medical attention, including laboratory testing for bloodborne pathogens. ©RSNA, 2015.

Neurocognitive dysfunction in children with β thalassemia major: psychometric, neurophysiologic and radiologic evaluation.

PubMed

Elalfy, M S; Aly, R H; Azzam, H; Aboelftouh, K; Shatla, R H; Tarif, M; Abdatty, M; Elsayed, R M

2017-12-01

To evaluate the impact of iron chelating drugs and serum ferritin on the neurocognitive functions of patients with β thalassemia major (β-TM), using psychometric, neurophysiologic and radiologic tests. Eighty children with β-TM were enrolled into the study and were compared to 40 healthy controls. All participants were evaluated by measuring serum ferritin, neurocognitive assessment by Benton Visual Retention Test, Wechsler Intelligence Scale for Children, Wisconsin Card Sort Test, P300 and magnetic resonance spectroscopy (MRS). WISC in our study showed that 40% of cases were borderline mental function as regards total IQ. Neurophysiologic tests were significantly impaired in patients compared to control group, with significant impairment in those receiving desferrioxamine (DFO). P300 amplitude was significantly lower in cases compared to controls (2.24 and 4.66 uv, respectively), recording the shortest amplitude in patients receiving DFO. Altered metabolic markers in the brain were detected by MRS in the form of reduced N-acetylaspartate to creatine ratio in 78.3% of our cases. There were significant correlations between psychometric tests and both neurophysiologic (P300) and radiologic (MRS) tests. β-TM is associated with neurocognitive impairment that can be assessed by psychometric, neurophysiologic and radiologic tests. The role of hemosiderosis and iron chelation therapy on cognitive functioning still need more research. β-TM: beta thalassemia major; DFO: Dysferal; DFP: Deferiprone; DFX: Deferasirox; WISC: Wechsler Intelligence Scale for Children; VIQ: verbal IQ; PIQ: performance IQ; TIQ: total IQ; BVRT: Benton Visual Retention Test; WCST: Wisconsin Card Sort Test; MRS: Magnetic resonant spectroscopy; NAA/Cr ratio: N-acetylaspartate to creatine ratio.

Software tools for interactive instruction in radiologic anatomy.

PubMed

Alvarez, Antonio; Gold, Garry E; Tobin, Brian; Desser, Terry S

2006-04-01

To promote active learning in an introductory Radiologic Anatomy course through the use of computer-based exercises. DICOM datasets from our hospital PACS system were transferred to a networked cluster of desktop computers in a medical school classroom. Medical students in the Radiologic Anatomy course were divided into four small groups and assigned to work on a clinical case for 45 minutes. The groups used iPACS viewer software, a free DICOM viewer, to view images and annotate anatomic structures. The classroom instructor monitored and displayed each group's work sequentially on the master screen by running SynchronEyes, a software tool for controlling PC desktops remotely. Students were able to execute the assigned tasks using the iPACS software with minimal oversight or instruction. Course instructors displayed each group's work on the main display screen of the classroom as the students presented the rationale for their decisions. The interactive component of the course received high ratings from the students and overall course ratings were higher than in prior years when the course was given solely in lecture format. DICOM viewing software is an excellent tool for enabling students to learn radiologic anatomy from real-life clinical datasets. Interactive exercises performed in groups can be powerful tools for stimulating students to learn radiologic anatomy.

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

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

PIERSON, R.M.

1999-10-27

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

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

Westinghouse corporate development of a decision software program for Radiological Evaluation Decision Input (REDI)

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

Bush, T.S.

1995-03-01

In December 1992, the Department of Energy (DOE) implemented the DOE Radiological Control Manual (RCM). Westinghouse Idaho Nuclear Company, Inc. (WINCO) submitted an implementation plan showing how compliance with the manual would be achieved. This implementation plan was approved by DOE in November 1992. Although WINCO had already been working under a similar Westinghouse RCM, the DOE RCM brought some new and challenging requirements. One such requirement was that of having procedure writers and job planners create the radiological input in work control procedures. Until this time, that information was being provided by radiological engineering or a radiation safety representative.more » As a result of this requirement, Westinghouse developed the Radiological Evaluation Decision Input (REDI) program.« less

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.

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

Key Performance Indicators in Radiology: You Can't Manage What You Can't Measure.

PubMed

Harvey, H Benjamin; Hassanzadeh, Elmira; Aran, Shima; Rosenthal, Daniel I; Thrall, James H; Abujudeh, Hani H

2016-01-01

Quality assurance (QA) is a fundamental component of every successful radiology operation. A radiology QA program must be able to efficiently and effectively monitor and respond to quality problems. However, as radiology QA has expanded into the depths of radiology operations, the task of defining and measuring quality has become more difficult. Key performance indicators (KPIs) are highly valuable data points and measurement tools that can be used to monitor and evaluate the quality of services provided by a radiology operation. As such, KPIs empower a radiology QA program to bridge normative understandings of health care quality with on-the-ground quality management. This review introduces the importance of KPIs in health care QA, a framework for structuring KPIs, a method to identify and tailor KPIs, and strategies to analyze and communicate KPI data that would drive process improvement. Adopting a KPI-driven QA program is both good for patient care and allows a radiology operation to demonstrate measurable value to other health care stakeholders. Copyright © 2015 Mosby, Inc. All rights reserved.

Endoscopy versus radiology in post-procedural monitoring after peroral endoscopic myotomy (POEM).

PubMed

Nast, Jan Friso; Berliner, Christoph; Rösch, Thomas; von Renteln, Daniel; Noder, Tania; Schachschal, Guido; Groth, Stefan; Ittrich, Harald; Kersten, Jan F; Adam, Gerhard; Werner, Yuki B

2018-03-15

The newly developed technique of peroral endoscopic myotomy (POEM) has been shown to be effective in several short- and mid-term studies. Limited information is available about the adequacy of immediate post-POEM monitoring tests. POEM was performed under general anesthesia in 228 patients (59.6% male, mean age 45.6 ± 15.5 years). Post-procedural checks comprised clinical and laboratory examination, and, during post-procedure days 1-5, endoscopy and-in the first 114 cases-radiologic examination using water-soluble contrast (1st group); the remaining patients underwent post-procedure controls without radiology (2nd group). Main outcome was value of endoscopic compared to radiologic control for recognition of early adverse events. In the first group, routine fluoroscopic contrast swallow suggested minor leakages at the mucosal entry site in two cases which was confirmed endoscopically in only one. Endoscopy revealed two minor entry site leakages and, in six additional cases, dislocated clips without leakage (overall 5.3%). All eight patients underwent reclipping and healed without clinical sequelae. In the 2nd group, endoscopy showed 5 clip dislocations (all reclipped) and one ischemic cardiac perforation in a patient with clinical deterioration on post-POEM day 1 who had to undergo surgery after confirmation of leakage by CT. Radiologic monitoring (contrast swallow) after POEM is not useful and can be omitted. Even routine endoscopic monitoring for detection and closure of minor defects of the mucosal entry site yields limited information with regards to final outcome; major complications are very rare and probably associated with clinical deterioration. Clinical Trials Gov Registration number of the main study: NCT01405417.

Cutting costs: the impact of price lists on the cost development at the emergency department.

PubMed

Schilling, Ulf Martin

2010-12-01

It was shown that physicians working at the Swedish emergency department (ED) are unaware of the costs for investigations performed. This study evaluated the possible impact of price lists on the overall laboratory and radiology costs at the ED of a Swedish university hospital. Price lists including the most common laboratory analyses and radiological investigations at the ED were created. The lists were distributed to all internal medicine physicians by e-mail and exposed above their working stations continually. No lists were provided for the orthopaedic control group. The average costs for laboratory and radiological investigations during the months of June and July 2007 and 2008 were calculated. Neither clinical nor admission procedures were changed. The physicians were blinded towards the study. Statistical analysis was performed using the Student's t-test. A total of 1442 orthopaedic and 1585 medical patients were attended to in 2007. In 2008, 1467 orthopaedic and 1637 medical patients required emergency service. The average costs per patient were 980.27 SKR (98€)/999.41 SKR (100€, +1.95%) for orthopaedic and 1081.36 SKR (108€)/877.3 SKR (88€, -18.8%) for medical patients. Laboratory costs decreased by 9% in orthopaedic and 21.4% in medical patients. Radiology costs changed +5.4% in orthopaedic and -20.59% in medical patients. The distribution and promotion of price lists as a tool at the ED to heighten cost awareness resulted in a major decrease in the investigation costs. A significant decrease in radiological costs could be observed. It can be concluded that price lists are an effective tool to cut costs in public healthcare.

Performance evaluation of a digital mammography unit using a contrast-detail phantom

NASA Astrophysics Data System (ADS)

Elizalde-Cabrera, J.; Brandan, M.-E.

2015-01-01

The relation between image quality and mean glandular dose (MGD) has been studied for a Senographe 2000D mammographic unit used for research in our laboratory. The magnitudes were evaluated for a clinically relevant range of acrylic thicknesses and radiological techniques. The CDMAM phantom was used to determine the contrast-detail curve. Also, an alternative method based on the analysis of signal-to-noise (SNR) and contrast-to-noise (CNR) ratios from the CDMAM image was proposed and applied. A simple numerical model was utilized to successfully interpret the results. Optimum radiological techniques were determined using the figures-of-merit FOMSNR=SNR2/MGD and FOMCNR=CNR2/MGD. Main results were: the evaluation of the detector response flattening process (it reduces by about one half the spatial non-homogeneities due to the X- ray field), MGD measurements (the values comply with standards), and verification of the automatic exposure control performance (it is sensitive to fluence attenuation, not to contrast). For 4-5 cm phantom thicknesses, the optimum radiological techniques were Rh/Rh 34 kV to optimize SNR, and Rh/Rh 28 kV to optimize CNR.

Interventional radiology procedures after pancreatic resections for pancreatic and periampullary diseases.

PubMed

Casadei, Riccardo; Ricci, Claudio; Giampalma, Emanuela; D'Ambra, Marielda; Taffurelli, Giovanni; Mosconi, Cristina; Golfieri, Rita; Minni, Francesco

2014-07-28

The use of interventional radiology has increased as the first-line management of complications after pancreatic resections. Patients in whom interventional radiology was performed were compared with those in whom interventional radiology was not performed as regards type of pancreatic resection, diagnosis, postoperative mortality and morbidity, postoperative pancreatic fistula postpancreatectomy haemorrhage, bile leakage, reoperation rate and length of hospital stay. Our aim was to evaluate the usefulness of interventional radiology in the treatment of complications after pancreatic resection. One hundred and eighty-two (62.8%) out of 290 patients experienced postoperative complications. Interventional radiology procedures were performed in 37 cases (20.3%): percutaneous drainage in 28, transhepatic biliary drainage in 8 and arterial embolisation in 3 cases. Technical success was obtained in all cases and clinical success in 75.7%. Reoperation was avoided in 86.5%. In patients with major complications, clinically relevant postoperative pancreatic fistula and bile leaks as well as those with late postpancreatectomy haemorrhage (P=0.030) and patients with postpancreatectomy haemorrhage grade C (P=0.029), interventional radiology was used (P<0.001, P<0.001 and P=0.009, respectively) significantly more frequently than in the remaining patients. The reoperation and mortality rates were similar in the two groups (P=0.885 and P=0.100, respectively) while patients treated with interventional radiology procedures had a significant longer length of hospital stay than those in the non-interventional radiology group (37.5 ± 23.4 vs. 18.7 ± 11.7 days; P<0.001). Interventional radiology procedures were useful, especially for patients with postoperative pancreatic fistulas and bile leaks in whom reoperation was very often avoided.

Tools to manage the enterprise-wide picture archiving and communications system environment.

PubMed

Lannum, L M; Gumpf, S; Piraino, D

2001-06-01

The presentation will focus on the implementation and utilization of a central picture archiving and communications system (PACS) network-monitoring tool that allows for enterprise-wide operations management and support of the image distribution network. The MagicWatch (Siemens, Iselin, NJ) PACS/radiology information system (RIS) monitoring station from Siemens has allowed our organization to create a service support structure that has given us proactive control of our environment and has allowed us to meet the service level performance expectations of the users. The Radiology Help Desk has used the MagicWatch PACS monitoring station as an applications support tool that has allowed the group to monitor network activity and individual systems performance at each node. Fast and timely recognition of the effects of single events within the PACS/RIS environment has allowed the group to proactively recognize possible performance issues and resolve problems. The PACS/operations group performs network management control, image storage management, and software distribution management from a single, central point in the enterprise. The MagicWatch station allows for the complete automation of software distribution, installation, and configuration process across all the nodes in the system. The tool has allowed for the standardization of the workstations and provides a central configuration control for the establishment and maintenance of the system standards. This report will describe the PACS management and operation prior to the implementation of the MagicWatch PACS monitoring station and will highlight the operational benefits of a centralized network and system-monitoring tool.

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

Evaluation of mammography equipment performance, dose and image quality in five Latin American countries

NASA Astrophysics Data System (ADS)

Brandan, M.-E.; Ruiz-Trejo, C.; Caspani, C. E. M.; Fleitas, I.; de-la-Mora, R.; Miranda, A. A.; Plazas, M.-C.; Betancourt, C.-M.; Borras, C.

2001-10-01

Under the auspices of PAHO/WHO, a multicentric investigation is carried out in five Latin American countries. Its aim is to correlate quality indicators of radiology services with the accuracy of the radiological interpretation as determined by a panel of radiology experts. We present preliminary results from mammographic imaging facilities. Evaluation of the equipment performance and dose measurements in 21 mammographic units show that, on the average, 75% of the units comply with recommendations issued by various organizations. An independent evaluation of the quality of the clinical images show strong variations among the different radiological services.

National audit of the sensitivity of double-contrast barium enema for colorectal carcinoma, using control charts For the Royal College of Radiologists Clinical Radiology Audit Sub-Committee.

PubMed

Tawn, D J; Squire, C J; Mohammed, M A; Adam, E J

2005-05-01

To audit the sensitivity of double-contrast barium enema (DCBE) for colorectal carcinoma, as currently practised in UK departments of radiology. As part of its programme of national audits, the Royal College of Radiologists Clinical Radiology Audit Sub-Committee undertook a retrospective audit of the sensitivity of DCBE for colorectal carcinoma during 2002. The following targets were set: demonstration of a lesion > or =95%; correct identification as a carcinoma > or =90%. Across the UK, 131 departments took part in the audit, involving 5454 examinations. The mean demonstration rate was 92.9% and the diagnosis rate was 85.9%, slightly below the targets set. The equivocal rate (lesion demonstrated, but not defined as malignant) was 6.9%, the perception failure rate was 2.8% and the technical failure rate was 4.4%. Control-chart methodology was used to analyze the data and to identify any departments whose performance was consistent with special-cause variation. When compared with the diagnosis rate (84.6%) and demonstration rate (92.7%) reported in the Wessex Audit 1995, [Thomas RD, Fairhurst JJ, Frost RA. Wessex regional audit: barium enema in colo-rectal carcinoma. Clin Radiol 1995;50:647-50.] a similar level of performance was observed in the NHS today, implying that the basic process for undertaking and reporting DCBE has remained relatively unchanged over the last few years. Improvement in the future will require fundamental changes to the process of reporting DCBE, in order to minimize the perception failure rate and accurately to describe lesions, so reducing the equivocal rate. Control-chart methodology has a useful role in identifying strategies to deliver continual improvement.

Characterization of X-ray fields at the center for devices and radiological health

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

Cerra, F.

This talk summarizes the process undertaken by the Center for Devices and Radiological Health (CDRH) for establishing reference x-ray fields in its accredited calibration laboratory. The main considerations and their effects on the calibration parameters are discussed. The characterization of fields may be broken down into two parts: (1) the initial setup of the calibration beam spectra and (2) the ongoing measurements and controls which ensure consistency of the reference fields. The methods employed by CDRH for both these stages and underlying considerations are presented. Uncertainties associated with the various parameters are discussed. Finally, the laboratory`s performance, as evidenced bymore » ongoing measurement quality assurance results, is reported.« less

The modern history and evolution of percutaneous nephrolithotomy.

PubMed

Patel, Sutchin R; Nakada, Stephen Y

2015-02-01

Serendipity, innovative physicians, evolving techniques for renal access, and improvements in equipment and radiology led to the evolution of percutaneous nephrolithotomy (PCNL). We searched urology texts and the literature for sources pertaining to the history and development of PCNL. In 1941, Rupel and Brown performed the first nephroscopy when a rigid cystoscope was passed into the kidney following open surgery. Willard Goodwin, in 1955, while trying to perform a renal arteriogram, placed a needle into the collecting system of a hydronephrotic kidney and performed the first antegrade nephrostogram. He left a tube to drain the kidney, thereby placing the first nephrostomy tube. By 1976, Fernström and Johansson were the first to describe a technique for extracting renal calculi through a percutaneous nephrostomy under radiological control. In 1978, Arthur Smith, would describe the first antegrade stent placement when he introduced a Gibbons stent through a percutaneous nephrostomy in a patient with a reimplanted ureter. Dr. Smith would coin the term "endourology" to describe closed, controlled manipulation of the genitourinary tract. His collaboration with Kurt Amplatz, an interventional radiologist and medical inventor, would lead to numerous innovations that would further advance PCNL. In the 1980s the process of renal access and tract dilation was improved upon and the use of a rigid cystoscope was replaced by offset nephroscopes with a large straight working channel. Radiographic innovations, including improvements in fluoroscopy would further aid in renal access. The development of various lithotripsy devices and the introduction of the holmium laser improved the efficiency of stone fragmentation and clearance. The increased clinical experience and utilization of PCNL would lead to the characterization of stone-free rates and complications for the procedure. Serendipity, innovations in renal access, optics, radiology, and improvements in lithotripsy all contributed to the modern day PCNL.

2014 Radiological Monitoring Results Associated with the Advanced Test Reactor Complex Cold Waste Pond

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

Lewis, Mike

2015-02-01

This report summarizes radiological monitoring performed of the Idaho National Laboratory Site’s Advanced Test Reactor Complex Cold Waste wastewater prior to discharge into the Cold Waste Pond and of specific groundwater monitoring wells associated with the Industrial Wastewater Reuse Permit (#LA-000161-01, Modification B). All radiological monitoring is performed to fulfill Department of Energy requirements under the Atomic Energy Act.

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.

Development of Medical Adjunctive Treatment for Acute Penetrating Head Injury

DTIC Science & Technology

1988-04-01

surgical procedure performed will naturally depend upon the nature of the injury. In general terms, however, a craniectomy or craniotomy will be performed...ICP cannot be kept under control, even with CSF drainage and mannitol when sedation and pancuronium are withdrawn. Radiological Studies All patients...will be hyperventilated to achieve a pCO2 of not less tan 25 mmHg. Ventricular drainage via the ventriculostomy will be simulta- neously employed. 11

Improving financial performance by modeling and analysis of radiology procedure scheduling at a large community hospital.

PubMed

Lu, Lingbo; Li, Jingshan; Gisler, Paula

2011-06-01

Radiology tests, such as MRI, CT-scan, X-ray and ultrasound, are cost intensive and insurance pre-approvals are necessary to get reimbursement. In some cases, tests may be denied for payments by insurance companies due to lack of pre-approvals, inaccurate or missing necessary information. This can lead to substantial revenue losses for the hospital. In this paper, we present a simulation study of a centralized scheduling process for outpatient radiology tests at a large community hospital (Central Baptist Hospital in Lexington, Kentucky). Based on analysis of the central scheduling process, a simulation model of information flow in the process has been developed. Using such a model, the root causes of financial losses associated with errors and omissions in this process were identified and analyzed, and their impacts were quantified. In addition, "what-if" analysis was conducted to identify potential process improvement strategies in the form of recommendations to the hospital leadership. Such a model provides a quantitative tool for continuous improvement and process control in radiology outpatient test scheduling process to reduce financial losses associated with process error. This method of analysis is also applicable to other departments in the hospital.

Summary of the proceedings of the International Forum 2017: "Position of interventional radiology within radiology".

PubMed

2018-04-01

The International Forum is held once a year by the ESR and its international radiological partner societies with the aim to address and discuss selected topics of global relevance in radiology. In 2017, the issue of the position of interventional radiology (IR) within radiology was analysed. IR is expanding because of the increased patient demand for minimally invasive therapies performed under imaging guidance, and its success in improving patient outcomes, reducing in-hospital stays, reducing morbidity and mortality of treatment in many organs and organ-systems. Despite the many successes of IR, public awareness about it is quite low. IR requires specific training and, in most countries, the majority of interventional radiologists do not dedicate their time completely to IR but perform diagnostic radiology investigations as well. Turf battles in IR are common in many countries. To preserve and keep IR within radiology, it is necessary to focus more on direct and longitudinal patient care. Having beds dedicated to IR within radiology departments is very important to increase clinical involvement of interventional radiologists. IR procedures fit perfectly within "value-based healthcare", but the metrics have to be developed. • IR should stay a prominent subspecialty within radiology. • Dedicated IR training pathways are mandatory. • Measures to increase recruitment of young doctors to IR and to increase public awareness of IR are needed. • Beds dedicated to IR within radiology departments are important in order to increase clinical involvement of interventional radiologists.

Which is the best way of performing a Micturating Cystourethrogram in children?

PubMed

Al-Imam, Ola Ali; Al-Nsour, Nareeman Moh'd; Al-Khulaifat, Samih

2008-01-01

The Micturating Cystourethrogram (MCU) is a tough and stressful examination for patients and their parents as well as the radiologists and pediatric radiology nurses. Even though, it is one of the most commonly used fluoroscopic procedures in pediatric radiology practice, there is no definite agreement as to the best way to perform it, considering that this examination results in the children receiving a high dose of radiation to the gonadal region. This review was undertaken to determine the best way to perform the MCU in modern pediatric radiology practice.

Telemedicine-based system for quality management and peer review in radiology.

PubMed

Morozov, Sergey; Guseva, Ekaterina; Ledikhova, Natalya; Vladzymyrskyy, Anton; Safronov, Dmitry

2018-06-01

Quality assurance is the key component of modern radiology. A telemedicine-based quality assurance system helps to overcome the "scoring" approach and makes the quality control more accessible and objective. A concept for quality assurance in radiology is developed. Its realization is a set of strategies, actions, and tools. The latter is based on telemedicine-based peer review of 23,199 computed tomography (CT) and magnetic resonance imaging (MRI) images. The conception of the system for quality management in radiology represents a chain of actions: "discrepancies evaluation - routine support - quality improvement activity - discrepancies evaluation". It is realized by an audit methodology, telemedicine, elearning, and other technologies. After a year of systemic telemedicine-based peer reviews, the authors have estimated that clinically significant discrepancies were detected in 6% of all cases, while clinically insignificant ones were found in 19% of cases. Most often, problems appear in musculoskeletal records; 80% of the examinations have diagnostic or technical imperfections. The presence of routine telemedicine support and personalized elearning allowed improving the diagnostics quality. The level of discrepancies has decreased significantly (p < 0.05). The telemedicine-based peer review system allows improving radiology departments' network effectiveness. • "Scoring" approach to radiologists' performance assessment must be changed. • Telemedicine peer review and personalized elearning significantly decrease the number of discrepancies. • Teleradiology allows linking all primary-level hospitals to a common peer review network.

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

10 CFR 835.501 - Radiological areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a.... These authorizations shall specify radiation protection measures commensurate with the existing and...

First installation of a dual-room IVR-CT system in the emergency room.

PubMed

Wada, Daiki; Nakamori, Yasushi; Kanayama, Shuji; Maruyama, Shuhei; Kawada, Masahiro; Iwamura, Hiromu; Hayakawa, Koichi; Saito, Fukuki; Kuwagata, Yasuyuki

2018-03-05

Computed tomography (CT) embedded in the emergency room has gained importance in the early diagnostic phase of trauma care. In 2011, we implemented a new trauma workflow concept with a sliding CT scanner system with interventional radiology features (IVR-CT) that allows CT examination and emergency therapeutic intervention without relocating the patient, which we call the Hybrid emergency room (Hybrid ER). In the Hybrid ER, all life-saving procedures, CT examination, damage control surgery, and transcatheter arterial embolisation can be performed on the same table. Although the trauma workflow realized in the Hybrid ER may improve mortality in severe trauma, the Hybrid ER can potentially affect the efficacy of other in/outpatient diagnostic workflow because one room is occupied by one severely injured patient undergoing both emergency trauma care and CT scanning for long periods. In July 2017, we implemented a new trauma workflow concept with a dual-room sliding CT scanner system with interventional radiology features (dual-room IVR-CT) to increase patient throughput. When we perform emergency surgery or interventional radiology for a severely injured or ill patient in the Hybrid ER, the sliding CT scanner moves to the adjacent CT suite, and we can perform CT scanning of another in/outpatient. We believe that dual-room IVR-CT can contribute to the improvement of both the survival of severely injured or ill patients and patient throughput.

Medical examinations for radiation workers

NASA Technical Reports Server (NTRS)

Alexander, R. E.

1969-01-01

The NASA radiological protection policy allows an employee to be assigned work in a radiologically controlled area only if all of the following conditions are met: (1) The area must be radiologically safe for the intended operations; (2) the employee must be medically fit; (3) the employee must be properly trained; (4) appropriate radiation protection procedures must be prepared; (5) appropriate dosimetric, survey, surveillance and reporting procedures must be implemented; and (6) adequate controls and records must be established.

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

PubMed

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

2016-02-01

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

DEMOLISHING A COLD-WAR-ERA FUEL STORAGE BASIN SUPERSTRUCTURE LADEN WITH ASBESTOS

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

LLOYD ER; ORGILL TK; DAGAN EB

The K East (KE) Basin facilities are located near the north end of the Hanford Site's 100 K area. The facilities were built in 1950 as part of the KE Reactor complex and constructed within 400 meters of the Columbia River, which is the largest river in the Pacific Northwest and by volume the fourth largest river in the United States. The basin, located adjacent to the reactor, was used for the underwater storage of irradiated nuclear fuel discharged from the reactor. The basin was covered by a superstructure comprising steel columns and beams, concrete, and cement asbestos board (CAB)more » siding. The project's mission was to complete demolition of the structure over the K East basin within six months of tumover from facility deactivation activities. The demolition project team implemented open-air demolition techniques to demolish the facility to slab-on-grade. Several innovative techniques were used to control contamination and maintain contamination control within the confines of the demolition exclusion zone. The techniques, which focused on a defense-in-depth approach, included spraying fixatives on interior and exterior surfaces before demolition began; applying fixatives; misting using a fine spray of water during demolition; and demolishing the facility systematically. Another innovation that aided demolition was to demolish the building with the non-friable CAB remaining in place. The CAB siding covered the exterior of the building, portions of the interior walls, and was an integral part of the multiple layered roof. The project evaluated the risks involved in removing the CAB material in a radiologically contaminated environment and determined that radiological dose rates and exposure to radiological contamination and industrial hazards would be significantly reduced by removing the CAB during demolition using heavy equipment. The ability to perform this demolition safely and without spreading contamination (radiological or asbestos) demonstrates that similar open-air demolition ofcontaminated structures can be performed successfully.« less

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.

External Factors That Influence the Practice of Radiology: Proceedings of the International Society for Strategic Studies in Radiology Meeting.

PubMed

Rubin, Geoffrey D; McNeil, Barbara J; Palkó, András; Thrall, James H; Krestin, Gabriel P; Muellner, Ada; Kressel, Herbert Y

2017-06-01

In both the United States and Europe, efforts to reduce soaring health care costs have led to intense scrutiny of both standard and innovative uses of imaging. Given that the United States spends a larger share of its gross domestic product on health care than any other nation and also has the most varied health care financing and delivery systems in the world, it has become an especially fertile environment for developing and testing approaches to controlling health care costs and value. This report focuses on recent reforms that have had a dampening effect on imaging use in the United States and provides a glimpse of obstacles that imaging practices may soon face or are already facing in other countries. On the basis of material presented at the 2015 meeting of the International Society for Strategic Studies in Radiology, this report outlines the effects of reforms aimed at (a) controlling imaging use, (b) controlling payer expense through changes in benefit design, and (c) controlling both costs and quality through "value-based" payment schemes. Reasons are considered for radiology practices on both sides of the Atlantic about why the emphasis needs to shift from providing a large volume of imaging services to increasing the value of imaging as manifested in clinical outcomes, patient satisfaction, and overall system savings. Options for facilitating the shift from volume to value are discussed, from the use of advanced management strategies that improve workflow to the creation of programs for patient engagement, the development of new clinical decision-making support tools, and the validation of clinically relevant imaging biomarkers. Radiologists in collaboration with industry must enhance their efforts to expand the performance of comparative effectiveness research to establish the value of these initiatives, while being mindful of the importance of minimizing conflicts of interest. © RSNA, 2017.

A preliminary study into performing routine tube output and automatic exposure control quality assurance using radiology information system data.

PubMed

Charnock, P; Jones, R; Fazakerley, J; Wilde, R; Dunn, A F

2011-09-01

Data are currently being collected from hospital radiology information systems in the North West of the UK for the purposes of both clinical audit and patient dose audit. Could these data also be used to satisfy quality assurance (QA) requirements according to UK guidance? From 2008 to 2009, 731 653 records were submitted from 8 hospitals from the North West England. For automatic exposure control QA, the protocol from Institute of Physics and Engineering in Medicine (IPEM) report 91 recommends that milliamperes per second can be monitored for repeatability and reproducibility using a suitable phantom, at 70-81 kV. Abdomen AP and chest PA examinations were analysed to find the most common kilovoltage used with these records then used to plot average monthly milliamperes per second with time. IPEM report 91 also recommends that a range of commonly used clinical settings is used to check output reproducibility and repeatability. For each tube, the dose area product values were plotted over time for two most common exposure factor sets. Results show that it is possible to do performance checks of AEC systems; however more work is required to be able to monitor tube output performance. Procedurally, the management system requires work and the benefits to the workflow would need to be demonstrated.

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.

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.

Common procedures and strategies for anaesthesia in interventional radiology.

PubMed

Landrigan-Ossar, Mary

2015-08-01

This review describes the range of cases now available in the interventional radiology suite and summarizes suggestions for their anaesthetic and perioperative management. The type and complexity of interventional radiology cases being performed increases from year to year. Anaesthesiologists' presence in interventional radiology is increasing in turn, due to increasingly ill patients and intricate procedures requiring more than local anaesthesia for well tolerated completion. The literature available describing this is largely written by radiologists, with little attention paid to anaesthetic considerations. Cases in interventional radiology are complex in terms of the logistics of working in an unfamiliar area, frequency of patient comorbidity and unfamiliar procedures. Ensuring familiarity with the variety of interventional radiology procedures and their periprocedure requirements can increase anaesthesiologists' comfort in interventional radiology.

Radiological Monitoring Results for Groundwater Samples Associated with the Industrial Wastewater Reuse Permit for the Materials and Fuels Complex Industrial Waste Ditch and Pond: November 1, 2011-October 31, 2012

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

Mike lewis

2013-02-01

This report summarizes radiological monitoring performed on samples from specific groundwater monitoring wells associated with the Industrial Wastewater Reuse Permit for the Materials and Fuels Complex Industrial Waste Ditch and Industrial Waste Pond WRU-I-0160-01, Modification 1 (formerly LA-000160-01). The radiological monitoring was performed to fulfill Department of Energy requirements under the Atomic Energy Act.

Radiological Monitoring Results for Groundwater Samples Associated with the Industrial Wastewater Reuse Permit for the Materials and Fuels Complex Industrial Waste Ditch and Pond: November 1, 2012-October 31, 2013

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

Mike Lewis

2014-02-01

This report summarizes radiological monitoring performed on samples from specific groundwater monitoring wells associated with the Industrial Wastewater Reuse Permit for the Materials and Fuels Complex Industrial Waste Ditch and Industrial Waste Pond WRU-I-0160-01, Modification 1 (formerly LA-000160-01). The radiological monitoring was performed to fulfill Department of Energy requirements under the Atomic Energy Act.

Touchless interaction with software in interventional radiology and surgery: a systematic literature review.

PubMed

Mewes, André; Hensen, Bennet; Wacker, Frank; Hansen, Christian

2017-02-01

In this article, we systematically examine the current state of research of systems that focus on touchless human-computer interaction in operating rooms and interventional radiology suites. We further discuss the drawbacks of current solutions and underline promising technologies for future development. A systematic literature search of scientific papers that deal with touchless control of medical software in the immediate environment of the operation room and interventional radiology suite was performed. This includes methods for touchless gesture interaction, voice control and eye tracking. Fifty-five research papers were identified and analyzed in detail including 33 journal publications. Most of the identified literature (62 %) deals with the control of medical image viewers. The others present interaction techniques for laparoscopic assistance (13 %), telerobotic assistance and operating room control (9 % each) as well as for robotic operating room assistance and intraoperative registration (3.5 % each). Only 8 systems (14.5 %) were tested in a real clinical environment, and 7 (12.7 %) were not evaluated at all. In the last 10 years, many advancements have led to robust touchless interaction approaches. However, only a few have been systematically evaluated in real operating room settings. Further research is required to cope with current limitations of touchless software interfaces in clinical environments. The main challenges for future research are the improvement and evaluation of usability and intuitiveness of touchless human-computer interaction and the full integration into productive systems as well as the reduction of necessary interaction steps and further development of hands-free interaction.

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…

42 CFR 402.3 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... physician. Radiologist service means radiology services performed only by, or under the direction of, a physician who is certified, or eligible to be certified, by the American Board of Radiology or for whom radiology services account for at least 50 percent of the total amount of charges made under part B of title...

Cervical Spine Status of Pilots and Air-Controllers of Airborne Early Warning and Control Aircraft.

PubMed

Shin, Young Ho; Yun, Chul; Han, Andrew Hogyu

2017-05-01

Many countries have developed their own airborne early warning and control (AEW&C) systems for use in surveying their territorial sky in real time. However, a review of the literature suggests that no studies have been conducted to analyze the cervical spine of pilots and air-controllers of AEW&C aircraft. The study subjects were 80 pilots and air-controllers of AEW&C aircraft with a period of service of > 1 yr and had data on physical examinations, simple radiographs and functional scores of the axial skeleton, and questionnaires about lifestyle and working conditions. Information about physical characteristics and experience of neck pain were collected. Functional scores including the neck disability index and short-form 36-item health survey were obtained. Radiological measurements were performed for the C2-7 Cobb angle and degree of forward head posture. Of the 80 subjects, 33 (41.3%) had experienced neck pain and 63 (78.8%) had impaired cervical lordosis. The results of functional and radiological evaluations were not significantly different between pilots and air-controllers. In multivariate analysis, only the age was significantly related to the occurrence of impaired cervical lordosis. However, there were no significant factors related to the occurrence of neck pain. The results of this study suggest that the working environment of pilots and air-controllers of AEW&C aircraft has a negative effect on their cervical spine. Age seemed to be the most significant factor affecting the occurrence of impaired cervical lordosis in these subjects.Shin YH, Yun C, Han AH. Cervical spine status of pilots and air-controllers of airborne early warning and control aircraft. Aerosp Med Hum Perform. 2017; 88(5):476-480.

Physiopathology of megarectum: the association of megarectum with encopresis.

PubMed Central

Meunier, P; Mollard, P; Marechal, J M

1976-01-01

Studies of both rectosphincteric reflex threshold and conscious rectal sensitivity threshold were performed on 15 control subjects and 61 children with a radiological megarectum, 70% of whom were encopretics. In control subjects, the reflex threshold and the sensitivity threshold were obtained with a comparable volume of rectal distension. In the megarectum patients, sensitivity was often considerably reduced, the incidence of encopresis increasing proportionally with the decrease in conscious rectal sensitivity. Patients were segregated in three functional groups, according to measurements of the sensitivity threshold. PMID:1269991

Telemedicine and pediatric radiology: a new environment for training, learning, and interactive discussions.

PubMed

Monteiro, Alexandra M V; Corrêa, Diogo Goulart; Santos, Alair Augusto Sarmet M D; Cavalcanti, Silvio A; Sakuno, Telma; Filgueiras, Tereza; Just, Eduardo; Santos, Munique; Messina, Luiz Ary; Haddad, Ana Estela; Marchiori, Edson

2011-12-01

To report the experience of the Brazilian Program of Pediatric Teleradiology in combining teleconferencing and a virtual learning environment for services integration, collaborative research, and continuing education in pediatric radiology. We performed virtual meetings from March 2005 to October 2010 on pediatric radiology-related themes, using a combination of videoconferences and Web conferences, which were recorded and made available in an open-source software (Moodle) for reuse. We performed 58 virtual sessions: 29 anatomical-clinical-radiological sessions, 28 on upgrading themes, and 1 virtual symposium. The average of connected points was 12 by videoconference and 39 by Web conference, and of 450 participants per event. At the time of this writing, 318 physicians and students are registered in the virtual learning environment, with a total of 14,678 accesses. Telemedicine is being included in pediatric radiology practice, as a means for distance education, training, and continuing integration between groups.

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

PubMed

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

2016-12-01

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

Method and apparatus for in-cell vacuuming of radiologically contaminated materials

DOEpatents

Spadaro, Peter R.; Smith, Jay E.; Speer, Elmer L.; Cecconi, Arnold L.

1987-01-01

A vacuum air flow operated cyclone separator arrangement for collecting, handling and packaging loose contaminated material in accordance with acceptable radiological and criticality control requirements. The vacuum air flow system includes a specially designed fail-safe prefilter installed upstream of the vacuum air flow power supply. The fail-safe prefilter provides in-cell vacuum system flow visualization and automatically reduces or shuts off the vacuum air flow in the event of an upstream prefilter failure. The system is effective for collecting and handling highly contaminated radiological waste in the form of dust, dirt, fuel element fines, metal chips and similar loose material in accordance with radiological and criticality control requirements for disposal by means of shipment and burial.

Creating a comprehensive customer service program to help convey critical and acute results of radiology studies.

PubMed

Towbin, Alexander J; Hall, Seth; Moskovitz, Jay; Johnson, Neil D; Donnelly, Lane F

2011-01-01

Communication of acute or critical results between the radiology department and referring clinicians has been a deficiency of many radiology departments. The failure to perform or document these communications can lead to poor patient care, patient safety issues, medical-legal issues, and complaints from referring clinicians. To mitigate these factors, a communication and documentation tool was created and incorporated into our departmental customer service program. This article will describe the implementation of a comprehensive customer service program in a hospital-based radiology department. A comprehensive customer service program was created in the radiology department. Customer service representatives were hired to answer the telephone calls to the radiology reading rooms and to help convey radiology results. The radiologists, referring clinicians, and customer service representatives were then linked via a novel workflow management system. This workflow management system provided tools to help facilitate the communication needs of each group. The number of studies with results conveyed was recorded from the implementation of the workflow management system. Between the implementation of the workflow management system on August 1, 2005, and June 1, 2009, 116,844 radiology results were conveyed to the referring clinicians and documented in the system. This accounts for more than 14% of the 828,516 radiology cases performed in this time frame. We have been successful in creating a comprehensive customer service program to convey and document communication of radiology results. This program has been widely used by the ordering clinicians as well as radiologists since its inception.

Educational treasures in radiology: a free online program for Radiology Boards preparation.

PubMed

Talanow, Roland

2011-01-01

An objective tool is desired, which optimally prepares for Radiology boards examination. Such program should prepare examinees with pertinent radiological contents and simulations as expected in the real examination. Many countries require written boards examinations for Radiology certification eligibility. No objective measure exists to tell if the examinee is ready to pass the exam or not. Time pressure and computer environment might be unfamiliar to examinees. Traditional preparation lectures don't simulate the "real" Radiology exam because they don't provide the special environment with multiple choice questions and timing. This online program consists of 4 parts. The entry section allows to create questions with additional fields for comprehensive information. Sections include Pediatrics/Mammography/GI/IR/Nucs/Thoracic/Musculoskeletal/GU/Neuro/Ultrasound/Cardiac/OB/GYN and Miscellaneous. Experienced radiologists and educators evaluate and release/delete these entries in the administrator section. In the exam section users can create (un)timed customized exams for individual needs and learning pace. Exams can either include all sections or only specific sections to gear learning towards areas with weaker performance. Comprehensive statistics unveil the user's strengths and weaknesses to help focussing on "weak" areas. In the search section a comprehensive search and review can be performed by searching the entire database for keywords/topics or only searching within specific sections. www.RadiologyBoards.org is a new working concept of Radiology boards preparation to detect and improve the examinee's weaknesses and finally to increase the examinee's confidence level for the final exam. It is beneficial for Radiology residents and also board certified radiologists to refresh/maintain radiological knowledge.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Family members of Randy Scott gather in the Radiological Control Center at NASA's Kennedy Space Center following ceremonies to name the facility in his honor. 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.

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

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.

Machine Learning in Radiology: Applications Beyond Image Interpretation.

PubMed

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

2018-02-01

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

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.

Physical and cognitive task analysis in interventional radiology.

PubMed

Johnson, S; Healey, A; Evans, J; Murphy, M; Crawshaw, M; Gould, D

2006-01-01

To identify, describe and detail the cognitive thought processes, decision-making, and physical actions involved in the preparation and successful performance of core interventional radiology procedures. Five commonly performed core interventional radiology procedures were selected for cognitive task analysis. Several examples of each procedure being performed by consultant interventional radiologists were videoed. The videos of those procedures, and the steps required for successful outcome, were analysed by a psychologist and an interventional radiologist. Once a skeleton algorithm of the procedures was defined, further refinement was achieved using individual interview techniques with consultant interventional radiologists. Additionally a critique of each iteration of the established algorithm was sought from non-participating independent consultant interventional radiologists. Detailed task descriptions and decision protocols were developed for five interventional radiology procedures (arterial puncture, nephrostomy, venous access, biopsy-using both ultrasound and computed tomography, and percutaneous transhepatic cholangiogram). Identical tasks performed within these procedures were identified and standardized within the protocols. Complex procedures were broken down and their constituent processes identified. This might be suitable for use as a training protocol to provide a universally acceptable safe practice at the most fundamental level. It is envisaged that data collected in this way can be used as an educational resource for trainees and could provide the basis for a training curriculum in interventional radiology. It will direct trainees towards safe practice of the highest standard. It will also provide performance objectives of a simulator model.

2015 Groundwater Radiological Monitoring Results Associated with the Advanced Test Reactor Complex Cold Waste Ponds

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

Lewis, Michael George

This report summarizes radiological monitoring results from groundwater wells associated with the Idaho National Laboratory Site’s Advanced Test Reactor Complex Cold Waste Ponds Reuse Permit (I-161-02). All radiological monitoring is performed to fulfill Department of Energy requirements under the Atomic Energy Act.

Radiologically occult medulloblastoma with hydrocephalus: case report.

PubMed

Honma, Hirokuni; Ogiwara, Hideki

2017-09-01

There have been no reports of occult medulloblastoma nor noncommunicating hydrocephalus due to radiologically occult brain tumors. Herein, we report radiologically occult medulloblastoma with noncommunicating hydrocephalus. A 3-year-old boy presented with macrocephaly, visual field constriction, and papilledema. Neuroimagings showed enlargement of the ventricles without any mass lesions. The CT cisternography did not show influx of the contrast into the ventricles, which suggested local cerebrospinal fluid (CSF) circulatory disturbance at the outlet of the fourth ventricle. Due to possible obstructive nature of hydrocephalus, endoscopic third ventriculostomy (ETV) was performed. Three months after the ETV, he presented with repeated vomiting. Neuroimagings showed a 3-cm fourth ventricular mass with progressive hydrocephalus. Surgical resection was performed, which revealed the pathology was medulloblastoma. We report the case of radiologically occult medulloblastoma which was demonstrated radiologically in the follow-up period of ETV for noncommunicating hydrocephalus of uncertain etiology. This is the first description of a radiologically occult medulloblastoma and also the first description of an occult brain tumor with noncommunicating hydrocephalus. The occult brain tumor may be included in the etiology of hydrocephalus.

Analysis of Operation TEAPOT nuclear test BEE radiological and meteorological data

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

Quinn, V.E.

This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the BEE nuclear test of Operation TEAPOT. Inconsistencies in the radiological data and their resolution are discussed. The methods of normalizing the radiological data to a standard time and estimating fallout-arrival times are presented. The meteorological situations on event day and the following day are described. A comparison of the WSNSO fallout analysis with an analysis performed in the 1950's is presented. The radiological data used to derive the WSNSO fallout pattern are tabulated in an appendix.

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.

Image degradation by glare in radiologic display devices

NASA Astrophysics Data System (ADS)

Badano, Aldo; Flynn, Michael J.

1997-05-01

No electronic devices are currently available that can display digital radiographs without loss of visual information compared to traditional transilluminated film. Light scattering within the glass faceplate of cathode-ray tube (CRT) devices causes excessive glare that reduces image contrast. This glare, along with ambient light reflection, has been recognized as a significant limitation for radiologic applications. Efforts to control the effect of glare and ambient light reflection in CRTs include the use of absorptive glass and thin film coatings. In the near future, flat panel displays (FPD) with thin emissive structures should provide very low glare, high performance devices. We have used an optical Monte Carlo simulation to evaluate the effect of glare on image quality for typical CRT and flat panel display devices. The trade-off between display brightness and image contrast is described. For CRT systems, achieving good glare ratio requires a reduction of brightness to 30-40 percent of the maximum potential brightness. For FPD systems, similar glare performance can be achieved while maintaining 80 percent of the maximum potential brightness.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Nancy Bray, director of Spaceport Integration and Services at NASA's Kennedy Space Center, speaks during ceremonies to name the Radiological Control Center in honor for 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.

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

PubMed

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

2013-12-01

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

Machine Learning and Radiology

PubMed Central

Wang, Shijun; Summers, Ronald M.

2012-01-01

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

Just-in-time learning is effective in helping first responders manage weapons of mass destruction events.

PubMed

Motola, Ivette; Burns, William A; Brotons, Angel A; Withum, Kelly F; Rodriguez, Richard D; Hernandez, Salma; Rivera, Hector F; Issenberg, Saul Barry; Schulman, Carl I

2015-10-01

Chemical, biologic, radiologic, nuclear, and explosive (CBRNE) incidents require specialized training. The low frequency of these events leads to significant skill decay among first responders. To address skill decay and lack of experience with these high-impact events, educational modules were developed for mobile devices to provide just-in-time training to first responders en route to a CBRNE event. This study assessed the efficacy and usability of the mobile training. Ninety first responders were randomized to a control or an intervention group. All participants completed a pretest to measure knowledge of CBRNE topics. The intervention group then viewed personal protective equipment and weapons of mass destruction field management videos as an overview. Both groups were briefed on a disaster scenario (chemical nerve agent, radiologic, or explosives) requiring them to triage, assess, and manage a patient. Intervention group participants watched a mobile training video corresponding to the scenario. The control group did not receive prescenario video training. Observers rated participant performance in each scenario. After completing the scenarios, all participants answered a cognitive posttest. Those in the intervention group also answered a questionnaire on their impressions of the training. The intervention group outperformed the control group in the explosives and chemical nerve agent scenarios; the differences were statistically significant (explosives, mean of 26.32 for intervention and 22.85 for control, p < 0.01; nerve agent, mean of 23.14 for intervention and 16.61 for control, p < 0.01). There was no statistically significant difference between the groups in the radiologic scenario (mean, 12.7 for intervention and 11.8 for control; p = 0.51). The change in pretest to posttest cognitive scores was significantly higher in the intervention group than in the control group (t = 3.28, p < 0.05). Mobile just-in-time training improved first-responder knowledge of CBRNE events and is an effective tool in helping first responders manage simulated explosive and chemical agent scenarios. Therapeutic/care management study, level II.

Survey of the prevalence and methodology of quality assurance for B-mode ultrasound image quality among veterinary sonographers.

PubMed

Hoscheit, Larry P; Heng, Hock Gan; Lim, Chee Kin; Weng, Hsin-Yi

2018-05-01

Image quality in B-mode ultrasound is important as it reflects the diagnostic accuracy and diagnostic information provided during clinical scanning. Quality assurance programs for B-mode ultrasound systems/components are comprised of initial quality acceptance testing and subsequent regularly scheduled quality control testing. The importance of quality assurance programs for B-mode ultrasound image quality using ultrasound phantoms is well documented in the human medical and medical physics literature. The purpose of this prospective, cross-sectional, survey study was to determine the prevalence and methodology of quality acceptance testing and quality control testing of image quality for ultrasound system/components among veterinary sonographers. An online electronic survey was sent to 1497 members of veterinary imaging organizations: the American College of Veterinary Radiology, the Veterinary Ultrasound Society, and the European Association of Veterinary Diagnostic Imaging, and a total of 167 responses were received. The results showed that the percentages of veterinary sonographers performing quality acceptance testing and quality control testing are 42% (64/151; 95% confidence interval 34-52%) and 26% (40/156: 95% confidence interval 19-33%) respectively. Of the respondents who claimed to have quality acceptance testing or quality control testing of image quality in place for their ultrasound system/components, 0% have performed quality acceptance testing or quality control testing correctly (quality acceptance testing 95% confidence interval: 0-6%, quality control testing 95% confidence interval: 0-11%). Further education and guidelines are recommended for veterinary sonographers in the area of quality acceptance testing and quality control testing for B-mode ultrasound equipment/components. © 2018 American College of Veterinary Radiology.

Analytical method for nitroaromatic explosives in radiologically contaminated soil for ISO/IEC 17025 accreditation

DOE PAGES

Boggess, Andrew; Crump, Stephen; Gregory, Clint; ...

