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.

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.

[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.

Glasgow Coma Scale and Outcomes after Structural Traumatic Head Injury in Early Childhood

PubMed Central

Heather, Natasha L.; Derraik, José G. B.; Beca, John; Hofman, Paul L.; Dansey, Rangi; Hamill, James; Cutfield, Wayne S.

2013-01-01

Objective To assess the association of the Glasgow Coma Scale (GCS) with radiological evidence of head injury (the Abbreviated Injury Scale for the head region, AIS-HR) in young children hospitalized with traumatic head injury (THI), and the predictive value of GCS and AIS-HR scores for long-term impairment. Methods Our study involved a 10-year retrospective review of a database encompassing all patients admitted to Starship Children’s Hospital (Auckland, New Zealand, 2000–2010) with THI. Results We studied 619 children aged <5 years at the time of THI, with long-term outcome data available for 161 subjects. Both GCS and AIS-HR scores were predictive of length of intensive care unit and hospital stay (all p<0.001). GCS was correlated with AIS-HR (ρ=-0.46; p<0.001), although mild GCS scores (13–15) commonly under-estimated the severity of radiological injury: 42% of children with mild GCS scores had serious–critical THI (AIS-HR 3–5). Increasingly severe GCS or AIS-HR scores were both associated with a greater likelihood of long-term impairment (neurological disability, residual problems, and educational support). However, long-term impairment was also relatively common in children with mild GCS scores paired with structural THI more severe than a simple linear skull fracture. Conclusion Severe GCS scores will identify most cases of severe radiological injury in early childhood, and are good predictors of poor long-term outcome. However, young children admitted to hospital with structural THI and mild GCS scores have an appreciable risk of long-term disability, and also warrant long-term follow-up. PMID:24312648

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.

SU-E-E-01: ABR Diagnostic Radiology Core Exam: Was Our Redesigned Physics Course Successful in Teaching Physics to Radiology Residents?

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

Kanal, K; Hoff, M; Dickinson, R

Purpose: Our purpose is to evaluate the effectiveness of our two year physics course in preparing radiology residents for the American Board of Radiology (ABR) diagnostic radiology exam. Methods: We designed a new two-year physics course that integrates radiology clinical content and practice and is primarily based on the AAPM curriculum and RSNA/AAPM physics modules. Biweekly classes focus on relevant concepts from assigned reading and use audience response systems to encourage participation. Teaching efficiency is optimized through lecturer rotations of physicists, radiologists, and guest speakers. An emphasis is placed on clinical relevance by requiring lab work and providing equipment demonstrations.more » Periodic quiz were given during the course. The course website was also redesigned for usability, and physics review lectures were conducted two weeks before the board exam to refresh key concepts. At the completion of our first two-year course, we conducted a confidential evaluation of the faculty and course. The evaluation assessed metrics such as overall organization, clinical relevance of content, and level of difficulty, with a rating scale from poor to excellent. Results: Our evaluation indicated that the redesigned course provided effective board exam preparation, with most responses between good and excellent. There was some criticism on the course length and on chronological discontinuity, but the review lectures were appreciated by the residents. All of our residents passed the physics component of the ABR exam with scores exceeding the minimum passing score by a significant margin. Conclusion: The course evaluation and board exam results indicate that our new two-year course format provides valuable board exam preparation. This is possible thanks to the time and effort taken by the physics faculty on ensuring the residents get quality physics education.« less

Activities carried out by the American College of Radiology in cooperation with the National Institute for Occupational Safety and Health. Final report

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

Not Available

1984-09-28

Activities carried out by the American College of Radiology are described. Guidelines on radiographic techniques for radiological technicians were developed. Annual training sessions for technologists and physicians were conducted by the American College of Radiology Task Force on Pneumoconiosis. Regulations for performing chest x rays were reviewed. Program activities such as the 12-point International Labor Organization (ILO) classification scale for diagnosis of coal workers' pneumoconiosis, and the reporting form for use of the 1980 ILO classification system were reviewed. The American College of Radiology maintained liaison between NIOSH and other medical specialty societies such as the American College of Chestmore » Physicians, the College of American Pathologists, the American Medical Association, and the American Osteopathic College of Radiology. The American College of Radiology assisted NIOSH with the initiation, development, and maintenance of a quality control method to monitor and advise physicians on the reading of radiographs.« less

Collaborative Branding of Partnered Health Systems in Radiology.

PubMed

Kalambo, Megan; Parikh, Jay R

2018-01-01

In an effort to expand clinical reach and achieve economies of scale, academic radiology practices are strategically expanding into the community by establishing partnerships with existing community health systems. A challenge with this model is to effectively brand the collaboration in a way that underscores the strengths of both partners. In this article, the authors look at the benefits and risks of cobranding and review cobranding strategies for implementation by academic radiology practices considering partnership-based network expansion. Published by Elsevier Inc.

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.

Induction for Radiology Patients

NASA Astrophysics Data System (ADS)

Yıldırım, Pınar; Tolun, Mehmet R.

This paper represents the implementation of an inductive learning algorithm for patients of Radiology Department in Hacettepe University hospitals to discover the relationship between patient demographics information and time that patients spend during a specific radiology exam. ILA has been used for the implementation which generates rules and the results are evaluated by evaluation metrics. According to generated rules, some patients in different age groups or birthplaces may spend more time for the same radiology exam than the others.

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.

Web-based segmentation and display of three-dimensional radiologic image data.

PubMed

Silverstein, J; Rubenstein, J; Millman, A; Panko, W

1998-01-01

In many clinical circumstances, viewing sequential radiological image data as three-dimensional models is proving beneficial. However, designing customized computer-generated radiological models is beyond the scope of most physicians, due to specialized hardware and software requirements. We have created a simple method for Internet users to remotely construct and locally display three-dimensional radiological models using only a standard web browser. Rapid model construction is achieved by distributing the hardware intensive steps to a remote server. Once created, the model is automatically displayed on the requesting browser and is accessible to multiple geographically distributed users. Implementation of our server software on large scale systems could be of great service to the worldwide medical community.

Time Is Not on Our Side: How Radiology Practices Should Manage Customer Queues.

PubMed

Loving, Vilert A; Ellis, Richard L; Rippee, Robert; Steele, Joseph R; Schomer, Donald F; Shoemaker, Stowe

2017-11-01

As health care shifts toward patient-centered care, wait times have received increasing scrutiny as an important metric for patient satisfaction. Long queues form when radiology practices inefficiently service their customers, leading to customer dissatisfaction and a lower perception of value. This article describes a four-step framework for radiology practices to resolve problematic queues: (1) analyze factors contributing to queue formation; (2) improve processes to reduce service times; (3) reduce variability; (4) address the psychology of queues. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2014-03-01

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

The state of radiologic teaching practice in preclinical medical education: survey of American medical, osteopathic, and podiatric schools.

PubMed

Rubin, Zachary; Blackham, Kristine

2015-04-01

This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Psychometric Analysis and Qualitative Review of an Outpatient Radiology-Specific Patient Satisfaction Survey: A Call for Collaboration in Validating a Survey Instrument.

PubMed

Dibble, Elizabeth H; Baird, Grayson L; Swenson, David W; Healey, Terrance T

2017-10-01

The aim of this study was to perform a psychometric analysis of the constructs and reliability of an outpatient radiology-specific patient satisfaction survey and identify factors that drive patient experience so that radiology practices can improve the quality of their diagnostic imaging services. This retrospective study examined responses to eight patient satisfaction questions from a survey originally developed by a nascent marketing team and then administered at five outpatient imaging centers from January 7, 2013, to November 11, 2015. Patients' responses were reviewed to identify factors that affected patient experience, and a psychometric analysis of the survey instrument itself was performed, including exploratory factor analyses and reliability testing. Patient responses were compared among sites, examination types, and questions. Free-text comments were qualitatively categorized and compared by examination type. In total, 6,512 surveys were completed among 137,059 patient encounters. Using exploratory factor analyses of the eight survey questions, three relevant patient experience constructs were derived: (1) front office experience, (2) intake experience, and (3) examination experience. Overall, good scale reliability was observed. Perceived quality of care had the most positive ratings; wait time had the most nonpositive ratings. Of 2,024 free-text comments, 1,859 were positive (most pertaining to staff), and 155 were negative (most pertaining to convenience). MRI patients were most likely to share negative comments, typically regarding the examination experience itself. Psychometric analysis of a patient survey derived three core patient experience constructs: front office experience, intake experience, and examination experience. The survey indicates the need to decrease wait times, streamline the registration process, and improve patient comfort during MRI examinations. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

Glascoe, Lee; Gowardhan, Akshay; Lennox, Kristin

In the interest of promoting the international exchange of technical expertise, the US Department of Energy’s Office of Emergency Operations (NA-40) and the French Commissariat à l'Energie Atomique et aux énergies alternatives (CEA) requested that the National Atmospheric Release Advisory Center (NARAC) of Lawrence Livermore National Laboratory (LLNL) in Livermore, California host a joint table top exercise with experts in emergency management and atmospheric transport modeling. In this table top exercise, LLNL and CEA compared each other’s flow and dispersion models. The goal of the comparison is to facilitate the exchange of knowledge, capabilities, and practices, and to demonstrate themore » utility of modeling dispersal at different levels of computational fidelity. Two modeling approaches were examined, a regional scale modeling approach, appropriate for simple terrain and/or very large releases, and an urban scale modeling approach, appropriate for small releases in a city environment. This report is a summary of LLNL and CEA modeling efforts from this exercise. Two different types of LLNL and CEA models were employed in the analysis: urban-scale models (Aeolus CFD at LLNL/NARAC and Parallel- Micro-SWIFT-SPRAY, PMSS, at CEA) for analysis of a 5,000 Ci radiological release and Lagrangian Particle Dispersion Models (LODI at LLNL/NARAC and PSPRAY at CEA) for analysis of a much larger (500,000 Ci) regional radiological release. Two densely-populated urban locations were chosen: Chicago with its high-rise skyline and gridded street network and Paris with its more consistent, lower building height and complex unaligned street network. Each location was considered under early summer daytime and nighttime conditions. Different levels of fidelity were chosen for each scale: (1) lower fidelity mass-consistent diagnostic, intermediate fidelity Navier-Stokes RANS models, and higher fidelity Navier-Stokes LES for urban-scale analysis, and (2) lower-fidelity single-profile meteorology versus higher-fidelity three-dimensional gridded weather forecast for regional-scale analysis. Tradeoffs between computation time and the fidelity of the results are discussed for both scales. LES, for example, requires nearly 100 times more processor time than the mass-consistent diagnostic model or the RANS model, and seems better able to capture flow entrainment behind tall buildings. As anticipated, results obtained by LLNL and CEA at regional scale around Chicago and Paris look very similar in terms of both atmospheric dispersion of the radiological release and total effective dose. Both LLNL and CEA used the same meteorological data, Lagrangian particle dispersion models, and the same dose coefficients. LLNL and CEA urban-scale modeling results show consistent phenomenological behavior and predict similar impacted areas even though the detailed 3D flow patterns differ, particularly for the Chicago cases where differences in vertical entrainment behind tall buildings are particularly notable. Although RANS and LES (LLNL) models incorporate more detailed physics than do mass-consistent diagnostic flow models (CEA), it is not possible to reach definite conclusions about the prediction fidelity of the various models as experimental measurements were not available for comparison. Stronger conclusions about the relative performances of the models involved and evaluation of the tradeoffs involved in model simplification could be made with a systematic benchmarking of urban-scale modeling. This could be the purpose of a future US / French collaborative exercise.« less

Applying Systems Engineering Reduces Radiology Transport Cycle Times in the Emergency Department.

PubMed

White, Benjamin A; Yun, Brian J; Lev, Michael H; Raja, Ali S

2017-04-01

Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays and determine the most effective techniques. This prospective, before-and-after analysis of radiology process flow improvements in an academic hospital ED was exempt from institutional review board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely using Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013-3/2016 and requiring plain film imaging were included. We analyzed electronic medical record data using Microsoft Excel and SAS version 9.4, and we used a two-sample t-test to compare data from the pre- and post-intervention periods. Following the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.7 ± 4.2 minutes during the three months pre-intervention. It was reduced by 15% in the first three months (4.4 minutes [95% confidence interval [CI] 1.5-7.3]; to 24.3 ± 3.3 min, P=0.021), 19% in the following six months (5.4 minutes, 95% CI [2.7-8.2]; to 23.3 ± 3.5 min, P=0.003), and 26% one year following the intervention (7.4 minutes, 95% CI [4.8-9.9]; to 21.3 ± 3.1 min, P=0.0001). This result was achieved without any additional resources, and demonstrated a continual trend towards improvement. This innovation demonstrates the value of systems engineering science to increase efficiency in ED radiology processes. In this study, reorganization of the ED radiology transport process using systems engineering science significantly increased process efficiency without additional resource use.

Applying Systems Engineering Reduces Radiology Transport Cycle Times in the Emergency Department

PubMed Central

White, Benjamin A.; Yun, Brian J.; Lev, Michael H.; Raja, Ali S.

2017-01-01

Introduction Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays and determine the most effective techniques. Methods This prospective, before-and-after analysis of radiology process flow improvements in an academic hospital ED was exempt from institutional review board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely using Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013–3/2016 and requiring plain film imaging were included. We analyzed electronic medical record data using Microsoft Excel and SAS version 9.4, and we used a two-sample t-test to compare data from the pre- and post-intervention periods. Results Following the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.7 ± 4.2 minutes during the three months pre-intervention. It was reduced by 15% in the first three months (4.4 minutes [95% confidence interval [CI] 1.5–7.3]; to 24.3 ± 3.3 min, P=0.021), 19% in the following six months (5.4 minutes, 95% CI [2.7–8.2]; to 23.3 ± 3.5 min, P=0.003), and 26% one year following the intervention (7.4 minutes, 95% CI [4.8–9.9]; to 21.3 ± 3.1 min, P=0.0001). This result was achieved without any additional resources, and demonstrated a continual trend towards improvement. This innovation demonstrates the value of systems engineering science to increase efficiency in ED radiology processes. Conclusion In this study, reorganization of the ED radiology transport process using systems engineering science significantly increased process efficiency without additional resource use. PMID:28435492

Real-Time Electronic Dashboard Technology and Its Use to Improve Pediatric Radiology Workflow.

PubMed

Shailam, Randheer; Botwin, Ariel; Stout, Markus; Gee, Michael S

The purpose of our study was to create a real-time electronic dashboard in the pediatric radiology reading room providing a visual display of updated information regarding scheduled and in-progress radiology examinations that could help radiologists to improve clinical workflow and efficiency. To accomplish this, a script was set up to automatically send real-time HL7 messages from the radiology information system (Epic Systems, Verona, WI) to an Iguana Interface engine, with relevant data regarding examinations stored in an SQL Server database for visual display on the dashboard. Implementation of an electronic dashboard in the reading room of a pediatric radiology academic practice has led to several improvements in clinical workflow, including decreasing the time interval for radiologist protocol entry for computed tomography or magnetic resonance imaging examinations as well as fewer telephone calls related to unprotocoled examinations. Other advantages include enhanced ability of radiologists to anticipate and attend to examinations requiring radiologist monitoring or scanning, as well as to work with technologists and operations managers to optimize scheduling in radiology resources. We foresee increased utilization of electronic dashboard technology in the future as a method to improve radiology workflow and quality of patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

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.

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

Facilitating process changes in meal delivery and radiological testing to improve inpatient insulin timing using six sigma method.

PubMed

Yamamoto, J Jay; Malatestinic, Bill; Lehman, Angela; Juneja, Rattan

2010-01-01

The objective of this project was to improve the timing of inpatient insulin administration related to meal delivery and the scheduling of radiology tests by Lean Six Sigma method. A multidisciplinary hospital team and a Six Sigma team from a pharmaceutical manufacturer collaborated to evaluate food delivery and radiology scheduling processes related to the timing of insulin administration. Key factors leading to problems within each system were addressed to improve the efficiency of each process while improving the timeliness of glucose testing and insulin administration. Standardizing the food delivery schedule and utilizing scorecards to track on-time meal deliveries to the floor enabled nursing to more accurately administer insulin in coordination with the delivery of meals. Increasing communication and restricting the scheduling of inpatient procedures during mealtimes reduced disruptions to insulin administration. Data at 6 months postimplementation demonstrated that the institution met goals for most primary outcome metrics including increasing on-time meal delivery and the proportion of patients taking insulin scheduled for radiology tests during appropriate times. By implementing the recommendations identified via Lean Six Sigma, this collaborative effort improved the timing of inpatient insulin administration related to meal delivery and radiology testing.

The influence of a fire-induced convection column on radiological fallout patterns

Treesearch

A. Broido; A.W. McMasters

1959-01-01

Since no nuclear devices have been detonated by the United States under conditions leading to both mass fires and radiological fallout, a theoretical and small-scale experimental study was undertaken to see if fire-induced convection columns could significantly affect fallout patterns. Experiments were conducted in a 6- by 6-foot low-velocity wind tunnel using full-...

Burnout: Job Resources and Job Demands Associated With Low Personal Accomplishment in United States Radiology Residents.

PubMed

Guenette, Jeffrey P; Smith, Stacy E

2018-06-01

We aimed to identify job resources and job demands associated with measures of personal accomplishment (PA) in radiology residents in the United States. A 34-item online survey was administered between May and June 2017 to U.S. radiology residents and included the 8 Likert-type PA questions from the Maslach Burnout Inventory-Human Services Survey, 19 visual analog scale job demands-resources questions, and 7 demographic questions. Multiple linear regression was calculated to predict PA based on job demands-resources. Effects of binomial demographic factors on PA scores were compared with independent-samples t tests. Effects of categorical demographic factors on PA scores were compared with one-way between-subjects analysis of variance tests. A linear regression was calculated to evaluate the relationship of age on PA scores. "The skills and knowledge that I am building are important and helpful to society" (P = 2 × 10 -16 ), "I have good social support from my co-residents" (P = 4 × 10 -5 ), and "I regularly receive adequate constructive feedback" (P = 4 × 10 -6 ) all positively correlated with PA. PA scores were significantly lower for individuals who were single vs those married or partnered (P = .01). Radiology residents score higher in the PA domain of burnout when they receive adequate constructive feedback, have good co-resident social support, and feel that the skills and knowledge they are building are important to society. Improving constructive feedback mechanisms, enabling resident-only social time, and supporting opportunities that reinforce the importance of their contributions may therefore improve radiology residents' sense of PA. Copyright © 2018. Published by Elsevier Inc.

Clinical-Radiological Parameters Improve the Prediction of the Thrombolysis Time Window by Both MRI Signal Intensities and DWI-FLAIR Mismatch.

PubMed

Madai, Vince Istvan; Wood, Carla N; Galinovic, Ivana; Grittner, Ulrike; Piper, Sophie K; Revankar, Gajanan S; Martin, Steve Z; Zaro-Weber, Olivier; Moeller-Hartmann, Walter; von Samson-Himmelstjerna, Federico C; Heiss, Wolf-Dieter; Ebinger, Martin; Fiebach, Jochen B; Sobesky, Jan

2016-01-01

With regard to acute stroke, patients with unknown time from stroke onset are not eligible for thrombolysis. Quantitative diffusion weighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) MRI relative signal intensity (rSI) biomarkers have been introduced to predict eligibility for thrombolysis, but have shown heterogeneous results in the past. In the present work, we investigated whether the inclusion of easily obtainable clinical-radiological parameters would improve the prediction of the thrombolysis time window by rSIs and compared their performance to the visual DWI-FLAIR mismatch. In a retrospective study, patients from 2 centers with proven stroke with onset <12 h were included. The DWI lesion was segmented and overlaid on ADC and FLAIR images. rSI mean and SD, were calculated as follows: (mean ROI value/mean value of the unaffected hemisphere). Additionally, the visual DWI-FLAIR mismatch was evaluated. Prediction of the thrombolysis time window was evaluated by the area-under-the-curve (AUC) derived from receiver operating characteristic (ROC) curve analysis. Factors such as the association of age, National Institutes of Health Stroke Scale, MRI field strength, lesion size, vessel occlusion and Wahlund-Score with rSI were investigated and the models were adjusted and stratified accordingly. In 82 patients, the unadjusted rSI measures DWI-mean and -SD showed the highest AUCs (AUC 0.86-0.87). Adjustment for clinical-radiological covariates significantly improved the performance of FLAIR-mean (0.91) and DWI-SD (0.91). The best prediction results based on the AUC were found for the final stratified and adjusted models of DWI-SD (0.94) and FLAIR-mean (0.96) and a multivariable DWI-FLAIR model (0.95). The adjusted visual DWI-FLAIR mismatch did not perform in a significantly worse manner (0.89). ADC-rSIs showed fair performance in all models. Quantitative DWI and FLAIR MRI biomarkers as well as the visual DWI-FLAIR mismatch provide excellent prediction of eligibility for thrombolysis in acute stroke, when easily obtainable clinical-radiological parameters are included in the prediction models. © 2016 S. Karger AG, Basel.

T1- Thresholds in Black Holes Increase Clinical-Radiological Correlation in Multiple Sclerosis Patients.

PubMed

Thaler, Christian; Faizy, Tobias; Sedlacik, Jan; Holst, Brigitte; Stellmann, Jan-Patrick; Young, Kim Lea; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

2015-01-01

Magnetic Resonance Imaging (MRI) is an established tool in diagnosing and evaluating disease activity in Multiple Sclerosis (MS). While clinical-radiological correlations are limited in general, hypointense T1 lesions (also known as Black Holes (BH)) have shown some promising results. The definition of BHs is very heterogeneous and depends on subjective visual evaluation. We aimed to improve clinical-radiological correlations by defining BHs using T1 relaxation time (T1-RT) thresholds to achieve best possible correlation between BH lesion volume and clinical disability. 40 patients with mainly relapsing-remitting MS underwent MRI including 3-dimensional fluid attenuated inversion recovery (FLAIR), magnetization-prepared rapid gradient echo (MPRAGE) before and after Gadolinium (GD) injection and double inversion-contrast magnetization-prepared rapid gradient echo (MP2RAGE) sequences. BHs (BHvis) were marked by two raters on native T1-weighted (T1w)-MPRAGE, contrast-enhancing lesions (CE lesions) on T1w-MPRAGE after GD and FLAIR lesions (total-FLAIR lesions) were detected separately. BHvis and total-FLAIR lesion maps were registered to MP2RAGE images, and the mean T1-RT were calculated for all lesion ROIs. Mean T1 values of the cortex (CTX) were calculated for each patient. Subsequently, Spearman rank correlations between clinical scores (Expanded Disability Status Scale and Multiple Sclerosis Functional Composite) and lesion volume were determined for different T1-RT thresholds. Significant differences in T1-RT were obtained between all different lesion types with highest T1 values in visually marked BHs (BHvis: 1453.3±213.4 ms, total-FLAIR lesions: 1394.33±187.38 ms, CTX: 1305.6±35.8 ms; p<0.05). Significant correlations between BHvis/total-FLAIR lesion volume and clinical disability were obtained for a wide range of T1-RT thresholds. The highest correlation for BHvis and total-FLAIR lesion masks were found at T1-RT>1500 ms (Expanded Disability Status Scale vs. lesion volume: rBHvis = 0.442 and rtotal-FLAIR = 0.497, p<0.05; Multiple Sclerosis Functional Composite vs. lesion volume: rBHvis = -0.53 and rtotal-FLAIR = -0.627, p<0.05). Clinical-radiological correlations in MS patients are increased by application of T1-RT thresholds. With the short acquisition time of the MP2RAGE sequences, quantitative T1 maps could be easily established in clinical studies.

Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial.

PubMed

Monticone, Marco; Ambrosini, Emilia; Cazzaniga, Daniele; Rocca, Barbara; Motta, Lorenzo; Cerri, Cesare; Brayda-Bruno, Marco; Lovi, Alessio

2016-10-01

To evaluate the effects of motor and cognitive rehabilitation on disability in adults with idiopathic scoliosis at lower risk of progression. 130 adults with idiopathic scoliosis (main curve <35°) were randomly assigned to a 20-week rehabilitation programme consisting of active self-correction, task-oriented exercises and cognitive-behavioural therapy (experimental group, 65 subjects, mean age of 51.6, females 48) or general physiotherapy consisting of active and passive mobilizations, stretching, and strengthening exercises of the spinal muscles (control group, 65 subjects, mean age of 51.7, females 46). Before, at the end, and 12 months after treatment, each participant completed the Oswestry disability index (ODI) (primary outcome), the Tampa scale for kinesiophobia, the pain catastrophizing scale, a pain numerical rating scale, and the Scoliosis Research Society-22 Patient Questionnaire. Radiological (Cobb angle) and clinical deformity (angle of trunk rotation) changes were also investigated. A linear mixed model for repeated measures was used for each outcome. Significant effects of time, group, and time by group interaction were found for all outcome measures (P < 0.001). After training, the primary outcome showed a clinically significant between-group change (12 % points), which was preserved at follow-up. At follow-up, the radiological deformities showed a significant, although not clinically meaningful, between-group difference of 4° in favour of the experimental group. The experimental programme was superior to general physiotherapy in reducing disability of adults with idiopathic scoliosis. Motor and cognitive rehabilitation also led to improvements in dysfunctional thoughts, pain, and quality of life. Changes were maintained for at least 1 year.

[Wireless digital radiography detectors in the emergency area: an efficacious solution].

PubMed

Garrido Blázquez, M; Agulla Otero, M; Rodríguez Recio, F J; Torres Cabrera, R; Hernando González, I

2013-01-01

To evaluate the implementation of a flat panel digital radiolography (DR) system with WiFi technology in an emergency radiology area in which a computed radiography (CR) system was previously used. We analyzed aspects related to image quality, radiation dose, workflow, and ergonomics. We analyzed the results obtained with the CR and WiFi DR systems related with the quality of images analyzed in images obtained using a phantom and after radiologists' evaluation of radiological images obtained in real patients. We also analyzed the time required for image acquisition and the workflow with the two technological systems. Finally, we analyzed the data related to the dose of radiation in patients before and after the implementation of the new equipment. Image quality improved in both the tests carried out with a phantom and in radiological images obtained in patients, which increased from 3 to 4.5 on a 5-point scale. The average time required for image acquisition decreased by 25 seconds per image. The flat panel required less radiation to be delivered in practically all the techniques carried out using automatic dosimetry, although statistically significant differences were found in only some of the techniques (chest, thoracic spine, and lumbar spine). Implementing the WiFi DR system has brought benefits. Image quality has improved and the dose of radiation to patients has decreased. The new system also has advantages in terms of functionality, ergonomics, and performance. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

Resources planning for radiological incidents management

NASA Astrophysics Data System (ADS)

Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.

2017-01-01

Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.

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

PubMed

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

2016-04-01

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

Correlation of matrix metalloproteinase (MMP)-1, -2, -3, and -9 expressions with demographic and radiological features in primary lumbar intervertebral disc disease.

PubMed

Basaran, Recep; Senol, Mehmet; Ozkanli, Seyma; Efendioglu, Mustafa; Kaner, Tuncay

2017-07-01

Degeneration of IVD is a progressive and irreversible process and can be evaluated with immunohistochemical examination or radiological grading. MMPs are a family of proteolytic enzymes and involved in the degradation of the matrix components of the IVD. We aimed to compare MMP-1, -2, -3, and -9 expressions with demographic features, visual analogue scale (VAS), Oswestry Disability Index (ODI) and radiological (MRI) grades. The study involved 60 participants. We recorded data about age, complaint, radiological imaging, expression levels of MMP-1, -2, -3, and -9, ODI and VAS for back pain retrospectively. Intervertebral disc degeneration was graded on a 0-5 scale according to the Pfirrmann classification. As a result of the study, the median age was 52.09±12.74years. There were statistical significances between age and MMP-1, and MMP-2. There was a close correlation between grade and MMP-9. We found correlation between the VAS and the MMP-9 expression. In addition, there was relationship between expression of MMP-2 and MMP-1, MMP-3, MMP-9. In conclusion, the expressions of MMP-1 and -2 are increased with aging. There was no relationship between radiological evaluation of IVDD and aging. Increased expression of MMPs affected IVDD positively. The relationship with MMPs is not explained. This study adds to our understanding of the interaction between MMPs and IVDD. Copyright © 2017 Elsevier Ltd. All rights reserved.

Stress Management and Resiliency Training (SMART) program among Department of Radiology faculty: a pilot randomized clinical trial.

PubMed

Sood, Amit; Sharma, Varun; Schroeder, Darrell R; Gorman, Brian

2014-01-01

To test the efficacy of a Stress Management and Resiliency Training (SMART) program for decreasing stress and anxiety and improving resilience and quality of life among Department of Radiology physicians. The study was approved by the institutional review board. A total of 26 Department of Radiology physicians were randomized in a single-blind trial to either the SMART program or a wait-list control arm for 12 weeks. The program involved a single 90-min group session in the SMART training with two follow-up phone calls. Primary outcomes measured at baseline and week 12 included the Perceived Stress Scale, Linear Analog Self-Assessment Scale, Mindful Attention Awareness Scale, and Connor-Davidson Resilience Scale. A total of 22 physicians completed the study. A statistically significant improvement in perceived stress, anxiety, quality of life, and mindfulness at 12 weeks was observed in the study arm compared to the wait-list control arm; resilience also improved in the active arm, but the changes were not statistically significant when compared to the control arm. A single session to decrease stress among radiologists using the SMART program is feasible. Furthermore, the intervention afforded statistically significant and clinically meaningful improvement in anxiety, stress, quality of life, and mindful attention. Further studies including larger sample size and longer follow-up are warranted. Copyright © 2014. Published by Elsevier Inc.

Corporate social responsibility of future radiology professionals.

PubMed

Collins, Sandra K; Collins, Kevin S

2011-01-01

Plagued by difficult economic times, many radiology managers may find themselves faced with ethical dilemmas surrounding ongoing organizational pressures to maintain high levels of productivity with restricted resources. This often times tests the level of moral resilience and corporate social consciousness of even the most experienced radiology professionals. A study was conducted to determine what Corporate Social Responsibility (CSR) orientation and viewpoint future radiology professionals may have. The results of the study indicate that these study participants may initially consider patient care more important than profit maximization. Study results indicate that these specific future radiology professionals will not need laws, legal sanctions, and intensified rules to force them to act ethically. However,they may need ongoing training as to the necessity of profit maximization if they seek the highest quality of care possible for their patients.

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

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

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

2011-04-15

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

Automated Radiology-Pathology Module Correlation Using a Novel Report Matching Algorithm by Organ System.

PubMed

Dane, Bari; Doshi, Ankur; Gfytopoulos, Soterios; Bhattacharji, Priya; Recht, Michael; Moore, William

2018-05-01

Radiology-pathology correlation is time-consuming and is not feasible in most clinical settings, with the notable exception of breast imaging. The purpose of this study was to determine if an automated radiology-pathology report pairing system could accurately match radiology and pathology reports, thus creating a feedback loop allowing for more frequent and timely radiology-pathology correlation. An experienced radiologist created a matching matrix of radiology and pathology reports. These matching rules were then exported to a novel comprehensive radiology-pathology module. All distinct radiology-pathology pairings at our institution from January 1, 2016 to July 1, 2016 were included (n = 8999). The appropriateness of each radiology-pathology report pairing was scored as either "correlative" or "non-correlative." Pathology reports relating to anatomy imaged in the specific imaging study were deemed correlative, whereas pathology reports describing anatomy not imaged with the particular study were denoted non-correlative. Overall, there was 88.3% correlation (accuracy) of the radiology and pathology reports (n = 8999). Subset analysis demonstrated that computed tomography (CT) abdomen/pelvis, CT head/neck/face, CT chest, musculoskeletal CT (excluding spine), mammography, magnetic resonance imaging (MRI) abdomen/pelvis, MRI brain, musculoskeletal MRI (excluding spine), breast MRI, positron emission tomography (PET), breast ultrasound, and head/neck ultrasound all demonstrated greater than 91% correlation. When further stratified by imaging modality, CT, MRI, mammography, and PET demonstrated excellent correlation (greater than 96.3%). Ultrasound and non-PET nuclear medicine studies demonstrated poorer correlation (80%). There is excellent correlation of radiology imaging reports and appropriate pathology reports when matched by organ system. Rapid, appropriate radiology-pathology report pairings provide an excellent opportunity to close feedback loop to the interpreting radiologist. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2012-01-01

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

Forecasting the Effect of the Change in Timing of the ABR Diagnostic Radiology Examinations: Results of the ACR Survey of Practice Leaders.

PubMed

Bluth, Edward I; Muroff, Lawrence R; Cernigliaro, Joseph G; Moore, Arl V; Smith, Geoffrey G; Flug, Jonathan; DeStigter, Kristen K; Allen, Bibb; Thorwarth, William T; Roberts, Anne C

2015-05-01

The results of a survey sent to practice leaders in the ACR Practice of Radiology Environment Database show that the majority of responding groups will continue to hire recently trained residents and fellows even though they have been unable to take the final ABR diagnostic radiology certifying examination. However, a significant minority of private practice groups will not hire these individuals. The majority of private practices expect the timing change for the ABR certifying examinations to affect their groups' function. In contrast, the majority of academic medical school practices expect little or no impact. Residents and fellows should not expect work time off or protected time to study for the certifying examination or for their maintenance of certification examinations in the future. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology research in mainland China in the past 10 years: a survey of original articles published in Radiology and European Radiology.

PubMed

Zhang, Long Jiang; Wang, Yun Fei; Yang, Zhen Lu; Schoepf, U Joseph; Xu, Jiaqian; Lu, Guang Ming; Li, Enzhong

2017-10-01

To evaluate the features and trends of Radiology research in Mainland China through bibliometric analysis of the original articles published in Radiology and European Radiology (ER) between 2006 and 2015. We reviewed the original articles published in Radiology and ER between 2006 and 2015. The following information was abstracted: imaging subspecialty, imaging technique(s) used, research type, sample size, study design, statistical analysis, study results, funding declarations, international collaborations, number of authors, department and province of the first author. All variables were examined longitudinally over time. Radiology research in Mainland China saw a substantial increase in original research articles published, especially in the last 5 years (P < 0.001). Within Mainland China's Radiology research, neuroradiology, vascular/interventional Radiology, and abdominal Radiology were the most productive fields; MR imaging was the most used modality, and a distinct geographic provenience was observed for articles published in Radiology and ER. Radiology research in Mainland China has seen substantial growth in the past 5 years with neuroradiology, vascular/interventional Radiology, and abdominal Radiology as the most productive fields. MR imaging is the most used modality. Article provenience shows a distinct geographical pattern. • Radiology research in Mainland China saw a substantial increase. • Neuroradiology, vascular/interventional Radiology, and abdominal Radiology are the most productive fields. • MRI is the most used modality in Mainland China's Radiology research. • Guangdong, Shanghai, and Beijing are the most productive provinces.

Influence of physical parameters on radiation protection and image quality in intra-oral radiology

NASA Astrophysics Data System (ADS)

Belinato, W.; Souza, D. N.

2011-10-01

In the world of diagnostic imaging, radiography is an important supplementary method for dental diagnosis. In radiology, special attention must be paid to the radiological protection of patients and health professionals, and also to image quality for correct diagnosis. In Brazil, the national rules governing the operation of medical and dental radiology were specified in 1998 by the National Sanitary Surveillance Agency, complemented in 2005 by the guide "Medical radiology: security and performance of equipment." In this study, quality control tests were performed in public clinics with dental X-ray equipment in the State of Sergipe, Brazil, with consideration of the physical parameters that influence radiological protection and also the quality of images taken in intra-oral radiography. The accuracy of the exposure time was considered acceptable for equipment with digital timers. Exposure times and focal-spot size variations can lead to increased entrance dose. Increased dose has also been associated with visual processing of radiographic film, which often requires repeating the radiographic examination.

The German Radiological Society and the Protagonists of Radiology during the Time of National Socialism--State of Research, Explanation Attempts, Desiderata and Research Prospects.

PubMed

Schmidt, M; Winzen, T; Groß, D

2015-06-01

The intention of the authors is the recognition and critical analysis of efforts to study the history of the German Radiological Society during the time of National Socialism from 1933 to 1945 with the goal of determining existing desiderata and identifying the resulting research prospects. There is a need to study concrete individual biographies of radiologists (members of the German Radiological Society, perpetrators, and victims) and their careers before and after 1945 as well as the importance of the interdisciplinarity of the discipline and the lack of institutional involvement during the "Third Reich". Moreover, the comparatively difficult starting situation of the study of the history of the German Radiological Society is discussed. © Georg Thieme Verlag KG Stuttgart · New York.

Interventional radiology peer, a newly developed peer-review scoring system designed for interventional radiology practice.

PubMed

d'Othée, Bertrand Janne; Haskal, Ziv J

2013-10-01

Existing diagnostic radiology peer-review systems do not address the specificities of interventional radiology (IR) practice. The purpose of this study was to assess the feasibility of a specifically developed interventional peer review method, IR Peer. Retrospective review of a prospectively encoded pilot database aimed at demonstrating the feasibility of IR Peer in a multiphysician practice was performed. This scoring system used morning peer review of selected IR cases from the previous day in the form of a five-item questionnaire and an ordinal answer scale that grades reviewers' agreement with imaging findings, procedural/technical management, early outcomes, and follow-up plan. Patient lists from IR Peer and morbidity and mortality (M&M) conferences were compared to evaluate the amount of overlap and capability of IR Peer to help detect adverse events (AEs). A total of 417 consecutive reviews of IR attending physician cases by peers were performed in 163 consecutive patients over 18 months, and 94% of cases were reviewed by two or three IR attending physicians. Each question was answered 99%-100% of the time. Answers showed disagreement in 10% of cases (2% by a single reviewer, 8% by several), most related to procedural technique. Overall AE incidence was 1.8%. IR Peer contributed 10.7% of cases to the M&M list. IR Peer is feasible, relevant, and easy to implement in a multiphysician IR practice. When used along with other quality-assurance processes, it might help in the detection of AEs for M&M; the latter will require further confirmatory research. © SIR, 2013.

Adjacent Segment Disease After Cervical Spine Fusion: Evaluation of a 70 Patient Long-Term Follow-Up.

PubMed

Alhashash, Mohamed; Shousha, Mootaz; Boehm, Heinrich

2018-05-01

A retrospective study of 70 patients undergoing surgical treatment for adjacent segment disease (ASD) after anterior cervical decompression and fusion (ACDF). To analyze the risk factors for the development of ASD in patients who underwent ACDF. ACDF has provided a high rate of clinical success for the cervical degenerative disc disease; nevertheless, adjacent segment degeneration has been reported as a complication at the adjacent level secondary to the rigid fixation. Between January 2005 and December 2012, 70 consecutive patients underwent surgery for ASD after ACDF in our institution. In all patients thorough clinical and radiological examination was performed preoperatively, postoperatively, and at the final follow-up. The clinical data included the Neck Disability Index (NDI) and the Visual Analogue Scale (VAS). The radiological evaluation included x-rays and magnetic resonance imaging (MRI) for all patients. The duration of follow up after the adjacent segment operation ranged from 3 to 10 years. Surgery for ASD was performed after a mean period of 32 months from the primary ACDF. ASD occurred after single level ACDF in 54% of cases, most commonly after C5/6 fusion (28%). Risk factors for ASD were found to be preexisting radiological signs of degeneration at the primary surgery (74%) and bad sagittal profile after the primary ACDF (90%). ASD occurred predominantly in the middle cervical region (C4-6); especially in patients with preexisting evidence of radiological degeneration in the adjacent segment at the time of primary cervical fusion, notably when this surgery failed to restore or maintain the cervical lordosis. 4.

Comparison of effectiveness of kyphoplasty and vertebroplasty in patients with osteoporotic vertebra fractures.

PubMed

Ateş, Ahmet; Gemalmaz, Halil Can; Deveci, Mehmet Ali; Şimşek, Sezai Aykın; Çetin, Engin; Şenköylü, Alpaslan

2016-12-01

The aim of this study was to compare the functional and radiological outcomes of vertebroplasty and kyphoplasty in patients with osteoporotic vertebra fractures. The files of the patients who underwent vertebroplasty or kyphoplasty for osteoporotic vertebrae fractures were retrieved from the archives. Forty-three patients with complete follow-up data were included in the study group. The patients were evaluated for radiological outcomes in terms of local kyphosis angle, wedging index, compression ratio, visual analog pain scale (VAS) and Oswestry Disability Index (ODI). In the study group, kyphoplasty was performed on 24 vertebrae of 22 patients (17 females, 5 males; mean age: 73 years) whereas vertebroplasty was applied on 24 vertebrae of 21 (16 females, 5 males; mean age: 74.7 years) patients. The mean follow-up time was 26 months. When the VAS and ODI values of the groups were analyzed, both groups showed statistically significant progress after the operation. Radiological data showed that the kyphoplasty group showed statistically significant improvement in the sagittal index values whereas the vertebroplasty group did not. The overall complication ratio was 4%. Both vertebroplasty and kyphoplasty are effective treatment methods for functional recovery and pain relief in osteoporotic fractures of the vertebra. Although radiological outcomes of the kyphoplasty seem to be better, this does not have any clinical relevance. We suggest vertebroplasty over kyphoplasty since it is an easier method to manage. Level III, Therapeutic study. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Clinical and radiological mid-term results of the thrust plate prosthesis

PubMed Central

v.d. Daele, R.; Simon, U.; Goetze, C.

2009-01-01

The purpose of this study was to perform an objective clinical and radiological assessment of the thrust plate prosthesis (TPP). Fifty-three prostheses were evaluated clinically using the Harris hip score (HHS), visual analog scale (VAS), and radiographically before surgery, at the time of discharge, and postoperatively after on average of 8.09 (range 4.61–9.93) years. The average HHS significantly (p ≤ 0.05) improved from 48 (range 18–77) points to 95 (range 46–100) points. The VAS revealed significant (p ≤ 0.05) reduction of pain at rest and under load. Radiographic analysis showed a considerable potential for osteolysis under the thrust plate. Sixteen prostheses revealed signs of radiolucent zones. In general, there was a good clinical outcome with no major limitations in function. Radiographic changes under the thrust plate indicate an adaptation processes resulting from changed biomechanics. This study suggests that the TPP could be a good alternative in total hip replacement in younger patients. PMID:19184010

Towards Social Radiology as an Information Infrastructure: Reconciling the Local With the Global

PubMed Central

2014-01-01

The current widespread use of medical images and imaging procedures in clinical practice and patient diagnosis has brought about an increase in the demand for sharing medical imaging studies among health professionals in an easy and effective manner. This article reveals the existence of a polarization between the local and global demands for radiology practice. While there are no major barriers for sharing such studies, when access is made from a (local) picture archive and communication system (PACS) within the domain of a healthcare organization, there are a number of impediments for sharing studies among health professionals on a global scale. Social radiology as an information infrastructure involves the notion of a shared infrastructure as a public good, affording a social space where people, organizations and technical components may spontaneously form associations in order to share clinical information linked to patient care and radiology practice. This article shows however, that such polarization establishes a tension between local and global demands, which hinders the emergence of social radiology as an information infrastructure. Based on an analysis of the social space for radiology practice, the present article has observed that this tension persists due to the inertia of a locally installed base in radiology departments, for which common teleradiology models are not truly capable of reorganizing as a global social space for radiology practice. Reconciling the local with the global signifies integrating PACS and teleradiology into an evolving, secure, heterogeneous, shared, open information infrastructure where the conceptual boundaries between (local) PACS and (global) teleradiology are transparent, signaling the emergence of social radiology as an information infrastructure. PMID:25600710

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

PubMed

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

2017-11-01

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

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

PubMed

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

2015-02-01

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

Specialising in radiology in Switzerland: still attractive for medical school graduates?

PubMed

Buddeberg-Fischer, B; Hoffmann, A; Christen, S; Weishaupt, D; Kubik-Huch, R A

2012-07-01

To gain insight into the professional characteristics of radiologists in Switzerland and to determine how to enhance the attractiveness of radiology to medical graduates as a specialty. Data from 262 members of the Swiss Society of Radiology (m:f = 76:24%) obtained in a questionnaire survey were analysed regarding socio-demographic variables, working status, specialty, main fields of interest, career success, mentoring and reasons for the shortage of radiologists. 35 (56.4%) female and 85 (45.5%) male radiologists were aged ≤ 45 years. 228 (87%) were board-certified; 44 (17.9%) had completed a sub-specialisation. Men worked part-time mostly just before retirement, while women worked part-time at a younger age. As reasons for specialty choice, the wide range of clinical work and the combination of technology and medicine were ranked highest. Women reported significantly less career success and support. To improve the attractiveness of radiology to graduates, radiology should be visible on medical school curricula. In Switzerland, more female radiologists work part-time than male ones, and there is less career success and support for women. In order to make radiology more attractive to medical graduates as a specialty, structured residency programmes and reliable gender-respecting career support are needed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting.

PubMed

Duyck, P; Pynoo, B; Devolder, P; Voet, T; Adang, L; Vercruysse, J

2008-01-01

The aim of this study is to gain insight into the individual user acceptance of PACS by the radiology department staff of the Ghent University Hospital. Hereto a basic--direct effects only--form of UTAUT was assessed. Ninety-four questionnaires were distributed and 56 usable questionnaires were returned (19 radiologists - 37 technologists). The questionnaire consisted of scales of Venkatesh et al. [13] for performance expectancy (PE), effort expectancy (EE), facilitating conditions (FC), social influence (SI), self-efficacy (SE), attitude (ATT), anxiety (ANX) and behavioral intention (BI), and a scale of Moore et al. [22] to assess the perceived voluntariness of PACS-use. The reliability of all scales, except FC and voluntariness, was acceptable to good. The voluntariness scale was divided into a mandatoriness (MAN) and a voluntariness (VOL) measure. Both radiologists and technologists seem to welcome PACS, with radiologists having higher ratings on PE, EE, ATT, VOL and BI. Only PE and FC were salient for predicting BI, while EE and SI were not salient. Variance explained in behavioral intention to use PACS was 48%. Both radiologists and technologists were positive towards PACS and had strong intentions to use PACS. As other healthcare professionals, they appear to make their technology acceptance decision independent from their superiors, hereby focusing on usefulness rather than on ease of use. It is also important that support is supplied. Basic UTAUT is an adequate model to assess technology acceptance in a radiological setting.

Factors influencing career choices in radiology trainees in Queensland, Australia.

PubMed

Ip, S W; Ko, H S; Applegate, K E

2010-04-01

The aim of this study was to investigate factors influencing career choices in radiology trainees. We distributed a 27-question written survey to all radiology registrars in Queensland. The questions investigated whether radiology was their first specialty choice, career satisfaction, ideal working conditions and attitudes regarding having children during the time of training. Forty-four of 51 surveys were returned (86% participation rate, 73% men, P = 0.048055) with 100% reporting a high job satisfaction; 28% of male registrars compared to 8% of female registrars did extra work outside of training to earn extra money (P = 0.000003), and 17% of female registrars took a leave of absence during their training, while no male registrar did (P = 0.087923). Only one female trainee worked part-time (P = 0.272727). In addition, 58% of female registrars planned a pregnancy (P = 0.731789) before completion of training; 83% of women versus 75% of men had no children (P = 0.329263). Only 5% of trainees agreed that it was easy to arrange part-time training, only 14% stated that it was easy to negotiate flexible work schedules and 7% agreed that it was easy to return to work after a period of absence. 'Time spent with immediate family' was rated the most important lifestyle factor, followed by 'work hours' and 'on-call duty'. The least important factors were 'being away from extended family', 'availability of part-time work' and whether 'work was in a rural location'. Overall job satisfaction is high among radiology trainees. Nevertheless, lifestyle factors, particularly those related to work time, are becoming more important for career decisions. This should be taken into account when designing and structuring radiology training to ensure that it is considered an attractive career choice.

National entrepreneurial radiology initiatives: what are they, and what can they do to and for you?

PubMed

Muroff, Lawrence R

2013-04-01

National entrepreneurial radiology companies have evolved over the past 3 decades. In the 1990s, a few initiatives were established to implement business principles and reward shareholders with gains derived from management expertise, practice efficiencies, and economies of scale. The next decade saw the emergence of night call coverage and "specialty read" companies. As the market for these services became saturated, the established corporate entities scrambled to find new revenue streams. Hospital radiology contracts were the obvious source for this needed capital. The pursuit of these contracts led to aggressive, nontraditional competition. If radiologists are to respond appropriately, they must understand the reasons behind the strategies used by these national entrepreneurial radiology companies. The author explores the goals and actions of these entities and describes why hospitals may find these national companies to be an attractive alternative to their incumbent radiology practices. Both the benefits and the problems associated with entrepreneurial companies are covered, and concepts such as disintermediation are discussed. Finally, the author suggests appropriate actions for radiologists seeking to retain their hospital contracts. Nontraditional competition is now a way of life for many radiology practices. Relationships, subspecialization, service, and measurable quality indicators are the foundation for the maintenance of tenure at hospitals. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Entrepreneurial Women in Radiology: Role Models of Success.

PubMed

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

2016-11-01

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

Radiology-led Follow-up System for IVC Filters: Effects on Retrieval Rates and Times

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

Lee, L.; Taylor, J.; Munneke, G.

Purpose: Successful IVC filter retrieval rates fall with time. Serious complications have been reported following attempts to remove filters after 3-18 months. Failed retrieval may be associated with adverse clinical sequelae. This study explored whether retrieval rates are improved if interventional radiologists organize patient follow-up, rather than relying on the referring clinicians. Methods: Proactive follow-up of patients who undergo filter placement was implemented in May 2008. At the time of filter placement, a report was issued to the referring consultant notifying them of the advised timeframe for filter retrieval. Clinicians were contacted to arrange retrieval within 30 days. We comparedmore » this with our practice for the preceding year. Results: The numbers of filters inserted during the two time periods was similar, as were the numbers of retrieval attempts and the time scale at which they occurred. The rate of successful retrievals increased but not significantly. The major changes were better documentation of filter types and better clinical follow-up. After the change in practice, only one patient was lost to follow-up compared with six the preceding year. Conclusions: Although there was no significant improvement in retrieval rates, the proactive, radiology-led approach improved follow-up and documentation, ensuring that a clinical decision was made about how long the filter was required and whether retrieval should be attempted and ensuring that patients were not lost to follow-up.« less

Computers and the supply of radiology services: anatomy of a disruptive technology.

PubMed

Levy, Frank

2008-10-01

Over the next decade, computers will augment the supply of radiology services at a time when reimbursement rules are likely to tighten. Increased supply and slower growing demand will result in a radiology market that is more competitive, with less income growth, than the market of the past 15 years.

Radiology workstation design for the medical intensive care unit.

PubMed

Moise, Adrian; Atkins, Stella M

2002-01-01

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

Emergency Response

EPA Pesticide Factsheets

Information for first responders, industry, federal, state and local governments on EPA's role and available resources for response to oil spills, chemical, biological, radiological releases, and large-scale national emergencies.

Patients' satisfaction towards radiological service and associated factors in Hawassa University Teaching and referral hospital, Southern Ethiopia.

PubMed

Mulisa, Teshome; Tessema, Fasil; Merga, Hailu

2017-06-26

Patient satisfaction, one of the main components of quality of care, is a crucial phenomenon for the overall health care delivery system. Even though a number of studies have been conducted about patient satisfaction in different health services, studies in radiology services are flimsy in Ethiopia. This study aimed at assessing patient satisfaction towards radiological service and associated factors in Hawassa University Teaching and Referral hospital. An institution based cross-sectional study was conducted among 321 adult patients presented for radiological service in the study area using stratified sampling technique. Patient satisfaction was measured using SERVQUAL (Service Quality) tool that consisted of seven items: accessibility, quality of radiological service, courtesy of radiology staff, existence of good communication with service provider and desk worker, physical environment and privacy technique. Exit interviews of patients were conducted using a structured and pretested questionnaire. Data was collected by three grade ten completed trained data collectors from May 12 to May 28, 2016. Multiple logistic regressions were used to identify independent factors associated with patient satisfaction on radiological services using SPSS version 21. The overall patient satisfaction towards radiological service was 71.6%. Satisfaction to accessibility of the service was 84.5% while it was 80.6% to courtesy of the staff. Similarly, 81.6% reported satisfied with quality of the service and 59.4% and 71% of reported satisfied with physical environment and radiological service provider respectively. On the other hand, 99.7% of the respondents were dissatisfied with privacy of the service. The study revealed that patients who attended primary school (AOR = 0.317, 95% CI: 0.11-0.88), unemployed patients (AOR = 0.067, 95% CI: 0.007-0.622) and patients who had short waiting time to enter into examination room less than one hour (AOR = 4.12, 95% CI: 1.4-11.62) were factors associated with patients satisfaction. This study found that majority of respondents was satisfied with the radiological services. Respondent's education level, occupation as well as duration of time taken to enter into examination room were important factors influencing the satisfaction condition. Hence, concerted effort is needed to constantly improve on patient satisfaction to better radiology returns arising from improved patient patronage. It is recommended to give great care and attention to clients during radiological examination procedure and also suggested that the department should decrease time taken to enter into examination room. On the other hand, the reasons behind more educated clients were less satisfied with radiologic service than more educated respondents need further investigation.

Radiology as the Point of Cancer Patient and Care Team Engagement: Applying the 4R Model at a Patient's Breast Cancer Care Initiation.

PubMed

Weldon, Christine B; Friedewald, Sarah M; Kulkarni, Swati A; Simon, Melissa A; Carlos, Ruth C; Strauss, Jonathan B; Bunce, Mikele M; Small, Art; Trosman, Julia R

2016-12-01

Radiologists aspire to improve patient experience and engagement, as part of the Triple Aim of health reform. Patient engagement requires active partnerships among health providers and patients, and rigorous teamwork provides a mechanism for this. Patient and care team engagement are crucial at the time of cancer diagnosis and care initiation but are complicated by the necessity to orchestrate many interdependent consultations and care events in a short time. Radiology often serves as the patient entry point into the cancer care system, especially for breast cancer. It is uniquely positioned to play the value-adding role of facilitating patient and team engagement during cancer care initiation. The 4R approach (Right Information and Right Care to the Right Patient at the Right Time), previously proposed for optimizing teamwork and care delivery during cancer treatment, could be applied at the time of diagnosis. The 4R approach considers care for every patient with cancer as a project, using project management to plan and manage care interdependencies, assign clear responsibilities, and designate a quarterback function. The authors propose that radiology assume the quarterback function during breast cancer care initiation, developing the care initiation sequence, as a project care plan for newly diagnosed patients, and engaging patients and their care teams in timely, coordinated activities. After initial consultations and treatment plan development, the quarterback function is transitioned to surgery or medical oncology. This model provides radiologists with opportunities to offer value-added services and solidifies radiology's relevance in the evolving health care environment. To implement 4R at cancer care initiation, it will be necessary to change the radiology practice model to incorporate patient interaction and teamwork, develop 4R content and local adaption approaches, and enrich radiology training with relevant clinical knowledge, patient interaction competence, and teamwork skill set. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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.

Clavicle hook plate fixation for distal-third clavicle fracture (Neer type II): comparison of clinical and radiologic outcomes between Neer types IIA and IIB.

PubMed

Lee, Wonyong; Choi, Chong-Hyuk; Choi, Yun-Rak; Lim, Kyung-Han; Chun, Yong-Min

2017-07-01

The purpose of this study was to investigate clinical and radiologic outcomes of clavicle hook plate fixation for distal-third clavicle fracture (Neer type II) and to compare the clinical and radiologic outcomes and complications between Neer type IIA and type IIB. We retrospectively reviewed 35 patients who underwent open reduction and internal fixation with AO hook locking compression plate (LCP) for distal clavicle fracture, including 13 patients with Neer type IIA and 22 patients with type IIB. Visual analog scale pain score, shoulder scores (subjective shoulder value, University of California-Los Angeles shoulder score, American Shoulder and Elbow Surgeons score), and active range of motion were evaluated to determine clinical outcome. Coracoclavicular distance was measured, and that of the injured side at last follow-up was compared with that of the uninjured side to evaluate radiologic outcomes. AO hook LCP fixation for distal-third clavicle fracture (Neer type II) produced satisfactory radiologic outcomes, including high union rates (100%) and coracoclavicular distance maintenance, as well as satisfactory clinical outcomes, including visual analog scale score for pain, shoulder scores (subjective shoulder value, University of California-Los Angeles shoulder score, American Shoulder and Elbow Surgeons score), and active range of motion. There were no significant differences between Neer type IIA and type IIB. With regard to complications, 22.9% of patients experienced shoulder stiffness and 17.1% had subacromial erosion; however, there were no significant differences between the 2 groups. The AO hook LCP is a suitable choice for Neer type IIA and type IIB distal-third clavicle fracture fixation. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Implementation of a computer-aided detection tool for quantification of intracranial radiologic markers on brain CT images

NASA Astrophysics Data System (ADS)

Aghaei, Faranak; Ross, Stephen R.; Wang, Yunzhi; Wu, Dee H.; Cornwell, Benjamin O.; Ray, Bappaditya; Zheng, Bin

2017-03-01

Aneurysmal subarachnoid hemorrhage (aSAH) is a form of hemorrhagic stroke that affects middle-aged individuals and associated with significant morbidity and/or mortality especially those presenting with higher clinical and radiologic grades at the time of admission. Previous studies suggested that blood extravasated after aneurysmal rupture was a potentially clinical prognosis factor. But all such studies used qualitative scales to predict prognosis. The purpose of this study is to develop and test a new interactive computer-aided detection (CAD) tool to detect, segment and quantify brain hemorrhage and ventricular cerebrospinal fluid on non-contrasted brain CT images. First, CAD segments brain skull using a multilayer region growing algorithm with adaptively adjusted thresholds. Second, CAD assigns pixels inside the segmented brain region into one of three classes namely, normal brain tissue, blood and fluid. Third, to avoid "black-box" approach and increase accuracy in quantification of these two image markers using CT images with large noise variation in different cases, a graphic User Interface (GUI) was implemented and allows users to visually examine segmentation results. If a user likes to correct any errors (i.e., deleting clinically irrelevant blood or fluid regions, or fill in the holes inside the relevant blood or fluid regions), he/she can manually define the region and select a corresponding correction function. CAD will automatically perform correction and update the computed data. The new CAD tool is now being used in clinical and research settings to estimate various quantitatively radiological parameters/markers to determine radiological severity of aSAH at presentation and correlate the estimations with various homeostatic/metabolic derangements and predict clinical outcome.

Student Perceptions of Online Radiologic Science Courses.

PubMed

Papillion, Erika; Aaron, Laura

2017-03-01

To evaluate student perceptions of the effectiveness of online radiologic science courses by examining various learning activities and course characteristics experienced in the online learning environment. A researcher-designed electronic survey was used to obtain results from students enrolled in the clinical portion of a radiologic science program that offers online courses. The survey consisted of elements associated with demographics, experience, and perceptions related to online radiologic science courses. Surveys were sent to 35 program directors of Joint Review Committee on Education in Radiologic Technology-accredited associate and bachelor's degree programs with requests to share the survey with students. The 38 students who participated in the survey identified 4 course characteristics most important for effective online radiologic science courses: a well-organized course, timely instructor feedback, a variety of learning activities, and informative documents, such as course syllabus, calendar, and rubrics. Learner satisfaction is a successful indicator of engagement in online courses. Descriptive statistical analysis indicated that elements related to the instructor's role is one of the most important components of effectiveness in online radiologic science courses. This role includes providing an organized course with informative documents, a variety of learning activities, and timely feedback and communication. Although online courses should provide many meaningful learning activities that appeal to a wide range of learning styles, the nature of the course affects the types of learning activities used and therefore could decrease the ability to vary learning activities. ©2017 American Society of Radiologic Technologists.

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.

Report of ICRP Task Group 80: 'radiological protection in geological disposal of long-lived solid radioactive waste'.

PubMed

Weiss, W

2012-01-01

The report of International Commission on Radiological Protection (ICRP) Task Group 80 entitled 'Radiological protection in geological disposal of long-lived solid radioactive waste' updates and consolidates previous ICRP recommendations related to solid waste disposal (ICRP Publications 46, 77, and 81). The recommendations given in this report apply specifically to geological disposal of long-lived solid radioactive waste. The report explains how the 2007 system of radiological protection, described in ICRP Publication 103, can be applied in the context of the geological disposal of long-lived solid radioactive waste. The report is written as a self-standing document. It describes the different stages in the lifetime of a geological disposal facility, and addresses the application of relevant radiological protection principles for each stage depending on the various exposure situations that can be encountered. In particular, the crucial factor that influences application of the protection system over the different phases in the lifetime of a disposal facility is the level of oversight that is present. The level of oversight affects the capability to reduce or avoid exposures. Three main time frames have to be considered for the purpose of radiological protection: time of direct oversight when the disposal facility is being implemented and active oversight is taking place; time of indirect oversight when the disposal facility is sealed and indirect oversight is being exercised to provide additional assurance on behalf of the population; and time of no oversight when oversight is no longer exercised because memory is lost. Copyright © 2012. Published by Elsevier Ltd.

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

PubMed Central

Lysdahl, Kristin B; Hofmann, Bjørn M

2009-01-01

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

The radiology digital dashboard: effects on report turnaround time.

PubMed

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

2008-03-01

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

Radiologists' preferences for just-in-time learning.

PubMed

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

2006-09-01

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

Radiology Resident Supply and Demand: A Regional Perspective.

PubMed

Pfeifer, Cory M

2017-09-01

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

Comparison between Closing-Wedge and Opening-Wedge High Tibial Osteotomy in Patients with Medial Knee Osteoarthritis: A Systematic Review and Meta-analysis.

PubMed

Sun, Hao; Zhou, Lin; Li, Fengsheng; Duan, Jun

2017-02-01

Young active patients with medial knee osteoarthritis (OA) combined with varus leg alignment can be treated with high tibial osteotomy (HTO) to stop the progression of OA and avoid or postpone total knee arthroplasty (TKA). Closing-wedge osteotomy (CWO) and opening-wedge osteotomy (OWO) are the most commonly used osteotomy techniques. The purpose of this study was to compare the clinical and radiologic outcomes and complications between OWO and CWO. We retrospectively evaluated 23 studies including 17 clinical trials from published databases from their inception to May 2015. We evaluated the clinical outcomes including operation time, visual analog scale (VAS), maximal flexion, and hospital for special surgery knee (HSS) score. The radiologic outcomes included patellar height measured by posterior tibial slope angle, hip-knee-ankle (HKA) angle, femorotibial (FT) axis, and limb length. Complications recorded included the incidence of deep vein thrombosis (DVT), common peroneal nerve injury, opposite cortical fracture, etc. There were no differences in most of the clinical outcomes except the operation time. OWO increased the posterior slope angle and limb length, decreased the patellar height, and provided higher accuracy of correction. CWO led to a higher incidence of opposite cortical fracture. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

PubMed

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

2017-05-01

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

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.

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.

Patients with Moderate and Severe Traumatic Brain Injury: Impact of Preinjury Platelet Inhibitor or Warfarin Treatment.

PubMed

Tollefsen, Marie Hexeberg; Vik, Anne; Skandsen, Toril; Sandrød, Oddrun; Deane, Susan Frances; Rao, Vidar; Moen, Kent Gøran

2018-06-01

We aimed to examine the effect of preinjury antithrombotic medication on clinical and radiologic neuroworsening in traumatic brain injury (TBI) and study the effect on outcome. A total of 184 consecutive patients ≥50 years old with moderate and severe TBI admitted to a level 1 trauma center were included. Neuroworsening was assessed clinically by using the Glasgow Coma Scale (GCS) score and radiologically by using the Rotterdam CT score on repeated time points. Functional outcome was assessed with the Glasgow Outcome Scale Extended 6 months after injury. The platelet inhibitor group (mean age, 77.3 years; n = 43) and the warfarin group (mean age, 73.2 years; n = 20) were significantly older than the nonuser group (mean age, 63.7 years; n = 121; P ≤ 0.001). In the platelet inhibitor group 74% and in the warfarin group, 85% were injured by falls. Platelet inhibitors were not significantly associated with clinical or radiologic neuroworsening (P = 0.37-1.00), whereas warfarin increased the frequency of worsening in GCS score (P = 0.001-0.028) and Rotterdam CT score (P = 0.004). In-hospital mortality was higher in the platelet inhibitor group (28%; P = 0.030) and the warfarin group (50%; P < 0.001) compared with the nonuser group (13%). Platelet inhibitors did not predict mortality or worse outcome after adjustment for age, preinjury disability, GCS score, and Rotterdam CT score, whereas warfarin predicted both mortality and worse outcome. In this study of patients with moderate and severe TBI, preinjury platelet inhibitors did not cause neuroworsening or predict higher mortality or worse outcome. In contrast, preinjury warfarin caused neuroworsening and was an independent risk factor for mortality and worse outcome at 6 months. Hence, fall prevention and liberal use of computed tomography examinations is important in this patient group. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

ICRP PUBLICATION 122: radiological protection in geological disposal of long-lived solid radioactive waste.

PubMed

Weiss, W; Larsson, C-M; McKenney, C; Minon, J-P; Mobbs, S; Schneider, T; Umeki, H; Hilden, W; Pescatore, C; Vesterlind, M

2013-06-01

This report updates and consolidates previous recommendations of the International Commission on Radiological Protection (ICRP) related to solid waste disposal (ICRP, 1985, 1997b, 1998). The recommendations given apply specifically to geological disposal of long-lived solid radioactive waste. The report explains how the ICRP system of radiological protection described in Publication 103 (ICRP, 2007) can be applied in the context of the geological disposal of long-lived solid radioactive waste. Although the report is written as a standalone document, previous ICRP recommendations not dealt with in depth in the report are still valid. The 2007 ICRP system of radiological protection evolves from the previous process-based protection approach relying on the distinction between practices and interventions by moving to an approach based on the distinction between three types of exposure situation: planned, emergency and existing. The Recommendations maintains the Commission's three fundamental principles of radiological protection namely: justification, optimisation of protection and the application of dose limits. They also maintain the current individual dose limits for effective dose and equivalent dose from all regulated sources in planned exposure situations. They re-enforce the principle of optimisation of radiological protection, which applies in a similar way to all exposure situations, subject to restrictions on individual doses: constraints for planned exposure situations, and reference levels for emergency and existing exposure situations. The Recommendations also include an approach for developing a framework to demonstrate radiological protection of the environment. This report describes the different stages in the life time of a geological disposal facility, and addresses the application of relevant radiological protection principles for each stage depending on the various exposure situations that can be encountered. In particular, the crucial factor that influences the application of the protection system over the different phases in the life time of a disposal facility is the level of oversight or 'watchful care' that is present. The level of oversight affects the capability to control the source, i.e. the waste and the repository, and to avoid or reduce potential exposures. Three main time frames are considered: time of direct oversight, when the disposal facility is being implemented and is under active supervision; time of indirect oversight, when the disposal facility is sealed and oversight is being exercised by regulators or special administrative bodies or society at large to provide additional assurance on behalf of society; and time of no oversight, when oversight is no longer exercised in case memory of the disposal facility is lost. Copyright © 2013. Published by Elsevier Ltd.

Implementation of DICOM Modality Worklist at Patient Registration Systems in Radiology Unit

NASA Astrophysics Data System (ADS)

Kartawiguna, Daniel; Georgiana, Vina

2014-03-01

Currently, the information and communication technology is developing very rapidly. A lot of hospitals have digital radiodiagnostic modality that supports the DICOM protocol. However, the implementation of integrated radiology information system with medical imaging equipment is still very limited until now, especially in developing countries like Indonesia. One of the obstacles is high prices for radiology information system. Whereas the radiology information systems can be widely used by radiologists to provide many benefit for patient, hospitals, and the doctors themselves. This study aims to develop a system that integrates the radiology administration information system with radiodiagnostic imaging modalities. Such a system would give some benefits that the information obtained is more accurate, timely, relevant, and accelerate the workflow of healthcare workers. This research used direct observation method to some hospital radiology unit. Data was collected through interviews, questionnaires, and surveys directly to some of the hospital's radiology department in Jakarta, and supported by the literature study. Based on the observations, the prototype of integrated patient registration systems in radiology unit is developed and interfaced to imaging equipment radiodiagnostic using standard DICOM communications. The prototype of radiology patient registration system is tested with the modality MRI and CT scan.

TH-E-201-00: Teaching Radiology Residents: What, How, and Expectation

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

NONE

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

TH-E-201-01: Diagnostic Radiology Residents Physics Curriculum and Updates

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

Sensakovic, W.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

A reliable and cost effective approach for radiographic monitoring in nutritional rickets.

PubMed

Chatterjee, D; Gupta, V; Sharma, V; Sinha, B; Samanta, S

2014-04-01

Radiological scoring is particularly useful in rickets, where pre-treatment radiographical findings can reflect the disease severity and can be used to monitor the improvement. However, there is only a single radiographic scoring system for rickets developed by Thacher and, to the best of our knowledge, no study has evaluated radiographic changes in rickets based on this scoring system apart from the one done by Thacher himself. The main objective of this study is to compare and analyse the pre-treatment and post-treatment radiographic parameters in nutritional rickets with the help of Thacher's scoring technique. 176 patients with nutritional rickets were given a single intramuscular injection of vitamin D (600 000 IU) along with oral calcium (50 mg kg(-1)) and vitamin D (400 IU per day) until radiological resolution and followed for 1 year. Pre- and post-treatment radiological parameters were compared and analysed statistically based on Thacher's scoring system. Radiological resolution was complete by 6 months. Time for radiological resolution and initial radiological score were linearly associated on regression analysis. The distal ulna was the last to heal in most cases except when the initial score was 10, when distal femur was the last to heal. Thacher's scoring system can effectively monitor nutritional rickets. The formula derived through linear regression has prognostic significance. The distal femur is a better indicator in radiologically severe rickets and when resolution is delayed. Thacher's scoring is very useful for monitoring of rickets. The formula derived through linear regression can predict the expected time for radiological resolution.

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

Residency Mini-fellowships in the PGY-5 Year: Is There Added Value?

PubMed

Shenoy-Bhangle, Anuradha S; Eisenberg, Ronald L; Fineberg, Tabitha; Slanetz, Priscilla J

2018-06-01

With the restructuring of radiology board certification, many residencies created PGY-5 "mini-fellowships," during which residents spend focused time pursuing advanced subspecialty training or developing nonclinical skills in leadership, health policy and health-care economics, education, quality improvement, informatics, research, or global health. We surveyed graduates of an academic diagnostic radiology residency to assess the relative value and impact of PGY-5 mini-fellowships on career satisfaction and success. From 2012 to 2016, 39 radiology residents at our institution were offered the opportunity to pursue a 3- to 6-month mini-fellowship during the PGY-5 year. Thirty of 39 radiology residents (77%) participated, whereas 9 of 39 (23%) opted out. Of 39 residents, 13 completed two clinical mini-fellowships, 3 completed research mini-fellowships only, and 14 completed one nonclinical and one clinical mini-fellowship. Through SurveyMonkey, 23 of 39 residents (59%) responded to a questionnaire that collected basic demographic information and asked respondents about the value of this experience as it relates to fellowship choice and career using a five-point Likert scale. Of 23 respondents (14 male, 8 female,1 not specified), 78.3% practice in an academic university-based setting, with 8.7% in a community-based hospital practice, 4.3% in the veterans system, and 4.3% in a private practice setting. Of 23 respondents, the most popular clinical mini-fellowships were magnetic resonance imaging (31.6%), neuroradiology (21.1%), and interventional radiology (15.8%). For nonclinical mini-fellowships, the most popular were research (10.5%), education (10.5%), global health (5.3%), and healthcare economics (5.3%). Of 23 respondents who did mini-fellowships, 95% felt that the mini-fellowship prepared them well for their career, 85% felt it gave them the necessary skills to succeed, 85% cited that it gave them additional skills beyond their peers, and 40% felt it helped them create a life-long connection to a mentor. Ninety-five percent of respondents would choose to do the mini-fellowship again. Respondents suggested increasing the duration to 6-9 months and to develop a more structured curriculum and mentorship component. Only one respondent felt that the nonclinical mini-fellowship took away time from furthering clinical skills. Graduates of a university-affiliated academic radiology residency who participated in clinical and nonclinical mini-fellowships during the PGY-5 year of residency greatly value this experience and uniformly recommend that this type of program continue to be offered to trainees given its ability to develop skills perceived to be vital to ultimate career satisfaction and success. Published by Elsevier Inc.

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

Magnetic resonance imaging in breast cancer treated with neoadjuvant chemotherapy: radiologic-pathologic correlation of the response and disease-free survival depending on molecular subtype.

PubMed

Cruz Ciria, S; Jiménez Aragón, F; García Mur, C; Esteban Cuesta, H; Gros Bañeres, B

2014-01-01

To evaluate the radiologic and pathologic responses to neoadjuvant chemotherapy and their correlation in the molecular subtypes of breast cancer and to analyze their impact in disease-free survival. We included 205 patients with breast cancer treated with neoadjuvant chemotherapy. We evaluated the radiologic response by comparing MRI images acquired before and after chemotherapy. The pathologic response was classified on the Miller and Payne scale. For each subtype (HER2+, TN, luminal A, luminal B HER2-, and luminal B HER2+), we used the χ(2) test, Student's t-test, ANOVA, and Kendall's Tau-b to evaluate the radiologic response and the pathologic response, the radiologic-pathologic correlation, and the disease-free survival. The subtypes HER2+ (62.1%) and TN (45.2%) had higher rates of complete radiologic response. The pathologic response was 65.5% in the HER2+ subtype, 38.1% in the TN subtype, 2.6% in the luminal A subtype, 8.2% in the luminal B HER2- subtype, and 31% in the luminal B HER2+ subtype. The rate of radiologic-pathologic correlation was significant in all subtypes, higher in TN and HER2 (Tau-b coefficients 0.805 and 0.717, respectively). Disease-free survival was higher in HER2+ (91.9±3.3 months) and lower in TN (69.5±6.3 months), with significant differences between the cases with poor and good radiologic responses (P=.040). Survival was greater in cases with good radiologic response, except in cases with luminal A subtype. MRI can be a useful tool that provides information about the evolution of breast cancer treated with neoadjuvant chemotherapy, which varies with the immunohistochemical subtype. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

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

Analysis of Operation Dominic II SMALL BOY radiological and meteorological data

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

Quinn, V.E., Kennedy, N.C.; Steadman, C.R.

1984-08-01

This report describes the Weather Service Nuclear Support Office (WSNSO) analyses of the radiological and meteorological data collected for the Operation Dominic II nuclear test SMALL BOY. Inconsistencies in the radiological data and their resolution are discussed. The methods of estimating fallout-arrival times are discussed. The meteorological situation on D-day and a few days following are described. A comparison of the fallout patterns resulting from these analyses and earlier (1966) analyses is presented. The radiological data used to derive the fallout pattern in this report are tabulated in an appendix. 11 references, 20 figures.

Teaching Radiology Trainees From the Perspective of a Millennial.

PubMed

Chen, Po-Hao; Scanlon, Mary H

2018-06-01

The millennial generation consists of today's medical students, radiology residents, fellows, and junior staff. Millennials' comfort with immersive technology, high expectations for success, and desire for constant feedback differentiate them from previous generations. Drawing from an author's experiences through radiology residency and fellowship as a millennial, from published literature, and from the mentorship of a long-time radiology educator, this article explores educational strategies that embrace these characteristics to engage today's youngest generation both in and out of the reading room. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The Neurologic Assessment in Neuro-Oncology (NANO) Scale as an Assessment Tool for Survival in Patients With Primary Glioblastoma.

PubMed

Ung, Timothy H; Ney, Douglas E; Damek, Denise; Rusthoven, Chad G; Youssef, A Samy; Lillehei, Kevin O; Ormond, D Ryan

2018-03-30

The Neurologic Assessment in Neuro-Oncology (NANO) scale is a standardized objective metric designed to measure neurological function in neuro-oncology. Current neuroradiological evaluation guidelines fail to use specific clinical criteria for progression. To determine if the NANO scale was a reliable assessment tool in glioblastoma (GBM) patients and whether it correlated to survival. Our group performed a retrospective review of all patients with newly diagnosed GBM from January 1, 2010, through December 31, 2012, at our institution. We applied the NANO scale, Karnofsky performance score (KPS), Eastern Cooperative Oncology Group (ECOG) scale, Macdonald criteria, and the Response Assessment in Neuro-Oncology (RANO) criteria to patients at the time of diagnosis as well as at 3, 6, and 12 mo. Initial NANO score was correlated with overall survival at time of presentation. NANO progression was correlated with decreased survival in patients at 6 and 12 mo. A decrease in KPS was associated with survival at 3 and 6 mo, an increase in ECOG score was associated only at 3 mo, and radiological evaluation (RANO and Macdonald) was correlated at 3 and 6 mo. Only the NANO scale was associated with patient survival at 1 yr. NANO progression was the only metric that was linked to decreased overall survival when compared to RANO and Macdonald at 6 and 12 mo. The NANO scale is specific to neuro-oncology and can be used to assess patients with glioma. This retrospective analysis demonstrates the usefulness of the NANO scale in glioblastoma.

EPA’s Role in Emergency Response

EPA Pesticide Factsheets

EPA provides support when requested, or when state and local first responder capabilities have been exceeded, in response to chemical, oil, biological, and radiological releases and large-scale national emergencies, including homeland security incidents.

The advantages, disadvantages, and policies for part-time radiologists: report of the ACR Commission on Human Resources.

PubMed

Harolds, Jay A; Coleman, Beverly G; Recht, Michael P; Bluth, Edward I

2014-07-01

The employment of part-time radiologists (PTRs) has both advantages and disadvantages in various practice settings. The authors examine the pros and cons of PTRs and review the literature regarding PTRs both within and outside the specialty of radiology. The complexity of this issue is manifested in our inability to reach consensus on many policy issues for PTRs. Nevertheless, this article should be helpful in offering an objective, nonbiased background to initiating a discussion on employing PTRs in various radiology practices. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiological dispersion devices: are we prepared?

PubMed

Sohier, Alain; Hardeman, Frank

2006-01-01

Already before the events of September 11th 2001 concern was raised about the spread of orphan sources and their potential use in Radiological Dispersion Devices by terrorist groups. Although most of the simulated scenarios foresee a rather limited direct health impact on the population, the affected region would suffer from the indirect consequences such as social disruption, cleanup requirements and economic costs. The nature of such a radiological attack would anyway be different compared to conventional radiological accidents, basically because it can happen anywhere at any time. Part of the response resides in a general preparedness scheme incorporating attacks with Radiological Dispersion Devices. Training of different potential intervention teams is essential. The response would consist of a prioritised list of actions adapted to the circumstances. As the psychosocial dimension of the crisis could be worse than the purely radiological one, an adapted communication strategy with the public aspect would be a key issue.

Presentation to publication: proportion of abstracts published for ESPR, SPR and IPR.

PubMed

Shelmerdine, Susan C; Lynch, Jeremy O; Langan, Dean; Arthurs, Owen J

2016-09-01

Advancement of knowledge requires presentation and publication of high-quality scientific research. Studies submitted for presentation undergo initial peer review before acceptance and the rate of subsequent publication may be taken as an indicator of access to publication for pediatric radiology studies. Evaluate the proportion of abstracts also published in journals for pediatric radiology conferences and identify factors associated with publication success. All Medline articles that originated from oral presentations at the European Society for Paediatric Radiology (ESPR), the Society for Pediatric Radiology (SPR) or the International Pediatric Radiology (IPR) conferences between 2010 - 2012 were evaluated. Descriptive statistics to evaluate published and unpublished groups were calculated overall and split by characteristics of the abstracts such as number of authors. Overall number of abstracts published was 300/715 (41.9%), with most articles published in radiology specific journals (181/300; 60.3%), with median impact factor 2.31 (interquartile range [IQR]: 1.65-3.14, range: 0-18.03). Those published after the conference (262/300, 87.6%) had a median time to publication of 18 months and for those published before, the median time was -11 months. Median sample size in published articles was 52 (IQR: 33-105, range: 1-6,351). Of pediatric radiology oral abstracts, 41.9% achieve publication after a period of at least 3 years from presentation. Studies originating from certain countries and on certain subspecialty topics were more likely to get published.

Plate fixation and bone grafting of distal clavicle nonunions: radiologic and functional outcomes.

PubMed

Villa, Jordan C; van der List, Jelle P; Gausden, Elizabeth B; Lorich, Dean G; Helfet, David L; Kloen, Peter; Wellman, David S

2016-11-01

The optimal treatment for distal clavicle nonunions remains unknown. Small series have reported outcomes following distal fragment excision and various fixation techniques. We present the clinical, radiographic and functional outcomes after superior plating or double (superior and anteroinferior) plating in combination with bone grafting as treatment for distal clavicle nonunions. We collected demographic and radiographic data from a consecutive series of ten patients with symptomatic nonunion of the distal clavicle treated since 1998. Functional outcomes were assessed, as well as the visual analogue scale (VAS) score. The mean clinical follow-up was 41.4 months (range of 12-158 months). The mean radiological follow-up was 30.6 months (range of 3-158 months). All nonunions healed as demonstrated by subsidence of clinical symptoms and radiographic criteria. The average time to union was 3.7 months (range of 2-8 months). The mean The Disabilities of the Arm, Shoulder and Hand (DASH) score was 11.9 (range of 0-62.5) and mean VAS score was 0.9 at follow-up. This study illustrates good clinical, radiologic and functional outcomes in ten patients with distal clavicle nonunion treated with superior or double (superior and anteroinferior) plating in combination with bone grafting. Double-plating can be considered an alternative to superior plating offering better resistance against the pulling effect of the arm with the use of smaller fixation plates.

A new e-learning platform for radiology education (RadEd).

PubMed

Xiberta, Pau; Boada, Imma

2016-04-01

One of the key elements of e-learning platforms is the content provided to the students. Content creation is a time demanding task that requires teachers to prepare material taking into account that it will be accessed on-line. Moreover, the teacher is restricted by the functionalities provided by the e-learning platforms. In contexts such as radiology where images have a key role, the required functionalities are still more specific and difficult to be provided by these platforms. Our purpose is to create a framework to make teacher's tasks easier, specially when he has to deal with contents where images have a main role. In this paper, we present RadEd, a new web-based teaching framework that integrates a smart editor to create case-based exercises that support image interaction such as changing the window width and the grey scale used to render the image, taking measurements on the image, attaching labels to images and selecting parts of the images, amongst others. It also provides functionalities to prepare courses with different topics, exercises and theory material, and also functionalities to control students' work. Different experts have used RadEd and all of them have considered it a very useful and valuable tool to prepare courses where radiological images are the main component. RadEd provides teachers functionalities to prepare more realistic cases and students the ability to make a more specific diagnosis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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.

Academic Radiology in the New Healthcare Delivery Environment

PubMed Central

Qayyum, Aliya; Yu, John-Paul J.; Kansagra, Akash P.; von Fischer, Nathaniel; Costa, Daniel; Heller, Matthew; Kantartzis, Stamatis; Plowman, R. Scooter; Itri, Jason

2014-01-01

Ongoing concerns over the rising cost of health care are driving large-scale changes in the way that health care is practiced and reimbursed in the United States. To effectively implement and thrive within this new health care delivery environment, academic medical institutions will need to modify financial and business models and adapt institutional cultures. In this paper, we review the expected features of the new health care environment from the perspective of academic radiology departments. Our review will include background on Accountable Care Organizations, identify challenges associated with the new managed care model, and outline key strategies—including expanding the use of existing information technology infrastructure, promoting continued medical innovation, balancing academic research with clinical care, and exploring new roles for radiologists in efficient patient management—that will ensure continued success for academic radiology. PMID:24200477

TH-E-201-02: Hands-On Physics Teaching of Residents in Diagnostic Radiology

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

Zhang, J.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

TH-E-201-03: A Radiology Resident’s Perspectives of Physics Teaching

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

Key, A.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

A national survey exploring UK trainees' perceptions, core training experience, and decisions to pursue advanced training in breast radiology.

PubMed

Lowes, S; Bydder, M; Sinnatamby, R

2017-11-01

To investigate UK radiology trainees' perceptions of breast radiology and the factors that influenced their decision whether or not to choose breast radiology as an area of special interest. An online survey was compiled and distributed to all UK specialty trainees in clinical radiology via the Royal College of Radiologists Junior Radiologists' Forum (JRF) regional representatives. There were 275 respondents, representing 22% of all UK radiology trainees. Responses were received from all regions. A significant factor identified in influencing whether or not trainees decide to pursue advanced training in breast radiology is the timing and quality of their initial core training experience. Specific positive aspects of breast radiology that were repeatedly identified included the high level of patient contact and frequent use of interventional procedures. Recurring negative aspects of breast radiology included isolation from general radiology and finding the subject matter boring. Breast radiology faces a significant workforce shortfall that is predicted to worsen in the coming years. There has never been a greater need to recruit specialty trainees into this field, and action is urgently needed to help ensure the sustainability of breast services and drive further improvements to patient care. The findings from this survey should be regarded as a challenge to all breast radiologists to engage with trainees from an early stage in their training and to enthuse them with the many positive aspects of a career in breast radiology. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Effect of direct neuroradiologist participation in physician marketing on imaging volumes in outpatient radiology.

PubMed

Grignon, L; Keiper, M; Vavricek, J; Horsley, W; Murphy, R; Grignon, A; Yu, F

2014-08-01

Over the past several years, decreased demand for and increased supply of imaging services has increased competition among outpatient imaging centers in the United States. This study hypothesizes that using a radiology sales representative and neuroradiologist as a team in marketing and sales will increase imaging referrals in outpatient imaging. From January to December 2009, baseline monthly physician referral data of CT and MR scans of 19 referring clinicians (neurologists, neurosurgeons, and anesthesiologists) to an outpatient radiology group were collected. During that time, a nonphysician radiology sales representative visited the referring clinicians' offices every 2 weeks. From January to June 2010, the same radiology sales representative visited the referring clinicians' offices every 2 weeks but was accompanied by a neuroradiologist once a month. From July 2010 to June 2011, the same radiology sales representative visited the referring clinicians' offices twice a month without a neuroradiologist. Cross-sectional imaging referral volumes were approximately 2.5 times greater during the 6-month period using the neuroradiologist for direct physician-to-physician marketing when compared with the volumes achieved with the sales representative alone, and continued neuroradiologist involvement in marketing and sales is required to maintain referral volumes over time. The impact on imaging referral volumes during the 6-month use of the neuroradiologist for direct physician-to-physician marketing in this study supports the assertion that neuroradiologist visits are an important element in establishing and maintaining a relationship with the referring clinician's office and thereby maximizing imaging referrals. © 2014 by American Journal of Neuroradiology.

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

PubMed Central

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

2011-01-01

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

A reliable and cost effective approach for radiographic monitoring in nutritional rickets

PubMed Central

Gupta, V; Sharma, V; Sinha, B; Samanta, S

2014-01-01

Objective: Radiological scoring is particularly useful in rickets, where pre-treatment radiographical findings can reflect the disease severity and can be used to monitor the improvement. However, there is only a single radiographic scoring system for rickets developed by Thacher and, to the best of our knowledge, no study has evaluated radiographic changes in rickets based on this scoring system apart from the one done by Thacher himself. The main objective of this study is to compare and analyse the pre-treatment and post-treatment radiographic parameters in nutritional rickets with the help of Thacher's scoring technique. Methods: 176 patients with nutritional rickets were given a single intramuscular injection of vitamin D (600 000 IU) along with oral calcium (50 mg kg−1) and vitamin D (400 IU per day) until radiological resolution and followed for 1 year. Pre- and post-treatment radiological parameters were compared and analysed statistically based on Thacher's scoring system. Results: Radiological resolution was complete by 6 months. Time for radiological resolution and initial radiological score were linearly associated on regression analysis. The distal ulna was the last to heal in most cases except when the initial score was 10, when distal femur was the last to heal. Conclusion: Thacher's scoring system can effectively monitor nutritional rickets. The formula derived through linear regression has prognostic significance. Advances in knowledge: The distal femur is a better indicator in radiologically severe rickets and when resolution is delayed. Thacher's scoring is very useful for monitoring of rickets. The formula derived through linear regression can predict the expected time for radiological resolution. PMID:24593231

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.

Reporting Magnetic Resonance Imaging in Men on Active Surveillance for Prostate Cancer: The PRECISE Recommendations-A Report of a European School of Oncology Task Force.

PubMed

Moore, Caroline M; Giganti, Francesco; Albertsen, Peter; Allen, Clare; Bangma, Chris; Briganti, Alberto; Carroll, Peter; Haider, Masoom; Kasivisvanathan, Veeru; Kirkham, Alex; Klotz, Laurence; Ouzzane, Adil; Padhani, Anwar R; Panebianco, Valeria; Pinto, Peter; Puech, Philippe; Rannikko, Antti; Renard-Penna, Raphaele; Touijer, Karim; Turkbey, Baris; van Poppel, Heinrik; Valdagni, Riccardo; Walz, Jochen; Schoots, Ivo

2017-04-01

Published data on prostate magnetic resonance imaging (MRI) during follow-up of men on active surveillance are lacking. Current guidelines for prostate MRI reporting concentrate on prostate cancer (PCa) detection and staging. A standardised approach to prostate MRI reporting for active surveillance will facilitate the robust collection of evidence in this newly developing area. To develop preliminary recommendations for reporting of individual MRI studies in men on active surveillance and for researchers reporting the outcomes of cohorts of men having MRI on active surveillance. The RAND/UCLA Appropriateness Method was used. Experts in urology, radiology, and radiation oncology developed a set of 394 statements relevant to prostate MRI reporting in men on active surveillance for PCa. Each statement was scored for agreement on a 9-point scale by each panellist prior to a panel meeting. Each statement was discussed and rescored at the meeting. Measures of agreement and consensus were calculated for each statement. The most important statements, derived from both group discussion and scores of agreement and consensus, were used to create the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) checklist and case report form. Key recommendations include reporting the index lesion size using absolute values at baseline and at each subsequent MRI. Radiologists should assess the likelihood of true change over time (ie, change in size or change in lesion characteristics on one or more sequences) on a 1-5 scale. A checklist of items for reporting a cohort of men on active surveillance was developed. These items were developed based on expert consensus in many areas in which data are lacking, and they are expected to develop and change as evidence is accrued. The PRECISE recommendations are designed to facilitate the development of a robust evidence database for documenting changes in prostate MRI findings over time of men on active surveillance. If used, they will facilitate data collection to distinguish measurement error and natural variability in MRI appearances from true radiologic progression. Few published reports are available on how to use and interpret magnetic resonance imaging for men on active surveillance for prostate cancer. The PRECISE panel recommends that data should be collected in a standardised manner so that natural variation in the appearance and measurement of cancer over time can be distinguished from changes indicating significant tumour progression. Copyright © 2016 European Association of Urology. All rights reserved.

Radiological clinical trials: Proposal of a problem-finding questionnaire to improve study success.

PubMed

Valdora, Francesca; Bignotti, Bianca; Calabrese, Massimo; Houssami, Nehmat; Tagliafico, Alberto

2016-12-26

To develop a survey to help define the main problems in radiological clinical trials. Since 2006, we have managed seven different radiological clinical trials recruiting patients in academic and non-academic centres. We developed a preliminary questionnaire using a four-round Delphi approach to identify problems occurring in radiological clinical trials run at our centre. We investigated the recruitment experience, involvement of all multi-disciplinary team members and main obstacles to completing the projects. A final round of Delphi processes elucidated solutions to the identified problems. Among 19/20 (95%) respondents, 10 (53%) were young physicians (under 35 years old), and the respondents included non-faculty members, fellows, residents, and undergraduate students. Ninety-four percent (18/19) of respondents showed interest in conducting clinical trials. On a scale of 1 to 10, the problems with higher/worse scores (8-9) were related to technical or communication problems. The most frequent problems across all studies were technical problems related to clinical trial equipment, insufficient willingness to participate, obstacles to understanding the design of electronic-case report form and extra work. The developed questionnaire identified the main recurring problems in radiological clinical trials as perceived by end-users and helped define possible solutions that are mostly related to having dedicated clinical trial research staff.

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.

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.

Neurofilament light chain and oligoclonal bands are prognostic biomarkers in radiologically isolated syndrome.

PubMed

Matute-Blanch, Clara; Villar, Luisa M; Álvarez-Cermeño, José C; Rejdak, Konrad; Evdoshenko, Evgeniy; Makshakov, Gleb; Nazarov, Vladimir; Lapin, Sergey; Midaglia, Luciana; Vidal-Jordana, Angela; Drulovic, Jelena; García-Merino, Antonio; Sánchez-López, Antonio J; Havrdova, Eva; Saiz, Albert; Llufriu, Sara; Alvarez-Lafuente, Roberto; Schroeder, Ina; Zettl, Uwe K; Galimberti, Daniela; Ramió-Torrentà, Lluís; Robles, René; Quintana, Ester; Hegen, Harald; Deisenhammer, Florian; Río, Jordi; Tintoré, Mar; Sánchez, Alex; Montalban, Xavier; Comabella, Manuel

2018-04-01

The prognostic role of cerebrospinal fluid molecular biomarkers determined in early pathogenic stages of multiple sclerosis has yet to be defined. In the present study, we aimed to investigate the prognostic value of chitinase 3 like 1 (CHI3L1), neurofilament light chain, and oligoclonal bands for conversion to clinically isolated syndrome and to multiple sclerosis in 75 patients with radiologically isolated syndrome. Cerebrospinal fluid levels of CHI3L1 and neurofilament light chain were measured by enzyme-linked immunosorbent assay. Uni- and multivariable Cox regression models including as covariates age at diagnosis of radiologically isolated syndrome, number of brain lesions, sex and treatment were used to investigate associations between cerebrospinal fluid CHI3L1 and neurofilament light chain levels and time to conversion to clinically isolated syndrome and multiple sclerosis. Neurofilament light chain levels and oligoclonal bands were independent risk factors for the development of clinically isolated syndrome (hazard ratio = 1.02, P = 0.019, and hazard ratio = 14.7, P = 0.012, respectively) and multiple sclerosis (hazard ratio = 1.03, P = 0.003, and hazard ratio = 8.9, P = 0.046, respectively). The best cut-off to classify cerebrospinal fluid neurofilament light chain levels into high and low was 619 ng/l, and high neurofilament light chain levels were associated with a trend to shorter time to clinically isolated syndrome (P = 0.079) and significant shorter time to multiple sclerosis (P = 0.017). Similarly, patients with radiologically isolated syndrome presenting positive oligoclonal bands converted faster to clinically isolated syndrome and multiple sclerosis (P = 0.005 and P = 0.008, respectively). The effects of high neurofilament light chain levels shortening time to clinically isolated syndrome and multiple sclerosis were more pronounced in radiologically isolated syndrome patients with ≥37 years compared to younger patients. Cerebrospinal fluid CHI3L1 levels did not influence conversion to clinically isolated syndrome and multiple sclerosis in radiologically isolated syndrome patients. Overall, these findings suggest that cerebrospinal neurofilament light chain levels and oligoclonal bands are independent predictors of clinical conversion in patients with radiologically isolated syndrome. The association with a faster development of multiple sclerosis reinforces the importance of cerebrospinal fluid analysis in patients with radiologically isolated syndrome.

Who Should Join the Environmental Response Laboratory Network

EPA Pesticide Factsheets

Laboratories that analyze biological samples, chemical warfare agents, radiological, or toxic industrial chemical samples can join the ERLN. Members make up a critical infrastructure that delivers data necessary for responses to large scale emergencies.

Enhanced radioactivity due to natural oil and gas production and related radiological problems.

PubMed

Kolb, W A; Wojcik, M

1985-10-01

Increased gamma radiation detected incidentally a few years ago in a North German oil field was traceable to radioactive scale. At the request of the Federal Ministry of the Interior a survey program was then established for dose rate measurements at various production sites, assessment of the radionuclide content of brines and scale and the Rn-222 content of natural gas. Dose equivalent rates of up to 50 mu Sv/h have been measured at the external surface of storage tanks for brines, but 73% of the 160 sites investigated did not show an increase above the natural background. Brines from gas fields contained Ra-226 of up to 286 Bq/l and scale of up to 1 kBq/g. In brines and scale from oil fields Ra-228 was usually the predominant radionuclide. Some samples contained "unsupported" Pb-210 and even Ac-227, too, but practically no uranium or thorium. The Rn-222 concentrations in natural gas samples varied between 0.004 and 4 Bq/l with a mean value of 0.6 Bq/l. It is shown that the radiation exposure due to natural gas consumption is negligible but some other problems or radiological relevance are recognized.

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

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

Gowardhan, Akshay; Neuscamman, Stephanie; Donetti, John

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

Approaching the Practice Quality Improvement Project in Interventional Radiology.

PubMed

Reis, Stephen P; White, Benjamin; Sutphin, Patrick D; Pillai, Anil K; Kalva, Sanjeeva P; Toomay, Seth M

2015-12-01

An important component of maintenance of certification and quality improvement in radiology is the practice quality improvement (PQI) project. In this article, the authors describe several methodologies for initiating and completing PQI projects. Furthermore, the authors illustrate several tools that are vital in compiling, analyzing, and presenting data in an easily understandable and reproducible manner. Last, they describe two PQI projects performed in an interventional radiology division that have successfully improved the quality of care for patients. Using the DMAIC (define, measure, analyze, improve, control) quality improvement framework, interventional radiology throughput has been increased, to lessen mediport wait times from 43 to 8 days, and mediport infection rates have decreased from more than 2% to less than 0.4%. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

PubMed

Duszak, Richard; Berlin, Jonathan W

2012-10-01

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

[Interventional radiology treatment of extensive pulmonary embolism and thromboembolic diseases].

PubMed

Battyáni, István; Dósa, Edit; Harmat, Zoltán

2015-04-26

The authors discuss interventional radiological methods in the field of vascular interventions applied in venous system diseases. Venous diseases can be life threatening without appropriate treatment and can lead to chronic venous diseases and venous insufficiency with long-term reduction in the quality of life. In addition, recurrent clinical symptoms require additional treatments. Interventional radiology has several methods that can provide fast and complete recovery if applied in time. The authors summarize these methods hoping that they will be available for a wide range of patients through the establishment of Interventional Radiological Centres and will be a part of the daily routine of patient care. Regarding the frequency of venous diseases and its influance on life quality the authors would like to draw attention to interventional radiological techniques and modern therapeutic possibilities.

Gender Trends in Academic Radiology Publication in the United States Revisited.

PubMed

O'Connor, Erin E; Chen, Pauline; Weston, Brian; Anderson, Redmond; Zeffiro, Timothy; Ahmed, Awad; Zeffiro, Thomas A

2018-02-12

Although substantial increases in publications by female academic radiologists have appeared over the last several decades, it is possible that the rate of increase is decreasing. We examined temporal trends in gender composition for full-time radiology faculty, radiology residents, and medical students over a 46-year period. We examined authorship gender trends to determine if the increases in female authorship seen since 1970 have been sustained in recent years and whether female radiologists continue to publish in proportion to their numbers in academic departments. Original articles for selected years in Radiology and in the American Journal of Roentgenology between 1970 and 2016 were examined to determine the gender of first, corresponding, and last authors. Generalized linear models evaluated (1) changes in proportions of female authorship over time and (2) associations between proportions of female authorship and female radiology faculty representation. While linear increases in first, corresponding, and senior authorships were observed for female radiologists from 1970 to 2000, the rate of increase in female first and corresponding authorships then changed, with the slope of the first author relationship decreasing from 0.81 to 0.34, corresponding to 47% fewer female first authors added per year. In contrast, the proportion of female last authorship continued to increase at the same rate. The proportion of female first authorship was linearly related to the proportion of female radiology faculty from 1970 to 2016. Annual increases in first author academic productivity of female radiologists have lessened in the past 16 years, possibly related to reductions in the growth of female radiology faculty and trainees. As mixed, compared to homogeneous gender, authorship teams are associated with more citations, efforts to encourage more women to pursue careers in academic radiology could benefit the radiology research community. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Evaluation of Stress and a Stress-Reduction Program Among Radiologic Technologists.