2017-12-06

Here, unique hazards are presented in the analysis of radiologically contaminated samples. Strenuous safety and security precautions must be in place to protect the analyst, laboratory, and instrumentation used to perform analyses. A validated method has been optimized for the analysis of select nitroaromatic explosives and degradative products using gas chromatography/mass spectrometry via sonication extraction of radiologically contaminated soils, for samples requiring ISO/IEC 17025 laboratory conformance. Target analytes included 2-nitrotoluene, 4-nitrotoluene, 2,6-dinitrotoluene, and 2,4,6-trinitrotoluene, as well as the degradative product 4-amino-2,6-dinitrotoluene. Analytes were extracted from soil in methylene chloride by sonication. Administrative and engineering controls, as well as instrument automationmore » and quality control measures, were utilized to minimize potential human exposure to radiation at all times and at all stages of analysis, from receiving through disposition. Though thermal instability increased uncertainties of these selected compounds, a mean lower quantitative limit of 2.37 µg/mL and mean accuracy of 2.3% relative error and 3.1% relative standard deviation were achieved. Quadratic regression was found to be optimal for calibration of all analytes, with compounds of lower hydrophobicity displaying greater parabolic curve. Blind proficiency testing (PT) of spiked soil samples demonstrated a mean relative error of 9.8%. Matrix spiked analyses of PT samples demonstrated that 99% recovery of target analytes was achieved. To the knowledge of the authors, this represents the first safe, accurate, and reproducible quantitative method for nitroaromatic explosives in soil for specific use on radiologically contaminated samples within the constraints of a nuclear analytical lab.« less

Analytical method for nitroaromatic explosives in radiologically contaminated soil for ISO/IEC 17025 accreditation

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

Boggess, Andrew; Crump, Stephen; Gregory, Clint

Here, unique hazards are presented in the analysis of radiologically contaminated samples. Strenuous safety and security precautions must be in place to protect the analyst, laboratory, and instrumentation used to perform analyses. A validated method has been optimized for the analysis of select nitroaromatic explosives and degradative products using gas chromatography/mass spectrometry via sonication extraction of radiologically contaminated soils, for samples requiring ISO/IEC 17025 laboratory conformance. Target analytes included 2-nitrotoluene, 4-nitrotoluene, 2,6-dinitrotoluene, and 2,4,6-trinitrotoluene, as well as the degradative product 4-amino-2,6-dinitrotoluene. Analytes were extracted from soil in methylene chloride by sonication. Administrative and engineering controls, as well as instrument automationmore » and quality control measures, were utilized to minimize potential human exposure to radiation at all times and at all stages of analysis, from receiving through disposition. Though thermal instability increased uncertainties of these selected compounds, a mean lower quantitative limit of 2.37 µg/mL and mean accuracy of 2.3% relative error and 3.1% relative standard deviation were achieved. Quadratic regression was found to be optimal for calibration of all analytes, with compounds of lower hydrophobicity displaying greater parabolic curve. Blind proficiency testing (PT) of spiked soil samples demonstrated a mean relative error of 9.8%. Matrix spiked analyses of PT samples demonstrated that 99% recovery of target analytes was achieved. To the knowledge of the authors, this represents the first safe, accurate, and reproducible quantitative method for nitroaromatic explosives in soil for specific use on radiologically contaminated samples within the constraints of a nuclear analytical lab.« less

Launching a permanent out-of-hour interventional radiology service: single-center experience from a German University Hospital.

PubMed

Goltz, J P; Janssen, H; Petritsch, B; Kickuth, R

2014-02-01

To evaluate the feasibility, frequency of use, types of intervention and labor costs of a formal round-the-clock interventional radiology on-call service. In 11/2011 a formal and permanent out-of-hour interventional radiology rota in addition to the general radiology out-of-hour rota (OOHR) was established. We retrospectively screened the interventional radiology database for procedures completed outside regular working hours, reviewed all interventions and manually selected cases in which the on-call interventionist was called in from home. We determined the type, frequency of use and costs (€/year and procedure) of this service between 1/2012 and 12/2012. The referring physicians' (sub-) specialties were evaluated. During the 12-month period, the on-call interventionists (n = 3) performed 92 procedures OOH. The procedures included angiography and hemorrhage control (n = 36, 39.1 %), angiography and intervention for acute limb ischemia (n = 25, 27.2 %), percutaneous biliary drainage (PTCD) (n = 10, 10.9 %), angiography for non-occlusive ischemia (n = 7, 7.6 %), and other (n = 14, 15.3 %). The total labor costs for the OOHR were € 42,312.21 (€ 32,982.60 lump sum for stand-by, €  9,329.61 for hours spent on procedures). The labor costs per procedure totaled € 459.92. The referring physicians' specialties were general/visceral (n = 25), vascular surgery (n = 24), internal medicine (n = 21), cardiac/thoracic vascular (n = 9), trauma surgery (n = 5), urology (n = 5), and anesthesiology (n = 3). A formal interventional OOHR is practicable in a university hospital setting. Most procedures were requested by general, vascular, and thoracic surgery as well as internal medicine with a focus on hemorrhage control, treatment of acute limb ischemia, and PTCD. The overall labor costs for the OOHR appear moderate. • In a university setting an OOHR for IR is feasible.• Labor costs per procedure appear moderate.• Hemorrhage control and treatment of limb ischemia were the most frequent procedures. Citation Format: • Goltz JP, Janssen H, Petritsch B et al. Launching a Permanent Out-of-Hour Interventional Radiology Service: Single-Center Experience from a German University Hospital. Fortschr Röntgenstr 2014; 186: 136 - 141. © Georg Thieme Verlag KG Stuttgart · New York.

WE-D-9A-06: Open Source Monitor Calibration and Quality Control Software for Enterprise Display Management

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

Bevins, N; Vanderhoek, M; Lang, S

2014-06-15

Purpose: Medical display monitor calibration and quality control present challenges to medical physicists. The purpose of this work is to demonstrate and share experiences with an open source package that allows for both initial monitor setup and routine performance evaluation. Methods: A software package, pacsDisplay, has been developed over the last decade to aid in the calibration of all monitors within the radiology group in our health system. The software is used to calibrate monitors to follow the DICOM Grayscale Standard Display Function (GSDF) via lookup tables installed on the workstation. Additional functionality facilitates periodic evaluations of both primary andmore » secondary medical monitors to ensure satisfactory performance. This software is installed on all radiology workstations, and can also be run as a stand-alone tool from a USB disk. Recently, a database has been developed to store and centralize the monitor performance data and to provide long-term trends for compliance with internal standards and various accrediting organizations. Results: Implementation and utilization of pacsDisplay has resulted in improved monitor performance across the health system. Monitor testing is now performed at regular intervals and the software is being used across multiple imaging modalities. Monitor performance characteristics such as maximum and minimum luminance, ambient luminance and illuminance, color tracking, and GSDF conformity are loaded into a centralized database for system performance comparisons. Compliance reports for organizations such as MQSA, ACR, and TJC are generated automatically and stored in the same database. Conclusion: An open source software solution has simplified and improved the standardization of displays within our health system. This work serves as an example method for calibrating and testing monitors within an enterprise health system.« less

An Advanced Microcosting System for Forecasting and Managing Radiology Expenses

PubMed Central

Arenson, Ronald; Viale, Richard; van der Voorde, Frans

1985-01-01

The new prospective payment system encourages hospital cost containment and necessitates understanding actual costs for radiology procedures. The automated microcosting system described here, utilizing data from the Radiology Information Management System, hospital expense reports, and payroll management reports, calculates an accurate unit cost for each procedure type. This data is very useful for cost control, enhancement of department efficiency, and planning.

Radiological Weapons Control: A Soviet and US Perspective. Occasional Paper 29.

ERIC Educational Resources Information Center

Issraelyan, Victor L.; Flowerree, Charles C.

Two international diplomats from the Soviet Union and the United States focus on the need for a treaty to ban the use of radiological weapons. Radiological weapons are those based on the natural decay of nuclear material such as waste from military or civilian nuclear reactors. Such devices include both weapons and equipment, other than a nuclear…

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.

Decision theory applied to image quality control in radiology.

PubMed

Lessa, Patrícia S; Caous, Cristofer A; Arantes, Paula R; Amaro, Edson; de Souza, Fernando M Campello

2008-11-13

The present work aims at the application of the decision theory to radiological image quality control (QC) in diagnostic routine. The main problem addressed in the framework of decision theory is to accept or reject a film lot of a radiology service. The probability of each decision of a determined set of variables was obtained from the selected films. Based on a radiology service routine a decision probability function was determined for each considered group of combination characteristics. These characteristics were related to the film quality control. These parameters were also framed in a set of 8 possibilities, resulting in 256 possible decision rules. In order to determine a general utility application function to access the decision risk, we have used a simple unique parameter called r. The payoffs chosen were: diagnostic's result (correct/incorrect), cost (high/low), and patient satisfaction (yes/no) resulting in eight possible combinations. Depending on the value of r, more or less risk will occur related to the decision-making. The utility function was evaluated in order to determine the probability of a decision. The decision was made with patients or administrators' opinions from a radiology service center. The model is a formal quantitative approach to make a decision related to the medical imaging quality, providing an instrument to discriminate what is really necessary to accept or reject a film or a film lot. The method presented herein can help to access the risk level of an incorrect radiological diagnosis decision.

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

PubMed

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

2007-01-01

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

Radiological Scoping Survey of the Scotia Depot Scotia, New York

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

E. N. Bailey

2005-02-05

At the request of the Defense Logistics Agency, the Oak Ridge Institute for Science and Education conducted radiological scoping surveys of the Scotia Depot during the period of September 24 through 27, 2007. The scoping survey included visual inspections and limited radiological surveys performed in accordance with area classification that included surface scans, total and removable activity measurements, and soil sampling.

Occupational musculoskeletal pain in cardiac sonographers compared to peer employees: a multisite cross-sectional study.

PubMed

Orme, Nicholas M; Geske, Jeffrey B; Pislaru, Sorin V; Askew, John Wells; Lennon, Ryan J; Lewis, Bradley R; Rihal, Charanjit S; Pellikka, Patricia A; Singh, Mandeep

2016-11-01

The purpose of this study was to compare the prevalence and impact of work-related musculoskeletal pain in cardiac sonographers to a large control group of peer employees with similar demographics. Cardiac sonographers are known to have high levels of occupational musculoskeletal pain. Comparative studies with other employees within cardiology/radiology departments have never been performed. An electronic survey was administered to Mayo Clinic employees at six major patient care facilities in four different states. There were 2682 employees within the departments of cardiology and radiology who were contacted, and 1532 (57%) completed the survey. After excluding those who wore protective lead aprons, 517 employees comprised the control group and 66 cardiac sonographers made up the study group. Cardiac sonographers reported work-related musculoskeletal pain more frequently than the control group (88% vs 40%; P<.001). This association persisted after multivariable adjustment for age, sex, body mass index, length of current employment, and history of preexisting musculoskeletal pain (OR 11.6; [95% CI 5.32, 25.5]; P<.001). Cardiac sonographers sought medical care for their work-related pain more often (55% vs 21%; P<.001) and missed more work due to pain (35% vs 12%, P<.001). In a secondary analysis, cardiac sonographers also experienced more work-related musculoskeletal pain than nurses, technicians, and physicians working in the interventional laboratory who regularly wear a protective lead apron (P<.001). In this multisite cross-sectional study, cardiac sonographers experienced significantly more work-related pain and missed more work due to pain than peer employees within cardiology/radiology departments. © 2016, Wiley Periodicals, Inc.

Classification of Radiological Changes in Burst Fractures

PubMed Central

Şentürk, Salim; Öğrenci, Ahmet; Gürçay, Ahmet Gürhan; Abdioğlu, Ahmet Atilla; Yaman, Onur; Özer, Ali Fahir

2018-01-01

AIM: Burst fractures can occur with different radiological images after high energy. We aimed to simplify radiological staging of burst fractures. METHODS: Eighty patients whom exposed spinal trauma and had burst fracture were evaluated concerning age, sex, fracture segment, neurological deficit, secondary organ injury and radiological changes that occurred. RESULTS: We performed a new classification in burst fractures at radiological images. CONCLUSIONS: According to this classification system, secondary organ injury and neurological deficit can be an indicator of energy exposure. If energy is high, the clinical status will be worse. Thus, we can get an idea about the likelihood of neurological deficit and secondary organ injuries. This classification has simplified the radiological staging of burst fractures and is a classification that gives a very accurate idea about the neurological condition. PMID:29531604

Machine learning and radiology.

PubMed

Wang, Shijun; Summers, Ronald M

2012-07-01

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

The Role of Mifepristone in Meningiomas Management: A Systematic Review of the Literature.

PubMed

Cossu, Giulia; Levivier, Marc; Daniel, Roy Thomas; Messerer, Mahmoud

2015-01-01

We performed a systematic literature review to analyze the clinical application and the safety of mifepristone, a prominent antiprogesterone agent, in meningioma patients. A systematic search was performed through Medline, Cochrane, and clinicaltrials.gov databases from 1960 to 2014. Study Selection. Studies were selected through a PICO approach. Population was meningioma patients, meningioma cells cultures, and animal models. Intervention was mifepristone administration. Control was placebo administration or any other drug tested. Outcomes were clinical and radiological responsiveness, safety profile, and cell growth inhibition. A total of 7 preclinical and 6 clinical studies and one abstract were included. Encouraging results were found in preclinical studies. Concerning clinical studies, the response rate to mifepristone in terms of radiological regression and symptomatic improvement/stability in patients with inoperable meningioma was low. In meningiomatosis, favorable preliminary results were recorded. The safety profile was good. Limitations were as follows. The tumoral expression of progesterone receptors was not analyzed systematically in every study considered. No clear evidence exists to recommend mifepristone in inoperable meningiomas. Preliminary encouraging results were found in diffuse meningiomatosis. Mifepristone is a well-tolerated treatment. Patients' selection and hormonal profile analysis in meningiomas are fundamental for a better understanding of its benefit. Multicenter placebo-controlled trials are required.

Efficient radiologic reading environment by using an open-source macro program as connection software.

PubMed

Lee, Young Han

2012-01-01

The objectives are (1) to introduce an easy open-source macro program as connection software and (2) to illustrate the practical usages in radiologic reading environment by simulating the radiologic reading process. The simulation is a set of radiologic reading process to do a practical task in the radiologic reading room. The principal processes are: (1) to view radiologic images on the Picture Archiving and Communicating System (PACS), (2) to connect the HIS/EMR (Hospital Information System/Electronic Medical Record) system, (3) to make an automatic radiologic reporting system, and (4) to record and recall information of interesting cases. This simulation environment was designed by using open-source macro program as connection software. The simulation performed well on the Window-based PACS workstation. Radiologists practiced the steps of the simulation comfortably by utilizing the macro-powered radiologic environment. This macro program could automate several manual cumbersome steps in the radiologic reading process. This program successfully acts as connection software for the PACS software, EMR/HIS, spreadsheet, and other various input devices in the radiologic reading environment. A user-friendly efficient radiologic reading environment could be established by utilizing open-source macro program as connection software. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Open Access Journal Policies: A Systematic Analysis of Radiology Journals.

PubMed

Narayan, Anand; Lobner, Katie; Fritz, Jan

2018-02-01

The open access movement has pushed for greater access to scientific knowledge by expanding access to scientific journal articles. There is limited information about the extent to which open access policies have been adopted by radiology journals. We performed a systematic analysis to ascertain the proportion of radiology journals with open access options. A search was performed with the assistance of a clinical informationist. Full and mixed English-language diagnostic and interventional radiology Web of Science journals (impact factors > 1.0) were included. Nuclear medicine, radiation oncology, physics, and solicitation-only journals were excluded. Primary outcome was open access option (yes or no) with additional outcomes including presence or absence of embargo, complete or partial copyright transfer, publication fees, and self-archiving policies. Secondary outcomes included journal citations, journal impact factors, immediacy, Eigenfactor, and article influence scores. Independent double readings were performed with differences resolved by consensus, supplemented by contacting editorial staff at each journal. In all, 125 journals were identified; review yielded 49 journals (39%, mean impact factor of 2.61). Thirty-six of the journals had open access options (73.4%), and four journals were exclusively open access (8.2%). Twelve-month embargoes were most commonly cited (90.6%) with 28.6% of journals stating that they did not require a complete transfer of copyright. Prices for open access options ranged from $750 to $4,000 (median $3,000). No statistically significant differences were found in journal impact measures comparing journals with open access options to journals without open access options. Diagnostic and interventional radiology journals have widely adopted open access options with a few radiology journals being exclusively open access. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Evaluation of the effectiveness of Haemophilus influenzae type b conjugate vaccine introduction against radiologically-confirmed hospitalized pneumonia in young children in Ukraine.

PubMed

Pilishvili, Tamara; Chernyshova, Liudmyla; Bondarenko, Anastasia; Lapiy, Fedir; Sychova, Irina; Cohen, Adam; Flannery, Brendan; Hajjeh, Rana

2013-07-01

Haemophilus influenzae type b (Hib) conjugate vaccine was included into the national vaccination schedule of Ukraine in 2006. The objective of this study was to demonstrate the effectiveness of Hib conjugate vaccine against radiologically-confirmed hospitalized pneumonia in children. Children <2 years old with radiologically confirmed pneumonia admitted to 11 participating hospitals in Kiev and Dnepropetrovsk between April 2007 and June 2009 were included in a case-control evaluation. Four controls were matched to each case by date of birth (within 14 days) and outpatient clinic. We estimated ORs for vaccination and vaccine effectiveness ((1 - OR)*100%) using conditional logistic regression, adjusting for comorbid conditions and contraindications for vaccination. We enrolled 188 case-children and 735 controls. Median age was 16 months (range 4-24 months). Fifty-one percent of cases and 67% of controls received ≥1 doses of Hib conjugate vaccine; 26% of cases and 37% of controls received ≥3 doses. The effectiveness of ≥1 dose Hib conjugate vaccine was estimated at 45% (95% CI 18%-63%). Our study showed that Hib infections are important causes of hospitalized radiologically confirmed pneumonia in young children in Ukraine. Copyright © 2013. Published by Mosby, Inc.

Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective.

PubMed

Tan, Lh; Kamarulzaman, A

2006-01-01

Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.

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.

Analysis of operation UPSHOT-KNOTHOLE nuclear test BADGER radiological and meteorological data

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

Quinn, V.E.

1986-04-01

This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the BADGER nuclear test of Operation UPSHOT-KNOTHOLE. Inconsistencies in the radiological data and their resolution are discussed. The methods of normalizing the radiological data to a standard time, of converting the aerial data to equivalent ground-level values, and of estimating fallout-arrival times are presented. The meteorological situations on event day and the following day are described. A comparison of the WSNSO fallout analysis with an analysis performed during the 1950's is presented. The radiological data used to derive the WSNSO falloutmore » pattern are tabulated in an appendix.« less

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

PubMed

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

2015-05-01

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

Occupational necessity and educational invention: resident teaching of radiologic technologists.

PubMed

Gunderman, Richard B; Fraley, Ronald; Jackson, Valerie; Robinson, Susan; Williamson, Kenneth

2003-04-01

Radiology faces a severe and growing shortage of radiologic technologists. One way of redressing this problem is to improve the quality of education provided to radiologic technology students. Yet growing clinical demands increasingly erode faculty time for teaching. This study examined whether radiology residents could provide equivalent instruction in radiologic technology at lower cost, and whether such experience could enhance residents' interest in teaching as part of their careers. Course evaluation forms completed by the students in a required radiologic pathology course were reviewed, and student-reported faculty and resident performances in teaching were compared. Residents also were surveyed for their reactions to the experience of teaching this course. Ninety percent of students (27 of 30) either agreed or strongly agreed that the course was well taught by radiology faculty members, and 97% (29 of 30) either agreed or strongly agreed that the course was well taught by radiology residents. The total direct cost of instruction by radiology residents was 73% lower than the cost of instruction by faculty. Residents who participated in teaching found the experience worthwhile, and they described a wide variety of personal and educational benefits. Involving radiology residents in teaching can help redress the growing shortage of radiologic technologists, relieve some of the pressure on faculty time, and contribute to the professional development of the next generation of radiologists.

Joint CDRH (Center for Devices and Radiological Health) and state quality-assurance surveys in nuclear medicine: Phase 2 - radiopharmaceuticals

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

Hamilton, D.R.; Evans, C.D.

The report discusses survey results on aspects of the quality assurance of radio-pharmaceuticals from 180 nuclear-medicine facilities in the United States. Data were collected from facilities in 8 states. Demographic information about nuclear-medicine operations and quality-assurance programs was gathered by state radiation-control-program personnel. The data collected from the survey show an incomplete acceptance of quality-assurance practices for radiopharmaceuticals. Most of the facilities in the survey indicated that, because an inferior radiopharmaceutical was prepared so infrequently, they did not believe it was cost-effective to perform extensive quality-assurance testing. The Center for Devices and Radiological Health hopes that the information from themore » survey will stimulate nuclear-medicine professionals and their organizations to encourage appropriate testing of all radiopharmaceuticals.« less

Community archiving of imaging studies

NASA Astrophysics Data System (ADS)

Fritz, Steven L.; Roys, Steven R.; Munjal, Sunita

1996-05-01

The quantity of image data created in a large radiology practice has long been a challenge for available archiving technology. Traditional methods ofarchiving the large quantity of films generated in radiology have relied on warehousing in remote sites, with courier delivery of film files for historical comparisons. A digital community archive, accessible via a wide area network, represents a feasible solution to the problem of archiving digital images from a busy practice. In addition, it affords a physician caring for a patient access to imaging studies performed at a variety ofhealthcare institutions without the need to repeat studies. Security problems include both network security issues in the WAN environment and access control for patient, physician and imaging center. The key obstacle to developing a community archive is currently political. Reluctance to participate in a community archive can be reduced by appropriate design of the access mechanisms.

Eight years of quality control in Bulgaria: impact on mammography practice.

PubMed

Avramova-Cholakova, S; Lilkov, G; Kaneva, M; Terziev, K; Nakov, I; Mutkurov, N; Kovacheva, D; Ivanova, M; Vasilev, D

2015-07-01

The requirements for quality control (QC) in diagnostic radiology were introduced in Bulgarian legislation in 2005. Hospital medical physicists and several private medical physics groups provide QC services to radiology departments. The aim of this study was to analyse data from QC tests in mammography and to investigate the impact of QC introduction on mammography practice in the country. The study was coordinated by the National Centre of Radiobiology and Radiation Protection. All medical physics services were requested to fill in standardised forms with information about most important parameters routinely measured during QC. All QC service providers responded. Results demonstrated significant improvement of practice since the introduction of QC, with reduction of established deviations from 65 % during the first year to 7 % in the last year. The systems that do not meet the acceptability criteria were suspended from use. Performance of automatic exposure control and digital detectors are not regularly tested because of the absence of requirements in the legislation. The need of updated guidance and training of medical physicists to reflect the change in technology was demonstrated. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Radiological control intraoperatory of a surgical piece in non palpable breast lesions].

PubMed

Ruvalcaba Limón, Eva; Espejo Fonseca, Ruby; Bautista Piña, Verónica; Madero Preciado, Luis; Capurso Garcia, Marino; Serratos Garduño, José Eduardo; Hohenstein, Fernando Guisa; Rodríguez Cuevas, Sergio

2009-09-01

nonconcrete the mammary injuries are frequent in programs of detection of breast cancer, estereotaxic or ecographic marking is required to realize its split. The intrasurgical radiation control of the surgical piece is indispensable to evaluate the margins of the mammary cancer. to determine the effectiveness of the intrasurgical radiation control of the surgical piece in nonconcrete mammary injuries to diminish the surgical reinterventions to extend margins. women with nonconcrete mammary injuries to those who biopsy by split became, previous marking and intraoperating radiation control of the surgical piece to value margins (suitable margin the same or major of 10 mm, smaller inadequate margin of 10 mm). Intrasurgical reesicion in inadequate radiological margins became. The demographic characteristics, masto-ecographics images, histopathology of the injuries and the radiological-histopatol6gica correlation of the margins studied. Cross-sectional, prospective and descriptive study. 103 patients with 113 nonconcrete mammary injuries included themselves, with age average of 51,35 (32-73) years. In all the injuries the intrasurgical radiation control became of the surgical piece. The prevalence of mammary cancer was of 28.3% (32/113), that corresponds to stellar images (42.8%), suspicious microcalcifications with density (39.2%), microcalcifications (31.2%) and nodules (20%). Of the 32 cancers, 16 had inadequate radiological margins that required intraoperating reescision; suitable histopatologic margins in 100% were obtained (16/16). The 16 (62.5%) cancers without intraoperating reescisi6n by suitable radiological margins had suitable histopatologic margins and 37.5% (6/16) inadequate ones that required surgical reinterventionn to control the margins. The discrepancy between margins was related to microcalcifications in 83.3% of the injuries. the intrasurgical radiation control of the surgical piece is effective to evaluate margins; the intrasurgical reescisión changed inadequate margins to suitable in 50% (16/32) of the cancers; only 18.7% (6/32) of the total of cases required another surgery to control the margins.

Surveying Fourth-Year Medical Students Regarding the Choice of Diagnostic Radiology as a Specialty.

PubMed

Arleo, Elizabeth Kagan; Bluth, Edward; Francavilla, Michael; Straus, Christopher M; Reddy, Sravanthi; Recht, Michael

2016-02-01

The aim of this study was to survey fourth-year medical students, both those choosing and those not choosing diagnostic radiology as their specialty, regarding factors influencing their choice of specialty and their perceptions of radiology. A voluntary anonymous online survey hyperlink was sent to 141 US medical schools for distribution to fourth-year students. Topics included demographics, radiology education, specialty choice and influencing factors, and opinions of radiology. A representative sampling (7%) of 2015 fourth-year medical students (n = 1,219; 51% men, 49% women) participated: 7% were applying in radiology and 93% were not. For respondents applying in radiology, the most important factor was intellectual challenge. For respondents applying in nonradiology specialties, degree of patient contact was the most important factor in the decision not to choose radiology; job market was not listed as a top-three factor. Women were less likely than men to apply in radiology (P < .001), with radiology selected by 11.8% of men (56 of 476) and only 2.8% of women (13 of 459). Respondents self-identifying as Asian had a significantly higher (P = .015) likelihood of selecting radiology (19 of 156 [12.2%]) than all other races combined (44 of 723 [6.1%]). Respondents at medical schools with required dedicated medical imaging rotations were more likely to choose radiology as a specialty, but most schools still do not require the clerkship (82%). The reasons fourth-year medical students choose, or do not choose, diagnostic radiology as a specialty are multifactorial, but noncontrollable factors, such as the job market, proved less compelling than controllable factors, such as taking a radiology rotation. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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.

Care and economic impact of thyroid ultrasound examination at single visits to endocrinology clinics (the ETIEN 1 study).

PubMed

Carral, Florentino; Ayala, María del Carmen; Jiménez, Ana Isabel; García, Concepción

2016-02-01

Routine thyroid ultrasound examination in a single medical appointment is rarely performed in Spain. The objective of this study was to evaluate the care and economic impact of thyroid US examination in a single endocrine appointment. A prospective, observational, descriptive study was conducted to analyze data from 2274 patients (mean age, 59±16 years; 83% females) performed at least one thyroid US in a single visit to an endocrinology clinic during 2013 and 2014. The number of endocrine acts with thyroid US, single endocrine and US acts without review, and the change in the number of thyroid US requested by endocrinologists to the radiology department and total thyroid US examinations performed at the radiology department during the study period were assessed. In 2013 and 2014, 2558 endocrine acts with thyroid US were performed, of which 42.2% were single endocrine and US appointments without a second endocrine act, with estimated savings of €58,946.40. As compared to 2012, the number of thyroid US requested by endocrinologists to the radiology department decreased by 43.3% and 86.0% in 2013 and 2014 respectively, and total thyroid US performed by the radiology department decreased by 28.1% and 68.3% respectively, with estimated savings of €94,441.36. Thyroid US examination in a single endocrine appointment allows for decreasing the number of both second endocrine acts and thyroid US examinations performed at the radiology department, thus reducing the number of unnecessary clinic visits and promoting considerable economic savings. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

[Renal denervation in refractory hypertension: joint statement of the German hypertension league DHL eV and the German societies of cardiology, angiology, nephrology and radiology].

PubMed

Vonend, Oliver; Böhm, Michael; Eckert, Siegfried; Hausberg, Martin; Rittger, Harald; Rump, Lars-Christian; Schmieder, Roland; Schulte, Karl-Ludwig; Schunkert, Heribert; Uder, Michael; Veelken, Roland; Vorwerk, Dierk; Weil, Joachim; Wenzel, Ulrich; Mahfoud, Felix

2015-03-01

Arterial hypertension is a major risk factor for cardiovascular mortality and remains insufficiently controlled in Germany. The sham controlled Symplicity HTN-3 trial did meet its primary safety endpoint but failed to meet its primary efficacy endpoint. Renal denervation can not replace established, well-proven therapies. It can only be used in selected truly resistant hypertensive patients as an additive approach and should be performed by specialized centers only. Randomized controlled trials are needed to further evaluate renal denervation. © Georg Thieme Verlag KG Stuttgart · New York.

How Visual Search Relates to Visual Diagnostic Performance: A Narrative Systematic Review of Eye-Tracking Research in Radiology

ERIC Educational Resources Information Center

van der Gijp, A.; Ravesloot, C. J.; Jarodzka, H.; van der Schaaf, M. F.; van der Schaaf, I. C.; van Schaik, J. P.; ten Cate, Th. J.

2017-01-01

Eye tracking research has been conducted for decades to gain understanding of visual diagnosis such as in radiology. For educational purposes, it is important to identify visual search patterns that are related to high perceptual performance and to identify effective teaching strategies. This review of eye-tracking literature in the radiology…

Otogenic Meningitis: A Comparison of Diagnostic Performance of Surgery and Radiology.

PubMed

Bruschini, Luca; Fortunato, Simona; Tascini, Carlo; Ciabotti, Annalisa; Leonildi, Alessandro; Bini, Belinda; Giuliano, Simone; Abbruzzese, Arturo; Berrettini, Stefano; Menichetti, Francesco

2017-01-01

Development of intracranial complications from middle ear infections might be difficult to diagnose. We compared radiological and surgical findings of 26 patients affected by otogenic meningitis. Results of our analysis showed that surgery is more reliable than imaging in revealing bone defects. Therefore, suggest that surgery be performed for diagnosis and eventual management of all cases of suspected otogenic meningitis.

An honest day's work: pay for performance in a pediatric radiology department.

PubMed

Bisset, George S

2017-06-01

Compensation models in radiology take a variety of forms, but regardless of practice type, successful models must reward productivity, be simple, and epitomize fairness. The ideal model should also be flexible enough to transition, based upon the changing strategic goals of a department. The plan should be constructed around rewarding the behaviors that the organization values. In this minisymposium article the author presents the value of different types of compensation plans and discusses advantages and disadvantages. Finally, the author presents a pay-for-performance model that has had long-term success at a private-turned-academic practice in pediatric radiology.

Informatics in radiology: automated Web-based graphical dashboard for radiology operational business intelligence.

PubMed

Nagy, Paul G; Warnock, Max J; Daly, Mark; Toland, Christopher; Meenan, Christopher D; Mezrich, Reuben S

2009-11-01

Radiology departments today are faced with many challenges to improve operational efficiency, performance, and quality. Many organizations rely on antiquated, paper-based methods to review their historical performance and understand their operations. With increased workloads, geographically dispersed image acquisition and reading sites, and rapidly changing technologies, this approach is increasingly untenable. A Web-based dashboard was constructed to automate the extraction, processing, and display of indicators and thereby provide useful and current data for twice-monthly departmental operational meetings. The feasibility of extracting specific metrics from clinical information systems was evaluated as part of a longer-term effort to build a radiology business intelligence architecture. Operational data were extracted from clinical information systems and stored in a centralized data warehouse. Higher-level analytics were performed on the centralized data, a process that generated indicators in a dynamic Web-based graphical environment that proved valuable in discussion and root cause analysis. Results aggregated over a 24-month period since implementation suggest that this operational business intelligence reporting system has provided significant data for driving more effective management decisions to improve productivity, performance, and quality of service in the department.

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.

Implementation of a Longitudinal Introduction to Radiology Course During Internship Year Improves Diagnostic Radiology Residents' Academic and Clinical Skills: A Canadian Experience.

PubMed

Darras, Kathryn E; Worthington, Anne; Russell, David; Hou, Daniel J; Forster, Bruce B; Hague, Cameron J; Mar, Colin; Chang, Silvia D

2016-07-01

In order to ease the transition from internship to diagnostic radiology residency, a year-long didactic introduction to radiology course was offered to post-graduate year one (PGY-1) diagnostic radiology residents during their internship, which consisted of 27 hours of lecture over 9 months. The purpose of this study was to determine the quantitative and qualitative educational value of this course and its effect with respect to on-call preparedness. Two consecutive cohorts of Diagnostic Radiology residents were included: the first cohort (PGY-1s in 2011-2012) did not participate in the new course (Old Curriculum Residents) and the second cohort (PGY-1s in 2012-2013) completed the new course (New Curriculum Residents). These two cohorts were compared both qualitatively and quantitatively. Scores were compared from the standardized Canadian National Pre-Call Observed Standardized Clinical Examination and American College of Radiology Diagnostic Radiology In-Training examination, which are taken in the PGY-2 year, at months 5 and 7, respectively. In addition, staff observation of on-call resident performance and resident self-reported preparedness were considered. Cohorts were compared using Mann-Whitney U test with significance defined as P value <0.05. P values from 0.05 to 0.10 were noted as possibly significant and further analyzed using a Cohen d test where the difference was determined to be small (0.2), medium (0.5), or large (0.8). New Curriculum Residents reported that the content of the PGY1 curriculum was more appropriate than the old curriculum to prepare them for call in PGY2 (P = 0.013). New Curriculum Residents scored better than the Old Curriculum Residents on the Diagnostic Radiology In-Training examination (P = 0.039) and on the emergency cases of the Canadian National Pre-Call Observed Standardized Clinical Examination (P = 0.035). Staff radiologists, who were not blinded, reported that the New Curriculum Residents were better prepared for daytime (P = 0.006) and overnight (P = 0.008) independent call were better prepared to perform common ultrasound examinations alone (P = 0.049), and required less guidance while on call for nine competency areas. There was, however, no statistical difference between the residents' self-reported preparedness for independent call. Participation in a lecture-based introductory radiology curriculum during the PGY-1 internship year improved both radiology residents' preparedness for call and their performance in PGY-2. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Is Radiologic Evaluation Necessary to Find out Foreign Bodies in Nasal Cavity?

PubMed

Oh, Hoon; Min, Hyun Jin; Yang, Hoon Shik; Kim, Kyung Soo

2016-01-01

Although there were previous studies on the clinical aspects such as etiology, treatment modalities, studies regarding the necessity of radiologic evaluation for nasal foreign body were limited. The aim of this study is to evaluate the necessity and indication of radiologic evaluation for nasal foreign bodies. There are consecutive patients aged less than 10 years who presented with suspected foreign bodies in nasal cavity. We reviewed the patient's age and sex, including the methods of evaluation, management tools, and types of foreign bodies. There were 35 cases (11.4%) on whom radiographs were performed in the 24 uncooperative patients and 11 cooperative patients who were not identified with any foreign bodies via nasal endoscopy. Among them, only 4 cases had positive reports of foreign body and the others were normal radiologic findings. We suggest that the radiologic evaluation is always not necessary to find the location of nasal foreign bodies. It, however, should be performed in cases of negative findings of physical examination with anterior rhinoscopy or sinus endoscopy and unwitnessed foreign bodies to rule out metallic contents, especially button type battery.

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

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Myrna Scott holds a replica of the emblem noting that the Radiological Control Center at NASA's Kennedy Space Center has been named in honor of her husband, Randy Scott who died last year. A ceremony honored the extensive contributions 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.

Ineffective Leadership.

PubMed

Itri, Jason N; Lawson, Leslie M

2016-07-01

Radiology leaders can have a profound impact on the success and working environment of a radiology department, promoting core values and inspiring staff members to achieve the organization's mission. On the other hand, ineffective leaders can have a devastating effect on a radiology department by impairing communication among members, undermining staff commitment to the organization's success, and stifling the development of other staff members and leaders in the organization. One of the most important investments a radiology department can make is in identifying, cultivating, and promoting new leaders. The authors describe 13 habits and characteristics of new leaders that lead these individuals to address situations in both ineffective and counterproductive ways, impeding the performance of a radiology department and its capacity to play a meaningful role in shaping the future of radiology. New leaders must continually learn and improve their leadership skills if they are to avoid the destructive habits of ineffective leaders and successfully overcome the challenges facing radiology today. Senior leaders may also benefit from understanding the pitfalls that make leaders ineffective and should strive to continually improve their leadership skills given the critical role of leadership in the success of radiology departments. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiation protection program for early detection of breast cancer in a mammography facility

NASA Astrophysics Data System (ADS)

Villagomez Casimiro, Mariana; Ruiz Trejo, Cesar; Espejo Fonseca, Ruby

2014-11-01

Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1-4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systems (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (<3 mGy per projection). The image quality test showed that most images (70%)- presented artifacts. A brief summary of the results of quality control tests applied to the equipment and film processor are presented. To maintain an adequate level of quality and safety at FUCAM-AC is necessary that the proposed radiation protection program in this work is applied.

Effective radiological contamination control and monitoring techniques in high alpha environments.

PubMed

Funke, Kevin C

2003-02-01

In the decommissioning of a highly contaminated alpha environment, such as the one at Hanford's 233-S Plutonium Concentration Facility, one of the key elements of a successful radiological control program is an integrated safety approach. This approach begins with the job-planning phase where the scope of the work is described. This is followed by a brainstorming session involving engineering and craft to identify how to perform the work in a logical sequence of events. Once the brainstorming session is over, a Job Hazard Analysis is performed to identify any potential problems. Mockups are utilized to enable the craft to get hands on experience and provide feedback and ideas to make the job run smoother. Ideas and experience gained during mockups are incorporated into the task instruction. To assure appropriate data are used in planning and executing the job, our principal evaluation tools included lapel and workplace air sampling, plus continuous air monitors and frequent surveys to effectively monitor job progress. In this highly contaminated alpha environment, with contamination levels ranging from 0.3 Bq cm-2 to approximately 100,000 Bq cm-2 (2,000 dpm per 100 cm2 to approximately 600 million dpm per 100 cm2), with average working levels of 1,600-3,200 Bq cm-2 (10-20 million dpm per 100 cm2) without concomitant ambient radiation levels, control of the spread of contamination is key to keeping airborne levels As Low As Reasonably Achievable.

Effective Radiological Contamination Control and Monitoring Techniques In High Alpha Environments.

PubMed

Funke, Kevin C.

2003-02-01

In the decommissioning of a highly contaminated alpha environment, such as the one at Hanford's 233-S Plutonium Concentration Facility, one of the key elements of a successful radiological control program is an integrated safety approach. This approach begins with the job-planning phase where the scope of the work is described. This is followed by a brainstorming session involving engineering and craft to identify how to perform the work in a logical sequence of events. Once the brainstorming session is over, a Job Hazard Analysis is performed to identify any potential problems. Mockups are utilized to enable the craft to get hands on experience and provide feedback and ideas to make the job run smoother. Ideas and experience gained during mockups are incorporated into the task instruction. To assure appropriate data are used in planning and executing the job, our principal evaluation tools included lapel and workplace air sampling, plus continuous air monitors and frequent surveys to effectively monitor job progress. In this highly contaminated alpha environment, with contamination levels ranging from 0.3 Bq cm to approximately 100,000 Bq cm (2,000 dpm per 100 cm to approximately 600 million dpm per 100 cm ), with average working levels of 1,600-3,200 Bq cm (10-20 million dpm per 100 cm ) without concomitant ambient radiation levels, control of the spread of contamination is key to keeping airborne levels As Low As Reasonably Achievable.

Retrospective Analysis of Clinical Performance of an Estonian Speech Recognition System for Radiology: Effects of Different Acoustic and Language Models.

PubMed

Paats, A; Alumäe, T; Meister, E; Fridolin, I

2018-04-30

The aim of this study was to analyze retrospectively the influence of different acoustic and language models in order to determine the most important effects to the clinical performance of an Estonian language-based non-commercial radiology-oriented automatic speech recognition (ASR) system. An ASR system was developed for Estonian language in radiology domain by utilizing open-source software components (Kaldi toolkit, Thrax). The ASR system was trained with the real radiology text reports and dictations collected during development phases. The final version of the ASR system was tested by 11 radiologists who dictated 219 reports in total, in spontaneous manner in a real clinical environment. The audio files collected in the final phase were used to measure the performance of different versions of the ASR system retrospectively. ASR system versions were evaluated by word error rate (WER) for each speaker and modality and by WER difference for the first and the last version of the ASR system. Total average WER for the final version throughout all material was improved from 18.4% of the first version (v1) to 5.8% of the last (v8) version which corresponds to relative improvement of 68.5%. WER improvement was strongly related to modality and radiologist. In summary, the performance of the final ASR system version was close to optimal, delivering similar results to all modalities and being independent on user, the complexity of the radiology reports, user experience, and speech characteristics.

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

PubMed Central

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

2015-01-01

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

Updates on Percutaneous Radiologic Gastrostomy/Gastrojejunostomy and Jejunostomy

PubMed Central

Park, Auh-Whan

2010-01-01

Gastrostomy placement for nutritional support for patients with inadequate oral intake has been attempted using surgical, endoscopic, and, more recently, percutaneous radiologically guided methods. Surgical gastrostomy has been superseded by both endoscopic and radiologic gastrostomy. We describe herein the indications, contraindications, patient preparations, techniques, complications, and aftercare with regard to radiologic gastrostomy. In addition, we discuss the available tube types and their perceived advantages. There remain some controversies regarding gastropexy performance and primary percutaneous gastrojejunostomy. Percutaneous jejunostomy is indicated for patients whose stomach is inaccessible for gastrostomy placement or for those who have had a previous gastrectomy. PMID:21103291

In vivo effect of shock-waves on the healing of fractured bone.

PubMed

Augat, P; Claes, L; Suger, G

1995-10-01

In a controlled animal experiment we attempted to clarify the question of whether there is a stimulating effect of extracorporeal shock-waves on the repair process of fractured long bones. As a fracture model we used an osteotomy in the diaphysis of the ovine tibia and an external fixation device. Shock-wave treatment at two levels of intensity and with four different numbers of applied shocks was performed with an electromagnetic acoustic source. Healing of the osteotomized bone was evaluated by biomechanical and radiological investigations on the whole bone as well as on bone sections from areas of the fracture gap and the periosteal fracture callus. We found a non-significant tendency to deterioration of the fracture healing with increasing shock-wave intensities. The study of treatment parameters led neither to significantly different biomechanical outcomes nor to altered radiological results in comparison to the untreated control group. RELEVANCE:--While we cannot comment upon the effectiveness of extracorporeal shock-waves in the delayed treatment of fractures or pseudarthrosis, our results suggest that shock-waves have no beneficial effect in acute fracture repair.

[Pancreatic trauma].

PubMed

Arvieux, C; Guillon, F; Létoublon, Ch; Oughriss, M

2003-10-01

Early diagnosis of pancreatic trauma has always been challenging because of the lack of correlation between the initial clinical symptomatology, radiologic and laboratory findings, and the severity of the injury. Thanks to the improved performance of spiral CT scanning and magnetic resonance pancreatography, it is now often possible to make an early diagnosis of pancreatic contusion, to localize the site of the injury, and (most importantly) to identify injury to the main pancreatic duct which has major implications for the management of the case. When the trauma victim is unstable, radiologic work-up may be impossible and urgent laparotomy is required. Control of hemorrhage is the primary concern here and a damage control approach with packing may be appropriate; if the pancreatic head has been destroyed, a pancreaticoduodenectomy with delayed reconstruction may be required. If the trauma victim is stable, the treatment strategy will be governed by a variety of parameters--age, clinical condition, associated local anatomic findings (pancreatitis, injury to the duodenum or biliary tract), involvement of the pancreatic duct, and localization of the injury within the gland (to right or left of the mesenteric vessels).

A data grid for imaging-based clinical trials

NASA Astrophysics Data System (ADS)

Zhou, Zheng; Chao, Sander S.; Lee, Jasper; Liu, Brent; Documet, Jorge; Huang, H. K.

2007-03-01

Clinical trials play a crucial role in testing new drugs or devices in modern medicine. Medical imaging has also become an important tool in clinical trials because images provide a unique and fast diagnosis with visual observation and quantitative assessment. A typical imaging-based clinical trial consists of: 1) A well-defined rigorous clinical trial protocol, 2) a radiology core that has a quality control mechanism, a biostatistics component, and a server for storing and distributing data and analysis results; and 3) many field sites that generate and send image studies to the radiology core. As the number of clinical trials increases, it becomes a challenge for a radiology core servicing multiple trials to have a server robust enough to administrate and quickly distribute information to participating radiologists/clinicians worldwide. The Data Grid can satisfy the aforementioned requirements of imaging based clinical trials. In this paper, we present a Data Grid architecture for imaging-based clinical trials. A Data Grid prototype has been implemented in the Image Processing and Informatics (IPI) Laboratory at the University of Southern California to test and evaluate performance in storing trial images and analysis results for a clinical trial. The implementation methodology and evaluation protocol of the Data Grid are presented.

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

PubMed

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

2018-05-01

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

Qualitative review of usability problems in health information systems for radiology.

PubMed

Dias, Camila Rodrigues; Pereira, Marluce Rodrigues; Freire, André Pimenta

2017-12-01

Radiology processes are commonly supported by Radiology Information System (RIS), Picture Archiving and Communication System (PACS) and other software for radiology. However, these information technologies can present usability problems that affect the performance of radiologists and physicians, especially considering the complexity of the tasks involved. The purpose of this study was to extract, classify and analyze qualitatively the usability problems in PACS, RIS and other software for radiology. A systematic review was performed to extract usability problems reported in empirical usability studies in the literature. The usability problems were categorized as violations of Nielsen and Molich's usability heuristics. The qualitative analysis indicated the causes and the effects of the identified usability problems. From the 431 papers initially identified, 10 met the study criteria. The analysis of the papers identified 90 instances of usability problems, classified into categories corresponding to established usability heuristics. The five heuristics with the highest number of instances of usability problems were "Flexibility and efficiency of use", "Consistency and standards", "Match between system and the real world", "Recognition rather than recall" and "Help and documentation", respectively. These problems can make the interaction time consuming, causing delays in tasks, dissatisfaction, frustration, preventing users from enjoying all the benefits and functionalities of the system, as well as leading to more errors and difficulties in carrying out clinical analyses. Furthermore, the present paper showed a lack of studies performed on systems for radiology, especially usability evaluations using formal methods of evaluation involving the final users. Copyright © 2017 Elsevier Inc. All rights reserved.

A portrait of interventional radiologists in the United States.

PubMed

Sunshine, Jonathan H; Lewis, Rebecca S; Bhargavan, Mythreyi

2005-11-01

In recognition of the emergence of interventional radiology as an important "new component of...radiology," the objective of our study was to provide an extensive and detailed portrait of interventional radiologists, their professional activities, and the practices in which they work. We tabulated data from the American College of Radiology's 2003 Survey of Radiologists, a stratified random-sample survey that oversampled interventionalists and achieved a 63% response rate with a total of 1,924 responses. Responses were weighted to make them representative of all radiologists in the United States. We compared information about interventionalists with that for other radiologists. Depending on the definition of who is an interventionalist, 8.5-11.5% of radiologists are interventionalists. By most definitions, only slightly under half of interventionalists spend 70% or more of their clinical work time performing interventional procedures. Interventionalists work, on average, 56-58 hr weekly, a few hours longer than other radiologists. The average interventionalist performs procedures in five of the seven categories of procedures into which we divided interventional radiology, compared with one or two categories for other radiologists. The average interventionalist performs procedures in five of the seven broad categories (such as MRI, CT, and nuclear medicine) into which we divided all of radiology, much the same breadth of practice as other subspecialists and also as nonsubspecialists. Interventionalists have become a sizable group within radiology. They are in some ways like other radiologists and in other ways different, but they do not spend as much of their time in their subspecialty as some assume and, overall, are not as different.

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

PubMed Central

2012-01-01

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

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.

Radiology Exposure in the Undergraduate Curriculum: A Medical Student Perspective on Quality and Opportunities for Positive Change.

PubMed

Visscher, Kari L; Faden, Lisa; Nassrallah, Georges; Speer, Stacey; Wiseman, Daniele

2017-08-01

This article is a continuation of a qualitative study designed to explore how radiology exposures can impact medical student opinions and perceptions of radiology and radiologists. We focused on: 1) conducting a radiology exposure inventory from the perspective of the medical student; 2) student evaluation of the quality of the radiology exposures and suggestions for positive change; and 3) development of a framework to address the needs of medical students as it relates to radiology education in the undergraduate medical curriculum. Research methodology and design for this qualitative study were described in detail in a previous article by Visscher et al [1]. Participants included 28 medical students; 18 were in medical school years 1 and 2 (preclerkship), and 10 were in years 3 and 4 (clerkship). Specific to the focus of this article, the data revealed 3 major findings: 1) multiple exposures to radiology exist, and they are received and valued differently depending on the medical student's stage of professional development; 2) medical students value radiology education and want their radiology exposure to be comprehensive and high quality; 3) Medical students have constructive suggestions for improving the quality of both formal and informal radiology exposures. Performing a radiology exposure inventory from a medical student perspective is a useful way to explore how students receive and value radiology instruction. Medical students want a more comprehensive radiology education that can be summarized using the 5 C's of Radiology Education framework. The 5 C's (curriculum, coaching, collaborating, career and commitment) reflect medical students' desires to learn content that will support them in clinical practice, be supported in their professional development, and have the necessary information to make informed career decisions. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Emergency management and infection control in a radiology department during an outbreak of severe acute respiratory syndrome.

PubMed

Lin, Y C; Dong, S L; Yeh, Y H; Wu, Y S; Lan, G Y; Liu, C M; Chu, T C

2005-07-01

The World Health Organization classified Taiwan as a serious epidemic-stricken area when the extent of severe acute respiratory syndrome (SARS) in Taiwan became clear. As of 11 July 2003, 671 probable SARS cases had been identified in Taiwan and 7 healthcare workers had died from the disease. Radiographers were easily infected by SARS because they had close contact with suspected or probable cases while conducting chest X-ray examinations. Three radiographers had been infected by the end of May 2003. Because of the impact of SARS on the Radiology Department, the department established a SARS emergency infection control team and re-designed the department's infection-control and emergency-management procedures based on the concept of risk-grade protection. This effort included installing a radiographic room at the fever-screening station, re-allocating human resources in the Radiology Department, training the department staff in infection control, and drafting new operational procedures for radiographers conducting X-ray examinations on SARS patients. The goal of this program was to reduce the infection rate and distribute materials efficiently in the department. This article introduces the emergency-management procedure of the Radiology Department during the SARS outbreak and the infection-protection experience of the department staff.