PubMed

Reingold, Lynn

2015-01-01

To investigate stress levels and causes of stress among radiologic technologists and determine whether an intervention could reduce stress in a selected radiologic technologist population. Demographic characteristics and data on preintervention stress sources and levels were collected through Internet-based questionnaires. A 6-week, self-administered, mindfulness-based stress-reduction program was conducted as a pilot intervention with 42 radiologic technologists from the Veterans Administration Medical Center. Data also were collected postintervention. Identified sources of stress were compared with findings from previous studies. Some radiologic technologists experienced improvement in their perceptions of stress after the intervention. Sources of stress for radiologic technologists were similar to those shown in earlier research, including inconsistent management, poor management communication, conflicting demands, long work hours, excessive workloads, lack of work breaks, and time pressures. The mindfulness-based stress-reduction program is an example of an inexpensive method that could improve personal well-being, reduce work errors, improve relationships in the workplace, and increase job satisfaction. More research is needed to determine the best type of intervention for stress reduction in a larger radiologic technologist population.

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

PubMed

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

2000-02-01

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

355 E Riverwalk, February 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 2,600 cpm to 4,300 cpm. No count rates were found at any time that exceeded the threshold limit of 7,029 cpm.

230 E. Ontario, May 2018, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,800 cpm to 2,600 cpm.No count rates were found at any time that exceeded the threshold limit of 7,366 cpm.

Improving Communication of Diagnostic Radiology Findings through Structured Reporting

PubMed Central

Panicek, David M.; Berk, Alexandra R.; Li, Yuelin; Hricak, Hedvig

2011-01-01

Purpose: To compare the content, clarity, and clinical usefulness of conventional (ie, free-form) and structured radiology reports of body computed tomographic (CT) scans, as evaluated by referring physicians, attending radiologists, and radiology fellows at a tertiary care cancer center. Materials and Methods: The institutional review board approved the study as a quality improvement initiative; no written consent was required. Three radiologists, three radiology fellows, three surgeons, and two medical oncologists evaluated 330 randomly selected conventional and structured radiology reports of body CT scans. For nonradiologists, reports were randomly selected from patients with diagnoses relevant to the physician’s area of specialization. Each physician read 15 reports in each format and rated both the content and clarity of each report from 1 (very dissatisfied or very confusing) to 10 (very satisfied or very clear). By using a previously published radiology report grading scale, physicians graded each report’s effectiveness in advancing the patient’s position on the clinical spectrum. Mixed-effects models were used to test differences between report types. Results: Mean content satisfaction ratings were 7.61 (95% confidence interval [CI]: 7.12, 8.16) for conventional reports and 8.33 (95% CI: 7.82, 8.86) for structured reports, and the difference was significant (P < .0001). Mean clarity satisfaction ratings were 7.45 (95% CI: 6.89, 8.02) for conventional reports and 8.25 (95% CI: 7.68, 8.82) for structured reports, and the difference was significant (P < .0001). Grade ratings did not differ significantly between conventional and structured reports. Conclusion: Referring clinicians and radiologists found that structured reports had better content and greater clarity than conventional reports. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11101913/-/DC1 PMID:21518775

Radiology's value chain.

PubMed

Enzmann, Dieter R

2012-04-01

A diagnostic radiology value chain is constructed to define its main components, all of which are vulnerable to change, because digitization has caused disaggregation of the chain. Some components afford opportunities to improve productivity, some add value, while some face outsourcing to lower labor cost and to information technology substitutes, raising commoditization risks. Digital image information, because it can be competitive at smaller economies of scale, allows faster, differential rates of technological innovation of components, initiating a centralization-to-decentralization technology trend. Digitization, having triggered disaggregation of radiology's professional service model, may soon usher in an information business model. This means moving from a mind-set of "reading images" to an orientation of creating and organizing information for greater accuracy, faster speed, and lower cost in medical decision making. Information businesses view value chain investments differently than do small professional services. In the former model, producing a better business product will extend image interpretation beyond a radiologist's personal fund of knowledge to encompass expanding external imaging databases. A follow-on expansion with integration of image and molecular information into a report will offer new value in medical decision making. Improved interpretation plus new integration will enrich and diversify radiology's key service products, the report and consultation. A more robust, information-rich report derived from a "systems" and "computational" radiology approach will be facilitated by a transition from a professional service to an information business. Under health care reform, radiology will transition its emphasis from volume to greater value. Radiology's future brightens with the adoption of a philosophy of offering information rather than "reads" for decision making. Staunchly defending the status quo via turf wars is unlikely to constitute a forward-looking, competitive strategy. © RSNA, 2012.

Glove Perforations During Interventional Radiological Procedures

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

Leena, R. V., E-mail: leenarv_76@yahoo.co.uk; Shyamkumar, N. K.

2010-04-15

Intact surgical gloves are essential to avoid contact with blood and other body fluids. The objective of this study was to estimate the incidence of glove perforations during interventional radiological procedures. In this study, a total of 758 gloves used in 94 interventional radiological procedures were examined for perforations. Eleven perforations were encountered, only one of which was of occult type. No significant difference in the frequency of glove perforation was found between the categories with varying time duration.

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

PubMed

Amaratunga, Thelina; Dobranowski, Julian

2016-09-01

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

Emergency Response Health Physics

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

Mena, RaJah; Pemberton, Wendy; Beal, William

2012-05-01

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

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

USGS Publications Warehouse

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

2008-01-01

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

Emergency response health physics.

PubMed

Mena, Rajah; Pemberton, Wendy; Beal, William

2012-05-01

Health physics is an important discipline with regard to understanding the effects of radiation on human health. This paper aims to illustrate the unique challenges presented to the health physicist or analyst of radiological data in a large-scale emergency.

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.

PathBot: A Radiology-Pathology Correlation Dashboard.

PubMed

Kelahan, Linda C; Kalaria, Amit D; Filice, Ross W

2017-12-01

Pathology is considered the "gold standard" of diagnostic medicine. The importance of radiology-pathology correlation is seen in interdepartmental patient conferences such as "tumor boards" and by the tradition of radiology resident immersion in a radiologic-pathology course at the American Institute of Radiologic Pathology. In practice, consistent pathology follow-up can be difficult due to time constraints and cumbersome electronic medical records. We present a radiology-pathology correlation dashboard that presents radiologists with pathology reports matched to their dictations, for both diagnostic imaging and image-guided procedures. In creating our dashboard, we utilized the RadLex ontology and National Center for Biomedical Ontology (NCBO) Annotator to identify anatomic concepts in pathology reports that could subsequently be mapped to relevant radiology reports, providing an automated method to match related radiology and pathology reports. Radiology-pathology matches are presented to the radiologist on a web-based dashboard. We found that our algorithm was highly specific in detecting matches. Our sensitivity was slightly lower than expected and could be attributed to missing anatomy concepts in the RadLex ontology, as well as limitations in our parent term hierarchical mapping and synonym recognition algorithms. By automating radiology-pathology correlation and presenting matches in a user-friendly dashboard format, we hope to encourage pathology follow-up in clinical radiology practice for purposes of self-education and to augment peer review. We also hope to provide a tool to facilitate the production of quality teaching files, lectures, and publications. Diagnostic images have a richer educational value when they are backed up by the gold standard of pathology.

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

PubMed

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

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

371 E. Lower Wacker Drive, March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,600 cpm to 2,600 cpm.No count rates were found at any time that exceeded the threshold limit of 7,029 cpm.

220 E. Illinois St., March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,500 cpm to 5,600 cpm.No count rates were found at any time that exceeded the threshold limit of 7,029 cpm.

8-37 W. Hubbard, March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,800 cpm to 5,200 cpm. No count rates were found at any time that exceeded the threshold limit of 7,389 cpm.

429 E. Grand Ave, March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,700 cpm to 3,700 cpm.No count rates were found at any time that exceeded the threshold limit of 7,029 cpm.

201-211 E. Grand Ave, January 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,700 cpm to 3,900 cpm. No count rates were found at any time that exceeded the threshold limit of 7,029 cpm.

230 N. Michigan Ave, April 2018, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,400 cpm to 3,800 cpm. No count rates were found at any time that exceeded the threshold limit of 6,542 cpm.

36 W. Illinois St, March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,800 cpm to 2,400 cpm.No count rates were found at any time that exceeded the threshold limit of 7,029 cpm.

1-37 W. Hubbard, March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,800 cpm to 5,000 cpm. No count rates were found at any time that exceeded the threshold limit of 7,389 cpm.

211 E. Ohio St., March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,700 cpm to 2,300 cpm.No count rates were found at any time that exceeded the threshold limit of 6,338 cpm.

140-200 E. Grand Ave, February 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,700 cpm to 2,400 cpm. No count rates were found at any time that exceeded the threshold limit of 6,738 cpm.

430 N. Michigan Ave, January 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,600 cpm to 2,100 cpm. No count rates were found at any time that exceeded the threshold limit of 6,338 cpm.

401-599 N. Dearborn St., March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation, The count rates in the excavation ranged from 1,700 cpm to 5,800 cpm.No count rates were found at any time that exceeded the threshold limit of 6,738 cpm.

To share or not to share? Expected pros and cons of data sharing in radiological research.

PubMed

Sardanelli, Francesco; Alì, Marco; Hunink, Myriam G; Houssami, Nehmat; Sconfienza, Luca M; Di Leo, Giovanni

2018-06-01

The aims of this paper are to illustrate the trend towards data sharing, i.e. the regulated availability of the original patient-level data obtained during a study, and to discuss the expected advantages (pros) and disadvantages (cons) of data sharing in radiological research. Expected pros include the potential for verification of original results with alternative or supplementary analyses (including estimation of reproducibility), advancement of knowledge by providing new results by testing new hypotheses (not explored by the original authors) on pre-existing databases, larger scale analyses based on individual-patient data, enhanced multidisciplinary cooperation, reduced publication of false studies, improved clinical practice, and reduced cost and time for clinical research. Expected cons are outlined as the risk that the original authors could not exploit the entire potential of the data they obtained, possible failures in patients' privacy protection, technical barriers such as the lack of standard formats, and possible data misinterpretation. Finally, open issues regarding data ownership, the role of individual patients, advocacy groups and funding institutions in decision making about sharing of data and images are discussed. • Regulated availability of patient-level data of published clinical studies (data-sharing) is expected. • Expected benefits include verification/advancement of knowledge, reduced cost/time of research, clinical improvement. • Potential drawbacks include faults in patients' identity protection and data misinterpretation.

Improving clinical instruction: comparison of literature.

PubMed

Giordano, Shelley

2008-01-01

Clinical education in radiologic technology and athletic training is similar in that both programs use clinical sites and clinical instructors to instruct and evaluate student competency. The purpose of this paper is to review and compare the literature from radiologic technology and athletic training clinical education. The literature for this review was obtained using ProQuest and PubMed databases, from the years 1998 to 2006. Research is available for both radiologic technology and athletic training and provides a good comparison. Radiologic technology students experience various clinical stressors that can be remedied by properly trained clinical instructors and instructors who spend quality time with students. The opinions regarding the necessary behaviors of clinical instructors vary between program directors, clinical instructors and students. Cooperation and communication between programs and clinical instructors is important for students to achieve clinical success. A comparison of the literature demonstrates that radiologic technology and athletic training programs are similar; thus, ideas from athletic training can be applied to radiologic technology clinical education.

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.

Professional profile of radiologic technology educators.

PubMed

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

2005-01-01

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

Ergonomics in radiology.

PubMed

Goyal, N; Jain, N; Rachapalli, V

2009-02-01

The use of computers is increasing in every field of medicine, especially radiology. Filmless radiology departments, speech recognition software, electronic request forms and teleradiology are some of the recent developments that have substantially increased the amount of time a radiologist spends in front of a computer monitor. Computers are also needed for searching literature on the internet, communicating via e-mails, and preparing for lectures and presentations. It is well known that regular computer users can suffer musculoskeletal injuries due to repetitive stress. The role of ergonomics in radiology is to ensure that working conditions are optimized in order to avoid injury and fatigue. Adequate workplace ergonomics can go a long way in increasing productivity, efficiency, and job satisfaction. We review the current literature pertaining to the role of ergonomics in modern-day radiology especially with the development of picture archiving and communication systems (PACS) workstations.

Progress and challenges in the development of physically-based numerical models for prediction of flow and contaminant dispersion in the urban environment

NASA Astrophysics Data System (ADS)

Lien, F. S.; Yee, E.; Ji, H.; Keats, A.; Hsieh, K. J.

2006-06-01

The release of chemical, biological, radiological, or nuclear (CBRN) agents by terrorists or rogue states in a North American city (densely populated urban centre) and the subsequent exposure, deposition and contamination are emerging threats in an uncertain world. The modeling of the transport, dispersion, deposition and fate of a CBRN agent released in an urban environment is an extremely complex problem that encompasses potentially multiple space and time scales. The availability of high-fidelity, time-dependent models for the prediction of a CBRN agent's movement and fate in a complex urban environment can provide the strongest technical and scientific foundation for support of Canada's more broadly based effort at advancing counter-terrorism planning and operational capabilities.The objective of this paper is to report the progress of developing and validating an integrated, state-of-the-art, high-fidelity multi-scale, multi-physics modeling system for the accurate and efficient prediction of urban flow and dispersion of CBRN (and other toxic) materials discharged into these flows. Development of this proposed multi-scale modeling system will provide the real-time modeling and simulation tool required to predict injuries, casualties and contamination and to make relevant decisions (based on the strongest technical and scientific foundations) in order to minimize the consequences of a CBRN incident in a populated centre.

Career advancement of men and women in academic radiology: is the playing field level?

PubMed

Vydareny, K H; Waldrop, S M; Jackson, V P; Manaster, B J; Nazarian, G K; Reich, C A; Ruzal-Shapiro, C B

2000-07-01

The authors' purposes were to determine if there are gender differences in the speed of promotion and/or academic productivity in academic radiology and if this situation had changed since a previous study was performed in 1987. Surveys were distributed to faculty members of academic radiology departments in May 1997. A total of 707 surveys were analyzed according to gender for time at rank for assistant and associate professor levels, in relation to publication rate, grant funding rate, and distribution of professional time. There was no difference between genders in the time at assistant professor rank. Among all current professors, women had been associate professors longer than men, but there was no difference between genders for those who had been in academic radiology for less than 15 years. There was no gender difference at any rank in the rate of publishing original articles. There was no difference in funding rates, although men had more total grant support. Male associate professors reported spending more time in administration and slightly more time in total hours at work than did their female colleagues, and male professors spent slightly more time teaching residents. Otherwise, there is no difference in how men and women at any rank spend their professional time. There are, however, lower percentages of women in tenured positions and in the uppermost levels of departmental administration. The time at rank for men and women and their rate of publication appear to have equalized. Women still are underrepresented at the uppermost levels of departmental administration, however, and are less likely than men to hold tenured positions.

Occupational Radiation Protection in Interventional Radiology: A Joint Guideline of the Cardiovascular and Interventional Radiology Society of Europe and the Society of Interventional Radiology

DTIC Science & Technology

2010-01-01

should be provided with properly fitted aprons, both to reduce ergo- nomic hazards and to provide optimal radiation protection [45]. Aprons should be...advised to use eye protection at all times [2, 15]. Leaded eyeglasses are an alternative to ceiling-suspended shields for this purpose. Leaded eye...glasses with large lenses and protective side shields pro- vide more protection than eyeglasses without these features. They help to minimize scatter

Sex Differences in Rank Attainment among Radiology and Internal Medicine Faculty.

ERIC Educational Resources Information Center

Dial, Thomas H.; And Others

1989-01-01

The Association of American Medical Colleges Faculty Roster System allows comparison of a cohort of faculty at any selected time following their first faculty appointments. Disparities between men and women in rank attained in radiology and internal medicine were examined. (Author/MLW)

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.

The influence of travel time on breast cancer characteristics, receipt of primary therapy, and surveillance mammography.

PubMed

Onega, Tracy; Cook, Andrea; Kirlin, Beth; Shi, Xun; Alford-Teaster, Jennifer; Tuzzio, Leah; Buist, Diana S M

2011-08-01

Travel time has been shown to influence some aspects of cancer characteristics at diagnosis and care for women with breast cancer, but important gaps remain in our understanding of its impact. We examined the influence of travel time to the nearest radiology facility on breast cancer characteristics, treatment, and surveillance for women with early-stage invasive breast cancer. We included 1,012 women with invasive breast cancer (stages I and II) who had access to care within an integrated health care delivery system in western Washington State. The travel times to the nearest radiology facility were calculated for all the U.S. Census blocks within the study area and assigned to women based on residence at diagnosis. We collected cancer characteristics, primary and adjuvant therapies, and surveillance mammography for at least 2.5 years post diagnosis and used multivariable analyses to test the associations of travel time. The majority of women (68.6%) lived within 20 min of the nearest radiology facility, had stage I disease (72.7%), received breast conserving therapy (68.7%), and had annual surveillance mammography the first 2 years after treatment (73.7%). The travel time was not significantly associated with the stage or surveillance mammography after adjusting for covariates. Primary therapy was significantly related to travel time, with greater travel time (>30 min vs. ≤ 10 min) associated with a higher likelihood of mastectomy compared to breast conserving surgery (RR = 1.53; 95% CI, 1.16-2.01). The travel time was not associated with the stage at diagnosis or surveillance mammography receipt. The travel time does seem to influence the type of primary therapy among women with breast cancer, suggesting that women may prefer low frequency services, such as mastectomy, if geographic access to a radiology facility is limited.

Spatial Estimation of Populations at Risk from Radiological Dispersion Device Terrorism Incidents

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

Regens, J.L.; Gunter, J.T.

2008-07-01

Delineation of the location and size of the population potentially at risk of exposure to ionizing radiation is one of the key analytical challenges in estimating accurately the severity of the potential health effects associated with a radiological terrorism incident. Regardless of spatial scale, the geographical units for which population data commonly are collected rarely coincide with the geographical scale necessary for effective incident management and medical response. This paper identifies major government and commercial open sources of U.S. population data and presents a GIS-based approach for allocating publicly available population data, including age distributions, to geographical units appropriate formore » planning and implementing incident management and medical response strategies. In summary: The gravity model offers a straight-forward, empirical tool for estimating population flows, especially when geographical areas are relatively well-defined in terms of accessibility and spatial separation. This is particularly important for several reasons. First, the spatial scale for the area impacted by a RDD terrorism event is unlikely to match fully the spatial scale of available population data. That is, the plume spread typically will not uniformly overlay the impacted area. Second, the number of people within the impacted area varies as a function whether an attack occurs during the day or night. For example, the population of a central business district or industrial area typically is larger during the day while predominately residential areas have larger night time populations. As a result, interpolation techniques that link population data to geographical units and allocate those data based on time-frame at a spatial scale that is relevant to enhancing preparedness and response. The gravity model's main advantage is that it efficiently allocates readily available, open source population data to geographical units appropriate for planning and implementing incident management and medical monitoring strategies. The importance of being able to link population estimates to geographic areas during the course of an RDD incident can be understood intuitively: - The spatial distribution of actual total dose equivalents of ionizing radiation is likely to vary due to changes in meteorological parameters as an event evolves over time; - The size of the geographical area affected also is likely to vary as a function of the actual release scenario; - The ability to identify the location and size of the populations that may be exposed to doses of ionizing radiation is critical to carrying out appropriate treatment and post-event medical monitoring; - Once a spatial interaction model has been validated for a city or a region, it can then be used for simulation and prediction purposes to assess the possible human health consequences of different release scenarios. (authors)« less

Grain boundary imaging, gallium diffusion and the fracture behavior of Al-Zn Alloy - An in situ study

NASA Astrophysics Data System (ADS)

Tsai, W. L.; Hwu, Y.; Chen, C. H.; Chang, L. W.; Je, J. H.; Lin, H. M.; Margaritondo, G.

2003-01-01

Phase contrast radiology using unmonochromatic synchrotron X-ray successfully imaged the grain boundaries of Al and AlZn alloy without contrast agent. Combining the high penetration of X-ray and the possibility of 3D reconstruction by tomorgraphy or stereography method, this approach can be very used for nondestructive characterization of polycrystalline materials. By examine the images with 3D perspective, we were able locate the observed void-like defects which lies exclusively on the grain boundary and identify their origin from last stage of the rolling process. We studied the Ga Liquid metal diffusion in the AlZn alloy, under different temperature and stress conditions. High resolution images, ˜2 μm, of Ga liquid metal diffusion in AlZn were obtained in real time and diffusion paths alone grain boundaries and surfaces were clearly identified. Embrittled AlZn responses to the tensile stress and fractures in a drastic different manner than the pure AlZn. These results, although very much expected from the known weakening effect of the liquid metal embrittlement demonstrated, however, that this particular radiology method is fully capable of dynamic study in the micrometer scale.

THE RABIT: A RAPID AUTOMATED BIODOSIMETRY TOOL FOR RADIOLOGICAL TRIAGE

PubMed Central

Garty, Guy; Chen, Youhua; Salerno, Alessio; Turner, Helen; Zhang, Jian; Lyulko, Oleksandra; Bertucci, Antonella; Xu, Yanping; Wang, Hongliang; Simaan, Nabil; Randers-Pehrson, Gerhard; Yao, Y. Lawrence; Amundson, Sally A.; Brenner, David J.

2010-01-01

In response to the recognized need for high throughput biodosimetry methods for use after large scale radiological events, a logical approach is complete automation of standard biodosimetric assays that are currently performed manually. We describe progress to date on the RABIT (Rapid Automated BIodosimetry Tool), designed to score micronuclei or γ-H2AX fluorescence in lymphocytes derived from a single drop of blood from a fingerstick. The RABIT system is designed to be completely automated, from the input of the capillary blood sample into the machine, to the output of a dose estimate. Improvements in throughput are achieved through use of a single drop of blood, optimization of the biological protocols for in-situ analysis in multi-well plates, implementation of robotic plate and liquid handling, and new developments in high-speed imaging. Automating well-established bioassays represents a promising approach to high-throughput radiation biodosimetry, both because high throughputs can be achieved, but also because the time to deployment is potentially much shorter than for a new biological assay. Here we describe the development of each of the individual modules of the RABIT system, and show preliminary data from key modules. Ongoing is system integration, followed by calibration and validation. PMID:20065685

Practice analysis of chiropractic radiology: identifying items for part I of the clinical competency examination.

PubMed

Smith, Sara Dawn; Beran, Tanya N

2012-01-01

The purpose of this study was to describe the current scope of practice of chiropractic radiologists by identifying frequent tasks conducted as well as those conditions most often seen and those that present the greatest risk of harm to patients. A mixed-methods approach was used. An online survey was conducted with 91 diplomates listed with the American Chiropractic Board of Radiology. Participants rated the frequency of tasks they perform and conditions they see on a 5-point scale from "never" to "daily." They also rated the level of risk each condition presents to patients on a 5-point scale from "no risk" to "severe risk." Frequency and risk ratings were then presented in rank order to 22 subject matter experts at 3 focus groups. The most frequent task reported was writing radiology reports (mean [SD], 4.29 [1.58]). Ratings of the frequency of conditions seen in practice and the risk they present to patients were ranked from the highest to lowest for frequency and risk separately. The most frequent conditions seen were reportedly those with structural or joint derangement; the highest risk conditions seen are those that are systemic. Focus group members recommended that some conditions receive higher rankings and that certain conditions be recategorized for future practice analyses. This study helps to define the current scope of practice of chiropractic radiologists and identify frequent tasks and conditions. These results inform the development of a new test outline for Part I of the chiropractic radiology certification examination to ensure that examinees are tested on the most important conditions chiropractic radiologists see in practice. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

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

PubMed

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

2016-10-11

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

[Development of an attitude-measurement questionnaire using the semantic differential technique: defining the attitudes of radiological technology students toward X-ray examination].

PubMed

Tamura, Naomi; Terashita, Takayoshi; Ogasawara, Katsuhiko

2014-03-01

In general, it is difficult to objectively evaluate the results of an educational program. The semantic differential (SeD) technique, a methodology used to measure the connotative meaning of objects, words, and concepts, can, however, be applied to the evaluation of students' attitudes. In this study, we aimed to achieve an objective evaluation of the effects of radiological technology education. We therefore investigated the attitude of radiological students using the SeD technique. We focused on X-ray examinations in the field of radiological technology science. Bipolar adjective scales were used for the SeD questionnaire. To create the questionnaire, appropriate adjectives were selected from past reports of X-ray examination practice. The participants were 32 senior students at Hokkaido University at the Division of Radiological Technology at the School of Medicine's Department of Health Sciences. All the participants completed the questionnaire. The study was conducted in early June 2012. Attitudes toward X-ray examination were identified using a factor analysis of 11 adjectives. The factor analysis revealed the following three attitudes: feelings of expectation, responsibility, and resistance. Knowledge regarding the attitudes that students have toward X-ray examination will prove useful for evaluating the effects of educational intervention. In this study, a sampling bias may have occurred due to the small sample size; however, no other biases were observed.

200-300 N. Stetson, January 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates throughout the grading ranged from 4,500 cpm to 8,000 cpm. No count rates were found at any time that exceeded the threshold limits of 17,246 cpm and 18,098 cpm.

0 - 36 W. Illinois St., January 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,600 cpm to 3,700 cpm.No count rates were found at any time that exceeded the threshold limits of 6,738 cpm and 7,029 cpm.

400-449 N. State St, March 2017, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation. The count rates in the excavation ranged from 1,600 cpm to 4,300 cpm. No count rates were found at any time that exceeded the threshold limits of 6,338 cpm and 7,038 cpm.

Aortic valve calcification - a commonly observed but frequently ignored finding during CT scanning of the chest.

PubMed

Raju, Prashanth; Sallomi, David; George, Bindu; Patel, Hitesh; Patel, Nikhil; Lloyd, Guy

2012-06-01

To describe the frequency and severity of Aortic valve calcification (AVC) in an unselected cohort of patients undergoing chest CT scanning and to assess the frequency with which AVC was being reported in the radiology reports. Consecutive CT scan images of the chest and the radiological reports (December 2009 to May 2010) were reviewed at the district general hospital (DGH). AVC on CT scan was visually graded on a scale ranging from 0 to IV (0 = no calcification, IV = severe calcification). Total of 416 (232 male; 184 female) CT chest scans [Contrast enhanced 302 (72%), unenhanced 114 (28%)] were reviewed. Mean age was 70.55 ± 11.48 years. AVC in CT scans was identified in 95 of the 416 patients (22.83%). AVC classification was as follows: Grade I: 60 (63.15%), Grade II: 22 (23.15%), Grade III: 9 (9.47%), Grade IV: 4 (4.21%). Only one CT report mentioned AVC. Only 31 of 95 AVC had Transthoracic echocardiogram (TTE). The interval time between CT scan and TTE was variable.   Aortic valve calcification in CT chest scans is a common finding and studies have shown that it is strongly related to the presence and severity of aortic valve disease. As CT scans are considered as a valuable additional screening tool for detection of aortic stenosis, AVC should always be commented upon in the radiology reports. Furthermore, patients with at least Grade III and IV AVC should be sent for TTE. © 2012 Blackwell Publishing Ltd.

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.

The value of medical student radiology education: A comparison of 1-week, 2-week, electives, and compulsories.

PubMed

Limchareon, Sornsupha; Kongprompsuk, Sutasinee

2018-06-01

Basic radiology interpretive skill is essential for all physicians. We developed a vertical type of radiology education, including basic radiology in the students' first clinical year and added the other 1-week or 2-week dedicated radiology rotation in the later clinical year. The objective of this study was to present a valuable radiology education to undergraduate medical students. At academic year 2014-2015, there were three different groups of the clinical-year students took a radiology rotation. All students completed the pretest of 30-image quiz at the first day of the course and the posttest of the same quiz at the last day of the course. The mean scores and the mean score changes of pretest and posttest were compared. A grade point average was used to determine the students' background characteristics. The relationships between students' background characteristics and the mean score changes were calculated. There were three groups of students including; 11 sixth-year elective students, 19 fifth-year compulsory students and 39 sixth-year compulsory students. The mean posttest score of all students were statistically significant greater than the mean pretest score (p < .001). For the students' years, time space or interest level had no significant effects on the improved score. Adding a 1-week dedicated radiology rotation to fifth- or sixth-year students after they finished the standard radiology course is beneficial to students. This type of vertical radiology curriculum is valuable and should be incorporated into formal medical school curricula. Copyright © 2017. Published by Elsevier Taiwan LLC.

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

PubMed

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

2017-06-01

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

Traditional text-only versus multimedia-enhanced radiology reporting: referring physicians' perceptions of value.

PubMed

Sadigh, Gelareh; Hertweck, Timothy; Kao, Cristine; Wood, Paul; Hughes, Danny; Henry, Travis S; Duszak, Richard

2015-05-01

The aim of this study was to evaluate referring physicians' perceptions of multimedia-enhanced radiology reporting (MERR) as an alternative to traditional text-only radiology reporting. MERR supplements text-only reports by embedding user-friendly interactive hyperlinks to key images and graphically plotting target lesion size longitudinally over time. Of 402 physicians responding to a web-based survey, 200 (50 each medical oncologists, radiation oncologists, neurosurgeons, and pulmonologists) practicing in the United States fulfilled criteria to complete an online survey with questions focusing on satisfaction with current text-only reports and the perceived value of image- and data-enriched reporting. The mean respondent age was 46 years, with a mean of 15 years in posttraining clinical practice (85% men; 47% from academic medical centers). Although 80% were satisfied with the format of their current text-only radiology reports, 80% believed that MERR would represent an improvement. The most commonly reported advantages of MERR were "improved understanding of radiology findings by correlating images to text reports" (86%) and "easier access to images while monitoring progression of a disease/condition" (79%). Of the 28% of physicians with concerns about MERR implementation, the most common were that it was "too time intensive" (53%) and "the clinic workflow does not allow itself to view reports in such a fashion" (42%). Physicians indicated a strong increased likelihood of preferentially referring patients to (80%) and recommending peers to (79%) facilities that offer MERR. Most specialist referring physicians believe that interactive image- and data-embedded MERR represents an improvement over current text-only radiology reporting. Compared with current report formatting, most would preferentially refer patients and peers to facilities offering more meaningful image- and graphically enriched reporting platforms. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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.

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.

A new approach to the film library: time-unit filing.

PubMed

Palmucci, J A

2000-01-01

The installation of a new radiology information system (RIS) at Children's Hospital Medical Center of Akron in Akron, Ohio, took the radiology department into a new world of technology, but raised issues we never anticipated. The major problem the new RIS forced the department to overcome was how to eliminate the film file's reliance on a proprietary radiology numbering system. Previously, the department had used its own numbering system--a proprietary x-ray number--to file film jackets and had used the hospital-issued medical record number to access patient and payer information from the hospital information system. It became clear that we should use a single number--the medical record number--to access all data, but we wondered how that would affect our film file room. An RIS consultant suggested that we consider filing films by last date of service, a system called "time-unit filing." Time-unit filing means keeping the most recent two-weeks worth of films in the main file room. They are organized by gender in blue or pink jackets and marked alphabetically by the patient's last name in a way that makes mis-files easy to see. If a patient's film jacket is activated again, it is refiled in the current two-week time unit. Inactive jackets remain in their two-week time unit indefinitely. Time-unit filing has had many benefits for the radiology department at Children's Hospital Medical Center of Akron: fewer mis-files, less time needed for filing and searching, and successful implementation of the new RIS.

Radioecology, radiobiology, and radiological protection: frameworks and fractures.

PubMed

Pentreath, R J

2009-12-01

A framework for the protection of the general public has been in existence for a very long time, although steps have recently been made by the ICRP to ensure that it is more fully comprehensive with regard to all actual and potential exposure situations. Protection of the environment, however, has only recently begun to be addressed in a structured manner, and is still an evolving subject. Nevertheless, it needs to be centred around some form of parallel framework to that which has evolved for the protection of human beings, although clearly on a different scale. It also needs to be embedded within the basic science of radiobiology, and form a central part of radioecology.

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

PubMed

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

2009-09-01

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

Hamstring Injuries in Professional Football Players

PubMed Central

Cohen, Steven B.; Towers, Jeffrey D.; Zoga, Adam; Irrgang, Jay J.; Makda, Junaid; Deluca, Peter F.; Bradley, James P.

2011-01-01

Background: Magnetic resonance imaging (MRI) allows for detailed evaluation of hamstring injuries; however, there is no classification that allows prediction of return to play. Purpose: To correlate time for return to play in professional football players with MRI findings after acute hamstring strains and to create an MRI scoring scale predictive of return to sports. Study Design: Descriptive epidemiologic study. Methods: Thirty-eight professional football players (43 cases) sustained acute hamstring strains with MRI evaluation. Records were retrospectively reviewed, and MRIs were evaluated by 2 musculoskeletal radiologists, graded with a traditional radiologic grade, and scored with a new MRI score. Results were correlated with games missed. Results: Players missed 2.6 ± 3.1 games. Based on MRI, the hamstring injury involved the biceps femoris long head in 34 cases and the proximal and distal hamstrings in 25 and 22 cases, respectively. When < 50% of the muscle was involved, the average number of games missed was 1.8; if > 75%, then 3.2. Ten players had retraction, missing 5.5 games. By MRI, grade I injuries yielded an average of 1.1 missed games; grade II, 1.7; and grade III, 6.4. Players who missed 0 or 1 game had an MRI score of 8.2; 2 or 3 games, 11.1; and 4 or more games, 13.9. Conclusions: Rapid return to play (< 1 week) occurred with isolated long head of biceps femoris injures with < 50% of involvement and minimal perimuscular edema, correlating to grade I radiologic strain (MRI score < 10). Prolonged recovery (missing > 2 or 3 games) occurs with multiple muscle injury, injuries distal to musculotendinous junction, short head of biceps injury, > 75% involvement, retraction, circumferential edema, and grade III radiologic strain (MRI score > 15). Clinical Relevance: MRI grade and this new MRI score are useful in determining severity of injury and games missed—and, ideally, predicting time missed from sports. PMID:23016038

Strategy development for anticipating and handling a disruptive technology.

PubMed

Chan, Stephen

2006-10-01

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

1-99 W. Hubbard St, May 2018, Lindsay Light Radiological Survey

EPA Pesticide Factsheets

Radiological Survey of Right-of-Way Utility Excavation.The count rates in the excavation ranged from 2,100 cpm to 4,200 cpm.No count rates were found at any time that exceeded the instrument specific threshold limits of 7,366 and 6,415 cpm.

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

Detilleux, Michel; Centner, Baudouin

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

University-Based Teleradiology in the United States.

PubMed

Hunter, Tim B; Krupinski, Elizabeth A

2014-04-15

This article reviews the University of Arizona's more than 15 years of experience with teleradiology and provides an overview of university-based teleradiology practice in the United States (U.S.). In the U.S., teleradiology is a major economic enterprise with many private for-profit companies offering national teleradiology services (i.e., professional interpretation of radiologic studies of all types by American Board of Radiology certified radiologists). The initial thrust for teleradiology was for after-hours coverage of radiologic studies, but teleradiology has expanded its venue to include routine full-time or partial coverage for small hospitals, clinics, specialty medical practices, and urgent care centers. It also provides subspecialty radiologic coverage not available at smaller medical centers and clinics. Many U.S. university-based academic departments of radiology provide teleradiology services usually as an additional for-profit business to supplement departmental income. Since academic-based teleradiology providers have to compete in a very demanding marketplace, their success is not guaranteed. They must provide timely, high-quality professional services for a competitive price. Academic practices have the advantage of house officers and fellows who can help with the coverage, and they have excellent subspecialty expertise. The marketplace is constantly shifting, and university-based teleradiology practices have to be nimble and adjust to ever-changing situations.

Radiological progression and its predictive risk factors in silicosis

PubMed Central

Lee, H; Phoon, W; Ng, T

2001-01-01

OBJECTIVES—To investigate the risk factors predicting radiological progression in silicosis in a prospective cohort study of patients with silicosis who were previously exposed to silica from granite dust.
METHODS—From among a total of 260 patients with silicosis contracted from granite work, 141 with available serial chest x ray films of acceptable quality taken over a period of 2 to 17 (mean 7.5) years, were selected for study. Ninety four (66.7%) had ended exposure 5 or more years perviously (mean 10.1 years, maximum 28 years). Radiological progression was assessed by paired comparison of the initial and most recent radiographs, with two or more steps of increase in profusion of small opacities according to the 12 point scale of the International Labour Organisation (ILO) classification of radiographs of pneumoconiosis, taken from the majority reading by a panel of three independent readers.
RESULTS—Overall, 37% of patients with silicosis had radiological evidence of progression. From the initial radiographs, 24 (31.6%) of those with radiological profusion category 1, 15 (37.5%) of those with radiological profusion category 2, and 13 (52%) of those with complicated silicosis (including all seven with category 3 profusion of small opacities) showed radiological progression. As expected, progression was more likely to be found after longer periods of follow up (the interval between the two chest x ray films) with a 20% increased odds of progression for every additional year of follow up. After adjustment for varying intervals of follow up, the probability of radiological progression was found to be significant if large opacities were present in the initial chest x ray film. Progression was also less likely to be found among those who had ended exposure to silica longer ago, although the result was of borderline significance (p=0.07). Tuberculosis was also associated with increased likelihood of progression (borderline significance).
CONCLUSIONS—There is a high probability of radiological progression in silicosis after high levels of exposure to granite dust among workers who were followed up for up to 17 years. A significant risk factor is the extent of radiological opacities in the initial chest x ray film. The probability of progression is also likely to be reduced with longer periods after the end of exposure.


Keywords: silicosis; radiological progression; granite quarry PMID:11404452

Added Value of Selected Images Embedded Into Radiology Reports to Referring Clinicians

PubMed Central

Iyer, Veena R.; Hahn, Peter F.; Blaszkowsky, Lawrence S.; Thayer, Sarah P.; Halpern, Elkan F.; Harisinghani, Mukesh G.

2011-01-01

Purpose The aim of this study was to evaluate the added utility of embedding images for findings described in radiology text reports to referring clinicians. Methods Thirty-five cases referred for abdominal CT scans in 2007 and 2008 were included. Referring physicians were asked to view text-only reports, followed by the same reports with pertinent images embedded. For each pair of reports, a questionnaire was administered. A 5-point, Likert-type scale was used to assess if the clinical query was satisfactorily answered by the text-only report. A “yes-or-no” question was used to assess whether the report with images answered the clinical query better; a positive answer to this question generated “yes-or-no” queries to examine whether the report with images helped in making a more confident decision on management, whether it reduced time spent in forming the plan, and whether it altered management. The questionnaire asked whether a radiologist would be contacted with queries on reading the text-only report and the report with images. Results In 32 of 35 cases, the text-only reports satisfactorily answered the clinical queries. In these 32 cases, the reports with attached images helped in making more confident management decisions and reduced time in planning management. Attached images altered management in 2 cases. Radiologists would have been consulted for clarifications in 21 and 10 cases on reading the text-only reports and the reports with embedded images, respectively. Conclusions Providing relevant images with reports saves time, increases physicians' confidence in deciding treatment plans, and can alter management. PMID:20193926

What can happen after lung transplantation and the importance of the time since transplantation: radiological review of post-transplantation complications.

PubMed

Daimiel Naranjo, I; Alonso Charterina, S

2016-01-01

Lung transplantation is the best treatment option in the final stages of diseases such as cystic fibrosis, pulmonary hypertension, chronic obstructive pulmonary disease, or idiopathic pulmonary fibrosis. Better surgical techniques and advances in immunosuppressor treatments have increased survival in lung transplant recipients, making longer follow-up necessary because complications can occur at any time after transplantation. For practical purposes, complications can be classified as early (those that normally occur within two months after transplantation), late (those that normally occur more than two months after transplantation), or time-independent (those that can occur at any time after transplantation). Many complications have nonspecific clinical and radiological manifestations, so the time factor is key to narrow the differential diagnosis. Imaging can guide interventional procedures and can detect complications early. This article aims to describe and illustrate the complications that can occur after lung transplantation from the clinical and radiological viewpoints so that they can be detected as early as possible. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

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.

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

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

Enqvist, Andreas; Koppal, Sanjeev; Riley, Phillip

2015-07-01

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

An indicator device for monitoring of room illuminance level in the radiological image viewing environment.

PubMed

Azlan, C A; Ng, K H; Anandan, S; Nizam, M S

2006-09-01

Illuminance level in the softcopy image viewing room is a very important factor to optimize productivity in radiological diagnosis. In today's radiological environment, the illuminance measurements are normally done during the quality control procedure and performed annually. Although the room is equipped with dimmer switches, radiologists are not able to decide the level of illuminance according to the standards. The aim of this study is to develop a simple real-time illuminance detector system to assist the radiologists in deciding an adequate illuminance level during radiological image viewing. The system indicates illuminance in a very simple visual form by using light emitting diodes. By employing the device in the viewing room, illuminance level can be monitored and adjusted effectively.

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

PubMed

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

2012-08-01

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

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

NASA Astrophysics Data System (ADS)

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

2017-09-01

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

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.

Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

PubMed

Somers, S; Stevenson, G W; Thompson, G

1986-06-01

Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

RESEARCH NEEDS FOR SCALING UP INDOOR SINK EFFECT MODELS

EPA Science Inventory

The events of 11 September 2001 underscored the need to study the vulnerability of buildings to weapons of mass destruction, including chemical, biological, physical, and radiological agents. Should these agents be released inside a building, they would interact with interior sur...

Screening CT angiography for pediatric blunt cerebrovascular injury with emphasis on the cervical "seatbelt sign".

PubMed

Desai, N K; Kang, J; Chokshi, F H

2014-09-01

There are no standard screening guidelines to evaluate blunt cerebrovascular injury in children. The purpose of this retrospective study was to understand the clinical and radiologic risk factors associated with pediatric blunt cerebrovascular injury on CTA of the neck with primary attention to the cervical "seatbelt sign." Radiology reports from 2002 to 2012 were queried for the examination "CTA neck." The electronic medical record was reviewed for mechanism of injury, Glasgow Coma Scale score, and physical examination findings. Radiology reports from adjunct radiographic studies were reviewed. CTA neck examinations with reported blunt cerebrovascular injury were reviewed to confirm imaging findings. Patients with penetrating injury or those without a history of trauma were excluded. Four hundred sixty-three patients underwent CTA of the neck; 137 had blunt trauma. Forty-two of 85 patients involved in a motor vehicle collision had a cervical seatbelt sign; none had blunt cerebrovascular injury. Nine vessels (4 vertebral arteries, 4 ICAs, 1 common carotid artery) in 8 patients ultimately were diagnosed with various grades (I-IV) of blunt cerebrovascular injury, representing 5.8% (8/137) of the population screened for blunt neck trauma. The mean Glasgow Coma Scale score was significantly lower (P=.02) in the blunt cerebrovascular injury group versus the non-blunt cerebrovascular injury group. Although not statistically significant, patients with blunt cerebrovascular injury had a higher tendency to have additional traumatic injuries, primarily basilar skull fractures (P=.05) and intracranial hemorrhage (P=.13). A common indication for neck CTA, the cervical seatbelt sign, was not associated with blunt cerebrovascular injury. With the exception of Glasgow Coma Scale score, no single risk factor was statistically significant in predicting vascular injury in this series. © 2014 by American Journal of Neuroradiology.

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

Large arterial occlusive strokes as a medical emergency: need to accurately predict clot location.

PubMed

Vanacker, Peter; Faouzi, Mohamed; Eskandari, Ashraf; Maeder, Philippe; Meuli, Reto; Michel, Patrik

2017-10-01

Endovascular treatment for acute ischemic stroke with a large intracranial occlusion was recently shown to be effective. Timely knowledge of the presence, site, and extent of arterial occlusions in the ischemic territory has the potential to influence patient selection for endovascular treatment. We aimed to find predictors of large vessel occlusive strokes, on the basis of available demographic, clinical, radiological, and laboratory data in the emergency setting. Patients enrolled in ASTRAL registry with acute ischemic stroke and computed tomography (CT)-angiography within 12 h of stroke onset were selected and categorized according to occlusion site. Easily accessible variables were used in a multivariate analysis. Of 1645 patients enrolled, a significant proportion (46.2%) had a large vessel occlusion in the ischemic territory. The main clinical predictors of any arterial occlusion were in-hospital stroke [odd ratios (OR) 2.1, 95% confidence interval 1.4-3.1], higher initial National Institute of Health Stroke Scale (OR 1.1, 1.1-1.2), presence of visual field defects (OR 1.9, 1.3-2.6), dysarthria (OR 1.4, 1.0-1.9), or hemineglect (OR 2.0, 1.4-2.8) at admission and atrial fibrillation (OR 1.7, 1.2-2.3). Further, the following radiological predictors were identified: time-to-imaging (OR 0.9, 0.9-1.0), early ischemic changes (OR 2.3, 1.7-3.2), and silent lesions on CT (OR 0.7, 0.5-1.0). The area under curve for this analysis was 0.85. Looking at different occlusion sites, National Institute of Health Stroke Scale and early ischemic changes on CT were independent predictors in all subgroups. Neurological deficits, stroke risk factors, and CT findings accurately identify acute ischemic stroke patients at risk of symptomatic vessel occlusion. Predicting the presence of these occlusions may impact emergency stroke care in regions with limited access to noninvasive vascular imaging.

International Radiation Monitoring and Information System (IRMIS)

NASA Astrophysics Data System (ADS)

Mukhopadhyay, Sanjoy; Baciu, Florian; Stowisek, Jan; Saluja, Gurdeep; Kenny, Patrick; Albinet, Franck

2017-09-01

This article describes the International Radiation Monitoring Information System (IRMIS) which was developed by the International Atomic Energy Agency (IAEA) with the goal to provide Competent Authorities, the IAEA and other international organizations with a client server based web application to share and visualize large quantities of radiation monitoring data. The data maps the areas of potential impact that can assist countries to take appropriate protective actions in an emergency. Ever since the Chernobyl nuclear power plant accident in April of 19861 European Community (EC) has worked towards collecting routine environmental radiological monitoring data from national networked monitoring systems. European Radiological Data Exchange Platform (EURDEP) was created in 19952 to that end - to provide radiation monitoring data from most European countries reported in nearly real-time. During the response operations for the Fukushima Dai-ichi nuclear power plant accident (March 2011) the IAEA Incident and Emergency Centre (IEC) managed, harmonized and shared the large amount of data that was being generated from different organizations. This task underscored the need for a system which allows sharing large volumes of radiation monitoring data in an emergency. In 2014 EURDEP started the submission of the European radiological data to the International Radiation Monitoring Information System (IRMIS) as a European Regional HUB for IRMIS. IRMIS supports the implementation of the Convention on Early Notification of a Nuclear Accident by providing a web application for the reporting, sharing, visualizing and analysing of large quantities of environmental radiation monitoring data during nuclear or radiological emergencies. IRMIS is not an early warning system that automatically reports when there are significant deviations in radiation levels or when values are detected above certain levels. However, the configuration of the visualization features offered by IRMIS may help Member States to determine where elevated gamma dose rate measurements during a radiological or nuclear emergency indicate that actions to protect the public are necessary. The data can be used to assist emergency responders determine where and when to take necessary actions to protect the public. This new web online tool supports the IAEA's Unified System for Information Exchange in Incidents and Emergencies (USIE)3, an online tool where competent authorities can access information about all emergency situations, ranging from a lost radioactive source to a full-scale nuclear emergency.

Anterior cruciate ligament reconstruction with 4-strand hamstring autograft and accelerated rehabilitation: a 10-year prospective study on clinical results, knee osteoarthritis and its predictors.

PubMed

Janssen, Rob P A; du Mée, Arthur W F; van Valkenburg, Juliette; Sala, Harm A G M; Tseng, Carroll M

2013-09-01

Analysis of long-term clinical and radiological outcomes after anterior cruciate ligament (ACL) reconstruction with special attention to knee osteoarthritis and its predictors. A prospective, consecutive case series of 100 patients. Arthroscopic transtibial ACL reconstruction was performed using 4-strand hamstring tendon autografts with a standardized accelerated rehabilitation protocol. Analysis was performed preoperatively and 10 years postoperatively. Clinical examination included Lysholm and Tegner scores, IKDC, KT-1000 testing (MEDmetric Co., San Diego, CA, USA) and leg circumference measurements. Radiological evaluation included AP weight bearing, lateral knee, Rosenberg and sky view X-rays. Radiological classifications were according to Ahlbäck and Kellgren & Lawrence. Statistical analysis included univariate and multivariate logistic regressions. RESULTS CLINICAL OUTCOME: A significant improvement (p < 0.001) between preoperative and postoperative measurements could be demonstrated for the Lysholm and Tegner scores, IKDC patient subjective assessment, KT-1000 measurements, pivot shift test, IKDC score and one-leg hop test. A pivot shift phenomenon (glide) was still present in 43 (50%) patients and correlated with lower levels of activity (p < 0.022). Radiological outcome: At follow-up, 46 (53.5%) patients had signs of osteoarthritis (OA). In this group, 33 patients (72%) had chondral lesions (≥grade 2) at the time of ACL reconstruction. A history of medial meniscectomy before or at the time of ACL reconstruction increased the risk of knee OA 4 times (95% CI 1.41-11.5). An ICRS grade 3 at the time of ACL reconstruction increased the risk of knee OA by 5.2 times (95% CI 1.09-24.8). There was no correlation between OA and activity level (Tegner score ≥6) nor between OA and a positive pivot shift test. Transtibial ACL reconstruction with 4-strand hamstring autograft and accelerated rehabilitation restored anteroposterior knee stability. Clinical parameters and patient satisfaction improved significantly. At 10-year follow-up, radiological signs of OA were present in 53.5 % of the subjects. Risk factors for OA were meniscectomy prior to or at the time of ACL reconstruction and chondral lesions at the time of ACL reconstruction. II.

Radiological reporting that combine continuous speech recognition with error correction by transcriptionists.

PubMed

Ichikawa, Tamaki; Kitanosono, Takashi; Koizumi, Jun; Ogushi, Yoichi; Tanaka, Osamu; Endo, Jun; Hashimoto, Takeshi; Kawada, Shuichi; Saito, Midori; Kobayashi, Makiko; Imai, Yutaka

2007-12-20

We evaluated the usefulness of radiological reporting that combines continuous speech recognition (CSR) and error correction by transcriptionists. Four transcriptionists (two with more than 10 years' and two with less than 3 months' transcription experience) listened to the same 100 dictation files and created radiological reports using conventional transcription and a method that combined CSR with manual error correction by the transcriptionists. We compared the 2 groups using the 2 methods for accuracy and report creation time and evaluated the transcriptionists' inter-personal dependence on accuracy rate and report creation time. We used a CSR system that did not require the training of the system to recognize the user's voice. We observed no significant difference in accuracy between the 2 groups and 2 methods that we tested, though transcriptionists with greater experience transcribed faster than those with less experience using conventional transcription. Using the combined method, error correction speed was not significantly different between two groups of transcriptionists with different levels of experience. Combining CSR and manual error correction by transcriptionists enabled convenient and accurate radiological reporting.

Clinical and Radiological Outcomes Comparing Percutaneous Chevron-Akin Osteotomies vs Open Scarf-Akin Osteotomies for Hallux Valgus.

PubMed

Lai, Mun Chun; Rikhraj, Inderjeet Singh; Woo, Yew Lok; Yeo, William; Ng, Yung Chuan Sean; Koo, Kevin

2018-03-01

Minimally invasive surgeries have gained popularity due to less soft tissue trauma and better wound healing. To date, limited studies have compared the outcomes of percutaneous and open osteotomies. This study aims to investigate the clinical and radiological outcomes of percutaneous chevron-Akin osteotomies vs open scarf-Akin osteotomies at 24-month follow-up. We reviewed a prospectively collected database in a tertiary hospital hallux valgus registry. Twenty-nine feet that underwent a percutaneous technique were matched to 58 feet that underwent open scarf and Akin osteotomies. Clinical outcome measures assessed included visual analog scale (VAS) scores, American Orthopaedic Foot & Ankle Society Hallux Metatarsophalangeal-Interphalangeal score (AOFAS Hallux MTP-IP), and Short Form 36 (SF-36) Health Survey. Radiological outcomes included hallux valgus angle (HVA) and intermetatarsal angle (IMA). All patients were prospectively followed up at 6 and 24 months. Both groups showed comparable clinical and radiological outcomes at the 24-month follow-up. However, the percutaneous group demonstrated less pain in the perioperative period ( P < .001). There were significant differences in the change in HVA between the groups but comparable radiological outcomes in IMA at the 24-month follow-up. The percutaneous group demonstrated shorter length of operation ( P < .001). There were no complications in the percutaneous group but 3 wound complications in the open group. We conclude that clinical and radiological outcomes of third-generation percutaneous chevron-Akin osteotomies were comparable with open scarf and Akin osteotomies at 24 months but with significantly less perioperative pain, shorter length of operation, and less risk of wound complications. Level III, retrospective comparative series.

[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.

Interventional Radiology-Operated Cholecystoscopy for the Management of Symptomatic Cholelithiasis: Approach, Technical Success, Safety, and Clinical Outcomes.

PubMed

Patel, Nishant; Chick, Jeffrey Forris Beecham; Gemmete, Joseph J; Castle, Jordan C; Dasika, Narasimham; Saad, Wael E; Srinivasa, Ravi N

2018-05-01

The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis. Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula. Cholecystostomy access, time between cholecystostomy and cholecystoscopy, endoscopic and fragmentation devices used, technical success, procedure time, fluoroscopy time, complications, length of hospital stay, time between cholecystoscopy and cholecystostomy removal, follow-up, and acute cholecystitis recurrence were recorded. Eleven (85%) patients underwent transhepatic cholecystostomy, and two (15%) patients underwent transperitoneal cholecystostomy. The mean time from cholecystostomy to cholecystoscopy was 151 days. Flexible endoscopy was used in eight (62%) patients, rigid endoscopy in three (23%), and both flexible and rigid in two (15%). Electrohydraulic lithotripsy was used in eight procedures, nitinol baskets in seven, ultrasonic lithotripsy in two, and percutaneous thrombectomy devices in one. Primary technical success was achieved in 11 (85%) patients, and secondary technical success was achieved in 13 (100%) patients. The mean procedure time was 164 minutes, and the mean number of procedures required to clear all gallstones was 1. One (8%) patient developed acute pancreatitis, and one (8%) patient died of gastrointestinal hemorrhage. The median hospital length of stay after cholecystoscopy was 1 day for postoperative monitoring. The mean time between cholecystoscopy and cholecystostomy removal was 39 days. One (8%) patient developed recurrent acute cholecystitis 1095 days after cholecystoscopy. Interventional radiology-operated cholecystoscopy may serve as an effective method for percutaneous gallstone removal in patients with multiple comorbidities precluding cholecystectomy.

Does gender impact upon application rejection rate among Canadian radiology residency applicants?

PubMed

Baerlocher, Mark O; Walker, Michelle

2005-10-01

To determine if and how gender ratios have changed within Canadian radiology, and to determine if gender discrimination occurs at the level of the radiology resident selection committee. The Canadian Medical Association, Canadian Association of Radiologists, Canadian Institute for Health Information, Royal College of Physicians and Surgeons of Canada, and Canadian Residency Matching Service provided gender-specific data. We compared the proportion of female applicants who ranked a radiology program as their top choice and were rejected from any radiology program with the corresponding proportion for male applicants. The numbers of women and men being awarded an MD from a Canadian university equalized nearly a decade ago. Women continue to be numerically underrepresented among practicing radiologists; however, the proportion of women continues to increase so that there is 1 female radiologist in practice to every 3 male radiologists in practice in 2005. More male medical students ranked a radiology residency training program as their top choice in the residency match; however, of those who did, they were as likely as women to be rejected from a radiology residency training program. Grouping all female and male graduating medical students participating in the residency match and ranking a radiology residency as their top choice between 1993 and 2004, the odds of men being rejected were 1.4 times (95% CI 0.99-1.9, p = 0.07) greater than for women. There continues to be more men than women radiologists in practice; however, the female-to-male ratio continues to increase. Our data suggest that discrimination against female applicants at the level of radiology residency selection does not occur.

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

PubMed

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

2016-03-01

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

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

PubMed

Napierala, Christoph; Boes, Stefan

2017-02-28

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

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.

The fate of abstracts presented at Turkish national radiology congresses in 2010–2012

PubMed Central

Beker-Acay, Mehtap; Fidan, Nurdan; Unlu, Ebru; Katirag, Ahmet; Ulker, Huseyin; Acay, Akif; Yucel, Aylin

2015-01-01

PURPOSE This study aims to evaluate the analysis and publication rates of abstracts presented at the Turkish National Radiology meetings in 2010–2012. METHODS Abstracts presented in the national radiology meetings of 2010, 2011, and 2012 were included in the study. The presentations were classified according to presentation type (oral or poster presentations), study type, study design, imaged organ or body systems, imaging modalities, time interval between the presentation and the publication date, and the journal in which the article was published. The conversion rate of presentations into full-text articles in peer-reviewed journals were surveyed through PubMed. The time from presentation in the meetings to publication was determined. The distribution of journals was also demonstrated. RESULTS The total number of presentations submitted in three national radiology meetings was 3,192. The publication rate was 11% for the 2010 meeting, 8.2% for the 2011 meeting, and 9.6% for the 2012 meeting. A total of 300 papers were published, with an average of 15 months (range, 0–42 months) between presentation and final publication. The first three refereed international journals with the most number of papers derived from these meetings were Diagnostic and Interventional Radiology, Clinical Imaging, and European Journal of Radiology. CONCLUSION The overall publication rate of scientific abstracts from Turkey was lower than those from overseas countries. Encouraging the authors to conduct higher-quality research would raise the publication rate as well as improve the quality and success of our scientific meetings. PMID:26133322

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

NASA Astrophysics Data System (ADS)

Donohue, Nathan

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

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.

3D surface and body documentation in forensic medicine: 3-D/CAD Photogrammetry merged with 3D radiological scanning.

PubMed

Thali, Michael J; Braun, Marcel; Wirth, Joachim; Vock, Peter; Dirnhofer, Richard

2003-11-01

A main goal of forensic medicine is to document and to translate medical findings to a language and/or visualization that is readable and understandable for judicial persons and for medical laymen. Therefore, in addition to classical methods, scientific cutting-edge technologies can and should be used. Through the use of the Forensic, 3-D/CAD-supported Photogrammetric method the documentation of so-called "morphologic fingerprints" has been realized. Forensic, 3-D/CAD-supported Photogrammetry creates morphologic data models of the injury and of the suspected injury-causing instrument allowing the evaluation of a match between the injury and the instrument. In addition to the photogrammetric body surface registration, the radiological documentation provided by a volume scan (i.e., spiral, multi-detector CT, or MRI) registers the sub-surface injury, which is not visible to Photogrammetry. The new, combined method of merging Photogrammetry and Radiology data sets creates the potential to perform many kinds of reconstructions and postprocessing of (patterned) injuries in the realm of forensic medical case work. Using this merging method of colored photogrammetric surface and gray-scale radiological internal documentation, a great step towards a new kind of reality-based, high-tech wound documentation and visualization in forensic medicine is made. The combination of the methods of 3D/CAD Photogrammetry and Radiology has the advantage of being observer-independent, non-subjective, non-invasive, digitally storable over years or decades and even transferable over the web for second opinion.

Source detection at 100 meter standoff with a time-encoded imaging system

NASA Astrophysics Data System (ADS)

Brennan, J.; Brubaker, E.; Gerling, M.; Marleau, P.; Monterial, M.; Nowack, A.; Schuster, P.; Sturm, B.; Sweany, M.

2018-01-01

We present the design, characterization, and testing of a laboratory prototype radiological search and localization system. The system, based on time-encoded imaging, uses the attenuation signature of neutrons in time, induced by the geometrical layout and motion of the system. We have demonstrated the ability to detect a ∼ 1mCi252Cf radiological source at 100m standoff with 90% detection efficiency and 10% false positives against background in 12min. This same detection efficiency is met at 15s for a 40m standoff, and 1 . 2s for a 20m standoff.

Comparative analysis of arthroscopic debridement in osseous versus soft tissue anterior ankle impingement.

PubMed

Devgan, Ashish; Rohilla, Rajesh; Tanwar, Milind; Jain, Aditya; Siwach, Karan; Devgan, Radika

2016-01-01

Arthroscopic debridement has been a gold standard procedure for anterior ankle impingement, both in cases of osseous and soft tissue impingement. There is sparse literature on comparative outcome with respect to functional results between the two types of impingement post-arthroscopic debridement. Our study included 14 patients diagnosed as cases of anterior ankle impingement on the basis of clinical and radiological examination. They were segregated into two groups (on the basis of cause of impingement (osseous versus soft tissue)). Both groups were treated by arthroscopic debridement. Primary outcome was patient satisfaction, which was assessed by Likert scale and clinical outcomes were measured using AOFAS ankle-hind foot scale, VAS score, range of motion and time to return to pre-injury activity level in both groups. Mean follow-up was of 15 months where eleven patients reported an excellent recovery, two patients had good recovery while one patient reported poor outcome. Mean AOFAS ankle hind foot scale improved from 50.5 preoperatively to 85.71 postoperatively (statistically significant; p value - 0.0001). Mean Likert scale value post-operative was 4.21. VAS score showed significant improvement in patients of both the groups. Range of motion was slightly better in soft tissue impingement type with a relatively shorter time to return to sports or preinjury activity level as compared to osseous impingement group. The patients in both the groups had comparable outcomes with no statistically significant difference with regard to patient satisfaction and clinical outcome.

Radiomics: a new application from established techniques

PubMed Central

Parekh, Vishwa; Jacobs, Michael A.

2016-01-01

The increasing use of biomarkers in cancer have led to the concept of personalized medicine for patients. Personalized medicine provides better diagnosis and treatment options available to clinicians. Radiological imaging techniques provide an opportunity to deliver unique data on different types of tissue. However, obtaining useful information from all radiological data is challenging in the era of “big data”. Recent advances in computational power and the use of genomics have generated a new area of research termed Radiomics. Radiomics is defined as the high throughput extraction of quantitative imaging features or texture (radiomics) from imaging to decode tissue pathology and creating a high dimensional data set for feature extraction. Radiomic features provide information about the gray-scale patterns, inter-pixel relationships. In addition, shape and spectral properties can be extracted within the same regions of interest on radiological images. Moreover, these features can be further used to develop computational models using advanced machine learning algorithms that may serve as a tool for personalized diagnosis and treatment guidance. PMID:28042608

Picture Archiving and Communication System (PACS) implementation, integration & benefits in an integrated health system.

PubMed

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

2012-02-01

The availability of the Picture Archiving and Communication System (PACS) has revolutionized the practice of radiology in the past two decades and has shown to eventually increase productivity in radiology and medicine. PACS implementation and integration may bring along numerous unexpected issues, particularly in a large-scale enterprise. To achieve a successful PACS implementation, identifying the critical success and failure factors is essential. This article provides an overview of the process of implementing and integrating PACS in a comprehensive health system comprising an academic core hospital and numerous community hospitals. Important issues are addressed, touching all stages from planning to operation and training. The impact of an enterprise-wide radiology information system and PACS at the academic medical center (four specialty hospitals), in six additional community hospitals, and in all associated outpatient clinics as well as the implications on the productivity and efficiency of the entire enterprise are presented. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

Times have changed! Forensic radiology--a new challenge for radiology and forensic pathology.

PubMed

Flach, Patricia M; Thali, Michael J; Germerott, Tanja

2014-04-01

The ongoing development of imaging and the recent integration of cross-sectional imaging methods into the medicolegal workflow have resulted in an increasing number of forensic institutes acquiring dedicated CT and MRI scanners. The purpose of this article is to evaluate the different aspects of postmortem imaging and to detail the necessary cooperation between radiologists and forensic pathologists for mutual learning and accurate science to form a new subspecialty: forensic radiology. CONCLUSION; Forensic radiology must integrate the expertise of forensic pathologists and radiologists. The challenge is to unite these two disciplines first by direct and intense communications and second by a basic understanding of forensic pathology by radiologists as well as a foundational knowledge of postmortem imaging by forensic pathologists, in combination with the establishment of educational and reporting guidelines.

[A radiological case collection with interactive character as a new element in the education of medical students].

PubMed

Heye, T; Kurz, P; Eiers, M; Kauffmann, G W; Schipp, A

2008-04-01

Evaluation of an interactive, multimedia case-based learning platform for the radiological education of medical students. An interactive electronic learning platform for the education of medical students was built in HTML format independent of the operating system in the context of the Heidelberg Curriculum Medicinale (HeiCuMed). A case collection of 30 common and authentic clinical cases is used as the central theme and clinical background. The user has to work on each case by making decisions regarding a selection of diagnostic modalities and by analyzing the chosen studies. After a reasonable selection and sequence of diagnostic radiological modalities and their interpretation, a diagnosis has to be made. An extensive collection of normal findings for any modality is available for the user as a reference in correlation with the pathology at anytime within each case. The case collection consists of 2053 files with 1109 Internet pages (HTML) and 869 image files (.jpeg) with approximately 10 000 crosslinks (links). The case collection was evaluated by a questionnaire (scale 1 - 5) at the end of the radiological student course. The development of the results of the radiological course exam was analyzed to investigate any effect on the learning performance after the case collection was introduced. 97.6 % of the course participants would use the case collection beyond the radiological student course to learn radiology in their medical studies. The handling of the case collection was rated excellent in 36.9 %, good in 54.6 %, satisfactory in 8 % and unsatisfactory in 0.4 %. 41 % felt that the case collection was overall excellent, 49.2 % good, 7.8 % satisfactory, 1.6 % unsatisfactory and 0.4 % poor. A positive trend in the development of the results in the radiological course exam with less variance after the introduction of the case collection was found but failed statistical significance. A platform-independent, interactive, multimedia learning platform with authentic clinical cases and multiple choice elements for the user is the ideal method for supporting and expanding medical education in radiology. The usefulness and the reasonable exertion of diagnostic modalities are conveyed in a practical context as teaching goals. The high acceptance among students is based on the interactivity and use of multimedia.

[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.

The evolution of the international system of radiological protection: stakeholder views from the 1st and 2nd NEA/ICRP fora.

PubMed

Lazo, Ted

2003-12-01

The Nuclear Energy Agency's (NEA's) Committee on Radiological Protection and Public Health (CRPPH) has collaborated closely with the ICRP in its efforts to develop new recommendations for radiological protection at the start of the 21st century. As part of this effort, the NEA organised, in collaboration with the ICRP, two fora to discuss the radiological protection of the environment (Taormina, February 2002) and the future policy for radiological protection (Lanzarote, April 2003). Both these meetings were attended by a broad representation of stakeholders. The CRPPH and other stakeholders universally appreciated the opportunity to speak directly with the ICRP on these important subjects. This report summarises the main conclusions made during these two meetings to advance the deliberations of the ICRP to create a new set of recommendations responsive to stakeholder needs, firmly rooted in science, and that can be implemented in a timely, efficient and cost-effective manner.

Diversity, Inclusion, and Representation: It Is Time to Act.

PubMed

Lightfoote, Johnson B; Deville, Curtiland; Ma, Loralie D; Winkfield, Karen M; Macura, Katarzyna J

2016-12-01

Although the available pool of qualified underrepresented minority and women medical school graduates has expanded in recent decades, their representation in the radiological professions has improved only marginally. Recognizing this deficit in diversity, many professional medical societies, including the ACR, have incorporated these values as core elements of their missions and instituted programs that address previously identified barriers to a more diverse workforce. These barriers include insufficient exposure of underrepresented minorities and women to radiology and radiation oncology; misperception of these specialties as non-patient care and not community service; unconscious bias; and delayed preparation of candidates to compete successfully for residency positions. Critical success factors in expanding diversity and inclusion are well identified both outside and within the radiological professions; these are reviewed in the current communication. Radiology leaders are positioned to lead the profession in expanding the diversity and improving the inclusiveness of our professional workforce in service to an increasingly diverse society and patient population. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2009-04-01

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

Educational Technology Network: a computer conferencing system dedicated to applications of computers in radiology practice, research, and education.

PubMed

D'Alessandro, M P; Ackerman, M J; Sparks, S M

1993-11-01

Educational Technology Network (ET Net) is a free, easy to use, on-line computer conferencing system organized and funded by the National Library of Medicine that is accessible via the SprintNet (SprintNet, Reston, VA) and Internet (Merit, Ann Arbor, MI) computer networks. It is dedicated to helping bring together, in a single continuously running electronic forum, developers and users of computer applications in the health sciences, including radiology. ET Net uses the Caucus computer conferencing software (Camber-Roth, Troy, NY) running on a microcomputer. This microcomputer is located in the National Library of Medicine's Lister Hill National Center for Biomedical Communications and is directly connected to the SprintNet and the Internet networks. The advanced computer conferencing software of ET Net allows individuals who are separated in space and time to unite electronically to participate, at any time, in interactive discussions on applications of computers in radiology. A computer conferencing system such as ET Net allows radiologists to maintain contact with colleagues on a regular basis when they are not physically together. Topics of discussion on ET Net encompass all applications of computers in radiological practice, research, and education. ET Net has been in successful operation for 3 years and has a promising future aiding radiologists in the exchange of information pertaining to applications of computers in radiology.

Assessing the impact of a radiology information management system in the emergency department

NASA Astrophysics Data System (ADS)

Redfern, Regina O.; Langlotz, Curtis P.; Lowe, Robert A.; Horii, Steven C.; Abbuhl, Stephanie B.; Kundel, Harold L.

1998-07-01

To evaluate a conventional radiology image management system, by investigating information accuracy, and information delivery. To discuss the customization of a picture archival and communication system (PACS), integrated radiology information system (RIS) and hospital information system (HIS) to a high volume emergency department (ED). Materials and Methods: Two data collection periods were completed. After the first data collection period, a change in work rules was implemented to improve the quality of data in the image headers. Data from the RIS, the ED information system, and the HIS as well as observed time motion data were collected for patients admitted to the ED. Data accuracy, patient waiting times, and radiology exam information delivery were compared. Results: The percentage of examinations scheduled in the RIS by the technologists increased from 0% (0 of 213) during the first period to 14% (44 of 317) during the second (p less than 0.001). The percentage of images missing identification numbers decreased from 36% (98 of 272) during the first data collection period to 10% (56 of 562) during the second period (p less than 0.001). Conclusions: Radiologic services in a high-volume ED, requiring rapid service, present important challenges to a PACS system. Strategies can be implemented to improve accuracy and completeness of the data in PACS image headers in such an environment.

The influence of travel time on breast cancer characteristics, receipt of primary therapy, and surveillance mammography

PubMed Central

Cook, Andrea; Kirlin, Beth; Shi, Xun; Alford-Teaster, Jennifer; Tuzzio, Leah; Buist, Diana S. M.

2013-01-01

Travel time has been shown to influence some aspects of cancer characteristics at diagnosis and care for women with breast cancer, but important gaps remain in our understanding of its impact. We examined the influence of travel time to the nearest radiology facility on breast cancer characteristics, treatment, and surveillance for women with early-stage invasive breast cancer. We included 1,012 women with invasive breast cancer (stages I and II) who had access to care within an integrated health care delivery system in western Washington State. The travel times to the nearest radiology facility were calculated for all the U.S. Census blocks within the study area and assigned to women based on residence at diagnosis. We collected cancer characteristics, primary and adjuvant therapies, and surveillance mammography for at least 2.5 years post diagnosis and used multivariable analyses to test the associations of travel time. The majority of women (68.6%) lived within 20 min of the nearest radiology facility, had stage I disease (72.7%), received breast conserving therapy (68.7%), and had annual surveillance mammography the first 2 years after treatment (73.7%). The travel time was not significantly associated with the stage or surveillance mammography after adjusting for covariates. Primary therapy was significantly related to travel time, with greater travel time (>30 min vs. ≤ 10 min) associated with a higher likelihood of mastectomy compared to breast conserving surgery (RR = 1.53; 95% CI, 1.16–2.01). The travel time was not associated with the stage at diagnosis or surveillance mammography receipt. The travel time does seem to influence the type of primary therapy among women with breast cancer, suggesting that women may prefer low frequency services, such as mastectomy, if geographic access to a radiology facility is limited. PMID:21553117

A comparative study for radiological decontamination of laboratory fume hood materials.

PubMed

Thomas, Elizabeth; Sweet, Lucas; MacFarlan, Paul; McNamara, Bruce; Kerschner, Harrison

2012-08-01

The efficacy for radiological decontamination of the laboratory standard fume hood as constructed of stainless steel, compared to that of powder-coated carbon steel is described. While the chemical inertness of powder-coated surfaces is good, faced with everyday abrasion, aggressive inorganic solutions and vapors, and penetrating organics commonly employed in government laboratory fume hoods, radiological decontamination of powder-coated steel surfaces was found to be similar to those made of stainless steel for easily solubilized or digestible radionuclides. Plutonium was difficult to remove from stainless steel and powder-coated surfaces, especially after prolonged contact times.

78 FR 29140 - Center for Devices and Radiological Health Appeals Processes: Questions and Answers About 517A...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-17

... availability of the draft guidance entitled ``Center for Devices and Radiological Health (CDRH) Appeals Processes: Questions and Answers About 517A.'' This draft document provides CDRH's proposed interpretation... decisions and actions taken by CDRH. This draft guidance is not final nor is it in effect at this time...

A kinematic-based methodology for radiological protection: Runoff analysis to calculate the effective dose for internal exposure caused by ingestion of radioactive isotopes

NASA Astrophysics Data System (ADS)

Sasaki, Syota; Yamada, Tadashi; Yamada, Tomohito J.

2014-05-01

We aim to propose a kinematic-based methodology similar with runoff analysis for readily understandable radiological protection. A merit of this methodology is to produce sufficiently accurate effective doses by basic analysis. The great earthquake attacked the north-east area in Japan on March 11, 2011. The system of electrical facilities to control Fukushima Daiichi nuclear power plant was completely destroyed by the following tsunamis. From the damaged reactor containment vessels, an amount of radioactive isotopes had leaked and been diffused in the vicinity of the plant. Radiological internal exposure caused by ingestion of food containing radioactive isotopes has become an issue of great interest to the public, and has caused excessive anxiety because of a deficiency of fundamental knowledge concerning radioactivity. Concentrations of radioactivity in the human body and internal exposure have been studied extensively. Previous radiologic studies, for example, studies by International Commission on Radiological Protection(ICRP), employ a large-scale computational simulation including actual mechanism of metabolism in the human body. While computational simulation is a standard method for calculating exposure doses among radiology specialists, these methods, although exact, are too difficult for non-specialists to grasp the whole image owing to the sophistication. In this study, the human body is treated as a vessel. The number of radioactive atoms in the human body can be described by an equation of continuity, which is the only governing equation. Half-life, the period of time required for the amount of a substance decreases by half, is only parameter to calculate the number of radioactive isotopes in the human body. Half-life depends only on the kinds of nuclides, there are no arbitrary parameters. It is known that the number of radioactive isotopes decrease exponentially by radioactive decay (physical outflow). It is also known that radioactive isotopes decrease exponentially by excretion (biological outflow). The total outflow is the sum of physical outflow and biological outflow. As a result, the number of radioactive atoms in the human body also decreases exponentially. Half-life can be determined by outflow flux from the definition. Intensity of radioactivity is linear respect to the number of radioactive atoms, both are equivalent analytically. Internal total exposure can be calculated by the time integral of intensity of radioactivity. The absorbed energy into the human body per radioactive decay and the effective dose are calculated by aid of Fermi's theory of beta decay and special relativity. The effective doses calculated by the present method almost agree with those of a study by ICRP. The present method shows that standard limit in general foods for radioactive cesium enforced in Japan, 100 Bq/kg, is too excessive. When we eat foods which contain cesium-137 of 100 Bq/kg at 1 kg/d during 50 years, we receive the effective dose less than natural exposure. Similarly, it is shown that we cannot find significant health damage medically and statistically by ingestion of rice which is harvested from a paddy field deposited current (January, 2014) radioactive cesium.

Pharmacometabolomics Informs Quantitative Radiomics for Glioblastoma Diagnostic Innovation.

PubMed

Katsila, Theodora; Matsoukas, Minos-Timotheos; Patrinos, George P; Kardamakis, Dimitrios

2017-08-01

Applications of omics systems biology technologies have enormous promise for radiology and diagnostics in surgical fields. In this context, the emerging fields of radiomics (a systems scale approach to radiology using a host of technologies, including omics) and pharmacometabolomics (use of metabolomics for patient and disease stratification and guiding precision medicine) offer much synergy for diagnostic innovation in surgery, particularly in neurosurgery. This synthesis of omics fields and applications is timely because diagnostic accuracy in central nervous system tumors still challenges decision-making. Considering the vast heterogeneity in brain tumors, disease phenotypes, and interindividual variability in surgical and chemotherapy outcomes, we believe that diagnostic accuracy can be markedly improved by quantitative radiomics coupled to pharmacometabolomics and related health information technologies while optimizing economic costs of traditional diagnostics. In this expert review, we present an innovation analysis on a systems-level multi-omics approach toward diagnostic accuracy in central nervous system tumors. For this, we suggest that glioblastomas serve as a useful application paradigm. We performed a literature search on PubMed for articles published in English between 2006 and 2016. We used the search terms "radiomics," "glioblastoma," "biomarkers," "pharmacogenomics," "pharmacometabolomics," "pharmacometabonomics/pharmacometabolomics," "collaborative informatics," and "precision medicine." A list of the top 4 insights we derived from this literature analysis is presented in this study. For example, we found that (i) tumor grading needs to be better refined, (ii) diagnostic precision should be improved, (iii) standardization in radiomics is lacking, and (iv) quantitative radiomics needs to prove clinical implementation. We conclude with an interdisciplinary call to the metabolomics, pharmacy/pharmacology, radiology, and surgery communities that pharmacometabolomics coupled to information technologies (chemoinformatics tools, databases, collaborative systems) can inform quantitative radiomics, thus translating Big Data and information growth to knowledge growth, rational drug development and diagnostics innovation for glioblastomas, and possibly in other brain tumors.

Acrylic kyphoplasty in recent nonosteoporotic fractures of the thoracolumbar junction: a prospective clinical and 3D radiologic study of 54 patients.

PubMed

Saget, Mathieu; Teyssedou, Simon; Prebet, Remi; Vendeuvre, Tanguy; Gayet, Louis-Etienne; Pries, Pierre

2014-08-01

Prospective clinical and radiological study. To evaluate the impact of stand-alone acrylic kyphoplasty in the treatment of recent traumatic fractures of the thoracolumbar spine in young patients. The management of fractures of the thoracolumbar spine without neurological deficit remains controversial. For a long time clinicians could only chose between functional treatment, orthopedic treatment, and traditional surgery. The recent advent of minimally invasive surgical techniques is an interesting alternative. Fifty-four patients with a mean age of 45.8±18.2 years and who had recently sustained a fracture of the thoracolumbar junction were enrolled into the study. Balloon kyphoplasty was performed using acrylic cement. Radiologic assessments (computed tomography scans) and clinical assessments (including Visual Analog Scale and Oswestry Disability Index scores) were used to determine kyphoplasty success and measure patient recovery over 2 years. Kyphoplasty reduced mean vertebral kyphosis from 12.8±5.0 degrees at trauma to 8.2±5.1 degrees at 2-year follow-up. Mean vertebral kyphosis was corrected by -5.7±4.7 degrees (P=0.0001) at the point of first verticalization, with no significant change at the 2-year follow-up visit (+1.1±4.3 degrees, P=0.1058). Kyphoplasty significantly augmented the height of the 6 anterior and intermediate segments. Maximum mean augmentation of intermediate vertebral height after 6 months was (11.6%±15.5%, P<0.0001). Patients tolerated the procedure well and 56% of them returned to work 3 months after kyphoplasty. Kyphoplasty is safe and effective in the correction of nonosteoporotic fractures of the thoracolumbar junction in young patients, and remains stable for at least 2 years postsurgery.

Time analysis for optimization of radiology workflow in conventional radiology during RIS-PACS-integration

NASA Astrophysics Data System (ADS)

Falkensammer, Peter; Soegner, Peter I.; zur Nedden, Dieter

2002-05-01

The integration of RIS-PACS systems in radiology units are intended to reduce time consumption in radiology workflow and thus to increase radiologist productivity. Along with the RIS-PACS integration at the University Hospital Innsbruck we analyzed workflow from patient admission to release of final reports before implementation. The follow up study after six months of the implementation is currently in work. In this study we compared chest to skeletal x-ray examinations in 969 patients before the implementation. Drawing the admission-to-release-of-final-report period showed a two-peak diagram with the first peak corresponding to a release of final results on the same day and the second peak to a release on the following day. In the chest x-ray group, 57% were released the same day (mean value 4:02 hours) and 43% the next day (mean value 21:47 hours). Looking at the skeletal x-rays 40% were released the same day (mean value 3:58 hours) and 60% were released the next day (mean value 21:05 hours). Summarizing the results we should say, that the average chest x-ray requires less time than an skeletal x-ray, due to the fact that a greater percentage of reports is released the same day. The most important result is, that the most time consuming workstep is the exchange of data media between radiologist and secretary with at least 5 hours.

[Survey and analysis of radiation safety education at radiological technology schools].

PubMed

Ohba, Hisateru; Ogasawara, Katsuhiko; Aburano, Tamio

2004-10-01

We carried out a questionnaire survey of all radiological technology schools, to investigate the status of radiation safety education. The questionnaire consisted of questions concerning full-time teachers, measures being taken for the Radiation Protection Supervisor Qualifying Examination, equipment available for radiation safety education, radiation safety education for other departments, curriculum of radiation safety education, and related problems. The returned questionnaires were analyzed according to different groups categorized by form of education and type of establishment. The overall response rate was 55%, and there were statistically significant differences in the response rates among the different forms of education. No statistically significant differences were found in the items relating to full-time teachers, measures for Radiation Protection Supervisor Qualifying Examination, and radiation safety education for other departments, either for the form of education or type of establishment. Queries on the equipment used for radiation safety education revealed a statistically significant difference in unsealed radioisotope institutes among the forms of education. In terms of curriculum, the percentage of radiological technology schools which dealt with neither the shielding calculation method for radiation facilities nor with the control of medical waste was found to be approximately 10%. Other educational problems that were indicated included shortages of full-time teachers and equipment for radiation safety education. In the future, in order to improve radiation safety education at radiological technology schools, we consider it necessary to develop unsealed radioisotope institutes, to appoint more full-time teachers, and to educate students about risk communication.

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.

Distributed radiology clerkship for the core clinical year of medical school.

PubMed

Chew, Felix S

2002-11-01

The central role that diagnostic radiology has in the modern practice of medicine has not always been reflected in radiology's place in the curriculum. We developed a new radiology clerkship for undergraduate medical students during their core clinical year that was supported by Web technology. The assumptions underlying the design of the clerkship were that radiology is best learned from radiologists and that students are most receptive to learning radiology when it is related to concurrent patient care experiences. Beginning in May 2000, a required radiology clerkship experience was incorporated into the core clinical year at Wake Forest University School of Medicine. The core clinical year was organized into three 16-week blocks of clerkships. Two or four independent half-day radiology tutorial sessions were included with each clerkship block, and attended by all students in the block (approximately 35 students), regardless of their specific clerkship assignments. There were ten different radiology tutorials, each given three times during the year as students rotated through the clerkship blocks. Thus, each student attended a radiology tutorial session every four to eight weeks during the year. The topics covered during the tutorials were correlated with the content of the clerkship blocks and included adult and pediatric chest radiology, adult and pediatric abdominal radiology, body CT, neuroradiology, obstetric ultrasound, gynecologic ultrasound, osteoporosis, adult and pediatric fractures, mammography, and cervical spine trauma. The tutorials included pre- and post-test, lectures, case presentations, and sometimes tours of the radiology department. The educational emphasis was on pragmatic case-based learning exercises, development of verbal and visual vocabulary, and learning when and where to seek more information. To provide continuity and organization, Web-based curriculum materials were designed and implemented as a component of the clerkship. The home page of the Web site provided the schedule, faculty names, attendance and grading policies, course overview, and links to individual tutorials. The pages for individual tutorials included educational objectives, glossary of radiology terminology relevant to the subject, lecture slides and handouts, and teaching cases. All students had laptop computers and access to the academic network, but did not use them during the actual tutorial sessions. Implementation of the radiology clerkship required extensive negotiation with directors of other clerkships so that students could be released from their other responsibilities in order to attend the radiology tutorials. The radiology clerkship format has proven to be complex in its administration, with faculty and students on different schedules commuting to the radiology lecture hall from various locations. Extensive use of e-mail and communication via the Web site have been instrumental in reminding faculty and students of upcoming sessions. Preliminary evaluations have indicated that students liked the radiology sessions and learned a great deal, but disliked the scheduling and the lack of continuity. An evaluation of the curriculum and its components is ongoing.

Multidisciplinary HIS DICOM interfaces at the Department of Veterans Affairs

NASA Astrophysics Data System (ADS)

Kuzmak, Peter M.; Dayhoff, Ruth E.

2000-05-01

The U.S. Department of Veterans Affairs (VA) is using the Digital Imaging and Communications in Medicine (DICOM) standard to integrate image data objects from multiple systems for use across the healthcare enterprise. DICOM uses a structured representation of image data and a communication mechanism that allows the VA to easily acquire images from multiple sources and store them directly into the online patient record. The VA can obtain both radiology and non- radiology images using DICOM, and can display them on low-cost clinician's color workstations throughout the medical center. High-resolution gray-scale diagnostic quality multi-monitor workstations with specialized viewing software can be used for reading radiology images. The VA's DICOM capabilities can interface six different commercial Picture Archiving and Communication Systems (PACS) and over twenty different image acquisition modalities. The VA is advancing its use of DICOM beyond radiology. New color imaging applications for Gastrointestinal Endoscopy and Ophthalmology using DICOM are under development. These are the first DICOM offerings for the vendors, who are planning to support the recently passed DICOM Visible Light and Structured Reporting service classes. Implementing these in VistA is a challenge because of the different workflow and software support for these disciplines within the VA HIS environment.

Automatic information extraction from unstructured mammography reports using distributed semantics.

PubMed

Gupta, Anupama; Banerjee, Imon; Rubin, Daniel L

2018-02-01

To date, the methods developed for automated extraction of information from radiology reports are mainly rule-based or dictionary-based, and, therefore, require substantial manual effort to build these systems. Recent efforts to develop automated systems for entity detection have been undertaken, but little work has been done to automatically extract relations and their associated named entities in narrative radiology reports that have comparable accuracy to rule-based methods. Our goal is to extract relations in a unsupervised way from radiology reports without specifying prior domain knowledge. We propose a hybrid approach for information extraction that combines dependency-based parse tree with distributed semantics for generating structured information frames about particular findings/abnormalities from the free-text mammography reports. The proposed IE system obtains a F 1 -score of 0.94 in terms of completeness of the content in the information frames, which outperforms a state-of-the-art rule-based system in this domain by a significant margin. The proposed system can be leveraged in a variety of applications, such as decision support and information retrieval, and may also easily scale to other radiology domains, since there is no need to tune the system with hand-crafted information extraction rules. Copyright © 2018 Elsevier Inc. All rights reserved.

Diagnosis of Richter transformation in chronic lymphocytic leukemia: histology tips the scales.

PubMed

Federmann, Birgit; Mueller, Martin R; Steinhilber, Julia; Horger, Marius S; Fend, Falko

2018-06-12

Development of diffuse large B-cell lymphoma in chronic lymphocytic leukemia, so-called Richter transformation (RT), occurs in 2-5% of patients and is associated with poor outcome. The clinical features of RT are fairly non-specific and unable to discriminate transformation from other mimics. In case of clinically suspected RT, a CT/MRT is recommended, and FDG-PET/CT may help to select the site of biopsy. Radiological features suggestive of RT have been defined, but there are only limited data about their predictive value, and histological confirmation is still considered the gold standard for RT diagnosis. We retrospectively analyzed 34 patients with clinically suspected RT and available radiological and histological data. A histopathological diagnosis of RT with concordant clinical and radiological findings was obtained in 13 patients. In 18 patients, CT did not show features of transformation, concordant with lack of RT in the biopsy. Of interest, a distinct lymphoma other than DLBCL was identified in two of these cases. A false-positive radiological diagnosis of RT was rendered in two patients, including a case of Herpes simplex virus lymphadenitis. In conclusion, our findings confirm the central role of tissue biopsy in the diagnostic work up in case of clinically suspected RT.

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.

Arthrodesis of the proximal interphalangeal joint of the 4th and 5th finger using an interlocking screw device to treat severe recurrence of Dupuytren's disease.

PubMed

Novoa-Parra, C D; Montaner-Alonso, D; Pérez-Correa, J I; Morales-Rodríguez, J; Rodrigo-Pérez, J L; Morales-Suarez-Varela, M

To assess the radiological and functional outcome of arthrodesis of the 4th and 5th finger using the APEX™ (Extremity Medical, Parsippany,NJ)intermedullary interlocking screw system in patients with severe recurrence of Dupuytren's disease. The DASH questionnaire and the VAS scale were used to assess the clinical outcomes. The angle of arthrodesis, fusion time and implant fixation were evaluated on x-rays. The patients were monitored for complications during surgery and the follow-up period. The sample comprised 6 patients. Mean follow up was 19.6 months. All of the patients presented clinical and radiological evidence of fusion at 8 weeks, with fusion angles of 30° (3) and 45° (3). There were no complications and none of the implants had to be removed. The functional outcomes in these patients were poor. The system offers a reliable method for IPJ arthrodesis at a precise angle. It promotes stable fixation that does not require prolonged immobilisation. It can be used together with other procedures on the hand with severe recurrence of DD. The functional outcomes for this group of patients using this device were poor. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

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.

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

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

Quality-of-Life Assessment of Fibroid Treatment Options and Outcomes

PubMed Central

Kong, Chung Yin; Tempany, Clare M.; Swan, J. Shannon

2011-01-01

Purpose: To obtain utilities (a unit of measure of a person’s relative preferences for different health states compared with death or worst possible outcome) for uterine fibroids before and after treatment and to measure short-term utilities for the following uterine fibroid treatments: abdominal hysterectomy, magnetic resonance (MR) imaging–guided focused ultrasound surgery, and uterine artery embolization (UAE). Materials and Methods: This retrospective study was approved by the institutional review board and was HIPAA compliant. The waiting trade-off (WTO) method, a variation on the time trade-off (TTO) method, is used to obtain utilities for diagnostic procedures on the basis of the fact that people wait longer to avoid noxious tests and/or procedures. The WTO method provides short-term quality of life tolls in terms of quality-adjusted life-weeks by scaling wait times with pre- and posttreatment utilities. Utilities for uterine fibroids before and after treatment were obtained with the TTO method and a visual analog scale (VAS) by using a questionnaire administered by means of a phone interview. WTO wait times were adjusted for quality of life with VAS and TTO utilities and a transformation of VAS. Wait times were compared by using nonparametric tests. The study participants included 62 patients who had undergone abdominal hysterectomy, 74 who had undergone UAE, and 61 who had undergone MR imaging–guided focused ultrasound surgery. Results: Quality of life increased with all treatments. The median WTO wait time was higher for hysterectomy (21.6 weeks) than for UAE or MR imaging–guided focused ultrasound surgery (14.1 weeks for both) (P < .05). Quality-adjusted life-week tolls were smaller when scaled according to TTO than when scaled according to VAS or transformation of VAS. Conclusion: Quality of life increased after all fibroid treatments. WTO is feasible for assessing the quality-adjusted morbidity of treatment procedures. © RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.11100704/-/DC1 PMID:21364084

Using Social Media to Share Your Radiology Research: How Effective Is a Blog Post?

PubMed

Hoang, Jenny K; McCall, Jonathan; Dixon, Andrew F; Fitzgerald, Ryan T; Gaillard, Frank

2015-07-01

The aim of this study was to compare the volume of individuals who viewed online versions of research articles in 2 peer-reviewed radiology journals and a radiology blog promoted by social media. The authors performed a retrospective study comparing online analytic logs of research articles in the American Journal of Neuroradiology (AJNR) and the American Journal of Roentgenology (AJR) and a blog posting on Radiopaedia.org from April 2013 to September 2014. All 3 articles addressed the topic of reporting incidental thyroid nodules detected on CT and MRI. The total page views for the research articles and the blog article were compared, and trends in page views were observed. Factors potentially affecting trends were an AJNR podcast and promotion of the blog article on the social media platforms Facebook, Tumblr, and Twitter to followers of Radiopaedia.org in February 2014 and August 2014. The total numbers of page views during the study period were 2,421 for the AJNR article and 3,064 for the AJR article. The Radiopaedia.org blog received 32,675 page views, which was 13.6 and 10.7 times greater than AJNR and AJR page views, respectively, and 6.0 times greater than both journal articles combined. Months with activity above average for the blog and the AJNR article coincided with promotion by Radiopaedia.org on social media. Dissemination of scientific material on a radiology blog promoted on social media can substantially augment the reach of more traditional publication venues. Although peer-reviewed publication remains the most widely accepted measure of academic productivity, researchers in radiology should not ignore opportunities for increasing the impact of research findings via social media. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Delivering radiology supplies just-in-time.

PubMed

Clinton, M

1999-01-01

The radiology department at Dartmouth Hitchcock Medical Center (DHMC) adopted a just-in-time (JIT) inventory management system in 1992, reducing the volume of its in-house inventory of radiology supplies from a value of $400,000 to $16,000, just enough for four to five days of activity. An asset manager, the only person authorized to order supplies, was given responsibility for maintaining the department's supply of fixed and consumable assets. The first step in implementing the new system was to identify the supplies needed, standardize them and determine how often deliveries would be made. The JIT implementation team developed a request for proposal (RFP) that incorporated the standardized list of supplies. Three radiology supply vendors were invited to respond to the RFP. The team later determined that only one vendor was capable of implementing the JIT program. A three-year contract was awarded to that vendor. As that three-year contract reached completion, DHMC offered the JIT program to its eight affiliate hospitals and four outpatient clinics. The team decided to re-bid the contract for the entire network, which collectively performed 700,000 radiology exams annually. The new RFP encompassed 90 percent of the network's consumable supplies and offered customized delivery for each facility. The team identified eight criteria necessary for the evaluation of each vendor response to the RFP, rather than use price as the only consideration. The company that won the three-year contract furnished 90 percent of the radiology supplies for the DHMC network, allowing even further savings by the network, particularly for the smaller facilities and clinics. The program is continually monitored, adjusted and enhanced in order to incorporate changing departmental needs.

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

PubMed

Talanow, Roland

2009-12-01

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

Utilization management in radiology, part 1: rationale, history, and current status.

PubMed

Duszak, Richard; Berlin, Jonathan W

2012-10-01

Previous growth in the utilization of medical imaging has led to numerous efforts to reduce associated spending. Although these have historically been directed toward unit cost reductions, recent interest has emerged by various stakeholders in curbing inappropriate utilization. Radiology benefits managers have widespread market penetration and have been promoted largely by the payer community as effective mechanisms to curb increases in imaging volume. The provider community has tended to favor real-time order entry decision support systems. These have demonstrated comparable effectiveness to radiology benefits managers in early projects but currently have only limited market penetration. In this first of a two-part series, the rationale for the development of utilization management programs will be discussed and their history and current status reviewed. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Coracoclavicular stabilization using a suture button device for Neer type IIB lateral clavicle fractures.

PubMed

Cho, Chul-Hyun; Jung, Jae-Hoon; Kim, Beom-Soo

2017-05-01

The purpose of this study was to evaluate the radiologic and clinical outcomes of coracoclavicular (CC) stabilization using a suture button device for Neer type IIB lateral clavicle fractures. Eighteen consecutive patients with Neer type IIB fractures were treated with CC stabilization using a TightRope device (Arthrex, Naples, FL, USA). The mean follow-up period was 46.6 months (range, 24-75 months). Radiologic outcomes were assessed using serial plain radiographs. Clinical outcomes were evaluated using the visual analog scale pain score; University of California, Los Angeles score; American Shoulder and Elbow Surgeons score; and subjective shoulder value. Intraoperative and postoperative complications were also evaluated. Of the 18 cases, 17 (94.4%) showed complete bony union. The mean final visual analog scale pain score was 1.1; University of California, Los Angeles score, 31.3; American Shoulder and Elbow Surgeons score, 88.6; and subjective shoulder value, 88.5%. Four complications were observed: (1) intraoperative coracoid process fracture, (2) nonunion, (3) delayed union, and (4) shoulder stiffness. The case with a coracoid process fracture during coracoid tunnel generation was converted to the K-wire tension band technique. CC stabilization using a suture button device for Neer type IIB lateral clavicle fractures yielded satisfactory radiologic and clinical outcomes. The major advantage of this technique is that implant removal is not required. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Source detection at 100 meter standoff with a time-encoded imaging system

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

Brennan, J.; Brubaker, E.; Gerling, M.

Here, we present the design, characterization, and testing of a laboratory prototype radiological search and localization system. The system, based on time-encoded imaging, uses the attenuation signature of neutrons in time, induced by the geometrical layout and motion of the system. We have demonstrated the ability to detect a ~1 mCi 252 Cf radiological source at 100 m standoff with 90% detection efficiency and 10% false positives against background in 12 min. As a result, this same detection efficiency is met at 15 s for a 40 m standoff, and 1.2 s for a 20 m standoff.

Source detection at 100 meter standoff with a time-encoded imaging system

DOE PAGES

Brennan, J.; Brubaker, E.; Gerling, M.; ...

2017-09-28

Here, we present the design, characterization, and testing of a laboratory prototype radiological search and localization system. The system, based on time-encoded imaging, uses the attenuation signature of neutrons in time, induced by the geometrical layout and motion of the system. We have demonstrated the ability to detect a ~1 mCi 252 Cf radiological source at 100 m standoff with 90% detection efficiency and 10% false positives against background in 12 min. As a result, this same detection efficiency is met at 15 s for a 40 m standoff, and 1.2 s for a 20 m standoff.

Two-year follow-up evaluation of surgical treatment for thoracolumbar fracture-dislocation.

PubMed

Hao, Dingjun; Wang, Wentao; Duan, Kun; Ma, Minjie; Jiang, Yong; Liu, Tuanjiang; He, Baorong

2014-10-01

A randomized, controlled clinical trial. This randomized controlled clinical trial was aimed at comparing the clinical outcomes of combined posteroanterior (P-A) fusion and transforaminal thoracic interbody fusion (TTIF) in cases of thoracolumbar fracture-dislocation. The optimal treatment strategy for thoracolumbar fracture-dislocation remains controversial. Sixty-one patients presenting with acute fracture-dislocation of the thoracolumbar joint between March 2010 and December 2011 were enrolled and randomly assigned to the P-A or TTIF group. The radiological outcome was assessed by acquiring radiographs in the standing position and computed tomographic scans. The clinical outcome was measured in terms of the American Spinal Injury Association score, visual analogue scale score, and Oswestry Disability Index. Moreover, we assessed the severity of overall morbidity and morbidity at the donor site in the 2 patient groups. The Student t and χ tests were used for the analysis of independent variables and categorical data, respectively. Only 57 of the enrolled patients were available for the required 24-month follow-up period, 27 underwent TTIF and 30 underwent P-A fusion. Both treatments were similar with respect to the fusion rate, extent of decompression, loss of correction, rate of instrumentation failure, American Spinal Injury Association score, visual analogue scale score, and Oswestry Disability Index (P > 0.05). However, the blood loss, operating time, and rate of perioperative complications were greater in the P-A group than in the TTIF group (P < 0.05). The clinical and radiological outcomes were similar for both the treatment procedures. However, our findings suggest that TTIF allows for safe interbody fusion and circumferential decompression, requires only a posterior approach, and is associated with a lower incidence of surgery-related complications. 2.