The effects of low-intensity pulsed ultrasound and pulsed electromagnetic fields bone growth stimulation in acute fractures: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Hannemann, P F W; Mommers, E H H; Schots, J P M; Brink, P R G; Poeze, M

2014-08-01

The aim of this systematic review and meta-analysis was to evaluate the best currently available evidence from randomized controlled trials comparing pulsed electromagnetic fields (PEMF) or low-intensity pulsed ultrasound (LIPUS) bone growth stimulation with placebo for acute fractures. We performed a systematic literature search of the medical literature from 1980 to 2013 for randomized clinical trials concerning acute fractures in adults treated with PEMF or LIPUS. Two reviewers independently determined the strength of the included studies by assessing the risk of bias according to the criteria in the Cochrane Handbook for Systematic Reviews of Interventions. Seven hundred and thirty-seven patients from 13 trials were included. Pooled results from 13 trials reporting proportion of nonunion showed no significant difference between PEMF or LIPUS and control. With regard to time to radiological union, we found heterogeneous results that significantly favoured PEMF or LIPUS bone growth stimulation only in non-operatively treated fractures or fractures of the upper limb. Furthermore, we found significant results that suggest that the use of PEMF or LIPUS in acute diaphyseal fractures may accelerate the time to clinical union. Current evidence from randomized trials is insufficient to conclude a benefit of PEMF or LIPUS bone growth stimulation in reducing the incidence of nonunions when used for treatment in acute fractures. However, our systematic review and meta-analysis suggest that PEMF or LIPUS can be beneficial in the treatment of acute fractures regarding time to radiological and clinical union. PEMF and LIPUS significantly shorten time to radiological union for acute fractures undergoing non-operative treatment and acute fractures of the upper limb. Furthermore, PEMF or LIPUS bone growth stimulation accelerates the time to clinical union for acute diaphyseal fractures.

Experience with high-performance PACS

NASA Astrophysics Data System (ADS)

Wilson, Dennis L.; Goldburgh, Mitchell M.; Head, Calvin

1997-05-01

Lockheed Martin (Loral) has installed PACS with associated teleradiology in several tens of hospitals. The PACS that have been installed have been the basis for a shift to filmless radiology in many of the hospitals. the basic structure for the PACS and the teleradiology that is being used is outlined. The way that the PACS are being used in the hospitals is instructive. The three most used areas for radiology in the hospital are the wards including the ICU wards, the emergency room, and the orthopedics clinic. The examinations are mostly CR images with 20 percent to 30 percent of the examinations being CT, MR, and ultrasound exams. The PACS are being used to realize improved productivity for radiology and for the clinicians. For radiology the same staff is being used for 30 to 50 percent more workload. For the clinicians 10 to 20 percent of their time is being saved in dealing with radiology images. The improved productivity stems from the high performance of the PACS that has been designed and installed. Images are available on any workstation in the hospital within less than two seconds, even during the busiest hour of the day. The examination management functions to restrict the attention of any one user to the examinations that are of interest. The examination management organizes the workflow through the radiology department and the hospital, improving the service of the radiology department by reducing the time until the information from a radiology examination is available. The remaining weak link in the PACS system is transcription. The examination can be acquired, read, an the report dictated in much less than ten minutes. The transcription of the dictated reports can take from a few hours to a few days. The addition of automatic transcription services will remove this weak link.

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.

Improved identification of noun phrases in clinical radiology reports using a high-performance statistical natural language parser augmented with the UMLS specialist lexicon.

PubMed

Huang, Yang; Lowe, Henry J; Klein, Dan; Cucina, Russell J

2005-01-01

The aim of this study was to develop and evaluate a method of extracting noun phrases with full phrase structures from a set of clinical radiology reports using natural language processing (NLP) and to investigate the effects of using the UMLS(R) Specialist Lexicon to improve noun phrase identification within clinical radiology documents. The noun phrase identification (NPI) module is composed of a sentence boundary detector, a statistical natural language parser trained on a nonmedical domain, and a noun phrase (NP) tagger. The NPI module processed a set of 100 XML-represented clinical radiology reports in Health Level 7 (HL7)(R) Clinical Document Architecture (CDA)-compatible format. Computed output was compared with manual markups made by four physicians and one author for maximal (longest) NP and those made by one author for base (simple) NP, respectively. An extended lexicon of biomedical terms was created from the UMLS Specialist Lexicon and used to improve NPI performance. The test set was 50 randomly selected reports. The sentence boundary detector achieved 99.0% precision and 98.6% recall. The overall maximal NPI precision and recall were 78.9% and 81.5% before using the UMLS Specialist Lexicon and 82.1% and 84.6% after. The overall base NPI precision and recall were 88.2% and 86.8% before using the UMLS Specialist Lexicon and 93.1% and 92.6% after, reducing false-positives by 31.1% and false-negatives by 34.3%. The sentence boundary detector performs excellently. After the adaptation using the UMLS Specialist Lexicon, the statistical parser's NPI performance on radiology reports increased to levels comparable to the parser's native performance in its newswire training domain and to that reported by other researchers in the general nonmedical domain.

21 CFR 1010.4 - Variances.

Code of Federal Regulations, 2010 CFR

2010-04-01

... (formerly the Radiation Control for Health and Safety Act of 1968), and: (i) The scope of the requested... FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH... and Radiological Health, Food and Drug Administration, may grant a variance from one or more...

Is Your Interventional Radiology Service Ready for SARS?: The Singapore Experience

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

Lau, Te-Neng; Teo, Ngee; Tay, Kiang-Hiong

2003-09-15

The recent epidemic of severe acute respiratory syndrome caught many by surprise. Hitherto, infection control has not been in the forefront of radiological practice. Many interventional radiology (IR) services are therefore not equipped to deal with such a disease. In this review, we share our experience from the interventional radiologist's perspective, report on the acute measures instituted within our departments and explore the long-term effects of such a disease on the practice of IR.

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

Nichols, T.

The Nuclear Forensics Analysis Center (NFAC) is part of Savannah River National Laboratory (SRNL) and is one of only two USG National Laboratories accredited to perform nuclear forensic analyses to the requirements of ISO 17025. SRNL NFAC is capable of analyzing nuclear and radiological samples from bulk material to ultra-trace samples. NFAC provides analytical support to the FBI's Radiological Evidence Examination Facility (REEF), which is located within SRNL. REEF gives the FBI the capability to perform traditional forensics on material that is radiological and/or is contaminated. SRNL is engaged in research and development efforts to improve the USG technical nuclearmore » forensics capabilities. Research includes improving predictive signatures and developing a database containing comparative samples.« less

Prospective randomized comparison of standard didactic lecture versus high-fidelity simulation for radiology resident contrast reaction management training.

PubMed

Wang, Carolyn L; Schopp, Jennifer G; Petscavage, Jonelle M; Paladin, Angelisa M; Richardson, Michael L; Bush, William H

2011-06-01

The objective of our study was to assess whether high-fidelity simulation-based training is more effective than traditional didactic lecture to train radiology residents in the management of contrast reactions. This was a prospective study of 44 radiology residents randomized into a simulation group versus a lecture group. All residents attended a contrast reaction didactic lecture. Four months later, baseline knowledge was assessed with a written test, which we refer to as the "pretest." After the pretest, the 21 residents in the lecture group attended a repeat didactic lecture and the 23 residents in the simulation group underwent high-fidelity simulation-based training with five contrast reaction scenarios. Next, all residents took a second written test, which we refer to as the "posttest." Two months after the posttest, both groups took a third written test, which we refer to as the "delayed posttest," and underwent performance testing with a high-fidelity severe contrast reaction scenario graded on predefined critical actions. There was no statistically significant difference between the simulation and lecture group pretest, immediate posttest, or delayed posttest scores. The simulation group performed better than the lecture group on the severe contrast reaction simulation scenario (p = 0.001). The simulation group reported improved comfort in identifying and managing contrast reactions and administering medications after the simulation training (p ≤ 0.04) and was more comfortable than the control group (p = 0.03), which reported no change in comfort level after the repeat didactic lecture. When compared with didactic lecture, high-fidelity simulation-based training of contrast reaction management shows equal results on written test scores but improved performance during a high-fidelity severe contrast reaction simulation scenario.

Computer modeling and design of diagnostic workstations and radiology reading rooms

NASA Astrophysics Data System (ADS)

Ratib, Osman M.; Amato, Carlos L.; Balbona, Joseph A.; Boots, Kevin; Valentino, Daniel J.

2000-05-01

We used 3D modeling techniques to design and evaluate the ergonomics of diagnostic workstation and radiology reading room in the planning phase of building a new hospital at UCLA. Given serious space limitations, the challenge was to provide more optimal working environment for radiologists in a crowded and busy environment. A particular attention was given to flexibility, lighting condition and noise reduction in rooms shared by multiple users performing diagnostic tasks as well as regular clinical conferences. Re-engineering workspace ergonomics rely on the integration of new technologies, custom designed cabinets, indirect lighting, sound-absorbent partitioning and geometric arrangement of workstations to allow better privacy while optimizing space occupation. Innovations included adjustable flat monitors, integration of videoconferencing and voice recognition, control monitor and retractable keyboard for optimal space utilization. An overhead compartment protecting the monitors from ambient light is also used as accessory lightbox and rear-view projection screen for conferences.

The Stability of Factors Influencing the Choice of Medical Specialty Among Medical Students and Postgraduate Radiology Trainees.

PubMed

Yen, Adam J; Webb, Emily M; Jordan, Eric J; Kallianos, Kimberly; Naeger, David M

2018-06-01

To investigate whether general psychological motivating factors that guide career selection of a medical specialty differ over the course of medical school and to compare differences in motivating factors among students choosing "controllable" lifestyle specialties, students choosing "uncontrollable" lifestyle specialties, and a cohort of radiology residents. An anonymous survey was distributed to first- through fourth-year medical students and radiology residents at a single institution. Participants were asked to select their top three of seven factors that most influenced their choice of medical specialty. Fourth-year students were asked to designate the specialty to which they had applied. The survey was distributed to 259 students and 47 radiology residents with a response rate of 93.8% (243 of 259) and 95.7% (45 of 47), respectively. The top three factors indicated by medical students were finding the daily work fulfilling, work-life balance, and interest in the subject. These top three factors were common to all medical student classes and did not differ between students choosing "controllable" versus "uncontrollable" fields. The factors uncommonly selected were similar personality to others in the field, attending income, competitiveness or prestige, and job market conditions. For radiology residents, the top three motivating factors were the same as for medical students. Three out of seven motivating factors were universally important to trainees, regardless of their stage of medical training or their selection of a controllable versus uncontrollable lifestyle specialty. These data suggest the variety of career choices made by students may not derive from differing underlying values. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

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.

Evaluation of an open source tool for indexing and searching enterprise radiology and pathology reports

NASA Astrophysics Data System (ADS)

Kim, Woojin; Boonn, William

2010-03-01

Data mining of existing radiology and pathology reports within an enterprise health system can be used for clinical decision support, research, education, as well as operational analyses. In our health system, the database of radiology and pathology reports exceeds 13 million entries combined. We are building a web-based tool to allow search and data analysis of these combined databases using freely available and open source tools. This presentation will compare performance of an open source full-text indexing tool to MySQL's full-text indexing and searching and describe implementation procedures to incorporate these capabilities into a radiology-pathology search engine.

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.

[Radiologic picture of maxillary sinus aspergilloma].

PubMed

Kaczmarek, I; Bilska, J; Osmola, K; Nowaczyk, M T

2010-06-01

Mycotic infection of paranasal sinus could be the etiological factor of chronic sinusitis. The increase in number of fungal sinusitis cases have been reported recently among nonimmunocompromised patient after endodontic treatment of maxillary teeth. Nonspecific clinical signs and incorrect radiologic pictures interpretation as well as loss of therapeutic standards seems to be the cause of false negative diagnosis and difficulties in treatment of fungal sinusitis. Clinical and radiological picture of maxillary sinus aspergillosis was described in this paper. In the period of 2006-2009 in the Department of Maxillo-Facial Surgery 19 patient with fungal maxillary sinusitis was treated. The endodontic treatment of maxillary teeth of the related side was performed previously in 80% examined cases. In 2 cases there were immunocompromised patients with immunosuppressive treatment. In 16 cases patients were referred to our Department due to metallic foreign body of the maxillary sinus. Routine diagnostic radiological imaging was performed in each case: paranasal sinus view--Water's view and panoramic radiograph (orthopantomograph). In 4 cases imaging was extended with computer tomography (CT) visualization. The surgical treatment was performed in each case. The final diagnosis was puted on histopathological examination and fungal culture. In 16 cases of analysed group histopathological examination and fungal culture revealed aspergilosis. In 2 cases fungal culture was negative, but histopathology slices confirm presence of hyphae of Aspergillus. In 1 case the root canal sealer was found in the maxillary sinus. In none case invasive form of aspergillosis was confirmed. In all cases Water's view of paranasal sinuses and ortopantomograph showed partially or totally clouded sinus with well-defined, single or multifocal radiopaque object similar to metallic foreign body. Characteristic finding in CT imaging was well-defined radiodence concretions that have been attributed to calcium deposits in inflammatory changed mucosa, that might suggest "foreign body" picture. In 1 to 3 years follow-up control there was a recurrence of symptoms in one case. Foreign body of maxillary sinus have to be differentiated with aspergilosis. Metallic "foreign body" view in maxillary sinus seems to be characteristic sign of aspergillosis. The most often form of maxillary sinus aspergilosis is aspergilloma.

Trends in radiology and experimental research.

PubMed

Sardanelli, Francesco

2017-01-01

European Radiology Experimental , the new journal launched by the European Society of Radiology, is placed in the context of three general and seven radiology-specific trends. After describing the impact of population aging, personalized/precision medicine, and information technology development, the article considers the following trends: the tension between subspecialties and the unity of the discipline; attention to patient safety; the challenge of reproducibility for quantitative imaging; standardized and structured reporting; search for higher levels of evidence in radiology (from diagnostic performance to patient outcome); the increasing relevance of interventional radiology; and continuous technological evolution. The new journal will publish not only studies on phantoms, cells, or animal models but also those describing development steps of imaging biomarkers or those exploring secondary end-points of large clinical trials. Moreover, consideration will be given to studies regarding: computer modelling and computer aided detection and diagnosis; contrast materials, tracers, and theranostics; advanced image analysis; optical, molecular, hybrid and fusion imaging; radiomics and radiogenomics; three-dimensional printing, information technology, image reconstruction and post-processing, big data analysis, teleradiology, clinical decision support systems; radiobiology; radioprotection; and physics in radiology. The journal aims to establish a forum for basic science, computer and information technology, radiology, and other medical subspecialties.

POOL WATER TREATMENT AND COOLING SYSTEM DESCRIPTION DOCUMENT

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

V. King

2000-06-19

The Pool Water Treatment and Cooling System is located in the Waste Handling Building (WHB), and is comprised of various process subsystems designed to support waste handling operations. This system maintains the pool water temperature within an acceptable range, maintains water quality standards that support remote underwater operations and prevent corrosion, detects leakage from the pool liner, provides the capability to remove debris from the pool, controls the pool water level, and helps limit radiological exposure to personnel. The pool structure and liner, pool lighting, and the fuel staging racks in the pool are not within the scope of themore » Pool Water Treatment and Cooling System. Pool water temperature control is accomplished by circulating the pool water through heat exchangers. Adequate circulation and mixing of the pool water is provided to prevent localized thermal hotspots in the pool. Treatment of the pool water is accomplished by a water treatment system that circulates the pool water through filters, and ion exchange units. These water treatment units remove radioactive and non-radioactive particulate and dissolved solids from the water, thereby providing the water clarity needed to conduct waste handling operations. The system also controls pool water chemistry to prevent advanced corrosion of the pool liner, pool components, and fuel assemblies. Removal of radioactivity from the pool water contributes to the project ALARA (as low as is reasonably achievable) goals. A leak detection system is provided to detect and alarm leaks through the pool liner. The pool level control system monitors the water level to ensure that the minimum water level required for adequate radiological shielding is maintained. Through interface with a demineralized water system, adequate makeup is provided to compensate for loss of water inventory through evaporation and waste handling operations. Interface with the Site Radiological Monitoring System provides continuous radiological monitoring of the pool water. The Pool Water Treatment and Cooling System interfaces with the Waste Handling Building System, Site-Generated Radiological Waste Handling System, Site Radiological Monitoring System, Waste Handling Building Electrical System, Site Water System, and the Monitored Geologic Repository Operations Monitoring and Control System.« less

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.

CHALLENGES IN SETTING UP QUALITY CONTROL IN DIAGNOSTIC RADIOLOGY FACILITIES IN NIGERIA.

PubMed

Inyang, S O; Egbe, N O; Ekpo, E

2015-01-01

The Nigerian Nuclear Regulatory Authority (NNRA) was established to regulate and control the use of radioactive and radiation emitting sources in Nigeria. Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the authorization of diagnostic radiology facilities in the Country. Some quality control tests (output, exposure linearity and reproducibility) were measured on the x-ray machines in the facilities that took part in the study. Questionnaire was developed to evaluate the frequencies at which QC tests were conducted in the facilities and the challenges in setting up QC. Results show great variation in the values of the QC parameters measured. Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study. The responses on the frequencies at which QC tests should be conducted did not correspond to the recommended standards; indicating that personnel were not familiar with QC implementation and may require further training on QC.

Radiological interventions in malignant biliary obstruction

PubMed Central

Madhusudhan, Kumble Seetharama; Gamanagatti, Shivanand; Srivastava, Deep Narayan; Gupta, Arun Kumar

2016-01-01

Malignant biliary obstruction is commonly caused by gall bladder carcinoma, cholangiocarcinoma and metastatic nodes. Percutaneous interventions play an important role in managing these patients. Biliary drainage, which forms the major bulk of radiological interventions, can be palliative in inoperable patients or pre-operative to improve liver function prior to surgery. Other interventions include cholecystostomy and radiofrequency ablation. We present here the indications, contraindications, technique and complications of the radiological interventions performed in patients with malignant biliary obstruction. PMID:27247718

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.

Safety and efficacy for new techniques and imaging using new equipment to support European legislation: an EU coordination action.

PubMed

Zoetelief, J; Faulkner, K

2008-01-01

The past two decades have witnessed a technologically driven revolution in radiology. At the centre of these developments has been the use of computing. These developments have also been driven by the introduction of new detector and imaging devices in radiology and nuclear medicine, as well as the widespread application of computing techniques to enhance and extract information within the images acquired. Further advances have been introduced into digital practice. These technological developments, however, have not been matched by justification and optimisation studies to ensure that these new imaging devices and techniques are as effective as they might be, or performed at the lowest possible dose. The work programme of the SENTINEL Coordination Action was subdivided into eight work packages: functional performance and standards; efficacy and safety in digital radiology, dentistry and nuclear medicine, cardiology, interventional radiology, population screening/sensitive groups; justification, ethics and efficacy; good practice guidance and training; and project management. The intention of the work programme was to underwrite the safety, efficacy and ethical aspects of digital practice as well as to protect and add value to the equipment used in radiology.

Accountable care organizations and radiology: threat or opportunity?

PubMed

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

2012-12-01

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

A practical approach for inexpensive searches of radiology report databases.

PubMed

Desjardins, Benoit; Hamilton, R Curtis

2007-06-01

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

DEMOLISHING A COLD WARE ERA FULE STORAGE BASIN SUPERSTRUCTURE LADEN WITH ASBESTOS

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

LLOYD ER; STEVENS JM; DAGAN EB

The K East (KE) Basin facilities are located near the north end of the Hanford Site's 100 K area. The facilities were built in 1950 as part of the KE Reactor complex and constructed within 400 meters of the Columbia River, which is the largest river in the Pacific Northwest and by volume the fourth largest river in the United States. The basin, located adjacent to the reactor, was used for the underwater storage of irradiated nuclear fuel discharged from the reactor. The basin was covered by a superstructure comprising steel columns and beams, concrete, and cement asbestos board (CAB)more » siding. The project's mission was to complete demolition of the structure over the KE Basin within six months of turnover from facility deactivation activities. The demolition project team applied open-air demolition techniques to bring the facility to slab-on-grade. Several innovative techniques were used to control contamination and maintain contamination control within the confines of the demolition exclusion zone. The techniques, which focused on a defense-in-depth approach, included spraying fixatives on interior and exterior surfaces before demolition began; applying fixatives during the demolition; misting using a fine spray of water during demolition; and demolishing the facility systematically. Another innovative approach that made demolition easier was to demolish the building with the non-friable CAB remaining in place. The CAB siding covered the exterior of the building and portions of the interior walls, and was an integral part of the multiple-layered roof. The project evaluated the risks involved in removing the CAB material in a radiologically contaminated environment and determined that radiological dose rates and exposure to radiological contamination and industrial hazards would be significantly reduced by using heavy equipment to remove the CAB during demolition. The ability to perform this demolition safely and without spreading contamination (radiological or asbestos) demonstrates that contaminated structures can be torn down successfully using similar open-air demolition techniques.« less

A survey of interventional radiology for the management of obstetric haemorrhage in the United Kingdom.

PubMed

Webster, V J; Stewart, R; Stewart, P

2010-07-01

Massive haemorrhage remains a leading cause of maternal death worldwide. Interventional radiology can be used to prevent or treat life-threatening haemorrhage, but evidence for its efficacy is limited to case series predominantly from large tertiary centres. The current availability of interventional radiology for management of obstetric haemorrhage in the UK is unknown. A postal questionnaire on the use of interventional radiology was sent to the lead clinician for obstetric anaesthesia in 226 UK maternity units. The response rate was 72%; 74 respondents (46%) had considered and 51 (31%) used interventional radiology for control of obstetric haemorrhage. Its use was primarily confined to large tertiary obstetric units and limited by availability of equipment and staff. Interventional radiology to assist in the management of obstetric haemorrhage is not uniformly available in the UK and experience remains limited. Access to this resource is subject to striking local variability and influenced by the size and nature of the hospital supporting the delivery unit. 2010 Elsevier Ltd. All rights reserved.

Overcoming hurdles in translating visual search research between the lab and the field.

PubMed

Clark, Kait; Cain, Matthew S; Adamo, Stephen H; Mitroff, Stephen R

2012-01-01

Research in visual search can be vital to improving performance in careers such as radiology and airport security screening. In these applied, or "field," searches, accuracy is critical, and misses are potentially fatal; however, despite the importance of performing optimally, radiological and airport security searches are nevertheless flawed. Extensive basic research in visual search has revealed cognitive mechanisms responsible for successful visual search as well as a variety of factors that tend to inhibit or improve performance. Ideally, the knowledge gained from such laboratory-based research could be directly applied to field searches, but several obstacles stand in the way of straightforward translation; the tightly controlled visual searches performed in the lab can be drastically different from field searches. For example, they can differ in terms of the nature of the stimuli, the environment in which the search is taking place, and the experience and characteristics of the searchers themselves. The goal of this chapter is to discuss these differences and how they can present hurdles to translating lab-based research to field-based searches. Specifically, most search tasks in the lab entail searching for only one target per trial, and the targets occur relatively frequently, but field searches may contain an unknown and unlimited number of targets, and the occurrence of targets can be rare. Additionally, participants in lab-based search experiments often perform under neutral conditions and have no formal training or experience in search tasks; conversely, career searchers may be influenced by the motivation to perform well or anxiety about missing a target, and they have undergone formal training and accumulated significant experience searching. This chapter discusses recent work that has investigated the impacts of these differences to determine how each factor can influence search performance. Knowledge gained from the scientific exploration of search can be applied to field searches but only when considering and controlling for the differences between lab and field.

[Tracheobronchial lavage--a supplementary measure in the initial management of meconium aspiration syndrome].

PubMed

Rosegger, H; Engele, H; Haas, J

1987-12-18

Pulmonary lavage - a supplementary measure of resuscitation in newborn infants with severe aspiration of meconium stained amniotic fluid. During 1984-1985 150 mature newborn infants who had aspirated heavily-stained or pea soup-like amniotic fluid were resuscitated at the University Hospital of Obstetrics and Gynaecology in Graz. In 109 of these infants (controls) routine aspiration of both the upper and lower airways was accomplished as soon as possible, whilst in the remaining 41 infants (lavaged) pulmonary lavage with saline was additionally performed via an endotracheal tube after aspiration to clear the trachea and the upper bronchi from thick meconium which could not have been removed as efficiently otherwise. The incidence of manifest meconium aspiration syndrome was significantly higher (22%) in the lavaged infants than in the controls (8%). Mechanical ventilation was performed in 36% of the lavaged infants, whereas only 5.5% of the controls had to be ventilated for more than 1 hour. The mean duration of ventilation, however, was shorter (Mh = 5.1 hrs vs Mh = 69 hrs) and the average age at discharge lower in the lavaged. Three infants died, two of whom had severe malformations. Only one death in the lavaged infants was attributable to severe meconium aspiration syndrome already manifest at birth. Three infants (two lavaged, one control) showed radiological evidence of pneumothorax, but without clinical appearance of respiratory distress. Since the lavaged group naturally contained the more severely distressed infants, with a high incidence of caesarean section on account of intrauterine asphyxia and lower Apgar scores at one and five minutes, the high incidence of radiologically confirmed meconium aspiration syndrome was not surprising.(ABSTRACT TRUNCATED AT 250 WORDS)

Radiology Technician (AFSC 90370).

ERIC Educational Resources Information Center

Sobczak, James

This five-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for radiology technicians. Covered in the individual volumes are radiographic fundamentals (x-ray production; primary beams; exposure devices; film, film holders, and darkrooms; control of film quality; and environmental safety);…

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...

Systematic Viewing in Radiology: Seeing More, Missing Less?

ERIC Educational Resources Information Center

Kok, Ellen M.; Jarodzka, Halszka; de Bruin, Anique B. H.; BinAmir, Hussain A. N.; Robben, Simon G. F.; van Merriënboer, Jeroen J. G.

2016-01-01

To prevent radiologists from overlooking lesions, radiology textbooks recommend "systematic viewing," a technique whereby anatomical areas are inspected in a fixed order. This would ensure complete inspection (full coverage) of the image and, in turn, improve diagnostic performance. To test this assumption, two experiments were…

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

PubMed

Li, Feng

2015-07-01

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

A novel quality assurance method in a university teaching paediatric radiology department.

PubMed

Gallet, J M; Reed, M H; Hlady, J

2000-08-01

Primary diagnostic equipment in a paediatric radiology department must perform at optimal levels at all times. The Children's Hospital Radiology Department in Winnipeg, Canada, has developed an impartial means of reporting radiographic image quality. The main objectives of this study programme were two-fold. First, to monitor diagnostic X-ray equipment performance, and second, to improve the resultant image quality as a means of implementing the fundamental concepts of continuous quality improvement. Reading radiologists completed a quality assurance (QA) card when they identified a radiographic image quality problem. The cards were subsequently collected by the clinical instructor who then informed, in confidence, the radiographers of the written comments or concerns. QA cards have been conspicuously installed in the paediatric radiology reading room since the middle of 1993. Since its inception, equipment malfunction has been monitored and indicators for improving image quality developed. This component of the QA programme has shown itself to be a successful means of communicating with radiographers in maintaining superior image quality.

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

Interventional therapeutic procedures in the musculoskeletal system: an Italian Survey by the Italian College of Musculoskeletal Radiology.

PubMed

Silvestri, Enzo; Barile, Antonio; Albano, Domenico; Messina, Carmelo; Orlandi, Davide; Corazza, Angelo; Zugaro, Luigi; Masciocchi, Carlo; Sconfienza, Luca Maria

2018-04-01

To perform an online survey among all members of the Italian College of Musculoskeletal Radiology to understand how therapeutic musculoskeletal procedures are performed in daily practice in Italy. We administered an online survey to all 2405 members about the use of therapeutic musculoskeletal procedures in their institutions asking 16 different questions. Subgroup analysis was performed between general and orthopaedic hospitals with Mann-Whitney U and χ 2 statistics. A total of 129/2405 answers (5.4% of members) were included in our analysis. A median of 142.5 (25th-75th percentiles: 50-535.5; range 10-5000) therapeutic musculoskeletal procedures per single institution was performed in 2016. Arthropathic pain was the main indication. The most common procedures were joint injection, bursal/tendon injection, and irrigation of calcific tendinopathy. Ultrasound-guided procedures were mainly performed in ultrasonography rooms (77.4%) rather than in dedicated interventional rooms (22.6%). Conversely, fluoroscopic procedures were performed almost with the same frequency in interventional radiology suites (52.4%) and in general radiology rooms (47.6%). In most institutions (72%), autologous blood or components were not used. The median number of therapeutic musculoskeletal procedures performed in orthopaedic hospitals was significantly higher than in general hospitals (P = 0.002), as well as for the use of autologous preparations (P = 0.004). Joint injection, bursal/tendon injection, and irrigation of calcific tendinopathy were the most common therapeutic musculoskeletal procedures, being arthropathic pain the main indication. The percentage of procedures and the use of autologous preparations were significantly higher in orthopaedic hospitals than in general hospitals.

Personalized technologist dose audit feedback for reducing patient radiation exposure from CT.

PubMed

Miglioretti, Diana L; Zhang, Yue; Johnson, Eric; Lee, Choonsik; Morin, Richard L; Vanneman, Nicholas; Smith-Bindman, Rebecca

2014-03-01

The aim of this study was to determine whether providing radiologic technologists with audit feedback on doses from CT examinations they conduct and education on dose-reduction strategies reduces patients' radiation exposure. This prospective, controlled pilot study was conducted within an integrated health care system from November 2010 to October 2011. Ten technologists at 2 facilities received personalized dose audit reports and education on dose-reduction strategies; 9 technologists at a control facility received no intervention. Radiation exposure was measured by the dose-length product (DLP) from CT scans performed before (n = 1,630) and after (n = 1,499) the intervention and compared using quantile regression. Technologists were surveyed before and after the intervention. For abdominal CT, DLPs decreased by 3% to 12% at intervention facilities but not at the control facility. For brain CT, DLPs significantly decreased by 7% to 12% at one intervention facility; did not change at the second intervention facility, which had the lowest preintervention DLPs; and increased at the control facility. Technologists were more likely to report always thinking about radiation exposure and associated cancer risk and optimizing settings to reduce exposure after the intervention. Personalized audit feedback and education can change technologists' attitudes about, and awareness of, radiation and can lower patient radiation exposure from CT imaging. Copyright © 2014 American College of Radiology. All rights reserved.

Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

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

Haslam, Philip J.; Yap, Bernard; Mueller, Peter R.

Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived frommore » a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are used in the United States. Trends toward making interventional radiology a clinical specialty are evident, with 51% of respondents having day case beds, and 30% having inpatient beds.« less

Performance of a Machine Learning Classifier of Knee MRI Reports in Two Large Academic Radiology Practices: A Tool to Estimate Diagnostic Yield.

PubMed

Hassanpour, Saeed; Langlotz, Curtis P; Amrhein, Timothy J; Befera, Nicholas T; Lungren, Matthew P

2017-04-01

The purpose of this study is to evaluate the performance of a natural language processing (NLP) system in classifying a database of free-text knee MRI reports at two separate academic radiology practices. An NLP system that uses terms and patterns in manually classified narrative knee MRI reports was constructed. The NLP system was trained and tested on expert-classified knee MRI reports from two major health care organizations. Radiology reports were modeled in the training set as vectors, and a support vector machine framework was used to train the classifier. A separate test set from each organization was used to evaluate the performance of the system. We evaluated the performance of the system both within and across organizations. Standard evaluation metrics, such as accuracy, precision, recall, and F1 score (i.e., the weighted average of the precision and recall), and their respective 95% CIs were used to measure the efficacy of our classification system. The accuracy for radiology reports that belonged to the model's clinically significant concept classes after training data from the same institution was good, yielding an F1 score greater than 90% (95% CI, 84.6-97.3%). Performance of the classifier on cross-institutional application without institution-specific training data yielded F1 scores of 77.6% (95% CI, 69.5-85.7%) and 90.2% (95% CI, 84.5-95.9%) at the two organizations studied. The results show excellent accuracy by the NLP machine learning classifier in classifying free-text knee MRI reports, supporting the institution-independent reproducibility of knee MRI report classification. Furthermore, the machine learning classifier performed well on free-text knee MRI reports from another institution. These data support the feasibility of multiinstitutional classification of radiologic imaging text reports with a single machine learning classifier without requiring institution-specific training data.

Pediatric Interventional Radiology: Vascular Interventions.

PubMed

Kandasamy, Devasenathipathy; Gamanagatti, Shivanand; Gupta, Arun Kumar

2016-07-01

Pediatric interventional radiology (PIR) comprises a range of minimally invasive diagnostic and therapeutic procedures that are performed using image guidance. PIR has emerged as an essential adjunct to various surgical and medical conditions. Over the years, technology has undergone dramatic and continuous evolution, making this speciality grow. In this review, the authors will discuss various vascular interventional procedures undertaken in pediatric patients. It is challenging for the interventional radiologist to accomplish a successful interventional procedure. There are many vascular interventional radiology procedures which are being performed and have changed the way the diseases are managed. Some of the procedures are life saving and have become the treatment of choice in those patients. The future is indeed bright for the practice and practitioners of pediatric vascular and non-vascular interventions. As more and more of the procedures that are currently being performed in adults get gradually adapted for use in the pediatric population, it may be possible to perform safe and successful interventions in many of the pediatric vascular lesions that are otherwise being referred for surgery.

The social media revolution.

PubMed

Dubose, Cheryl

2011-01-01

The growing popularity and use of social media tools such as Facebook, YouTube, Twitter, blogging, and wikis have led to a social media revolution. Given this widespread influence, it is important for educators, administrators, and technologists to understand the risks of using social media in the classroom and workplace. To investigate popular social media sites and their effect on radiologic technology education and business practices. A comprehensive search of literature was performed to examine social media and its applications in education, health care, and business. Social media use is on the rise, affecting all aspects of mainstream society. Leaders in the radiologic sciences should be familiar with social media and cognizant of its risks. Future studies regarding social media use in the radiologic sciences are necessary to determine its effect on the radiologic science community. ©2011 by the American Society of Radiologic Technologists.

Controversy in urinary tract infection management in children: a review of new data and subsequent changes in guidelines.

PubMed

Kari, Jameela Abdulaziz; Tullus, Kjell

2013-12-01

Controversy and lack of consensus have been encountered in the management of pediatric urinary tract infection (UTI), including its diagnosis, radiological investigations and the use of antibiotic therapy. In this review, we discuss the need for radiological investigations and the extent of their use as well as the need for prophylactic antibiotics in children with UTI and vesicoureteral reflux. Only a small proportion of children with first UTI and no history of antenatal renal abnormalities have clinically important malformations. Renal ultrasound should be performed in febrile infants and young children with UTI; a micturating cystourethrogram should not be performed routinely after the first febrile UTI. Long-term antibiotics appear to reduce the risk of recurrent symptomatic UTI in susceptible children, although the clinical benefit is marginal. Current recommendations encourage performing radiological investigations only in children at risk and discourage routine prophylactic antibiotic use.

Role of conventional radiology and MRi defecography of pelvic floor hernias

PubMed Central

2013-01-01

Background Purpose of the study is to define the role of conventional radiology and MRI in the evaluation of pelvic floor hernias in female pelvic floor disorders. Methods A MEDLINE and PubMed search was performed for journals before March 2013 with MeSH major terms 'MR Defecography' and 'pelvic floor hernias'. Results The prevalence of pelvic floor hernias at conventional radiology was higher if compared with that at MRI. Concerning the hernia content, there were significantly more enteroceles and sigmoidoceles on conventional radiology than on MRI, whereas, in relation to the hernia development modalities, the prevalence of elytroceles, edroceles, and Douglas' hernias at conventional radiology was significantly higher than that at MRI. Conclusions MRI shows lower sensitivity than conventional radiology in the detection of pelvic floor hernias development. The less-invasive MRI may have a role in a better evaluation of the entire pelvic anatomy and pelvic organ interaction especially in patients with multicompartmental defects, planned for surgery. PMID:24267789

Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

PubMed

Lääperi, A L

1996-01-01

The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and nonmonetary variables was developed. In it the radiologist, radiographer and examination-specific equipment costs were allocated to the examinations applying estimated cost equivalents. Some minor cost items were replaced by a general cost factor (GCF). The program is suitable for internal cost accounting of radiological departments as well as regional planning. If more accurate cost information is required, cost assignment employing the actual consumption of the resources and applying the principles of activity-based cost accounting is recommended. As an application of the cost accounting formula the average costs of the radiological examinations were calculated. In conventional radiography the average proportion of the cost factors in the total material was: personnel costs 43%, equipment costs 26%, material costs 7%, real estate costs 11%, administration and overheads 14%. The average total costs including radiologist costs in the hospitals were (FIM): conventional roentgen examinations 188, contrast medium examinations 695, ultrasound 296, mammography 315, roentgen examinations with mobile equipment 1578. The average total costs without radiologist costs in the public health centres were (FIM): conventional roentgen examinations 107, contrast medium examinations 988, ultrasound 203, mammography 557. The average currency rate of exchange in 1991 was USD 1 = FIM 4.046. The following formula is proposed for calculating the cost of a radiological examination (or a group of examinations) performed with a certain piece of equipment during a period of time (e.g. 1 year): a2/ sigma ax*ax+ b2/ sigma bx*bx+ d1/d5*dx+ e1 + [(c1+ c2) + d4 + (e2 - e3) + f5 + g1+ g2+ i]/n.

Radiation protection program for early detection of breast cancer in a mammography facility

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

Mariana, Villagomez Casimiro, E-mail: marjim10-66@ciencias.unam.mx, E-mail: cesar@fisica.unam.mx; Cesar, Ruiz Trejo, E-mail: marjim10-66@ciencias.unam.mx, E-mail: cesar@fisica.unam.mx; Ruby, Espejo Fonseca

Mammography is the best tool for early detection of Breast Cancer. In this diagnostic radiology modality it is necessary to establish the criteria to ensure the proper use and operation of the equipment used to obtain mammographic images in order to contribute to the safe use of ionizing radiation. The aim of the work was to implement at FUCAM-AC the radiation protection program which must be established for patients and radiation workers according to Mexican standards [1–4]. To achieve this goal, radiation protection and quality control manuals were elaborated [5]. Furthermore, a quality control program (QCP) in the mammography systemsmore » (analog/digital), darkroom included, has been implemented. Daily sensitometry, non-variability of the image quality, visualizing artifacts, revision of the equipment mechanical stability, compression force and analysis of repetition studies are some of the QCP routine tests that must be performed by radiological technicians of this institution as a set of actions to ensure the protection of patients. Image quality and patients dose assessment were performed on 4 analog equipment installed in 2 mobile units. In relation to dose assessment, all equipment passed the acceptance criteria (<3 mGy per projection). The image quality test showed that most images (70%)– presented artifacts. A brief summary of the results of quality control tests applied to the equipment and film processor are presented. To maintain an adequate level of quality and safety at FUCAM-AC is necessary that the proposed radiation protection program in this work is applied.« less

Pediatric interventional radiology workforce survey: 10-year follow-up.

PubMed

Kaufman, Claire S; James, Charles A; Harned, Roger K; Connolly, Bairbre L; Roebuck, Derek J; Cahill, Anne M; Dubois, Josee; Morello, Frank P; Morgan, Robin K; Sidhu, Manrita K

2017-05-01

Pediatric interventional radiology is a distinct subspecialty differing from both pediatric diagnostic radiology and adult interventional radiology. We conducted a workforce survey in 2005 to evaluate the state of pediatric interventional radiology at that time. Since then there have been many advancements to the subspecialty, including the founding of the Society for Pediatric Interventional Radiology (SPIR). To evaluate the current state of the pediatric interventional radiology workforce and compare findings with those of the initial 2005 workforce survey. We sent a two-part survey electronically to members of SPIR, the Society for Pediatric Radiology (SPR), the Society of Chairmen of Radiology in Children's Hospitals (SCORCH) and the Society of Interventional Radiology (SIR). Part 1 focused on individual practitioners (n=177), while part 2 focused on group practices and was answered by a leader from each group (n=88). We examined descriptive statistics and, when possible, compared the results to the study from 2005. A total of 177 individuals replied (a 331% increase over the first study) and 88 pediatric interventional radiology (IR) service sites responded (a 131.6% increase). Pediatric IR has become a more clinically oriented specialty, with a statistically significant increase in services with admitting privileges, clinics and performance of daily rounds. Pediatric IR remains diverse in training and practice. Many challenges still exist, including anesthesia/hospital support, and the unknown impact of the new IR residency on pediatric IR training, although the workforce shortage has been somewhat alleviated, as demonstrated by the decreased mean call from 165 days/year to 67.2 days/year. Pediatric interventional radiology practitioners and services have grown significantly since 2005, although the profile of this small subspecialty has changed and some challenges remain.

The Importance of Human-Computer Interaction in Radiology E-learning.

PubMed

den Harder, Annemarie M; Frijlingh, Marissa; Ravesloot, Cécile J; Oosterbaan, Anne E; van der Gijp, Anouk

2016-04-01

With the development of cross-sectional imaging techniques and transformation to digital reading of radiological imaging, e-learning might be a promising tool in undergraduate radiology education. In this systematic review of the literature, we evaluate the emergence of image interaction possibilities in radiology e-learning programs and evidence for effects of radiology e-learning on learning outcomes and perspectives of medical students and teachers. A systematic search in PubMed, EMBASE, Cochrane, ERIC, and PsycInfo was performed. Articles were screened by two authors and included when they concerned the evaluation of radiological e-learning tools for undergraduate medical students. Nineteen articles were included. Seven studies evaluated e-learning programs with image interaction possibilities. Students perceived e-learning with image interaction possibilities to be a useful addition to learning with hard copy images and to be effective for learning 3D anatomy. Both e-learning programs with and without image interaction possibilities were found to improve radiological knowledge and skills. In general, students found e-learning programs easy to use, rated image quality high, and found the difficulty level of the courses appropriate. Furthermore, they felt that their knowledge and understanding of radiology improved by using e-learning. In conclusion, the addition of radiology e-learning in undergraduate medical education can improve radiological knowledge and image interpretation skills. Differences between the effect of e-learning with and without image interpretation possibilities on learning outcomes are unknown and should be subject to future research.

JOURNAL CLUB: Radiologists' Online Identities: What Patients Find When They Search Radiologists by Name.

PubMed

Vijayasarathi, Arvind; Loehfelm, Thomas; Duszak, Richard; Hawkins, C Matthew

2016-11-01

Patients are increasingly seeking online information regarding their health and their health care providers. Concurrently, more patients are accessing their electronic medical records, including their radiology reports, via online portals. Thus, this study aims to characterize what patients find when they search for radiologists online. All Medicare-participating U.S. radiologists were identified using the Physician Compare National Downloadable File dataset obtained from the Centers for Medicare & Medicaid Services (CMS). Using a custom application, the top 10 Google search results for each radiologist in the national dataset were retrieved, and 90.5% of website domains with more than one occurrence were categorized as follows: physician or institution controlled, third party-controlled physician information systems, social media, or other. Aggregate and subgroup analyses were performed. Of all U.S. health care providers recognized by CMS, 30,601 self-identified as radiologists. There was at least one search result for 30,600 radiologists (99.997%), for a total of 305,795 websites. Of all the domains, 69.8% were third party-controlled physician information systems, 17.7% were physician or institution controlled, 1.0% were social media platforms, 2.1% were other, and 9.5% were not classified. Nine of the top 10 most commonly encountered domains were commercially controlled third-party physician information systems. Most U.S. radiologists lack self-controlled online content within the first page of Google search results. Opportunities exist for individual radiologists, radiology groups, academic departments, and professional societies to amend their online presence, control the content patients discover, and improve the visibility of the field at large.

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.

Introducing radiology report checklists among residents: adherence rates when suggesting versus requiring their use and early experience in improving accuracy.

PubMed

Powell, Daniel K; Lin, Eaton; Silberzweig, James E; Kagetsu, Nolan J

2014-03-01

To retrospectively compare resident adherence to checklist-style structured reporting for maxillofacial computed tomography (CT) from the emergency department (when required vs. suggested between two programs). To compare radiology resident reporting accuracy before and after introduction of the structured report and assess its ability to decrease the rate of undetected pathology. We introduced a reporting checklist for maxillofacial CT into our dictation software without specific training, requiring it at one program and suggesting it at another. We quantified usage among residents and compared reporting accuracy, before and after counting and categorizing faculty addenda. There was no significant change in resident accuracy in the first few months, with residents acting as their own controls (directly comparing performance with and without the checklist). Adherence to the checklist at program A (where it originated and was required) was 85% of reports compared to 9% of reports at program B (where it was suggested). When using program B as a secondary control, there was no significant difference in resident accuracy with or without using the checklist (comparing different residents using the checklist to those not using the checklist). Our results suggest that there is no automatic value of checklists for improving radiology resident reporting accuracy. They also suggest the importance of focused training, checklist flexibility, and a period of adjustment to a new reporting style. Mandatory checklists were readily adopted by residents but not when simply suggested. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

The prevalence of radiological glenohumeral osteoarthritis in long-term type 1 diabetes: the Dialong shoulder study.

PubMed

Juel, N G; Brox, J I; Hellund, J C; Holte, K B; Berg, T J

2017-12-14

This study compares the prevalence of radiological osteoarthritis (OA) in patients with type 1 diabetes mellitus (DM1) for > 45 years and controls, and explores the association with shoulder pain and glycaemic burden in patients with DM1. The Dialong study is a cross-sectional, observational study with 30 years of historical data on long-term glycaemic control. We included 102 patients with DM1 and 73 diabetes-free controls. Demographic data, worst shoulder pain last week [numeric rating scale (NRS) 0-10], pain on abduction at examination (NRS 0-10), and current and historical glycosylated haemoglobin (HbA 1c ) levels were collected. Standardized shoulder X-rays were taken and interpreted for OA applying the Kellgren-Lawrence classification. In the diabetes group (49% women), the mean ± sd duration of DM1 was 50.6 ± 4.8 years, mean 30 year HbA 1c 7.4%, and age 61.9 ± 7.1 years. The mean age of controls (57% women) was 62.6 ± 7.0 years. Radiological glenohumeral OA was found in 36 diabetes patients (35%) and 10 controls (14%) [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.6 to 7.5; p = 0.002]. Few persons had moderate and severe OA [6.9% vs 1.3%, OR 5.3 (95% Cl 0.6 to 44.1); p = 0.1]. Fifteen diabetes patients had painful OA versus two controls (adjusted OR 5.4, 95% CI 0.6 to 47.9; p = 0.13). There was no association between OA and long-term glycaemic burden (mean 30 year HbA 1c ) in the diabetes group (p > 0.2). Radiological glenohumeral OA was more common in patients with DM1 than in controls for mild, but not moderate and severe OA. The radiological findings were not associated with shoulder pain or long-term glycaemic burden.

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.

Activity-based costing in radiology. Application in a pediatric radiological unit.

PubMed

Laurila, J; Suramo, I; Brommels, M; Tolppanen, E M; Koivukangas, P; Lanning, P; Standertskjöld-Nordenstam, G

2000-03-01

To get an informative and detailed picture of the resource utilization in a radiology department in order to support its pricing and management. A system based mainly on the theoretical foundations of activity-based costing (ABC) was designed, tested and compared with conventional costing. The study was performed at the Pediatric Unit of the Department of Radiology, Oulu University Hospital. The material consisted of all the 7,452 radiological procedures done in the unit during the first half of 1994, when both methods of costing where in use. Detailed cost data were obtained from the hospital financial and personnel systems and then related to activity data captured in the radiology information system. The allocation of overhead costs was greatly reduced by the introduction of ABC compared to conventional costing. The overhead cost as a percentage of total costs dropped to one-fourth of total costs, from 57% to 16%. The change of unit costs of radiological procedures varied from -42% to +82%. Costing is much more detailed and precise, and the percentage of unspecified allocated overhead costs diminishes drastically when ABC is used. The new information enhances effective departmental management, as the whole process of radiological procedures is identifiable by single activities, amenable to corrective actions and process improvement.

Manpower Needs in Environmental Engineering

ERIC Educational Resources Information Center

Middlebrooks, E. J.; And Others

1974-01-01

Outlines manpower needs in both the public and private sectors in the areas of air pollution control, solid waste management, radiological hazard control, pesticide hazard control, and water pollution control. (GS)

A general natural-language text processor for clinical radiology.

PubMed Central

Friedman, C; Alderson, P O; Austin, J H; Cimino, J J; Johnson, S B

1994-01-01

OBJECTIVE: Development of a general natural-language processor that identifies clinical information in narrative reports and maps that information into a structured representation containing clinical terms. DESIGN: The natural-language processor provides three phases of processing, all of which are driven by different knowledge sources. The first phase performs the parsing. It identifies the structure of the text through use of a grammar that defines semantic patterns and a target form. The second phase, regularization, standardizes the terms in the initial target structure via a compositional mapping of multi-word phrases. The third phase, encoding, maps the terms to a controlled vocabulary. Radiology is the test domain for the processor and the target structure is a formal model for representing clinical information in that domain. MEASUREMENTS: The impression sections of 230 radiology reports were encoded by the processor. Results of an automated query of the resultant database for the occurrences of four diseases were compared with the analysis of a panel of three physicians to determine recall and precision. RESULTS: Without training specific to the four diseases, recall and precision of the system (combined effect of the processor and query generator) were 70% and 87%. Training of the query component increased recall to 85% without changing precision. PMID:7719797

[Preliminary study on the action of hypopressive gymnastics in the treatment of idiopathic scoliosis].