A public health perspective on the U.S. response to the Fukushima radiological emergency.

PubMed

Whitcomb, Robert C; Ansari, Armin J; Buzzell, Jennifer J; McCurley, M Carol; Miller, Charles W; Smith, James M; Evans, D Lynn

2015-03-01

On 11 March 2011, northern Japan was struck by first a magnitude 9.0 earthquake off the eastern coast and then by an ensuing tsunami. At the Fukushima Dai-ichi Nuclear Power Plant (NPP), these twin disasters initiated a cascade of events that led to radionuclide releases. Radioactive material from Japan was subsequently transported to locations around the globe, including the U.S. The levels of radioactive material that arrived in the U.S. were never large enough to cause health effects, but the presence of this material in the environment was enough to require a response from the public health community. Events during the response illustrated some U.S. preparedness challenges that previously had been anticipated and others that were newly identified. Some of these challenges include the following: (1) Capacity, including radiation health experts, for monitoring potentially exposed people for radioactive contamination are limited and may not be adequate at the time of a large-scale radiological incident; (2) there is no public health authority to detain people contaminated with radioactive materials; (3) public health and medical capacities for response to radiation emergencies are limited; (4) public health communications regarding radiation emergencies can be improved to enhance public health response; (5) national and international exposure standards for radiation measurements (and units) and protective action guides lack uniformity; (6) access to radiation emergency monitoring data can be limited; and (7) the Strategic National Stockpile may not be currently prepared to meet the public health need for KI in the case of a surge in demand from a large-scale radiation emergency. Members of the public health community can draw on this experience to improve public health preparedness.

Undergraduate radiology education in private and public teaching hospitals in Karachi, Pakistan: teaching duties, methodologies, and rewards

PubMed Central

Nadeem, Naila; Khawaja, Ranish Deedar Ali; Beg, Madiha; Naeem, Muhammad; Majid, Zain

2013-01-01

Background In an integrated method of education, medical students are introduced to radiology in their preclinical years. However, no study has been conducted in Pakistan to demonstrate an academic framework of medical radiology education at an undergraduate level. Therefore, we aimed to document and compare the current level of teaching duties, teaching methodologies, and teaching rewards among radiologists and residents in private and public teaching hospitals in Karachi, Pakistan. Methods A survey was conducted among 121 radiologists and residents in two private and two public teaching hospitals in Karachi, Pakistan. Radiologists who were nationally registered with the Pakistan Medical and Dental Council either part-time or full-time were included. Radiology residents and fellows who were nationally registered with the Pakistan Medical and Dental Council were also included. Self-administered questionnaires addressing teaching duties, methods, and rewards were collected from 95 participants. Results The overall response rate was 78.51% (95/121). All of the radiologists were involved in teaching residents and medical students, but only 36% reported formal training in teaching skills. Although most of the respondents (76%) agreed that medical students appeared enthusiastic about learning radiology, the time spent on teaching medical students was less than five hours per week annually (82%). Only 37% of the respondents preferred dedicated clerkships over distributed clerkships (41%). The most common preferred teaching methodology overall was one-on-one interaction. Tutorials, teaching rounds, and problem-based learning sessions were less favored by radiologists than by residents. Teaching via radiology films (86%) was the most frequent mode of instruction. Salary (59%) was the most commonly cited teaching reward. The majority of respondents (88%) were not satisfied with their current level of teaching rewards. Conclusion All radiologists and residents working in an academic radiology department are involved in teaching undergraduate students at multiple levels. The most valued teaching methodology involves use of images, with one-on-one interaction between the trainer and trainee. The monetary reward for teaching is inbuilt into the salary. The methodology adopted for teaching purposes was significantly different between respondents from private hospitals and those from public teaching hospitals. Because of low satisfaction among the respondents, efforts should be made to provide satisfying teaching rewards. PMID:23745098

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…

Cloud rise model for radiological dispersal devices events

NASA Astrophysics Data System (ADS)

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

2012-07-01

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

Information on radiation hazard and on radiological protection in medical school in Italy.

PubMed

Biagini, C

1993-04-01

The state of teaching Radiation Protection in Medical School in Italy was considered. An historical approach was utilized, in order to define periods of time characterized by different conditions. Some data are collected by a concise enquiry on the information given during the course of Radiology in the second triennal cycle, and on some other teaching courses including information on radiation effects. The conclusion is that teaching times are exceedingly reduced, and the need of improving the diffusion of knowledge in the field is stressed. An official Act of the OECD and of European Community is expected, with the aim of emphasizing the importance of the information of doctors on Radiation protection as a problem of public interest. A proposal is advanced of implementing the Teaching of Radiobiology in the second triennal cycle, changing the name of the course in "Radiobiology and Radiological Protection".

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

PubMed

Swan, J Shannon; Miksad, Rebecca A

2009-08-01

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

Effects of instructional strategies using cross sections on the recognition of anatomical structures in correlated CT and MR images.

PubMed

Khalil, Mohammed K; Paas, Fred; Johnson, Tristan E; Su, Yung K; Payer, Andrew F

2008-01-01

This research is an effort to best utilize the interactive anatomical images for instructional purposes based on cognitive load theory. Three studies explored the differential effects of three computer-based instructional strategies that use anatomical cross-sections to enhance the interpretation of radiological images. These strategies include: (1) cross-sectional images of the head that can be superimposed on radiological images, (2) transparent highlighting of anatomical structures in radiological images, and (3) cross-sectional images of the head with radiological images presented side-by-side. Data collected included: (1) time spent on instruction and on solving test questions, (2) mental effort during instruction and test, and (3) students' performance to identify anatomical structures in radiological images. Participants were 28 freshmen medical students (15 males and 13 females) and 208 biology students (190 females and 18 males). All studies used posttest-only control group design, and the collected data were analyzed by either t test or ANOVA. In self-directed computer-based environments, the strategies that used cross sections to improve students' ability to recognize anatomic structures in radiological images showed no significant positive effects. However, when increasing the complexity of the instructional materials, cross-sectional images imposed a higher cognitive load, as indicated by higher investment of mental effort. There is not enough evidence to claim that the simultaneous combination of cross sections and radiological images has no effect on the identification of anatomical structures in radiological images for novices. Further research that control for students' learning and cognitive style is needed to reach an informative conclusion.

Thirteenth Annual Warren K. Sinclair Keynote Address: Where Are the Radiation Professionals (WARP)?

PubMed

Toohey, Richard E

2017-02-01

In July 2013, the National Council on Radiation Protection and Measurements convened a workshop for representatives from government, professional organizations, academia, and the private sector to discuss a potential shortage of radiation protection professionals in the not-too-distant future. This shortage manifests itself in declining membership of professional societies, decreasing enrollment in university programs in the radiological sciences, and perhaps most importantly, the imminent retirement of the largest birth cohort in American history, the so-called "baby boomer" generation. Consensus emerged that shortages already are, or soon will be, felt in government agencies (including state radiation control programs); membership in professional societies is declining precipitously; and student enrollments and university support for radiological disciplines are decreasing with no reversals expected. The supply of medical physicists appears to be adequate at least in the near term, although a shortage of available slots in accredited clinical training programs looms large. In general, the private sector appears stable, due in part to retirees joining the consultant ranks. However, it is clear that a severe problem exists with the lack of an adequate surge capacity to respond to a large-scale reactor accident or radiological terrorism attack in the United States. The workshop produced a number of recommendations, including increased funding of both fellowships and research in the radiological sciences, as well as creation of internships, practicums, and post-doctoral positions. A federal joint program support office that would more efficiently manage the careers of radiological professionals in the civil service would enhance recruiting and development, and increase the flexibility of the various agencies to manage their staffing needs.

Health literacy in vascular and interventional radiology: a comparative analysis of online patient education resources.

PubMed

Hansberry, David R; Kraus, Carl; Agarwal, Nitin; Baker, Stephen R; Gonzales, Sharon F

2014-08-01

The Internet is frequently accessed by patients as a resource for medical knowledge. However, the provided material is typically written at a level well above the recommended 7th grade level. A clear understanding of the capabilities, limitations, risks, and benefits of interventional radiology by patients, both current and prospective, is hindered when the textual information offered to the public is pitched at a level of sophistication too high for general comprehension. In January 2013, all 25 patient education resources from the Cardiovascular and Interventional Radiology Society of Europe (CIRSE) Web site ( http://www.cirse.org ) and all 31 resources from the Society of Interventional Radiology (SIR) Web site ( http://www.sirweb.org ) were analyzed for their specific level of readability using ten quantitative scales: Flesch Reading Ease, Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Gunning fog index, New Fog Count, Coleman-Liau index, FORCAST formula, Fry graph, Raygor Readability Estimate, and New Dale-Chall. Collectively, the patient education resources on the CIRSE Web site are written at the 12.3 grade level, while the resources on the SIR Web site are written at the 14.5 grade level. Educational health care materials available on both the CIRSE and the SIR Web sites are presented in language in the aggregate that could be too difficult for many lay people to fully understand. Given the complex nature of vascular and interventional radiology, it may be advantageous to rewrite these educational resources at a lower reading level to increase comprehension.

Development of Report Turnaround Times in a University Department of Radiology during Implementation of a Reformed Curriculum for Undergraduate Medical Education.

PubMed

Albrecht, Liane; Maurer, Martin H; Seithe, Tim; Braun, Joachim; Gummert, Richard; Auer, Jonas; Sponheuer, Keno; Meyl, Tobias Philipp; Hamm, Bernd; de Bucourt, Maximilian

2018-03-01

 The implementation of a reformed curriculum for undergraduate medical education with a problem-oriented focus and more bedside teaching in small groups increases the academic teaching workload. The aim of this study was to investigate whether this increase in teaching duties is associated with an increase in report turnaround times of radiologists or increased unplanned absence during term times compared with term breaks (lecture-free periods) and over the whole period under investigation.  The database of all radiological examinations performed at a large German university hospital was retrospectively analyzed for a two-year period from the winter term 2011/12 to the summer term 2013. A total of 192 984 radiological examinations performed during this period were included in an analysis of reporting times (i. e., time from end of examination to completion of report) during term times versus term breaks. Reporting times were analyzed for all radiological examinations and for intensive care unit (ICU) patients. In addition, radiologists' schedules were analyzed in terms of teaching duties, unplanned absence, vacation days, and days away from work for education and training.  During the period under investigation, the teaching load increased from overall 1.75 hours/day in the winter term 2011/12 to 6.49 hours/day in the summer term 2013 and in the term break from overall 0.10 hours/day in the winter term 2011/12 to 0.71 hours/day in the summer term 2013. Reporting time increased during this period (p < 0.05) but remained shorter during term times than during term breaks. The difference between term and term break for ICU patients was not significant. There was no increase in unplanned absences during term times.  Overall, radiologists' reporting times increased during the period when the reformed curriculum for undergraduate medical education was implemented. As this was observed both during term and during term breaks, increased teaching duties alone cannot serve as a sole causal explanation. · Digital high-quantitative parameters can be used to evaluate workflow in radiology.. · Reporting time can be a criterion for efficient staffing.. · The acquisition and evaluation of parameters such as reporting times could lead to a more efficient resource allocation by providing hints of changed framework conditions and changing working intensities and/or capicity reserves - which may not be immediately apparent.. · During the period under investigation with the implementation of a teaching-intensive reformed curriculum for undergraduate medical education there was an increase in reporting time, which was not significant in intense care units.. · Since during the period under investigation the increase in reporting times can be stated both during term time and in the lecture free period, the implementation of the reformed curriculum for undergraduate medical education alone cannot serve as a sole causal explanation.. · Albrecht L, Maurer MH, Seithe T et al. Development of the Report Turnaround Times in a University Department of Radiology during Implementation of a Reformed Curriculum for Undergraduate Medical Education. Fortschr Röntgenstr 2018; 190: 259 - 264. © Georg Thieme Verlag KG Stuttgart · New York.

Centers for Disease Control and Prevention (CDC) Radiation Hazard Scale Data Product Review Feedback Report

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

Askin, A.; Buddemeier, B.; Alai, M.

In support of the Department of Energy (DOE) National nuclear Security Administration (NNSA) and the Centers for Disease Control and Prevention (CDC), Lawrence Livermore National Laboratory (LLNL) assisted in the development of new data templates for disseminating and communicating FRMAC1 data products using the CDC Radiation Hazard Scale communication tool. To ensure these data products will be useful to stakeholders during a radiological emergency, LLNL facilitated opportunities for product socialization and review.

Visualization of conserved structures by fusing highly variable datasets.

PubMed

Silverstein, Jonathan C; Chhadia, Ankur; Dech, Fred

2002-01-01

Skill, effort, and time are required to identify and visualize anatomic structures in three-dimensions from radiological data. Fundamentally, automating these processes requires a technique that uses symbolic information not in the dynamic range of the voxel data. We were developing such a technique based on mutual information for automatic multi-modality image fusion (MIAMI Fuse, University of Michigan). This system previously demonstrated facility at fusing one voxel dataset with integrated symbolic structure information to a CT dataset (different scale and resolution) from the same person. The next step of development of our technique was aimed at accommodating the variability of anatomy from patient to patient by using warping to fuse our standard dataset to arbitrary patient CT datasets. A standard symbolic information dataset was created from the full color Visible Human Female by segmenting the liver parenchyma, portal veins, and hepatic veins and overwriting each set of voxels with a fixed color. Two arbitrarily selected patient CT scans of the abdomen were used for reference datasets. We used the warping functions in MIAMI Fuse to align the standard structure data to each patient scan. The key to successful fusion was the focused use of multiple warping control points that place themselves around the structure of interest automatically. The user assigns only a few initial control points to align the scans. Fusion 1 and 2 transformed the atlas with 27 points around the liver to CT1 and CT2 respectively. Fusion 3 transformed the atlas with 45 control points around the liver to CT1 and Fusion 4 transformed the atlas with 5 control points around the portal vein. The CT dataset is augmented with the transformed standard structure dataset, such that the warped structure masks are visualized in combination with the original patient dataset. This combined volume visualization is then rendered interactively in stereo on the ImmersaDesk in an immersive Virtual Reality (VR) environment. The accuracy of the fusions was determined qualitatively by comparing the transformed atlas overlaid on the appropriate CT. It was examined for where the transformed structure atlas was incorrectly overlaid (false positive) and where it was incorrectly not overlaid (false negative). According to this method, fusions 1 and 2 were correct roughly 50-75% of the time, while fusions 3 and 4 were correct roughly 75-100%. The CT dataset augmented with transformed dataset was viewed arbitrarily in user-centered perspective stereo taking advantage of features such as scaling, windowing and volumetric region of interest selection. This process of auto-coloring conserved structures in variable datasets is a step toward the goal of a broader, standardized automatic structure visualization method for radiological data. If successful it would permit identification, visualization or deletion of structures in radiological data by semi-automatically applying canonical structure information to the radiological data (not just processing and visualization of the data's intrinsic dynamic range). More sophisticated selection of control points and patterns of warping may allow for more accurate transforms, and thus advances in visualization, simulation, education, diagnostics, and treatment planning.

Teaching physics to radiology residents.

PubMed

Hendee, William R

2009-04-01

The complexity of diagnostic imaging has expanded dramatically over the past two decades. Over the same period, the time and effort devoted to teaching physics (the science and technology of the discipline) have diminished. This paradox compromises the ability of future radiologists to master imaging technologies so that they are used in an efficient, safe, and cost-effective manner. This article addresses these issues. Efforts involving many professional organizations are under way to resolve the paradox of the expanding complexity of medical imaging contrasted with the declining emphasis on physics in radiology residency programs. These efforts should help to reestablish physics education as a core value in radiology residency programs.

Radiologic Errors in Patients With Lung Cancer

PubMed Central

Forrest, John V.; Friedman, Paul J.

1981-01-01

Some 20 percent to 50 percent of detectable malignant lesions are missed or misdiagnosed at the time of their first radiologic appearance. These errors can result in delayed diagnosis and treatment, which may affect a patient's survival. Use of moderately high (130 to 150) kilovolt peak films, awareness of portions of the lung where lesions are often missed (such as lung apices and paramediastinal and hilar areas), careful comparison of current roentgenograms with those taken previously and the use of an independent second observer can help to minimize the rate of radiologic diagnostic errors in patients with lung cancer. ImagesFigure 3.Figure 4. PMID:7257363

Computer-assisted virtual autopsy using surgical navigation techniques.

PubMed

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

2015-01-01

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

Patients' experience of outsourcing and care related to magnetic resonance examinations.

PubMed

Tavakol Olofsson, Parvin; Aspelin, Peter; Bergstrand, Lott; Blomqvist, Lennart

2014-11-01

Outsourcing radiological examinations from public university hospitals affects the patient, who has to attend a different clinic or hospital for the radiological examination. We currently have a limited understanding of how patients view outsourcing and their care related to MR examinations. To examine the experiences of patients who are sent to private radiology units when their referrals for MR examinations are outsourced from a university hospital, as well as to explore factors which influence patient satisfaction regarding the quality of care related to the MR examination. A group of patients (n = 160) referred for MR examinations and either examined at a university hospital or at an external private unit were interviewed. The interview was designed as a verbal questionnaire. Data were analyzed using Student's t test, analysis of variance (ANOVA), and Pearson's correlation. Sixty-nine percent of the patients could neither choose nor influence the location at which they were examined. For those who could, aspects that influenced the patient's choice of radiology department were: short waiting time 79% (127/160), ease of traveling to the radiology department 68% (110/160), and short distance to their home or work 58% (93/160). For 40% (60/160) of the patients, a short time in the waiting room was related to a positive experience of the MR examination. If patients were informed about outsourcing and could also choose where to have their examination, key factors contributing to patient satisfaction could be met even when MR examinations are outsourced.

Architecture of next-generation information management systems for digital radiology enterprises

NASA Astrophysics Data System (ADS)

Wong, Stephen T. C.; Wang, Huili; Shen, Weimin; Schmidt, Joachim; Chen, George; Dolan, Tom

2000-05-01

Few information systems today offer a clear and flexible means to define and manage the automated part of radiology processes. None of them provide a coherent and scalable architecture that can easily cope with heterogeneity and inevitable local adaptation of applications. Most importantly, they often lack a model that can integrate clinical and administrative information to aid better decisions in managing resources, optimizing operations, and improving productivity. Digital radiology enterprises require cost-effective solutions to deliver information to the right person in the right place and at the right time. We propose a new architecture of image information management systems for digital radiology enterprises. Such a system is based on the emerging technologies in workflow management, distributed object computing, and Java and Web techniques, as well as Philips' domain knowledge in radiology operations. Our design adapts the approach of '4+1' architectural view. In this new architecture, PACS and RIS will become one while the user interaction can be automated by customized workflow process. Clinical service applications are implemented as active components. They can be reasonably substituted by applications of local adaptations and can be multiplied for fault tolerance and load balancing. Furthermore, it will provide powerful query and statistical functions for managing resources and improving productivity in real time. This work will lead to a new direction of image information management in the next millennium. We will illustrate the innovative design with implemented examples of a working prototype.

FORENSIC RADIOLOGY AND IMAGING FOR VETERINARY RADIOLOGISTS.

PubMed

Watson, Elizabeth; Heng, Hock Gan

2017-05-01

Imaging studies are often of evidentiary value in medicolegal investigations involving animals and the role of the veterinary radiologist is to interpret those images for courts as an expert or opinion witness. With progressing interest in prosecuting animal crimes and strengthening of penalties for crimes against animals, the participation of veterinary radiologists in medicolegal investigations is expected to increase. Veterinary radiologists who are aware of radiographic and imaging signs that result in animal suffering, abuse, or neglect; knowledgeable in ways radiology and imaging may support cause of death determinations; conversant in postmortem imaging; comfortable discussing mechanisms and timing of blunt or sharp force and projectile trauma in imaging; and prepared to identify mimics of abuse can assist court participants in understanding imaging evidence. The goal of this commentary review is to familiarize veterinary radiologists with the forensic radiology and imaging literature and with the advantages and disadvantages of various imaging modalities utilized in forensic investigations. Another goal is to provide background information for future research studies in veterinary forensic radiology and imaging. © 2017 American College of Veterinary Radiology.

[No exchange of information without technology : modern infrastructure in radiology].

PubMed

Hupperts, H; Hermann, K-G A

2014-01-01

Modern radiology cannot accomplish the daily numbers of examinations without supportive technology. Even though technology seems to be becoming increasingly more indispensable, business continuity should be ensured at any time and if necessary even with a limited technical infrastructure by business continuity management. An efficient information security management system forms the basis. The early radiology information systems were islands of information processing. A modern radiology department must be able to be modularly integrated into an informational network of a bigger organization. The secondary use of stored data for clinical decision-making support poses new challenges for the integrity of the data or systems because medical knowledge is displayed and provided in a context of treatment. In terms of imaging the creation and distribution radiology services work in a fully digital manner which is often different for radiology reports. Legally secure electronic diagnostic reports require a complex technical infrastructure; therefore, diagnostic findings still need to be filed as a paper document. The internal exchange and an improved dose management can be simplified by systems which continuously and automatically record the doses and thus provide the possibility of permanent analysis and reporting. Communication between patient and radiologist will gain ongoing importance. Intelligent use of technology will convey this to the radiologist and it will facilitate the understanding of the information by the patient.

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

PubMed

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

2011-06-01

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

Interventional Radiology of Male Varicocele: Current Status

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

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

2012-12-15

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

Status of SRNL radiological field lysimeter experiment-Year 1

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

Kaplan, D.; Roberts, K.; Bagwell, L.

The Savannah River National Laboratory (SRNL) Radiological Field Lysimeter Experiment is a one-of-a-kind field facility designed to study radionuclide geochemical processes at a larger spatial scale (from grams to tens of kilograms sediment) and temporal scale (from months to 10 years) than is readily afforded through laboratory studies. The lysimeter facility is intended to capture the natural heterogeneity of moisture and temperature regimes in the vadose zone, the unsaturated subsurface region between the surface soil and the underlying aquifer. The 48 lysimeter columns, which contain various radionuclides (and stable iodine), were opened to rainfall infiltration on July 5, 2012. Themore » objective of this report is to provide a status of the lysimeter facility operations and to compile data collected during FY13, including leachate volume, rainfall, and soil moisture and temperature in situ probe data. Radiological leachate data are not presented in this document but will be the subject of a separate document.1 Leachate samples were collected quarterly and shipped to Clemson University for radiological analyses. Rainfall, leachate volume, moisture and temperature probe data were collected continuously. During operations of the facility this year, there were four safety or technical concerns that required additional maintenance: 1) radioactivity was detected in one of the overflow bottles (captured water collected from the secondary containment that does not come in contact with the radiological source material); 2) rainwater accumulated within the sample-bottle storage sheds; 3) overflow containers collected more liquid than anticipated; and 4) significant spider infestation occurred in the sample-bottle storage sheds. To address the first three concerns, each of the lysimeter columns was re-plumbed to improve and to minimize the number of joint unions. To address the fourth concern regarding spiders, new sample-bottle water sheds were purchased and a pest control program was established. During this retrofit, the lysimeters were temporarily capped (covered to preclude additional water from entering lysimeter columns) for about two months (except the four Tc-cementitious containing lysimeters, which remain capped). At a later date, data summarized in this report will be combined with the leachate radionuclide concentration data that are presently being analyzed. Together, these data can be numerically modeled to provide bench-marking information, to test hypotheses regarding hydrogeochemical conceptual models, and to estimate effective transport parameters under field conditions.« less

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.

Proving Value in Radiology: Experience Developing and Implementing a Shareable Open Source Registry Platform Driven by Radiology Workflow.

PubMed

Gichoya, Judy Wawira; Kohli, Marc D; Haste, Paul; Abigail, Elizabeth Mills; Johnson, Matthew S

2017-10-01

Numerous initiatives are in place to support value based care in radiology including decision support using appropriateness criteria, quality metrics like radiation dose monitoring, and efforts to improve the quality of the radiology report for consumption by referring providers. These initiatives are largely data driven. Organizations can choose to purchase proprietary registry systems, pay for software as a service solution, or deploy/build their own registry systems. Traditionally, registries are created for a single purpose like radiation dosage or specific disease tracking like diabetes registry. This results in a fragmented view of the patient, and increases overhead to maintain such single purpose registry system by requiring an alternative data entry workflow and additional infrastructure to host and maintain multiple registries for different clinical needs. This complexity is magnified in the health care enterprise whereby radiology systems usually are run parallel to other clinical systems due to the different clinical workflow for radiologists. In the new era of value based care where data needs are increasing with demand for a shorter turnaround time to provide data that can be used for information and decision making, there is a critical gap to develop registries that are more adapt to the radiology workflow with minimal overhead on resources for maintenance and setup. We share our experience of developing and implementing an open source registry system for quality improvement and research in our academic institution that is driven by our radiology workflow.

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

Mobile devices and their prospective future role in emergency radiology.

PubMed

O'Connell, Timothy W; Patlas, Michael N

2016-01-01

Mobile devices, wireless networks and software have significantly evolved since the late 1990s and are now available with sufficient computing power, speed and complexity to allow real-time interpretation of radiology studies. Emergency radiology (ER)'s time-sensitive nature would seem to be an excellent match for study interpretation using mobile devices, allowing the radiologist to read studies anywhere, at any time. While suitable for use by the radiologist outside of the hospital, or clinicians and surgeons at the bedside or in the operating room, these devices do have limitations, and regulatory approval for in-hospital diagnostic use is limited. In the ER setting, we suggest that the best use of mobile devices is to be available to consult directly with patients about their imaging findings and to the clinical team during rounds and at handover. This will bring the radiologist to the clinician and patient, helping us to better understand the patient's presentation, educate both the physician and patient and increase the visibility and value of the radiologist as a member of the clinical care team.

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.

Prognostic factors to succeed in surgical treatment of chronic acromioclavicular dislocations.

PubMed

Barth, J; Duparc, F; Baverel, L; Bahurel, J; Toussaint, B; Bertiaux, S; Clavert, P; Gastaud, O; Brassart, N; Beaudouin, E; De Mourgues, P; Berne, D; Duport, M; Najihi, N; Boyer, P; Faivre, B; Meyer, A; Nourissat, G; Poulain, S; Bruchou, F; Ménard, J F

2015-12-01

Treatment of chronic acromioclavicular joint dislocation (ACJD) remains a poorly known and controversial subject. Given the many surgical options, it is not always easy to determine which steps are indispensable. This article reports a multicenter prospective study. The clinical and radiological follow-up involved a comparative analysis of the preoperative and postoperative data at 1 year, including pain (visual analogue scale), subjective functional incapacity (QuickDASH), and the objective Constant score, as well as a comparative analysis of vertical and horizontal movements measured on simple x-rays. Based on a series of 140 operated ACJDs, we included 24 chronic ACJDs. The mean time to surgery was 46 weeks (range, 1 month to 4 years). The patients' mean age was 41 years, with a majority of males (75%), 72% of whom participated in recreational sports. Professionally, 40% of the subjects had jobs involving manual labor. We noted 40% grade III, 24% grade IV, and 36% grade V injury according to the Rockwood classification. In 92% of cases, coracoclavicular stabilization was provided by a double button implant, reinforced with a biological graft in 88% of the cases. In 29%, millimeters to centimeters of the distal clavicle were resected and acromioclavicular stabilization was associated in 54%. We observed complications in 33% of the cases. At 1 year postoperative, 21 patients underwent clinical and radiological follow-up (87.5%). Only 35% of the patients were satisfied or very satisfied, whereas 100% of them would recommend the operation. Full-time work was resumed in 91% of the cases and all sports could be resumed in 86%. The pre- and postoperative values at 1 year changed as follows: the mean Constant score improved from 61 to 87 (p=0.00002); the subjective QuickDASH score decreased from 41 to 9 (p=0.00002); and radiologically significant reduction of the initial displacement was observed in the vertical plane (p<10(-3)) and the horizontal plane (p=0.022). In this study, the favorable prognostic factors found were: time to surgery less than 3 months (p=0.02), associated acromioclavicular stabilization, and postoperative immobilization with a sling extended to 6 weeks. However, resection of the distal clavicle did not influence the final result. Level II prospective non-randomized comparative study. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Hands-on Physics Education of Residents in Diagnostic Radiology.

PubMed

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

2017-06-01

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

iPad: Semantic annotation and markup of radiological images.

PubMed

Rubin, Daniel L; Rodriguez, Cesar; Shah, Priyanka; Beaulieu, Chris

2008-11-06

Radiological images contain a wealth of information,such as anatomy and pathology, which is often not explicit and computationally accessible. Information schemes are being developed to describe the semantic content of images, but such schemes can be unwieldy to operationalize because there are few tools to enable users to capture structured information easily as part of the routine research workflow. We have created iPad, an open source tool enabling researchers and clinicians to create semantic annotations on radiological images. iPad hides the complexity of the underlying image annotation information model from users, permitting them to describe images and image regions using a graphical interface that maps their descriptions to structured ontologies semi-automatically. Image annotations are saved in a variety of formats,enabling interoperability among medical records systems, image archives in hospitals, and the Semantic Web. Tools such as iPad can help reduce the burden of collecting structured information from images, and it could ultimately enable researchers and physicians to exploit images on a very large scale and glean the biological and physiological significance of image content.

Breast diseases in children: the spectrum of radiologic findings in a cohort study

PubMed Central

Durmaz, Emel; Öztek, Murat Alp; Habibi, Hatice Arıöz; Kesimal, Uğur; Sindel, Hakkı Timur

2017-01-01

PURPOSE We aimed to investigate the spectrum of radiologic findings and referral reasons for breast diseases in children considering age-appropriate presentation. METHODS Our retrospective cohort study included 348 consecutive pediatric patients aged <19 years (median, 13 years) referred to radiology with a clinical presentation between 2005 and 2016. Radiologic findings were reviewed in four age ranges (0–2 years, 2–8 years, 8–15 years, >15 years). RESULTS Of 348 patients, 257 had a referral reason. The most frequent referral reason was a palpable mass (35%). Developmental abnormalities accounted for 48% of all radiologic findings in 348 patients. We did not detect any breast malignancy. According to age groups, the most common radiologic findings were neonatal hypertrophy (0–2 years), early breast development (2–8 years), developmental abnormalities by a majority of gynecomastia (8–15 years), and normal findings or developmental abnormalities (>15 years). Interestingly, the frequency of gynecomastia was only 4% in neonatal period or early childhood. Fibroadenomas and fibroadenoma-like solid masses were seen after 8 years and constituted the majority of solid masses (65%). Cysts were seen at a rate of 7% and majority of them were of simple type, which tends to resolve in time. CONCLUSION In our study, the most common referral reason to radiology was a palpable breast mass. Neonatal hypertrophy and early breast development in younger children, and developmental abnormalities in older children may be kept in mind as the most common radiologic findings. Our study confirms the substantial absence of malignancies in children as well as a widely different disease spectrum in comparison with the adult population. PMID:29033391

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

PubMed

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

2017-03-01

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

Radiology Jobs: Uncovering Hidden and Not-So-Hidden Opportunities From the ACR Jobs Board.

PubMed

Misono, Alexander S; Saini, Sanjay; Prabhakar, Anand M

2016-04-01

The radiology job market remains daunting. Trainees choosing fellowships benefit from understanding employers' likely future needs. Radiology practices may similarly refine recruiting practices. This study quantitatively analyzes the current radiology job landscape. Job postings on the ACR Career Center online portal between June 2014 and June 2015 were reviewed. As entries are frequently added and removed, posts were manually collected weekly. Postings were recorded in a database and included date, practice, location, specialty/subspecialty, job type, years of experience, salary, and job description. The database was analyzed to characterize employer needs, salary, partnership track availability, and job availability by geography. A total of 1,778 jobs were posted during the study period. Of these, 1,529 (86.0%) were diagnostic; 240 (13.5%) were interventional; and 9 (0.5%) were administrative. Most jobs were in private practice (75.7%), compared with academic (16.3%) and other (7.9%). Although many did not require a specific specialty (46%), the most-frequent needs were breast (17%), neuroradiology (11%), musculoskeletal (8%), and body (7%). Of non-breast-imaging jobs, roughly 30% indicated an interest in breast-imaging skills. A minority (13%) requested prior experience of greater than 1 year, with some seeking 7-10 years of experience. Although most (87%) were full-time positions, part-time, temporary, and contractor roles were described in the remaining 13%. Salary data were rarely reported (7%), with a range of $98,967-$1,000,000. The most jobs were based in California (11%); New York (7%); Pennsylvania (7%); and Illinois (6%). However, when indexed per million population, the highest job rates were in Nevada (14.1); Washington DC (13.7); Hawaii (13.4); Montana (9.8); and Pennsylvania (9.1). Roughly 31% of postings described partnership tracks, with the highest rates in New England (58%), the Pacific Northwest (56%), the Midwest (40%), and Southern (40%) regions; the lowest were in the Mountain (26%), Mid-Atlantic (25%), and Southwest (21%) regions. Most radiology jobs remain in private practice general radiology. Breast, neuroradiology, and musculoskeletal radiology were most frequently desired among areas of subspecialty training. Advertised partnership tracks were less common and varied widely geographically. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Method and system for real-time analysis of biosensor data

DOEpatents

Greenbaum, Elias; Rodriguez, Jr., Miguel

2014-08-19

A method of biosensor-based detection of toxins includes the steps of providing a fluid to be analyzed having a plurality of photosynthetic organisms therein, wherein chemical, biological or radiological agents alter a nominal photosynthetic activity of the photosynthetic organisms. At a first time a measured photosynthetic activity curve is obtained from the photosynthetic organisms. The measured curve is automatically compared to a reference photosynthetic activity curve to determine differences therebetween. The presence of the chemical, biological or radiological agents, or precursors thereof, are then identified if present in the fluid using the differences.

Establishment of a public docket for medical device/radiological health policy statements and operating procedure guides--FDA. Notice.

PubMed

1993-07-27

The Food and Drug Administration (FDA) is announcing that it is establishing a public docket for policy speeches, policy statements, and standard operating procedure guides pertaining to product evaluation and regulatory enforcement for its medical device and radiological health programs. The docket will operate on a 1-year trial basis and will serve both as a repository for critical policy documents generated by the Center for Devices and Radiological Health (CDRH) and as a public display mechanism for access by representatives of the industry and other interested persons. This action is one element of an overall communications initiative to ensure uniform and timely access to important information.

Comparison of the WOMAC (Western Ontario and McMaster Universities) osteoarthritis index and a self-report format of the self-administered Lequesne-Algofunctional index in patients with knee and hip osteoarthritis.

PubMed

Stucki, G; Sangha, O; Stucki, S; Michel, B A; Tyndall, A; Dick, W; Theiler, R

1998-03-01

To compare the metric properties and validity of German versions of the WOMAC (Western Ontario and McMaster Universities) and a self-administered questionnaire-format of the Lequesne-Algofunctional-Index in patients with osteoarthritis (OA) of the lower extremities. Cross-sectional analysis of the instruments' internal consistency (Cronbach's coefficient alpha) and construct validity (correlation with radiological OA-severity and limitation in range-of-motion) in ambulatory patients and patients before hip arthroplasty. Test-retest reliability was assessed on a subsample after 10 days. Data from 51 patients out of 91 contacted could be analyzed. Twenty-nine patients had knee and 22 patients had hip OA. Both the WOMAC and Lequesne OA-indices and their scales or sections had a satisfactory test-retest reliability (Intraclass correlation coefficient 0.43-0.96). All scales of the WOMAC were internally consistent (Cronbach's coefficient alpha 0.81-0.96) and associated with radiological OA-severity and joint range of motion. However, only the function but not the symptom sections (Cronbach's coefficient alpha knee: 0.55; hip: 0.63) of the self-administered Lequesne OA index were internally consistent for both, patients with knee and hip OA. Also, the symptom components were not or only weakly associated with radiological OA-severity and joint range of motion. Although our results are based on a German version using a self-report format we may caution using the self-administered Lequesne OA index without prior testing of its metric properties and validity.

Bridging the gap between basic and clinical sciences: A description of a radiological anatomy course.

PubMed

Torres, Anna; Staśkiewicz, Grzegorz J; Lisiecka, Justyna; Pietrzyk, Łukasz; Czekajlo, Michael; Arancibia, Carlos U; Maciejewski, Ryszard; Torres, Kamil

2016-05-06

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 requires the practitioner to not only hone certain technical skills, but to command an excellent knowledge of sectional anatomy and an understanding of the pathophysiology of the examined areas as well. Yet throughout many medical curricula there is often a large gap between traditional anatomy coursework and clinical training in imaging techniques. The authors present a radiological anatomy course developed to teach sectional anatomy with particular emphasis on ultrasonography and computed tomography, while incorporating elements of medical simulation. To assess students' overall opinions about the course and to examine its impact on their self-perceived improvement in their knowledge of radiological anatomy, anonymous evaluation questionnaires were provided to the students. The questionnaires were prepared using standard survey methods. A five-point Likert scale was applied to evaluate agreement with statements regarding the learning experience. The majority of students considered the course very useful and beneficial in terms of improving three-dimensional and cross-sectional knowledge of anatomy, as well as for developing practical skills in ultrasonography and computed tomography. The authors found that a small-group, hands-on teaching model in radiological anatomy was perceived as useful both by the students and the clinical teachers involved in their clinical education. In addition, the model was introduced using relatively few resources and only two faculty members. Anat Sci Educ 9: 295-303. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

Radiology Online Patient Education Materials Provided by Major University Hospitals: Do They Conform to NIH and AMA Guidelines?

PubMed

Prabhu, Arpan V; Donovan, Ashley L; Crihalmeanu, Tudor; Hansberry, David R; Agarwal, Nitin; Beriwal, Sushil; Kale, Hrishikesh; Heller, Matthew

The internet creates opportunities for Americans to access medical information about imaging tests and modalities to guide them in their medical decision-making. Owing to health literacy variations in the general population, the American Medical Association and National Institutes of Health recommend patient education resources to be written between the third and seventh grade levels. Our purpose is to quantitatively assess the readability levels of online radiology educational materials, written for the public, in 20 major university hospitals. In September and October 2016, we identified 20 major university hospitals with radiology residency-affiliated hospital systems. On each hospital׳s website, we downloaded all radiology-related articles written for patient use. A total of 375 articles were analyzed for readability level using 9 quantitative readability scales that are well validated in the medical literature. The 375 articles from 20 hospital systems were collectively written at an 11.4 ± 3.0 grade level (range: 8.4-17.1). Only 11 (2.9%) articles were written at the recommended third to seventh grade levels. Overall, 126 (33.6%) were written above a full high-school reading level. University of Washington Medical Center׳s articles were the most readable with a reading level corresponding to 7.9 ± 0.9. The vast majority of websites at major academic hospitals with radiology residencies designed to provide patients with information about imaging were written above the nationally recommended health literacy guidelines to meet the needs of the average American. This may limit the benefit that patients can derive from these educational materials. Copyright © 2018 Elsevier Inc. All rights reserved.

Cultural adaptation and validation of a German version of the Arthritis Impact Measurement Scales (AIMS2).

PubMed

Rosemann, T; Szecsenyi, J

2007-10-01

To validate a translated and culturally adapted version of the Arthritis Impact Measurement Scale (AIMS) 2 in primary care patients with osteoarthritis (OA) of the hip and knee. The AIMS2 was translated into German and culturally adapted. The questionnaire then was administered to 220 primary care patients with OA of the knee or hip. Two hundred and nine questionnaires were returned and analysed. Test-retest reliability was tested in 50 randomly selected patients, of those 42 completed the questionnaire after 2 weeks for a second time. Item-scale correlations were reasonably good as well as the discriminative power of separate scales. The assessment of internal consistency reliability also revealed satisfactory values; Cronbach's alpha was 0.77 or higher for all scales. The test-retest reliability, estimated in an intraclass correlation coefficient (ICC), exceeded 0.90, except the "social activities" scale (0.87). Since only patients with OA of the lower limb were enrolled, substantial floor effects occurred in the "arm function" (28.2%) and the "hand and finger function" scale (29.2%). The principal factor analysis confirmed the postulated three-factor structure with a physical, physiological and social dimension, explaining 48.5%, 13.9% and 6.8% of the variation, respectively. External validity was assessed by calculating correlations to the Western Ontario and MacMaster (WOMAC) osteoarthritis questionnaire a pain visual analogue scale (VAS) and the Kellgren score as well as to disease duration. Spearman's "R" achieved satisfactory values for the corresponding WOMAC scales and the pain-VAS. Correlations with disease duration as well as with the radiological grading were low. The GERMAN-AIMS2 is a reliable and valid instrument to assess the quality of life (QoL) in primary care patients suffering from OA.

Patients’ experience of outsourcing and care related to magnetic resonance examinations

PubMed Central

Aspelin, Peter; Bergstrand, Lott; Blomqvist, Lennart

2014-01-01

Background Outsourcing radiological examinations from public university hospitals affects the patient, who has to attend a different clinic or hospital for the radiological examination. We currently have a limited understanding of how patients view outsourcing and their care related to MR examinations. Aim Aim. To examine the experiences of patients who are sent to private radiology units when their referrals for MR examinations are outsourced from a university hospital, as well as to explore factors which influence patient satisfaction regarding the quality of care related to the MR examination. Methods A group of patients (n = 160) referred for MR examinations and either examined at a university hospital or at an external private unit were interviewed. The interview was designed as a verbal questionnaire. Data were analyzed using Student’s t test, analysis of variance (ANOVA), and Pearson’s correlation. Results Sixty-nine percent of the patients could neither choose nor influence the location at which they were examined. For those who could, aspects that influenced the patient’s choice of radiology department were: short waiting time 79% (127/160), ease of traveling to the radiology department 68% (110/160), and short distance to their home or work 58% (93/160). For 40% (60/160) of the patients, a short time in the waiting room was related to a positive experience of the MR examination. Conclusion Conclusion. If patients were informed about outsourcing and could also choose where to have their examination, key factors contributing to patient satisfaction could be met even when MR examinations are outsourced. PMID:25142133

Evolution of the clinical review station for enterprise-wide multimedia radiology reporting

NASA Astrophysics Data System (ADS)

Hanlon, William B.; Valtchinov, Vladimir I.; Davis, Scott D.; Lester, James; Khorasani, Ramin; Carrino, John A.; Benfield, Andrew

2000-05-01

Efforts to develop Picture Archiving and Communications Systems (PACS) for the last ten years have concentrated mainly on developing systems for primary interpretation of digital radiological images. Much less attention has been paid to the clinical aspects of the radiology process. Clinical radiology services are an important component of the overall care delivery process, providing information and consultation services to referring physicians, the customers of radiology, in a timely fashion to aid in care decisions. Information management systems (IMS) are playing an increasingly central role in the care delivery process. No suitable commercial PACS or IMS products were available that could effectively provide for the requirements of the clinicians. We endeavored to fill this void at our institution by developing a system to deliver images and text reports electronically on-demand to the referring physicians. This system has evolved substantially since initial deployment eight years ago. As new technologies become available they are evaluated and integrated as appropriate to improve system performance and manageability. Not surprisingly, the internet and World Wide Web (WWW) technology has had the greatest impact on system design in recent years. Additional features have been added over time to provide services for teleradiology, teaching, and research needs. We also discovered that these value-added services give us a competitive edge in attracting new business to our department. Commercial web-based products are now becoming available which do a satisfactory job of providing many of these clinical services. These products are evaluated for integration into our system as they mature. The result is a system that impacts positively on patient care.

Radiological assessment. A textbook on environmental dose analysis

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

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

1983-09-01

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

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.

[Diagnostic radiology in the technological era. Comparison between two models].

PubMed

Andrade-Barreto, O A; Villa-Caballero, Leonel

2005-01-01

Diagnostic Radiology is a medical specialty that has played a dynamic role in the medical arena during the last three decades of the XX century. As a part of the evolution of this specialty, medicine and society at large have received diverse benefits in areas of diagnosis and for the decision making process in the clinical practice. Modern radiology has provided numerous advances and refined tools that give more convenience speed and precise diagnosis in the current medical practice. At the present time, these technologies are part of the standard of care in the US and other industrialized countries, representing the ultimate desire or goal to reach for other healthcare systems in developing countries as well. Unfortunately, many of the clinical skills in the health care personal have not evolved at the same pace of those modern technologies, conditioning a reduction in the performance of sensitive areas to the patient's interest, such as the caring, compassion and quality of health care. It is unquestionable the value and benefits that technologies such as CAT and MRI scans have brought to the standard practice in the recent time. Nonetheless, it is desirable to maintain the highest possible level of clinical skills despite the extended use of modern technologies by the health personnel, without compromising the quality of care. Yet is pending the future role and rational use for those technologies in radiology, especially in times when delivering good, reliable health care have become a priority for many health institutions worldwide. This approach would be the ultimate goal to reach in times and circumstances where health for all is the highest precious value to obtain at global level.

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.

Women in the radiology profession: data from a 1995 national survey.

PubMed

Deitch, C H; Sunshine, J H; Chan, W C; Shaffer, K A

1998-02-01

This report provides an in-depth picture of similarities and differences in the professional and practice characteristics of women and men who are radiologists in the United States, with specific attention to whether gender differences are less pronounced among younger radiologists. Data were taken from a national stratified random sample survey of radiologists. The response rate was 75%. The 1731 men and 294 women responding included diagnostic radiologists, radiation oncologists, and radiology-related nuclear medicine specialists. Seven percent of respondents who completed their radiology residency before 1970 were women, compared with 9% in 1970-1979, 19% in 1980-1989, and 27% in 1990-1995. Gender differences were smaller among posttraining radiologists younger than 40 years old than among those 40 years old or older for the following questions: when the respondent decided to specialize in radiology, whether the respondent is a subspecialist within diagnostic radiology, whether the respondent's practice is primarily academic, whether the practice is privately owned, and whether the respondent is a practice owner (partner, shareholder). Women who were residents and fellows more frequently indicated problems with unwanted sexual attention occurring in the past 2 years than did women who were not in training positions. However, posttraining women were more likely to have encountered discrimination in salary, hiring, or promotion at some time in their careers. Women's professional roles in radiology are changing slowly. A narrowing gender gap among younger radiologists on some professional and practice characteristics may indicate a further diminishing of gender differences in radiology in the future. It may also reflect greater gender equality at earlier rather than later stages of one's career.

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.

Adult spinal deformity treated with minimally invasive surgery. Description of surgical technique, radiological results and literature review.

PubMed

Domínguez, I; Luque, R; Noriega, M; Rey, J; Alía, J; Urda, A; Marco, F

The prevalence of adult spinal deformity has been increasing exponentially over time. Surgery has been credited with good radiological and clinical results. The incidence of complications is high. MIS techniques provide good results with fewer complications. This is a retrospective study of 25 patients with an adult spinal deformity treated by MIS surgery, with a minimum follow-up of 6 months. Radiological improvement was SVA from 5 to 2cm, coronal Cobb angle from 31° to 6°, and lumbar lordosis from 18° to 38°. All of these parameters remained stable over time. We also present the complications that appeared in 4 patients (16%). Only one patient needed reoperation. We describe the technique used and review the references on the subject. We conclude that the MIS technique for treating adult spinal deformity has comparable results to those of the conventional techniques but with fewer complications. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Audience response techniques for 21st century radiology education.

PubMed

Richardson, Michael L

2014-07-01

Audience response system (ARS) provides an excellent tool for improving interactive learning in radiology residents. However, it is not the technology but the pedagogy that matters the most. It is long past time to upgrade our ARS teaching techniques to match our ARS technology. In this article, several problems with current usage of ARS are discussed and several prescriptions for improving this are presented. Simplifying the ease of use of ARS will get this useful technology into more hands. Using ARS in a bidirectional manner will give us an even better idea of how and what our students are learning. Asking questions on the fly will obviate the usual tedium of multiple-choice questions and allow us to quiz our students in a much more natural manner. It is time to move on to more innovative ARS techniques that are well adapted to radiology and its different styles of learning. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Learning, technology and intellectual property: a survey of the philosophies and preferences of our trainees and peers.

PubMed

Bedoya, Maria A; Back, Susan J; Scanlon, Mary H; Delgado, Jorge; Darge, Kassa; Reid, Janet R

2016-12-01

Increasing workloads threaten the quality of teaching in academic radiology practices. There is a wealth of unfiltered educational resources for radiology on the internet. As a digital native, today's radiology trainee may have differing opinions from teachers about learning and intellectual property. To identify the preferences and philosophies regarding learning, technology and intellectual property toward the future development of an innovative radiology curriculum. An electronic survey with 22 questions was sent to 2,010 members of the Society for Pediatric Radiology and 100 radiology trainees. Three hundred sixty-one of the 2,110 surveys were returned. All questions were completed in 342 surveys. Fifty-three respondents were trainees (residents and fellows) and 289 respondents were radiologists (teachers). Time needed for a single learning activity in both groups is <30 min, but teachers spend less time (P=0.007). The preferred learning environments were point-of-care and outside work hours for both groups. Ideal lecture durations were 31-45 min for trainees and 21-30 min for teachers (P=0.001). Adoption of new technology showed late majority and laggard trends for both groups (P=0.296). Interest in gadgets was greater in trainees (17%) than teachers (2%) (P<0.001). Interest in lecture recording was greater in trainees (84%) than teachers (61%) (P=0.008). More trainees (61%) than teachers (42%) would not charge money for educational materials (P=0.028); 27% versus 13%, respectively, disagreed with dissemination of those materials beyond the institution (P=0.013). While millennial trainees are adult learners with a stronger comfort with technology, learning styles of trainees and teachers are more similar than was previously believed. Trainees and teachers hold conflicting philosophies about intellectual property. Results herein speak favorably for revising our teaching portfolio to include practical learning materials of short duration available at point-of-care.

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.

Long-term MRI findings in neuromyelitis optica: seropositive versus seronegative patients.

PubMed

Kıyat-Atamer, A; Ekizoğlu, E; Tüzün, E; Kürtüncü, M; Shugaiv, E; Akman-Demir, G; Eraksoy, M

2013-05-01

Neuromyelitis optica (NMO) is a severe demyelinating inflammatory disorder associated with serum antibodies against aquaporin 4 (AQP4-Ab). A significant number of patients with NMO remain seronegative over time. Long-term observational magnetic resonance imaging (MRI) studies of the CNS in patients with NMO are rare or of limited duration. The objective of this study is to determine long-term MRI characteristics of seropositive and seronegative patients, and assess possible overlap with multiple sclerosis (MS). Clinical and radiological characteristics of 28 patients with NMO at onset and of 17 patients after an average follow-up time of 9 years were recorded. Fifty percent of patients were seropositive for AQP4-Ab. Onset and final brain/spinal MRI scans were retrospectively analysed and compared. Significantly more patients in the seronegative group had brain lesions at onset. Spinal lesions of seropositive patients were longer and showed increased cord swelling at onset MRI scans. After the follow-up time the differences between both groups disappeared. Patients in the seropositive group tended to develop brain lesions over time. No patient fulfilled Barkhof's or McDonald's radiological criteria for MS at onset or over time. Brain MRI features show differences between seropositive and seronegative patients at time of onset in NMO, but differences between groups vanish over time. None of the AQP4-negative patients fulfill radiological MS criteria on a long-term basis, suggesting that seronegative NMO constitutes an independent entity. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

Impact of an in-house emergency radiologist on report turnaround time.

PubMed

Lamb, Leslie; Kashani, Paria; Ryan, John; Hebert, Guy; Sheikh, Adnan; Thornhill, Rebecca; Fasih, Najla

2015-01-01

One of the many challenges facing emergency departments (EDs) across North America is timely access to emergency radiology services. Academic institutions, which are typically also regional referral centres, frequently require cross-sectional studies to be performed 24 hours a day with expedited final reports to accelerate patient care and ED flow. The purpose of this study was to determine if the presence of an in-house radiologist, in addition to a radiology resident dedicated to the ED, had a significant impact on report turnaround time. Preliminary and final report turnaround times, provided by the radiology resident and staff, respectively, for patients undergoing computed tomography or ultrasonography of their abdomen/pelvis in 2008 (before the implementation of emergency radiology in-house staff service) were compared to those performed during the same time frame in 2009 and 2010 (after staffing protocols were changed). A total of 1,624 reports were reviewed. Overall, there was no statistically significant decrease in the preliminary report turnaround times between 2008 and 2009 (p = 0.1102), 2009 and 2010 (p = 0.6232), or 2008 and 2010 (p = 0.0890), although times consistently decreased from a median of 2.40 hours to 2.08 hours to 2.05 hours (2008 to 2009 to 2010). There was a statistically significant decrease in final report turnaround times between 2008 and 2009 (p < 0.0001), 2009 and 2010 (p < 0.0011), and 2008 and 2010 (p < 0.0001). Median final report times decreased from 5.00 hours to 3.08 hours to 2.75 hours in 2008, 2009, and 2010, respectively. There was also a significant decrease in the time interval between preliminary and final reports between 2008 and 2009 (p < 0.0001) and 2008 and 2010 (p < 0.0001) but no significant change between 2009 and 2010 (p = 0.4144). Our results indicate that the presence of a dedicated ED radiologist significantly reduces final report turnaround time and thus may positively impact the time to ED patient disposition. Patient care is improved when attending radiologists are immediately available to read complex films, both in terms of health care outcomes and regarding the need for repeat testing. Providing emergency physicians with accurate imaging findings as rapidly as possible facilitates effective and timely management and thus optimizes patient care.

Anterior-only stabilization using cage versus plating with bone autograft for the treatment of type II/IIA Hangman's fracture combined with intervertebral disc injury.

PubMed

Wei, Fuxin; Pan, Ximin; Zhou, Zhiyu; Cui, Shangbin; Zhong, Rui; Wang, Le; Gao, Manman; Chen, Ningning; Liang, Zijian; Zou, Xuenong; Huang, Sheng; Liu, Shaoyu

2015-03-11

Anterior C2/3 discectomy and interbody fusion (ACDF) with plating is increasingly performed as the primary treatment of unstable Hangman's fracture; however, plate-related complications, such as screw back-out, plate fracture and soft-tissue injury, is not uncommon. Polyetheretherketone (PEEK) cage has now been developed to provide initial stability before fusion; however, whether and how ACDF with PEEK cage offer better clinical results compared with ACDF with plating in management of Hangman's fracture remains unknown. This study compares the efficacy of ACDF with plating to that of ACDF with PEEK cage in management of type II/IIA Hangman's fractures (according to Levine and Edwards classification) retrospectively. From February 2006 to March 2012, a total of 21 patients with type II/IIA Hangman's fractures combined with intervertebral disc injury underwent ACDF with PEEK cage, and 28 patients underwent ACDF with plating. Perioperative parameters were compared. The average follow-up period was 50.3 months (range 27-76 months). The clinical outcome (visual analog scale (VAS), American Spinal Injury Association (ASIA) scale, and clinical post-traumatic neck score (PTNC)) and radiological outcome (translation of C2, local kyphotic angle (LKA), and fusion status of C2/3) was compared retrospectively. The operative time and blood loss were significantly less in the ACDF with cage group compared with that in the ACDF with plating group (P < 0.05). All patients showed neurological recovery and achieved solid fusion. There were no significant differences in the clinical and radiological outcomes at final follow-up between groups, except in the LKA and the correction loss rate of LKA which were higher in the ACDF with plating group (P < 0.05). Donor-site pain occurred in two patients (10.1%) within 6 months after operation in the ACDF with plating group and none in the ACDF with cage group. All patients recovered without any adverse effects. ACDF with PEEK cage is effective and reliable in management of type II/IIA Hangman's fractures and is more cost-effective due to shorter operative time and less blood loss requirements.

Identifying and classifying hyperostosis frontalis interna via computerized tomography.

PubMed

May, Hila; Peled, Nathan; Dar, Gali; Hay, Ori; Abbas, Janan; Masharawi, Youssef; Hershkovitz, Israel

2010-12-01

The aim of this study was to recognize the radiological characteristics of hyperostosis frontalis interna (HFI) and to establish a valid and reliable method for its identification and classification. A reliability test was carried out on 27 individuals who had undergone a head computerized tomography (CT) scan. Intra-observer reliability was obtained by examining the images three times, by the same researcher, with a 2-week interval between each sample ranking. The inter-observer test was performed by three independent researchers. A validity test was carried out using two methods for identifying and classifying HFI: 46 cadaver skullcaps were ranked twice via computerized tomography scans and then by direct observation. Reliability and validity were calculated using Kappa test (SPSS 15.0). Reliability tests of ranking HFI via CT scans demonstrated good results (K > 0.7). As for validity, a very good consensus was obtained between the CT and direct observation, when moderate and advanced types of HFI were present (K = 0.82). The suggested classification method for HFI, using CT, demonstrated a sensitivity of 84%, specificity of 90.5%, and positive predictive value of 91.3%. In conclusion, volume rendering is a reliable and valid tool for identifying HFI. The suggested three-scale classification is most suitable for radiological diagnosis of the phenomena. Considering the increasing awareness of HFI as an early indicator of a developing malady, this study may assist radiologists in identifying and classifying the phenomena.

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

PubMed

Moulder, John E

2014-08-01

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

Diaphyseal forearm fractures, 20 years after surgical treatment. Is there still an indication for percutaneous fixation?

PubMed

Fernández-Marín, M R; Hidalgo-Pérez, M; Arias-Rodríguez, G; García-Mendoza, A; Prada-Chamorro, E; Domecq-Fernández de Bobadilla, G

This is a retrospective study of 98 diaphyseal forearm fractures in adults, treated by a percutaneous technique with intramedullar Kirchner wires. We reviewed 64 patients with 98 forearm fractures with a radiographic follow-up, assessing the presence of pseudarthrosis or delayed bone union and evaluating functional outcomes with the Anderson and the Disability of the Arm, Shoulder and Hand scale. Clinical and radiological bone union was achieved in an average of 12 weeks. We obtained 77% of excellent and good results following Anderson's scale. There were 4 cases of pseudarthrosis and 6 cases of delayed bone union. This surgical technique provides several advantages, such as a low incidence of complications and a total absence of infections, refractures and iatrogenic neurovascular injuries. It allows a lower hospital stay and a shortening of the surgery time compared with other techniques such as plates and intramedullary nails, that have similar results, in terms of bone union and functional outcomes, as we have verified from the published literature. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Modeling And Simulation Of Multimedia Communication Networks

NASA Astrophysics Data System (ADS)

Vallee, Richard; Orozco-Barbosa, Luis; Georganas, Nicolas D.

1989-05-01

In this paper, we present a simulation study of a browsing system involving radiological image servers. The proposed IEEE 802.6 DQDB MAN standard is designated as the computer network to transfer radiological images from file servers to medical workstations, and to simultaneously support real time voice communications. Storage and transmission of original raster scanned images and images compressed according to pyramid data structures are considered. Different types of browsing as well as various image sizes and bit rates in the DQDB MAN are also compared. The elapsed time, measured from the time an image request is issued until the image is displayed on the monitor, is the parameter considered to evaluate the system performance. Simulation results show that image browsing can be supported by the DQDB MAN.

A radiological chronicle of the presentation and management of a long gap oesophageal atresia.

PubMed

Charlesworth, Paul; Mahomed, Anies

2009-01-01

Long gap oesophageal atresia is a clinically and technically challenging condition to manage. Documentation of the gap between the upper and lower pouches is critical to deciding the timing and feasibility of a primary anastamosis. Integral to this process is the role of radiology. We present a case of long gap oesophageal atresia accompanied by chronological radiography demonstrating its' staged management and highlighting some common complications.

How competitive is the match for radiology residency? Present view and historical perspective.

PubMed

Chen, Jim Y; Heller, Matthew T

2014-05-01

Interest in radiology as a career among US medical students has changed. The aim of this study was to investigate the recent and historical trends in residency applications and how they have affected competitiveness in obtaining a position. Statistics published by the National Resident Matching Program in "Results and Data: Main Residency Match" for 1991 to 2013 were analyzed. The number of radiology residency positions has trended upward over the past 23 years; however, the number of applicants from US medical schools has been widely variable. The number of applicants peaked in 2009 but has since decreased every year. The number of positions per US senior applicant (PPUSA) is a judge of specialty competitiveness on a supply-and-demand basis. A lower PPUSA indicates a more competitive specialty. Radiology saw its most competitive year in 2001, with only 0.91 PPUSA. PPUSA has been on the rise every year since 2009. From 2009 to 2013, the number of residency positions increased by 56, but there were 241 fewer US senior medical students preferring radiology. In 2013, there were 1,143 residency positions available for only 845 US senior medical students who preferred the specialty. The PPUSA was 1.35, making 2013 the least competitive year in obtaining a radiology residency position since 1998. Over the past 23 years, 5.5% of all US senior medical students have applied to radiology for residency. Interest reached an all-time high in 2009, at almost 7%. In 2013, only 4.8% of all US seniors preferred radiology, the lowest since 1999. The historical (1991-2013), current (2011-2013), and most recent (2013) PPUSAs for radiology were 1.19, 1.29, and 1.35, respectively. For comparison, the current PPUSAs for the following specialties were: 0.74 for plastic surgery, 0.83 for orthopedic surgery, 0.95 for dermatology, 1.10 for general surgery, 1.24 for obstetrics and gynecology, 1.31 for anesthesiology, 1.42 for pediatrics, and 1.80 for internal medicine (1.80). Although radiology residency positions have continued to increase, interest among US seniors has dropped every year since 2009. The 2013 match was the least competitive since 1998. Over the past 3 years, the competitiveness of matching radiology on a supply-and-demand basis has been close to that of obstetrics and gynecology and anesthesiology. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

An automatic multi-atlas prostate segmentation in MRI using a multiscale representation and a label fusion strategy

NASA Astrophysics Data System (ADS)

Álvarez, Charlens; Martínez, Fabio; Romero, Eduardo

2015-01-01

The pelvic magnetic Resonance images (MRI) are used in Prostate cancer radiotherapy (RT), a process which is part of the radiation planning. Modern protocols require a manual delineation, a tedious and variable activity that may take about 20 minutes per patient, even for trained experts. That considerable time is an important work ow burden in most radiological services. Automatic or semi-automatic methods might improve the efficiency by decreasing the measure times while conserving the required accuracy. This work presents a fully automatic atlas- based segmentation strategy that selects the more similar templates for a new MRI using a robust multi-scale SURF analysis. Then a new segmentation is achieved by a linear combination of the selected templates, which are previously non-rigidly registered towards the new image. The proposed method shows reliable segmentations, obtaining an average DICE Coefficient of 79%, when comparing with the expert manual segmentation, under a leave-one-out scheme with the training database.

Target diagnostics for commissioning the AWE HELEN Laser Facility 100 TW chirped pulse amplification beam

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

Eagleton, R. T.; Clark, E. L.; Davies, H. M.

2006-10-15

The capability of the HELEN laser at the Atomic Weapons Establishment Aldermaston has been enhanced by the addition of a short-pulse laser beam to augment the twin opposing nanosecond time scale beams. The short-pulse beam utilizes the chirped pulse amplification (CPA) technique and is capable of delivering up to 60 J on target in a 500 fs pulse, around 100 TW, at the fundamental laser wavelength of 1.054 {mu}m. During the commissioning phase a number of diagnostic systems have been fielded, these include: x-ray pinhole imaging of the laser heated spot, charged particle time of flight, thermoluminescent dosimeter array, calibratedmore » radiochromic film, and CR39 nuclear track detector. These diagnostic systems have been used to verify the performance of the CPA beam to achieve a focused intensity of around 10{sup 19} W cm{sup -2} and to underwrite the facility radiological safety system.« less

RENEB - Running the European Network of biological dosimetry and physical retrospective dosimetry.

PubMed

Kulka, Ulrike; Abend, Michael; Ainsbury, Elizabeth; Badie, Christophe; Barquinero, Joan Francesc; Barrios, Lleonard; Beinke, Christina; Bortolin, Emanuela; Cucu, Alexandra; De Amicis, Andrea; Domínguez, Inmaculada; Fattibene, Paola; Frøvig, Anne Marie; Gregoire, Eric; Guogyte, Kamile; Hadjidekova, Valeria; Jaworska, Alicja; Kriehuber, Ralf; Lindholm, Carita; Lloyd, David; Lumniczky, Katalin; Lyng, Fiona; Meschini, Roberta; Mörtl, Simone; Della Monaca, Sara; Monteiro Gil, Octávia; Montoro, Alegria; Moquet, Jayne; Moreno, Mercedes; Oestreicher, Ursula; Palitti, Fabrizio; Pantelias, Gabriel; Patrono, Clarice; Piqueret-Stephan, Laure; Port, Matthias; Prieto, María Jesus; Quintens, Roel; Ricoul, Michelle; Romm, Horst; Roy, Laurence; Sáfrány, Géza; Sabatier, Laure; Sebastià, Natividad; Sommer, Sylwester; Terzoudi, Georgia; Testa, Antonella; Thierens, Hubert; Turai, Istvan; Trompier, François; Valente, Marco; Vaz, Pedro; Voisin, Philippe; Vral, Anne; Woda, Clemens; Zafiropoulos, Demetre; Wojcik, Andrzej

2017-01-01

A European network was initiated in 2012 by 23 partners from 16 European countries with the aim to significantly increase individualized dose reconstruction in case of large-scale radiological emergency scenarios. The network was built on three complementary pillars: (1) an operational basis with seven biological and physical dosimetric assays in ready-to-use mode, (2) a basis for education, training and quality assurance, and (3) a basis for further network development regarding new techniques and members. Techniques for individual dose estimation based on biological samples and/or inert personalized devices as mobile phones or smart phones were optimized to support rapid categorization of many potential victims according to the received dose to the blood or personal devices. Communication and cross-border collaboration were also standardized. To assure long-term sustainability of the network, cooperation with national and international emergency preparedness organizations was initiated and links to radiation protection and research platforms have been developed. A legal framework, based on a Memorandum of Understanding, was established and signed by 27 organizations by the end of 2015. RENEB is a European Network of biological and physical-retrospective dosimetry, with the capacity and capability to perform large-scale rapid individualized dose estimation. Specialized to handle large numbers of samples, RENEB is able to contribute to radiological emergency preparedness and wider large-scale research projects.

Deep Learning in Radiology.

PubMed

McBee, Morgan P; Awan, Omer A; Colucci, Andrew T; Ghobadi, Comeron W; Kadom, Nadja; Kansagra, Akash P; Tridandapani, Srini; Auffermann, William F

2018-03-29

As radiology is inherently a data-driven specialty, it is especially conducive to utilizing data processing techniques. One such technique, deep learning (DL), has become a remarkably powerful tool for image processing in recent years. In this work, the Association of University Radiologists Radiology Research Alliance Task Force on Deep Learning provides an overview of DL for the radiologist. This article aims to present an overview of DL in a manner that is understandable to radiologists; to examine past, present, and future applications; as well as to evaluate how radiologists may benefit from this remarkable new tool. We describe several areas within radiology in which DL techniques are having the most significant impact: lesion or disease detection, classification, quantification, and segmentation. The legal and ethical hurdles to implementation are also discussed. By taking advantage of this powerful tool, radiologists can become increasingly more accurate in their interpretations with fewer errors and spend more time to focus on patient care. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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.

Doctor-patient communication in radiology: a great opportunity for future radiology.

PubMed

Bazzocchi, M

2012-04-01

This text discusses several aspects of doctor-patient communication in radiology, including the origins, advantages, and ethical and legal aspects. Over the last 10 years, radiologists have assumed increasing responsibilities towards patients and society. Patients, who are becoming better informed and more aware about medical issues, have a right to be given a timely diagnosis and want to receive as much information as possible from the radiologist. This has implications for several levels of everyday radiological practice, including the organisation of work, legal and ethical aspects and radiologist training. Better interaction with the patient helps to build a closer, more trusting, relationship with the result that the radiologist will be more motivated in his or her work. Until now, radiologists were not adequately trained to communicate the diagnosis directly and verbally to patients, especially when the diagnosis was unfavourable. It is important to emphasise the need for more specific and practical training in this respect, which is indispensable for future developments of the discipline.

Hand-held digital books in radiology: convenient access to information.

PubMed

D'Alessandro, M P; Galvin, J R; Santer, D M; Erkonen, W E

1995-02-01

Radiologists need constant, convenient access to current information throughout the course of their daily work. Today most learning in radiology is obtained from the printed word in books, journals, and teaching files, supplemented by the spoken word in lectures and conferences. Although learning from printed material and lectures has been proved efficacious over time, these media share the disadvantage of not being conveniently available for reference during the course of daily work at the alternator or in the examination room when accurate and up-to-date information is needed the most. As a result, many important questions about patient care go unanswered. We have developed a technique--hand-held digital books--to lower this barrier to searching and retrieval. When radiologists have a digital library that can be carried with them, they will be able to incorporate current radiology information into their daily decision making. We describe a technique for creating hand-held digital books and their future use in radiology.

IRQN award paper: Operational rounds: a practical administrative process to improve safety and clinical services in radiology.

PubMed

Donnelly, Lane F; Dickerson, Julie M; Lehkamp, Todd W; Gessner, Kevin E; Moskovitz, Jay; Hutchinson, Sally

2008-11-01

As part of a patient safety program in the authors' department of radiology, operational rounds have been instituted. This process consists of radiology leaders' visiting imaging divisions at the site of imaging and discussing frontline employees' concerns about patient safety, the quality of care, and patient and family satisfaction. Operational rounds are executed at a time to optimize the number of attendees. Minutes that describe the issues identified, persons responsible for improvement, and updated improvement plan status are available to employees online. Via this process, multiple patient safety and other issues have been identified and remedied. The authors believe that the process has improved patient safety, the quality of care, and the efficiency of operations. Since the inception of the safety program, the mean number of days between serious safety events involving radiology has doubled. The authors review the background around such walk rounds, describe their particular program, and give multiple illustrative examples of issues identified and improvement plans put in place.

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.

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.

Forensic veterinary radiology: ballistic-radiological 3D computertomographic reconstruction of an illegal lynx shooting in Switzerland.

PubMed

Thali, Michael J; Kneubuehl, Beat P; Bolliger, Stephan A; Christe, Andreas; Koenigsdorfer, Urs; Ozdoba, Christoph; Spielvogel, Elke; Dirnhofer, Richard

2007-08-24

The lynx, which was reintroduced to Switzerland after being exterminated at the beginning of the 20th century, is protected by Swiss law. However, poaching occurs from time to time, which makes criminal investigations necessary. In the presented case, an illegally shot lynx was examined by conventional plane radiography and three-dimensional multislice computertomography (3D MSCT), of which the latter yielded superior results with respect to documentation and reconstruction of the inflicted gunshot wounds. We believe that 3D MSCT, already described in human forensic-pathological cases, is also a suitable and promising new technique for veterinary pathology.

Measuring and improving productivity in general radiology.

PubMed

Wilt, Michelle A; Miranda, Rafael; Johnson, C Daniel; Love, Peggy Sue

2010-10-01

The aim of this study was to determine a method of measuring productivity among general radiographers in a moderate-sized hospital and to improve and sustain productivity within that work area. The average times needed to perform the 13 most common examinations were measured. Performance of the various examinations was tracked and multiplied by the time allocated per procedure; this measure was divided by the length of the work shift to determine productivity. Productivity measures were shared among the work group, and decisions to improve productivity (eg, whether to fill open positions) were made by group members. Average time spent per examination type was calculated (range, 10 minutes to 1 hour 16 minutes). At baseline (February 2008), group productivity was 50%. Productivity increased during the first year of monitoring and was sustained through November 2009 (productivity range, 57%-63%). Yearly savings from not filling open positions were estimated to be $174,000. Productivity in a general radiology work area can be measured. Consensus among the work group helped increase productivity and assess progress. This methodology, if widely adopted, could be standardized and used to compare productivity across departments and institutions. Copyright © 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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.

Anterior Cervical Corpectomy with free vascularized fibular graft versus multilevel discectomy and grafting for Cervical Spondylotic Myelopathy

PubMed Central

Addosooki, Ahmad I; El-deen, Mohamed Alam

2015-01-01

Purpose A retrospective study to compare the radiologic and clinical outcomes of 2 different anterior approaches, multilevel anterior cervical discectomy with fusion (ACDF) using autologus ticortical bone graft versus anterior cervical corpectomy with fusion (ACCF) using free vascularized fibular graft (FVFG) for the management of cervical spondylotic myelopathy(CSM). Methods A total of 15 patients who underwent ACDF or ACCF using FVFG for multilevel CSM were divided into two groups. Group A (n = 7) underwent ACDF and group B (n = 8) ACCF. Clinical outcomes using Japanese Orthopaedic Association (JOA) score, perioperative parameters including operation time and hospital stay, radiological parameters including fusion rate and cervical lordosis, and complications were compared. Results Both group A and group B demonstrated significant increases in JOA scores. Patients who underwent ACDF experienced significantly shorter operation times and hospital stay. Both groups showed significant increases in postoperative cervical lordosis and achieved the same fusion rate (100 %). No major complications were encountered in both groups. Conclusion Both ACDF and ACCF using FVFG provide satisfactory clinical outcomes and fusion rates for multilevel CSM. However, multilevel ACDF is associated with better radiologic parameters, shorter hospital stay and shorter operative times. PMID:26767152

Improving language models for radiology speech recognition.

PubMed

Paulett, John M; Langlotz, Curtis P

2009-02-01

Speech recognition systems have become increasingly popular as a means to produce radiology reports, for reasons both of efficiency and of cost. However, the suboptimal recognition accuracy of these systems can affect the productivity of the radiologists creating the text reports. We analyzed a database of over two million de-identified radiology reports to determine the strongest determinants of word frequency. Our results showed that body site and imaging modality had a similar influence on the frequency of words and of three-word phrases as did the identity of the speaker. These findings suggest that the accuracy of speech recognition systems could be significantly enhanced by further tailoring their language models to body site and imaging modality, which are readily available at the time of report creation.

Interventional radiology: a half century of innovation.

PubMed

Baum, Richard A; Baum, Stanley

2014-11-01

The evolution of modern interventional radiology began over half century ago with a simple question. Was it possible to use the same diagnostic imaging tools that had revolutionized the practice of medicine to guide the real-time treatment of disease? This disruptive concept led to rapid treatment advances in every organ system of the body. It became clear that by utilizing imaging some patients could undergo targeted procedures, eliminating the need for major surgery, while others could undergo procedures for previously unsolvable problems. The breadth of these changes now encompasses all of medicine and has forever changed the way we think about disease. In this brief review article, major advances in the field, as chronicled in the pages of Radiology, will be described.

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

PubMed

Hess, J A; Mootz, R D

1999-06-01

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

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.

Using Twitter for Teaching and Learning in an Oral and Maxillofacial Radiology Course.

PubMed

Gonzalez, Shawneen M; Gadbury-Amyot, Cynthia C

2016-02-01

The aim of this study was to describe the implementation of one form of social media (Twitter) in an oral radiology course and evaluate dental students' use and perceptions of this technology for teaching and learning. An author-developed questionnaire was used to solicit second-year students' knowledge, use, and perceptions of Twitter for teaching and learning in an oral radiology course at one U.S. dental school. A combination of Likert scales, multiple allowable answers, and an open-ended comment question was employed. The questionnaire was piloted in spring 2010 followed by data collection in spring 2011. Out of 45 students, 40 (88.9%) completed the questionnaire. Of the respondents, 95% reported having not used Twitter prior to their second year of dental school; 55% of them created an account for the course. The top two reasons they gave for creating an account were viewing radiographic examples and staying informed about questions and answers that were posted. The top two reasons they gave for not creating an account were that the content was viewable online without an account and not wanting another online account. The students perceived the Twitter sessions as helpful and reported it improved accessibility to the instructor. The results of this study challenged the assumption that dental students are well versed in all forms of social media, but overall, these students agreed that the use of Twitter had enhanced the learning environment in the radiology course.

The Patient Experience in Radiology: Observations From Over 3,500 Patient Feedback Reports in a Single Institution.

PubMed

Rosenkrantz, Andrew B; Pysarenko, Kristine

2016-11-01

To identify factors associated with the patient experience in radiology based on patient feedback reports from a single institution. In a departmental patient experience committee initiative, all imaging outpatients are provided names and roles of all departmental employees with whom they interact, along with contact information for providing feedback after their appointment. All resulting feedback was recorded in a web-based database. A total of 3,675 patient comments over a 3-year period were assessed in terms of major themes. Roles of employees recognized within the patient comments were also assessed. Patient feedback comments most commonly related to professional staff behavior (74.5%) and wait times (11.9%), and less commonly related to a spectrum of other issues (comfort during the exam, quality of the facilities, access to information regarding the exam, patient privacy, medical records, the radiology report, billing). The most common attributes relating to staff behavior involved patients' perceptions of staff caring, professionalism, pleasantness, helpfulness, and efficiency. Employees most commonly recognized by the comments were the technologist (50.2%) and receptionist (31.6%) and much less often the radiologist (2.2%). No radiologist was in the top 10% of employees in terms of the number of comments received. Patients' comments regarding their experiences in undergoing radiologic imaging were largely influenced by staff behavior and communication (particularly relating to technologists and receptionists), as well as wait times, with radiologists having a far lesser immediate impact. Radiologists are encouraged to engage in activities that promote direct visibility to their patients and thereby combat risks of the perceived "invisible" radiologist. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Establishment of an inferior vena cava filter database and interventional radiology led follow-up - retrieval rates and patients lost to follow-up.

PubMed

Klinken, Sven; Humphries, Charlotte; Ferguson, John

2017-10-01

To evaluate the rates of inferior vena cava (IVC) filter retrieval and the number of patient's lost to follow-up, before and after the establishment of an IVC filter database and interventional radiology (inserting physician) led follow-up. On the 1st of June 2012, an electronic interventional radiology database was established at our Institution. In addition, the interventional radiology team took responsibility for follow-up of IVC filters. Data were prospectively collected from the database for all patients who had an IVC filter inserted between the 1st June 2012 and the 31st May 2014. Data on patients who had an IVC filter inserted between the 1st of June 2009 to the 31st of May 2012 were retrospectively reviewed. Patient demographics, insertion indications, filter types, retrieval status, documented retrieval decisions, time in situ, trackable events and complications were obtained in the pre-database (n = 136) and post-database (n = 118) cohorts. Attempted IVC filter retrieval rates were improved from 52.9% to 72.9% (P = 0.001) following the establishment of the database. The number of patients with no documented decision (lost to follow-up) regarding their IVC filter reduced from 31 of 136 (23%) to 0 of 118 patients (P = < 0.001). There was a non-significant reduction in IVC filter dwell time in the post-database group (113 as compared to 137 days, P = 0.129). Following the establishment of an IVC filter database and interventional radiology led follow-up, we demonstrate a significant improvement in the attempted retrieval rates of IVC filters and the number of patient's lost to follow-up. © 2017 The Royal Australian and New Zealand College of Radiologists.

Patient-centered Radiology: Where Are We, Where Do We Want to Be, and How Do We Get There?

PubMed

Kemp, Jennifer L; Mahoney, Mary C; Mathews, Vincent P; Wintermark, Max; Yee, Judy; Brown, Stephen D

2017-11-01

Purpose The objectives of the Radiological Society of North America (RSNA) Patient-Centered Radiology Steering Committee survey were to (a) assess RSNA members' general attitudes and experiences concerning patient-centered radiology, with specific attention paid to radiologist-to-patient communication; (b) examine the members' barriers to communicating more directly with patients; and (c) explore their perceptions of how such barriers can be overcome. Materials and Methods A total of 5999 radiologists were invited by e-mail to complete an anonymous electronic survey developed by the Steering Committee and the RSNA Department of Research. Participants were asked to identify aspects of patient-centered care important to their practice, report on their interactions with patients, and share their opinions on radiologist-patient communication. Statistical analyses were performed by using the χ 2 test and analysis of variance. Results The response rate was 12% (n = 694, 109 invitations were undeliverable). Most respondents (89%, 611 of 684) agreed that promoting awareness of the role of radiology in patients' overall health care is important to how they practice. The majority (73%, 421 of 575) reported that time or workload frequently prevented them from communicating directly with patients. The majority (74%, 423 of 572) reported that a personal sense of satisfaction was likely to motivate them to communicate more directly with patients, but many commented that changes to reimbursement and compensation would help them communicate with patients more directly. Conclusion Many radiologists support the concept of communicating more directly with patients but report they are constrained by time or workload. Changes to reimbursement schemes may help mitigate these barriers to one crucial aspect of patient-centered care. © RSNA, 2017 Online supplemental material is available for this article.

Patient dose in interventional radiology: a multicentre study of the most frequent procedures in France.

PubMed

Etard, Cécile; Bigand, Emeline; Salvat, Cécile; Vidal, Vincent; Beregi, Jean Paul; Hornbeck, Amaury; Greffier, Joël

2017-10-01

A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom. Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure. RLs were calculated as the 3rd quartiles of the distributions. Results on 4600 procedures from 36 departments confirmed the large variability in patient dose for the same procedure. RLs were proposed for the four dosimetric estimators and the 15 procedures. RLs in terms of KAP and FT were 90 Gm.cm 2 and 11 mins for cerebral angiography, 35 Gy.cm 2 and 16 mins for biliary drainage, 75 Gy.cm 2 and 6 mins for lower limbs arteriography and 70 Gy.cm 2 and 11 mins for vertebroplasty. For these four procedures, RLs were defined according to the complexity of the procedure. For all the procedures, the results were lower than most of those already published. This study reports RLs in interventional radiology based on a national survey. Continual evolution of practices and technologies requires regular updates of RLs. • Delivered dose in interventional radiology depends on procedure, practice and patient. • National RLs are proposed for 15 interventional procedures. • Reference levels (RLs) are useful to benchmark practices and optimize protocols. • RLs are proposed for kerma area product, air kerma, fluoroscopy time and number of images. • RLs should be adapted to the procedure complexity and updated regularly.

Medical lessons learned from chernobyl relative to nuclear detonations and failed nuclear reactors.

PubMed

Dallas, Cham E

2012-12-01

The Chernobyl disaster in 1986 involved the largest airborne release of radioactivity in history, more than 100 times as much radioactivity as the Hiroshima and Nagasaki atomic bombs together. The resulting emergency response, administrative blunders, and subsequent patient outcomes from this large-scale radiological disaster provide a wealth of information and valuable lessons for those who may find themselves having to deal with the staggering consequences of nuclear war. Research findings, administrative strategies (successful and otherwise), and resulting clinical procedures from the Chernobyl experience are reviewed to determine a current utility in addressing the appropriate protocols for a medical response to nuclear war. As various myths are still widely associated with radiation exposure, attention is given to the realities of a mass casualty medical response as it would occur with a nuclear detonation.

Changes in radiological protection and quality control in Spanish dental installations: 1996-2003.

PubMed

Alcaraz-Baños, Miguel; Parra-Pérez, María del Carmen; Armero-Barranco, David; Velasco-Hidalgo, Francisco; Velasco-Hidalgo, Esteban

2009-10-01

The European Union has established specific directives concerning radiological protection which are obligatory for member States. In addition, all Spanish dental clinics with radiological equipment are required to have an annual quality control check. To analyze the effect of new European legislation on dental radiological practice in Spain and to determine whether it has resulted in lower doses being administered to patients. A total of 10,171 official radiological quality control reports on Spanish dental clinics, covering 16 autonomous regions, were studied following the passing of Royal Decree 2071/1995 on quality criteria in radiodiagnostic installations. The reports, compiled by U.T.P.R Asigma S.A., a company authorised by the Nuclear Safety Council, cover the years 1996 to 2003, which has enabled us to monitor the evolution of radiological procedures in dental clinics over a seven year period. According to the reports for 2003, 77.3 % of clinics complied with EU requirements, using equipment of 70 kVp, 8 mA, 1.5 mm Al filters, with a collimator length of 20 cm. However, non-compliance was detected in approximately a third (30.8%) of the equipment inspected: alterations in the kilovoltage used, exposure time, performance of the tubing, dosage, linearity/intensity of current and acoustic-luminous signal 6.86%. The mean skin dose reached 3.11 mGy for patients who received an x-ray of an upper molar, representing a decrease of 18% over the seven years studied. there has obviously been a general improvement in the parameters studied, but only 77.3% of the installations complied fully with official EU regulations concerning dental radiological protection.

Cumulative radiation dose caused by radiologic studies in critically ill trauma patients.

PubMed

Kim, Patrick K; Gracias, Vicente H; Maidment, Andrew D A; O'Shea, Michael; Reilly, Patrick M; Schwab, C William

2004-09-01

Critically ill trauma patients undergo many radiologic studies, but the cumulative radiation dose is unknown. The purpose of this study was to estimate the cumulative effective dose (CED) of radiation resulting from radiologic studies in critically ill trauma patients. The study group was composed of trauma patients at an urban Level I trauma center with surgical intensive care unit length of stay (LOS) greater than 30 days. The radiology records were reviewed. A typical effective dose per study for each type of plain film radiograph, computed tomographic scan, fluoroscopic study, and nuclear medicine study was used to calculate CED. Forty-six patients met criteria. The mean surgical intensive care unit and hospital LOS were 42.7 +/- 14.0 and 59.5 +/- 28.5 days, respectively. The mean Injury Severity Score was 32.2 +/- 15.0. The mean number of studies per patient was 70.1 +/- 29.0 plain film radiographs, 7.8 +/- 4.1 computed tomographic scans, 2.5 +/- 2.6 fluoroscopic studies, and 0.065 +/- 0.33 nuclear medicine study. The mean CED was 106 +/- 59 mSv per patient (range, 11-289 mSv; median, 104 mSv). Among age, mechanism, Injury Severity Score, and LOS, there was no statistically significant predictor of high CED. The mean CED in the study group was 30 times higher than the average yearly radiation dose from all sources for individuals in the United States. The theoretical additional morbidity attributable to radiologic studies was 0.78%. From a radiobiologic perspective, risk-to-benefit ratios of radiologic studies are favorable, given the importance of medical information obtained. Current practice patterns regarding use of radiologic studies appear to be acceptable.

Randomized controlled trial of Gastrografin in adhesive small bowel obstruction.

PubMed

Burge, Jonathan; Abbas, Saleh M; Roadley, Graeme; Donald, Jennifer; Connolly, Andrew; Bissett, Ian P; Hill, Andrew G

2005-08-01

Several previous studies have shown that Gastrografin can be utilized to triage patients with adhesive small bowel obstruction (ASBO) to an operative or a non-operative course. Previous studies assessing the therapeutic effect of Gastrografin have been confounded by post-administration radiology alerting the physician to the treatment group of the patient. Therefore the aim of the present paper was to test the hypothesis that Gastrografin hastens the non-operative resolution of (ASBO). Patients, diagnosed with ASBO on clinical and radiological grounds, were randomized to receive Gastrografin or placebo in a double-blinded fashion. Patients did not undergo further radiological investigation. If the patient required subsequent radiological intervention or surgical intervention they were excluded from the study. End-points were passage of time to resolution of ASBO (flatus and bowel motion), length of hospital stay and complications. Forty-five patients with ASBO were randomized to receive either Gastrografin or placebo. Two patients were excluded due to protocol violations. Four patients in each group required surgery. Eighteen of the remaining patients received Gastrografin and 17 received placebo. Patients who received Gastrografin had complete resolution of their ASBO significantly earlier than placebo patients (12 vs 21 h, P = 0.009) and this translated into a median of a 1-day saving in time in hospital (3 vs 4 days, P = 0.03). Gastrografin accelerates resolution of ASBO by a specific therapeutic effect.

Design requirements for radiology workstations.

PubMed

Moise, Adrian; Atkins, M Stella

2004-06-01

This article stresses the importance of capturing feedback from representative users in the early stages of product development. We present our solution to producing quality requirement specifications for radiology workstations, specifications that remain valid over time because we successfully anticipated the industry trends and the user's needs. We present the results from a user study performed in December 1999 in a radiology clinic equipped with state-of-the-art Picture Archiving and Communications Systems (PACS) and imaging scanners. The study involved eight radiologists who answered questions and provided comments on three complementary research topics. First, we asked our subjects to enumerate the advantages and the disadvantages for both softcopy and hardcopy reading. We identified the two major factors for productivity improvement through the use of PACS workstations: workflow re-engineering and process automation. Second, we collected radiologist feedback on the use of hanging protocols (HPs). The results indicated the high importance of automatic image organization through HPs, with the potential effect of reducing the interpretation time by 10-20%. Our subjects estimated that 10-15 HPs would cover about 85%-95% of the regular radiological examinations. Third, we investigated the impact of the display devices on the radiologist's workflow. Our results indicated that the number and the properties of the monitors is a modality-specific requirement. The main results from this study on key functional requirements for softcopy interpretation only recently were incorporated in most of the current, successful PACS workstations.

Sorbent materials for rapid remediation of wash water during radiological event relief

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

Jolin, William C.; Kaminski, Michael

2016-11-01

Procedures for removing harmful radiation from interior and exterior surfaces of homes and businesses after a nuclear or radiological disaster may generate large volumes of radiologically contaminated waste water. Rather than releasing this waste water to potentially contaminate surrounding areas, it is preferable to treat it onsite. Retention barrels are a viable option because of their simplicity in preparation and availability of possible sorbent materials. This study investigated the use of aluminosilicate clay minerals as sorbent materials to retain 137Cs, 85Sr, and 152Eu. Vermiculite strongly retained 137Cs, though other radionuclides displayed diminished affinity for the surface. Montmorillonite exhibited increased affinitymore » to sorb 85Sr and 152Eu in the presence of higher concentrations of 137Cs. To simulate flow within retention barrels, vermiculite was mixed with sand and used in small-scale column experiments. The GoldSim contaminate fate module was used to model breakthrough and assess the feasibility of using clay minerals as sorbent materials in retention barrels. The modeled radionuclide breakthrough profiles suggest that vermiculite-sand and montmorillonite-sand filled barrels could be used for treatment of contaminated water generated from field operations.« less

Development of a radiology faculty appraisal instrument by using critical incident interviewing.

PubMed

Collins, J; Albanese, M A; Thakor, S K; Propeck, P A; Scanlan, K A

1997-12-01

To develop a valid and reliable radiology faculty appraisal instrument based on scientific methods. Fifteen radiology residents participated in critical incident interviewing. During a 1-hour interview, a resident was asked to describe five incidents each of effective and ineffective faculty behavior. Two investigators independently listened to the tape-recorded interviews, and two different investigators sorted the incidents into broad categories. A faculty appraisal instrument was developed by listing similar incidents under broad categories. A five-point rating scale was applied to each item. Content validity was assessed by resident and faculty critique of the appraisal instrument. A total of 168 incidents of faculty behavior were generated. The frequency with which similar incidents were reported was recorded. The most common behaviors reported were related to staff expertise and teaching. Interjudge reliability was good, as determined by computing K indices of agreement (overall K = 0.59). There was good agreement regarding instrument content validity among residents but not among faculty. Residents supported the use of the new appraisal instrument, but further tests of validity and reliability and faculty acceptance of the instrument will determine its usefulness as a tool for monitoring faculty teaching performance and making decisions regarding faculty promotion.

Assessment of the radiological impact of oil refining industry.

PubMed

Bakr, W F

2010-03-01

The field of radiation protection and corresponding national and international regulations has evolved to ensure safety in the use of radioactive materials. Oil and gas production processing operations have been known to cause naturally occurring radioactive materials (NORMs) to accumulate at elevated concentrations as by-product waste streams. A comprehensive radiological study on the oil refining industry in Egypt was carried out to assess the radiological impact of this industry on the workers. Scales, sludge, water and crude oil samples were collected at each stage of the refining process. The activity concentration of (226)Ra, (232)Th and (40)K were determined using high-resolution gamma spectrometry. The average activity concentrations of the determined isotopes are lower than the IAEA exempt activity levels for NORM isotopes. Different exposure scenarios were studied. The average annual effective dose for workers due to direct exposure to gamma radiation and dust inhalation found to be 0.6 microSv and 3.2 mSv, respectively. Based on the ALARA principle, the results indicate that special care must be taken during cleaning operations in order to reduce the personnel's exposure due to maintenance as well as to avoid contamination of the environment. 2009 Elsevier Ltd. All rights reserved.

[Functional and radiological evaluation of patients with midshaft clavicle fracture surgically treated].

PubMed

Ojeda-Reyes, Ángel Jesús; Barragán-Hervella, Rodolfo Gregorio; Vallecillo-Velázquez, Hernán; Alvarado-Ortega, Iván; Romero-Figueroa, María Socorro; Montiel-Jarquín, Álvaro José

2016-01-01

Functional and radiographic evaluation at midshaft clavicle fractures is better with surgical than conservative management. The aim of this paper is to describe the functional and radiological evaluation of patients with midshaft clavicle fracture surgery at the Hospital de Traumatología y Ortopedia of the Instituto Mexicano del Seguro Social. Descriptive studies, conducted during the period June 2014 to June 2015, patients undergoing surgical treatment for midshaft clavicle fracture were included. Constant-Murley and Montoya Scales were used to evaluate the functionality and radiological consolidation 6 months after the treatment. There were 90 patients, average age was 33.63 years, 78.9% were men, left side affected in 53.3% patients. At 6 months after surgery, functional results were excellent in 87.8% of patients, in 91% there was disappearance of fracture line regardless callus. The group of patients aged 18 and 40 years present better functional and radiographic results compared to the other groups (p <0.05). The management of patients with diaphyseal clavicle fracture should be surgical, ages between 18 to 40 years and between 61 to 76 years have better functional outcomes with greater consolidation of fracture line regardless of the callus.

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

PubMed

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

2014-02-01

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

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

PubMed

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

2014-10-01

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

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

PubMed

Rosenkrantz, Andrew B; Rawson, James V

2017-05-01

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

An evaluation of the functional and radiological results of percutaneous vertebroplasty versus conservative treatment for acute symptomatic osteoporotic spinal fractures.

PubMed

Balkarli, Hüseyin; Kilic, Mesut; Balkarli, Ayşe; Erdogan, Murat

2016-04-01

This study aimed to compare the results of the two different treatment regimens (percutaneous vertebroplasty (PV) and conservative treatment (CT)) regarding to efficacy, quality of life, functional and radiological results in patients with acute osteoporotic vertebral compression fractures (OVF). The study comprised 83 patients who presented with complaints of OVF associated with osteoporosis and were treated with CT (37) or PV (46). All patients were evaluated according to preoperative and postoperative visual analogue scale (VAS), Oswestry disability index (ODI) and plain radiographs. All patients in VP group reported a significant decrease in pain at 1st day postoperative. While Pain relief and functional outcomes were significantly better in PV group than CT at 1st and 3rd months according to VAS and ODI scores, there were no statistically significant differences between the groups at 6th months follow-up. The mean preoperative local sagittal Cobb angle (LSCA) and the mean vertebra corpus mid-level height (MVCH) were 42.3° and 14.6 mm in the PV group, while they were measured as 39.8° and 15.7 mm in CT group, respectively. 15.6° decreasing the LSCA and 10.2 mm increasing MVCH were noted in the PV group at the 6th month follow-up. While LSCA increased 19.1° and MVCH decreased 7.6mm in CT group at same time period (p<0.001). Compared to the CT group, PV provides a rapid decrease of pain and an early return to daily life activities. Although improvement was observed on the radiological findings following treatment in the PV group, PV may not enhance the quality of life in patients with acute OVF at 6th months follow up. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Multiple Parameters Biodosimetry Tool with Various Blood Cell Counts - the Hemodose Approach

NASA Technical Reports Server (NTRS)

Hu, Shaowen

2014-01-01

There continue to be important concerns about the possibility of the occurrence of acute radiation syndromes following nuclear and radiological terrorism or accidents that may result in mass casualties in densely populated areas. To guide medical personnel in their clinical decisions for effective medical management and treatment of the exposed individuals, biological markers are usually applied to examine radiation induced biological changes to assess the severity of radiation injury to sensitive organ systems. Among these the peripheral blood cell counts are widely used to assess the extent of radiation induced bone marrow injury. This is due to the fact that the hematopoietic system is the most vulnerable part of the human body to radiation damage. Particularly, the lymphocyte, granulocyte, and platelet cells are the most radiosensitive of the blood elements, and monitoring their changes after exposure is regarded as a practical and recommended laboratory test to estimate radiation dose and injury. Based upon years of physiological and pathophysiological investigation of mammalian hematopoietic systems, and rigorous coarse-grained bio-mathematical modeling and validation on species from mouse, to dog, monkey, and human, we have developed a set of software tools Hemodose, which can use single or serial granulocyte, lymphocyte, leukocyte, or platelet counts after exposure to estimate absorbed doses of adult victims very rapidly and accurately. Some patient data from historical accidents are utilized as examples to demonstrate the capabilities of these tools as a rapid point-of-care diagnostic or centralized high-throughput assay system in a large-scale radiological disaster scenario. Most significant to the improvement of national and local preparedness of a potential nuclear/radiological disaster, this HemoDose approach establishes robust correlations between the absorbed doses and victim's various types of blood cell counts not only in the early time window (1 or 2 days), but also in the very late phase (up to 4 weeks) after exposure.

A Clinical Comparison of Anterior Cervical Plates Versus Stand-Alone Intervertebral Fusion Devices for Single-Level Anterior Cervical Discectomy and Fusion Procedures.

PubMed

Panchal, Ripul R; Kim, Kee D; Eastlack, Robert; Lopez, John; Clavenna, Andrew; Brooks, Daina M; Joshua, Gita

2017-03-01

To compare radiologic and clinical outcomes, including rates of dysphagia and dysphonia, using a no-profile stand-alone intervertebral spacer with integrated screw fixation versus an anterior cervical plate and spacer construct for single-level anterior cervical discectomy and fusion (ACDF) procedures. This multicenter, randomized, prospective study included 54 patients with degenerative disc disease requiring ACDF at a single level at C3-C7. Twenty-six patients underwent single-level ACDF with stand-alone spacers, and 28 with plate fixation and spacers. Analyses were based on comparison of perioperative outcomes, radiologic and clinical metrics, and incidence of dysphagia and/or dysphonia. Mean patient age was 48.8 ± 10.1years (53.7% female). No significant differences were observed between groups in operative time (101.8 ± 34.4 minutes, 114.4 ± 31.5 minutes), estimated blood loss (44.8 ± 76.5 mL, 82.5 ± 195.1 mL), or length of hospital stay (1.2 ± 0.6 days, 1.3 ± 0.6 days). Mean visual analog scale pain scores and Neck Disability Index scores improved significantly from preoperative to last follow-up (10.8 ± 2.6 months) in both groups (P < 0.05). Mean Voice Handicap Index and Eating Assessment Tool scores improved significantly from discharge to last follow-up in both groups (P < 0.05). From discharge to 6 months, the stand-alone spacers group consistently demonstrated greater improvement in Voice Handicap Index. Preoperative intervertebral disc and neuroforaminal heights increased significantly across treatment groups (P < 0.01), and no cases required surgical revision at index or adjacent levels. Anterior cervical discectomy and fusion with stand-alone spacers resulted in similar clinical and radiologic outcomes as compared with plate and spacers and may help minimize postoperative dysphonia. Copyright © 2016 Elsevier Inc. All rights reserved.

Medical students' preferences in radiology education a comparison between the Socratic and didactic methods utilizing powerpoint features in radiology education.

PubMed

Zou, Lily; King, Alexander; Soman, Salil; Lischuk, Andrew; Schneider, Benjamin; Walor, David; Bramwit, Mark; Amorosa, Judith K

2011-02-01

The Socratic method has long been a traditional teaching method in medicine and law. It is currently accepted as the standard of teaching in clinical wards, while the didactic teaching method is widely used during the first 2 years of medical school. There are arguments in support of both styles of teaching. After attending a radiology conference demonstrating different teaching methods, third-year and fourth-year medical students were invited to participate in an online anonymous survey. Of the 74 students who responded, 72% preferred to learn radiology in an active context. They preferred being given adequate time to find abnormalities on images, with feedback afterward from instructors, and they thought the best approach was a volunteer-based system of answering questions using the Socratic method in the small group. They desired to be asked questions in a way that was constructive and not belittling, to realize their knowledge deficits and to have daily pressure to come prepared. The respondents thought that pimping was an effective teaching tool, supporting previous studies. When teaching radiology, instructors should use the Socratic method to a greater extent. Combining Socratic teaching with gentle questioning by an instructor through the use of PowerPoint is a preferred method among medical students. This information is useful to improve medical education in the future, especially in radiology education. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

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.