PubMed

Caufriez, Marcel; Fernández-Domínguez, Juan Carlos; Brynhildsvoll, Nils

2011-01-01

Our goal is to describe the results of a hypopressive gymnastics (HG) program applied to 3 children with idiopathic scoliosis. Three children (ages ranging from 8 to 15 years) suffering from idiopathic scoliosis were recruited for this study. Thoracic or thoracolumbar curves showed between 15° and 40° Cobb degrees. The evolutionary character of the curves had been confirmed. A study of different clinical and radiological parameters was carried out to compare the measurements before and after (3 months later) the application of a 5 HG daily exercises programme: A radiological study of the spine was carried out to compare the measurements of the vertebral rotation. A radiological study, a plumb line and a measuring tape were used to assess the vertebral tilt in this study. A Scoliometer was used to measure the deformation of the rib cage (gibbosity). The most significant results were: a trend to reach stabilisation in the vertebral tilt and rotation, and stabilisation of gibbosity, which probably might improve the respiratory function of these subjects. Finally, the performance of an ordinary HG exercise program shows a trend to control and stabilise dorsal idiopathic scoliosis progression. Copyright © 2010 Elsevier España, S.L. All rights reserved.

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.

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

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

PubMed

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

2018-03-30

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

Curriculum Development and Alignment in Radiologic Technology.

ERIC Educational Resources Information Center

Dowd, Steven B.

Before developing a curriculum for radiologic technology, one must first attempt to define the term "curriculum." The term is not easy to define precisely, although it does imply the necessity of a master plan that outlines institutional philosophy and goals, course descriptions, description of competency-based evaluation, performance objectives,…

42 CFR 413.122 - Payment for hospital outpatient radiology services and other diagnostic procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... and other diagnostic procedures. 413.122 Section 413.122 Public Health CENTERS FOR MEDICARE & MEDICAID... radiology services and other diagnostic procedures. (a) Basis and purpose. (1) This section implements... services and other diagnostic procedures performed by a hospital on an outpatient basis. (2) For purposes...

21 CFR 1002.3 - Notification to user of performance and technical data.

Code of Federal Regulations, 2010 CFR

2010-04-01

... data. 1002.3 Section 1002.3 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) RADIOLOGICAL HEALTH RECORDS AND REPORTS General Provisions § 1002.3 Notification to... Radiological Health, as authorized under delegated authority, may require a manufacturer of a radiation...

The Effectiveness of Hypermedia Instructional Modules for Radiology Residents.

ERIC Educational Resources Information Center

Shaw, Steven G.; And Others

1995-01-01

Details the development and field testing of hypermedia training materials for teaching radiology residents at the Montreal General Hospital (Canada). Compares results of randomly teaching 24 residents with either hypermedia or traditional classroom methods. Results indicate that residents who learned with hypermedia generally performed as well as…

An assessment of the performance and quality control procedures of PACS workstation monitors used in Irish radiology departments

NASA Astrophysics Data System (ADS)

Wade, Cherrie; Brennan, Patrick C.; Mc Entee, Mark F.

2005-04-01

Diagnostic efficacy in soft-copy reporting relies heavily on the quality of workstation monitors and an investigation performed in 2002 demonstrated that CRT monitors in Dublin imaging departments were not operating at optimal levels. The current work examines the performance of CRTs being used in Dublin and other parts of Ireland to establish if problems reported in the earlier work have been rectified. All hospitals performing soft-copy reporting for general radiology using CRTs were included in the work. Examination of ambient lighting, calibration of monitors and analysis of CRT performance using the SMPTE test pattern and a selection of the AAPM test images was performed. Maximum luminance, spatial uniformity of luminance, temporal luminance stability, gamma, geometry, sharpness, veiling glare and spatial resolution of each monitor was evaluated. Ambient lighting in all reporting areas was within recommended levels. All the monitors were calibrated appropriately and were performing at acceptable levels for maximum luminance and temporal stability and only one of the thirty-three investigated failed to reach the standard for spatial uniformity. In contrast a number of the CRTs investigated showed poor adherence to acceptable levels for geometrical distortions, veiling glare and spatial resolution all of which are important influencers of image quality. Gamma values also appeared to be low for a number of monitors but this interpretation is provisional and subject to the establishment of ratified guideline values. The results demonstrate that although some improvement on the previous situation is evident, greater adherence to acceptable levels is required for certain parameters.

Radiological Control Center (RADCC) Renaming Ceremony

NASA Image and Video Library

2017-03-31

Nancy Bray, director of Spaceport Integration and Services at NASA's Kennedy Space Center, left, is joined by Myrna Scott, center, and Dr. David Tipton, chief of Aerospace Medicine and Occupational Health, in cutting a ceremonial ribbon dedicating the Randal E. Scott Radiological Control Center at the Florida spaceport. Myrna Scott is the widow of Randy Scott, who was 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.

NegBio: a high-performance tool for negation and uncertainty detection in radiology reports.

PubMed

Peng, Yifan; Wang, Xiaosong; Lu, Le; Bagheri, Mohammadhadi; Summers, Ronald; Lu, Zhiyong

2018-01-01

Negative and uncertain medical findings are frequent in radiology reports, but discriminating them from positive findings remains challenging for information extraction. Here, we propose a new algorithm, NegBio, to detect negative and uncertain findings in radiology reports. Unlike previous rule-based methods, NegBio utilizes patterns on universal dependencies to identify the scope of triggers that are indicative of negation or uncertainty. We evaluated NegBio on four datasets, including two public benchmarking corpora of radiology reports, a new radiology corpus that we annotated for this work, and a public corpus of general clinical texts. Evaluation on these datasets demonstrates that NegBio is highly accurate for detecting negative and uncertain findings and compares favorably to a widely-used state-of-the-art system NegEx (an average of 9.5% improvement in precision and 5.1% in F1-score). https://github.com/ncbi-nlp/NegBio.

A Head and Neck Simulator for Radiology and Radiotherapy

NASA Astrophysics Data System (ADS)

Thompson, Larissa; Campos, Tarcísio P. R.

2013-06-01

Phantoms are suitable tools to simulate body tissues and organs in radiology and radiation therapy. This study presents the development of a physical head and neck phantom and its radiological response for simulating brain pathology. The following features on the phantom are addressed and compared to human data: mass density, chemical composition, anatomical shape, computerized tomography images and Hounsfield Units. Mass attenuation and kerma coefficients of the synthetic phantom and normal tissues, as well as their deviations, were also investigated. Radiological experiments were performed, including brain tumors and subarachnoid hemorrhage simulations. Computerized tomography images of such pathologies in phantom and human were obtained. The anthropometric dimensions of the phantom present anatomical conformation similar to a human head and neck. Elemental weight percentages of the equivalent tissues match the human ones. Hounsfield Unit values of the main developed structures are presented, approaching human data. Kerma and mass attenuation coefficients spectra from human and phantom are presented, demonstrating smaller deviations in the radiological X-ray spectral domain. In conclusion, the phantom presented suitable normal and pathological radiological responses relative to those observed in humans. It may improve radiological protocols and education in medical imaging.

Natural Language Processing in Radiology: A Systematic Review.

PubMed

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

2016-05-01

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

["Activity based costing" in radiology].

PubMed

Klose, K J; Böttcher, J

2002-05-01

The introduction of diagnosis related groups for reimbursement of hospital services in Germany (g-drg) demands for a reconsideration of utilization of radiological products and costs related to them. Traditional cost accounting as approach to internal, department related budgets are compared with the accounting method of activity based costing (ABC). The steps, which are necessary to implement ABC in radiology are developed. The introduction of a process-oriented cost analysis is feasible for radiology departments. ABC plays a central role in the set-up of decentralized controlling functions within this institutions. The implementation seems to be a strategic challenge for department managers to get more appropriate data for adequate enterprise decisions. The necessary steps of process analysis can be used for other purposes (Certification, digital migration) as well.

Radiologic discrepancies in children with special healthcare needs in a pediatric emergency department.

PubMed

Festekjian, Ara; Kwan, Karen Y; Chang, Todd P; Lai, Hollie; Fahit, Margil; Liberman, Danica B

2017-12-21

After-hours radiologic interpretation by nonradiology attendings or resident radiologists introduces the risk of discrepancies. Clinical outcomes following radiologic discrepancies among pediatric emergency department (ED) patients are poorly described. In particular, children with special healthcare needs (CSHCN), have more opportunities for discrepancies and potential consequences than non- CSHCN. Our objective was to determine the rates and types of radiologic discrepancies, and to compare CSHCN to non-CSHCN. From July 2014 to February 2015, all children who underwent a diagnostic imaging study at a free-standing children's ED were included. Data collected included radiologic studies - type and location - and clinical details - chief complaint and CSHCN type. Differences between preliminary reads and final pediatric radiology attending reads were defined as discrepancies, and categorized by clinical significance. Descriptive statistics, z-tests, and chi-square were used. Over 8months, 8310 visits (7462 unique patients) had radiologic studies (2620 CSHCN, 5690 non-CSHCN). A total of 198 (2.4%) radiologic discrepancies [56 (28.3%) CSHCN, 142 (71.7%) non-CSHCN] were found. Chief complaints for CSCHN were more often within the cardiac, pulmonary and neurologic systems (p<0.001 for each), whereas non-CSHCN presented with more trauma (p<0.001). The rates of discrepancies (CSHCN 2.1%, non- CSHCN 2.5%, p=0.3) and severity of clinical consequences (p=0.6) were not significantly different between CSHCN and non-CSHCN. Though the frequency and type of radiologic studies performed between CSHCN and non-CSHCN were different, we found no significant difference in the rate of radiologic discrepancies or the rate of clinically significant radiologic discrepancies. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

Focused process improvement events: sustainability of impact on process and performance in an academic radiology department.

PubMed

Rosenkrantz, Andrew B; Lawson, Kirk; Ally, Rosina; Chen, David; Donno, Frank; Rittberg, Steven; Rodriguez, Joan; Recht, Michael P

2015-01-01

To evaluate sustainability of impact of rapid, focused process improvement (PI) events on process and performance within an academic radiology department. Our department conducted PI during 2011 and 2012 in CT, MRI, ultrasound, breast imaging, and research billing. PI entailed participation by all stakeholders, facilitation by the department chair, collection of baseline data, meetings during several weeks, definition of performance metrics, creation of an improvement plan, and prompt implementation. We explore common themes among PI events regarding initial impact and durability of changes. We also assess performance in each area pre-PI, immediately post-PI, and at the time of the current study. All PI events achieved an immediate improvement in performance metrics, often entailing both examination volumes and on-time performance. IT-based solutions, process standardization, and redefinition of staff responsibilities were often central in these changes, and participants consistently expressed improved internal leadership and problem-solving ability. Major environmental changes commonly occurred after PI, including a natural disaster with equipment loss, a change in location or services offered, and new enterprise-wide electronic medical record system incorporating new billing and radiology informatics systems, requiring flexibility in the PI implementation plan. Only one PI team conducted regular post-PI follow-up meetings. Sustained improvement was frequently, but not universally, observed: in the long-term following initial PI, measures of examination volume showed continued progressive improvements, whereas measures of operational efficiency remained stable or occasionally declined. Focused PI is generally effective in achieving performance improvement, although a changing environment influences the sustainability of impact. Thus, continued process evaluation and ongoing workflow modifications are warranted. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Mobile laboratories: An innovative and efficient solution for radiological characterization of sites under or after decommissioning.

PubMed

Goudeau, V; Daniel, B; Dubot, D

2017-04-21

During the operation and the decommissioning of a nuclear site the operator must assure the protection of the workers and the environment. It must furthermore identify and classify the various wastes, while optimizing the associated costs. At all stages of the decommissioning radiological measurements are performed to determine the initial situation, to monitor the demolition and clean-up, and to verify the final situation. Radiochemical analysis is crucial for the radiological evaluation process to optimize the clean-up operations and to the respect limits defined with the authorities. Even though these types of analysis are omnipresent in activities such as the exploitation, the monitoring, and the cleaning up of nuclear plants, some nuclear sites do not have their own radiochemical analysis laboratory. Mobile facilities can overcome this lack when nuclear facilities are dismantled, when contaminated sites are cleaned-up, or in a post-accident situation. The current operations for the characterization of radiological soils of CEA nuclear facilities, lead to a large increase of radiochemical analysis. To manage this high throughput of samples in a timely manner, the CEA has developed a new mobile laboratory for the clean-up of its soils, called SMaRT (Shelter for Monitoring and nucleAR chemisTry). This laboratory is dedicated to the preparation and the radiochemical analysis (alpha, beta, and gamma) of potentially contaminated samples. In this framework, CEA and Eichrom laboratories has signed a partnership agreement to extend the analytical capacities and bring on site optimized and validated methods for different problematic. Gamma-emitting radionuclides can usually be measured in situ as little or no sample preparation is required. Alpha and beta-emitting radionuclides are a different matter. Analytical chemistry laboratory facilities are required. Mobile and transportable laboratories equipped with the necessary tools can provide all that is needed. The main advantage of a mobile laboratory is its portability; the shelter can be placed in the vicinity of nuclear facilities under decommissioning, or of contaminated sites with infrastructures unsuitable for the reception and treatment of radioactive samples. Radiological analysis can then be performed without the disadvantages of radioactive material transport. This paper describes how this solution allows a fast response and control of costs, with a high analytical capacity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Improved Identification of Noun Phrases in Clinical Radiology Reports Using a High-Performance Statistical Natural Language Parser Augmented with the UMLS Specialist Lexicon

PubMed Central

Huang, Yang; Lowe, Henry J.; Klein, Dan; Cucina, Russell J.

2005-01-01

Objective: The aim of this study was to develop and evaluate a method of extracting noun phrases with full phrase structures from a set of clinical radiology reports using natural language processing (NLP) and to investigate the effects of using the UMLS® Specialist Lexicon to improve noun phrase identification within clinical radiology documents. Design: The noun phrase identification (NPI) module is composed of a sentence boundary detector, a statistical natural language parser trained on a nonmedical domain, and a noun phrase (NP) tagger. The NPI module processed a set of 100 XML-represented clinical radiology reports in Health Level 7 (HL7)® Clinical Document Architecture (CDA)–compatible format. Computed output was compared with manual markups made by four physicians and one author for maximal (longest) NP and those made by one author for base (simple) NP, respectively. An extended lexicon of biomedical terms was created from the UMLS Specialist Lexicon and used to improve NPI performance. Results: The test set was 50 randomly selected reports. The sentence boundary detector achieved 99.0% precision and 98.6% recall. The overall maximal NPI precision and recall were 78.9% and 81.5% before using the UMLS Specialist Lexicon and 82.1% and 84.6% after. The overall base NPI precision and recall were 88.2% and 86.8% before using the UMLS Specialist Lexicon and 93.1% and 92.6% after, reducing false-positives by 31.1% and false-negatives by 34.3%. Conclusion: The sentence boundary detector performs excellently. After the adaptation using the UMLS Specialist Lexicon, the statistical parser's NPI performance on radiology reports increased to levels comparable to the parser's native performance in its newswire training domain and to that reported by other researchers in the general nonmedical domain. PMID:15684131

Intracranial imaging of uncommon diseases is more frequently reported in clinical publications than in radiology publications.

PubMed

Lehman, V T; Doolittle, D A; Hunt, C H; Eckel, L J; Black, D F; Schwartz, K M; Diehn, F E

2014-01-01

Descriptions of uncommon diseases with intracranial imaging abnormalities are often difficult to find in the radiology literature. We hypothesized that reported imaging findings of such conditions in the recent literature were more frequent in clinical compared with radiology journals. PubMed searches from December 1, 2007 to December 1, 2012 were performed for 5 uncommon CNS diseases with intracranial imaging manifestations: 1) Susac syndrome; 2) amyloid β-related angiitis; 3) Parry-Romberg syndrome/en coup de sabre; 4) transient lesion of the splenium of the corpus callosum; and 5) reversible cerebral vasoconstriction syndrome. Articles were classified as a case report, case series, or original research. Journals were categorized as radiology or clinical. The 1- and 5-year Impact Factors of the journals were recorded. Two hundred two articles were identified for the 5 diseases, including 151 (74%) case reports, 26 case series (13%), and 25 original research articles (13%); 179 (89%) were published in nonradiology journals, compared with 23 (11%) in radiology journals. There was no significant difference between the mean 1- and 5-year Impact Factors of the radiology and clinical journals. Recent reports of the selected uncommon diseases with intracranial manifestations are more frequent in clinical journals when compared with dedicated radiology publications. Most publications are case reports. Radiologists should review both radiology and clinical journals when reviewing imaging features of uncommon diseases affecting the brain. Lack of reporting on such disease in the radiology literature may have significant practice, educational, and research implications for the radiology community.

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.

Hanford Radiological Protection Support Services Annual Report for 1998

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

DE Bihl; JA MacLellan; ML Johnson

1999-05-14

During calendar year (CY) 1998, the Pacific Northwest National Laboratory (PNNL) performed its customary radiological protection support services in support of the U.S. Department of Energy (DOE) Richland Operations OffIce (RL) and the Hanford contractors. These services included: 1) external dosimetry, 2) internal dosimetry, 3) in vivo measurements, 4) radiological records, 5) instrument calibra- tion and evaluation, and 6) calibration of radiation sources traceable to the National Institute of Standards and Technology (MST). The services were provided under a number of projects as summarized here.

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

ICRP special radiation protection issues in interventional radiology, digital and cardiac imaging.

PubMed

Vano, E; Faulkner, K

2005-01-01

The International Commission on Radiological Protection (ICRP) has published two reports giving recommendations dealing with the avoidance of deterministic injuries in interventional radiology and the management of patient dose in digital radiology in 2001 and 2004, respectively. Another document, on radiation protection for cardiologists performing fluoroscopically guided procedures, will be produced during 2005. This paper highlights some of the topics of the published reports, their relevance to European legislation on medical exposures and the importance of radiation protection research in underpinning the ICRP task groups' work in to producing these documents. It is also anticipated that the results, obtained in the cardiology work package of the European research project, will be used in the new document on radiation protection for cardiologists.

Effects of Hospital Workers' Friendship Networks on Job Stress.

PubMed

Shin, Sung Yae; Lee, Sang Gyu

2016-01-01

This study attempted to identify the sources of job stress according to job position and investigate how friendship networks affect job stress. Questionnaires based on The Health Professions Stress Inventory (HPSI) developed by Wolfgang experienced by healthcare providers were collected from 420 nurses, doctors and radiological technologists in two general hospitals in Korea by a multistage cluster sampling method. Multiple regression analysis was used to examine the effects of friendship networks on job stress after controlling for other factors. The severity of job stress differed according to level of job demands (p = .006); radiologic technologists experienced the least stress (45.4), nurses experienced moderate stress (52.4), and doctors experienced the most stress (53.6). Those with long-term friendships characterized by strong connections reported lower levels of stress than did those with weak ties to friends among nurses (1.3, p < .05) and radiological technologists (11.4, p < .01). The degree of cohesion among friends had a positive impact on the level of job stress experienced by nurses (8.2, p < .001) and radiological technologists (14.6, p < .1). Doctors who participated in workplace alumni meetings scored higher than those who did not. However, those who participated in alumni meetings outside the workplace showed the opposite tendency, scoring 9.4 (p < .05) lower than those who did not. The resources from their friendship network include both information and instrumental support. As most radiological technologists were male, their instrumental support positively affected their job stress (9.2, p < .05). Life information support was the primary positive contributor to control of nurses' (4.1, p < .05), radiological technologists' (8.0, p < .05) job stress. The strength and density of such friendship networks were related to job stress. Life information support from their friendship network was the primary positive contributor to control of job stress.

Effects of Hospital Workers’ Friendship Networks on Job Stress

PubMed Central

Shin, Sung Yae; Lee, Sang Gyu

2016-01-01

Background This study attempted to identify the sources of job stress according to job position and investigate how friendship networks affect job stress. Methods Questionnaires based on The Health Professions Stress Inventory (HPSI) developed by Wolfgang experienced by healthcare providers were collected from 420 nurses, doctors and radiological technologists in two general hospitals in Korea by a multistage cluster sampling method. Multiple regression analysis was used to examine the effects of friendship networks on job stress after controlling for other factors. Results The severity of job stress differed according to level of job demands (p = .006); radiologic technologists experienced the least stress (45.4), nurses experienced moderate stress (52.4), and doctors experienced the most stress (53.6). Those with long-term friendships characterized by strong connections reported lower levels of stress than did those with weak ties to friends among nurses (1.3, p < .05) and radiological technologists (11.4, p < .01). The degree of cohesion among friends had a positive impact on the level of job stress experienced by nurses (8.2, p < .001) and radiological technologists (14.6, p < .1). Doctors who participated in workplace alumni meetings scored higher than those who did not. However, those who participated in alumni meetings outside the workplace showed the opposite tendency, scoring 9.4 (p < .05) lower than those who did not. The resources from their friendship network include both information and instrumental support. As most radiological technologists were male, their instrumental support positively affected their job stress (9.2, p < .05). Life information support was the primary positive contributor to control of nurses’ (4.1, p < .05), radiological technologists’ (8.0, p < .05) job stress. Conclusion The strength and density of such friendship networks were related to job stress. Life information support from their friendship network was the primary positive contributor to control of job stress. PMID:26900945

Volume Changes After Stereotactic LINAC Radiotherapy in Vestibular Schwannoma: Control Rate and Growth Patterns

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

Langenberg, Rick van de, E-mail: rickvandelangenberg@hotmail.com; Dohmen, Amy J.C.; Bondt, Bert J. de

2012-10-01

Purpose: The purpose of this study was to evaluate the control rate of vestibular schwannomas (VS) after treatment with linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) or radiotherapy (SRT) by using a validated volumetric measuring tool. Volume-based studies on prognosis after LINAC-based SRS or SRT for VS are reported scarcely. In addition, growth patterns and risk factors predicting treatment failure were analyzed. Materials and Methods: Retrospectively, 37 VS patients treated with LINAC based SRS or SRT were analyzed. Baseline and follow-up magnetic resonance imaging scans were analyzed with volume measurements on contrast enhanced T1-weighted magnetic resonance imaging. Absence of intervention aftermore » radiotherapy was defined as 'no additional intervention group, ' absence of radiological growth was defined as 'radiological control group. ' Significant growth was defined as a volume change of 19.7% or more, as calculated in a previous study. Results: The cumulative 4-year probability of no additional intervention was 96.4% {+-} 0.03; the 4-year radiological control probability was 85.4% {+-} 0.1). The median follow-up was 40 months. Overall, shrinkage was seen in 65%, stable VS in 22%, and growth in 13%. In 54% of all patients, transient swelling was observed. No prognostic factors were found regarding VS growth. Previous treatment and SRS were associated with transient swelling significantly. Conclusions: Good control rates are reported for LINAC based SRS or SRT in VS, in which the lower rate of radiological growth control is attributed to the use of the more sensitive volume measurements. Transient swelling after radiosurgery is a common phenomenon and should not be mistaken for treatment failure. Previous treatment and SRS were significantly associated with transient swelling.« less

On-line data collection platform for national dose surveys in diagnostic and interventional radiology.

PubMed

Vassileva, J; Simeonov, F; Avramova-Cholakova, S

2015-07-01

According to the Bulgarian regulation for radiation protection at medical exposure, the National Centre of Radiobiology and Radiation Protection (NCRRP) is responsible for performing national dose surveys in diagnostic and interventional radiology and nuclear medicine and for establishing of national diagnostic reference levels (DRLs). The next national dose survey is under preparation to be performed in the period of 2015-16, with the aim to cover conventional radiography, mammography, conventional fluoroscopy, interventional and fluoroscopy guided procedures and CT. It will be performed electronically using centralised on-line data collection platform established by the NCRRP. The aim is to increase the response rate and to improve the accuracy by reducing human errors. The concept of the on-line dose data collection platform is presented. Radiological facilities are provided with a tool to determine local typical patient doses, and the NCRRP to establish national DRLs. Future work will include automatic retrieval of dose data from hospital picture archival and communicating system. The on-line data collection platform is expected to facilitate the process of dose audit and optimisation of radiological procedures in Bulgarian hospitals. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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.

Consensus Statement of Society of Abdominal Radiology Disease-Focused Panel on Barium Esophagography in Gastroesophageal Reflux Disease.

PubMed

Levine, Marc S; Carucci, Laura R; DiSantis, David J; Einstein, David M; Hawn, Mary T; Martin-Harris, Bonnie; Katzka, David A; Morgan, Desiree E; Rubesin, Stephen E; Scholz, Francis J; Turner, Mary Ann; Wolf, Ellen L; Canon, Cheri L

2016-11-01

The Society of Abdominal Radiology established a panel to prepare a consensus statement on the role of barium esophagography in gastroesophageal reflux disease (GERD), as well as recommended techniques for performing the fluoroscopic examination and the gamut of findings associated with this condition. Because it is an inexpensive, noninvasive, and widely available study that requires no sedation, barium esophagography may be performed as the initial test for GERD or in conjunction with other tests such as endoscopy.

Multiservice Tactics, Techniques, and Procedures for Chemical, Biological, Radiological and Nuclear Contamination Avoidance

DTIC Science & Technology

2006-02-01

Radiological and Nuclear Contamination Avoidance 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) 5d. PROJECT NUMBER 5e. TASK...NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Federation of American Scientists 1717 K St., NW Suite 209 Washington...DC 20036 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING/MONITORING AGENCY NAME( S ) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM( S ) 11

Limitations Influencing Interventional Radiology in Canada: Results of a National Survey by the Canadian Interventional Radiology Association (CIRA)

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

O'Brien, Jeremy; Baerlocher, Mark Otto; Asch, Murray R.

2007-09-15

Purpose. To describe the current state and limitations to interventional radiology (IR) in Canada through a large, national survey of Canadian interventional radiologists. Methods. An anonymous online survey was offered to members of the Canadian Interventional Radiology Association (CIRA). Only staff radiologists were invited to participate. Results. Seventy-five (75) responses were received from a total of 247, giving a response rate of 30%. Respondents were split approximately equally between academic centers (47%) and community practice (53%), and the majority of interventional radiologists worked in hospitals with either 200-500 (49%) or 500-1,000 (39%) beds. Procedures listed by respondents as most commonlymore » performed in their practice included PICC line insertion (83%), angiography and stenting (65%), and percutaneous biopsy (37%). Procedures listed as not currently performed but which interventional radiologists believed would benefit their patient population included radiofrequency ablation (36%), carotid stenting (34%), and aortic stenting (21%); the majority of respondents noted that a lack of support from referring services was the main reason for not performing these procedures (56%). Impediments to increasing scope and volume of practice in Canadian IR were most commonly related to room or equipment shortage (35%), radiologist shortage (33%), and a lack of funding or administrative support (28%). Conclusion. Interventional radiology in Canada is limited by a number of factors including funding, manpower, and referral support. A concerted effort should be undertaken by individual interventional radiologists and IR organizations to increase training capacity, funding, remuneration, and public exposure to IR in order to help advance the subspecialty.« less

Bridging the Gap between Basic and Clinical Sciences: A Description of a Radiological Anatomy Course

ERIC Educational Resources Information Center

Torres, Anna; Staskiewicz, Grzegorz J.; Lisiecka, Justyna; Pietrzyk, Lukasz; Czekajlo, Michael; Arancibia, Carlos U.; Maciejewski, Ryszard; Torres, Kamil

2016-01-01

A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images…

A randomised trial of high and low pressure level settings on an adjustable ventriculoperitoneal shunt valve for idiopathic normal pressure hydrocephalus: results of the Dutch evaluation programme Strata shunt (DEPSS) trial.

PubMed

Delwel, Ernst J; de Jong, Dirk A; Dammers, Ruben; Kurt, Erkan; van den Brink, Wimar; Dirven, Clemens M F

2013-07-01

In treating idiopathic normal pressure hydrocephalus (INPH) with a shunt there is always a risk of underdrainage or overdrainage. The hypothesis is tested whether patients treated using an adjustable valve preset at the highest opening pressure leads to comparable good clinical results with less subdural effusions than in a control group with an opening pressure preset at a low pressure level. A multicentre prospective randomised trial was performed on a total of 58 patients suspected of INPH. Thirty patients were assigned to (control) group 1 and received a Strata shunt (Medtronic, Goleta, USA) with the valve preset at a performance level (PL) of 1.0, while 28 patients were assigned to group 2 and received a Strata shunt with the valve preset at PL 2.5. In this group the PL was allowed to be lowered until improvement or radiological signs of overdrainage were met. Significantly more subdural effusions were observed in the improved patients of group 1. There was no statistically significant difference in improvement between both groups overall. On the basis of this multicentre prospective randomised trial it is to be recommended to treat patients with INPH with a shunt with an adjustable valve, preset at the highest opening pressure and lowered until clinical improvement or radiological signs of overdrainage occur although slower improvement and more shunt adjustments might be the consequence.

Radiation dose from common radiological investigations and cumulative exposure in children with cystic fibrosis: an observational study from a single UK centre

PubMed Central

Ward, Rebecca; Carroll, William D; Cunningham, Paula; Ho, Sheng-Ang; Jones, Mary; Lenney, Warren; Thompson, David

2017-01-01

Objectives Cumulative radiation exposure is associated with increased risk of malignancy. This is important in cystic fibrosis (CF) as frequent imaging is required to monitor disease progression and diagnose complications. Previous estimates of cumulative radiation are outdated as the imaging was performed on older equipment likely to deliver higher radiation. Our objectives were to determine the radiation dose delivered to children during common radiological investigations using modern equipment and to identify the number of such investigations performed in a cohort of children with CF to calculate their cumulative radiation exposure. Design, setting and participants Data including age at investigation and radiation exposure measured as estimated effective dose (EED) were collected on 2827 radiological studies performed on children at one UK paediatric centre. These were combined with the details of all radiological investigations performed on 65 children with CF attending the same centre to enable calculation of each child’s cumulative radiation exposure. Results The mean EED for the common radiological investigations varied according to age. The range was 0.01–0.02 mSv for chest X-rays, 0.03–0.11 mSv for abdominal X-rays, 0.57–1.69 mSv for CT chest, 2.9–3.9 mSv for abdominal and pelvic CT, 0.20–0.21 mSv for sinus CT and 0.15–0.52 mSv for fluoroscopy-guided procedures. The mean EED was three to five times higher for helical compared with axial chest CT scans. The mean annual cumulative EED for our cohort of children with CF was 0.15 mSv/year with an estimated cumulative paediatric lifetime EED (0–18 years) of 3.5 mSv. Conclusions This study provides up-to-date estimations of the radiation exposure when using common radiological investigations. These doses and the estimates of cumulative radiation exposure in children with CF are lower than previously reported. This reflects the reduced EED associated with modern equipment and the use of age-specific scanning protocols. PMID:28827272

How visual search relates to visual diagnostic performance: a narrative systematic review of eye-tracking research in radiology.

PubMed

van der Gijp, A; Ravesloot, C J; Jarodzka, H; van der Schaaf, M F; van der Schaaf, I C; van Schaik, J P J; Ten Cate, Th J

2017-08-01

Eye tracking research has been conducted for decades to gain understanding of visual diagnosis such as in radiology. For educational purposes, it is important to identify visual search patterns that are related to high perceptual performance and to identify effective teaching strategies. This review of eye-tracking literature in the radiology domain aims to identify visual search patterns associated with high perceptual performance. Databases PubMed, EMBASE, ERIC, PsycINFO, Scopus and Web of Science were searched using 'visual perception' OR 'eye tracking' AND 'radiology' and synonyms. Two authors independently screened search results and included eye tracking studies concerning visual skills in radiology published between January 1, 1994 and July 31, 2015. Two authors independently assessed study quality with the Medical Education Research Study Quality Instrument, and extracted study data with respect to design, participant and task characteristics, and variables. A thematic analysis was conducted to extract and arrange study results, and a textual narrative synthesis was applied for data integration and interpretation. The search resulted in 22 relevant full-text articles. Thematic analysis resulted in six themes that informed the relation between visual search and level of expertise: (1) time on task, (2) eye movement characteristics of experts, (3) differences in visual attention, (4) visual search patterns, (5) search patterns in cross sectional stack imaging, and (6) teaching visual search strategies. Expert search was found to be characterized by a global-focal search pattern, which represents an initial global impression, followed by a detailed, focal search-to-find mode. Specific task-related search patterns, like drilling through CT scans and systematic search in chest X-rays, were found to be related to high expert levels. One study investigated teaching of visual search strategies, and did not find a significant effect on perceptual performance. Eye tracking literature in radiology indicates several search patterns are related to high levels of expertise, but teaching novices to search as an expert may not be effective. Experimental research is needed to find out which search strategies can improve image perception in learners.

Spanish Radiology in the second half of the XX Century: a view from inside.

PubMed

Bonmatí, José

2008-09-01

Radiology was born in 1896 with the immediate recognition of the diagnostic value of X-rays in medicine and progressed throughout the XX Century with the increasing knowledge of its properties and clinical applications. By mid-century Radiology was a respected clinical specialty in advanced countries, the radiological report was a requirement in hospital practice and radiologists' opinions requested in scientific meetings. In the last decades of the century has had a spectacular expansion with the emergence of new imaging modalities and revolutionary technologies that have transformed the specialty worldwide. In Spain Radiology lagged behind needs and demand in 1950. Radiological practice was unregulated and performance of X-ray exams by non-radiologists was common. Teaching of Radiology was non-existent in Medical Schools or postgraduation. The diagnostic value of the specialty was unrecognized by physicians and the role of radiologists ignored. Most hospital radiology services were poorly equipped and functionally inadequate. The shadow of the Civil War (1936-39) was conditioning Radiology in the country. The point of inflexion in the development of Radiology in Spain was the inclusion of film reading sessions in the 1965 academic program of the Society of Radiology. It was in the presentation of cases at these conferences that Clinical Radiology found the finest demonstration ground and as a result was immediately adopted by radiologists and progressively applied in scientific meetings, clinical practices and training programs. Its influence was important in reforming hospital practice, legislation on specialization and education, as well as in national health care plans. At the end of the century radiology in Spain was at a par with the standards of other western nations. The author was a witness of the evolution of Radiology during his 50 years of professional life. This article does not pretend to be exhaustive in names or contributions. It is an overview of the period from the perspective of his past experience and seen from the distance of events that influenced the course of developments. I hope that those interested in the subject find that the effort has been worthwhile and helpful.

Occupational dose in interventional radiology procedures.

PubMed

Chida, Koichi; Kaga, Yuji; Haga, Yoshihiro; Kataoka, Nozomi; Kumasaka, Eriko; Meguro, Taiichiro; Zuguchi, Masayuki

2013-01-01

Interventional radiology tends to involve long procedures (i.e., long fluoroscopic times). Therefore, radiation protection for interventional radiology staff is an important issue. This study describes the occupational radiation dose for interventional radiology staff, especially nurses, to clarify the present annual dose level for interventional radiology nurses. We compared the annual occupational dose (effective dose and dose equivalent) among interventional radiology staff in a hospital where 6606 catheterization procedures are performed annually. The annual occupational doses of 18 physicians, seven nurses, and eight radiologic technologists were recorded using two monitoring badges, one worn over and one under their lead aprons. The annual mean ± SD effective dose (range) to the physicians, nurses, and radiologic technologists using two badges was 3.00 ± 1.50 (0.84-6.17), 1.34 ± 0.55 (0.70-2.20), and 0.60 ± 0.48 (0.02-1.43) mSv/y, respectively. Similarly, the annual mean ± SD dose equivalent range was 19.84 ± 12.45 (7.0-48.5), 4.73 ± 0.72 (3.9-6.2), and 1.30 ± 1.00 (0.2-2.7) mSv/y, respectively. The mean ± SD effective dose for the physicians was 1.02 ± 0.74 and 3.00 ± 1.50 mSv/y for the one- and two-badge methods, respectively (p < 0.001). Similarly, the mean ± SD effective dose for the nurses (p = 0.186) and radiologic technologists (p = 0.726) tended to be lower using the one-badge method. The annual occupational dose for interventional radiology staff was in the order physicians > nurses > radiologic technologists. The occupational dose determined using one badge under the apron was far lower than the dose obtained with two badges in both physicians and nonphysicians. To evaluate the occupational dose correctly, we recommend use of two monitoring badges to evaluate interventional radiology nurses as well as physicians.

(Lack of) Measurable Clinical or Knowledge Gains From Resident Participation in Noon Conference.

PubMed

Meyer, Nathaniel B; Gaetke-Udager, Kara; Shampain, Kimberly L; Spencer, Amy; Cohan, Richard H; Davenport, Matthew S

2018-06-01

The objective of this study was to determine whether noon conference attendance by diagnostic radiology residents is predictive of measurable performance. This single-center retrospective Health Insurance and Portability and Accountability Act (HIPAA)-compliant cross-sectional study was considered "not regulated" by the institutional review board. All diagnostic radiology residents who began residency training from 2008 to 2012 were included (N = 54). Metrics of clinical performance and knowledge were collected, including junior and senior precall test results, American Board of Radiology scores (z-score transformed), American College of Radiology in-training scores (years 1-3), on-call "great call" and minor and major discrepancy rates, on-call and daytime case volumes, and training rotation scores. Multivariate regression models were constructed to determine if conference attendance, match rank order, or starting year could predict these outcomes. Pearson bivariate correlations were calculated. Senior precall test results were moderately correlated with American Board of Radiology (r = 0.41) and American College of Radiology (r = 0.38-0.48) test results and mean rotation scores (r = 0.41), indicating moderate internal validity. However, conference attendance, match rank order, and year of training did not correlate with (r = -0.16-0.16) or predict (P > .05) measurable resident knowledge. On multivariate analysis, neither match rank order (P = .14-.96) nor conference attendance (P = .10-.88) predicted measurable clinical efficiency or accuracy. Year started training predicted greater cross-sectional case volume (P < .0001, β = 0.361-0.516) and less faculty-to-resident feedback (P < 0.0001, β = [-0.628]-[-0.733]). Residents with lower conference attendance are indistinguishable from those who attend more frequently in a wide range of clinical and knowledge-based performance assessments, suggesting that required attendance may not be necessary to gain certain measurable core competencies. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2009-05-01

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

Investigation of injury/illness data at a nuclear facility. Part II

DOE PAGES

Cournoyer, Michael E.; Garcia, Vincent E.; Sandoval, Arnold N.; ...

2015-07-01

At Los Alamos National Laboratory (LANL), there are several nuclear facilities, accelerator facilities, radiological facilities, explosives sites, moderate- and high-hazard non-nuclear facilities, biosciences laboratory, etc. The Plutonium Science and Manufacturing Directorate (ADPSM) provides special nuclear material research, process development, technology demonstration, and manufacturing capabilities. ADPSM manages the LANL Plutonium Facility. Within the Radiological Control Area at TA-55 (PF-4), chemical and metallurgical operations with plutonium and other hazardous materials are performed. LANL Health and Safety Programs investigate injury and illness data. In this study, statistically significant trends have been identified and compared for LANL, ADPSM, and PF-4 injury/illness cases. A previouslymore » described output metric is used to measures LANL management progress towards meeting its operational safety objectives and goals. Timelines are used to determine trends in Injury/Illness types. Pareto Charts are used to prioritize causal factors. The data generated from analysis of Injury/Illness data have helped identify and reduce the number of corresponding causal factors.« less

A real-time haptic interface for interventional radiology procedures.

PubMed

Moix, Thomas; Ilic, Dejan; Fracheboud, Blaise; Zoethout, Jurjen; Bleuler, Hannes

2005-01-01

Interventional Radiology (IR) is a minimally-invasive surgery technique (MIS) where guidewires and catheters are steered in the vascular system under X-ray imaging. In order to perform these procedures, a radiologist has to be correctly trained to master hand-eye coordination, instrument manipulation and procedure protocols. This paper proposes a computer-assisted training environment dedicated to IR. The system is composed of a virtual reality (VR) simulation of the anatomy of the patient linked to a robotic interface providing haptic force feedback.The paper focuses on the requirements, design and prototyping of a specific part of the haptic interface dedicated to catheters. Translational tracking and force feedback on the catheter is provided by two cylinders forming a friction drive arrangement. The whole friction can be set in rotation with an additional motor providing torque feedback. A force and a torque sensor are integrated in the cylinders for direct measurement on the catheter enabling disturbance cancellation with a close-loop force control strategy.

The role of interventional radiology in the treatment of intrahepatic cholangiocarcinoma.

PubMed

Ierardi, Anna Maria; Angileri, Salvatore Alessio; Patella, Francesca; Panella, Silvia; Lucchina, Natalie; Petre, Elena N; Pinto, Antonio; Franceschelli, Giuseppe; Carrafiello, Gianpaolo; Cornalba, Gianpaolo; Sofocleous, Constantinos T

2017-01-01

Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy after hepatocellular carcinoma. Complete surgical resection remains the only potentially curative option for patients with ICC. However, until now, early diagnosis with potential surgical intervention has been the exception rather than the rule with only 30% of patients qualifying for attempted surgical cure. Many patients are unresectable because of disease stage, anatomic conditions, medical comorbidities, and small future remnant liver. Interventional radiology procedures are available for these types of patients with intra-arterial therapies and/or ablative treatments both for curative and for palliative treatment. The goals of interventional therapy are to control local tumor growth, to relieve symptoms, and to improve and preserve quality of life. The choice of treatment depends largely on tumor extent and patient performance. No randomized studies exist to compare treatments. The present review describes the current evidence of the interventional treatments in the management of the ICC. Moreover, interventional procedures available to increase the future liver reserve before surgery were analyzed.

2008 Mississippi Curriculum Framework: Postsecondary Radiologic Technology. (Program CIP: 51.0911 - Radiologic Technology/Science - Radiographer)

ERIC Educational Resources Information Center

Armstrong, David; Cochran, Timothy; Compton, Steve; Davis, Jennifer; Edgerton, Seena Shazowee; Kisner, Christie; Lewis, Judy; Sartin, Billie Faye; Shell, Deborah

2008-01-01

As the world economy continues to evolve, businesses and industries must adopt new practices and processes in order to survive. Quality and cost control, work teams and participatory management, and an infusion of technology are transforming the way people work and do business. Employees are now expected to read, write, and communicate…

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.

Assessing the value of diagnostic imaging: the role of perception

NASA Astrophysics Data System (ADS)

Potchen, E. J.; Cooper, Thomas G.

2000-04-01

The value of diagnostic radiology rests in its ability to provide information. Information is defined as a reduction in randomness. Quality improvement in any system requires diminution in the variation in its performance. The major variation in performance of the system of diagnostic radiology occurs in observer performance and in the communication of information from the observer to someone who will apply that information to the benefit of the patient. The ability to provide information can be determined by observer performance studies using a receiver-operating characteristic (ROC) curve analysis. The amount of information provided by each observer can be measured in terms of the uncertainty they reduce. Using a set of standardized radiographs, some normal and some abnormal, sorting them randomly, and then asking an observer to redistribute them according to their probability of normality can measure the difference in the value added by different observers. By applying this observer performance measure, we have been able to characterize individual radiologists, groups of radiologists, and regions of the United States in their ability to add value in chest radiology. The use of these technologies in health care may improve upon the contribution of diagnostic imaging.

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

Bibliometric Analysis of Manuscript Characteristics That Influence Citations: A Comparison of Six Major Radiology Journals.

PubMed

Shekhani, Haris Naseem; Shariff, Shoaib; Bhulani, Nizar; Khosa, Faisal; Hanna, Tarek Noel

2017-12-01

The objective of our study was to investigate radiology manuscript characteristics that influence citation rate, capturing features of manuscript construction that are discrete from study design. Consecutive articles published from January 2004 to June 2004 were collected from the six major radiology journals with the highest impact factors: Radiology (impact factor, 5.076), Investigative Radiology (2.320), American Journal of Neuroradiology (AJNR) (2.384), RadioGraphics (2.494), European Radiology (2.364), and American Journal of Roentgenology (2.406). The citation count for these articles was retrieved from the Web of Science, and 29 article characteristics were tabulated manually. A point-biserial correlation, Spearman rank-order correlation, and multiple regression model were performed to predict citation number from the collected variables. A total of 703 articles-211 published in Radiology, 48 in Investigative Radiology, 106 in AJNR, 52 in RadioGraphics, 129 in European Radiology, and 157 in AJR-were evaluated. Punctuation was included in the title in 55% of the articles and had the highest statistically significant positive correlation to citation rate (point-biserial correlation coefficient [r pb ] = 0.85, p < 0.05). Open access status provided a low-magnitude, but significant, correlation to citation rate (r pb = 0.140, p < 0.001). The following variables created a significant multiple regression model to predict citation count (p < 0.005, R 2 = 0.186): study findings in the title, abstract word count, abstract character count, total number of words, country of origin, and all authors in the field of radiology. Using bibliometric knowledge, authors can craft a title, abstract, and text that may enhance visibility and citation count over what they would otherwise experience.

Value management program: performance, quantification, and presentation of imaging value-added actions.

PubMed

Patel, Samir

2015-03-01

Health care is in a state of transition, shifting from volume-based success to value-based success. Hospital executives and referring physicians often do not understand the total value a radiology group provides. A template for easy, cost-effective implementation in clinical practice for most radiology groups to demonstrate the value they provide to their clients (patients, physicians, health care executives) has not been well described. A value management program was developed to document all of the value-added activities performed by on-site radiologists, quantify them in terms of time spent on each activity (investment), and present the benefits to internal and external stakeholders (outcomes). The radiology value-added matrix is the platform from which value-added activities are categorized and synthesized into a template for defining investments and outcomes. The value management program was first implemented systemwide in 2013. Across all serviced locations, 9,931.75 hours were invested. An annual executive summary report template demonstrating outcomes is given to clients. The mean and median individual value-added hours per radiologist were 134.52 and 113.33, respectively. If this program were extrapolated to the entire field of radiology, approximately 30,000 radiologists, this would have resulted in 10,641,161 uncompensated value-added hours documented in 2013, with an estimated economic value of $2.21 billion. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

PubMed Central

Körner, Markus; Bernstein, Mark P; Sodickson, Aaron D; Beenen, Ludo F; McLaughlin, Patrick D; Kool, Digna R; Bilow, Ronald M

2016-01-01

In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior training drills. Over the recent decades, imaging has increasingly been used to evaluate critically ill patients. It can also be used to increase the accuracy of triaging MCI victims, since overtriage (falsely higher triage category) and undertriage (falsely lower triage category) can severely impact resource availability and mortality rates, respectively. This article emphasizes the importance of including the radiology department in hospital preparations for a MCI and highlights factors expected to influence performance during hospital DMP activation including issues pertinent to effective simulation, such as establishing proper learning objectives. After-action reviews including performance evaluation and debriefing on issues are invaluable following simulation drills and DMP activation, in order to improve subsequent preparedness. Historically, most hospital DMPs have not adequately included radiology department operations, and they have not or to a little extent been integrated in the DMP activation simulation. This article aims to increase awareness of the need for radiology department engagement in order to increase radiology department preparedness for DMP activation after a MCI occurs. PMID:26781837

Strategic planning and radiology practice management in the new health care environment.

PubMed

Sharpe, Richard E; Mehta, Tejas S; Eisenberg, Ronald L; Kruskal, Jonathan B

2015-01-01

Current comprehensive health care reform in the United States demands that policy makers, insurers, providers, and patients work in reshaping the health care system to deliver care that is both more affordable and of higher quality. A tectonic shift is under way that runs contrary to the traditional goal of radiology groups to perform and interpret large numbers of imaging examinations. In fact, radiology service requisitions now must be evaluated for their appropriateness, possibly resulting in a reduction in the number of imaging studies performed. To be successful, radiology groups will have to restructure their business practices and strategies to align with the emerging health care paradigm. This article outlines a four-stage strategic framework that has aided corporations in achieving their goals and that can be readily adapted and applied by radiologists. The four stages are (a) definition and articulation of a purpose, (b) clear definition of strategic goals, (c) prioritization of specific strategic enablers, and (d) implementation of processes for tracking progress and enabling continuous adaptation. The authors provide practical guidance for applying specific tools such as analyses of strengths, weaknesses, opportunities, and threats (so-called SWOT analyses), prioritization matrices, and balanced scorecards to accomplish each stage. By adopting and applying these tools within the strategic framework outlined, radiology groups can position themselves to succeed in the evolving health care environment. RSNA, 2015

Organizational decentralization in radiology.

PubMed

Aas, I H Monrad

2006-01-01

At present, most hospitals have a department of radiology where images are captured and interpreted. Decentralization is the opposite of centralization and means 'away from the centre'. With a Picture Archiving and Communication System (PACS) and broadband communications, transmitting radiology images between sites will be far easier than before. Qualitative interviews of 26 resource persons were performed in Norway. There was a response rate of 90%. Decentralization of radiology interpretations seems less relevant than centralization, but several forms of decentralization have a role to play. The respondents mentioned several advantages, including exploitation of capacity and competence. They also mentioned several disadvantages, including splitting professional communities and reduced contact between radiologists and clinicians. With the new technology decentralization and centralization of image interpretation are important possibilities in organizational change. This will be important for the future of teleradiology.

Compression ultrasonography of the lower extremity with portable vascular ultrasonography can accurately detect deep venous thrombosis in the emergency department.

PubMed

Crisp, Jonathan G; Lovato, Luis M; Jang, Timothy B

2010-12-01

Compression ultrasonography of the lower extremity is an established method of detecting proximal lower extremity deep venous thrombosis when performed by a certified operator in a vascular laboratory. Our objective is to determine the sensitivity and specificity of bedside 2-point compression ultrasonography performed in the emergency department (ED) with portable vascular ultrasonography for the detection of proximal lower extremity deep venous thrombosis. We did this by directly comparing emergency physician-performed ultrasonography to lower extremity duplex ultrasonography performed by the Department of Radiology. This was a prospective, cross-sectional study and diagnostic test assessment of a convenience sample of ED patients with a suspected lower extremity deep venous thrombosis, conducted at a single-center, urban, academic ED. All physicians had a 10-minute training session before enrolling patients. ED compression ultrasonography occurred before Department of Radiology ultrasonography and involved identification of 2 specific points: the common femoral and popliteal vessels, with subsequent compression of the common femoral and popliteal veins. The study result was considered positive for proximal lower extremity deep venous thrombosis if either vein was incompressible or a thrombus was visualized. Sensitivity and specificity were calculated with the final radiologist interpretation of the Department of Radiology ultrasonography as the criterion standard. A total of 47 physicians performed 199 2-point compression ultrasonographic examinations in the ED. Median number of examinations per physician was 2 (range 1 to 29 examinations; interquartile range 1 to 5 examinations). There were 45 proximal lower extremity deep venous thromboses observed on Department of Radiology evaluation, all correctly identified by ED 2-point compression ultrasonography. The 153 patients without proximal lower extremity deep venous thrombosis all had a negative ED compression ultrasonographic result. One patient with a negative Department of Radiology ultrasonographic result was found to have decreased compression of the popliteal vein on ED compression ultrasonography, giving a single false-positive result, yet repeated ultrasonography by the Department of Radiology 1 week later showed a popliteal deep venous thrombosis. The sensitivity and specificity of ED 2-point compression ultrasonography for deep venous thrombosis were 100% (95% confidence interval 92% to 100%) and 99% (95% confidence interval 96% to 100%), respectively. Emergency physician-performed 2-point compression ultrasonography of the lower extremity with a portable vascular ultrasonographic machine, conducted in the ED by this physician group and in this patient sample, accurately identified the presence and absence of proximal lower extremity deep venous thrombosis. Copyright © 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

[Quality assurance in diagnostic radiology using an automated system. Experience and results].