Intradiscal injection of simvastatin results in radiologic, histologic, and genetic evidence of disc regeneration in a rat model of degenerative disc disease

PubMed Central

Than, Khoi D.; Rahman, Shayan U.; Wang, Lin; Khan, Adam; Kyere, Kwaku A.; Than, Tracey T.; Miyata, Yoshinari; Park, Yoon-Shin; La Marca, Frank; Kim, Hyungjin M.; Zhang, Huina; Park, Paul; Lin, Chia-Ying

2014-01-01

BACKGROUND CONTEXT A large percentage of back pain can be attributed to degeneration of the intervertebral disc (IVD). Bone morphogenetic protein-2 (BMP-2) is known to play an important role in chondrogenesis of the IVD. Simvastatin is known to up-regulate expression of BMP-2. Thus, we hypothesized that intradiscal injection of simvastatin in a rat model of degenerative disc disease (DDD) would result in retardation of DDD. PURPOSE To develop a novel conservative treatment for DDD and related discogenic back pain. STUDY DESIGN/SETTING Laboratory investigation. METHODS Disc injury was induced in 272 rats via 21-gauge needle puncture. After 6 weeks, injured discs were treated with simvastatin in a saline or hydrogel carrier. Rats were sacrificed at predetermined time points. Outcome measures assessed were radiologic, histologic, and genetic. Radiologically, the MRI index (number of pixels multiplied by corresponding image densities) was determined. Histologically, disc spaces were read by 3 blinded scorers employing a previously described histological grading scale. Genetically, nuclei pulposi were harvested and polymerase chain reaction was run to determine relative levels of aggrecan, collagen type II, and BMP-2 gene expression. This project was supported by Grant No. R01 AR056649 from NIAMS/NIH. There are no other financial conflicts of interest to report. RESULTS Radiologically, discs treated with 5 mg/mL simvastatin in hydrogel or saline demonstrated MRI indices that were normal through 8 weeks post-treatment, although this was more sustained when delivered in hydrogel. Histologically, discs treated with 5 mg/mL simvastatin in hydrogel demonstrated improved grades in comparison to discs treated at higher doses. Genetically, discs treated with 5 mg/mL of simvastatin in hydrogel demonstrated higher gene expression of aggrecan and collagen type II than control. CONCLUSIONS Degenerate discs treated with 5 mg/mL simvastatin in a hydrogel carrier demonstrated radiographic and histologic features resembling normal, non-injured IVDs. In addition, gene expression of aggrecan and collagen type II (important constituents of the IVD extracellular matrix) was up-regulated in treated discs. Injection of simvastatin into degenerate IVDs may result in retardation of disc degeneration and represents a promising investigational therapy for conservative treatment of DDD. PMID:24291703

Truly anatomic coracoclavicular ligament reconstruction with 2 Endobutton devices for acute Rockwood type V acromioclavicular joint dislocations.

PubMed

Xue, Cheng; Song, Li-Jun; Zhang, Hao; Tang, Guo-Long; Li, Xiang; Fang, Jia-Hu

2018-06-01

Truly anatomic coracoclavicular ligament reconstruction (TACCR) according to the original insertions is a creative new method for the treatment of severe acromioclavicular separation. This research analyzed the clinical and radiologic results of TACCR in 25 patients with at least 2-year follow-up. The study enrolled 25 patients with Rockwood type V acromioclavicular joint dislocations who underwent TACCR using 2 Endobutton (Smith & Nephew Inc., Andover, MA, USA) devices from May 2013 to October 2015. Patients were assessed with clinical and radiologic follow-up at 3, 6, 12, 18, and 24 months postoperatively. The clinical assessments consisted of the visual analog scale and the Constant score. The radiographic evaluations were performed by measurements of the coracoclavicular distance. The mean follow-up was 34 ± 6.8 months (range, 24-48 months). The visual analog scale and Constant scores revealed significant advancements from 5 ± 0.9 (range, 4-7) and 45 ± 5.6 (range, 30-54) scores preoperatively to 0 ± 0.5 (range, 0-2) and 95 ± 2.9 (range, 91-98) scores at 24 months postoperatively, respectively. The coracoclavicular distance significantly decreased from 23 ± 5.4 mm (range, 16-34 mm) preoperatively to 8 ± 0.9 mm (range, 7-10 mm) at the final follow-up. TACCR represents a safe, reliable and creative surgical technique that yields good to excellent clinical and radiologic outcomes in the treatment of severe acromioclavicular separation. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

A Survey of the Methods Developed in the National Coal Board's Pneumoconiosis Field Research for Correlating Environmental Exposure with Medical Condition

PubMed Central

Fay, J. W. J.; Ashford, J. R.

1961-01-01

The correlation of the medical and environmental data (i.e. the derivation of the dosage-response relationship) in a study such as the National Coal Board's Pneumoconiosis Field Research (P.F.R.) is subject to many complicating factors compared with the more conventional types of biological assay. Several methods have been developed within the Research to overcome these difficulties, and the new procedures are described. Each is concerned with the estimation of the direct relation between the radiological abnormality associated with simple pneumoconiosis and some single measure of the past hazard, but the basic techniques are sufficiently general to be applicable in other fields of study. The first development involves the definition of an underlying continuous scale of radiological abnormality. This prepares the way for the derivation of the “quantitative” relation between exposure and response, to replace the “semi-quantal” relation which is inherent in the use of a small number of discrete categories of radiological abnormality. The effect of errors of observation of dosage and response on the corresponding quantitative and quantal relationships is then determined. The second development concerns the use of a “multi-dimensional” representation of past hazard. Most of the men under observation had worked in a number of different mining occupations before their first chest radiograph was taken, but this exposure cannot be assessed in terms of dust concentrations, for which reliable data are not available. Nevertheless, it is shown that past hazard can usefully be represented by three “dimensions” corresponding to the periods spent in three main types of environment—(a) the coal-face (coal-getting shift), (b) the coal-face (preparation shift) and (c) elsewhere underground. Each man's past exposure up to the time of his first chest radiograph can be expressed in terms of these three dimensions and the effect of each environment separately can be determined. The third development extends the multi-dimensional approach to cover not only the working history before the first medical examination, but also the recorded exposure (in terms of measured dust concentrations), to which each man has been subject between the first and subsequent “follow-up” surveys. This measured exposure is regarded as one dimension of the man's total exposure up to the time of his second (or later) examination, and it is possible in this way to determine the direct relation between radiological abnormality and measured exposure, even when this component represents only part of the total hazard to which the man has been subject. The application of the methods is illustrated by the analysis of some of the data which have been obtained in the Pneumoconiosis Field Research. PMID:13698432

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.

Comprehensive innovative solution for resident education using the Intranet Journal of Chest Radiology.

PubMed

Nishino, Mizuki; Wolfe, Donna; Yam, Chun-Shan; Larson, Michael; Boiselle, Phillip M; Hatabu, Hiroto

2004-10-01

Because of the rapid increase in clinical workload in academic radiology departments, time for teaching rotating residents is getting more and more limited. As a solution to this problem, we introduced the Intranet Journal of Chest Radiology as a comprehensive innovative tool for assisting resident education. The Intranet Journal of Chest Radiology is constructed using Microsoft FrontPage version 2002 (Microsoft Corp, Redmond, WA) and is hosted in our departmental web server (Beth Israel Deaconess Medical Center, Boston, MA). The home page of the intranet journal provides access to the main features, "Cases of the Month," "Teaching File," "Selected Articles for Residents," "Lecture Series," and "Current Publications." These features provide quick access to the selected radiology articles, the interesting chest cases, and the lecture series and current publication from the chest section. Our intranet journal has been well utilized for 6 months after its introduction. It enhances residents' interest and motivation to work on case collections, to search and read articles, and to generate interest in research. Frequent updating is necessary for the journal to be kept current, relevant, and well-utilized. The intranet journal serves as a comprehensive innovative solution for resident education, providing basic educational resources and opportunities of interactive participation by residents.

Bioremediation of Petroleum and Radiological Contaminated Soils at the Savannah River Site: Laboratory to Field Scale Applications

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

BRIGMON, ROBINL.

In the process of Savannah River Site (SRS) operations limited amounts of waste are generated containing petroleum, and radiological contaminated soils. Currently, this combination of radiological and petroleum contaminated waste does not have an immediate disposal route and is being stored in low activity vaults. SRS developed and implemented a successful plan for clean up of the petroleum portion of the soils in situ using simple, inexpensive, bioreactor technology. Treatment in a bioreactor removes the petroleum contamination from the soil without spreading radiological contamination to the environment. This bioreactor uses the bioventing process and bioaugmentation or the addition of themore » select hydrocarbon degrading bacteria. Oxygen is usually the initial rate-limiting factor in the biodegradation of petroleum hydrocarbons. Using the bioventing process allowed control of the supply of nutrients and moisture based on petroleum contamination concentrations and soil type. The results of this work have proven to be a safe and cost-effective means of cleaning up low level radiological and petroleum-contaminated soil. Many of the other elements of the bioreactor design were developed or enhanced during the demonstration of a ''biopile'' to treat the soils beneath a Polish oil refinery's waste disposal lagoons. Aerobic microorganisms were isolated from the aged refinery's acidic sludge contaminated with polycyclic aromatic hydrocarbons (PAHs). Twelve hydrocarbon-degrading bacteria were isolated from the sludge. The predominant PAH degraders were tentatively identified as Achromobacter, Pseudomonas Burkholderia, and Sphingomonas spp. Several Ralstonia spp were also isolated that produce biosurfactants. Biosurfactants can enhance bioremediation by increasing the bioavailability of hydrophobic contaminants including hydrocarbons. The results indicated that the diversity of acid-tolerant PAH-degrading microorganisms in acidic oil wastes may be much greater than previously demonstrated and they have numerous applications to environmental restoration. Twelve of the isolates were subsequently added to the bioreactor to enhance bioremediation. In this study we showed that a bioreactor could be bioaugmented with select bacteria to enhance bioremediation of petroleum-contaminated soils under radiological conditions.« less

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

PubMed Central

Moulder, John E.

2014-01-01

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

Impact of a voice recognition system on report cycle time and radiologist reading time

NASA Astrophysics Data System (ADS)

Melson, David L.; Brophy, Robert; Blaine, G. James; Jost, R. Gilbert; Brink, Gary S.

1998-07-01

Because of its exciting potential to improve clinical service, as well as reduce costs, a voice recognition system for radiological dictation was recently installed at our institution. This system will be clinically successful if it dramatically reduces radiology report turnaround time without substantially affecting radiologist dictation and editing time. This report summarizes an observer study currently under way in which radiologist reporting times using the traditional transcription system and the voice recognition system are compared. Four radiologists are observed interpreting portable intensive care unit (ICU) chest examinations at a workstation in the chest reading area. Data are recorded with the radiologists using the transcription system and using the voice recognition system. The measurements distinguish between time spent performing clerical tasks and time spent actually dictating the report. Editing time and the number of corrections made are recorded. Additionally, statistics are gathered to assess the voice recognition system's impact on the report cycle time -- the time from report dictation to availability of an edited and finalized report -- and the length of reports.

MRI: unique costing and pricing issues.

PubMed

Schwartz, H W; Jarl, D F

1985-01-01

Acquisition of magnetic resonance imaging (MRI) involves a plethora of costs not traditionally encountered in radiology procedure cost accounting models. Experiences with MRI gained at the University of Minnesota Hospitals and Clinics during 1984 uncovered a wide variety of unique costing issues which were eventually identified at the time when the MRI hospital charge was being established. Our experience at UMHC can provide those radiology departments now acquiring MRI with an earlier awareness of these special costing issues, hopefully resulting in better and more timely data collection. Current reimbursement and pricing issues are also having a dramatic impact on MRI costs at each institution and must be assessed in terms of third-party payor intentions.

[A brief review of the history of interventional medicine].

PubMed

Wang, Zi-xuan; Chen, Feng

2009-03-01

Interventional medicine is an important part of modern medicine. The origin of its thought can be traced back to ancient Egypt and the Babylonian Period. After long-time accumulation of experiences, interventional medicine gradually evolved as a system with the rise of radiology in 20th century. New equipment as well as new techniques promoted the improvement of interventional medicine. Through its development over several decades, interventional medicine has already taken shape. Its techniques and application fields have exceeded those of interventional radiology.

[Vocal recognition in dental and oral radiology].

PubMed

La Fianza, A; Giorgetti, S; Marelli, P; Campani, R

1993-10-01

Speech reporting benefits by units which can recognize sentences in any natural language in real time. The use of this method in the everyday practice of radiology departments shows its possible application fields. We used the speech recognition method to report orthopantomographic exams in order to evaluate the advantages the method offers to the management and quality of reporting the exams which are difficult to fit in other closed computed reporting systems. Both speech recognition and the conventional reporting method (tape recording and typewriting) were used to report 760 orthopantomographs. The average time needed to make the report, the legibility (or Flesch) index, as adapted for the Italian language, and finally a clinical index (the subjective opinion of 4 odontostomatologists) were evaluated for each exam, with both techniques. Moreover, errors in speech reporting (crude, human and overall errors) were also evaluated. The advantages of speech reporting consisted in the shorter time needed for the report to become available (2.24 vs 2.99 minutes) (p < 0.0005), in the improved Flesch index (30.62 vs 28.9) and in the clinical index. The data obtained from speech reporting in odontostomatologic radiology were useful not only to reduce the mean reporting time of orthopantomographic exams but also to improve report quality by reducing both grammar and transmission mistakes. However, the basic condition for such results to be obtained is the speaker's skills to make a good report.

The medical decision model and decision maker tools for management of radiological and nuclear incidents.

PubMed

Koerner, John F; Coleman, C Norman; Murrain-Hill, Paula; FitzGerald, Denis J; Sullivan, Julie M

2014-06-01

Effective decision making during a rapidly evolving emergency such as a radiological or nuclear incident requires timely interim decisions and communications from onsite decision makers while further data processing, consultation, and review are ongoing by reachback experts. The authors have recently proposed a medical decision model for use during a radiological or nuclear disaster, which is similar in concept to that used in medical care, especially when delay in action can have disastrous effects. For decision makers to function most effectively during a complex response, they require access to onsite subject matter experts who can provide information, recommendations, and participate in public communication efforts. However, in the time before this expertise is available or during the planning phase, just-in-time tools are essential that provide critical overview of the subject matter written specifically for the decision makers. Recognizing the complexity of the science, risk assessment, and multitude of potential response assets that will be required after a nuclear incident, the Office of the Assistant Secretary for Preparedness and Response, in collaboration with other government and non-government experts, has prepared a practical guide for decision makers. This paper illustrates how the medical decision model process could facilitate onsite decision making that includes using the deliberative reachback process from science and policy experts and describes the tools now available to facilitate timely and effective incident management.

Evaluation of a new imaging tool for use with major trauma cases in the emergency department.

PubMed

Crönlein, Moritz; Holzapfel, Konstantin; Beirer, Marc; Postl, Lukas; Kanz, Karl-Georg; Pförringer, Dominik; Huber-Wagner, Stefan; Biberthaler, Peter; Kirchhoff, Chlodwig

2016-11-17

The aim of this study was to evaluate potential benefits of a new diagnostic software prototype (Trauma Viewer, TV) automatically reformatting computed tomography (CT) data on diagnostic speed and quality, compared to CT-image data evaluation using a conventional CT console. Multiple trauma CT data sets were analysed by one expert radiology and one expert traumatology fellow independently twice, once using the TV and once using the secondary conventional CT console placed in the CT control room. Actual analysis time and precision of diagnoses assessment were evaluated. The TV and CT-console results were compared respectively, but also a comparison to the initial multiple trauma CT reports assessed by emergency radiology fellows considered as the gold standard was performed. Finally, design and function of the Trauma Viewer were evaluated in a descriptive manner. CT data sets of 30 multiple trauma patients were enrolled. Mean time needed for analysis of one CT dataset was 2.43 min using the CT console and 3.58 min using the TV respectively. Thus, secondary conventional CT console analysis was on average 1.15 min shorter compared to the TV analysis. Both readers missed a total of 11 diagnoses using the secondary conventional CT console compared to 12 missed diagnoses using the TV. However, none of these overlooked diagnoses resulted in an Abbreviated Injury Scale (AIS) > 2 corresponding to life threatening injuries. Even though it took the two expert fellows a little longer to analyse the CT scans on the prototype TV compared to the CT console, which can be explained by the new user interface of the TV, our preliminary results demonstrate that, after further development, the TV might serve as a new diagnostic feature in the trauma room management. Its high potential to improve time and quality of CT-based diagnoses might help in fast decision making regarding treatment of severely injured patients.

Is top-down vs bottom-up radiological evaluation after febrile urinary tract infection really less stressful for the child and family? Challenging the dogma.

PubMed

Telli, Onur; Mermerkaya, Murat; Hajiyev, Perviz; Aydogdu, Ozgu; Afandiyev, Faraj; Suer, Evren; Soygur, Tarkan; Burgu, Berk

2015-03-01

We evaluated whether stress levels in children and parents during radiological evaluation after febrile urinary tract infection are really lower using the top-down approach, where (99m)technetium dimercaptosuccinic acid renal scintigraphy is used initially, than the bottom-up approach, where voiding cystourethrography is initially performed and repeated examinations are easier for all. We prospectively evaluated 120 children 3 to 8 years old. Pain ratings were obtained using the Faces Pain Scale-Revised, and conversation during the procedure was evaluated using the Child-Adult Medical Procedure Interaction Scale-Revised by 2 independent observers. To evaluate parental anxiety, the State-Trait Anxiety Inventory form was also completed. Following a documented febrile urinary tract infection children were randomized to the top-down or bottom-up group. A third group of 44 children undergoing repeat voiding cystourethrography and their parents were also evaluated. Child ratings of pain using the Faces Pain Scale-Revised were not significantly different between the top-down group following (99m)technetium dimercaptosuccinic acid renal scintigraphy (2.99 on a scale of 10) and the bottom-up group following voiding cystourethrography (3.21). Also the Faces Pain Scale-Revised was not significantly different in the repeat voiding cystourethrography group (3.35). On the Child-Adult Medical Procedure Interaction Scale-Revised there was negative correlation between child coping and child distress, as well as rate of child distress and adult coping promoting behavior. Parental state anxiety scores were significantly less in the top-down and repeat voiding cystourethrography groups than in the bottom-up group. Although the top-down approach and repeat voiding cystourethrography cause less anxiety for caregivers, these values do not correlate to pain scale in children. This finding might be due to lack of appropriate evaluation tools of pediatric pain and anxiety. However, the theory that the top-down approach is less invasive, and thus less stressful, requires further research. The Child-Adult Medical Procedure Interaction Scale-Revised data indicate that influences in adult-child interaction are bidirectional. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The quantity time relation in the ionizing radiations

NASA Astrophysics Data System (ADS)

Jordão, B. O.; Quaresma, D. S.; Peixoto, J. G. P.

2018-03-01

The metrology area has taken a step forward with regard to the uncertainty calculation. This mathematical tool used in laboratories is essential to ensure that the values resulting from a measurement are reliable. For this to be possible, all equipment used in a measurement process must be reliable and, above all, traceable to the international metrology system. We propose to present in this work: (i) the development and calibration of a microcontrolled time device with a resolution of 1x10-4 s, in order to characterize the time greatness and make it re-producible; (ii) the calibration of the quartz clock present in a computer present in the dosimetry laboratories; (iii) a more in-depth study of the influence of time quantity on calibrations of instruments used in the area of radiological protection, diagnostic radiology and radiotherapy, with measurements performed on the Kerma magnitude in air or its rate.

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.

A Comprehensive Analysis of Authorship in Radiology Journals.

PubMed

Dang, Wilfred; McInnes, Matthew D F; Kielar, Ania Z; Hong, Jiho

2015-01-01

The purpose of our study was to investigate authorship trends in radiology journals, and whether International Committee of Medical Journal Editors (ICMJE) recommendations have had an impact on these trends. A secondary objective was to explore other variables associated with authorship trends. A retrospective, bibliometric analysis of 49 clinical radiology journals published from 1946-2013 was conducted. The following data was exported from MEDLINE (1946 to May 2014) for each article: authors' full name, year of publication, primary author institution information, language of publication and publication type. Microsoft Excel Visual Basics for Applications scripts were programmed to categorize extracted data. Statistical analysis was performed to determine the overall mean number of authors per article over time, impact of ICMJE guidelines, authorship frequency per journal, country of origin, article type and language of publication. 216,271 articles from 1946-2013 were included. A univariate analysis of the mean authorship frequency per year of all articles yielded a linear relationship between time and authorship frequency. The mean number of authors per article in 1946 (1.42) was found to have increased consistently by 0.07 authors/ article per year (R² = 0.9728, P<0.001) to 5.79 authors/article in 2013. ICMJE guideline dissemination did not have an impact on this rise in authorship frequency. There was considerable variability in mean authors per article and change over time between journals, country of origin, language of publication and article type. Overall authorship for 49 radiology journals across 68 years has increased markedly with no demonstrated impact from ICMJE guidelines. A higher number of authors per article was seen in articles from: higher impact journals, European and Asian countries, original research type, and those journals who explicitly endorse the ICMJE guidelines.

A novel diagnostic tool for detecting functional patency of the small bowel: the Given patency capsule.

PubMed

Spada, C; Spera, G; Riccioni, M; Biancone, L; Petruzziello, L; Tringali, A; Familiari, P; Marchese, M; Onder, G; Mutignani, M; Perri, V; Petruzziello, C; Pallone, F; Costamagna, G

2005-09-01

The current visualization of small-bowel strictures using traditional radiological methods is associated with high radiation doses and false-negative results. These methods do not always reveal small-bowel patency for solids. The aim is to assess the safety of the Given patency system and its ability to detect intestinal strictures in patients with strictures that are known or suspected radiologically. The Given patency capsule is composed of lactose, remains intact in the gastrointestinal tract for 40-100 hours post ingestion, and disintegrates thereafter. A total of 34 patients with small-bowel stricture were prospectively enrolled; 30 had a previous diagnosis of Crohn's disease, three had adhesion syndrome and in one ischemic enteritis was suspected. Of the patients, 15 (44.1 %) had previously undergone surgery. Following ingestion, the capsule was monitored for integrity and transit time, using a specially designed Given scanner and also radiologically. Seventeen patients had been enrolled with the intent of using the patency capsule as a preliminary test in patients with small-bowel strictures before undergoing video capsule endoscopy. 30 patients (88.2 %) retrieved the capsule in the stool; it was intact in 20 (median transit time 22 hours), and disintegrated in 10 patients (median transit time 53 hours). Six patients complained of abdominal pain which disappeared within 24 hours. The scanner successfully indicated the presence of the capsule in 94 % of cases. Ten patients underwent video capsule endoscopy following the patency capsule examination; in all of these the video capsule passed through the small-bowel stricture. This feasibility study has shown that the Given patency capsule is a safe, effective, and convenient tool for assessment of functional patency of the small bowel. It can indicate functional patency even in cases where traditional radiology indicates stricture.

A Comprehensive Analysis of Authorship in Radiology Journals

PubMed Central

Dang, Wilfred; McInnes, Matthew D. F.; Kielar, Ania Z.; Hong, Jiho

2015-01-01

Objectives The purpose of our study was to investigate authorship trends in radiology journals, and whether International Committee of Medical Journal Editors (ICMJE) recommendations have had an impact on these trends. A secondary objective was to explore other variables associated with authorship trends. Methods A retrospective, bibliometric analysis of 49 clinical radiology journals published from 1946–2013 was conducted. The following data was exported from MEDLINE (1946 to May 2014) for each article: authors’ full name, year of publication, primary author institution information, language of publication and publication type. Microsoft Excel Visual Basics for Applications scripts were programmed to categorize extracted data. Statistical analysis was performed to determine the overall mean number of authors per article over time, impact of ICMJE guidelines, authorship frequency per journal, country of origin, article type and language of publication. Results 216,271 articles from 1946–2013 were included. A univariate analysis of the mean authorship frequency per year of all articles yielded a linear relationship between time and authorship frequency. The mean number of authors per article in 1946 (1.42) was found to have increased consistently by 0.07 authors/ article per year (R² = 0.9728, P<0.001) to 5.79 authors/article in 2013. ICMJE guideline dissemination did not have an impact on this rise in authorship frequency. There was considerable variability in mean authors per article and change over time between journals, country of origin, language of publication and article type. Conclusion Overall authorship for 49 radiology journals across 68 years has increased markedly with no demonstrated impact from ICMJE guidelines. A higher number of authors per article was seen in articles from: higher impact journals, European and Asian countries, original research type, and those journals who explicitly endorse the ICMJE guidelines. PMID:26407072

Barriers to Safety Event Reporting in an Academic Radiology Department: Authority Gradients and Other Human Factors.

PubMed

Siewert, Bettina; Swedeen, Suzanne; Brook, Olga R; Eisenberg, Ronald L; Hochman, Mary

2018-05-15

Purpose To investigate barriers to reporting safety concerns in an academic radiology department and to evaluate the role of human factors, including authority gradients, as potential barriers to safety concern reporting. Materials and Methods In this institutional review board-approved, HIPAA-compliant retrospective study, an online questionnaire link was emailed four times to all radiology department staff members (n = 648) at a tertiary care institution. Survey questions included frequency of speaking up about safety concerns, perceived barriers to speaking up, and the annual number of safety concerns that respondents were unsuccessful in reporting. Respondents' sex, role in the department, and length of employment were recorded. Statistical analysis was performed with the Fisher exact test. Results The survey was completed by 363 of the 648 employees (56%). Of those 363 employees, 182 (50%) reported always speaking up about safety concerns, 134 (37%) reported speaking up most of the time, 36 (10%) reported speaking up sometimes, seven (2%) reported rarely speaking up, and four (1%) reported never speaking up. Thus, 50% of employees spoke up about safety concerns less than 100% of the time. The most frequently reported barriers to speaking up included high reporting threshold (69%), reluctance to challenge someone in authority (67%), fear of disrespect (53%), and lack of listening (52%). Conclusion Of employees in a large academic radiology department, 50% do not attain 100% reporting of safety events. The most common human barriers to speaking up are high reporting threshold, reluctance to challenge authority, fear of disrespect, and lack of listening, which suggests that existing authority gradients interfere with full reporting of safety concerns. © RSNA, 2018.

Functional and radiological evaluations of high-energy tibial plateau fractures treated with double-buttress plate fixation.

PubMed

Yu, Z; Zheng, L; Zhang, Y; Li, J; Ma, Bao'an

2009-05-14

This study was designed to evaluate the functional and radiological outcomes of patients with complex tibial plateau fractures treated with double-buttress plate fixation. Sixty five cases of complex (Schatzker type V and VI) tibial plateau fractures were treated with double-buttress plate fixation in our centre from September 2001 to September 2006 through two separate plate incisions. Fifty four patients were followed up for a period ranging from 12 to 48 months and evaluated for the functional and radiological outcomes by a series of standard questionnaire and measurement. Due to the good exposure without any extensive soft-tissue dissection of the double-buttress plate fixation, the fractures in all 54 patients were healed and the treatment achieved greater than 90% of satisfactory-to-excellent rates of reduction. The mean time of bone union was 15.4 weeks (range, 12-30 weeks), and the mean time of full weight-bearing was 18.7 weeks (range, 14-26 weeks). At the final follow-up visit, no patients showed knee instability; the mean range of motion was 107.6 degrees (range, 85 degrees -130 degrees ). For all patients, no statistically significant difference in the functional outcomes was observed between their 6-months and final follow-up visits; or in the radiological findings between their immediate postoperative and final follow-up examinations. Double-buttress plate fixation is a feasible treatment option for bilcondylar and complex tibial plateau fractures. Although technically demanding, it offers reliable stability without additional postoperative adjuvant external fixation, and at the same time avoids extensive soft tissue dissection, allowing the early painless range of motion.

Feasibility of a semiconductor dosimeter to monitor skin dose in interventional radiology.

PubMed

Meyer, P; Regal, R; Jung, M; Siffert, P; Mertz, L; Constantinesco, A

2001-10-01

The design and preliminary test results of a semiconductor silicon dosimeter are presented in this article. Use of this dosimeter is foreseen for real-time skin dose control in interventional radiology. The strong energy dependence of this kind of radiation detector is well overcome by filtering the silicon diode. Here, the optimal filter features have been calculated by numerical Monte Carlo simulations. A prototype has been built and tested in a radiological facility. The first experimental results show a good match between the filtered semiconductor diode response and an ionization chamber response, within 2% fluctuation in a 2.2 to 4.1 mm Al half-value layer (HVL) energy range. Moreover, the semiconductor sensor response is linear from 0.02 Gy/min to at least 6.5 Gy/min, covering the whole dose rate range found in interventional radiology. The results show that a semiconductor dosimeter could be used to monitor skin dose during the majority of procedures using x-rays below 150 keV. The use of this device may assist in avoiding radiation-induced skin injuries and lower radiation levels during interventional procedures.

Design and implementation of an open source indexing solution for a large set of radiological reports and images.

PubMed

Voet, T; Devolder, P; Pynoo, B; Vercruysse, J; Duyck, P

2007-11-01

This paper hopes to share the insights we experienced during designing, building, and running an indexing solution for a large set of radiological reports and images in a production environment for more than 3 years. Several technical challenges were encountered and solved in the course of this project. One hundred four million words in 1.8 million radiological reports from 1989 to the present were indexed and became instantaneously searchable in a user-friendly fashion; the median query duration is only 31 ms. Currently, our highly tuned index holds 332,088 unique words in four languages. The indexing system is feature-rich and language-independent and allows for making complex queries. For research and training purposes it certainly is a valuable and convenient addition to our radiology informatics toolbox. Extended use of open-source technology dramatically reduced both implementation time and cost. All software we developed related to the indexing project has been made available to the open-source community covered by an unrestricted Berkeley Software Distribution-style license.

A Strategy to Overcome the Radiology Lottery in the Staging of Head and Neck Cancer: An Aid to Attaining the 30-Day Rule

PubMed Central

Elloy, Marianne; Jarvis, Sara; Davis, Anne

2009-01-01

INTRODUCTION Rapid access to radiological services is essential, if the British Association of Otolaryngologists – Head and Neck Surgeons Minimum Temporal Standards are to be met in the management of head and neck cancer patients. This study assesses a new initiative whereby the multidisciplinary team prioritises allocated imaging appointments rather than using the traditional radiological triage system. PATIENTS AND METHODS This study was a prospective audit of all patients referred over a 3-month period with suspected head and neck cancer. The main outcome measures were: (i) median interval in days from general practitioner (GP) referral to staging scan; and (ii) median interval in days from first clinic appointment to staging scan. RESULTS The new multidisciplinary team booking system led to a statistically significant reduction in the ‘request-to-scan time’ (from 12 days to 5 days). The time from ‘GP to scan’ also improved. CONCLUSIONS This new multidisciplinary team-led booking system, could, in the future, speed up access to radiology services lead and neck cancer patients, allowing earlier definitive treatment. PMID:19126338

Strategic planning in diagnostic imaging: meeting the challenge.

PubMed

Lexa, Frank J

2008-02-01

The 21st century has raised new and significant challenges to the practice of diagnostic imaging. Radiologists will have to navigate a difficult path as they face threats from disruptive technologies, adverse demographic changes, pressures to limit reimbursement both from the public and from the private sectors, increased domestic and crossborder competition, and many others. Success in these trying times will require greater attention to strategic planning if we are to thrive and survive in radiology. Strategic planning and tactical implementation methodologies were reviewed, from Sun Tzu to the present day, for applicability to the needs of modern radiology groups. A framework for developing and implementing strategic plans was constructed to assist radiology leaders and groups in considering the spectrum of tasks, from gathering intelligence, to developing scenarios, to implementing and evaluating tactical plans. Strategy and tactics are too important to be ignored or left to others. They need to be core activities for all radiology leaders. Frameworks can be used to help in providing structure and rigour to strategic planning efforts at the department and group level.

Scenario planning.

PubMed

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

2011-03-01

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

PTGER4 gene variant rs76523431 is a candidate risk factor for radiological joint damage in rheumatoid arthritis patients: a genetic study of six cohorts.

PubMed

Rodriguez-Rodriguez, Luis; Ivorra-Cortes, Jose; Carmona, F David; Martín, Javier; Balsa, Alejandro; van Steenbergen, Hanna W; van der Helm-van Mil, Annette H M; González-Álvaro, Isidoro; Fernandez-Gutiérrez, Benjamín

2015-11-05

Prostaglandin E receptor 4 (PTGER4) is implicated in immune regulation and bone metabolism. The aim of this study was to analyze its role in radiological joint damage in rheumatoid arthritis (RA). Six independent cohorts of patients with RA of European or North American descent were included, comprising 1789 patients with 5083 sets of X-rays. The Hospital Clínico San Carlos Rheumatoid Arthritis, Princesa Early Arthritis Register Longitudinal study, and Hospital Universitario de La Paz early arthritis (Spain) cohorts were used as discovery cohorts, and the Leiden Early Arthritis Clinic (The Netherlands), Wichita (United States), and National Databank for Rheumatic Diseases (United States and Canada) cohorts as replication cohorts. First, the PTGER4 rs6896969 single-nucleotide polymorphism (SNP) was genotyped using TaqMan assays and available Illumina Immunochip data and studied in the discovery and replication cohorts. Second, the PTGER4 gene and adjacent regions were analyzed using Immunochip genotyping data in the discovery cohorts. On the basis of pooled p values, linkage disequilibrium structure of the region, and location in regions with transcriptional properties, SNPs were selected for replication. The results from discovery, replication, and overall cohorts were pooled using inverse-variance-weighted meta-analysis. Influence of the polymorphisms on the overall radiological damage (constant effect) and on damage progression over time (time-varying effect) was analyzed. The rs6896969 polymorphism showed a significant association with radiological damage in the constant effect pooled analysis of the discovery cohorts, although no significant association was observed in the replication cohorts or the overall pooled analysis. Regarding the analysis of the PTGER4 region, 976 variants were analyzed in the discovery cohorts. From the constant and time-varying effect analyses, 12 and 20 SNPs, respectively, were selected for replication. Only the rs76523431 variant showed a significant association with radiographic progression in the time-varying effect pooled analysis of the discovery, replication, and overall cohorts. The overall pooled effect size was 1.10 (95 % confidence interval 1.05-1.14, p = 2.10 × 10(-5)), meaning that radiographic yearly progression was 10 % greater for each copy of the minor allele. The PTGER4 gene is a candidate risk factor for radiological progression in RA.

Cooperative learning as applied to resident instruction in radiology reporting.

PubMed

Mueller, Donald; Georges, Alexandra; Vaslow, Dale

2007-12-01

The study is designed to evaluate the effectiveness of an active form of resident instruction, cooperative learning, and the residents' response to that form of instruction. The residents dictated three sets of reports both before and after instruction in radiology reporting using the cooperative learning method. The reports were evaluated for word count, Flesch-Kincaid grade level, advancement on clinical spectrum, clarity, and comparison to prior reports. The reports were evaluated for changes in performance characteristics between the pre- and postinstruction dictations. The residents' response to this form of instruction was evaluated by means of a questionnaire. The instruction was effective in changing the resident dictations. The results became shorter (P<.035), more complex (P<.0126), and demonstrated increased advancement on clinical spectrum (P<.0204). The resident response to this form of instruction was positive. One hundred percent or respondents indicated enjoyment working with their groups. Seventy-five percent stated they would like to participate in more cooperative learning activities. The least positive responses related to the amount of time devoted to the project. Sixty-three percent of respondents stated that the time devoted to the project was appropriate. Cooperative learning can be an effective tool in the setting of the radiology residency. Instructional time requirements must be strongly considered in designing a cooperative learning program.

Development of Medical Technology for Contingency Response to Marrow Toxic Agents

DTIC Science & Technology

2014-07-11

the transplant community about the critical importance of establishing a nationwide contingency response plan. 2. Rapid Identification of Matched...to rapidly identify the best available donor or cord blood unit for each patient utilizing its state-of-the-art communication infrastructure, sample...York City (NYC)-NY State Radiological Disaster - tabletop exercise 2. Minneapolis-full scale exercise 3. Dana Farber Cancer Institute – full

Reducing Bottlenecks to Improve the Efficiency of the Lung Cancer Care Delivery Process: A Process Engineering Modeling Approach to Patient-Centered Care.

PubMed

Ju, Feng; Lee, Hyo Kyung; Yu, Xinhua; Faris, Nicholas R; Rugless, Fedoria; Jiang, Shan; Li, Jingshan; Osarogiagbon, Raymond U

2017-12-01

The process of lung cancer care from initial lesion detection to treatment is complex, involving multiple steps, each introducing the potential for substantial delays. Identifying the steps with the greatest delays enables a focused effort to improve the timeliness of care-delivery, without sacrificing quality. We retrospectively reviewed clinical events from initial detection, through histologic diagnosis, radiologic and invasive staging, and medical clearance, to surgery for all patients who had an attempted resection of a suspected lung cancer in a community healthcare system. We used a computer process modeling approach to evaluate delays in care delivery, in order to identify potential 'bottlenecks' in waiting time, the reduction of which could produce greater care efficiency. We also conducted 'what-if' analyses to predict the relative impact of simulated changes in the care delivery process to determine the most efficient pathways to surgery. The waiting time between radiologic lesion detection and diagnostic biopsy, and the waiting time from radiologic staging to surgery were the two most critical bottlenecks impeding efficient care delivery (more than 3 times larger compared to reducing other waiting times). Additionally, instituting surgical consultation prior to cardiac consultation for medical clearance and decreasing the waiting time between CT scans and diagnostic biopsies, were potentially the most impactful measures to reduce care delays before surgery. Rigorous computer simulation modeling, using clinical data, can provide useful information to identify areas for improving the efficiency of care delivery by process engineering, for patients who receive surgery for lung cancer.

Improving Procedure Start Times and Decreasing Delays in Interventional Radiology: A Department's Quality Improvement Initiative.

PubMed

Villarreal, Monica C; Rostad, Bradley S; Wright, Richard; Applegate, Kimberly E

2015-12-01

To identify and reduce reasons for delays in procedure start times, particularly the first cases of the day, within the interventional radiology (IR) divisions of the Department of Radiology using principles of continuous quality improvement. An interdisciplinary team representative of the IR and preprocedure/postprocedure care area (PPCA) health care personnel, managers, and data analysts was formed. A standardized form was used to document both inpatient and outpatient progress through the PPCA and IR workflow in six rooms and to document reasons for delays. Data generated were used to identify key problems areas, implement improvement interventions, and monitor their effects. Project duration was 6 months. The average number of on-time starts for the first case of the day increased from 23% to 56% (P value < .01). The average number of on-time, scheduled outpatients increased from 30% to 45% (P value < .01). Patient wait time to arrive at treatment room once they were ready for their procedure was reduced on average by 10 minutes (P value < .01). Patient care delay duration per 100 patients was reduced from 30.3 to 21.6 hours (29% reduction). Number of patient care delays per 100 patients was reduced from 46.6 to 40.1 (17% reduction). Top reasons for delay included waiting for consent (26% of delays duration) and laboratory tests (12%). Many complex factors contribute to procedure start time delays within an IR practice. A data-driven and patient-centered, interdisciplinary team approach was effective in reducing delays in IR. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

French Sizing of Medical Devices is not Fit for Purpose

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

Kibriya, Nabil, E-mail: nabskib@yahoo.co.uk; Hall, Rebecca; Powell, Steven

PurposeThe purpose of the study is to quantify the variation in the metric equivalent of French size in a range of medical devices, from various manufacturers, used in interventional radiology.MethodsThe labelling of a range of catheters, introducers, drains, balloons, stents, and endografts was examined. Products were chosen to achieve a broad range of French sizes from several manufacturers. To assess manufacturing accuracy, eight devices were selected for measurement using a laser micrometer. The external diameters of three specimens of each device were measured at centimeter intervals along the length of the device to ensure uniformity.ResultsA total of 200 labels ofmore » interventional radiology equipment were scrutinized. The results demonstrate a wide variation in the metric equivalent of French sizing. Labelled products can vary in diameter across the product range by up to 0.79 mm.The devices selected for measurement with the non-contact laser micrometer demonstrate acceptable manufacturing consistency. The external diameter differed by 0.05 mm on average.ConclusionsOur results demonstrate wide variation in the interpretation of the French scale by different manufacturers of medical devices. This has the potential to lead to problems using coaxial systems especially when the products are from different manufacturers. It is recommended that standard labelling should be employed by all manufacturers conveying specific details of the equipment. Given the wide variation in the interpretation of the French scale, our opinion is that this scale either needs to be abandoned or be strictly defined and followed.« less

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.

Thyroid cancer and employment as a radiologic technologist.

PubMed

Zabel, Erik W; Alexander, Bruce H; Mongin, Steven J; Doody, Michele M; Sigurdson, Alice J; Linet, Martha S; Freedman, D Michal; Hauptmann, Michael; Mabuchi, Kiyohiko; Ron, Elaine

2006-10-15

The association between chronic occupational ionizing radiation exposure in the medical field and thyroid cancer is not well characterized. Thyroid cancer incidence was ascertained for 2 periods in a cohort of radiologic technologists certified for a minimum 2 years and enumerated in 1983: (i) cases identified prospectively in 73,080 radiologic technologists who were free of thyroid cancer at the baseline survey and completed a second questionnaire a decade later (N = 121), and (ii) cases occurring prior to cohort enumeration among 90,245 technologists who completed the baseline survey and were thyroid cancer free 2 years after certification (N = 148). Survival analyses estimated risks associated with employment as a radiologic technologist, including duration of employment, period of employment, types of procedures and work practices. The only occupational history characteristic associated with prospectively identified thyroid cancer was a history of holding patients for X-ray procedures at least 50 times (HR = 1.47, 95% CI = 1.01-2.15). Total years worked as a radiologic technologist, years performing diagnostic, therapeutic, and nuclear medicine procedures, employment under age 20 and calendar period of first employment were not associated with thyroid cancer risk. Risk of thyroid cancers diagnosed before the baseline questionnaire was inversely associated with decade first employed as a technologist, and was elevated, albeit imprecisely, among those working more than 5 years prior to 1950 (HR = 3.04, 95% CI = 1.01-10.78). These data provide modest evidence of an association between employment as a radiologic technologist and thyroid cancer risk; however, the findings require confirmation with more accurate exposure models. Copyright 2006 Wiley-Liss, Inc.

Multisociety consensus quality improvement guidelines for intraarterial catheter-directed treatment of acute ischemic stroke, from the American Society of Neuroradiology, Canadian Interventional Radiology Association, Cardiovascular and Interventional Radiological Society of Europe, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, European Society of Minimally Invasive Neurological Therapy, and Society of Vascular and Interventional Neurology.

PubMed

Sacks, David; Black, Carl M; Cognard, Christophe; Connors, John J; Frei, Donald; Gupta, Rishi; Jovin, Tudor G; Kluck, Bryan; Meyers, Philip M; Murphy, Kieran J; Ramee, Stephen; Rüfenacht, Daniel A; Bernadette Stallmeyer, M J; Vorwerk, Dierk

2013-02-01

In this international multispecialty document, quality benchmarks for processes of care and clinical outcomes are defined. It is intended that these benchmarks be used in a quality assurance program to assess and improve processes and outcomes in acute stroke revascularization. Members of the writing group were appointed by the American Society of Neuroradiology, Canadian Interventional Radiology Association, Cardiovascular and Interventional Radiological Society of Europe, Society of Cardiac Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, European Society of Minimally Invasive Neurological Therapy, and Society of Vascular and Interventional Neurology. The writing group reviewed the relevant literature from 1986 through February 2012 to create an evidence table summarizing processes and outcomes of care. Performance metrics and thresholds were then created by consensus. The guideline was approved by the sponsoring societies. It is intended that this guideline be fully updated in 3 years. In this international multispecialty document, quality benchmarks for processes of care and clinical outcomes are defined. These include process measures of time to imaging, arterial puncture, and revascularization and measures of clinical outcome up to 90 days. Quality improvement guidelines are provided for endovascular acute ischemic stroke revascularization procedures. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

Quantitative analysis of the level of readability of online emergency radiology-based patient education resources.

PubMed

Hansberry, David R; D'Angelo, Michael; White, Michael D; Prabhu, Arpan V; Cox, Mougnyan; Agarwal, Nitin; Deshmukh, Sandeep

2018-04-01

The vast amount of information found on the internet, combined with its accessibility, makes it a widely utilized resource for Americans to find information pertaining to medical information. The field of radiology is no exception. In this paper, we assess the readability level of websites pertaining specifically to emergency radiology. Using Google, 23 terms were searched, and the top 10 results were recorded. Each link was evaluated for its readability level using a set of ten reputable readability scales. The search terms included the following: abdominal ultrasound, abdominal aortic aneurysm, aortic dissection, appendicitis, cord compression, CT abdomen, cholecystitis, CT chest, diverticulitis, ectopic pregnancy, epidural hematoma, dural venous thrombosis, head CT, MRI brain, MR angiography, MRI spine, ovarian torsion, pancreatitis, pelvic ultrasound, pneumoperitoneum, pulmonary embolism, subarachnoid hemorrhage, and subdural hematoma. Any content that was not written for patients was excluded. The 230 articles that were assessed were written, on average, at a 12.1 grade level. Only 2 of the 230 articles (1%) were written at the third to seventh grade recommended reading level set forth by the National Institutes of Health (NIH) and American Medical Association (AMA). Fifty-two percent of the 230 articles were written so as to require a minimum of a high school education (at least a 12th grade level). Additionally, 17 of the 230 articles (7.3%) were written at a level that exceeded an undergraduate education (at least a 16th grade level). The majority of websites with emergency radiology-related patient education materials are not adhering to the NIH and AMA's recommended reading levels, and it is likely that the average reader is not benefiting fully from these information outlets. With the link between health literacy and poor health outcomes, it is important to address the online content in this area of radiology, allowing for patient to more fully benefit from their online searches.

A kinematic model to estimate effective dose of radioactive substances in a human body

NASA Astrophysics Data System (ADS)

Sasaki, S.; Yamada, T.

2013-05-01

The great earthquake occurred in the north-east area in Japan in March 11, 2011. Facility system to control Fukushima Daiichi nuclear power station was completely destroyed by the following giant tsunami. From the damaged reactor containment vessels, an amount of radioactive substances had leaked and diffused in the vicinity of this station. Radiological internal exposure became a serious social issue both in Japan and all over the world. The present study provides an easily understandable, kinematic-based model to estimate the effective dose of radioactive substances in a human body by simplifying the complicated mechanism of metabolism. International Commission on Radiological Protection (ICRP) has developed a sophisticated model, which is well-known as a standard method to calculate the effective dose for radiological protection. However, owing to that ICRP method is fine, it is rather difficult for non-professional people of radiology to gasp the whole images of the movement and the influences of radioactive substances in a human body. Therefore, in the present paper we propose a newly-derived and easily-understandable model to estimate the effective dose. The present method is very similar with the traditional and conventional tank model in hydrology. Ingestion flux of radioactive substances corresponds to rain intensity and the storage of radioactive substances to the water storage in a basin in runoff analysis. The key of the present method is to estimate the energy radiated in the radioactive nuclear disintegration of an atom by using classical theory of β decay and special relativity for various kinds of radioactive atoms. The parameters used in this model are only physical half-time and biological half-time, and there are no operational parameters or coefficients to adjust our theoretical runoff to ICRP. Figure shows the time-varying effective dose with ingestion duration, and we can confirm the validity of our model. The time-varying effective dose with ingestion duration

Influence of radiation therapy on the lung-tissue in breast cancer patients: CT-assessed density changes and associated symptoms

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

Rotstein, S.; Lax, I.; Svane, G.

1990-01-01

The relative electron density of lung tissue was measured from computer tomography (CT) slices in 33 breast cancer patients treated by various techniques of adjuvant radiotherapy. The measurements were made before radiotherapy, 3 months and 9 months after completion of radiation therapy. The changes in lung densities at 3 months and 9 months were compared to radiation induced radiological (CT) findings. In addition, subjective symptoms such as cough and dyspnoea were assessed before and after radiotherapy. It was observed that the mean of the relative electron density of lung tissue varied from 0.25 when the whole lung was considered tomore » 0.17 when only the anterior lateral quarter of the lung was taken into account. In patients with positive radiological (CT) findings the mean lung density of the anterior lateral quarter increased 2.1 times 3 months after radiotherapy and was still increased 1.6 times 6 months later. For those patients without findings, in the CT pictures the corresponding values were 1.2 and 1.1, respectively. The standard deviation of the pixel values within the anterior lateral quarter of the lung increased 3.8 times and 3.2 times at 3 months and 9 months, respectively, in the former group, as opposed to 1.2 and 1.1 in the latter group. Thirteen patients had an increase in either cough or dyspnoea as observed 3 months after completion of radiotherapy. In eleven patients these symptoms persisted 6 months later. No significant correlation was found between radiological findings and subjective symptoms. However, when three different treatment techniques were compared among 29 patients the highest rate of radiological findings was observed in patients in which the largest lung volumes received the target dose. A tendency towards an increased rate of subjective symptoms was also found in this group.« 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.

Utility of complete trauma series radiographs in alert pediatric patients presenting to Emergency Department of a Tertiary Care Hospital.