PubMed

Princivalli, M; Stea, L; Ordóñez, P L; Bussoli, L; Marchetti, C

1995-05-01

The authors report their personal experience with the use of an integrated quality control system in the radiology department. The system we used was the RTI DIGI-X Plus, a Swedish-made product, allowing a wide range of parameters to be measured on diagnostic X-ray units for general radiography, mammography and fluoroscopy. Data can be retrieved with a minimum number of measurements. The "oRTIgo" software improves the quality assurance system and ensures document compliance with international recommendations. The equipment consists of a detector unit, a processor and a display unit. The detector consists of a rotating holder with 12 combinations of metal filters of various thickness mounted in front of two photo-diodes covered with identical X-ray intensifying gadoliniumoxysulfide screens. This unit is connected to a data acquisition system controlled by a microcomputer. Peak tube voltage and total tube filtration are derived from the ratio of detector signals. The relationship between this ratio and the measured quantity is determined by a calibration procedure. Furthermore, exposure time "mAs" value, "mAs" linearity and exposure (or kerma in air) can be measured. Digital storage can be performed and input signals displayed. A serial interface is used to communicate with a PC for QC management purposes. An error propagation model is used to determine the inaccuracy of peak tube voltage measurements. With the DIGI-X Plus system, measurements can be carried out in a shorter time and the stored data reprocessed later on. After QA testing on 20 X-ray units in the radiology department, in vivo doses were measured using a TLD Harshaw 100 on 46 randomly selected patients undergoing chest examinations. The results are reported and analyzed following the NRPB protocol and show high agreement with the recommended values.

Incorporating Radiology into Medical Gross Anatomy: Does the Use of Cadaver CT Scans Improve Students' Academic Performance in Anatomy?

ERIC Educational Resources Information Center

Lufler, Rebecca S.; Zumwalt, Ann C.; Romney, Carla A.; Hoagland, Todd M.

2010-01-01

Radiological images show anatomical structures in multiple planes and may be effective for teaching anatomical spatial relationships, something that students often find difficult to master. This study tests the hypotheses that (1) the use of cadaveric computed tomography (CT) scans in the anatomy laboratory is positively associated with…

Occupational Analysis: Hospital Radiologic Technologist. The UCLA Allied Health Professions Project.

ERIC Educational Resources Information Center

Reeder, Glenn D.; And Others

In an effort to meet the growing demand for skilled radiologic technologists and other supportive personnel educated through the associate degree level, a national survey was conducted as part of the UCLA Allied Health Professions Project to determine the tasks performed by personnel in the field and lay the groundwork for development of…

Metal levels in corrosion of spinal implants

PubMed Central

Beguiristain, Jose; Duart, Julio

2007-01-01

Corrosion affects spinal instrumentations and may cause local and systemic complications. Diagnosis of corrosion is difficult, and nowadays it is performed almost exclusively by the examination of retrieved instrumentations. We conducted this study to determine whether it is possible to detect corrosion by measuring metal levels on patients with posterior instrumented spinal fusion. Eleven asymptomatic patients, with radiological signs of corrosion of their stainless steel spinal instrumentations, were studied by performing determinations of nickel and chromium in serum and urine. Those levels were compared with the levels of 22 patients with the same kind of instrumentation but without evidence of corrosion and to a control group of 22 volunteers without any metallic implants. Statistical analysis of our results revealed that the patients with spinal implants without radiological signs of corrosion have increased levels of chromium in serum and urine (P < 0.001) compared to volunteers without implants. Corrosion significantly raised metal levels, including nickel and chromium in serum and urine when compared to patients with no radiological signs of corrosion and to volunteers without metallic implants (P < 0.001). Metal levels measured in serum have high sensibility and specificity (area under the ROC curve of 0.981). By combining the levels of nickel and chromium in serum we were able to identify all the cases of corrosion in our series of patients. The results of our study confirm that metal levels in serum and urine are useful in the diagnosis of corrosion of spinal implants and may be helpful in defining the role of corrosion in recently described clinical entities such as late operative site pain or late infection of spinal implants. PMID:17256156

Unsatisfactory clinical outcomes of second-generation mobile bearing floating platform total knee arthroplasty: comparing outcomes with fixed bearing after five years minimum.

PubMed

Yoon, Jung-Ro; Yang, Jae-Hyuk

2018-03-20

The purpose of this retrospective study was to analyze and compare the clinical and radiologic outcomes of fixed bearing ultracongruent (UC) insert total knee arthroplasty (TKA) and mobile bearing (MB) floating platform TKA using the navigation-assisted gap balancing technique with a minimum follow-up of five years. The study retrospectively enrolled 105 patients who received the UC type fixed bearing insert (group 1) and 95 patients who received the floating platform MB insert (group 2) during the period from August 2009 to June 2012. All surgery was performed using the navigation-assisted gap balancing technique. For strict assessment of gap measurements, the offset-type-force-controlled-spreader-system was used. Radiologic and clinical outcomes were assessed before operation and at the most recent follow-up using the Knee Society Score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. For statistical analysis, paired sample t tests were used. A p value less than 0.05 was considered significant. Although the radiologic alignments were satisfactory for both groups (99/105 [94%] cases were neutral for group 1 and 90/95 [94%] for group 2), the functional and total WOMAC scores were inferior in group 2 (p < 0.05). There were two cases of insert breakage in group 2 that required bearing exchange. The Kaplan-Meier survivorship rates for groups 1 and 2 at 77 months were 100.0 and 97.9%, respectively. Second-generation MB floating platform TKA cases did not have satisfactory outcomes. There were two cases of insert breakage, which required bearing exchange. Other patients who underwent surgery with second-generation MB floating platform were encouraged to avoid high knee flexion activities, resulting in lower clinical performance.

Effects of outsourcing magnetic resonance examinations from a public university hospital to a private agent.

PubMed

Tavakol, Parvin; Labruto, Fausto; Bergstrand, Lott; Blomqvist, Lennart

2011-02-01

Sometimes the measures taken to make a radiology department more effective, such as prioritizing the workload and keeping equipment running for as many hours as staffing permits, are not enough. In such cases, outsourcing radiological examinations is a potential solution for reducing waiting times. To investigate differences in waiting time, quality and costs between magnetic resonance (MR) examinations performed in a university hospital and examinations outsourced to private service. We retrospectively selected a group of consecutive, outsourced MR examinations (n=97) and a control group of in-house MR examinations, matched for type of examination. In each group there were referrals that had a specified preferred timeframe for completion. We measured the percentage of cases in which this timeframe was met and if it was not met, how many days exceeded the preferred time. In referrals without a specified preferred timeframe, we also calculated the waiting time. Quality standards were measured by the percentage of examinations that had to be re-done and re-assessed. Finally, we calculated the cumulative costs, taking into account the costs for re-doing and re-assessing examinations. There was no statistically significant difference between the groups, in either the number of examinations that were not performed within the preferred time or the number of days that exceeded the preferred timeframe. For referrals without a preferred timeframe, the waiting time was shorter for outsourced examinations than those not outsourced. There were no differences in the number of examinations that had to be re-done, but more examinations needed to be re-assessed in the outsourced group than in the in-house group. The calculated costs for outsourced examinations were lower than the costs for internally performed examinations. Outsourcing magnetic resonance examinations may be an effective way of reducing a radiology department's workload. Ways in which to reduce the additional costs incurred for re-assessment of outsourced examinations must be investigated further.

[New international networks in radiology graduate and continuing education: www.eurorad.org--a EAR Project for online publication of radiological data].

PubMed

Vorwerk, D

2002-02-01

Eurorad (www.eurorad.org) is a joint project of EAR and has support of 27 national and 8 subspeciality radiology societies. Eurorad is the first noncommercial radiological publication that is exclusively based on the internet as a communication line with all steps of submission, reviewing and publication being performed online. Eurorad wants to build up a huge and exhaustive case file of diagnostic and interventional radiology. Like all scientific publications, Eurorad bases on an editor in chief and 13 section editors who are responsible for organizing each section of Eurorad. Each section has a number of peer reviewer with an overall total of more than 100. For submission and publication, all cases are structured in the same manner with case report, method and discussion. For the time being, Eurorad hosts 779 cases, of whom 346 are free available on the net. The actual rejection rate is 4.5%, other cases are under review.

Clinical and radiological factors related to the presence of motor deficit in lumbar disc prolapse: a prospective analysis of 70 consecutive cases with neurological deficit.

PubMed

Krishnan, Vibhu; Rajasekaran, Shanmuganathan; Aiyer, Siddharth N; Kanna, Rishi; Shetty, Ajoy Prasad

2017-10-01

To analyse the clinic-radiological factors associated with neurological deficit following lumbar disc herniation. A prospective, cross-sectional study was performed in 140 cases of micro-discectomy following lumbar disc herniation. Group 1 included 70 consecutive patients with motor deficit and group 2 (controls) included 70 patients with intact neurology. Motor deficit was defined as the occurrence of motor power ≤3/5 in L2-S1 myotomes. Multiple clinical and radiological parameters were studied between the two groups. Patients with diabetes (p 0.004), acute onset of symptoms (p 0.036), L3-4 discs (p 0.001), sequestrated discs (p 0.004), superiorly migrated discs (p 0.012) and central discs (p 0.004), greater antero-posterior disc dimension (p 0.023), primary canal stenosis (p 0.0001); and greater canal compromise (p 0.002) had a significant correlation with the development of neurological deficit. The presence of four or more of these risk factors showed a higher chance of the presence of motor deficit (sensitivity of 74%, specificity of 77%). Age, sex, previous precipitating events, severity of pain, smoking, and number of herniations levels did not affect the occurrence of deficit (p > 0.05 for all). Patients with or without bladder symptoms were similar with respect to all clinico-radiological parameters. However, the time delay since the occurrence of deficit was significantly shorter in patients with bladder involvement (p 0.001). Patients with diabetes, acute presentation, central, sequestrated and superiorly migrated discs, high lumbar disc prolapse, and greater spinal canal compromise are predisposed to the presence of motor deficit.

Zero-Profile Spacer Versus Cage-Plate Construct in Anterior Cervical Diskectomy and Fusion for Multilevel Cervical Spondylotic Myelopathy: Systematic Review and Meta-Analysis.

PubMed

Tong, Min-Ji; Xiang, Guang-Heng; He, Zi-Li; Chen, De-Heng; Tang, Qian; Xu, Hua-Zi; Tian, Nai-Feng

2017-08-01

Anterior cervical diskectomy and fusion with plate-screw construct has been gradually applied for multilevel cervical spondylotic myelopathy in recent years. However, long cervical plate was associated with complications including breakage or loosening of plate and screws, trachea-esophageal injury, neurovascular injury, and postoperative dysphagia. To reduce these complications, the zero-profile spacer has been introduced. This meta-analysis was performed to compare the clinical and radiologic outcomes of zero-profile spacer versus cage-plate construct for the treatment of multilevel cervical spondylotic myelopathy. We systematically searched MEDLINE, Springer, and Web of Science databases for relevant studies that compared the clinical and radiologic outcomes of zero-profile spacer versus cage and plate for multilevel cervical spondylotic myelopathy. Risk of bias in included studies was assessed. Pooled estimates and corresponding 95% confidence intervals were calculated. On the basis of predefined inclusion criteria, 7 studies with a total of 409 patients were included in this analysis. The pooled data revealed that zero-profile spacer was associated with a decreased dysphagia rate at 2, 3, and 6 months postoperatively when compared with the cage-plate group. Both techniques had similar perioperative outcomes, functional outcome, radiologic outcome, and dysphagia rate immediately and at >1-year after operation. On the basis of available evidence, zero-profile spacer was more effective in reducing postoperative dysphagia rate for multilevel cervical spondylotic myelopathy. Both devices were safe in anterior cervical surgeries, and they had similar efficacy in improving the functional and radiologic outcomes. More randomized controlled trials are needed to compare these 2 devices. Copyright © 2017 Elsevier Inc. All rights reserved.

SNIFFER: An aerial platform for the plume phase of a nuclear emergency

NASA Astrophysics Data System (ADS)

Castelluccio, D. M.; Cisbani, E.; Frullani, S.

2012-04-01

When a nuclear or radiological accident results in a release of a radioactive plume, AGS (Aerial Gamma Spectrometry) systems used in many countries, equipped with passive detectors, can help in giving quantitative assessment on the radiological situation (land surface contamination level) only when the air contamination due to the passage of the travelling plume has become negligible. To overcome this limitation, the Italian Institute of Health has developed and implemented a multi purpose air sampling system based on a fixed wing aircraft, for time-effective, large areas radiological surveillance (to face radiological emergency and to support homeland security). A fixed wing aircraft (Sky Arrow 650) with the front part of the fuselage properly adapted to house the detection equipment has been equipped with a compact air sampling line where the isokinetic sampling is dynamically maintained. Aerosol is collected on a Teflon® filter positioned along the line and hosted on a rotating 4-filters disk. A complex of detectors allows radionuclide identification in the collected aerosol samples. A correlated analysis of these two detectors data allows a quantitative measurement of air as well as ground surface concentration of gamma emitting radioisotopes. Environmental sensors and a GPS receiver support the characterization of the sampling conditions and the temporal and geolocation of the acquired data. Acquisition and control system based on compact electronics and real time software that operate the sampling line actuators, guarantee the dynamical isokinetic condition, and acquire the detectors and sensor data. The system is also equipped with other sampling lines to provide information on the concentration of other chemical pollutants. Operative flights have been carried out in the last years, and performances and results are presented.

Estimation of the herd protection of Haemophilus influenzae type b conjugate vaccine against radiologically confirmed pneumonia in children under 2 years old in Dhaka, Bangladesh.

PubMed

Chen, Wei-Ju; Moulton, Lawrence H; Saha, Samir K; Mahmud, Abdullah Al; Arifeen, Shams El; Baqui, Abdullah H

2014-02-12

Herd protection of Haemophilus influenzae type b (Hib) conjugate vaccine has been associated with excessive decrease of invasive Hib diseases, i.e., pneumonia and meningitis, with increased national or regional Hib vaccine coverage. Only a few studies have examined herd protection at the individual level and even less evidence is available from Asia. We examined Hib vaccine herd protection against radiologically confirmed pneumonia among children less than 2 years old. We incorporated data from a matched case-control study and a vaccine coverage survey in Dhaka, Bangladesh. Pneumonia cases (n=343) were confirmed by radiology. For each case, two controls with conditions other than pneumonia or meningitis were selected from the same hospital. Hib vaccine coverage was calculated as percentages of children who received at least 2 doses of Hib vaccine from a survey in the neighborhood centered on each case and control. Conditional logistic regression was fit to examine the association between vaccine coverage and risk of radiologically confirmed pneumonia. Neighborhood Hib vaccine coverage varied from 0% to 63.5% for cases and from 8.7% to 61.5% for controls, respectively. Cases were less likely to have neighborhood coverage higher than 20% (OR=0.49, 0.52, 0.55, and 0.69 for coverage 20-29%, 30-39%, 40-49%, and ≥50%, respectively) than coverage <20%, compared to controls, although the estimates for coverage 40-49% and ≥50% were not statistically significant. The study indicates that Hib vaccine may provide herd protection, even when the coverage is as low as 20-39%, in a low-income country. Asian countries should consider herd protection in implementing effective vaccine policy with limited resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

Music during interventional radiological procedures, effect on sedation, pain and anxiety: a randomised controlled trial

PubMed Central

Kulkarni, S; Johnson, P C D; Kettles, S; Kasthuri, R S

2012-01-01

Objective : To assess the effects of playing patient-selected music during interventional procedures on (1) the doses of sedation and analgesia and (2) anxiety levels. Methods : Patients undergoing interventional radiological procedures were randomised to either the intervention (music) or the control (no music) group. Patients in the intervention group had music of their choice played via headphones during the procedure. The primary outcomes were reductions in the doses of drugs for sedation (midazolam) and analgesia (fentanyl). Anxiety levels were assessed both before and after the procedure using the validated State Anxiety Inventory. Mean pulse rate and average of mean blood pressures were also recorded before and during the procedures as surrogate indicators of anxiety levels. Results : 100 patients were randomised in a 1:1 ratio. There were 58 males and 42 females, with a mean age of 58 years. Sedation was required in 21 (42%) patients in the music group compared with 30 (60%) patients in the control group (p=0.046). The mean [standard deviation (SD)] midazolam dose was 2.1 mg (2.3 mg) in the control group and 1.3 mg (2.2 mg) in the music group (p=0.027). The mean (SD) fentanyl dose was 29 mg (40 mg) in the control group and 18 mg (34 mg) in the music group (p=0.055). There was no significant effect of music on the change from baseline in anxiety levels (p=0.74), pulse rate (p=0.56) or blood pressure (p=0.34). Conclusion : Sedation requirements are significantly reduced by playing self-selected music to the patient during interventional radiology procedures. By lowering sedation during interventional radiology, music makes the procedure safer. It also contributes favourably to the overall patient experience. PMID:22422386

Waste Sampling & Characterization Facility (WSCF) Complex Safety Analysis

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

MELOY, R.T.

2002-04-01

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

National Alliance for Radiation Readiness: Leveraging Partnerships to Increase Preparedness.

PubMed

Blumenstock, James S; Allen, Meredith

2016-02-01

The National Alliance for Radiation Readiness (NARR) is an alliance of 16 national member organizations that have banded together to serve as the collective "voice of health" in radiological preparedness through: • participation in national dialogues on radiological emergency issues; • provision of thoughtful feedback on documents, policies, and guidelines; and • convening of partners to raise awareness of and resolve radiological emergency issues. NARR benefits from the intersection and interaction of public health, radiation control, healthcare, and emergency management professionals--all with an interest in bolstering the nation's preparedness for a radiological or nuclear incident. NARR is able to provide a unique perspective on radiological and nuclear preparedness by creating multi-disciplinary workgroups to develop guidance, recommendations, and provide subject matter feedback. NARR aims to build response and recovery capacity and capabilities by supporting the sharing of resources and tools, including technical methods and information through the development of an online clearinghouse. NARR also aims to identify and disseminate best practices, as well as define and educate on the roles and responsibilities of local, state, and federal government and the numerous agencies involved with the response to a radiological emergency.

Criteria for radiologic diagnosis of hypochondroplasia in neonates.

PubMed

Saito, Tomoko; Nagasaki, Keisuke; Nishimura, Gen; Wada, Masaki; Nyuzuki, Hiromi; Takagi, Masaki; Hasegawa, Tomonobu; Amano, Naoko; Murotsuki, Jun; Sawai, Hideaki; Yamada, Takahiro; Sato, Shuhei; Saitoh, Akihiko

2016-04-01

A radiologic diagnosis of hypochondroplasia is hampered by the absence of age-dependent radiologic criteria, particularly in the neonatal period. To establish radiologic criteria and scoring system for identifying neonates with fibroblast growth factor receptor 3 (FGFR3)-associated hypochondroplasia. This retrospective study included 7 hypochondroplastic neonates and 30 controls. All subjects underwent radiologic examination within 28 days after birth. We evaluated parameters reflecting the presence of (1) short ilia, (2) squared ilia, (3) short greater sciatic notch, (4) horizontal acetabula, (5) short femora, (6) broad femora, (7) metaphyseal flaring, (8) lumbosacral interpedicular distance narrowing and (9) ovoid radiolucency of the proximal femora. Only parameters 1, 3, 4, 5 and 6 were statistically different between the two groups. Parameters 3, 5 and 6 did not overlap between the groups, while parameters 1 and 4 did. Based on these results, we propose a scoring system for hypochondroplasia. Two major criteria (parameters 3 and 6) were assigned scores of 2, whereas 4 minor criteria (parameters 1, 4, 5 and 9) were assigned scores of 1. All neonates with hypochondroplasia in our material scored ≥6. Our set of diagnostic radiologic criteria might be useful for early identification of hypochondroplastic neonates.

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.

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

PubMed

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

2003-09-01

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

[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 .

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.

Auditor recommendations resulting from three clinical audit rounds in Finnish radiology units.

PubMed

Miettunen, Kirsi; Metsälä, Eija

2017-06-01

Background The purpose of clinical audits performed in radiology units is to reduce the radiation dose of patients and staff and to implement evidence-based best practices. Purpose To describe auditor recommendations in three Finnish clinical audit rounds performed in 2002-2014, and to determine if auditor recommendations have had any impact on improving medical imaging practice. Material and Methods The retrospective observational study was performed in radiology units holding a radiation safety license issued by the Finnish Radiation and Nuclear Safety Authority. The data comprised a systematic sample (n = 120) of auditor reports produced in three auditing rounds in these units during the years 2002-2014. The data were analyzed by descriptive methods and by using the Friedman two-way ANOVA test. Results The number of auditor recommendations given varied between clinical audit rounds and according to the type of imaging unit, as well as according to calculation method. Proportionally, the most recommendations in all three clinical audit rounds were given about defining and using quality assurance functions and about guidelines and practices for carrying out procedures involving radiation exposure. Demanding radiology units improved their practices more than basic imaging units towards the third round. Conclusion Auditor recommendations help to address the deficiencies in imaging practices. There is a need to develop uniform guidelines and to provide tutoring for clinical auditors in order to produce comparable clinical audit results.

A randomized controlled trial on the efficacy of thoracic CT screening for lung cancer in non-smokers and smokers of <30 pack-years aged 50-64 years (JECS study): research design.

PubMed

Sagawa, Motoyasu; Nakayama, Tomio; Tanaka, Makoto; Sakuma, Tsutomu; Sobue, Tomotaka

2012-12-01

In order to assess the efficacy of lung cancer screening using low-dose thoracic computed tomography, compared with chest roentgenography, in people aged 50-64 years with a smoking history of <30 pack-years, a randomized controlled trial is being conducted in Japan. The screening methods are randomly assigned individually. The duration of this trial is 10 years. In the intervention arm, low-dose thoracic computed tomography is performed for each participant in the first and the sixth years. In the control arm, chest roentgenography is performed for each participant in the first year. The participants in both arms are also encouraged to receive routine lung cancer screening using chest roentgenography annually. The interpretation of radiological findings and the follow-up of undiagnosed nodules are to be carried out according to the guidelines published in Japan. The required sample size is calculated to be 17 500 subjects for each arm.

Addressing the coming radiology crisis-the Society for Computer Applications in Radiology transforming the radiological interpretation process (TRIP) initiative.

PubMed

Andriole, Katherine P; Morin, Richard L; Arenson, Ronald L; Carrino, John A; Erickson, Bradley J; Horii, Steven C; Piraino, David W; Reiner, Bruce I; Seibert, J Anthony; Siegel, Eliot

2004-12-01

The Society for Computer Applications in Radiology (SCAR) Transforming the Radiological Interpretation Process (TRIP) Initiative aims to spearhead research, education, and discovery of innovative solutions to address the problem of information and image data overload. The initiative will foster interdisciplinary research on technological, environmental and human factors to better manage and exploit the massive amounts of data. TRIP will focus on the following basic objectives: improving the efficiency of interpretation of large data sets, improving the timeliness and effectiveness of communication, and decreasing medical errors. The ultimate goal of the initiative is to improve the quality and safety of patient care. Interdisciplinary research into several broad areas will be necessary to make progress in managing the ever-increasing volume of data. The six concepts involved are human perception, image processing and computer-aided detection (CAD), visualization, navigation and usability, databases and integration, and evaluation and validation of methods and performance. The result of this transformation will affect several key processes in radiology, including image interpretation; communication of imaging results; workflow and efficiency within the health care enterprise; diagnostic accuracy and a reduction in medical errors; and, ultimately, the overall quality of care.

ACR-SPR-STR Practice Parameter for the Performance of Cardiac Positron Emission Tomography - Computed Tomography (PET/CT) Imaging.

PubMed

Subramaniam, Rathan M; Janowitz, Warren R; Johnson, Geoffrey B; Lodge, Martin A; Parisi, Marguerite T; Ferguson, Mark R; Hellinger, Jeffrey C; Gladish, Gregory W; Gupta, Narainder K

2017-12-01

This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death. Optimum utility of cardiac PET/CT is achieved when images are interpreted in conjunction with clinical information and laboratory data. Measurement of myocardial blood flow, coronary flow reserve and detection of balanced ischemia are significant advantages of cardiac PET perfusion studies. Increasingly cardiac PET/CT is used in diagnosis and treatment response assessment for cardiac sarcoidosis.

Trainees May Add Value to Patient Care by Decreasing Addendum Utilization in Radiology Reports.

PubMed

Balthazar, Patricia; Konstantopoulos, Christina; Wick, Carson A; DeSimone, Ariadne K; Tridandapani, Srini; Simoneaux, Stephen; Applegate, Kimberly E

2017-11-01

The purpose of this study was to evaluate the impact of trainee involvement and other factors on addendum rates in radiology reports. This retrospective study was performed in a tertiary care pediatric hospital. From the institutional radiology data repository, we extracted all radiology reports from January 1 to June 30, 2016, as well as trainee (resident or fellow) involvement, imaging modality, patient setting (emergency, inpatient, or outpatient), order status (routine vs immediate), time of interpretation (regular work hours vs off-hours), radiologist's years of experience, and sex. We grouped imaging modalities as advanced (CT, MRI, and PET) or nonadvanced (any modality that was not CT, MRI, or PET) and radiologist experience level as ≤ 20 years or > 20 years. Our outcome measure was the rate of addenda in radiology reports. Statistical analysis was performed using multivariate logistic regression. From 129,033 reports finalized during the study period, 418 (0.3%) had addenda. Reports generated without trainees were 12 times more likely than reports with trainee involvement to have addenda (odds ratio [OR] = 12.2, p < 0.001). Advanced imaging studies were more likely than nonadvanced studies to be associated with addendum use (OR = 4.7, p < 0.001). Reports generated for patients in emergency or outpatient settings had a slightly higher likelihood of addendum use than those in an inpatient setting (OR = 1.5, p = 0.04; and OR = 1.3, p = 0.04, respectively). Routine orders had a slightly higher likelihood of addendum use compared with immediate orders (OR = 1.3, p = 0.01). We found no difference in addendum use by radiologist's sex, radiologist's years of experience, emergency versus outpatient setting, or time of interpretation. Trainees may add value to patient care by decreasing addendum rates in radiology reports.

Evaluating and Measuring the Return on Investment of an Emergency Center Health Care Professional Picture Archiving and Communication Systems Training Program

ERIC Educational Resources Information Center

Roelandt, James P.

2012-01-01

Picture archiving and communication system (PACS) workflow directly affects the quality of emergency patient care through radiology exam turn-around times and the speed of delivery of diagnostic radiology results. This study was a mixed methods training and performance improvement study that evaluated the effectiveness and value of a hospital…

Psychophysical Comparison Of A Video Display System To Film By Using Bone Fracture Images

NASA Astrophysics Data System (ADS)

Seeley, George W.; Stempski, Mark; Roehrig, Hans; Nudelman, Sol; Capp, M. P.

1982-11-01

This study investigated the possibility of using a video display system instead of film for radiological diagnosis. Also investigated were the relationships between characteristics of the system and the observer's accuracy level. Radiologists were used as observers. Thirty-six clinical bone fractures were separated into two matched sets of equal difficulty. The difficulty parameters and ratings were defined by a panel of expert bone radiologists at the Arizona Health Sciences Center, Radiology Department. These two sets of fracture images were then matched with verifiably normal images using parameters such as film type, angle of view, size, portion of anatomy, the film's density range, and the patient's age and sex. The two sets of images were then displayed, using a counterbalanced design, to each of the participating radiologists for diagnosis. Whenever a response was given to a video image, the radiologist used enhancement controls to "window in" on the grey levels of interest. During the TV phase, the radiologist was required to record the settings of the calibrated controls of the image enhancer during interpretation. At no time did any single radiologist see the same film in both modes. The study was designed so that a standard analysis of variance would show the effects of viewing mode (film vs TV), the effects due to stimulus set, and any interactions with observers. A signal detection analysis of observer performance was also performed. Results indicate that the TV display system is almost as good as the view box display; an average of only two more errors were made on the TV display. The difference between the systems has been traced to four observers who had poor accuracy on a small number of films viewed on the TV display. This information is now being correlated with the video system's signal-to-noise ratio (SNR), signal transfer function (STF), and resolution measurements, to obtain information on the basic display and enhancement requirements for a video-based radiologic system. Due to time constraints the results are not included here. The complete results of this study will be reported at the conference.

Placement of central venous port catheters and peripherally inserted central catheters in the routine clinical setting of a radiology department: analysis of costs and intervention duration learning curve.

PubMed

Rotzinger, Roman; Gebauer, Bernhard; Schnapauff, Dirk; Streitparth, Florian; Wieners, Gero; Grieser, Christian; Freyhardt, Patrick; Hamm, Bernd; Maurer, Martin H

2017-12-01

Background Placement of central venous port catheters (CVPS) and peripherally inserted central catheters (PICC) is an integral component of state-of-the-art patient care. In the era of increasing cost awareness, it is desirable to have more information to comprehensively assess both procedures. Purpose To perform a retrospective analysis of interventional radiologic implantation of CVPS and PICC lines in a large patient population including a cost analysis of both methods as well as an investigation the learning curve in terms of the interventions' durations. Material and Methods All CVPS and PICC line related interventions performed in an interventional radiology department during a three-year period from January 2011 to December 2013 were examined. Documented patient data included sex, venous access site, and indication for CVPS or PICC placement. A cost analysis including intervention times was performed based on the prorated costs of equipment use, staff costs, and expenditures for disposables. The decrease in intervention duration in the course of time conformed to the learning curve. Results In total, 2987 interventions were performed by 16 radiologists: 1777 CVPS and 791 PICC lines. An average implantation took 22.5 ± 0.6 min (CVPS) and 10.1 ± 0.9 min (PICC lines). For CVPS, this average time was achieved by seven radiologists newly learning the procedures after performing 20 CVPS implantations. Total costs per implantation were €242 (CVPS) and €201 (PICC lines). Conclusion Interventional radiologic implantations of CVPS and PICC lines are well-established procedures, easy to learn by residents, and can be implanted at low costs.

UWGSP6: a diagnostic radiology workstation of the future

NASA Astrophysics Data System (ADS)

Milton, Stuart W.; Han, Sang; Choi, Hyung-Sik; Kim, Yongmin

1993-06-01

The Univ. of Washington's Image Computing Systems Lab. (ICSL) has been involved in research into the development of a series of PACS workstations since the middle 1980's. The most recent research, a joint UW-IBM project, attempted to create a diagnostic radiology workstation using an IBM RISC System 6000 (RS6000) computer workstation and the X-Window system. While the results are encouraging, there are inherent limitations in the workstation hardware which prevent it from providing an acceptable level of functionality for diagnostic radiology. Realizing the RS6000 workstation's limitations, a parallel effort was initiated to design a workstation, UWGSP6 (Univ. of Washington Graphics System Processor #6), that provides the required functionality. This paper documents the design of UWGSP6, which not only addresses the requirements for a diagnostic radiology workstation in terms of display resolution, response time, etc., but also includes the processing performance necessary to support key functions needed in the implementation of algorithms for computer-aided diagnosis. The paper includes a description of the workstation architecture, and specifically its image processing subsystem. Verification of the design through hardware simulation is then discussed, and finally, performance of selected algorithms based on detailed simulation is provided.

Role of interventional radiology in the management of acute gastrointestinal bleeding

PubMed Central

Ramaswamy, Raja S; Choi, Hyung Won; Mouser, Hans C; Narsinh, Kazim H; McCammack, Kevin C; Treesit, Tharintorn; Kinney, Thomas B

2014-01-01

Acute gastrointestinal bleeding (GIB) can lead to significant morbidity and mortality without appropriate treatment. There are numerous causes of acute GIB including but not limited to infection, vascular anomalies, inflammatory diseases, trauma, and malignancy. The diagnostic and therapeutic approach of GIB depends on its location, severity, and etiology. The role of interventional radiology becomes vital in patients whose GIB remains resistant to medical and endoscopic treatment. Radiology offers diagnostic imaging studies and endovascular therapeutic interventions that can be performed promptly and effectively with successful outcomes. Computed tomography angiography and nuclear scintigraphy can localize the source of bleeding and provide essential information for the interventional radiologist to guide therapeutic management with endovascular angiography and transcatheter embolization. This review article provides insight into the essential role of Interventional Radiology in the management of acute GIB. PMID:24778770

Experimental system for measurement of radiologists' performance by visual search task.

PubMed

Maeda, Eriko; Yoshikawa, Takeharu; Nakashima, Ryoichi; Kobayashi, Kazufumi; Yokosawa, Kazuhiko; Hayashi, Naoto; Masutani, Yoshitaka; Yoshioka, Naoki; Akahane, Masaaki; Ohtomo, Kuni

2013-01-01

Detective performance of radiologists for "obvious" targets should be evaluated by visual search task instead of ROC analysis, but visual task have not been applied to radiology studies. The aim of this study was to set up an environment that allows visual search task in radiology, to evaluate its feasibility, and to preliminarily investigate the effect of career on the performance. In a darkroom, ten radiologists were asked to answer the type of lesion by pressing buttons, when images without lesions, with bulla, ground-glass nodule, and solid nodule were randomly presented on a display. Differences in accuracy and reaction times depending on board certification were investigated. The visual search task was successfully and feasibly performed. Radiologists were found to have high sensitivity, specificity, positive predictive values and negative predictive values in non-board and board groups. Reaction time was under 1 second for all target types in both groups. Board radiologists were significantly faster in answering for bulla, but there were no significant differences for other targets and values. We developed an experimental system that allows visual search experiment in radiology. Reaction time for detection of bulla was shortened with experience.

The performance of a prototype device designed to evaluate general quality parameters of X-ray equipment

NASA Astrophysics Data System (ADS)

Murata, C. H.; Fernandes, D. C.; Lavínia, N. C.; Caldas, L. V. E.; Pires, S. R.; Medeiros, R. B.

2014-02-01

The performance of radiological equipment can be assessed using non-invasive methods and portable instruments that can analyze an X-ray beam with just one exposure. These instruments use either an ionization chamber or a state solid detector (SSD) to evaluate X-ray beam parameters. In Brazil, no such instruments are currently being manufactured; consequently, these instruments come at a higher cost to users due to importation taxes. Additionally, quality control tests are time consuming and impose a high workload on the X-ray tubes when evaluating their performance parameters. The assessment of some parameters, such as the half-value layer (HVL), requires several exposures; however, this can be reduced by using a SSD that requires only a single exposure. One such SSD uses photodiodes designed for high X-ray sensitivity without the use of scintillation crystals. This sensitivity allows one electron-hole pair to be created per 3.63 eV of incident energy, resulting in extremely high and stable quantum efficiencies. These silicon photodiodes operate by absorbing photons and generating a flow of current that is proportional to the incident power. The aim of this study was to show the response of the solid sensor PIN RD100A detector in a multifunctional X-ray analysis system that is designed to evaluate the average peak voltage (kVp), exposure time, and HVL of radiological equipment. For this purpose, a prototype board that uses four SSDs was developed to measure kVp, exposure time, and HVL using a single exposure. The reproducibility and accuracy of the results were compared to that of different X-ray beam analysis instruments. The kVp reproducibility and accuracy results were 2% and 3%, respectively; the exposure time reproducibility and accuracy results were 2% and 1%, respectively; and the HVL accuracy was ±2%. The prototype's methodology was able to calculate these parameters with appropriate reproducibility and accuracy. Therefore, the prototype can be considered a multifunctional instrument that can appropriately evaluate the performance of radiological equipment.

Real-time stereographic display of volumetric datasets in radiology

NASA Astrophysics Data System (ADS)

Wang, Xiao Hui; Maitz, Glenn S.; Leader, J. K.; Good, Walter F.

2006-02-01

A workstation for testing the efficacy of stereographic displays for applications in radiology has been developed, and is currently being tested on lung CT exams acquired for lung cancer screening. The system exploits pre-staged rendering to achieve real-time dynamic display of slabs, where slab thickness, axial position, rendering method, brightness and contrast are interactively controlled by viewers. Stereo presentation is achieved by use of either frame-swapping images or cross-polarizing images. The system enables viewers to toggle between alternative renderings such as one using distance-weighted ray casting by maximum-intensity-projection, which is optimal for detection of small features in many cases, and ray casting by distance-weighted averaging, for characterizing features once detected. A reporting mechanism is provided which allows viewers to use a stereo cursor to measure and mark the 3D locations of specific features of interest, after which a pop-up dialog box appears for entering findings. The system's impact on performance is being tested on chest CT exams for lung cancer screening. Radiologists' subjective assessments have been solicited for other kinds of 3D exams (e.g., breast MRI) and their responses have been positive. Objective estimates of changes in performance and efficiency, however, must await the conclusion of our study.

Three case reports of radiation-induced glioblastoma after complete remission of acute lymphoblastic leukemia.

PubMed

Kajitani, Takumi; Kanamori, Masayuki; Saito, Ryuta; Watanabe, Yuko; Suzuki, Hiroyoshi; Watanabe, Mika; Kure, Shigeo; Tominaga, Teiji

2018-04-01

Radiation therapy is sometimes performed to control intracranial acute lymphoblastic leukemia (ALL), but may lead to radiation-induced malignant glioma. The clinical, radiological, histological, and molecular findings are described of three cases of radiation-induced glioblastoma after the treatment for ALL. They received radiation therapy at age 6-8 years. The latency from radiation therapy to the onset of radiation-induced glioblastoma was 5-10 years. Magnetic resonance imaging demonstrated diffuse lesions with multiple small enhanced lesions in all cases. Histological examination showed that the tumors consisted of mainly small round astrocytic atypical cells in one case, and astrocytic atypical cells with elongated cytoplasm and nuclear pleomorphism with small cell component in two cases. Microvascular proliferation was present in all cases. Immunohistochemical analysis for B-Raf V600E, and mutational analysis for the isocitrate dehydrogenase (IDH) 1, IDH2, and H3F3A gene revealed the wild-type alleles in all three cases. The integrated diagnoses were IDH wild-type glioblastoma, and local irradiation and concomitant temozolomide were performed. After the initial treatment, significant shrinkage of the diffuse lesion and enhanced lesion was found in all cases. Radiation-induced glioblastoma occurring after the treatment for ALL had unique clinical, radiological, histological, and molecular characteristics in our three cases.

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.

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

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

Griffin, J.; Gonzales, W.

2007-07-01

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

Mixed methods study on the use of and attitudes towards safety checklists in interventional radiology.

PubMed

Munn, Zachary; Giles, Kristy; Aromataris, Edoardo; Deakin, Anita; Schultz, Timothy; Mandel, Catherine; Peters, Micah Dj; Maddern, Guy; Pearson, Alan; Runciman, William

2018-02-01

The use of safety checklists in interventional radiology is an intervention aimed at reducing mortality and morbidity. Currently there is little known about their practical use in Australian radiology departments. The primary aim of this mixed methods study was to evaluate how safety checklists (SC) are used and completed in radiology departments within Australian hospitals, and attitudes towards their use as described by Australian radiologists. A mixed methods approach employing both quantitative and qualitative techniques was used for this study. Direct observations of checklist use during radiological procedures were performed to determine compliance. Medical records were also audited to investigate whether there was any discrepancy between practice (actual care measured by direct observation) and documentation (documented care measured by an audit of records). A focus group with Australian radiologists was conducted to determine attitudes towards the use of checklists. Among the four participating radiology departments, overall observed mean completion of the components of the checklist was 38%. The checklist items most commonly observed to be addressed by the operating theatre staff as noted during observations were correct patient (80%) and procedure (60%). Findings from the direct observations conflicted with the medical record audit, where there was a higher percentage of completion (64% completion) in comparison to the 38% observed. The focus group participants spoke of barriers to the use of checklists, including the culture of radiology departments. This is the first study of safety checklist use in radiology within Australia. Overall completion was low across the sites included in this study. Compliance data collected from observations differed markedly from reported compliance in medical records. There remain significant barriers to the proper use of safety checklists in Australian radiology departments. © 2017 The Royal Australian and New Zealand College of Radiologists.

Developing an automated database for monitoring ultrasound- and computed tomography-guided procedure complications and diagnostic yield.

PubMed

Itri, Jason N; Jones, Lisa P; Kim, Woojin; Boonn, William W; Kolansky, Ana S; Hilton, Susan; Zafar, Hanna M

2014-04-01

Monitoring complications and diagnostic yield for image-guided procedures is an important component of maintaining high quality patient care promoted by professional societies in radiology and accreditation organizations such as the American College of Radiology (ACR) and Joint Commission. These outcome metrics can be used as part of a comprehensive quality assurance/quality improvement program to reduce variation in clinical practice, provide opportunities to engage in practice quality improvement, and contribute to developing national benchmarks and standards. The purpose of this article is to describe the development and successful implementation of an automated web-based software application to monitor procedural outcomes for US- and CT-guided procedures in an academic radiology department. The open source tools PHP: Hypertext Preprocessor (PHP) and MySQL were used to extract relevant procedural information from the Radiology Information System (RIS), auto-populate the procedure log database, and develop a user interface that generates real-time reports of complication rates and diagnostic yield by site and by operator. Utilizing structured radiology report templates resulted in significantly improved accuracy of information auto-populated from radiology reports, as well as greater compliance with manual data entry. An automated web-based procedure log database is an effective tool to reliably track complication rates and diagnostic yield for US- and CT-guided procedures performed in a radiology department.

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

NASA Astrophysics Data System (ADS)

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

1990-08-01

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

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

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.

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.

Palliative Airway Stenting Performed Under Radiological Guidance and Local Anesthesia

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

Profili, Stefano; Manca, Antonio; Feo, Claudio F.

2007-02-15

Purpose. To assess the effectiveness of airway stenting performed exclusively under radiological guidance for the palliation of malignant tracheobronchial strictures. Methods. We report our experience in 16 patients with malignant tracheobronchial stricture treated by insertion of 20 Ultraflex self-expandable metal stents performed under fluoroscopic guidance only. Three patients presented dysphagia grade IV due to esophageal malignant infiltration; they therefore underwent combined airway and esophageal stenting. All the procedures were performed under conscious sedation in the radiological room; average procedure time was around 10 min, but the airway impediment never lasted more than 40 sec. Results. We obtained an overall technicalmore » success in 16 cases (100%) and clinical success in 14 patients (88%). All prostheses were successfully placed without procedural complications. Rapid clinical improvement with symptom relief and normalization of respiratory function was obtained in 14 cases. Two patients died within 48 hr from causes unrelated to stent placement. Two cases (13%) of migration were observed; they were successfully treated with another stent. Tumor overgrowth developed in other 2 patients (13%); however, no further treatment was possible because of extensive laryngeal infiltration. Conclusions. Tracheobronchial recanalization with self-expandable metal stents is a safe and effective palliative treatment for malignant strictures. Airway stenting performed exclusively under fluoroscopic view was rapid and well tolerated.« 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.

Water soluble contrast enema examination of the integrity of the rectal anastomosis prior to loop ileostomy reversal may be superfluous.

PubMed

Larsson, Anna; Lindmark, Gudrun; Syk, Ingvar; Buchwald, Pamela

2015-03-01

Defunctioning loop ileostomy in low anterior resection (LAR) is routinely used to reduce consequences of anastomotic leakage. The purpose of this study was to analyze which examination technique is optimal for evaluating the integrity of the anastomosis prior to loop ileostomy reversal. Retrospective analysis of 95 patients who had been subjected to LAR at Helsingborg Hospital and Skåne University Hospital, Sweden, was undertaken between January 2007 and June 2009. The examination techniques of the rectal anastomosis prior to reversal and the clinical outcome after reversal were studied. Radiologic anastomosis control using water soluble contrast enema, digital rectal examination (DRE), and rectoscopy were performed in 53 % (50/95), 98 % (93/95), and 69 % (66/95), respectively. In two patients, no control of the anastomosis was performed before reversal. Fifty-two percent (49/95) of the patients were examined using all techniques. Six patients demonstrated leakage detected before reversal of which two were only radiological leakages. These two patients underwent loop ileostomy reversal after delay without complications. They were the only ones where the three examination techniques did not prove coherence. Four patients had symptomatic leakage; these were detected with rectoscopy and DRE and verified with enema. Three patients developed anastomotic leakage after loop ileostomy reversal despite normal preoperative examinations. Two of these patients had rectovaginal fistulas (AVFs). This retrospective study indicates that contrast enema does not provide additional information if rectoscopy and DRE are normal. Despite negative examinations, three of nine leakages were diagnosed after loop ileostomy reversal. Especially, AVFs seem difficult to diagnose.

Assessment of feasibility of running RSNA's MIRC on a Raspberry Pi: a cost-effective solution for teaching files in radiology.

PubMed

Pereira, Andre; Atri, Mostafa; Rogalla, Patrik; Huynh, Thien; O'Malley, Martin E

2015-11-01

The value of a teaching case repository in radiology training programs is immense. The allocation of resources for putting one together is a complex issue, given the factors that have to be coordinated: hardware, software, infrastructure, administration, and ethics. Costs may be significant and cost-effective solutions are desirable. We chose Medical Imaging Resource Center (MIRC) to build our teaching file. It is offered by RSNA for free. For the hardware, we chose the Raspberry Pi, developed by the Raspberry Foundation: a small control board developed as a low cost computer for schools also used in alternative projects such as robotics and environmental data collection. Its performance and reliability as a file server were unknown to us. For the operational system, we chose Raspbian, a variant of Debian Linux, along with Apache (web server), MySql (database server) and PHP, which enhance the functionality of the server. A USB hub and an external hard drive completed the setup. Installation of software was smooth. The Raspberry Pi was able to handle very well the task of hosting the teaching file repository for our division. Uptime was logged at 100 %, and loading times were similar to other MIRC sites available online. We setup two servers (one for backup), each costing just below $200.00 including external storage and USB hub. It is feasible to run RSNA's MIRC off a low-cost control board (Raspberry Pi). Performance and reliability are comparable to full-size servers for the intended purpose of hosting a teaching file within an intranet environment.

Making the invisible visible: a qualitative study of the values, attitudes and norms of radiologists relating to radiation safety.

PubMed

Fridell, Kent; Ekberg, Jessica

2016-06-01

Some shortcomings regarding safety have emerged in inspections by the Swedish Radiation Safety Authority of Swedish radiology departments which perform 5.4 million radiological examinations and 100 000 nuclear scans annually. To ensure safety in the healthcare system and to build a strong environment of radiation protection for patients (and for employees) there must be a strong culture of safety. To understand an organization's behaviour, decisions and actions it is important to study its cultural values. The aims of this study were to discuss how values, attitudes and norms affect radiologists' decisions as well as how they influence the implementation of various radiation protection measures. To investigate this, focus group interviews and in-depth individual interviews were performed in a sample from a number of radiology departments at hospitals in Sweden. The results show that the core value was derived from the patients' perspective with the focus on the knowledge that he or she has come to the healthcare system for a particular reason: to discover disease or, in the best case, to be declared healthy. The majority attitudes were based on experiences associated with aspects that the radiologist could not influence. This often concerns increased pressure on radiology investigations from clinics in the various operational units. Under the concept of norms, the radiologists in the study requested that the development of regulations and guidelines should be connected to issues of justification for various radiological queries.

Management and follow-up of gallbladder polyps : Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE).

PubMed

Wiles, Rebecca; Thoeni, Ruedi F; Barbu, Sorin Traian; Vashist, Yogesh K; Rafaelsen, Søren Rafael; Dewhurst, Catherine; Arvanitakis, Marianna; Lahaye, Max; Soltes, Marek; Perinel, Julie; Roberts, Stuart Ashley

2017-09-01

The management of incidentally detected gallbladder polyps on radiological examinations is contentious. The incidental radiological finding of a gallbladder polyp can therefore be problematic for the radiologist and the clinician who referred the patient for the radiological examination. To address this a joint guideline was created by the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), European Association for Endoscopic Surgery and other Interventional Techniques (EAES), International Society of Digestive Surgery - European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE). A targeted literature search was performed and consensus guidelines were created using a series of Delphi questionnaires and a seven-point Likert scale. A total of three Delphi rounds were performed. Consensus regarding which patients should have cholecystectomy, which patients should have ultrasound follow-up and the nature and duration of that follow-up was established. The full recommendations as well as a summary algorithm are provided. These expert consensus recommendations can be used as guidance when a gallbladder polyp is encountered in clinical practice. • Management of gallbladder polyps is contentious • Cholecystectomy is recommended for gallbladder polyps >10 mm • Management of polyps <10 mm depends on patient and polyp characteristics • Further research is required to determine optimal management of gallbladder polyps.

Evaluation of patients diagnosed with fascioliasis: A six-year experience at a university hospital in Turkey.

PubMed

Boşnak, Vuslat Keçik; Karaoğlan, İlkay; Sahin, Handan Haydaroğlu; Namiduru, Mustafa; Pehlivan, Mustafa; Okan, Vahap; Mete, Ayşe Özlem

2016-04-28

In this study, clinical, laboratory, radiological, and serological examinations of fascioliasis patients were analyzed, and data with a significant impact on differential diagnosis were evaluated. Clinical, radiological, and laboratory findings and treatment responses of a total of 22 fascioliasis patients, treated between October 2009 and September 2014, were evaluated. Nineteen patients were diagnosed with fascioliasis at the invasive phase and three patients at the chronic phase. Patients were followed up for clinical, laboratory, and radiology findings for a period of three months to one year after treatment. The most frequent complaints in both groups were abdominal pain, and the most common physical examination finding was epigastric tenderness. In the performed examination, an eosinophil elevation in whole blood count was detected in 19 patients (100%) in the hepatic phase, and in 2 patients (66.6%) in the biliary phase. The results of the Fasciola hepatica indirect hemagglutination assay (IHA) test ordered in the diagnosis were positive in all patients. Treatment with 10 mg/kg/day triclabendazole for two consecutive days was effective. Live parasites were extracted from patients in the biliary phase with endoscopic retrograde cholangiopancreatography. In the follow-ups, remission in IHA titer and clinical and radiological improvement was achieved in all patients. If hypereosinophilia is detected by peripheral smear in patients who are admitted with complaints such as abdominal pain, weakness, nausea, myalgia, and weight loss, radiological evaluation and serological tests should be performed and fascioliasis should be considered in the differential diagnosis.

Remote inspection with multi-copters, radiological sensors and SLAM techniques

NASA Astrophysics Data System (ADS)

Carvalho, Henrique; Vale, Alberto; Marques, Rúben; Ventura, Rodrigo; Brouwer, Yoeri; Gonçalves, Bruno

2018-01-01

Activated material can be found in different scenarios, such as in nuclear reactor facilities or medical facilities (e.g. in positron emission tomography commonly known as PET scanning). In addition, there are unexpected scenarios resulting from possible accidents, or where dangerous material is hidden for terrorism attacks using nuclear weapons. Thus, a technological solution is important to cope with fast and reliable remote inspection. The multi-copter is a common type of Unmanned Aerial Vehicle (UAV) that provides the ability to perform a first radiological inspection in the described scenarios. The paper proposes a solution with a multi-copter equipped with on-board sensors to perform a 3D reconstruction and a radiological mapping of the scenario. A depth camera and a Geiger-Müler counter are the used sensors. The inspection is performed in two steps: i) a 3D reconstruction of the environment and ii) radiation activity inference to localise and quantify sources of radiation. Experimental results were achieved with real 3D data and simulated radiation activity. Experimental tests with real sources of radiation are planned in the next iteration of the work.

Dutch guideline for clinical foetal-neonatal and paediatric post-mortem radiology, including a review of literature.

PubMed

Sonnemans, L J P; Vester, M E M; Kolsteren, E E M; Erwich, J J H M; Nikkels, P G J; Kint, P A M; van Rijn, R R; Klein, W M

2018-06-01

Clinical post-mortem radiology is a relatively new field of expertise and not common practice in most hospitals yet. With the declining numbers of autopsies and increasing demand for quality control of clinical care, post-mortem radiology can offer a solution, or at least be complementary. A working group consisting of radiologists, pathologists and other clinical medical specialists reviewed and evaluated the literature on the diagnostic value of post-mortem conventional radiography (CR), ultrasonography, computed tomography (PMCT), magnetic resonance imaging (PMMRI), and minimally invasive autopsy (MIA). Evidence tables were built and subsequently a Dutch national evidence-based guideline for post-mortem radiology was developed. We present this evaluation of the radiological modalities in a clinical post-mortem setting, including MIA, as well as the recently published Dutch guidelines for post-mortem radiology in foetuses, neonates, and children. In general, for post-mortem radiology modalities, PMMRI is the modality of choice in foetuses, neonates, and infants, whereas PMCT is advised in older children. There is a limited role for post-mortem CR and ultrasonography. In most cases, conventional autopsy will remain the diagnostic method of choice. Based on a literature review and clinical expertise, an evidence-based guideline was developed for post-mortem radiology of foetal, neonatal, and paediatric patients. What is Known: • Post-mortem investigations serve as a quality check for the provided health care and are important for reliable epidemiological registration. • Post-mortem radiology, sometimes combined with minimally invasive techniques, is considered as an adjunct or alternative to autopsy. What is New: • We present the Dutch guidelines for post-mortem radiology in foetuses, neonates and children. • Autopsy remains the reference standard, however minimal invasive autopsy with a skeletal survey, post-mortem computed tomography, or post-mortem magnetic resonance imaging can be complementary thereof.

Fixation of Radiological Contamination; International Collaborative Development

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

Rick Demmer

2013-03-01

A cooperative international project was conducted by the Idaho National Laboratory (INL) and the United Kingdom’s National Nuclear Laboratory (NNL) to integrate a capture coating with a high performance atomizing process. The initial results were promising, and lead to further trials. The somewhat longer testing and optimization process has resulted in a product that could be demonstrated in the field to reduce airborne radiological dust and contamination.

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.

Characteristics and trends of radiology research: a survey of original articles published in AJR and Radiology between 2001 and 2010.

PubMed

Lim, Kyoung Ja; Yoon, Dae Young; Yun, Eun Joo; Seo, Young Lan; Baek, Sora; Gu, Dong Hyeon; Yoon, Soo Jeong; Han, Ari; Ku, You Jin; Kim, Sam Soo

2012-09-01

To determine the characteristics and trends of the original articles published in two major American radiology journals, AJR American Journal of Roentgenology (AJR) and Radiology, between 2001 and 2010. This was a retrospective bibliometric analysis that did not involve human subjects and was exempt from institutional review board approval. All 6542 original articles published in AJR and Radiology between 2001 and 2010 were evaluated. The following information was abstracted from each article: radiologic subspecialty, radiologic technique used, type of research, sample size, study design, statistical analysis, study outcome, declared funding, number of authors, affiliation of the first author, and country of the first author. In addition, all the variables examined were presented along with the trend over time. The most common subspecialty of study was abdominal (1219 of 6542, 18.6%), followed by vascular/interventional (804 of 6542, 12.3%). A total of 3744 (57.2%) original articles used magnetic resonance (MR) imaging or computed tomography (CT), 5495 (84.1%) were clinical research articles, 3060 (46.8%) had sample size of more than 50, 4087 (62.5%) were retrospective, 4714 (72.1%) performed statistical analysis, 6225 (95.2%) showed positive study outcome, 4784 (73.1%) were not funded, 3942 (60.3%) had four to seven authors, and 5731 (87.6%) were written by the primary author who was from a department of radiology or radiology-related specialties. The United States published 45.5% (2975 of 6542) of the articles, followed by Japan (n = 525, 8.0%), Germany (n = 485, 7.4%), and South Korea (n = 455, 7.0%). In the time trend analysis, the following variables showed a significantly positive trend: cardiac subspecialty, CT and MR imaging as the radiologic techniques, type of research as other (nonbasic, nonclinical), sample size of more than 50, four to seven as the number of authors, medicine-related department of the first author, and South Korea and Italy as countries of the first author. On the other hand, pediatric subspecialty, combined (basic and clinical) type of research, and number of authors fewer than four showed a significantly negative trend. The bibliometric analysis of the AJR and Radiology journals with articles published between 2001 and 2010 revealed characteristics and trends of the current radiology research that may provide useful information to researchers and editorial staff in radiology. © RSNA, 2012

Coping in a calamity: Radiology during the cloudburst at Leh

PubMed Central

Sen, Debraj

2013-01-01

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

Radiological Characterization Methodology of INEEL Stored RH-TRU Waste from ANL-E

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

Rajiv N. Bhatt

2003-02-01

An Acceptable Knowledge (AK)-based radiological characterization methodology is being developed for RH TRU waste generated from ANL-E hot cell operations performed on fuel elements irradiated in the EBR-II reactor. The methodology relies on AK for composition of the fresh fuel elements, their irradiation history, and the waste generation and collection processes. Radiological characterization of the waste involves the estimates of the quantities of significant fission products and transuranic isotopes in the waste. Methods based on reactor and physics principles are used to achieve these estimates. Because of the availability of AK and the robustness of the calculation methods, the AK-basedmore » characterization methodology offers a superior alternative to traditional waste assay techniques. Using this methodology, it is shown that the radiological parameters of a test batch of ANL-E waste is well within the proposed WIPP Waste Acceptance Criteria limits.« less

Radiological Characterization Methodology for INEEL-Stored Remote-Handled Transuranic (RH TRU) Waste from Argonne National Laboratory-East

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

Kuan, P.; Bhatt, R.N.

2003-01-14

An Acceptable Knowledge (AK)-based radiological characterization methodology is being developed for RH TRU waste generated from ANL-E hot cell operations performed on fuel elements irradiated in the EBR-II reactor. The methodology relies on AK for composition of the fresh fuel elements, their irradiation history, and the waste generation and collection processes. Radiological characterization of the waste involves the estimates of the quantities of significant fission products and transuranic isotopes in the waste. Methods based on reactor and physics principles are used to achieve these estimates. Because of the availability of AK and the robustness of the calculation methods, the AK-basedmore » characterization methodology offers a superior alternative to traditional waste assay techniques. Using the methodology, it is shown that the radiological parameters of a test batch of ANL-E waste is well within the proposed WIPP Waste Acceptance Criteria limits.« less

Microbiological contamination in digital radiography: evaluation at the radiology clinic of an educational institution.

PubMed

Malta, Cristiana P; Damasceno, Naiana Nl; Ribeiro, Rosangela A; Silva, Carolina Sf; Devito, Karina L

2016-12-01

The aim of this study was to evaluate the contamination rate of intra and extraoral digital X ray equipment in a dental radiology clinic at a public educational institution. Samples were collected on three different days, at two times in the day: in the morning, before attending patients, and at the end of the day, after appointment hours and before cleaning and disinfection procedures. Samples were collected from the periapical X-ray machine (tube head, positioning device, control panel and activator button), the panoramic X- ray machine (temporal support, bite block, control panel and activator button), the intraoral digital system (sensor), and the digital system computers (keyboard and mouse). The samples were seeded in different culture media, incubated, and colony forming units (CFU/mL) counted. Biochemical tests were performed for suspected colonies of Staphylococcus, Streptococcus and Gramnegative bacilli (GNB). Fungi were visually differentiated into filamentous fungi and yeasts. The results indicated the growth of fungi and Staphylococcus fromall sampling locations. GNB growth was observed from all sites sampled from the intraoral X-ray equipment. On the panoramic unit, GNB growth was observed in samples from activator button, keyboard and mouse. In general, a higher number of CFU/mL was present before use. It can be concluded that more stringent protocols are needed to control infection and prevent X-ray exams from acting as vehicle for cross contamination. Sociedad Argentina de Investigación Odontológica.

Developing Navy Capability to Recover Forces in Chemical, Biological, and Radiological Hazard Environments

DTIC Science & Technology

2013-01-01

damage control; LHD flight deck and well deck operations; fleet surgical team; Afloat Training Group; Assault Craft Unit; Naval Surface Warfare Center ...Biological, Radiological and Nuclear School, and U.S. Army Edgewood Chemical Biological Center , Guidelines for Mass Casualty Decontamination During a HAZMAT...Policy Center of the RAND National Defense Research Institute, a federally funded research and development center sponsored by OSD, the Joint Staff

RADIOLOGICAL SEALED SOURCE LIBRARY: A NUCLEAR FORENSICS TOOL

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

Canaday, Jodi; Chamberlain, David; Finck, Martha

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

Action research regarding the optimisation of radiological protection for nurses during vascular interventional radiology.

PubMed

Mori, Hiroshige

2015-06-01

The optimisation and decision-making processes for radiological protection have been broadened by the introduction of re-examination or feedback after introducing protective measures. In this study, action research was used to reduce the occupational exposure of vascular interventional radiology (IR) nurses. Four radiological protection improvement measures were continuously performed in cooperation with the researchers, nurses and stakeholders, and the nurses' annual effective doses were compared before and after the improvements. First, the dosimetry equipment was changed from one electronic personal dosimeter (EPD) to two silver-activated phosphate glass dosimeters (PGDs). Second, the nurses were educated regarding maintaining a safe distance from the sources of scattered and leakage radiation. Third, portable radiation shielding screens were placed in the IR rooms. Fourth, the x-ray units' pulse rates were reduced by half. On changing the dosimetry method, the two PGDs recorded a 4.4 fold greater dose than the single EPD. Educating nurses regarding radiological protection and reducing the pulse rates by half decreased their effective doses to one-third and two-fifths of the baseline dose, respectively. No significant difference in their doses was detected after the placement of the shielding screens. Therefore, the action research effectively decreased the occupational doses of the vascular IR nurses.

Use of dynamic images in radiology education: Movies of CT and MRI in the anatomy classroom.

PubMed

Jang, Hye Won; Oh, Chang-Seok; Choe, Yeon Hyeon; Jang, Dong Su

2018-04-19

Radiology education is a key component in many preclinical anatomy courses. However, the reported effectiveness of radiology education within such anatomy classrooms has varied. This study was conducted to determine if a novel educational method using dynamic images of movies of computed tomography (CT) and magnetic resonance imaging (MRI) was effective in radiology education during a preclinical anatomy course, aided by clay modeling, specific hand gestures (digit anatomy), and reports from dissection findings uploaded to the anatomy course website (digital reports). Feedback surveys using a five-point Likert scale were administered to better clarify students' opinions regarding their understanding of CT and MRI of anatomical structures, as well as to determine if such preclinical radiology education was helpful in their clinical studies. After completion of the anatomy course taught with dynamic images of CT and MRI, most students demonstrated an adequate understanding of basic CT and MR images. Additionally, students in later clinical years generally believed that their study of radiologic images during the preclinical anatomy course was helpful for their clinical studies and clerkship rotations. Moreover, student scores on imaging anatomy examinations demonstrated meaningful improvements in performance after using dynamic images from movies of CT and MRI. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

Radiation exposure levels within timber industries in Calabar, Nigeria

PubMed Central

Inyang, S. O.; Inyang, I. S.; Egbe, N. O.

2009-01-01

The UNSCEAR (2000) observed that there could be some exposure at work which would require regulatory control but is not really considered. This study was, therefore, set up to evaluate the effective dose in timber industries in Calabar, Nigeria to determine if the evaluated dose levels could lead to any radiological health effect in the workers, and also determine if the industries require regulatory control. The gamma ray exposure at four timber industries measured using an exposure meter were converted to effective dose and compared with the public and occupational values. The evaluated effective dose values in the timber industries were below public and occupational exposure limits and may not necessarily result in any radiological health hazard. Therefore, they may not require regulatory control. PMID:20098544

Performance comparison of quantitative semantic features and lung-RADS in the National Lung Screening Trial

NASA Astrophysics Data System (ADS)

Li, Qian; Balagurunathan, Yoganand; Liu, Ying; Schabath, Matthew; Gillies, Robert J.

2016-03-01

Background: Lung-RADS is the new oncology classification guideline proposed by American College of Radiology (ACR), which provides recommendation for further follow up in lung cancer screening. However, only two features (solidity and size) are included in this system. We hypothesize that additional sematic features can be used to better characterize lung nodules and diagnose cancer. Objective: We propose to develop and characterize a systematic methodology based on semantic image traits to more accurately predict occurrence of cancerous nodules. Methods: 24 radiological image traits were systematically scored on a point scale (up to 5) by a trained radiologist, and lung-RADS was independently scored. A linear discriminant model was used on the semantic features to access their performance in predicting cancer status. The semantic predictors were then compared to lung-RADS classification in 199 patients (60 cancers, 139 normal controls) obtained from the National Lung Screening Trial. Result: There were different combinations of semantic features that were strong predictors of cancer status. Of these, contour, border definition, size, solidity, focal emphysema, focal fibrosis and location emerged as top candidates. The performance of two semantic features (short axial diameter and contour) had an AUC of 0.945, and was comparable to that of lung-RADS (AUC: 0.871). Conclusion: We propose that a semantics-based discrimination approach may act as a complement to the lung-RADS to predict cancer status.

Prevalence of Paget's disease of bone in Italy.

PubMed

Gennari, Luigi; Di Stefano, Marco; Merlotti, Daniela; Giordano, Nicola; Martini, Giuseppe; Tamone, Cristina; Zatteri, Roberto; De Lucchi, Roberto; Baldi, Carlo; Vattimo, Angelo; Capoccia, Silvia; Burroni, Luca; Geraci, Simone; De Paola, Vincenzo; Calabrò, Anna; Avanzati, Annalisa; Isaia, Giancarlo; Nuti, Ranuccio

2005-10-01

We examined the prevalence of PDB in Italy from radiological, scintigraphic, and biochemical surveys in two Italian towns. Prevalence rates varied from 0.7% to 2.4%, were higher in males than in females, and slightly differed between the two towns. Unlike previous studies in populations of British descent, no secular trend for a decreasing prevalence emerged. Clinical, radiological, and necropsy data from different countries suggested pronounced geographical variations in the prevalence of Paget's disease of bone (PDB). Despite the impact of the disease on the population, there are limited data on the prevalence of PDB in Italy. The objective of this study was to estimate the prevalence of PDB in the district of Siena (Central Italy) and Turin (Northern Italy) from radiological, biochemical, and scintigraphic surveys. We examined a sample of 1778 consecutive pelvic radiographs performed between 1999 and 2000 at the Hospital Radiology Unit in Siena and 6609 pelvic radiographs performed in 1986-1987, 1992-1993, and 1999-2002 from the Radiology Department of Molinette Hospital in Turin. In Siena, 7906 consecutive (99m)TC-MDP bone scans performed over a 4-year period (January 2000 to May 2004) were also screened for the presence of PDB, and the prevalence of elevated alkaline phosphatase (ALP) levels (>300 UI/liter) was estimated from 7449 computerized medical records over a 3-year period (January 2000 to February 2003). The finding of PDB on the pelvic radiograph and bone scan was based on standardized radiological criteria. At the end of the radiological surveys, 16/1778 pelvic PDB cases (8 males and 8 females) were observed in Siena and 41/6609 (27 males and 14 females) in Turin. The crude prevalence of the disease was 0.89% in Siena and 0.62% in Turin. Given that pelvic involvement is commonly described in 60-90% of PDB patients, the estimated overall prevalence of PDB ranged from 1.0% to 1.5% in Siena and from 0.7% to 1.0% in Turin. No decrease in the prevalence of PDB was evident after comparison of prevalence rates from different periods. Biochemical analyses showed 296/7449 subjects with elevated ALP levels and normal liver enzymes, 87 of whom had confirmed diagnosis of PDB. The estimated prevalence of biochemical PDB was 1.5%. The scintigraphic survey showed a PDB prevalence of 194/7906 (2.4%), which was significantly higher than the radiological and biochemical estimates. Our surveys suggest that PDB in Italy has an estimated prevalence of at least 1%, comparable with that observed in United States and other European countries, but lower than that described in Britain and New Zealand. No secular trend for a decreasing prevalence of PDB was observed.

ICRP publication 121: radiological protection in paediatric diagnostic and interventional radiology.

PubMed

Khong, P-L; Ringertz, H; Donoghue, V; Frush, D; Rehani, M; Appelgate, K; Sanchez, R

2013-04-01

Paediatric patients have a higher average risk of developing cancer compared with adults receiving the same dose. The longer life expectancy in children allows more time for any harmful effects of radiation to manifest, and developing organs and tissues are more sensitive to the effects of radiation. This publication aims to provide guiding principles of radiological protection for referring clinicians and clinical staff performing diagnostic imaging and interventional procedures for paediatric patients. It begins with a brief description of the basic concepts of radiological protection, followed by the general aspects of radiological protection, including principles of justification and optimisation. Guidelines and suggestions for radiological protection in specific modalities - radiography and fluoroscopy, interventional radiology, and computed tomography - are subsequently covered in depth. The report concludes with a summary and recommendations. The importance of rigorous justification of radiological procedures is emphasised for every procedure involving ionising radiation, and the use of imaging modalities that are non-ionising should always be considered. The basic aim of optimisation of radiological protection is to adjust imaging parameters and institute protective measures such that the required image is obtained with the lowest possible dose of radiation, and that net benefit is maximised to maintain sufficient quality for diagnostic interpretation. Special consideration should be given to the availability of dose reduction measures when purchasing new imaging equipment for paediatric use. One of the unique aspects of paediatric imaging is with regards to the wide range in patient size (and weight), therefore requiring special attention to optimisation and modification of equipment, technique, and imaging parameters. Examples of good radiographic and fluoroscopic technique include attention to patient positioning, field size and adequate collimation, use of protective shielding, optimisation of exposure factors, use of pulsed fluoroscopy, limiting fluoroscopy time, etc. Major paediatric interventional procedures should be performed by experienced paediatric interventional operators, and a second, specific level of training in radiological protection is desirable (in some countries, this is mandatory). For computed tomography, dose reduction should be optimised by the adjustment of scan parameters (such as mA, kVp, and pitch) according to patient weight or age, region scanned, and study indication (e.g. images with greater noise should be accepted if they are of sufficient diagnostic quality). Other strategies include restricting multiphase examination protocols, avoiding overlapping of scan regions, and only scanning the area in question. Up-to-date dose reduction technology such as tube current modulation, organ-based dose modulation, auto kV technology, and iterative reconstruction should be utilised when appropriate. It is anticipated that this publication will assist institutions in encouraging the standardisation of procedures, and that it may help increase awareness and ultimately improve practices for the benefit of patients. Copyright © 2012. Published by Elsevier Ltd.

Cost analysis of equipment failure of a radiology department and possible choices about maintenance.

PubMed

Grisi, Guido; Dalla Palma, Ludovico; Rimondini, Allesandra; Palmolungo, Chiara; Cuttin Zernich, Roberto; Pozzi Mucelli, Roberto

2002-01-01

Our aim was to evaluate the economic impact of equipment failures in a radiology department with a view to guiding maintenance policy decisions. We assessed the negative economic impact caused by the interruption of activity of a radiodiagnostics section due to equipment failure, taking into account: the effects occurring during the first day of equipment down-time (assuming that the equipment failure occurs in the middle of the shift) and the effects during the following days until the repair of the failure; the effects occurring in the short- and long-term. To exemplify the negative impact of inactivity due to equipment failure, we chose three radiology sections with different levels of technological and operational complexity (chest radiology, gastrointestinal radiology and remote-controlled diagnostics). For each, we evaluated the loss of contribution margin and the idle capacity costs (short- and long-term impact). The negative economic effects were: for thoracic radiology, 496,77 Euro in the first day, and 30,99 Euro from the second day onwards; for gastrointestinal radiology, 526,40 Euro for the first day, and 730,39 Euro from the second day onwards; for remote-controlled diagnostics, 786,25 Euro for the first day, and 927,67 Euro from the second days onwards. Our results indicate that the level of idle capacity costs (mainly equipment and staff) increases with the complexity of the equipment, whereas the contribution margin appears to fluctuate, because the charges are state-imposed and do not vary with the complexity of equipment. Moreover, our analysis shows that if the workload of a broken machine can easily be assigned to an additional shift using another machine, losses are considerably reduced from the second day onwards. Once the negative economic impact of equipment failures has been evaluated, the second step is to choose the best kind of maintenance. A sound calculation of the economic impact of equipment failures is very useful for guiding the head of department and the hospital manager in deciding whether to purchase maintenance services (or a long-term guarantee) from the equipment manufacturer, to set up an auxiliary centre for maintenance and repair, or to purchase a third-party maintenance contract.

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.

Evaluation of Efficacy of Bone Scan With SPECT/CT in the Management of Low Back Pain: A Study Supported by Differential Diagnostic Local Anesthetic Blocks.

PubMed

Jain, Anuj; Jain, Suruchi; Agarwal, Anil; Gambhir, Sanjay; Shamshery, Chetna; Agarwal, Amita

2015-12-01

Conventional radiologic modalities provide details only about the anatomic aspect of the various structures of the spine. Frequently the structures that show abnormal morphology may not be the cause of low back pain (LBP). Functional imaging in the form of bone scan along with single photon emission computerized tomography (SPECT/CT) may be helpful in identifying structures causing pain, whether morphologically normal or not. The objective of this study is to evaluate the role of bone scan with SPECT/CT in management of patients with LBP. This is randomized double-blinded controlled study performed on 80 patients with LBP aged 20 to 80 years, ASA physical status I to III. Patients were randomized into bone scan and control groups consisting of 40 patients each. On the basis of the clinical features and radiologic findings a clinical diagnosis was made. After making a clinical diagnosis, the patients in bone scan group were subjected to bone scan with SPECT/CT. On the basis of the finding of the bone scan and SPECT/CT, a new working diagnosis was made and intervention was performed according to the new working diagnosis. Diagnostic blocks in the control group were given based on clinical diagnosis. Controlled comparative diagnostic blocks were performed with local anesthetic. The pain score just after the diagnostic block and at the time of discharge (approximately 4 h later) was recorded; the pain relief was recorded in percentage. In both the groups, sacroilitis was the most common diagnosis followed by facet joint arthropathy. The number of patients obtaining pain relief of >50% was significantly higher in the bone scan-positive group as compared with the control group. Three new clinical conditions were identified in the bone scan group. These conditions were multiple myeloma, avascular necrosis of the femoral head, and ankylosing spondylitis. Bone scan with SPECT/CT was found to complement the clinical workup of patients with LBP. Inclusion of bone scan with SPECT/CT in LBP management protocol can help in making a correct diagnosis. At times it might bring out some new information that may be vital for further management of the patients with LBP.

Breast Tomosynthesis

MedlinePlus

... and disease management. top of page How is the procedure performed? Breast tomosynthesis is performed on an outpatient basis. During this exam, a specially qualified radiologic technologist will position your breast in the mammography unit. ...

Communication interventions to improve adherence to infection control precautions: a randomised crossover trial.

PubMed

Ong, Mei-Sing; Magrabi, Farah; Post, Jeffrey; Morris, Sarah; Westbrook, Johanna; Wobcke, Wayne; Calcroft, Ross; Coiera, Enrico

2013-02-06

Ineffective communication of infection control requirements during transitions of care is a potential cause of non-compliance with infection control precautions by healthcare personnel. In this study, interventions to enhance communication during inpatient transfers between wards and radiology were implemented, in the attempt to improve adherence to precautions during transfers. Two interventions were implemented, comprising (i) a pre-transfer checklist used by radiology porters to confirm a patient's infectious status; (ii) a coloured cue to highlight written infectious status information in the transfer form. The effectiveness of the interventions in promoting adherence to standard precautions by radiology porters when transporting infectious patients was evaluated using a randomised crossover trial at a teaching hospital in Australia. 300 transfers were observed over a period of 4 months. Compliance with infection control precautions in the intervention groups was significantly improved relative to the control group (p < 0.01). Adherence rate in the control group was 38%. Applying the coloured cue resulted in a compliance rate of 73%. The pre-transfer checklist intervention achieved a comparable compliance rate of 71%. When both interventions were applied, a compliance rate of 74% was attained. Acceptability of the coloured cue was high, but adherence to the checklist was low (40%). Simple measures to enhance communication through the provision of a checklist and the use a coloured cue brought about significant improvement in compliance with infection control precautions by transport personnel during inpatient transfers. The study underscores the importance of effective communication in ensuring compliance with infection control precautions during transitions of care.

Sciatica-like symptoms and the sacroiliac joint: clinical features and differential diagnosis.

PubMed

Visser, L H; Nijssen, P G N; Tijssen, C C; van Middendorp, J J; Schieving, J

2013-07-01

To compare the clinical features of patients with sacroiliac joint (SIJ)-related sciatica-like symptoms to those with sciatica from nerve root compression and to investigate the necessity to perform radiological imaging in patients with sciatica-like symptoms derived from the SIJ. Patients with pain radiating below the buttocks with a duration of 4 weeks to 1 year were included. After physical and radiological examinations, a diagnosis of SI joint-related pain, pain due to disk herniation, or a combination of these two causes was made. Patients with SIJ-related leg pain (n = 77/186) were significantly more often female, had shorter statue, a shorter duration of symptoms, and had more often pain radiating to the groin and a history of a fall on the buttocks. Muscle weakness, corkscrew phenomenon, finger-floor distance ≥25 cm, lumbar scoliosis, positive Bragard or Kemp sign, and positive leg raising test were more often present when radiologic nerve root compression was present. Although these investigations may help, MRI of the spine is necessary to discriminate between the groups. Sciatica-like symptoms derived from the SIJ can clinically mimic a radiculopathy. We suggest to perform a thorough physical examination of the spine, SI joints, and hips with additional radiological tests to exclude other causes.

Design and Implementation of PACS at Georgetown University Hospital

NASA Astrophysics Data System (ADS)

Mun, S. K.; Benson, H.. R.; Choyke, P.; Fahey, F. H.; Wang, P. C.; Zeman, R. K...; Elliott, L. P.

1985-09-01

During the preparation and planning phase of the PACS project at Georgetown University Hospital it was realized that PACS requires truly the state of the art technology in data communication, image processing and man machine interfacing. It was also realized that un-like many other technology intensive devices used in radiology, PACS cannot be seen as an independent system that will provide well defined services. PACS will be the backbone of the department operation in clinical, educational and managerial functions. It will indeed be the nerve center of the radiologic services affecting every aspect of the department. PACS will have to be designed to perform in a cost-effective manner to widely varying needs within the radiology departments. The integration of ever changing complex technology that will impact every aspect of a radiology service is not a trivial matter. This transition period going from current manual film based PACS to Digital PACS can be long, expansive and disruptive unless careful planning preceeds the implementation. PACS is still an emerging technology at its infancy. Performance monitoring and evaluation of diversified functions have to be also established so that improvement to the system can be efficiently implemented. Thus the evaluation criteria should be also established as early as possible.

[The trial of business data analysis at the Department of Radiology by constructing the auto-regressive integrated moving-average (ARIMA) model].

PubMed

Tani, Yuji; Ogasawara, Katsuhiko

2012-01-01

This study aimed to contribute to the management of a healthcare organization by providing management information using time-series analysis of business data accumulated in the hospital information system, which has not been utilized thus far. In this study, we examined the performance of the prediction method using the auto-regressive integrated moving-average (ARIMA) model, using the business data obtained at the Radiology Department. We made the model using the data used for analysis, which was the number of radiological examinations in the past 9 years, and we predicted the number of radiological examinations in the last 1 year. Then, we compared the actual value with the forecast value. We were able to establish that the performance prediction method was simple and cost-effective by using free software. In addition, we were able to build the simple model by pre-processing the removal of trend components using the data. The difference between predicted values and actual values was 10%; however, it was more important to understand the chronological change rather than the individual time-series values. Furthermore, our method was highly versatile and adaptable compared to the general time-series data. Therefore, different healthcare organizations can use our method for the analysis and forecasting of their business data.

10 CFR 960.5-2-2 - Site ownership and control.

Code of Federal Regulations, 2010 CFR

2010-01-01

... NUCLEAR WASTE REPOSITORY Preclosure Guidelines Preclosure Radiological Safety § 960.5-2-2 Site ownership... control of access that are required in order that surface and subsurface activities during repository...

[Alpha-1 antitrypsin deficiency. The experience of Pulido Valente Hospital with augmentation therapy].

PubMed

Alves Costa, Carla; Santos, Cristina

2009-01-01

Alpha-1 antitrypsin (AAT) is synthesised in the liver and has half-life of 4-5 days. AAT has antiprotease activity, with particular affinity for neutrophil elastase. Its deficiency leads to a lack of effective lung protection against activated neutrophil enzymes. Deficiency of AAT is a genetic disorder that occurs as a result of the inheritance of two protease inhibitor deficient alleles. Of the deficient alleles, Pi*Z is the most common, and the homozygous form Pi*ZZ results in the lowest serum levels, usually below 50 mg/ dl. The "protective threshold" is 80 mg/dl. Smoking increases the risk of emphysema. The current goal of augmentation therapy is to raise the plasma levels, above protective threshold and slow disease progression. The authors present the experience of the Day Care Hospital of the Pulido Valente Hospital with five male patients presenting emphysema due to AAT deficiency, receiving weekly intravenous treatment with Prolastin. We performed a clinical, respiratory functional and radiological evaluation between 2003 and 2007. The results point to a slower progression of the disease, with clinical and radiological stability and a reduced rate of FEV1 decline. Augmentation therapy is an expensive treatment and its use is lacking supportive evidence of efficacy by randomized controlled clinical trials. Evidence that it confers benefits is based on observational studies. Our experience is positive, showing clinical, radiological and functional benefits. The literature available points to a decrease in mortality, but we could not affirm so in our small population.

Surgical treatment of spondylodiscitis in the cervical spine: a minimum 2-year follow-up

PubMed Central

Boehm, Heinrich; El Saghir, Hesham; Tschöke, Sven K.; Kayser, Ralph

2006-01-01

Cervical spine spondylodiscitis is a rare, but serious manifestation of spinal infection. We present a retrospective study of 20 consecutive patients between 01/1994 and 12/1999 treated because of cervical spondylodiscitis. Mean age at the time of treatment was 59.7 (range 34–81) years, nine of them female. In all cases, diagnosis had been established with a delay. All patients in this series underwent surgery such as radical debridement, decompression if necessary, autologous bone grafting and instrumentation. Surgery was indicated if a neurological deficit, symptoms of sepsis, epidural abscess formation with consecutive stenosis, instability or severe deformity were present. Postoperative antibiotic therapy was carried out for 8–12 weeks. Follow-up examinations were performed a mean of 37 (range 24–63) months after surgery. Healing of the inflammation was confirmed in all cases by laboratory, clinical and radiological parameters. Spondylodesis was controlled radiologically and could be achieved in all cases. One case showed a 15°kyphotic angle in the proximal adjacent segment. Spontaneous bony bridging of the proximal adjacent segment was observed in one patient. In the other cases the adjacent segments radiologically showed neither fusion nor infection related changes. Preoperative neurological deficits improved in all cases. Residual neurological deficits persisted in three of eight cases. The results indicate that spondylodiscitis in cervical spine should be treated early and aggressive to avoid local and systemic complications. PMID:16868782

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

Alternative Payment Models in Radiology: The Legislative and Regulatory Roadmap for Reform.

PubMed

Silva, Ezequiel; McGinty, Geraldine B; Hughes, Danny R; Duszak, Richard

2016-10-01

The Medicare Access and CHIP Reauthorization Act (MACRA) replaces the sustainable growth rate with a payment system based on the Merit-Based Incentive Payment System and incentives for alternative payment model participation. It is important that radiologists understand the statutory requirements of MACRA. This includes the nature of the Merit-Based Incentive Payment System composite performance score and its impact on payments. The timeline for MACRA implementation is fairly aggressive and includes a robust effort to define episode groups, which include radiologic services. A number of organizations, including the ACR, are commenting on the structure of MACRA-directed initiatives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[Management of acute and subacute clinical situations by interventional radiology: non-vascular interventions and treatment for hemoptysis].

PubMed

Nemes, Balázs; Doros, Attila

2015-04-26

Interventional radiology provides fast, straightforward and tolerable solutions for many medical problems including acute and subacute situations. Aspiration and drainage of fluid collections, biliary and endourologic interventions and gastrointestinal interventions are parts of non-vascular interventions. In addition, the authors discuss in detail interventional radiological treatment options in patients with hemoptysis. In acute cases interventions must be performed within 12-24 hours. For background, an everyday 24 hours service should be provided with well-trained personnel, high quality equipment and devices, and a reasonable financial reimbursement should be included, too. Multidisciplinary teamwork, consultations, consensus in indications and structured education should make these centers function most effectively.

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.

Information extraction from multi-institutional radiology reports.

PubMed

Hassanpour, Saeed; Langlotz, Curtis P

2016-01-01

The radiology report is the most important source of clinical imaging information. It documents critical information about the patient's health and the radiologist's interpretation of medical findings. It also communicates information to the referring physicians and records that information for future clinical and research use. Although efforts to structure some radiology report information through predefined templates are beginning to bear fruit, a large portion of radiology report information is entered in free text. The free text format is a major obstacle for rapid extraction and subsequent use of information by clinicians, researchers, and healthcare information systems. This difficulty is due to the ambiguity and subtlety of natural language, complexity of described images, and variations among different radiologists and healthcare organizations. As a result, radiology reports are used only once by the clinician who ordered the study and rarely are used again for research and data mining. In this work, machine learning techniques and a large multi-institutional radiology report repository are used to extract the semantics of the radiology report and overcome the barriers to the re-use of radiology report information in clinical research and other healthcare applications. We describe a machine learning system to annotate radiology reports and extract report contents according to an information model. This information model covers the majority of clinically significant contents in radiology reports and is applicable to a wide variety of radiology study types. Our automated approach uses discriminative sequence classifiers for named-entity recognition to extract and organize clinically significant terms and phrases consistent with the information model. We evaluated our information extraction system on 150 radiology reports from three major healthcare organizations and compared its results to a commonly used non-machine learning information extraction method. We also evaluated the generalizability of our approach across different organizations by training and testing our system on data from different organizations. Our results show the efficacy of our machine learning approach in extracting the information model's elements (10-fold cross-validation average performance: precision: 87%, recall: 84%, F1 score: 85%) and its superiority and generalizability compared to the common non-machine learning approach (p-value<0.05). Our machine learning information extraction approach provides an effective automatic method to annotate and extract clinically significant information from a large collection of free text radiology reports. This information extraction system can help clinicians better understand the radiology reports and prioritize their review process. In addition, the extracted information can be used by researchers to link radiology reports to information from other data sources such as electronic health records and the patient's genome. Extracted information also can facilitate disease surveillance, real-time clinical decision support for the radiologist, and content-based image retrieval. Copyright © 2015 Elsevier B.V. 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.

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.

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.

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.

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.

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.

"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.

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.

Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination.

PubMed

Grayson, James; Basciano, Peter; Rawson, James V; Klein, Kandace

2015-12-01

The aim of this study was to examine the referral pattern of imaging studies requested in a single state compared with the potential location of interpretation. Analysis of Medicare patients in a DocGraph data set was performed to identify sequential different physician services claims for the same patient for which the second claim was for services provided by a radiologist. In the 2011 Medicare population, radiology referrals from physicians practicing in Georgia resulted in 76.5% of radiology interpretations by radiologists inside the state of Georgia. The states bordering Georgia accounted for 11.6% of interpretations in the Georgia market. The remaining interpretations were distributed throughout the remainder of the country. A significant proportion of routine imaging interpretation occurs outside the state in which an examination is performed. Additional studies are needed to identify complex drivers of imaging referral patterns, such as patient geographic location and demographics, radiologist workforce distribution, contractual obligations, and social relationships. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Automatic Identification of Critical Follow-Up Recommendation Sentences in Radiology Reports

PubMed Central

Yetisgen-Yildiz, Meliha; Gunn, Martin L.; Xia, Fei; Payne, Thomas H.

2011-01-01

Communication of follow-up recommendations when abnormalities are identified on imaging studies is prone to error. When recommendations are not systematically identified and promptly communicated to referrers, poor patient outcomes can result. Using information technology can improve communication and improve patient safety. In this paper, we describe a text processing approach that uses natural language processing (NLP) and supervised text classification methods to automatically identify critical recommendation sentences in radiology reports. To increase the classification performance we enhanced the simple unigram token representation approach with lexical, semantic, knowledge-base, and structural features. We tested different combinations of those features with the Maximum Entropy (MaxEnt) classification algorithm. Classifiers were trained and tested with a gold standard corpus annotated by a domain expert. We applied 5-fold cross validation and our best performing classifier achieved 95.60% precision, 79.82% recall, 87.0% F-score, and 99.59% classification accuracy in identifying the critical recommendation sentences in radiology reports. PMID:22195225

Automatic identification of critical follow-up recommendation sentences in radiology reports.

PubMed

Yetisgen-Yildiz, Meliha; Gunn, Martin L; Xia, Fei; Payne, Thomas H

2011-01-01

Communication of follow-up recommendations when abnormalities are identified on imaging studies is prone to error. When recommendations are not systematically identified and promptly communicated to referrers, poor patient outcomes can result. Using information technology can improve communication and improve patient safety. In this paper, we describe a text processing approach that uses natural language processing (NLP) and supervised text classification methods to automatically identify critical recommendation sentences in radiology reports. To increase the classification performance we enhanced the simple unigram token representation approach with lexical, semantic, knowledge-base, and structural features. We tested different combinations of those features with the Maximum Entropy (MaxEnt) classification algorithm. Classifiers were trained and tested with a gold standard corpus annotated by a domain expert. We applied 5-fold cross validation and our best performing classifier achieved 95.60% precision, 79.82% recall, 87.0% F-score, and 99.59% classification accuracy in identifying the critical recommendation sentences in radiology reports.

Effectiveness of online instruction in the radiologic sciences.

PubMed

Johnston, James

2008-01-01

Online courses are becoming increasingly common in all academic disciplines and many studies have indicated that there is no significant difference in student outcomes between the 2 instructional methods or, more recently, that online instruction is superior. However, because course content and expectations about mastery of material vary, it is important to evaluate the effectiveness of online courses in different academic disciplines and settings, including radiologic technology. To examine the instructional effectiveness of 2 online radiologic science courses that were converted from a face-to-face instruction format. Archival data were gathered from a sample of convenience (N = 317) to compare 2 years of performance indicators for each course and format. This study also compared course formats in terms of national certification exam results. The results regarding which delivery type performed better were mixed. However, the national certification exam scores for the patient care section were higher for students who completed face-to-face instruction than for those who had online instruction.

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

75 FR 68200 - Medical Devices; Radiology Devices; Reclassification of Full-Field Digital Mammography System

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... exposure control, image processing and reconstruction programs, patient and equipment supports, component..., acquisition workstation, automatic exposure control, image processing and reconstruction programs, patient and... may include was revised by adding automatic exposure control, image processing and reconstruction...

10 CFR 835.1102 - Control of areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Radioactive Contamination Control § 835.1102 Control... transfer of removable contamination to locations outside of radiological areas under normal operating conditions. (b) Any area in which contamination levels exceed the values specified in appendix D of this part...

Emergency radiology and mass casualty incidents-report of a mass casualty incident at a level 1 trauma center.

PubMed

Bolster, Ferdia; Linnau, Ken; Mitchell, Steve; Roberge, Eric; Nguyen, Quynh; Robinson, Jeffrey; Lehnert, Bruce; Gross, Joel

2017-02-01

The aims of this article are to describe the events of a recent mass casualty incident (MCI) at our level 1 trauma center and to describe the radiology response to the event. We also describe the findings and recommendations of our radiology department after-action review. An MCI activation was triggered after an amphibious military vehicle, repurposed for tourist activities, carrying 37 passengers, collided with a charter bus carrying 45 passengers on a busy highway bridge in Seattle, WA, USA. There were 4 deaths at the scene, and 51 patients were transferred to local hospitals following prehospital scene triage. Nineteen patients were transferred to our level 1 trauma center. Eighteen casualties arrived within 72 min. Sixteen arrived within 1 h of the first patient arrival, and 1 casualty was transferred 3 h later having initially been assessed at another hospital. Eighteen casualties (94.7 %) underwent diagnostic imaging in the emergency department. Of these 18 casualties, 15 had a trauma series (portable chest x-ray and x-ray of pelvis). Whole-body trauma computed tomography scans (WBCT) were performed on 15 casualties (78.9 %), 12 were immediate and performed during the initial active phase of the MCI, and 3 WBCTs were delayed. The initial 12 WBCTs were completed in 101 min. The mean number of radiographic studies performed per patient was 3 (range 1-8), and the total number of injuries detected was 88. The surge in imaging requirements during an MCI can be significant and exceed normal operating capacity. This report of our radiology experience during a recent MCI and subsequent after-action review serves to provide an example of how radiology capacity and workflow functioned during an MCI, in order to provide emergency radiologists and response planners with practical recommendations for implementation in the event of a future MCI.

10 CFR 835.602 - Controlled areas.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Controlled areas. 835.602 Section 835.602 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Posting and Labeling § 835.602 Controlled areas. (a) Each access point to a controlled area (as defined at § 835.2) shall be posted whenever radiological...

10 CFR 835.602 - Controlled areas.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Controlled areas. 835.602 Section 835.602 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Posting and Labeling § 835.602 Controlled areas. (a) Each access point to a controlled area (as defined at § 835.2) shall be posted whenever radiological...

10 CFR 835.602 - Controlled areas.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Controlled areas. 835.602 Section 835.602 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Posting and Labeling § 835.602 Controlled areas. (a) Each access point to a controlled area (as defined at § 835.2) shall be posted whenever radiological...

10 CFR 835.602 - Controlled areas.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Controlled areas. 835.602 Section 835.602 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Posting and Labeling § 835.602 Controlled areas. (a) Each access point to a controlled area (as defined at § 835.2) shall be posted whenever radiological...

10 CFR 835.602 - Controlled areas.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Controlled areas. 835.602 Section 835.602 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Posting and Labeling § 835.602 Controlled areas. (a) Each access point to a controlled area (as defined at § 835.2) shall be posted whenever radiological...

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

PubMed

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

2016-01-01

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

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.

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.

TU-CD-BRA-01: A Novel 3D Registration Method for Multiparametric Radiological Images

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

Akhbardeh, A; Parekth, VS; Jacobs, MA

2015-06-15

Purpose: Multiparametric and multimodality radiological imaging methods, such as, magnetic resonance imaging(MRI), computed tomography(CT), and positron emission tomography(PET), provide multiple types of tissue contrast and anatomical information for clinical diagnosis. However, these radiological modalities are acquired using very different technical parameters, e.g.,field of view(FOV), matrix size, and scan planes, which, can lead to challenges in registering the different data sets. Therefore, we developed a hybrid registration method based on 3D wavelet transformation and 3D interpolations that performs 3D resampling and rotation of the target radiological images without loss of information Methods: T1-weighted, T2-weighted, diffusion-weighted-imaging(DWI), dynamic-contrast-enhanced(DCE) MRI and PET/CT were usedmore » in the registration algorithm from breast and prostate data at 3T MRI and multimodality(PET/CT) cases. The hybrid registration scheme consists of several steps to reslice and match each modality using a combination of 3D wavelets, interpolations, and affine registration steps. First, orthogonal reslicing is performed to equalize FOV, matrix sizes and the number of slices using wavelet transformation. Second, angular resampling of the target data is performed to match the reference data. Finally, using optimized angles from resampling, 3D registration is performed using similarity transformation(scaling and translation) between the reference and resliced target volume is performed. After registration, the mean-square-error(MSE) and Dice Similarity(DS) between the reference and registered target volumes were calculated. Results: The 3D registration method registered synthetic and clinical data with significant improvement(p<0.05) of overlap between anatomical structures. After transforming and deforming the synthetic data, the MSE and Dice similarity were 0.12 and 0.99. The average improvement of the MSE in breast was 62%(0.27 to 0.10) and prostate was 63%(0.13 to 0.04;p<0.05). The Dice similarity was in breast 8%(0.91 to 0.99) and for prostate was 89%(0.01 to 0.90;p<0.05) Conclusion: Our 3D wavelet hybrid registration approach registered diverse breast and prostate data of different radiological images(MR/PET/CT) with a high accuracy.« less

Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study.

PubMed

Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

2016-01-01

Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. "Management and empowerment of human resources'' (weight = 0.465) and "requirements and facilities" (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country's hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards further efficiency and effectiveness of the health care evaluation systems.

Application of Analytical Hierarchy Process Approach for Service Quality Evaluation in Radiology Departments: A Cross-Sectional Study

PubMed Central

Alimohammadzadeh, Khalil; Bahadori, Mohammadkarim; Hassani, Fariba

2016-01-01

Background: Radiology department as a service provider organization requires realization of quality concept concerning service provisioning knowledge, satisfaction and all issues relating to the customer as well as quality assurance and improvement issues. At present, radiology departments in hospitals are regarded as income generating units and they should continuously seek performance improvement so that they can survive in the changing and competitive environment of the health care sector. Objectives: The aim of this study was to propose a method for ranking of radiology departments in selected hospitals of Tehran city using analytical hierarchical process (AHP) and quality evaluation of their service in 2015. Materials and Methods: This study was an applied and cross-sectional study, carried out in radiology departments of 6 Tehran educational hospitals in 2015. The hospitals were selected using non-probability and purposeful method. Data gathering was performed using customized joint commission international (JCI) standards. Expert Choice 10.0 software was used for data analysis. AHP method was used for prioritization. Results: “Management and empowerment of human resources’’ (weight = 0.465) and “requirements and facilities” (weight = 0.139) were of highest and lowest significance respectively in the overall ranking of the hospitals. MS (weight = 0.316), MD (weight = 0.259), AT (weight = 0.14), TS (weight = 0.108), MO (weight = 0.095), and LH (0.082) achieved the first to sixth rankings respectively. Conclusion: The use of AHP method can be promising for fostering the evaluation method and subsequently promotion of the efficiency and effectiveness of the radiology departments. The present model can fill in the gap in the accreditation system of the country’s hospitals in respect with ranking and comparing them considering the significance and value of each individual criteria and standard. Accordingly, it can predict an integration of qualitative and quantitative criteria involved and thereby take a decisive step towards further efficiency and effectiveness of the health care evaluation systems. PMID:27127577

Detection of pneumonia using free-text radiology reports in the BioSense system.

PubMed

Asatryan, Armenak; Benoit, Stephen; Ma, Haobo; English, Roseanne; Elkin, Peter; Tokars, Jerome

2011-01-01

Near real-time disease detection using electronic data sources is a public health priority. Detecting pneumonia is particularly important because it is the manifesting disease of several bioterrorism agents as well as a complication of influenza, including avian and novel H1N1 strains. Text radiology reports are available earlier than physician diagnoses and so could be integral to rapid detection of pneumonia. We performed a pilot study to determine which keywords present in text radiology reports are most highly associated with pneumonia diagnosis. Electronic radiology text reports from 11 hospitals from February 1, 2006 through December 31, 2007 were used. We created a computerized algorithm that searched for selected keywords ("airspace disease", "consolidation", "density", "infiltrate", "opacity", and "pneumonia"), differentiated between clinical history and radiographic findings, and accounted for negations and double negations; this algorithm was tested on a sample of 350 radiology reports. We used the algorithm to study 189,246 chest radiographs, searching for the keywords and determining their association with a final International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis of pneumonia. Performance of the search algorithm in finding keywords, and association of the keywords with a pneumonia diagnosis. In the sample of 350 radiographs, the search algorithm was highly successful in identifying the selected keywords (sensitivity 98.5%, specificity 100%). Analysis of the 189,246 radiographs showed that the keyword "pneumonia" was the strongest predictor of an ICD-9-CM diagnosis of pneumonia (adjusted odds ratio 11.8) while "density" was the weakest (adjusted odds ratio 1.5). In general, the most highly associated keyword present in the report, regardless of whether a less highly associated keyword was also present, was the best predictor of a diagnosis of pneumonia. Empirical methods may assist in finding radiology report keywords that are most highly predictive of a pneumonia diagnosis. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Terminology and reporting criteria for radiofrequency ablation of tumors in the scientific literature: systematic review of compliance with reporting standards.

PubMed

Kang, Tae Wook; Rhim, Hyunchul; Lee, Min Woo; Kim, Young-sun; Choi, Dongil; Lim, Hyo Keun

2014-01-01

To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. The proposal for standardization of terminology and reporting criteria for RF tumor ablation has been gaining support according to the recently published scientific reports, especially in the field of radiology. However, more work is still needed for the complete standardization of terminology.

Terminology and Reporting Criteria for Radiofrequency Ablation of Tumors in the Scientific Literature: Systematic Review of Compliance with Reporting Standards

PubMed Central

Kang, Tae Wook; Lee, Min Woo; Kim, Young-sun; Choi, Dongil; Lim, Hyo Keun

2014-01-01

Objective To perform a systematic review of compliance with standardized terminology and reporting criteria for radiofrequency (RF) tumor ablation, proposed by the International Working Group on Image-Guided Tumor Ablation in 2003, in the published reports. Materials and Methods Literature search in the PubMed database was performed using index keywords, PubMed limit system, and eligibility criteria. The entire content of each article was reviewed to assess the terminology used for procedure terms, imaging findings, therapeutic efficacy, follow-up, and complications. Accuracy of the terminology and the use of alternative terms instead of standard terminology were analyzed. In addition, disparities in accuracy of terminology in articles according to the medical specialty and the type of radiology journal were evaluated. Results Among the articles (n = 308) included in this study, the accuracy of the terms 'procedure or session', 'treatment', 'index tumor', 'ablation zone', 'technical success', 'primary technique effectiveness rate', 'secondary technique effectiveness rate', 'local tumor progression', 'major complication', and 'minor complication' was 97% (298/307), 97% (291/300), 8% (25/307), 65% (103/159), 55% (52/94), 33% (42/129), 94% (17/18), 45% (88/195), 99% (79/80), and 100% (77/77), respectively. The overall accuracy of each term showed a tendency to improve over the years. The most commonly used alternative terms for 'technical success' and 'local tumor progression' were 'complete ablation' and 'local (tumor) recurrence', respectively. The accuracy of terminology in articles published in radiology journals was significantly greater than that of terminology in articles published in non-radiology journals, especially in Radiology and The Journal of Vascular and Interventional Radiology. Conclusion The proposal for standardization of terminology and reporting criteria for RF tumor ablation has been gaining support according to the recently published scientific reports, especially in the field of radiology. However, more work is still needed for the complete standardization of terminology. PMID:24497798

[Bladder pseudotumor in childhood].

PubMed

Fernández Arjona, M; Muñoz-Delgado Salmerón, J; Shihadei, S; Colomar, P J; García Estevez, J A

1997-01-01

Case report of a 10 year-old male with vesical mass suggestive of a rabdomiosarcoma based on the radiologic studies performed. The existence of an inflammatory process with no signs of malignancy was confirmed by transurethral resection. The serological studies were negative and the absence of malignant disease in further substantiated by immunohistochemistry. We want to emphasize that certain vesical masses. which appear to be malignant on the radiological study (Pseudotumours), may be just inflammatory processes.

Examination of a novel, specified local antibiotic therapy through polymethylmethacrylate capsules in a rabbit osteomyelitis model.

PubMed

Börzsei, László; Mintál, Tibor; Koós, Zoltán; Kocsis, Béla; Helyes, Zsuzsanna; Kereskai, László; Nyárády, József

2006-01-01

Chronic bone and soft tissue suppurations have become more frequent recently due to the increasing number of high-energy injuries. There are certain antibiotic beads available for local administration, but they cannot always be applied specifically against the pyogenic microorganisms. In the present study, a new technique of local antibiotic therapy for the treatment of infections is described. Polymethylmethacrylate (PMMA) capsules were produced and filled with 0.1 ml Tazocin (0.02 g piperacillin sodium + 0.005 g tazobactam). The efficacy of these Tazocin-filled capsules was examined in vivo using a rabbit osteomyelitis model. Chronic osteomyelitis was induced in rabbit tibia by local injection of Staphylococcus aureus. The treatment included surgical debridement and implantation of Tazocin-containing PMMA capsules into the medullar cavity (n = 12). Simple surgical debridement with no antibiotic implantation was performed in control animals (n = 7). Results were evaluated using microbiological, radiological and histological methods 14 weeks after induction of osteomyelitis. Eight weeks after the implantation of PMMA capsules, complete physical, radiological and histological healing was achieved in 7 animals, initiation of the reparative phase was observed histologically in 3 cases and no reparative signs were detected in 2 rabbits. In the control group, no significant sign of reparation could be seen in any of the cases. Copyright 2006 S. Karger AG, Basel.

Radiological, histological, and hematological evaluation of hydroxyapatite-coated resorbable magnesium alloy screws placed in rabbit tibia.

PubMed

Lim, Ho-Kyung; Byun, Soo-Hwan; Lee, Jin-Yong; Lee, Jung-Woo; Kim, Sae-Mi; Lee, Sung-Mi; Kim, Hyoun-Ee; Lee, Jong-Ho

2017-08-01

Titanium (Ti) screw has excellent mechanical property, and osseointegration capacity. However, they require surgery for removal. In contrast, polymer screws are resorbable, but they have poor mechanical properties. In this research, magnesium alloy screws (WE43: Mg-Y-Nd-Zr) that have advantages of titanium and polymer were manufactured. In addition, to increase biocompatibility and control degradation rate, the Mg alloy was coated with hydroxyapatite (HA). Torsion test and corrosion test were performed in vitro. For clinical, radiological and histological evaluation, on the eight rabbits, two HA-coated screws were installed in left tibia, and two noncoated screws were installed in right tibia. Each four rabbits were sacrificed 6 and 12 weeks postoperatively. For hematological evaluation, the same type of screws were installed on both legs. Complete blood count (CBC), Mg 2+ concentrate were sampled from the ear central artery on the operation day for a control point, and at 1, 2, 4, 6, 8, and 12 weeks. Mg alloy screws have no differences of biocompatibility according to the HA coating. However, resorption of screw was slower in case of the HA coating. The hematological problem related releasing of Mg was not found. The results suggest that Mg alloy screws have feasibility for clinical application. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1636-1644, 2017. © 2016 Wiley Periodicals, Inc.

What is industrial hygiene? | News

Science.gov Websites

Radiological Control Manual (FRCM) Graphic design standards Quality Assurance Manual (QAM) Forms Forms , 2016 | Rob Bushek icon icon icon Industrial hygiene is concerned primarily with the control of that science and art devoted to the anticipation, recognition, evaluation and control of those

Bridging the gap: linking a legacy hospital information system with a filmless radiology picture archiving and communications system within a nonhomogeneous environment.

PubMed

Rubin, R K; Henri, C J; Cox, R D

1999-05-01

A health level 7 (HL7)-conformant data link to exchange information between the mainframe hospital information system (HIS) of our hospital and our home-grown picture archiving and communications system (PACS) is a result of a collaborative effort between the HIS department and the PACS development team. Based of the ability to link examination requisitions and image studies, applications have been generated to optimise workflow and to improve the reliability and distribution of radiology information. Now, images can be routed to individual radiologists and clinicians; worklists facilitate radiology reporting; applications exist to create, edit, and view reports and images via the internet; and automated quality control now limits the incidence of "lost" cases and errors in image routing. By following the HL7 standard to develop the gateway to the legacy system, the development of a radiology information system for booking, reading, reporting, and billing remains universal and does not preclude the option to integrate off-the-shelf commercial products.

Big Data and the Future of Radiology Informatics.

PubMed

Kansagra, Akash P; Yu, John-Paul J; Chatterjee, Arindam R; Lenchik, Leon; Chow, Daniel S; Prater, Adam B; Yeh, Jean; Doshi, Ankur M; Hawkins, C Matthew; Heilbrun, Marta E; Smith, Stacy E; Oselkin, Martin; Gupta, Pushpender; Ali, Sayed

2016-01-01

Rapid growth in the amount of data that is electronically recorded as part of routine clinical operations has generated great interest in the use of Big Data methodologies to address clinical and research questions. These methods can efficiently analyze and deliver insights from high-volume, high-variety, and high-growth rate datasets generated across the continuum of care, thereby forgoing the time, cost, and effort of more focused and controlled hypothesis-driven research. By virtue of an existing robust information technology infrastructure and years of archived digital data, radiology departments are particularly well positioned to take advantage of emerging Big Data techniques. In this review, we describe four areas in which Big Data is poised to have an immediate impact on radiology practice, research, and operations. In addition, we provide an overview of the Big Data adoption cycle and describe how academic radiology departments can promote Big Data development. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Is past academic productivity predictive of radiology resident academic productivity?

PubMed

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

2002-02-01

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

E-learning and education in radiology.

PubMed

Pinto, Antonio; Brunese, Luca; Pinto, Fabio; Acampora, Ciro; Romano, Luigia

2011-06-01

To evaluate current applications of e-learning in radiology. A Medline search was performed using PubMed (National Library of Medicine, Bethesda, MD) for publications discussing the applications of e-learning in radiology. The search strategy employed a single combination of the following terms: (1) e-learning, and (2) education and (3) radiology. This review was limited to human studies and to English-language literature. We reviewed all the titles and subsequent the abstract of 29 articles that appeared pertinent. Additional articles were identified by reviewing the reference lists of relevant papers. Finally, the full text of 38 selected articles was reviewed. Literature data shows that with the constant development of technology and global spread of computer networks, in particular of the Internet, the integration of multimedia and interactivity introduced into electronic publishing has allowed the creation of multimedia applications that provide valuable support for medical teaching and continuing medical education, specifically for radiology. Such technologies are valuable tools for collaboration, interactivity, simulation, and self-testing. However, not everything on the World Wide Web is useful, accurate, or beneficial: the quality and veracity of medical information on the World Wide Web is variable and much time can be wasted as many websites do not meet basic publication standards. E-learning will become an important source of education in radiology. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Correlation between thigh pain and radiological findings with a proximally porous-coated stem.

PubMed

Kinov, Plamen; Radl, Roman; Zacherl, Maximilian; Leithner, Andreas; Windhager, Reinhard

2007-10-01

Thigh pain has been consistently reported with cementless hip arthroplasty. The correlation between thigh pain and radiological findings and the clinical significance of thigh pain have not been studied in any detail. We carried out a retrospective study to analyse the performance of a proximally porous-coated cementless femoral component. Ninety-eight total hip arthroplasties were followed up clinically and radiologically for an average of 33 months (range: 12 to 64) after operation. The clinical results were good or excellent in 85 cases (87%). Thirteen patients (13%) reported thigh pain at latest follow-up. Subsidence of the stem was recorded in 10 cases, cortical thickening occurred in 14 hips (14%), and 17 hips (17%) presented proximal osteopenia. Proximally, radiolucent lines were observed in 11 cases. Thigh pain correlated with radiolucent lines, femoral thickening, fibrous fixation and stem migration. Bone remodelling was noted to continue even five years after implantation. Our observations demonstrated bone ingrowth in the majority of the cases and a low incidence of thigh pain. The correlation between radiological changes and thigh pain suggests implant micromotion and migration in some hips. Patients with thigh pain, changes in the proximal femur and progressive subsidence need further clinical and radiological follow-up.

Coagulation necrosis induced by radiofrequency ablation in the liver: histopathologic and radiologic review of usual to extremely rare changes.

PubMed

Kim, Young-sun; Rhim, Hyunchul; Lim, Hyo Keun; Choi, Dongil; Lee, Min Woo; Park, Min Jung

2011-01-01

As the clinical role of radiofrequency ablation (RFA) of the liver grows, the importance of radiologic imaging after liver RFA to depict the diversity of post-RFA manifestations is also increasing. Because RFA induces coagulation necrosis of the hepatic parenchyma, cross-sectional imaging studies, in principle, demonstrate an area with a defect in contrast enhancement. However, for various reasons, such as the occurrence of a complication, the RFA zone may demonstrate different patterns or be accompanied by other abnormalities. In this investigation, a large number of imaging studies performed after more than 4000 procedures of liver RFA during the past 10-year period were reviewed, and various radiologic manifestations of the RFA zone were compiled. Herein, the basic principles of RFA, as well as the histopathologic features of coagulation necrosis of the liver, are catalogued to provide a more complete understanding of such changes. Through this review, the reader will become more familiar with the usual and unusual radiologic findings of coagulation necrosis induced by RFA in the liver. This increased familiarity will not only facilitate the daily practice of radiology but also deepen understanding of the therapeutic modality of RFA. © RSNA, 2011.

Selected accounts receivable performance statistics for radiology practices: an analysis of the adjusted collection percentage and days charges in accounts receivable.

PubMed

Cergnul, John J; Russell, Philip J; Sunshine, Jonathan H

2005-12-01

To provide comparative data and analysis with respect to accounts receivable management performance criteria. Data from 3 sources were analyzed: the Radiology Business Management Association's (RBMA) 2003 Accounts Receivable Performance Survey; the RBMA's 2003 Accounts Receivable Survey; and Hogan and Sunshine's 2004 Radiology article "Financial Ratios in Diagnostic Radiology Practices: Variability and Trends," the data for which were drawn primarily from the ACR's 1999 Survey of Practices. The RBMA surveyed (via e-mail and postal mail) only its members, with response rates of 15% and 9%, respectively. The ACR's survey response rate was 66%, via postal mail, and was distributed without regard to the RBMA membership status of the practice manager or even whether the practice employed a practice manager. Comparison among the survey results provided information on trends. Median practice professional component adjusted collection percentage (ACP) deteriorated from 87.3% to 85.1% between the RBMA surveys. Practices limited to global fee billing faired much better when performing their billing in house, as opposed to using a billing service, with mean ACPs of 91.2% and 79.4%, respectively. Days charges in accounts receivable 2004 mean results for professional component billing and global fee billing were nearly identical at 56.11 and 55.54 days, respectively. The 2003 RBMA survey reported 63.74 days for professional component billing and 77.33 days for global fee billing. The improvement from 2003 to 2004 was highly significant for both professional component billing and global fee billing. The 2004 RBMA survey also reflected a rather dramatic improvement in days charges in accounts receivable compared with Hogan and Sunshine's results, which showed a mean of 69 days charges in accounts receivable. The conflicting trends between ACP performance and days charges in accounts receivable performance may be explained by the increasing sophistication of accounts receivable management processes (improving days charges in accounts receivable) and the deterioration in the general economy between survey periods (decreasing ACPs). Additionally, generally better accounts receivable management performance was experienced by practices employing RBMA members (RBMA survey participants) compared with those that may or may not have employed RBMA members (ACR survey participants).

SU-C-18C-06: Radiation Dose Reduction in Body Interventional Radiology: Clinical Results Utilizing a New Imaging Acquisition and Processing Platform

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

Kohlbrenner, R; Kolli, KP; Taylor, A

2014-06-01

Purpose: To quantify the patient radiation dose reduction achieved during transarterial chemoembolization (TACE) procedures performed in a body interventional radiology suite equipped with the Philips Allura Clarity imaging acquisition and processing platform, compared to TACE procedures performed in the same suite equipped with the Philips Allura Xper platform. Methods: Total fluoroscopy time, cumulative dose area product, and cumulative air kerma were recorded for the first 25 TACE procedures performed to treat hepatocellular carcinoma (HCC) in a Philips body interventional radiology suite equipped with Philips Allura Clarity. The same data were collected for the prior 85 TACE procedures performed to treatmore » HCC in the same suite equipped with Philips Allura Xper. Mean values from these cohorts were compared using two-tailed t tests. Results: Following installation of the Philips Allura Clarity platform, a 42.8% reduction in mean cumulative dose area product (3033.2 versus 1733.6 mGycm∧2, p < 0.0001) and a 31.2% reduction in mean cumulative air kerma (1445.4 versus 994.2 mGy, p < 0.001) was achieved compared to similar procedures performed in the same suite equipped with the Philips Allura Xper platform. Mean total fluoroscopy time was not significantly different between the two cohorts (1679.3 versus 1791.3 seconds, p = 0.41). Conclusion: This study demonstrates a significant patient radiation dose reduction during TACE procedures performed to treat HCC after a body interventional radiology suite was converted to the Philips Allura Clarity platform from the Philips Allura Xper platform. Future work will focus on evaluation of patient dose reduction in a larger cohort of patients across a broader range of procedures and in specific populations, including obese patients and pediatric patients, and comparison of image quality between the two platforms. Funding for this study was provided by Philips Healthcare, with 5% salary support provided to authors K. Pallav Kolli and Robert G. Gould for time devoted to the study. Data acquisition and analysis was performed by the authors independent of the funding source.« less

Variability in the Use of Simulation for Procedural Training in Radiology Residency: Opportunities for Improvement.

PubMed

Matalon, Shanna A; Chikarmane, Sona A; Yeh, Eren D; Smith, Stacy E; Mayo-Smith, William W; Giess, Catherine S

2018-03-19

Increased attention to quality and safety has led to a re-evaluation of the classic apprenticeship model for procedural training. Many have proposed simulation as a supplementary teaching tool. The purpose of this study was to assess radiology resident exposure to procedural training and procedural simulation. An IRB-exempt online survey was distributed to current radiology residents in the United States by e-mail. Survey results were summarized using frequency and percentages. Chi-square tests were used for statistical analysis where appropriate. A total of 353 current residents completed the survey. 37% (n = 129/353) of respondents had never used procedure simulation. Of the residents who had used simulation, most did not do so until after having already performed procedures on patients (59%, n = 132/223). The presence of a dedicated simulation center was reported by over half of residents (56%, n = 196/353) and was associated with prior simulation experience (P = 0.007). Residents who had not had procedural simulation were somewhat likely or highly likely (3 and 4 on a 4-point Likert-scale) to participate if it were available (81%, n = 104/129). Simulation training was associated with higher comfort levels in performing procedures (P < 0.001). Although procedural simulation training is associated with higher comfort levels when performing procedures, there is variable use in radiology resident training and its use is not currently optimized. Given the increased emphasis on patient safety, these results suggest the need to increase procedural simulation use during residency, including an earlier introduction to simulation before patient exposure. Copyright © 2018 Elsevier Inc. All rights reserved.

Barriers and facilitators to adoption of soft copy interpretation from the user perspective: Lessons learned from filmless radiology for slideless pathology

PubMed Central

Patterson, Emily S.; Rayo, Mike; Gill, Carolina; Gurcan, Metin N.

2011-01-01

Background: Adoption of digital images for pathological specimens has been slower than adoption of digital images in radiology, despite a number of anticipated advantages for digital images in pathology. In this paper, we explore the factors that might explain this slower rate of adoption. Materials and Method: Semi-structured interviews on barriers and facilitators to the adoption of digital images were conducted with two radiologists, three pathologists, and one pathologist's assistant. Results: Barriers and facilitators to adoption of digital images were reported in the areas of performance, workflow-efficiency, infrastructure, integration with other software, and exposure to digital images. The primary difference between the settings was that performance with the use of digital images as compared to the traditional method was perceived to be higher in radiology and lower in pathology. Additionally, exposure to digital images was higher in radiology than pathology, with some radiologists exclusively having been trained and/or practicing with digital images. The integration of digital images both improved and reduced efficiency in routine and non-routine workflow patterns in both settings, and was variable across the different organizations. A comparison of these findings with prior research on adoption of other health information technologies suggests that the barriers to adoption of digital images in pathology are relatively tractable. Conclusions: Improving performance using digital images in pathology would likely accelerate adoption of innovative technologies that are facilitated by the use of digital images, such as electronic imaging databases, electronic health records, double reading for challenging cases, and computer-aided diagnostic systems. PMID:21383925

Comparison Between Manual Auditing and a Natural Language Process With Machine Learning Algorithm to Evaluate Faculty Use of Standardized Reports in Radiology.

PubMed

Guimaraes, Carolina V; Grzeszczuk, Robert; Bisset, George S; Donnelly, Lane F

2018-03-01

When implementing or monitoring department-sanctioned standardized radiology reports, feedback about individual faculty performance has been shown to be a useful driver of faculty compliance. Most commonly, these data are derived from manual audit, which can be both time-consuming and subject to sampling error. The purpose of this study was to evaluate whether a software program using natural language processing and machine learning could accurately audit radiologist compliance with the use of standardized reports compared with performed manual audits. Radiology reports from a 1-month period were loaded into such a software program, and faculty compliance with use of standardized reports was calculated. For that same period, manual audits were performed (25 reports audited for each of 42 faculty members). The mean compliance rates calculated by automated auditing were then compared with the confidence interval of the mean rate by manual audit. The mean compliance rate for use of standardized reports as determined by manual audit was 91.2% with a confidence interval between 89.3% and 92.8%. The mean compliance rate calculated by automated auditing was 92.0%, within that confidence interval. This study shows that by use of natural language processing and machine learning algorithms, an automated analysis can accurately define whether reports are compliant with use of standardized report templates and language, compared with manual audits. This may avoid significant labor costs related to conducting the manual auditing process. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Occupational radiation exposure in vascular interventional radiology: A complete evaluation of different body regions.

PubMed

Bacchim Neto, Fernando Antonio; Alves, Allan Felipe Fattori; Mascarenhas, Yvone Maria; Nicolucci, Patrícia; Pina, Diana Rodrigues de

2016-08-01

To perform a complete evaluation on radiation doses, received by primary and assistant medical staff, while performing different vascular interventional radiology procedures. We evaluated dose received in different body regions during three categories of vascular procedures: lower limb angiography (Angiography), lower limb percutaneous transluminal angioplasty (Angioplasty) and stent graft placement for abdominal aortic aneurysm treatment (A. A. A. Treatment). We positioned the dosimeters near the eye lens, thyroid, chest, abdomen, hands, and feet of the interventional physicians. Equivalent dose was compared with annual dose limits for workers in order to determine the maximum number of procedures per year that each physician could perform. We assessed 90 procedures. We found the highest equivalent doses in the A. A. A. Treatment, in which 90% of the evaluations indicated at least one region receiving more than 1mSv per procedure. Angioplasty was the only procedural modality that provided statistically different doses for different professionals, which is an important aspect on regards to radiological protection strategies. In comparison with the dose limits, the most critical region in all procedures was the eye lens. Since each body region of the interventionist is exposed to different radiation levels, dose distribution measurements are essential for radiological protection strategies. These results indicate that dosimeters placed in abdomen instead of chest may represent more accurately the whole body doses received by the medical staff. Additional dosimeters and a stationary shield for the eye lens are strongly recommended. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

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.

Outbreak of vancomycin-resistant enterococcus colonization among pediatric oncology patients.

PubMed

Nolan, Sheila M; Gerber, Jeffrey S; Zaoutis, Theoklis; Prasad, Priya; Rettig, Susan; Gross, Kimberly; McGowan, Karin L; Reilly, Anne F; Coffin, Susan E

2009-04-01

To detect the burden of vancomycin-resistant Enterococcus (VRE) colonization among pediatric oncology patients and to determine risk factors for VRE acquisition. Retrospective case-control study. The Children's Hospital of Philadelphia. Pediatric oncology patients hospitalized from June 2006 through December 2007. Prevalence surveys revealed an increased VRE burden among pediatric oncology patients. For the case-control study, the 16 case patients were pediatric oncology patients who had 1 stool sample negative for VRE at screening before having a stool sample positive for VRE at screening; the 62 control patients had 2 consecutive screenings in which stool samples were negative for VRE. Case and control patients were matched on the duration of the interval between screens. Analyses were performed to determine the association between multiple exposures and VRE acquisition. The prevalence survey revealed that 5 (9.6%) of 52 patients had unsuspected VRE colonization at the time of hospitalization. Multivariate analysis identified a lack of empirical contact precautions (odds ratio [OR], 17.16 [95% confidence interval {CI}, 1.49-198.21]; P= .02) and the presence of a gastrointestinal device (OR, 4.03 [95% CI, 1.04-15.56]; P= .04) as significant risk factors for acquisition of VRE. Observations in the interventional radiology department revealed that staff could not access the portions of the electronic medical record in which isolation precautions were documented. Simple interventions that granted access and that trained interventional radiology staff to review the need for precautions, coupled with enhanced infection control practices, interrupted ongoing transmission and reduced the proportion of VRE screens that were positive to 15 (1.2%) of 1,270. Inadequate communication with regard to infection control precautions can increase the risk of transmission of epidemiologically important organisms, particularly when patients receive care at multiple clinic locations. Adherence to infection control practices across the spectrum of care may limit the spread of resistant organisms.

Outbreak of Vancomycin-Resistant Enterococcus Colonization Among Pediatric Oncology Patients

PubMed Central

Nolan, Sheila M.; Gerber, Jeffrey S.; Zaoutis, Theoklis; Prasad, Priya; Rettig, Susan; Gross, Kimberly; McGowan, Karin L.; Reilly, Anne F.; Coffin, Susan E.

2010-01-01

OBJECTIVE To detect the burden of vancomycin-resistant Enterococcus (VRE) colonization among pediatric oncology patients and to determine risk factors for VRE acquisition. DESIGN Retrospective case-control study. SETTING The Children’s Hospital of Philadelphia. PATIENTS Pediatric oncology patients hospitalized from June 2006 through December 2007. METHODS Prevalence surveys revealed an increased VRE burden among pediatric oncology patients. For the case-control study, the 16 case patients were pediatric oncology patients who had 1 stool sample negative for VRE at screening before having a stool sample positive for VRE at screening; the 62 control patients had 2 consecutive screenings in which stool samples were negative for VRE. Case and control patients were matched on the duration of the interval between screens. Analyses were performed to determine the association between multiple exposures and VRE acquisition. RESULTS The prevalence survey revealed that 5 (9.6%) of 52 patients had unsuspected VRE colonization at the time of hospitalization. Multivariate analysis identified a lack of empirical contact precautions (odds ratio [OR], 17.16 [95% confidence interval {CI}, 1.49–198.21]; P = .02) and the presence of a gastrointestinal device (OR, 4.03 [95% CI, 1.04–15.56]; P = .04) as significant risk factors for acquisition of VRE. Observations in the interventional radiology department revealed that staff could not access the portions of the electronic medical record in which isolation precautions were documented. Simple interventions that granted access and that trained interventional radiology staff to review the need for precautions, coupled with enhanced infection control practices, interrupted ongoing transmission and reduced the proportion of VRE screens that were positive to 15 (1.2%) of 1,270. CONCLUSIONS Inadequate communication with regard to infection control precautions can increase the risk of transmission of epidemiologically important organisms, particularly when patients receive care at multiple clinic locations. Adherence to infection control practices across the spectrum of care may limit the spread of resistant organisms. PMID:19239375

Who will be the Radiologists of Tomorrow? A survey of radiology during the "Practical Year" in Germany.

PubMed

Dettmer, Sabine; Fischer, Volkhard; Paeßens, Carolin; Meyer, Simone; Wacker, Frank K; Rodt, Thomas

2017-10-01

Purpose  Aim of our study was to evaluate the motivation of medical students in their final year of medical school to choose radiology for further specialization by means of a Germany-wide survey. Materials and Methods  The survey was performed during the 2015/16 semester among German medical students in their four months radiology elective during the final year. Invitations for the study were distributed by the Student Secretariats of each university. The survey was web-based with EvaSys 7.0 software. Questions on radiology contents during medical studies and "practical year" were part of the survey. Plans for residency and possible advantages and disadvantages of radiology as medical specialty were inquired. Descriptive statistics and group comparisons were used as analysis methods. Results  89 students participated in the survey at the beginning and 60 students at the end of the practical year. Of these 39 students could be identified who answered both questionnaires. Most students were satisfied with their final year radiology elective (mean 1.8 on a range from 1 to 5). Nevertheless, they criticized mentoring during routine work (mean 2.1) and a lack of educational courses (mean 2.1). Most students (83 %) were uncertain about their residency choice at the beginning of their "practical year" and about one fifth changed their plans. From the students' point of view main advantages of radiology included contact with many other clinical disciplines (87 %) and the working conditions (68 %). The reduced patient contact (42 %), the large amount of work at a computer (43 %), and the dependency on referring physicians (42 %) were regarded as the main disadvantages. The students regarded the way radiology is taught during the studies as not practical enough. With regard to radiology the majority of students (63 %) felt poorly prepared for their future work. Conclusion  The "practical year" is important regarding the choice of future specialization. There was a high degree of satisfaction with the "practical year" in radiology. The mentoring during routine work and a lack of educational courses was mildly criticized. These factors provide room for improvement to foster students' interest in radiology. Key Points   · The "practical year" is important regarding the choice of further specialization.. · Criticisms of radiology in the "practical year" were mentoring and courses.. · Students feel poorly prepared for their future work regarding practical radiological skills.. Citation Format · Dettmer S, Fischer V, Paeßens C et al. Who will be the Radiologists of Tomorrow? A survey of radiology during the "Practical Year" in Germany. Fortschr Röntgenstr 2017; 189: 967 - 976. © Georg Thieme Verlag KG Stuttgart · New York.

Utility of Interobserver Agreement Statistics in Establishing Radiology Resident Learning Curves During Self-directed Radiologic Anatomy Training.

PubMed

Tureli, Derya; Altas, Hilal; Cengic, Ismet; Ekinci, Gazanfer; Baltacioglu, Feyyaz

2015-10-01

The aim of the study was to ascertain the learning curves for the radiology residents when first introduced to an anatomic structure in magnetic resonance images (MRI) to which they have not been previously exposed to. The iliolumbar ligament is a good marker for testing learning curves of radiology residents because the ligament is not part of a routine lumbar MRI reporting and has high variability in detection. Four radiologists, three residents without previous training and one mentor, studied standard axial T1- and T2-weighted images of routine lumbar MRI examinations. Radiologists had to define iliolumbar ligament while blinded to each other's findings. Interobserver agreement analyses, namely Cohen and Fleiss κ statistics, were performed for groups of 20 cases to evaluate the self-learning curve of radiology residents. Mean κ values of resident-mentor pairs were 0.431, 0.608, 0.604, 0.826, and 0.963 in the analysis of successive groups (P < .001). The results indicate that the concordance between the experienced and inexperienced radiologists started as weak (κ <0.5) and gradually became very acceptable (κ >0.8). Therefore, a junior radiology resident can obtain enough experience in identifying a rather ambiguous anatomic structure in routine MRI after a brief instruction of a few minutes by a mentor and studying approximately 80 cases by oneself. Implementing this methodology will help radiology educators obtain more concrete ideas on the optimal time and effort required for supported self-directed visual learning processes in resident education. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

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.

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

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.

Mission Analysis for Using Preventive Radiological/Nuclear Detection Equipment for Consequence Management

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

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

The overall objective of this project is to research, evaluate, and test first responder preventive radiological/nuclear detection (PRND) equipment to provide state and local agencies with scientific guidance on how to effectively use this equipment for response after a radiological/nuclear release or detonation. While the equipment being tested in this effort has been specifically designed by technology manufacturers and purchased by responders for preventive detection and source interdiction operations, the fleet of PRND equipment can help fill critical needs for radiological instrumentation should a consequence management (CM) response take place, as it is currently the most widely available and fieldedmore » radiological instrumentation by state and local agencies. This effort will provide scientific guidance on the most effective way to utilize this class of equipment for consequence management missions. Gaining a better understanding of how PRND equipment can operate and perform for these missions will allow for recommendations on the tactical approach responders can use for consequence management operations. PRND equipment has been placed into service by federal, state, and local agencies throughout the nation. If the equipment capability and limitations are taken into account, this large inventory can be leveraged to support the emergency response in the aftermath of a radiological or nuclear event. With several hundred makes and models of PRND equipment, often with significantly different detection capabilities that do not align with their nominal PRND equipment type, development of a streamlined categorization scheme with respect to consequence management missions was the first step to identifying safe and effective uses of PRND equipment for radiological/nuclear incident response.« less

Quality of the written radiology report: a review of the literature.

PubMed

Pool, Felicity; Goergen, Stacy

2010-08-01

A literature review was carried out, guided by the question, What are the important elements of a high-quality radiology written report? Two papers known to the authors were used as a basis for 5 PubMed search strategies. Exclusion criteria were applied to retrieved citations. Reference lists of retrieved citations were scanned for additional relevant papers and exclusion criteria applied to these. Web sites of professional radiology organizations were scanned for guidelines relating to the written radiology report. Retrieved guidelines were appraised using the Appraisal of Guidelines for Research & Evaluation instrument. Methodologies of retrieved papers were not suitable for conventional appraisal, and an evidence table was constructed. The search strategy identified 25 published papers and 4 guidelines. Published study methodologies included 1 randomized controlled trial; 1 before-and-after study of interventions; 10 observational studies, audits, or analyses; 12 surveys; and 1 narrative review of the literature. Existing guidelines have a number of weaknesses with regard to scope and purpose, methods of development, stakeholder consultation, and editorial independence and applicability. There is a major gap in published studies relating to testing of interventions to improve report quality using conventional randomized controlled trial methods. Published studies and guidelines generally support report content, including clinical history, examination quality, description of findings, comparison, and diagnosis. Important report attributes include accuracy, clarity, and certainty. There is wide variation in the language used to describe imaging findings and diagnostic certainty. Survey participants strongly preferred reports with structured or itemized formats, but few studies exist regarding the effect of report structure on quality. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Histological and radiological evaluation of sintered and non-sintered deproteinized bovine bone substitute materials in sinus augmentation procedures. A prospective, randomized-controlled, clinical multicenter study.

PubMed

Fienitz, Tim; Moses, Ofer; Klemm, Christoph; Happe, Arndt; Ferrari, Daniel; Kreppel, Matthias; Ormianer, Zeev; Gal, Moti; Rothamel, Daniel

2017-04-01

The objective of this study is to histologically and radiologically compare a sintered and a non-sintered bovine bone substitute material in sinus augmentation procedures. Thirty-three patients were included in the clinically controlled randomized multicentre study resulting in a total of 44 treated sinuses. After lateral approach, sinuses were filled with either a sintered (SBM, Alpha Bio's Graft ® ) or a non-sintered (NSBM, Bio Oss ® ) deproteinized bovine bone substitute material. The augmentation sites were radiologically assessed before and immediately after the augmentation procedure as well as prior to implant placement. Bone trephine biopsies for histological analysis were harvested 6 months after augmentation whilst preparing the osteotomies for implant placement. Healing was uneventful in all patients. After 6 months, radiological evaluation of 43 sinuses revealed a residual augmentation height of 94.65 % (±2.74) for SBM and 95.76 % (±2.15) for NSBM. One patient left the study for personal reasons. Histological analysis revealed a percentage of new bone of 29.71 % (±13.67) for SBM and 30.57 % (±16.07) for NSBM. Residual bone substitute material averaged at 40.68 % (±16.32) for SBM compared to 43.43 % (±19.07) for NSBM. All differences between the groups were not statistically significant (p > 0.05, Student's t test). Both xenogeneic bone substitute materials showed comparable results regarding new bone formation and radiological height changes in external sinus grafting procedures. Both bone substitute materials allow for a predictable new bone formation following sinus augmentation procedures.

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

PubMed

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

2013-11-07

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

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

PubMed Central

2013-01-01

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

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

Medical errors arising from outsourcing laboratory and radiology services.

PubMed

Chasin, Brian S; Elliott, Sean P; Klotz, Stephen A

2007-09-01

Document errors and the nuisance factor inherent in the informational exchange that occurs with the outsourcing of laboratory and radiology examinations. Three infectious diseases physicians at a tertiary care hospital recorded problems involving data transmitted by telephone or fax from outsource providers for 4 months. This included in- and outpatients, and those in transition from one status to another. Outsourcing laboratory and radiology examinations of insured outpatients is a common practice. Insurance companies determine which healthcare facility performs these tests based on contractual agreements with outsource providers. This leads to confusion and frustration for the doctor and patient alike, and occasionally, to medical error. The exchange of patient data involved in outsourcing is subject to systemic errors that do not allow of easy solution.

A default normal chest CT structured reporting field for coronary calcifications does not cause excessive false-negative reporting.

PubMed

Walter, William R; Goldberg-Stein, Shlomit; Levsky, Jeffrey M; Cohen, Hillel W; Scheinfeld, Meir H

2015-08-01

The aim of this study was to compare the accuracy of coronary atherosclerosis reporting before and after the implementation of a structured reporting chest CT template. A noncardiac, noncontrast chest CT structured reporting template was developed and mandated for department-wide use at a large academic center. The template included the statement "There are no coronary artery calcifications." All noncardiac, noncontrast chest CT examinations reported over 3 days, 1 month after template implementation (structured template group), and from a 3-day period 1 year prior (control group) were retrospectively collected. Final radiology reports were reviewed and designated positive or negative for coronary calcifications. CT images were reviewed in consensus by 2 radiologists, who scored each case for the presence or absence of coronary calcifications, blinded to the original report. Statistical analysis was performed using Pearson χ(2) and Fisher exact tests. Sixty-five percent (69 of 106) of structured template group and 58% (62 of 106) of control group cases had coronary calcifications. Reports from the structured template group were more likely to correctly state the presence or absence of coronary atherosclerosis compared with those from the control group (96.2% vs 85.8%; odds ratio, 4.2; 95% confidence interval, 1.3-13.1; P = .008). Structured template group reports were less likely to be falsely negative compared with control group reports (3.8% vs 11.7%; odds ratio, 3.4; 95% confidence interval, 1.0-10.8; P = .03). Implementing a structured reporting template improves reporting accuracy of coronary calcifications. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Dose measurements in intraoral radiography using thermoluminescent dosimeters

NASA Astrophysics Data System (ADS)

Azorín, C.; Azorín, J.; Aguirre, F.; Rivera, T.

2015-01-01

The use of X-ray in medicine demands to expose the patient and the professional to the lowest radiation doses available in agreement with ALARA philosophy. The reference level for intraoral dental radiography is 7 mGy and, in Mexico, a number of examinations of this type are performed annually. It is considered that approximately 25% of all the X-rays examinations carried out in our country correspond to intraoral radiographies. In other hand, most of the intraoral X-ray equipment correspond to conventional radiological systems using film, which are developed as much manual as automatically. In this work the results of determining the doses received by the patients in intraoral radiological examinations made with different radiological systems using LiF:Mg,Cu,P+PTFE thermoluminescent dosimeters are presented. In some conventional radiological systems using film, when films are developed manual or automatically, incident kerma up to 10.61 ± 0.74 mGv were determined. These values exceed that reference level suggested by the IAEA and in the Mexican standards for intraoral examinations.

Definition of Local Diagnostic Reference Levels in a Radiology Department Using a Dose Tracking Software.

PubMed

Ghetti, C; Ortenzia, O; Palleri, F; Sireus, M

2017-06-01

Dose optimization in radiological examinations is a mandatory issue: in this study local Diagnostic Reference Levels (lDRLs) for Clinical Mammography (MG), Computed Tomography (CT) and Interventional Cardiac Procedures (ICP) performed in our Radiology Department were established. Using a dose tracking software, we have collected Average Glandular Dose (AGD) for two clinical mammographic units; CTDIvol, Size-Specific Dose Estimate (SSDE), Dose Length Product (DLP) and total DLP (DLPtot) for five CT scanners; Fluoro Time, Fluoro Dose Area Product (DAP) and total DAP (DAPtot) for two angiographic systems. Data have been compared with Italian Regulation and with the recent literature. The 75th percentiles of the different dosimetric indices have been calculated. Automated methods of radiation dose data collection allow a fast and detailed analysis of a great amount of data and an easy determination of lDRLs for different radiological procedures. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

Spontaneous resolution of traumatic acute subdural haematomas: A systematic review.

PubMed

Vital, Roberto Bezerra; Hamamoto Filho, Pedro Tadao; Oliveira, Victor Azevedo de; Romero, Flávio Ramalho; Zanini, Marco Antônio

2016-01-01

Traumatic subdural haematomas often require emergency surgical evacuation. Spontaneous resolution of traumatic acute subdural haematomas (TASDH) is under-reported. Two patients are described with spontaneous resolution of TASDH correlating with previous reports. A discussion is presented on the clinical, pathological and radiological features of TASDH. A review of the literature was performed using PubMed (Medline), Embase, and Cochrane Library for similar cases. A total 21 articles were included, involving 27 cases well detailed of TASDH with spontaneous resolution or neurological and radiological improvement in less than 24 h. There are two main mechanisms for the spontaneous resolution of acute subdural haematomas: dilution in subarachnoid space and redistribution of the haematoma in the subdural space. The primary radiological characteristic of these lesions is a hypodense rim on the outer surface of the clot. Spontaneous resolution of TASDH is unusual. Clinical and radiological surveillance is essential for appropriate management of these patients. Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

An analysis of nursing diagnoses for patients undergoing procedures in a Brazilian interventional radiology suite.

PubMed

Viegas, Liza de Souza; Turrini, Ruth Natalia Teresa; da Silva Bastos Cerullo, Josinete Aparecida

2010-05-01

Innovations in minimally invasive surgery have led to more procedures being performed in the interventional radiology suite. It, therefore, is essential that nurses in radiology departments be competent to care for all types of patients. Use of nursing classification systems can improve care by providing standardized language for documentation. We conducted a project that involved 25 patients undergoing interventional radiology procedures between August and October 2006 in São Paulo, Brazil, to identify the most frequent North American Nursing Diagnosis Association (NANDA) nursing diagnoses used and then compared the NANDA diagnoses to Perioperative Nursing Data Set diagnoses. The most frequent nursing diagnoses in the participants were anxiety, chronic pain, inefficient tissue perfusion-peripheral, deficient knowledge, and risk for falls. These results are similar to diagnoses that have been reported in outpatient centers. The NANDA and Perioperative Nursing Data Set diagnoses were found to be similar. Copyright 2010 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Enterprise imaging: planning and business justification.

PubMed

Avrin, David; Hou, Stephanie W

2012-02-01

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

Development, Implementation, and Evaluation of a Structured Reporting Web Tool for Abdominal Aortic Aneurysms

PubMed Central

Karim, Sulafa; Fegeler, Christian; Boeckler, Dittmar; H Schwartz, Lawrence; Kauczor, Hans-Ulrich

2013-01-01

Background The majority of radiological reports are lacking a standard structure. Even within a specialized area of radiology, each report has its individual structure with regards to details and order, often containing too much of non-relevant information the referring physician is not interested in. For gathering relevant clinical key parameters in an efficient way or to support long-term therapy monitoring, structured reporting might be advantageous. Objective Despite of new technologies in medical information systems, medical reporting is still not dynamic. To improve the quality of communication in radiology reports, a new structured reporting system was developed for abdominal aortic aneurysms (AAA), intended to enhance professional communication by providing the pertinent clinical information in a predefined standard. Methods Actual state analysis was performed within the departments of radiology and vascular surgery by developing a Technology Acceptance Model. The SWOT (strengths, weaknesses, opportunities, and threats) analysis focused on optimization of the radiology reporting of patients with AAA. Definition of clinical parameters was achieved by interviewing experienced clinicians in radiology and vascular surgery. For evaluation, a focus group (4 radiologists) looked at the reports of 16 patients. The usability and reliability of the method was validated in a real-world test environment in the field of radiology. Results A Web-based application for radiological “structured reporting” (SR) was successfully standardized for AAA. Its organization comprises three main categories: characteristics of pathology and adjacent anatomy, measurements, and additional findings. Using different graphical widgets (eg, drop-down menus) in each category facilitate predefined data entries. Measurement parameters shown in a diagram can be defined for clinical monitoring and be adducted for quick adjudications. Figures for optional use to guide and standardize the reporting are embedded. Analysis of variance shows decreased average time required with SR to obtain a radiological report compared to free-text reporting (P=.0001). Questionnaire responses confirm a high acceptance rate by the user. Conclusions The new SR system may support efficient radiological reporting for initial diagnosis and follow-up for AAA. Perceived advantages of our SR platform are ease of use, which may lead to more accurate decision support. The new system is open to communicate not only with clinical partners but also with Radiology Information and Hospital Information Systems. PMID:23956062

Development, implementation, and evaluation of a structured reporting web tool for abdominal aortic aneurysms.

PubMed

Karim, Sulafa; Fegeler, Christian; Boeckler, Dittmar; H Schwartz, Lawrence; Kauczor, Hans-Ulrich; von Tengg-Kobligk, Hendrik

2013-08-16

The majority of radiological reports are lacking a standard structure. Even within a specialized area of radiology, each report has its individual structure with regards to details and order, often containing too much of non-relevant information the referring physician is not interested in. For gathering relevant clinical key parameters in an efficient way or to support long-term therapy monitoring, structured reporting might be advantageous. Despite of new technologies in medical information systems, medical reporting is still not dynamic. To improve the quality of communication in radiology reports, a new structured reporting system was developed for abdominal aortic aneurysms (AAA), intended to enhance professional communication by providing the pertinent clinical information in a predefined standard. Actual state analysis was performed within the departments of radiology and vascular surgery by developing a Technology Acceptance Model. The SWOT (strengths, weaknesses, opportunities, and threats) analysis focused on optimization of the radiology reporting of patients with AAA. Definition of clinical parameters was achieved by interviewing experienced clinicians in radiology and vascular surgery. For evaluation, a focus group (4 radiologists) looked at the reports of 16 patients. The usability and reliability of the method was validated in a real-world test environment in the field of radiology. A Web-based application for radiological "structured reporting" (SR) was successfully standardized for AAA. Its organization comprises three main categories: characteristics of pathology and adjacent anatomy, measurements, and additional findings. Using different graphical widgets (eg, drop-down menus) in each category facilitate predefined data entries. Measurement parameters shown in a diagram can be defined for clinical monitoring and be adducted for quick adjudications. Figures for optional use to guide and standardize the reporting are embedded. Analysis of variance shows decreased average time required with SR to obtain a radiological report compared to free-text reporting (P=.0001). Questionnaire responses confirm a high acceptance rate by the user. The new SR system may support efficient radiological reporting for initial diagnosis and follow-up for AAA. Perceived advantages of our SR platform are ease of use, which may lead to more accurate decision support. The new system is open to communicate not only with clinical partners but also with Radiology Information and Hospital Information Systems.

Radiology system evolution in the new millennium.

PubMed

Nauert, R C

2001-01-01

For many decades the practice of radiology grew slowly in America and was largely a secondary function under the control of hospitals. In more recent times it has vastly expanded its array of diagnostic, interventional, and therapeutic abilities. There is increasing consumer logic for direct access. Motivations have grown to create large independent entities with broadly diverse capabilities in order to succeed in the new millennium. Most regional markets are evolving rapidly in terms of managed care penetration, health system formation, physician practice consolidation and aggressive purchaser behavior by employers and consumers. To understand the enormity of healthcare evolution, it is useful to look at the industry's paradigm shifts in recent decades. Virtually every aspect of organizational infrastructure, delivery approaches, and the business environment has evolved markedly during the past fifty years. These changes will accelerate. To succeed financially, radiology groups must strengthen their market positions, technical capabilities, continuums of care and geographic dominance. Equally important is the wisdom of diversifying incomes into related services and businesses that provide additional related revenues. Key factors for successful development include facility market growth, full coverage of managed care contracts, high efficiency and aggressive diversification. A fully evolved system generates significant revenues and profitability by protecting and strengthening its financial position in this environment. That is accomplished through the development of strategically located radiology groups, aggressive alliances with medical practices in allied disciplines, and managed radiology departments and facilities for partner health systems. Organizational success ultimately depends on the ability to accept capitated payments under risk-bearing arrangements. The strategic business plan should be organized with the appropriate levels of detail needed to establish executive focus and priorities. These should be woven into operational and capital budgets to reflect expectations of the revenues, expenses and investments tied to the plan. While formidable, all of these objectives are realistic and can be accomplished if the right decisions are made. Initially, the entity's principle business objective is to formulate and begin implementation of methodical yet aggressive strategies for growth that are sensitive to sustaining high levels of quality patient care. The next phase features mergers with large, independent radiology practices in key geographic areas and successful acquisition of smaller practices. The objective of the final phase is to aggressively expand into select metropolitan areas with regional coverage and full teleradiology capabilities. High levels of market strength and financial performance are necessary to succeed. Passive limitations to small geographic areas and narrow practices will undermine their market position and dissolve financial strength with no hope of recovery. Only the dominant systems will survive and prosper.

Is fusion necessary for thoracolumbar burst fracture treated with spinal fixation? A systematic review and meta-analysis.

PubMed

Diniz, Juliete M; Botelho, Ricardo V

2017-11-01

OBJECTIVE Thoracolumbar fractures account for 90% of spinal fractures, with the burst subtype corresponding to 20% of this total. Controversy regarding the best treatment for this condition remains. The traditional surgical approach, when indicated, involves spinal fixation and arthrodesis. Newer studies have brought the need for fusion associated with internal fixation into question. Not performing arthrodesis could reduce surgical time and intraoperative bleeding without affecting clinical and radiological outcomes. With this study, the authors aimed to assess the effect of fusion, adjuvant to internal fixation, on surgically treated thoracolumbar burst fractures. METHODS A search of the Medline and Cochrane Central Register of Controlled Trials databases was performed to identify randomized trials that compared the use and nonuse of arthrodesis in association with internal fixation for the treatment of thoracolumbar burst fractures. The search encompassed all data in these databases up to February 28, 2016. RESULTS Five randomized/quasi-randomized trials, which involved a total of 220 patients and an average follow-up time of 69.1 months, were included in this review. No significant difference between groups in the final scores of the visual analog pain scale or Low Back Outcome Scale was detected. Surgical time and blood loss were significantly lower in the group of patients who did not undergo fusion (p < 0.05). Among the evaluated radiological outcomes, greater mobility in the affected segment was found in the group of those who did not undergo fusion. No significant difference between groups in the degree of kyphosis correction, loss of kyphosis correction, or final angle of kyphosis was observed. CONCLUSIONS The data reviewed in this study suggest that the use of arthrodesis did not improve clinical outcomes, but it was associated with increased surgical time and higher intraoperative bleeding and did not promote significant improvement in radiological parameters.

Should radiology IT be owned by the chief information officer?

PubMed

Channin, David S; Bowers, George; Nagy, Paul

2009-06-01

Considerable debate within the medical community has focused on the optimal location of information technology (IT) support groups on the organizational chart. The challenge has been to marry local accountability and physician acceptance of IT with the benefits gained by the economies of scale achieved by centralized knowledge and system best practices. In the picture archiving and communication systems (PACS) industry, a slight shift has recently occurred toward centralized control. Radiology departments, however, have begun to realize that no physicians in any other discipline are as dependent on IT as radiologists are on their PACS. The potential strengths and weaknesses of centralized control of the PACS is the topic of discussion for this month's Point/Counterpoint.

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

None

Papers and/or abstracts of 42 papers presented at this waste management seminar are included in this volume. Separate abstracts of 27 papers have been prepared for inclusion in the Energy Data Base (EDB). There are 8 papers represented in the proceedings by abstract only and are not included separately in EDB. The subjects covered in these abstracts include: requirements and compliance for the issuance of the second round NPDES permit for the Portsmouth Plant; performance of the pollution abatement facilities at the Portsmouth Plant; the impact of the Kentucky hazardous waste regulations on the Paducah Plant; control of R-114 lossesmore » at the gaseous diffusion plants; innovative alternatives to pollution control projects; evaluating the fate and potential radiological impacts of Technetium-99 released to the environment; and technical support interfacing for the FY-1981 line item project control of water pollution and solid wastes at the Paducah Plant. There are 15 other papers which were previously input to the EDB. (RJC)« less

Westinghouse Hanford Company health and safety performance report. Fourth quarter calendar year 1994

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

Lansing, K.A.

1995-03-01

Detailed information pertaining to As Low As Reasonably Achievable/Contamination Control Improvement Project (ALARA/CCIP) activities are outlined. Improved commitment to the WHC ALARA/CCIP Program was experienced throughout FY 1994. During CY 1994, 17 of 19 sitewide ALARA performance goals were completed on or ahead of schedule. Estimated total exposure by facility for CY 1994 is listed in tables by organization code for each dosimeter frequency. Facilities/areas continue to utilize the capabilities of the RPR tracking system in conjunction with the present site management action-tracking system to manage deficiencies, trend performance, and develop improved preventive efforts. Detailed information pertaining to occupational injuries/illnessesmore » are provided. The Industrial Safety and Hygiene programs are described which have generated several key initiatives that are believed responsible for improved safety performance. A breakdown of CY 1994 occupational injuries/illnesses by type, affected body group, cause, job type, age/gender, and facility is provided. The contributing experience of each WHC division/department in attaining this significant improvement is described along with tables charting specific trends. The Radiological Control Program is on schedule to meet all RL Site Management System milestones and program commitments.« less

Aircraft mishap investigation with radiology-assisted autopsy: helicopter crash with control injury.

PubMed

Folio, R Les; Harcke, H Theodore; Luzi, Scott A

2009-04-01

Radiology-assisted autopsy traditionally has been plain film-based, but now is being augmented by computed tomography (CT). The authors present a two-fatality rotary wing crash scenario illustrating application of advanced radiographic techniques that can guide and supplement the forensic pathologist's physical autopsy. The radiographic findings also have the potential for use by the aircraft mishap investigation board. Prior to forensic autopsy, the two crash fatalities were imaged with conventional two-dimensional radiographs (digital technique) and with multidetector CT The CT data were used for multiplanar two-dimensional and three-dimensional (3D) image reconstruction. The forensic pathologist was provided with information about skeletal fractures, metal fragment location, and other pathologic findings of potential use in the physical autopsy. The radiologic autopsy served as a supplement to the physical autopsy and did not replace the traditional autopsy in these cases. Both individuals sustained severe blunt force trauma with multiple fractures of the skull, face, chest, pelvis, and extremities. Individual fractures differed; however, one individual showed hand and lower extremity injuries similar to those associated with control of the aircraft at the time of impact. The concept of "control injury" has been challenged by Campman et al., who found that control surface injuries have a low sensitivity and specificity for establishing who the pilot was in an accident. The application of new post mortem imaging techniques may help to resolve control injury questions. In addition, the combination of injuries in our cases may contribute to further understanding of control surface injury patterns in helicopter mishaps.

Validation of Case Finding Algorithms for Hepatocellular Cancer from Administrative Data and Electronic Health Records using Natural Language Processing

PubMed Central

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

2013-01-01

Background Accurate identification of hepatocellular cancer (HCC) cases from automated data is needed for efficient and valid quality improvement initiatives and research. We validated HCC ICD-9 codes, and evaluated whether natural language processing (NLP) by the Automated Retrieval Console (ARC) for document classification improves HCC identification. Methods 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 to manual classification. PPV, sensitivity, and specificity of ARC were calculated. Results 1138 patients with HCC were identified by ICD-9 codes. Based on 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. Conclusion A combined approach of ICD-9 codes and NLP of pathology and radiology reports improves HCC case identification in automated data. PMID:23929403

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 Diagnostic Dilemma for the Pediatrician: Radiolucent Tracheobronchial Foreign Body.

PubMed

Taşkınlar, Hakan; Bahadır, Gökhan Berktuğ; Erdoğan, Cankat; Yiğit, Doğakan; Avlan, Dinçer; Naycı, Ali

2017-06-01

The purpose of this study is to determine the role of clinical history, physical examinations, and radiological findings in the evaluation of patients with suspected radiolucent foreign body aspiration. The medical records of 236 children (under the age of 18 years), on whom a rigid bronchoscopy was performed between 1999 and 2015 because of suspected radiolucent foreign body aspiration, were analyzed retrospectively. Sensitivity, specificity, positive and negative predictive values of clinical history, physical examinations, and radiological findings were evaluated. In 71.1% of all cases, the children were under the age of 3 years. The bronchoscopy showed the presence of a foreign body in 52.9% of cases, with the locations of the foreign bodies being as follows: (1) right main bronchus, 47.2%; (2) left main bronchus, 36.0%; (3) trachea, 11.2%; (4) both bronchi, 5.6%. Organic foreign bodies were found in 78% of the patients, whereas inorganic foreign bodies were detected in 22% of the patients. The sensitivity and specificity of clinical history, physical examinations, and radiological findings were 98.4% and 54.9%, 47.2% and 74.7%, and 35.2% and 92.7%, respectively. Tracheobronchial foreign body aspirations usually occur prior to the age of 3 years, with the most frequently aspirated foreign bodies being food or items of a radiolucent nature. Clinical history, physical examinations, and radiological findings are not able to detect the presence of a radiolucent foreign body aspiration in children. Therefore, a bronchoscopy should be performed on children in whom a choking event has been witnessed, even in cases of normal radiological and clinical findings. Copyright © 2016. Published by Elsevier B.V.

A Low-Cost Tele-Imaging Platform for Developing Countries

PubMed Central

Adambounou, Kokou; Adjenou, Victor; Salam, Alex P.; Farin, Fabien; N’Dakena, Koffi Gilbert; Gbeassor, Messanvi; Arbeille, Philippe

2014-01-01

Purpose: To design a “low-cost” tele-imaging method allowing real-time tele-ultrasound expertise, delayed tele-ultrasound diagnosis, and tele-radiology between remote peripherals hospitals and clinics (patient centers) and university hospital centers (expert center). Materials and methods: A system of communication via internet (IP camera and remote access software) enabling transfer of ultrasound videos and images between two centers allows a real-time tele-radiology expertise in the presence of a junior sonographer or radiologist at the patient center. In the absence of a sonographer or radiologist at the patient center, a 3D reconstruction program allows a delayed tele-ultrasound diagnosis with images acquired by a lay operator (e.g., midwife, nurse, technician). The system was tested both with high and low bandwidth. The system can further accommodate non-ultrasound tele-radiology (conventional radiography, mammography, and computer tomography for example). The system was tested on 50 patients between CHR Tsevie in Togo (40 km from Lomé-Togo and 4500 km from Tours-France) and CHU Campus at Lomé and CHU Trousseau in Tours. Results: A real-time tele-expertise was successfully performed with a delay of approximately 1.5 s with an internet bandwidth of around 1 Mbps (IP Camera) and 512 kbps (remote access software). A delayed tele-ultrasound diagnosis was also performed with satisfactory results. The transmission of radiological images from the patient center to the expert center was of adequate quality. Delayed tele-ultrasound and tele-radiology was possible even in the presence of a low-bandwidth internet connection. Conclusion: This tele-imaging method, requiring nothing by readily available and inexpensive technology and equipment, offers a major opportunity for telemedicine in developing countries. PMID:25250306

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

An Evidence-Based Approach to the Management of Children with Morquio A Syndrome Presenting with Craniocervical Pathology.

PubMed

Williams, Nicole; Narducci, Alessandro; Eastwood, Deborah M; Cleary, Maureen; Thompson, Dominic

2018-06-12

Retrospective case series OBJECTIVE.: To review clinical and radiological outcomes of craniovertebral surgery in children with Morquio A syndrome (Mucopolysaccharidosis type IVA) and develop an evidence-based management algorithm. Myelopathy secondary to craniovertebral pathology is a common cause of neurological disability in Morquio A syndrome. Previously unresolved surgical controversies include the value of surveillance, surgical indications and operative technique. A retrospective case-based review of children with Morquio A syndrome and craniovertebral pathology seen in a tertiary referral paediatric centre from 1992-2016 was performed. Patients treated non-operatively and operatively were included. Medical records and imaging were reviewed to determine clinical and radiological findings at initial assessment, prior to cervical spine surgery, early post-operative period and final follow-up. The clinical outcomes of interest were neurological status and mobility at follow-up, complications and need for further surgery. Twenty-seven patients were included. Surgical indications were radiological evidence of cervicomedullary compression alone (6 cases) or with clinical evidence of myelopathy (12 cases). Eighteen patients (median age 6.2 years, range 3.5 - 15.9 years) underwent surgery, with median follow-up of 8.5years. Occiput to upper cervical spine fusion with C1 decompression was performed in all cases with the addition of autologous calvarial graft in young patients (12 cases) and occipital-cervical plate fixation in older children (6 cases). Neurological improvement occurred in 38% of cases but by one functional level only. Six of 9 conservatively treated patients remained independent walkers. Surgery for craniovertebral pathology is required in the majority of children with Morquio A syndrome. Close clinical and radiological surveillance is essential for timely intervention. Occiput to cervical fusion is safe and feasible even in young patients and improves clinical and radiological parameters. 4.

Modelling a radiology department service using a VDL integrated approach.

PubMed

Guglielmino, Maria Gabriella; Celano, Giovanni; Costa, Antonio; Fichera, Sergio

2009-01-01

The healthcare industry is facing several challenges such as the reduction of costs and quality improvement of the provided services. Engineering studies could be very useful in supporting organizational and management processes. Healthcare service efficiency depends on a strong collaboration between clinical and engineering experts, especially when it comes to analyzing the system and its constraints in detail and subsequently, when it comes to deciding on the reengineering of some key activities. The purpose of this paper is to propose a case study showing how a mix of representation tools allow a manager of a radiology department to solve some human and technological resource re-organizational issues, which have to be faced due to the introduction of a new technology and a new portfolio of services. In order to simulate the activities within the radiology department and examine the relationship between human and technological resources, different visual diagrammatic language (VDL) techniques have been implemented to get knowledge about the heterogeneous factors related to the healthcare service delivery. In particular, flow charts, IDEFO diagrams and Petri nets have been integrated each other with success as a modelisation tools. The simulation study performed through the application of the aforementioned VDL techniques suggests the opportunity of re-organizing the nurse activities within the radiology department. The re-organization of a healthcare service and in particular of a radiology department by means of joint flow charts, IDEF0 diagrams and Petri nets is a poorly investigated topic in literature. This paper demonstrates how flow charts and IDEF0 can help people working within the department to understand the weak points of their organization and constitute an efficient base of knowledge for the implementation of a Petri net aimed at improving the departmental performance.

Home-based radiology transcription and a productivity pay plan.

PubMed

Kerr, K

1997-01-01

Shands Hospital in Gainesville, Fla., decided to evaluate the way it provided transcription services in its radiology department. It identified four goals: increased productivity, decreased operating expense, finding much needed space in the radiology department and increasing employee morale. The department performs 165,000 procedures annually, with 66 radiologists, 29 faculty, and 37 residents and fellows on staff. Six FTEs comprised the transcription pool in the radiology department, with transcription their only duty. Transcriptionists were paid an hourly rate based on their years of service, not their productivity. Evaluation and measurement studies were undertaken by the hospital's management systems engineering department. The transcriptionists' hours were then changed to provide coverage during the periods of heaviest dictation. The productivity level of the transcription staff was also measured and various methods of measurement reviewed. The goal was a pure incentive pay plan that would reward employees for every increase in productivity. The incentive pay plan was phased in over a three-month period. Transcriptionists were paid for work performed, with no base pay beyond minimum wage. The move to home-based transcription was planned. The necessary equipment was identified and various issues specific to working at home were addressed. Approximately six months later, the transcriptionists were set up to work at home. The astounding results achieved are presented: 28% increase in productivity, operational cost savings exceeding $25,000 and a space savings of 238 square feet.

Performance of CMOS imager as sensing element for a Real-time Active Pixel Dosimeter for Interventional Radiology procedures

NASA Astrophysics Data System (ADS)

Magalotti, D.; Bissi, L.; Conti, E.; Paolucci, M.; Placidi, P.; Scorzoni, A.; Servoli, L.

2014-01-01

Staff members applying Interventional Radiology procedures are exposed to ionizing radiation, which can induce detrimental effects to the human body, and requires an improvement of radiation protection. This paper is focused on the study of the sensor element for a wireless real-time dosimeter to be worn by the medical staff during the interventional radiology procedures, in the framework of the Real-Time Active PIxel Dosimetry (RAPID) INFN project. We characterize a CMOS imager to be used as detection element for the photons scattered by the patient body. The CMOS imager has been first characterized in laboratory using fluorescence X-ray sources, then a PMMA phantom has been used to diffuse the X-ray photons from an angiography system. Different operating conditions have been used to test the detector response in realistic situations, by varying the X-ray tube parameters (continuous/pulsed mode, tube voltage and current, pulse parameters), the sensor parameters (gain, integration time) and the relative distance between sensor and phantom. The sensor response has been compared with measurements performed using passive dosimeters (TLD) and also with a certified beam, in an accredited calibration centre, in order to obtain an absolute calibration. The results are very encouraging, with dose and dose rate measurement uncertainties below the 10% level even for the most demanding Interventional Radiology protocols.

[Pulmonary Langerhans' cell histiocytosis (PLCH) revealed by pneumothorax: about a case].

PubMed

Sajiai, Hafsa; Rachidi, Mariam; Serhane, Hind; Aitbatahar, Salma; Amro, Lamyae

2016-01-01

Langerhans cell histiocytosis is a rare disease of unknown etiology characterized by the infiltration of Langerhans cells in one or more organs. It has a polymorphic clinical presentation. We report the case of Mr R.Y, age 22, with 8 pack year history of smoking, admitted to hospital with complete spontaneous right-sided pneumothorax. Chest drainage was performed with good evolution. Control chest CT scan showed multiple diffuse cyst formations, predominant in the upper lobes. Lab and imaging tests were performed in order to detect systemic histiocytosis with negative results. Patient's evolution was marked by pneumothorax recurrence; pleurodesis and lung biopsy were performed which confirmed the diagnosis. The diagnosis of Langerhans cell histiocytosis should be evoked in front of pneumothorax associated with lung cystic. The diagnosis is easy in front of a suggestive clinical and radiological picture. Nevertheless, therapeutic options are limited and pneumothorax recurrence is common.

Modeling Urban Scenarios & Experiments: Fort Indiantown Gap Data Collections Summary and Analysis

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

Archer, Daniel E.; Bandstra, Mark S.; Davidson, Gregory G.

This report summarizes experimental radiation detector, contextual sensor, weather, and global positioning system (GPS) data collected to inform and validate a comprehensive, operational radiation transport modeling framework to evaluate radiation detector system and algorithm performance. This framework will be used to study the influence of systematic effects (such as geometry, background activity, background variability, environmental shielding, etc.) on detector responses and algorithm performance using synthetic time series data. This work consists of performing data collection campaigns at a canonical, controlled environment for complete radiological characterization to help construct and benchmark a high-fidelity model with quantified system geometries, detector response functions,more » and source terms for background and threat objects. This data also provides an archival, benchmark dataset that can be used by the radiation detection community. The data reported here spans four data collection campaigns conducted between May 2015 and September 2016.« less

Oral hydration for prevention of contrast-induced acute kidney injury in elective radiological procedures: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Cheungpasitporn, Wisit; Thongprayoon, Charat; Brabec, Brady A; Edmonds, Peter J; O'Corragain, Oisin A; Erickson, Stephen B

2014-12-01

The reports on efficacy of oral hydration treatment for the prevention of contrast-induced acute kidney injury (CIAKI) in elective radiological procedures and cardiac catheterization remain controversial. The objective of this meta-analysis was to assess the use of oral hydration regimen for prevention of CIAKI. Comprehensive literature searches for randomized controlled trials (RCTs) of outpatient oral hydration treatment was performed using MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials Systematic Reviews, and clinicaltrials.gov from inception until July 4(th), 2014. Primary outcome was the incidence of CIAKI. Six prospective RCTs were included in our analysis. Of 513patients undergoing elective procedures with contrast exposures,45 patients (8.8%) had CIAKI. Of 241 patients with oral hydration regimen, 23 (9.5%) developed CIAKI. Of 272 patients with intravenous (IV) fluid regimen, 22 (8.1%) had CIAKI. Study populations in all included studies had relatively normal kidney function to chronic kidney disease (CKD) stage 3. There was no significant increased risk of CIAKI in oral fluid regimen group compared toIV fluid regimen group (RR = 0.94, 95% confidence interval, CI = 0.38-2.31). According to our analysis,there is no evidence that oral fluid regimen is associated with more risk of CIAKI in patients undergoing elective procedures with contrast exposures compared to IV fluid regimen. This finding suggests that the oral fluid regimen might be considered as a possible outpatient treatment option for CIAKI prevention in patients with normal to moderately reduced kidney function.

Influence of hip and knee osteoarthritis on dynamic postural control parameters among older fallers.

PubMed

Mat, Sumaiyah; Ng, Chin Teck; Tan, Maw Pin

2017-03-06

To compare the relationship between postural control and knee and hip osteoarthritis in older adults with and without a history of falls. Fallers were those with ≥ 2 falls or 1 injurious fall over 12 months. Non-fallers were volunteers with no falls in the past year. Radiological evidence of osteoarthritis with no reported symptoms was considered "asymptomatic osteoarthritis", while "symptomatic osteoarthritis" was defined as radiographic osteoarthritis with pain or stiffness. Dynamic postural control was quantified with the limits of stability test measured on a balance platform (Neurocom® Balancemaster, California, USA). Parameters assessed were end-point excursion, maximal excursion, and directional control. A total of 102 older individuals, mean age 73 years (standard deviation 5.7) years were included. The association between falls and poor performance in maximal excursion and directional control was confounded by age and comorbidities. In the same linear equation model with falls, symptomatic osteoarthritis remained independently associated with poor end-point excursion (β-coefficient (95% confidence interval) -6.80 (-12.14 to -1.42)). Poor performance in dynamic postural control (maximal excursion and directional control) among fallers was not accounted for by hip/knee osteoarthritis, but was confounded by old age and comorbidities. Loss of postural control due to hip/knee osteoarthritis is not a risk factor for falls among community-dwelling older adults.

Validation of an imaging based cardiovascular risk score in a Scottish population.

PubMed

Kockelkoren, Remko; Jairam, Pushpa M; Murchison, John T; Debray, Thomas P A; Mirsadraee, Saeed; van der Graaf, Yolanda; Jong, Pim A de; van Beek, Edwin J R

2018-01-01

A radiological risk score that determines 5-year cardiovascular disease (CVD) risk using routine care CT and patient information readily available to radiologists was previously developed. External validation in a Scottish population was performed to assess the applicability and validity of the risk score in other populations. 2915 subjects aged ≥40 years who underwent routine clinical chest CT scanning for non-cardiovascular diagnostic indications were followed up until first diagnosis of, or death from, CVD. Using a case-cohort approach, all cases and a random sample of 20% of the participant's CT examinations were visually graded for cardiovascular calcifications and cardiac diameter was measured. The radiological risk score was determined using imaging findings, age, gender, and CT indication. Performance on 5-year CVD risk prediction was assessed. 384 events occurred in 2124 subjects during a mean follow-up of 4.25 years (0-6.4 years). The risk score demonstrated reasonable performance in the studied population. Calibration showed good agreement between actual and 5-year predicted risk of CVD. The c-statistic was 0.71 (95%CI:0.67-0.75). The radiological CVD risk score performed adequately in the Scottish population offering a potential novel strategy for identifying patients at high risk for developing cardiovascular disease using routine care CT data. Copyright © 2017 Elsevier B.V. All rights reserved.

Point-of-care ultrasound education for non-physician clinicians in a resource-limited emergency department.

PubMed

Stolz, Lori A; Muruganandan, Krithika M; Bisanzo, Mark C; Sebikali, Mugisha J; Dreifuss, Bradley A; Hammerstedt, Heather S; Nelson, Sara W; Nayabale, Irene; Adhikari, Srikar; Shah, Sachita P

2015-08-01

To describe the outcomes and curriculum components of an educational programme to train non-physician clinicians working in a rural, Ugandan emergency department in the use of POC ultrasound. The use of point-of-care ultrasound was taught to emergency care providers through lectures, bedsides teaching and hands-on practical sessions. Lectures were tailored to care providers' knowledge base and available therapeutic means. Every ultrasound examination performed by these providers was recorded over 4.5 years. Findings of these examinations were categorised as positive, negative, indeterminate or procedural. Other radiologic studies ordered over this same time period were also recorded. A total of 22,639 patients were evaluated in the emergency department by emergency care providers, and 2185 point-of-care ultrasound examinations were performed on 1886 patients. Most commonly used were the focused assessment with sonography in trauma examination (53.3%) and echocardiography (16.4%). Point-of-care ultrasound studies were performed more frequently than radiology department-performed studies. Positive findings were documented in 46% of all examinations. We describe a novel curriculum for point-of-care ultrasound education of non-physician emergency practitioners in a resource-limited setting. These non-physician clinicians integrated ultrasound into clinical practice and utilised this imaging modality more frequently than traditional radiology department imaging with a large proportion of positive findings. © 2015 John Wiley & Sons Ltd.

10 CFR 73.55 - Requirements for physical protection of licensed activities in nuclear power reactors against...

Code of Federal Regulations, 2013 CFR

2013-01-01

... shall: (i) Design, construct, install and maintain physical barriers as necessary to control access into.... (10) Vehicle control measures. Consistent with the physical protection program design requirements of... maintain vehicle control measures, as necessary, to protect against the design basis threat of radiological...

10 CFR 73.55 - Requirements for physical protection of licensed activities in nuclear power reactors against...

Code of Federal Regulations, 2012 CFR

2012-01-01

... shall: (i) Design, construct, install and maintain physical barriers as necessary to control access into.... (10) Vehicle control measures. Consistent with the physical protection program design requirements of... maintain vehicle control measures, as necessary, to protect against the design basis threat of radiological...

10 CFR 73.55 - Requirements for physical protection of licensed activities in nuclear power reactors against...

Code of Federal Regulations, 2014 CFR

2014-01-01

... shall: (i) Design, construct, install and maintain physical barriers as necessary to control access into.... (10) Vehicle control measures. Consistent with the physical protection program design requirements of... maintain vehicle control measures, as necessary, to protect against the design basis threat of radiological...

21 CFR 892.5700 - Remote controlled radionuclide applicator system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Remote controlled radionuclide applicator system. 892.5700 Section 892.5700 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5700 Remote controlled...

Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures.

PubMed

Bernier, Marie Odile; Doody, Michele M; Van Dyke, Miriam E; Villoing, Daphné; Alexander, Bruce H; Linet, Martha S; Kitahara, Cari M

2018-05-02

Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices. From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003-2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012-2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade. During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers. Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Computed Tomography

NASA Astrophysics Data System (ADS)

Castellano, Isabel; Geleijns, Jacob

After its clinical introduction in 1973, computed tomography developed from an x-ray modality for axial imaging in neuroradiology into a versatile three dimensional imaging modality for a wide range of applications in for example oncology, vascular radiology, cardiology, traumatology and even in interventional radiology. Computed tomography is applied for diagnosis, follow-up studies and screening of healthy subpopulations with specific risk factors. This chapter provides a general introduction in computed tomography, covering a short history of computed tomography, technology, image quality, dosimetry, room shielding, quality control and quality criteria.

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

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

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

2015-08-15

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

Contrast Medium-Induced Acute Kidney Injury

PubMed Central

Sadat, Umar; Usman, Ammara; Boyle, Jonathan R.; Hayes, Paul D.; Solomon, Richard J.

2015-01-01

Contrast medium-induced acute kidney injury (CI-AKI) is a predominant cause of hospital-acquired renal insufficiency. With an increasing number of contrast medium-enhanced radiological procedures being performed in a rapidly increasing ageing population in the Western world, it is imperative that more attention is given to understand the aetiology of CI-AKI to devise novel diagnostic methods and to formulate effective prophylactic and therapeutic regimens to reduce its incidence and its associated morbidity and mortality. This article presents high-yield information on the above-mentioned aspects of CI-AKI, primarily based on results of randomised controlled trials, meta-analyses, systematic reviews and international consensus guidelines. PMID:26195974

Improving the interactivity and functionality of Web-based radiology teaching files with the Java programming language.

PubMed

Eng, J

1997-01-01

Java is a programming language that runs on a "virtual machine" built into World Wide Web (WWW)-browsing programs on multiple hardware platforms. Web pages were developed with Java to enable Web-browsing programs to overlay transparent graphics and text on displayed images so that the user could control the display of labels and annotations on the images, a key feature not available with standard Web pages. This feature was extended to include the presentation of normal radiologic anatomy. Java programming was also used to make Web browsers compatible with the Digital Imaging and Communications in Medicine (DICOM) file format. By enhancing the functionality of Web pages, Java technology should provide greater incentive for using a Web-based approach in the development of radiology teaching material.

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.

Adult learning principles for effective teaching in radiology programmes: a review of the literature.

PubMed

Arogundade, R A

2011-01-01

Adult learning processes of acquisition of new knowledge, behaviours, skills, values or preferences generally occur as part of personal professional development. There is need for radiology residency trainers to understand the basic adult learning principles for effective teaching processes. To review the different adult learning styles, learning theories and educational practice as a guide for radiology residency trainers. Literature materials from journals, web articles and reputable textbooks in the last 20 years on adult learning principles in general and radiology in particular were reviewed. Most medical educators, including radiologists, lack appropriate formal training background in educational practice. The adult residency trainee brings to the learning environment high quantity and quality of experiences and some amount of control. Connection of this rich adult experience base to the learning process requires facilitation and motivation by the radiology educator, who must be familiar with the use of appropriate learning theories and educational practices. there is a general agreement about the content of good practice in adult education but a definite comprehensive list does not seem to exist in the literature. Nonetheless, understanding of the basic adult learning principles would aid the concept of guided training, where the adult residency trainee shoulders the bulk of the training responsibilities of acquisition of knowledge.

Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

PubMed

Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

2010-03-01

Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.

Invited review: study design considerations for clinical research in veterinary radiology and radiation oncology.

PubMed

Scrivani, Peter V; Erb, Hollis N

2013-01-01

High quality clinical research is essential for advancing knowledge in the areas of veterinary radiology and radiation oncology. Types of clinical research studies may include experimental studies, method-comparison studies, and patient-based studies. Experimental studies explore issues relative to pathophysiology, patient safety, and treatment efficacy. Method-comparison studies evaluate agreement between techniques or between observers. Patient-based studies investigate naturally acquired disease and focus on questions asked in clinical practice that relate to individuals or populations (e.g., risk, accuracy, or prognosis). Careful preplanning and study design are essential in order to achieve valid results. A key point to planning studies is ensuring that the design is tailored to the study objectives. Good design includes a comprehensive literature review, asking suitable questions, selecting the proper sample population, collecting the appropriate data, performing the correct statistical analyses, and drawing conclusions supported by the available evidence. Most study designs are classified by whether they are experimental or observational, longitudinal or cross-sectional, and prospective or retrospective. Additional features (e.g., controlled, randomized, or blinded) may be described that address bias. Two related challenging aspects of study design are defining an important research question and selecting an appropriate sample population. The sample population should represent the target population as much as possible. Furthermore, when comparing groups, it is important that the groups are as alike to each other as possible except for the variables of interest. Medical images are well suited for clinical research because imaging signs are categorical or numerical variables that might be predictors or outcomes of diseases or treatments. © 2013 Veterinary Radiology & Ultrasound.

Utilization of Local Law Enforcement Aerial Resources in Consequence Management (CM) Response

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

Wasiolek, Piotr T.; Malchow, Russell L.

2013-03-12

During the past decade the U.S. Department of Homeland Security (DHS) was instrumental in enhancing the nation’s ability to detect and prevent a radiological or nuclear attack in the highest risk cities. Under the DHS Securing the Cities initiative, nearly 13,000 personnel in the New York City region have been trained in preventive radiological and nuclear detection operations, and nearly 8,500 pieces of radiological detection equipment have been funded. As part of the preventive radiological/nuclear detection (PRND) mission, several cities have received funding to purchase commercial aerial radiation detection systems. In 2008, the U.S. Department of Energy, National Nuclear Securitymore » Administration Aerial Measuring System (AMS) program started providing Mobile Aerial Radiological Surveillance (MARS) training to such assets, resulting in over 150 HAZMAT teams’ officers and pilots from 10 law enforcement organizations and fire departments being trained in the aerial radiation detection. From the beginning, the MARS training course covered both the PRND and consequence management (CM) missions. Even if the law enforcement main focus is PRND, their aerial assets can be utilized in the collection of initial radiation data for post-event radiological CM response. Based on over 50 years of AMS operational experience and information collected during MARS training, this presentation will focus on the concepts of CM response using aerial assets as well as utilizing law enforcement/fire department aerial assets in CM. Also discussed will be the need for establishing closer relationships between local jurisdictions’ aerial radiation detection capabilities and state and local radiation control program directors, radiological health department managers, etc. During radiological events these individuals may become primary experts/advisers to Incident Commanders for radiological emergency response, especially in the early stages of a response. The knowledge of the existence, specific capabilities, and use of local aerial radiation detection systems would be critical in planning the response, even before federal assets arrive on the scene. The relationship between local and federal aerial assets and the potential role for the further use of the MARS training and expanded AMS Reachback capabilities in facilitating such interactions will be discussed.« less

Quality measures and pediatric radiology: suggestions for the transition to value-based payment.

PubMed

Heller, Richard E; Coley, Brian D; Simoneaux, Stephen F; Podberesky, Daniel J; Hernanz-Schulman, Marta; Robertson, Richard L; Donnelly, Lane F

2017-06-01

Recent political and economic factors have contributed to a meaningful change in the way that quality in health care, and by extension value, are viewed. While quality is often evaluated on the basis of subjective criteria, pay-for-performance programs that link reimbursement to various measures of quality require use of objective and quantifiable measures. This evolution to value-based payment was accelerated by the 2015 passage of the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA). While many of the drivers of these changes are rooted in federal policy and programs such as Medicare and aimed at adult patients, the practice of pediatrics and pediatric radiology will be increasingly impacted. This article addresses issues related to the use of quantitative measures to evaluate the quality of services provided by the pediatric radiology department or sub-specialty section, particularly as seen from the viewpoint of a payer that may be considering ways to link payment to performance. The paper concludes by suggesting a metric categorization strategy to frame future work on the subject.

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.

Nephrocalcinosis in Amelogenesis Imperfecta Caused by the FAM20A Mutation.

PubMed

Koruyucu, Mine; Seymen, Figen; Gencay, Genco; Gencay, Koray; Tuna, Elif Bahar; Shin, Teo Jeon; Hyun, Hong-Keun; Kim, Young-Jae; Kim, Jung-Wook

2018-01-01

Enamel-renal syndrome is characterized by nephrocalcinosis, enamel defects, gingival hyperplasia and eruption failures. It has been recently identified that recessive mutations in the FAM20A gene result in amelogenesis imperfecta (AI)-gingival fibromatosis. The aim of this research to determine whether AI patients with known -FAM20A mutations also have nephrocalcinosis. Complete oral and radiological examinations were performed for all participating family members. Renal examinations were performed using ultrasound. The teeth were evaluated for severe loss, and multiple eruption failures were evident from the clinical and radiological examinations. Unexpected extensive and fast crown resorption was found by radiological examination. Renal ultrasound revealed bilateral nephrocalcinosis in both affected individuals. Recessive FAM20A mutations can cause nephrocalcinosis in addition to the oral phenotype. AI patients with similar clinical phenotypes and FAM20A mutations should be examined for nephropathy even if they lack pertinent symptoms. Nephrology referral is warranted for patients who have clinical phenotypes related to AI-gingival fibromatosis even if they are not symptomatic. © 2018 S. Karger AG, Basel.

Virtual management of radiology examinations in the virtual radiology environment using common object request broker architecture services.

PubMed

Martinez, R; Rozenblit, J; Cook, J F; Chacko, A K; Timboe, H L

1999-05-01

In the Department of Defense (DoD), US Army Medical Command is now embarking on an extremely exciting new project--creating a virtual radiology environment (VRE) for the management of radiology examinations. The business of radiology in the military is therefore being reengineered on several fronts by the VRE Project. In the VRE Project, a set of intelligent agent algorithms determine where examinations are to routed for reading bases on a knowledge base of the entire VRE. The set of algorithms, called the Meta-Manager, is hierarchical and uses object-based communications between medical treatment facilities (MTFs) and medical centers that have digital imaging network picture archiving and communications systems (DIN-PACS) networks. The communications is based on use of common object request broker architecture (CORBA) objects and services to send patient demographics and examination images from DIN-PACS networks in the MTFs to the DIN-PACS networks at the medical centers for diagnosis. The Meta-Manager is also responsible for updating the diagnosis at the originating MTF. CORBA services are used to perform secure message communications between DIN-PACS nodes in the VRE network. The Meta-Manager has a fail-safe architecture that allows the master Meta-Manager function to float to regional Meta-Manager sites in case of server failure. A prototype of the CORBA-based Meta-Manager is being developed by the University of Arizona's Computer Engineering Research Laboratory using the unified modeling language (UML) as a design tool. The prototype will implement the main functions described in the Meta-Manager design specification. The results of this project are expected to reengineer the process of radiology in the military and have extensions to commercial radiology environments.

Incidence, risks and outcome of radiological leak following early contrast enema after anterior resection.

PubMed

Reilly, Frank; Burke, John P; Appelmans, Eline; Manzoor, Talha; Deasy, Joseph; McNamara, Deborah A

2014-04-01

Anastomotic leak (AL) is a major complication following anterior resection for colorectal cancer. Early contrast enema may diagnose subclinical anastomotic leakage. Knowledge of factors concerning AL is vital to its detection. The aim of this study was to define the incidence, risks and outcome of radiological leak following routine early contrast enema after anterior resection. A cohort of 129 patients who underwent anterior resection for colorectal cancer and had an early Gastrografin enema between July 2008 and December 2012 in a tertiary referral centre was identified from a prospective database. The severity of AL was defined using the International Study Group of Rectal Cancer (ISREC) grading system. Of the 129 patients, 65.1 % were male, and the mean age at surgery was 64.6 ± 1.1 years. Gastrografin enema was performed on average on post-operative day 4.8 ± 0.2. Eighteen patients (14.0 %) had a radiological leak on Gastrografin enema, and nine patients (7.0 %) had a clinical AL. On multivariate analysis, only being of male sex and having a loop ileostomy increased the risk of radiological AL. Gastrografin enema had a sensitivity of 100 % (95 % CI 66-100 %) and specificity of 93 % (95 % CI 86-97 %) for predicting clinical AL. Of the 18 patients with radiological leaks, 11 were ISREC grade A, 3 were grade B and 4 were grade C. In the current series, early Gastrografin enema following anterior resection identifies a 14 % radiological leak rate and has a high sensitivity and specificity for predicting clinical AL. The majority of radiological leaks may be managed conservatively.

A cloud-based multimodality case file for mobile devices.

PubMed

Balkman, Jason D; Loehfelm, Thomas W

2014-01-01

Recent improvements in Web and mobile technology, along with the widespread use of handheld devices in radiology education, provide unique opportunities for creating scalable, universally accessible, portable image-rich radiology case files. A cloud database and a Web-based application for radiologic images were developed to create a mobile case file with reasonable usability, download performance, and image quality for teaching purposes. A total of 75 radiology cases related to breast, thoracic, gastrointestinal, musculoskeletal, and neuroimaging subspecialties were included in the database. Breast imaging cases are the focus of this article, as they best demonstrate handheld display capabilities across a wide variety of modalities. This case subset also illustrates methods for adapting radiologic content to cloud platforms and mobile devices. Readers will gain practical knowledge about storage and retrieval of cloud-based imaging data, an awareness of techniques used to adapt scrollable and high-resolution imaging content for the Web, and an appreciation for optimizing images for handheld devices. The evaluation of this software demonstrates the feasibility of adapting images from most imaging modalities to mobile devices, even in cases of full-field digital mammograms, where high resolution is required to represent subtle pathologic features. The cloud platform allows cases to be added and modified in real time by using only a standard Web browser with no application-specific software. Challenges remain in developing efficient ways to generate, modify, and upload radiologic and supplementary teaching content to this cloud-based platform. Online supplemental material is available for this article. ©RSNA, 2014.

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

PubMed

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

2015-07-01

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

The sharing of radiological images by professional mixed martial arts fighters on social media.

PubMed

Rahmani, George; Joyce, Cormac W; McCarthy, Peter

2017-06-01

Mixed martial arts is a sport that has recently enjoyed a significant increase in popularity. This rise in popularity has catapulted many of these "cage fighters" into stardom and many regularly use social media to reach out to their fans. An interesting result of this interaction on social media is that athletes are sharing images of their radiological examinations when they sustain an injury. To review instances where mixed martial arts fighters shared images of their radiological examinations on social media and in what context they were shared. An Internet search was performed using the Google search engine. Search terms included "MMA," "mixed martial arts," "injury," "scan," "X-ray," "fracture," and "break." Articles which discussed injuries to MMA fighters were examined and those in which the fighter themselves shared a radiological image of their injury on social media were identified. During our search, we identified 20 MMA fighters that had shared radiological images of their injuries on social media. There were 15 different types of injury, with a fracture of the mid-shaft of the ulna being the most common. The most popular social media platform was Twitter. The most common imaging modality X-ray (71%). The majority of injuries were sustained during competition (81%) and 35% of these fights resulted in a win for the fighter. Professional mixed martial artists are sharing radiological images of their injuries on social media. This may be in an attempt to connect with fans and raise their profile among other fighters.

Gender Trends in Radiology Authorship: A 35-Year Analysis.

PubMed

Piper, Crystal L; Scheel, John R; Lee, Christoph I; Forman, Howard P

2016-01-01

The purpose of this study was to describe trends over time in female authorship in the radiology literature and to investigate the tendency of female first authors to publish with female senior authors. Data on the gender of academic physician authors based in the United States for all major articles published in three general radiology journals--Radiology, AJR, and Academic Radiology--were collected and analyzed for the years 1978, 1988, 1998, 2008, and 2013. Multivariate logistic regression was used to identify significant trends over time, and a chi-square test of independence was performed to determine significant relations between the genders of first and senior authors. The gender of 4182 of 4217 (99.17%) authors with MD degrees was determined. The proportion of original research articles published by women as first authors increased from 8.33% in 1978 to 32.35% in 2013 (p < 0.001). The proportion of original research articles with women as senior authors increased from 6.75% in 1978 to 21.90% in 2013 (p < 0.001). Female first and senior authorship increased significantly over time (first author, p < 0.001; senior author, p < 0.001). There was a statistically significant relation between the genders of first and senior authors of original research articles and guest editorials (p < 0.001). Over 35 years, there was a statistically significant upward linear trend of female physician participation in authorship of academic radiology literature. Female first authors were more likely to publish with female senior authors.

Medical Imaging and Infertility.

PubMed

Peterson, Rebecca

2016-11-01

Infertility affects many couples, and medical imaging plays a vital role in its diagnosis and treatment. Radiologic technologists benefit from having a broad understanding of infertility risk factors and causes. This article describes the typical structure and function of the male and female reproductive systems, as well as congenital and acquired conditions that could lead to a couple's inability to conceive. Medical imaging procedures performed for infertility diagnosis are discussed, as well as common interventional options available to patients. © 2016 American Society of Radiologic Technologists.

Serving, Following, and Leading in Health Care.

PubMed

Penny, Steven M

2017-07-01

Radiologic technologists often perform diverse roles throughout the workday, and they should have at least a minimal understanding of the responsibility and effects of these roles on the patient and organization. Although technologists can practice independently or as part of a work group, individuals should be prepared to improve patient care and to function as a servant, follower, and leader for the overall success of the organization. This article examines those roles, emphasizing servantship. ©2017 American Society of Radiologic Technologists.

Procedures manual for the ORNL Radiological Survey Activities (RASA) Program

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

Myrick, T.E.; Berven, B.A.; Cottrell, W.D.

The portion of the radiological survey program performed by ORNL is the subject of this Procedures Manual. The RASA group of the Health and Safety Research Division (HASRD) at ORNL is responsible for the planning, conducting, and reporting of the results of radiological surveys at specified sites and associated vicinity properties. The results of these surveys are used by DOE in determining the need for and extent of remedial actions. Upon completion of the necessary remedial actions, the ORNL-RASA group or other OOS contractor may be called upon to verify the effectiveness of the remedial action. Information from these postremedialmore » action surveys is included as part of the data base used by DOE in certifying a site for unrestricted use.« 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.

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

PubMed

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

2015-09-01

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

MEASUREMENT OF NATURAL RADIONUCLIDES AND EXTERNAL RADIATION EXPOSURE DUE TO FLY ASH FROM A COAL-FIRED POWER PLANT (SPAIN) DEPOSITED ON SOILS. COMPARISON USING TWO DIFFERENT MEASUREMENT TECHNIQUES.

PubMed

Corbacho, J A; Baeza, A

2018-05-17

The evaluation of the radiological impact in soils due to the fly-ash ponds using both in situ techniques and laboratory based measurements is presented. In order to check the in situ techniques capabilities for monitoring this type of industries, a comparison between both techniques was performed. A characterization of external radiation exposure in the fly-ash pond and in its surrounding soils was made. The associated external radiological hazard due to the fly-ash pond has been evaluated. In situ techniques could be used to determine the radiological impact on soils due to fly-ash deposition, but its use could be limited due to the associated uncertainties.

Idiopathic normal pressure hydrocephalus: the CSF tap-test may predict the clinical response to shunting.

PubMed

Sand, T; Bovim, G; Grimse, R; Myhr, G; Helde, G; Cappelen, J

1994-05-01

A follow-up study was performed in nine patients with idiopathic normal pressure hydrocephalus (NPH) 37 months (mean) after shunting and 10 non-operated controls with comparable degrees of ventricular enlargement, gait disorder, and dementia. Five operated patients vs. no controls reported sustained general improvement (p < 0.02). Objectively improved gait at follow-up (compared with preoperative status) was found in five of the six tested NPH-patients vs. none of the controls (p < 0.005). Improved gait and/or psychometric function was found in four of six NPH vs. none of eight control patients (p < 0.02) after drainage of 40 ml cerebrospinal fluid (CSF tap-test). Improved gait during the CSF tap-test predicted continued improvement at follow-up. Temporal horn size was the only radiological variable which showed a (moderate) positive correlation with resistance to CSF absorption and rate of pressure increase. The size of the third ventricle diminished in parallel with clinical improvement.

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

NASA Astrophysics Data System (ADS)

Vaz, Pedro

2015-11-01

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

Improving Patient Safety: Avoiding Unread Imaging Exams in the National VA Enterprise Electronic Health Record.

PubMed

Bastawrous, Sarah; Carney, Benjamin

2017-06-01

In the current digital and filmless age of radiology, rates of unread radiology exams remain low, however, may still exist in unique environments. Veterans Affairs (VA) health care systems may experience higher rates of unread exams due to coexistence of Veterans Health Information Systems and Technology Architecture (VistA) imaging and commercial picture archiving and communication systems (PACS). The purpose of this patient safety initiative was to identify any unread exams and causes leading to unread exams. Following approval by departmental quality assurance committee, a comprehensive review was performed of all radiology exams within VistA imaging from July 1, 2009 to June 30, 2014 to identify unread radiology exams. Over the 5-year period, the total unread exam rate was calculated to be 0.17%, with the highest yearly unread exam rate of 0.25%. The leading majority of unread exam type was plain radiographs. Analysis revealed unfinished dictations, unassociated accession numbers, technologist errors, and inefficient radiologist work lists as top contributors to unread exams. Once unread radiology exams were discovered and the causes identified, valuable process changes were implemented within our department to ensure simultaneous tracking of all unread exams in VistA imaging as well as the commercial PACS.

Is excision biopsy of fibroadenomas based solely on size criteria warranted?

PubMed

Neville, Grace; Neill, Cathleen O'; Murphy, Rosemary; Corrigan, Mark; Redmond, Paul H; Feeley, Linda; Bennett, Michael W; O'Connell, Fionnuala; Browne, Tara Jane

2018-05-25

Fibroadenomas (FA) are the most common benign tumor in the female breast. Most are managed conservatively provided there is clinical, radiologic, and pathologic concordance. However, surgical excision is typically recommended for cellular fibroepithelial lesions or those lesions with clinical, radiologic, or pathologic features concerning for phyllodes tumor (PT). Some studies have suggested surgical excision in all FA >30 mm to reduce core needle biopsy (CNB) sampling errors. The aim of our study was to evaluate, in the absence of any other concerning clinicopathologic features, whether surgical excision of FA was warranted based on size criteria alone. Cork University Hospital is a large academic center in Southern Ireland. Its breast cancer center provides both a screening and symptomatic service and diagnoses approximately 600 cancers per year. The breast histopathological data base was reviewed for all CNBs from January 1, 2010, to June 30, 2015, with a diagnosis of FA that went on to have excision at our institution. We excluded all cellular fibroepithelial lesions and those cases with co-existent lobular neoplasia, ductal carcinoma in situ, invasive carcinoma, atypical ductal hyperplasia, or lesions which would require excision in their own right. Cases in which the radiologic targeted mass was discordant with a diagnosis of FA were also excluded. Patient demographics and preoperative radiologic size and the radiologic target were recorded in each case. All radiology was reviewed by a breast radiologist prior to inclusion in the study, and there was histologic radiologic concordance with a diagnosis of FA in all cases. A total of 12,109 consecutive radiologically guided CNB were performed January 2010-June 2015; 3438 with a diagnosis of FA were identified of which 290 cases went on to have surgical excision. Of those 290 cases; 98.28% (n = 285) were confirmed as FA on excision. The remaining 1.72% (n = 5) had atypical features-FA with LCIS (n = 1), benign PT (n = 3), and invasive ductal carcinoma (n = 1). Our study suggests that, excision based solely on size is not warranted in clinical and radiologically concordant cases with a diagnosis of FA on CNB. © 2018 Wiley Periodicals, Inc.

Evolution of the Preliminary Clinical Year and the Case for a Categorical Diagnostic Radiology Residency.

PubMed

Pfeifer, Cory M

2016-07-01

While other specialties traditionally utilizing a segregated clinical internship year have slowly progressed toward integrated training curricula, diagnostic radiology has been slow to adopt this path. The aim of this study was to analyze the trends in stand-alone preliminary clinical years as well as the shift toward categorical residencies currently being undertaken in other specialties. Advantages of mimicking the trends of other specialties and current integrated radiology programs are discussed. The perception of diagnostic radiology as a competitive specialty is explored, and the prospect of change as a recruiting tool is examined. Data assimilated by the NRMP from 1994 through 2016 were processed and analyzed. The total number of postgraduate year (PGY) 1 preliminary year programs has remained relatively constant over the past 10 years despite a gradual increase in overall NRMP applicants. The proportion of these programs offered as a transitional year declined from 31% in 1994 to 20% in 2016. The proportion of categorical anesthesiology positions gradually rose from 43% in 2007 to 70% in 2016. The fraction of categorical neurology positions increased from 30% in 2007 to 59% in 2016. The percentage of diagnostic radiology programs beginning at the PGY 1 level has been relatively constant at 12% to 14% since 2007. Dermatology has increased advanced (PGY 2) positions while decreasing categorical (PGY 1) positions. Those matching in diagnostic radiology have performed at a high level compared with the composite NRMP average since 2007. In the 2015 match, there were 65 diagnostic radiology programs that did not fill all of their offered positions. Of the institutions housing these programs, only 22% of them had preliminary internal medicine or transitional year positions available after the match. In response to the evolving nature of health care and graduate medical education, other specialties are gradually shifting toward curricular structures that begin at the PGY 1 level. By considering such a transition, diagnostic radiology would be well served to position itself as a valuable clinical specialty while maintaining a lesser dependence on other specialties to train its physicians. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Anatomy of an incident

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

Cournoyer, Michael E.; Trujillo, Stanley; Lawton, Cindy M.

A traditional view of incidents is that they are caused by shortcomings in human competence, attention, or attitude. It may be under the label of “loss of situational awareness,” procedure “violation,” or “poor” management. A different view is that human error is not the cause of failure, but a symptom of failure – trouble deeper inside the system. In this perspective, human error is not the conclusion, but rather the starting point of investigations. During an investigation, three types of information are gathered: physical, documentary, and human (recall/experience). Through the causal analysis process, apparent cause or apparent causes are identifiedmore » as the most probable cause or causes of an incident or condition that management has the control to fix and for which effective recommendations for corrective actions can be generated. A causal analysis identifies relevant human performance factors. In the following presentation, the anatomy of a radiological incident is discussed, and one case study is presented. We analyzed the contributing factors that caused a radiological incident. When underlying conditions, decisions, actions, and inactions that contribute to the incident are identified. This includes weaknesses that may warrant improvements that tolerate error. Measures that reduce consequences or likelihood of recurrence are discussed.« less