PubMed

Alam Khan, T; Jamil Khattak, Y; Awais, M; Alam Khan, A; Husen, Y; Nadeem, N; Rehman, A

2015-06-01

To assess the utility of trauma series radiographs in the management of alert pediatric patients with traumatic injury and to ascertain whether it is necessary to acquire the entire trauma series in these children. A total of 176 consecutive children below the age of 15 years and having Glasgow Coma Scale score greater than 12, who presented to the emergency department of a tertiary care hospital with a history of recent trauma, were retrospectively reviewed. All the children had undergone a thorough clinical examination followed by complete trauma series radiographs, according to the American College of Surgery guidelines. A total of 558 radiographs were reviewed by a consultant pediatric radiologist including 528 trauma series radiographs and 30 additional radiographs. Among the trauma series radiographs, 35 (6.63 %) had evidence of injury; 24 (4.54 %) and 11 (2.08 %) involving the chest and pelvic regions, respectively. All children with normal physical examination had normal cervical spine and chest radiographs. Among the 11 positive pelvic X-rays, only two had radiological signs of injury in the absence of localizing physical signs, and all these children were less than 3 years of age. In all the remaining cases, children had localizing signs on physical examination. Out of the 30 additional X-rays, 27 (90 %) had radiological evidence of injury. The routine use of entire radiological trauma series in alert pediatric patients with a normal physical examination has a very low yield. In these children, the localizing signs and symptoms can help us in determining the specific radiological examination to be utilized.

Exploring the Usability of Mobile Apps Supporting Radiologists' Training in Diagnostic Decision Making.

PubMed

Kim, Min Soon; Aro, Michael R; Lage, Kraig J; Ingalls, Kevin L; Sindhwani, Vivek; Markey, Mia K

2016-03-01

The objective of this study was to conduct a usability evaluation of mobile apps for supporting education and training in radiologic diagnostic decision-making processes. Of 381 mobile apps available at two major stores (Google Play and iTunes), eight iOS apps were selected for laboratory-based usability tests. Six staff radiologists completed eight app-specific task sets, using a think-aloud strategy. The triangular methods approach included quantitative performance measures, System Usability Scale (SUS), and qualitative thematic analysis using heuristic usability principles of usability issues. Overall, radiologists achieved higher than 70% success, with favorable SUS scores, in completing the tasks for seven of the eight apps. However, task success rate and SUS score had a weak relation (r = 0.23), indicating that the perceived usability may not reflect the holistic usability of the app. Task analysis and self-report revealed 108 usability issues, which were condensed to 55 unique issues and categorized by nine usability themes and mapped to ten usability heuristics. Nonintuitive functionality (eg, nonintuitive or misleading labels) was the most frequent theme observed, leading to inefficient navigation. These usability findings were consistent with the 13 improvements the radiologists suggested. This study demonstrates the feasibility of usability evaluation of radiology mobile apps and suggests potential improvements in the development of radiology mobile apps. This study also suggests that proficiency with mobile devices may not be equivalent to being an expert user, proficient in using the apps. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Clinical and radiological outcomes of endoscopic partial facetectomy for degenerative lumbar foraminal stenosis.

PubMed

Youn, Myung Soo; Shin, Jong Ki; Goh, Tae Sik; Lee, Jung Sub

2017-06-01

Several different techniques exist to treat degenerative lumbar foraminal stenosis. Failure to adequately decompress the lumbar foramen may lead to failed back surgery syndrome. However, wide decompression often causes spinal instabilities or may require an additional fusion surgery. The aim of this study was to report the outcomes of endoscopic partial facetectomy (EPF) performed on patients with degenerative lumbar foraminal stenosis. Between 2012 and 2014, 25 consecutive patients (12 women and 13 men) who underwent EPF were included in the study. The patients were assessed before surgery and followed-up regularly during outpatient visits (preoperatively and 1, 3, 6, 12, and 24 months postoperatively). The clinical outcomes were evaluated using the visual analog scale (VAS), Oswestry Disability Index (ODI), and Short Form-36 (SF-36) outcome questionnaire. The radiological outcome was measured using the lumbar Cobb angle, disc wedging angle, lumbar lordosis (LL), slip percentage, and disc height index (DHI) in plain standing radiographs. The VAS, ODI, and SF-36 scores significantly improved at 1 month of follow-up compared with the baseline mean values and were maintained within the 2-year follow-up period. There was no radiologic progression in the lumbar Cobb's angle, disc wedging angle, LL, slip percentage, and DHI between preoperatively and 2 years postoperatively. In addition, the EPF with discectomy group and the EPF group were not significantly different in terms of clinical and radiological outcomes. EPF is an effective option in decompressing the lumbar exiting nerve root without causing spinal instabilities for the treatment of patients with lumbar foraminal stenosis.

Interpretive versus noninterpretive content in top-selling radiology textbooks: what are we teaching medical students?

PubMed

Webb, Emily M; Vella, Maya; Straus, Christopher M; Phelps, Andrew; Naeger, David M

2015-04-01

There are little data as to whether appropriate, cost effective, and safe ordering of imaging examinations are adequately taught in US medical school curricula. We sought to determine the proportion of noninterpretive content (such as appropriate ordering) versus interpretive content (such as reading a chest x-ray) in the top-selling medical student radiology textbooks. We performed an online search to identify a ranked list of the six top-selling general radiology textbooks for medical students. Each textbook was reviewed including content in the text, tables, images, figures, appendices, practice questions, question explanations, and glossaries. Individual pages of text and individual images were semiquantitatively scored on a six-level scale as to the percentage of material that was interpretive versus noninterpretive. The predominant imaging modality addressed in each was also recorded. Descriptive statistical analysis was performed. All six books had more interpretive content. On average, 1.4 pages of text focused on interpretation for every one page focused on noninterpretive content. Seventeen images/figures were dedicated to interpretive skills for every one focused on noninterpretive skills. In all books, the largest proportion of text and image content was dedicated to plain films (51.2%), with computed tomography (CT) a distant second (16%). The content on radiographs (3.1:1) and CT (1.6:1) was more interpretive than not. The current six top-selling medical student radiology textbooks contain a preponderance of material teaching image interpretation compared to material teaching noninterpretive skills, such as appropriate imaging examination selection, rational utilization, and patient safety. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

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

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

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

1995-09-01

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

Developing an orientation program.

PubMed

Edwards, K

1999-01-01

When the local area experienced tremendous growth and change, the radiology department at Maury Hospital in Columbia, Tennessee looked seriously at its orientation process in preparation for hiring additional personnel. It was an appropriate time for the department to review its orientation process and to develop a manual to serve as both a tool for supervisors and an ongoing reference for new employees. To gather information for the manual, supervisors were asked to identify information they considered vital for new employees to know concerning the daily operations of the department, its policies and procedures, the organizational structure of the hospital, and hospital and departmental computer systems. That information became the basis of the orientation manual, and provided an introduction to the hospital and radiology department; the structure of the organization; an overview of the radiology department; personnel information; operating procedures and computer systems; and various policies and procedures. With the manual complete, the radiology department concentrated on an orientation process that would meet the needs of supervisors who said they had trouble remembering the many details necessary to teach new employees. A pre-orientation checklist was developed, which contained the many details supervisors must handle between the time an employee is hired and arrives for work. The next step was the creation of a checklist for use by the supervisor during a new employee's first week on the job. A final step in the hospital's orientation program is to have each new employee evaluate the entire orientation process. That information is then used to update and revise the manual.

Standalone Anterior Cervical Discectomy and Fusion Versus Combination with Foraminotomy for the Treatment of Cervical Spondylotic Radiculopathy Secondary to Bony Foraminal Stenosis.

PubMed

Guo, Qunfeng; Wang, Liang; Zhang, Bangke; Jiang, Jiayao; Guo, Xiang; Lu, Xuhua; Ni, Bin

2016-11-01

To compare the results of anterior cervical discectomy and fusion (ACDF) combined with anterior cervical foraminotomy (ACF) and standalone ACDF for the treatment of cervical spondylotic radiculopathy (CSR). The data of 24 consecutive patients who underwent ACDF combined with ACF for significant bony foraminal stenosis were reviewed. The clinical outcomes, including visual analog scale (VAS) scores for neck pain and arm pain and Neck Disability Index, were evaluated by questionnaires. Radiologic outcomes as manifested by C2-7 angle and surgical segmental angle were recorded. The outcomes were compared with outcomes of standalone ACDF for CSR secondary to posterolateral spurs. At the final follow-up evaluation, all patients obtained bone fusion. No patient developed adjacent segment disease. Operative time was longer and blood loss was more in the ACDF combined with ACF group than in the ACDF group (all P < 0.05). However, in both groups, the neck VAS score, arm VAS score, and Neck Disability Index were significantly reduced postoperatively (all P < 0.05). The segmental curve and C2-7 lordosis were significantly improved postoperatively (all P < 0.05). There was no significant difference between the 2 groups in clinical and radiologic outcomes (P > 0.05). For CSR with foraminal stenosis secondary to significant bony pathology that cannot be managed with standalone ACDF, ACDF combined with ACF is an effective and safe treatment strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

Canadian Cytogenetic Emergency network (CEN) for biological dosimetry following radiological/nuclear accidents.

PubMed

Miller, Susan M; Ferrarotto, Catherine L; Vlahovich, Slavica; Wilkins, Ruth C; Boreham, Douglas R; Dolling, Jo-Anna

2007-07-01

To test the ability of the cytogenetic emergency network (CEN) of laboratories, currently under development across Canada, to provide rapid biological dosimetry using the dicentric assay for triage assessment, that could be implemented in the event of a large-scale radiation/nuclear emergency. A workshop was held in May 2004 in Toronto, Canada, to introduce the concept of CEN and recruit clinical cytogenetic laboratories at hospitals across the country. Slides were prepared for dicentric assay analysis following in vitro irradiation of blood to a range of gamma-ray doses. A minimum of 50 metaphases per slide were analyzed by 41 people at 22 different laboratories to estimate the exposure level. Dose estimates were calculated based on a dose response curve generated at Health Canada. There were a total of 104 dose estimates and 96 (92.3%) of them fell within the expected range using triage scoring criteria. Half of the laboratories analyzed 50 metaphases in

Clinical, functional and radiological results of Achilles tenorraphy surgically treated with mini-open technique.

PubMed

Vadalà, A; De Carli, A; Vulpiani, M C; Iorio, R; Vetrano, M; Scapellato, S; Suarez, T; Di Salvo, F; Ferretti, A

2012-12-01

The aim of this paper was to report clinical, functional and radiological results of 80 patients surgically treated with a combined mini-open and percutaneous surgical repair as proposed by Kakiuchi. All patients were evaluated with a physical examination, evaluation scales, a functional test (Ergo-jump Bosco System), and an ultrasonographic exam along with Power Doppler Ultrasonography (PDU) (S/S). At a mean follow-up of 58 months no cases of rerupture were detected. VISA-A evaluation scale showed an excellent score in 63 patients (78.75%), a good score in 14 patients (17.5%), a fair score in two patients (2.5%), and a poor score in one patient (1.25%). Hannover scale showed an excellent score in 63 patients (78.75%), and a good score in 17 patients (21.25%). Ergo-Jump evaluation showed a 2.07% mean deficit of the affected limb at the Squatting Jump test, a 3.26% mean deficit at the Counter Movement Jump test, and a 0.0062% mean improvement at the Repetitive Jump test. Ultrasonographic exam showed in all cases a satisfactory recovery of the integrity of the operated tendon. The mean AP and LL widths showed a significant increase of 7.13±2.97 mm (+56.1%) and of 4.01±2.36 mm (+43.81%) respectively. According to the modified Öhberg score scale, PDU exam showed a grade +1 in 16 patients (20%) and a grade +2 in seven cases (8.7%). The absence of rerupture cases, the satisfactory functional and ultrasonographic results of the patients included in this study cause us to consider this technique as reliable and effective even in young high-demand patients.

Computer-aided resource planning and scheduling for radiological services

NASA Astrophysics Data System (ADS)

Garcia, Hong-Mei C.; Yun, David Y.; Ge, Yiqun; Khan, Javed I.

1996-05-01

There exists tremendous opportunity in hospital-wide resource optimization based on system integration. This paper defines the resource planning and scheduling requirements integral to PACS, RIS and HIS integration. An multi-site case study is conducted to define the requirements. A well-tested planning and scheduling methodology, called Constrained Resource Planning model, has been applied to the chosen problem of radiological service optimization. This investigation focuses on resource optimization issues for minimizing the turnaround time to increase clinical efficiency and customer satisfaction, particularly in cases where the scheduling of multiple exams are required for a patient. How best to combine the information system efficiency and human intelligence in improving radiological services is described. Finally, an architecture for interfacing a computer-aided resource planning and scheduling tool with the existing PACS, HIS and RIS implementation is presented.

Validation of Rapid Radiochemical Method for Californium ...

EPA Pesticide Factsheets

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

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.

[Ergonomics of the workplace in radiology].

PubMed

García-Lallana, A; Viteri-Ramírez, G; Saiz-Mendiguren, R; Broncano, J; Dámaso Aquerreta, J

2011-01-01

The replacement of conventional films and view boxes with digital images and computer monitors managed by PACS has clearly improved the diagnostic imaging workplace. The new setup has many advantages, including increased productivity brought about by decreased overall time required for image interpretation. On the other hand, the implementation of the digital workplace has increased the importance of factors like background lighting and the position of the chair, work table, mouse, keyboard, and monitor to prevent lesions that can disable the radiologist. The influence of these factors is often undervalued in the design and implementation of the radiological workplace. This article provides recommendations for the design of the radiological workplace based on ergonomics, which is the science that studies interactions among humans and other elements of a system. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

Paranasal sinus disease in HIV antibody positive patients.

PubMed Central

Grant, A; von Schoenberg, M; Grant, H R; Miller, R F

1993-01-01

OBJECTIVE--To investigate the prevalence of radiologically-diagnosed paranasal sinus disease in HIV-1 seropositive patients. SUBJECTS AND SETTING--476 patients admitted to a dedicated inpatient unit for HIV and AIDS at the Middlesex Hospital, London, between September 1988 and February 1992. DESIGN--Retrospective review of patients' case notes and radiological records. RESULTS--30 patients (6.3%) had radiological evidence of paranasal sinus disease. At the time of admission, sinusitis was in the differential diagnosis in only 12 of the 30 patients; 13 patients were initially diagnosed as having meningitis. Pseudomonas aeruginosa was the causative organism in four patients, all of whom had advanced HIV disease. All four responded to appropriate antibiotics but had early relapse of infection. CONCLUSIONS--Sinusitis is an important and under-recognised cause of morbidity in patients with HIV disease. Images PMID:8335314

NTS radiological assessment project: comparison of delta-surface interpolation with kriging for the Frenchman Lake region of area 5

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

Foley, T.A. Jr.

The primary objective of this report is to compare the results of delta surface interpolation with kriging on four large sets of radiological data sampled in the Frenchman Lake region at the Nevada Test Site. The results of kriging, described in Barnes, Giacomini, Reiman, and Elliott, are very similar to those using the delta surface interpolant. The other topic studied is in reducing the number of sample points and obtaining results similar to those using all of the data. The positive results here suggest that great savings of time and money can be made. Furthermore, the delta surface interpolant ismore » viewed as a contour map and as a three dimensional surface. These graphical representations help in the analysis of the large sets of radiological data.« less

Haptic interface of web-based training system for interventional radiology procedures

NASA Astrophysics Data System (ADS)

Ma, Xin; Lu, Yiping; Loe, KiaFock; Nowinski, Wieslaw L.

2004-05-01

The existing web-based medical training systems and surgical simulators can provide affordable and accessible medical training curriculum, but they seldom offer the trainee realistic and affordable haptic feedback. Therefore, they cannot offer the trainee a suitable practicing environment. In this paper, a haptic solution for interventional radiology (IR) procedures is proposed. System architecture of a web-based training system for IR procedures is briefly presented first. Then, the mechanical structure, the working principle and the application of a haptic device are discussed in detail. The haptic device works as an interface between the training environment and the trainees and is placed at the end user side. With the system, the user can be trained on the interventional radiology procedures - navigating catheters, inflating balloons, deploying coils and placing stents on the web and get surgical haptic feedback in real time.

Environmental monitoring in interventional radiology

NASA Astrophysics Data System (ADS)

Del Sol, S.; Garcia, R.; Sánchez-Guzmán, D.; Ramirez, G.; Chavarin, E. U.; Rivera, T.

2017-01-01

The procedures in Interventional Radiology involve long times of exposure and high number of radiographic images that bring higher radiation doses to patients, staff and environmental than those received in conventional Radiology. Currently for monitoring the dose, the thermoluminescent dosimetry use is recommended. The aim of this work was to carry out the monitoring of the environmental scattered radiation inside the IR room using two types of thermoluminescent dosimeters, TLD-100 (reference dosimeter), CaSO4:Dy (synthesized in our laboratory). The results indicate that the TLD-100 is not effective for the environmental monitoring of low-energy Rx rooms. The CaSO4:Dy presented good behaviour over the 6 months of study. The results will be specific to each room so it is recommended such studies as part of the program of quality control of each Rx room.

STEPS: lean thinking, theory of constraints and identifying bottlenecks in an emergency department.

PubMed

Ryan, A; Hunter, K; Cunningham, K; Williams, J; O'Shea, H; Rooney, P; Hickey, F

2013-04-01

This study aimed to identify the bottlenecks in patients' journeys through an emergency department (ED). For each stage of the patient journey, the average times were compared between two groups divided according to the four hour time frame and disproportionate delays were identified using a significance test These bottlenecks were evaluated with reference to a lean thinking value-stream map and the five focusing steps of the theory of constraints. A total of 434 (72.5%) ED patients were tracked over one week. Logistic regression showed that patients who had radiological tests, blood tests or who were admitted were 4.4, 4.1 and 7.7 times more likely, respectively, to stay over four hours in the ED than those who didn't The stages that were significantly delayed were the time spent waiting for radiology (p = 0.001), waiting for the in-patient team (p = 0.004), waiting for a bed (p < 0.001) and ED doctor turnaround time (p < 0.001).

White Paper: Curriculum in Interventional Radiology.

PubMed

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

2017-04-01

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

Metacarpophalangeal joint of the thumb arthrodesis using intramedullary interlocking screws XMCP™.

PubMed

Novoa-Parra, C N; Montaner-Alonso, D; Morales-Rodríguez, J

2017-09-04

The study objective was to assess the results of a thumb metacarpophalangeal joint (MCPJ) arthrodesis using intramedullary interlocking screws at 25°, XMCP ™ (Extremity Medical, Parsippany, NJ). Radiographs evaluated the angle of arthrodesis, time of fusion and fixation of the implant. Clinical and functional outcomes were assessed using the DASH questionnaire and the VAS scale. Any complications found during surgery or the follow-up period were noted. We studied 9 patients. The mean follow-up was 27.6 months. Patients showed clinical and radiological evidence of fusion in an average of 8 weeks, the angle of fusion was 25°. There were no complications and no implant had to be removed. The XMCP™ system provides a reliable method for MCPJ arthrodesis for several indications and can be used with other procedures in the complex hand. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Free-hand ultrasound guidance permits safe and efficient minimally invasive intrathymic injections in both young and aged mice

PubMed Central

Tuckett, Andrea Z.; Zakrzewski, Johannes L.; Li, Duan; van den Brink, Marcel R.M.; Thornton, Raymond H.

2014-01-01

The goal of this study was to evaluate whether using an aseptic free-hand approach for ultrasound-guided injection facilitates injection into the thymic gland in mice. We used this interventional radiology technique in young, aged, and immunodeficient mice and found that the thymus was visible in all cases. The mean injection period was 8 s in young mice and 19 s in aged or immunodeficient mice. Injection accuracy was confirmed by intrathymic location of an injected dye, or by in vivo bioluminescence imaging of injected luciferase-expressing cells. Accurate intrathymic injection was confirmed in 97% of cases. No major complications were observed. We conclude that an aseptic free-hand technique for ultrasound-guided intrathymic injection is safe, accurate, and reduces the time required for intrathymic injections. This method facilitates large-scale experiments, injection of individual thymic lobes, and is clinically relevant. PMID:25701534

Radiologic sciences. Faculty needs assessment.

PubMed

Powers, Kevin J

2005-01-01

A total of 326 programs are represented in the data collected. Based on the average number of full- and part-time faculty members reported per program, this survey represents more than 1500 faculty positions. Based on the forecast of retirement and career change for all faculty members, there will be a turnover of 700 to 800 positions over the next 5 to 10 years. Part-time/adjunct faculty vacancies are expected to create the greatest number of opportunities for technologists to make the transition to education, with approximately one third of current part-time/adjunct educators planning on leaving radiologic sciences education within 5 years. To encourage retention of part-time/adjunct educators, annual evaluations should be modified to recognize the important educational role these instructors play. There is a need to create enthusiasm and interest in education as a career pathway for radiologic technologists. Resources are needed that help radiologic technologists make the transition to teaching. Finally, the retention of educators must be emphasized. Program applicant trends indicate radiologic technology students are older, have prior postsecondary education experience or are making a career change. This data emphasizes the need for educators, both full time and part time, to understand the characteristics and needs of the adult learner. Adult learners bring a wealth of education, experience and life skills that create both opportunities and challenges in the classroom and clinical setting. All categories of respondents indicated that their current salaries were greater than those of program graduates in their firstjob. Of interest is that 1 in 5 (20%) of part-time/adjunct educators indicated the opposite--that program graduates earn more in their firstjob than educators earn. When asked about salaries if working full time in clinical practice, the majority of all groups indicated their salary would be about the same or would decrease. Only 20% of program directors, 21% of full-time educators and 26% of part-time/adjunct educators indicated their salary would be higher in clinical practice. Part-time/adjunct educators reported working the most in clinical practice within the past week to month. Program directors exhibited the greatest separation from clinical practice, with more than half indicating a gap of 2 years or more from practicing in the clinical environment. While academic achievement is common among the educator populations sampled, a very low percentage of these educators are seeking an advanced academic degree. Less than a third of those surveyed indicated that they were pursuing an advanced degree. Becoming involved in research is not a requirement for many current educators, although survey participants expressed an interest in information about how to conduct a research project. A primary motivator for conducting the faculty development needs assessment was to use the data in strategic planning to set priorities for the resources available to the ASRT Education Department. The data will help maximize ASRT support for present and future educators. Services created by the ASRT Education Department will deepen the relationship with this key segment of the professional community.

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.

Handheld technology acceptance in radiologic science education and training programs

NASA Astrophysics Data System (ADS)

Powers, Kevin Jay

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

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

PubMed

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

2017-01-16

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

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

PubMed

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

2014-04-01

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

2000 RSNA annual oration in diagnostic radiology: The future of interventional radiology.

PubMed

Becker, G J

2001-08-01

Origins in imaging, procedural emphasis, and dependence on innovation characterize interventional radiology, which will continue as the field of image-guided minimally invasive therapies. A steady supply of innovators will be needed. Current workforce shortages demand that this problem be addressed and in an ongoing fashion. Interventional radiology's major identity problem will require multiple corrective measures, including a name change. Diagnostic radiologists must fully embrace the concept of the dedicated interventionalist. Interspecialty turf battles will continue, especially with cardiologists and vascular surgeons. To advance the discipline, interventional radiologists must remain involved in cutting-edge therapies such as endograft repair of aortic aneurysms and carotid stent placement. As the population ages, interventionalists will experience a shift toward a greater emphasis on cancer treatment. Political agendas and public pressure will improve access to care and result in managed health care reforms. Academic centers will continue to witness a decline in time and resources available to pursue academic missions. The public outcry for accountability will result in systems changes aimed at reducing errors and process changes in the way physicians are trained, certified, and monitored. Evidence-based medicine will be the watchword of this century. Interventional radiology will maintain its role through development of methods for delivery of genes, gene products, and drugs to specific target sites; control of angiogenesis and other biologic processes; and noninvasive image-guided delivery of various forms of energy for ablation.

Natural Language Processing Technologies in Radiology Research and Clinical Applications.

PubMed

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

2016-01-01

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

Job satisfaction among radiology assistants: a multicentre cross-sectional study in Italy.

PubMed

Gualano, Maria Rosaria; Gili, Renata; Bert, Fabrizio; Scaioli, Giacomo; Cerutti, Stefano; Gatti, Giovanni; Siliquini, Roberta

2016-01-20

Job satisfaction among physicians is an important occupational health issue since it is related to different factors such as work motivation or career decisions. The aim of this study was to investigate  job satisfaction among radiology assistants for the first time in Italy. In 2012, a cross-sectional survey was conducted among a convenience sample of radiology assistants drawn from all Italian regions who submitted an electronic or paper-based self-administered questionnaire. The data collected were analysed using logistic regressions in order to assess the role of socio-demographic variables. Overall, 574 radiology assistants were interviewed. More than half of the subjects were males and  were younger than 40 years old. Around 76% of the sample was not satisfied  as regards salary. Moreover, the majority of the participants (66.1%) was not satisfied  with the professional refresher courses. Compared with males, females were more satisfied in terms of professional enrichment (OR=1.79, 95% CI: 1.23-2.62) but less satisfied with their relationships with superiors (OR=0.57, 95% CI: 0.38-0.85). Since radiology assistants and, in general, healthcare workers assist medical doctors, thus playing a  significant role  in safeguarding patients' health , it would be  desirable to give  due importance to the issue of job satisfaction,  from all points of view.

Why Isn't There More High-fidelity Simulation Training in Diagnostic Radiology? Results of a Survey of Academic Radiologists.

PubMed

Cook, Tessa S; Hernandez, Jessica; Scanlon, Mary; Langlotz, Curtis; Li, Chun-Der L

2016-07-01

Despite its increasing use in training other medical specialties, high-fidelity simulation to prepare diagnostic radiology residents for call remains an underused educational resource. To attempt to characterize the barriers toward adoption of this technology, we conducted a survey of academic radiologists and radiology trainees. An Institutional Review Board-approved survey was distributed to the Association of University Radiologists members via e-mail. Survey results were collected electronically, tabulated, and analyzed. A total of 68 survey responses representing 51 programs were received from program directors, department chairs, chief residents, and program administrators. The most common form of educational activity for resident call preparation was lectures. Faculty supervised "baby call" was also widely reported. Actual simulated call environments were quite rare with only three programs reporting this type of educational activity. Barriers to the use of simulation include lack of faculty time, lack of faculty expertise, and lack of perceived need. High-fidelity simulation can be used to mimic the high-stress, high-stakes independent call environment that the typical radiology resident encounters during the second year of training, and can provide objective data for program directors to assess the Accreditation Council of Graduate Medical Education milestones. We predict that this technology will begin to supplement traditional diagnostic radiology teaching methods and to improve patient care and safety in the next decade. Published by Elsevier Inc.

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

NASA Astrophysics Data System (ADS)

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

2018-01-01

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

Natural Language Processing Technologies in Radiology Research and Clinical Applications

PubMed Central

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

2016-01-01

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

Cloud Computing for radiologists.

PubMed

Kharat, Amit T; Safvi, Amjad; Thind, Ss; Singh, Amarjit

2012-07-01

Cloud computing is a concept wherein a computer grid is created using the Internet with the sole purpose of utilizing shared resources such as computer software, hardware, on a pay-per-use model. Using Cloud computing, radiology users can efficiently manage multimodality imaging units by using the latest software and hardware without paying huge upfront costs. Cloud computing systems usually work on public, private, hybrid, or community models. Using the various components of a Cloud, such as applications, client, infrastructure, storage, services, and processing power, Cloud computing can help imaging units rapidly scale and descale operations and avoid huge spending on maintenance of costly applications and storage. Cloud computing allows flexibility in imaging. It sets free radiology from the confines of a hospital and creates a virtual mobile office. The downsides to Cloud computing involve security and privacy issues which need to be addressed to ensure the success of Cloud computing in the future.

A pilot study measuring changes in student impressions before and after clinical training using a questionnaire based on the semantic differential technique.

PubMed

Tamura, Naomi; Terashita, Takayoshi; Ogasawara, Katsuhiko

2013-01-01

Students with a positive impression of their studies can become more motivated. This study measured the learning impact of clinical training by comparing student impressions before and after clinical training. The study included 32 students of radiological technology in their final year with the Division of Radiological Science and Technology, Department of Health Sciences, School of Medicine, Hokkaido University. To measure student impressions of x-ray examination training, we developed a questionnaire using the semantic differential technique. The resulting factor analysis identified 2 factors that accounted for 44.9% of the 10 bipolar adjective scales. Factor 1 represented a "resistance" impression of x-ray examination training, and factor 2 represented a "responsibility" impression. The differences in factor scores before and after the clinical training suggest that student impressions are affected by clinical training.

INTEGRATED CIRCUITS FROM MOBILE PHONES AS POSSIBLE EMERGENCY OSL/TL DOSIMETERS.

PubMed

Sholom, S; McKeever, S W S

2016-09-01

In this article, optically stimulated luminescence (OSL) data are presented from integrated circuits (ICs) extracted from mobile phones. The purpose is to evaluate the potential of using OSL from components in personal electronic devices such as smart phones as a means of emergency dosimetry in the event of a large-scale radiological incident. ICs were extracted from five different makes and models of mobile phone. Sample preparation procedures are described, and OSL from the IC samples following irradiation using a (90)Sr/(90)Y source is presented. Repeatability, sensitivity, dose responses, minimum measureable doses, stability and fading data were examined and are described. A protocol for measuring absorbed dose is presented, and it was concluded that OSL from these components is a viable method for assessing dose in the days following a radiological incident. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Cloud Computing for radiologists

PubMed Central

Kharat, Amit T; Safvi, Amjad; Thind, SS; Singh, Amarjit

2012-01-01

Cloud computing is a concept wherein a computer grid is created using the Internet with the sole purpose of utilizing shared resources such as computer software, hardware, on a pay-per-use model. Using Cloud computing, radiology users can efficiently manage multimodality imaging units by using the latest software and hardware without paying huge upfront costs. Cloud computing systems usually work on public, private, hybrid, or community models. Using the various components of a Cloud, such as applications, client, infrastructure, storage, services, and processing power, Cloud computing can help imaging units rapidly scale and descale operations and avoid huge spending on maintenance of costly applications and storage. Cloud computing allows flexibility in imaging. It sets free radiology from the confines of a hospital and creates a virtual mobile office. The downsides to Cloud computing involve security and privacy issues which need to be addressed to ensure the success of Cloud computing in the future. PMID:23599560

An Internet-Based Radiology Course in Medical School: Comparison of Academic Performance of Students on Campus Versus Those With Absenteeism Due to Residency Interviews.

PubMed

Alexander, Andrew George; Deas, Deborah; Lyons, Paul Eric

2018-05-18

Imaging and its optimal use are imperative to the practice of medicine, yet many students don't receive a formal education in radiology. Concurrently, students look for ways to take time away from medical school for residency interviewing. Web-based instruction provides an opportunity to combine these imperatives using online modalities. A largely Web-based course in radiology during the 4th year of medical school was evaluated both for its acceptance to students who needed to be away from campus for interviews, and its effectiveness on a nationally administered standardized test. All students were placed into a structured program utilizing online videos, online modules, online textbook assignments, and live interactive online lectures. Over half of the course could be completed away from campus. The Alliance of Medical Student Educators in Radiology test exam bank was used as a final exam to evaluate medical knowledge. Positive student feedback included the freedom to travel for interviews, hands-on ultrasound training, interactive teaching sessions, and quality Web-based learning modules. Negative feedback included taking quizzes in-person, a perceived outdated online textbook, and physically shadowing hospital technicians. Most students elected to take the course during the interview months of October through January. The Alliance of Medical Student Educators in Radiology final exam results (70.5%) were not significantly different than the national cohort (70%) who took the course in-person. Test scores from students taking the course during interview travel months were not significantly different from students who took the course before (P=.30) or after (P=.34) the interview season. Students desire to learn radiology and often choose to do so when they need to be away from campus during the fall of their 4th year of study to accomplish their residency interviews. Web-based education in radiology allows students' interview traveling and radiology course objectives to be successfully met without adversely affecting the outcomes on a nationally normed examination in radiology. A curriculum that includes online content and live Web-based teleconference access to faculty can accomplish both imperatives. ©Andrew George Alexander, Deborah Deas, Paul Eric Lyons. Originally published in JMIR Medical Education (http://mededu.jmir.org), 18.05.2018.

Associated lumbar scoliosis does not affect outcomes in patients undergoing focal minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF) for neurogenic symptoms-a minimum 2-year follow-up study.

PubMed

Tay, Kae Sian; Bassi, Anupreet; Yeo, William; Yue, Wai Mun

2017-01-01

There is no current literature comparing outcomes of patients with and without lumbar scoliosis having neurologic symptoms undergoing minimally invasive surgery-transforaminal lumbar interbody fusion (MISTLIF) technique. This study aimed to determine whether associated lumbar scoliosis will result in different clinical, radiological, and operative outcomes in patients undergoing focal MISTLIF for neurogenic symptoms, without specific correction of the scoliosis. A retrospective case comparison study from prospectively collected hospital registry data was carried out. Two hundred and thirty eligible patients were evaluated and divided into two groups: Scoliosis Group (SG; n=57) with Cobb angle >10 degrees on anterioposterior (AP) plain lumbar spine radiographs and Non-Scoliosis Group (NSG; n=173) consisting of the remaining patients. Clinical outcomes were assessed using the Oswestry Disability Index, the North American Spine Society (NASS) Neurogenic Symptom Score, the NASS Satisfaction with Surgery Rating, the 36-Item Short-Form Health Survey (SF-36), and the Numerical Pain Rating Scale for back and leg pain. Radiological findings included Cobb angle, fusion, implant failure or loosening, and adjacent segment degeneration (ASD). Both groups were compared for demographics, perioperative parameters, complications, clinical, and radiological outcomes. Interobserver agreement (kappa statistics) for measurement of Cobb angle was calculated on all cases of both groups by two authors. Patients were evaluated preoperatively, at 6 months, and 2 years after surgery. The average follow-up was 2.88±1.47 years in the SG and 2.71±1.34 years in the NSG (p=.444). Differences in mean age (SG: 62.9±10.9 years and NSG: 57.6±13.1 years), estimated related risk of death (SG: 3.05±2.13 and NSG: 2.41±1.74), and gender (female=SG: 87.7% and NSG: 64.2%) were statistically significant (p<.05), whereas race distribution, body mass index |(BMI), spinal levels operated, number of levels operated, bone morphogenetic protein (BMP)-2 use, and type of bone graft were not. Fluoroscopic time, operative time, blood loss, postoperative opioid usage, time to ambulation, and length of hospitalization were similar (p>.05). Preoperative and postoperative clinical outcomes were similar in both groups (p>.05) except SF-36 physical function score, which was found to be significantly higher in the NSG at final follow-up (p<.05). Clinical outcomes scores improved significantly postoperatively (p<.05), and grade 1 fusion (Bridwell classification) was achieved in 93% in the SG and in 93.6% in the NSG (p=.417). Total complications were 11 (19.29%) in the SG and 21 (12.13%) in the NSG (p=.097). De novo ASD was found in 1 case in the SG and in 14 cases in the NSG (p=.124), with 1 case in the NSG requiring further surgery. Associated mild lumbar scoliosis (Cobb angle <30°) does not result in significantly different perioperative, clinical, and radiological outcomes in patients undergoing focal decompression and MISTLIF for neurogenic symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

US screening of international travelers for radioactive contamination after the Japanese nuclear plant disaster in March 2011.

PubMed

Wilson, Todd; Chang, Arthur; Berro, Andre; Still, Aaron; Brown, Clive; Demma, Andrew; Nemhauser, Jeffrey; Martin, Colleen; Salame-Alfie, Adela; Fisher-Tyler, Frieda; Smith, Lee; Grady-Erickson, Onalee; Alvarado-Ramy, Francisco; Brunette, Gary; Ansari, Armin; McAdam, David; Marano, Nina

2012-10-01

On March 11, 2011, a magnitude 9.0 earthquake and subsequent tsunami damaged nuclear reactors at the Fukushima Daiichi complex in Japan, resulting in radionuclide release. In response, US officials augmented existing radiological screening at its ports of entry (POEs) to detect and decontaminate travelers contaminated with radioactive materials. During March 12 to 16, radiation screening protocols detected 3 travelers from Japan with external radioactive material contamination at 2 air POEs. Beginning March 23, federal officials collaborated with state and local public health and radiation control authorities to enhance screening and decontamination protocols at POEs. Approximately 543 000 (99%) travelers arriving directly from Japan at 25 US airports were screened for radiation contamination from March 17 to April 30, and no traveler was detected with contamination sufficient to require a large-scale public health response. The response highlighted synergistic collaboration across government levels and leveraged screening methods already in place at POEs, leading to rapid protocol implementation. Policy development, planning, training, and exercising response protocols and the establishment of federal authority to compel decontamination of travelers are needed for future radiological responses. Comparison of resource-intensive screening costs with the public health yield should guide policy decisions, given the historically low frequency of contaminated travelers arriving during radiological disasters.

Knee osteoarthritis image registration: data from the Osteoarthritis Initiative

NASA Astrophysics Data System (ADS)

Galván-Tejada, Jorge I.; Celaya-Padilla, José M.; Treviño, Victor; Tamez-Peña, José G.

2015-03-01

Knee osteoarthritis is a very common disease, in early stages, changes in joint structures are shown, some of the most common symptoms are; formation of osteophytes, cartilage degradation and joint space reduction, among others. Based on a joint space reduction measurement, Kellgren-Lawrence grading scale, is a very extensive used tool to asses radiological OA knee x-ray images, based on information obtained from these assessments, the objective of this work is to correlate the Kellgren-Lawrence score to the bilateral asymmetry between knees. Using public data from the Osteoarthritis initiative (OAI), a set of images with different Kellgren-Lawrencescores were used to determine a relationship of Kellgren-Lawrence score and the bilateral asymmetry, in order to measure the asymmetry between the knees, the right knee was registered to match the left knee, then a series of similarity metrics, mutual information, correlation, and mean squared error where computed to correlate the deformation (mismatch) of the knees to the Kellgren-Lawrence score. Radiological information was evaluated and scored by OAI radiologist groups. The results of the study suggest an association between Radiological Kellgren-Lawrence score and image registration metrics, mutual information and correlation is higher in the early stages, and mean squared error is higher in advanced stages. This association can be helpful to develop a computer aided grading tool.

Reading the Writing in Radiology: 1923-2013.

PubMed

Scott, James A; Palmer, Edwin L; Connolly, Leonard P

2015-07-01

The style and tone of the writing in Radiology has changed over the years since its first publication in 1923. Many of the tonal changes have occurred transiently and likely in relation to political and professional issues in play at a particular time. Others represent more consistent trends in the evolution of the professional writing style. In this report, we analyze the tone of the editorial content from 1923 to 2013 in a historical context as well as progressive changes in readability parameters involving both editorial and technical content.

Feasibility and Top Level Design of a Scalable Emergency Response System for Oceangoing Assets

DTIC Science & Technology

2008-10-20

hazard response. The DC is responsible for the initial response. In a small-scale hazard situation, the DC will assign a Risk Assessment Code (RAC) and...Qualification Standard R&D Research and Development RAC Risk Assessment Code RADSAFE Radiological Safety RAM Rolling Airframe Missile RFID Radio...easily be used for other environmental remediation efforts including Superfund sites, decommissioned Navy vessels and Brownfield locations, among others

Expedient Encapsulation: Protective Structural Coatings

DTIC Science & Technology

2004-11-16

strippable coating applied to the interior of a portable ‘office’ shed. The barrier polymer was assessed for its ability to significantly diminish the...proof-of-concept study that will assess the application of two select coatings on a large-scale (approximately 8’ x 8’ x 8’) shelter interior...available coating applied to a portable storage building. The coating selected for use in the study was developed for radiological surface

Measuring Concentrations of Particulate 140La in the Air

DOE PAGES

Okada, Colin E.; Kernan, Warnick J.; Keillor, Martin E.; ...

2016-05-01

Air sampling systems were deployed to measure the concentration of radioactive material in the air during the Full-Scale Radiological Dispersal Device experiments. The air samplers were positioned 100-600 meters downwind of the release point. The filters were collected immediately and analyzed in the field. Quantities for total activity collected on the air filters are reported along with additional information to compute the average or integrated air concentrations.

Imaging and radiology

MedlinePlus

Interventional radiology; Diagnostic radiology; X-ray imaging ... DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care professionals see structures inside your body. Doctors that specialize in the interpretation ...

Utilization of a radiology-centric search engine.

PubMed

Sharpe, Richard E; Sharpe, Megan; Siegel, Eliot; Siddiqui, Khan

2010-04-01

Internet-based search engines have become a significant component of medical practice. Physicians increasingly rely on information available from search engines as a means to improve patient care, provide better education, and enhance research. Specialized search engines have emerged to more efficiently meet the needs of physicians. Details about the ways in which radiologists utilize search engines have not been documented. The authors categorized every 25th search query in a radiology-centric vertical search engine by radiologic subspecialty, imaging modality, geographic location of access, time of day, use of abbreviations, misspellings, and search language. Musculoskeletal and neurologic imagings were the most frequently searched subspecialties. The least frequently searched were breast imaging, pediatric imaging, and nuclear medicine. Magnetic resonance imaging and computed tomography were the most frequently searched modalities. A majority of searches were initiated in North America, but all continents were represented. Searches occurred 24 h/day in converted local times, with a majority occurring during the normal business day. Misspellings and abbreviations were common. Almost all searches were performed in English. Search engine utilization trends are likely to mirror trends in diagnostic imaging in the region from which searches originate. Internet searching appears to function as a real-time clinical decision-making tool, a research tool, and an educational resource. A more thorough understanding of search utilization patterns can be obtained by analyzing phrases as actually entered as well as the geographic location and time of origination. This knowledge may contribute to the development of more efficient and personalized search engines.

Utility of spiral CAT scan in the follow-up of patients with pulmonary Langerhans cell histiocytosis.

PubMed

Abbritti, M; Mazzei, M A; Bargagli, E; Refini, R M; Penza, F; Perari, M G; Volterrani, L; Rottoli, P

2012-08-01

Pulmonary Langerhans cell histiocytosis (PLCH) is a rare disease that occurs almost exclusively in smokers, generally young adults between 20 and 40 years old. Prognostic biomarkers of the disease are lacking. This study describes the clinical-radiological features of a group of PLCH patients and applies a semi-quantitative CT score of the chest to verify the prognostic value of radiological findings in this disease. Clinical-radiological and immunological data from 12 Caucasian patients (6M, 7 smokers and 5 ex-smokers, mean age 36±8 years) were recorded at onset and after a follow-up period of 4 years. Application of the semi-quantitative CT score revealed a prevalently cystic pattern at onset and follow-up in the majority of the patients. Patients with a prevalently nodular pattern developed cystic lesions during follow-up. Interestingly, significant correlations were found between the extent of cystic lesions and DLCO values at onset (time 0: p<0.05) and at the end of follow-up (time 1, p<0.05) and with FEV1 values at time 0 (p<0.05) and time 1 (p<0.05). Patients with progressive functional decline were those with CT evidence of severe cystic alterations. The results suggest that high resolution CT scan of the chest is mandatory for characterizing PLCH patients at diagnosis and during follow-up. The proposed CT score of the chest showed potential prognostic value. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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.

[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.

The predictable swarm: staying on top of radiology's cyclical staffing "bug".

PubMed

Ryan, Mary Jane

2005-01-01

Partners HealthCare System in Boston, MA, took some progressive and bold steps to address the recent staffing shortages in radiology. By addressing the shortage at the system level versus the individual hospital level, Partners was able to successfully recruit and support more than 80 new radiologic technologists from initial interest through graduation in 2 years. The recruitment effort helped reduce the utilization of temporary/agency personnel that cost the system more than dollar 6 million in 2001. The system utilized a multi-disciplinary team of professionals at many levels in the organization to achieve significant results in a relatively short period of time. Further, the organization channeled all available resources, including a grant from the US Department of Labor (DOL). The Boston Private Industry Council (BPIC), a local organization well known to the Partners HealthCare community benefits and human resources departments, managed the DOL grant. At least 64 of the first 80 graduates have accepted positions within Partners HealthCare radiology departments. The organization has further populated a database of more than 1,000 interested candidates, some of whom are currently in school and preparing for a future career in radiology, hopefully within the Partners HealthCare System. Partners HealthCare has managed to maintain a diversity rate at over 25% people of color by utilizing targeted recruiting efforts. Partners plans to continue to offer scholarships and other methods of support and career laddering for radiologic technologists in order to continue to meet staffing needs well in to the future. Partners HealthCare developed and implemented a "grow your own" strategy, and the system's leaders hold the philosophy that workforce development is a long-term investment requiring a flexible, permanent plan to stay ahead of the clinical staffing curve.

ASPECT

EPA Pesticide Factsheets

Able to deploy within one hour of notification, EPA's Airborne Spectral Photometric Environmental Collection Technology (ASPECT) is the nation’s only airborne real-time chemical and radiological detection, infrared and photographic imagery platform.

Comparison of intra-operative specimen mammography to standard specimen mammography for excision of non-palpable breast lesions: a randomized trial.

PubMed

Miller, Cynthia L; Coopey, Suzanne B; Rafferty, Elizabeth; Gadd, Michele; Smith, Barbara L; Specht, Michelle C

2016-02-01

Standard specimen mammography (SSM) is performed in the radiology department after wire-localized excision of non-palpable breast lesions to confirm the presence of the target and evaluate margins. Alternatively, intra-operative specimen mammography (ISM) allows surgeons to view images in the operating room (OR). We conducted a randomized study comparing ISM and SSM. Women undergoing wire-localized excision for breast malignancy or imaging abnormality were randomized to SSM or ISM. For SSM, the specimen was transported to the radiology department for imaging and interpretation. For ISM, the specimen was imaged in the OR for interpretation by the surgeon and sent for SSM. Interpretation time was from specimen leaving OR until radiologist interpretation for SSM and from placement in ISM device until surgeon interpretation for ISM. Procedure and interpretation times were compared. Concordance between ISM and SSM for target and margins was evaluated. 72 patients were randomized, 36 ISM and 36 SSM. Median procedure times were similar, 48.5 (17-138) min for ISM, and 54 (17-40) min for SSM (p = 0.72), likely since specimens in both groups traveled to radiology for SSM. Median interpretation time was significantly shorter with ISM, 1 (0.5-2.0) and 9 (4-16) min for ISM and SSM, respectively (p < 0.0001). Among specimens with ISM and SSM, concordance was 100 % (35/35) for target and 93 % (14/15) for margins. In this randomized trial, use of ISM compared with SSM significantly reduced interpretation times, while accurately identifying the target. This could result in decreased operative costs from shorter OR times with use of ISM.

Using PCR-based detection and genotyping to trace Streptococcus salivarius meningitis outbreak strain to oral flora of radiology physician assistant.

PubMed

Srinivasan, Velusamy; Gertz, Robert E; Shewmaker, Patricia L; Patrick, Sarah; Chitnis, Amit S; O'Connell, Heather; Benowitz, Isaac; Patel, Priti; Guh, Alice Y; Noble-Wang, Judith; Turabelidze, George; Beall, Bernard

2012-01-01

We recently investigated three cases of bacterial meningitis that were reported from a midwestern radiology clinic where facemasks were not worn during spinal injection of contrast agent during myelography procedures. Using pulsed field gel electrophoresis we linked a case strain of S. salivarius to an oral specimen of a radiology physician assistant (RPA). We also used a real-time PCR assay to detect S. salivarius DNA within a culture-negative cerebrospinal fluid (CSF) specimen. Here we extend this investigation through using a nested PCR/sequencing strategy to link the culture-negative CSF specimen to the case strain. We also provide validation of the real-time PCR assay used, demonstrating that it is not solely specific for Streptococcus salivarius, but is also highly sensitive for detection of the closely related oral species Streptococcus vestibularis. Through using multilocus sequence typing and 16S rDNA sequencing we further strengthen the link between the CSF case isolate and the RPA carriage isolate. We also demonstrate that the newly characterized strains from this study are distinct from previously characterized S. salivarius strains associated with carriage and meningitis.

Can academic radiology departments become more efficient and cost less?

PubMed

Seltzer, S E; Saini, S; Bramson, R T; Kelly, P; Levine, L; Chiango, B F; Jordan, P; Seth, A; Elton, J; Elrick, J; Rosenthal, D; Holman, B L; Thrall, J H

1998-11-01

To determine how successful two large academic radiology departments have been in responding to market-driven pressures to reduce costs and improve productivity by downsizing their technical and support staffs while maintaining or increasing volume. A longitudinal study was performed in which benchmarking techniques were used to assess the changes in cost and productivity of the two departments for 5 years (fiscal years 1992-1996). Cost per relative value unit and relative value units per full-time equivalent employee were tracked. Substantial cost reduction and productivity enhancement were realized as linear improvements in two key metrics, namely, cost per relative value unit (decline of 19.0% [decline of $7.60 on a base year cost of $40.00] to 28.8% [$12.18 of $42.21]; P < or = .001) and relative value unit per full-time equivalent employee (increase of 46.0% [increase of 759.55 units over a base year productivity of 1,651.45 units] to 55.8% [968.28 of 1,733.97 units]; P < .001), during the 5 years of study. Academic radiology departments have proved that they can "do more with less" over a sustained period.

[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.

Workflow in interventional radiology: uterine fibroid embolization (UFE)

NASA Astrophysics Data System (ADS)

Lindisch, David; Neumuth, Thomas; Burgert, Oliver; Spies, James; Cleary, Kevin

2008-03-01

Workflow analysis can be used to record the steps taken during clinical interventions with the goal of identifying bottlenecks and streamlining the procedure efficiency. In this study, we recorded the workflow for uterine fibroid embolization (UFE) procedures in the interventional radiology suite at Georgetown University Hospital in Washington, DC, USA. We employed a custom client/server software architecture developed by the Innovation Center for Computer Assisted Surgery (ICCAS) at the University of Leipzig, Germany. This software runs in a JAVA environment and enables an observer to record the actions taken by the physician and surgical team during these interventions. The data recorded is stored as an XML document, which can then be further processed. We recorded data from 30 patients and found a mean intervention time of 01:49:46 (+/- 16:04) minutes. The critical intervention step, the embolization, had a mean time of 00:15:42 (+/- 05:49) minutes, which was only 15% of the total intervention time.

Errors in imaging patients in the emergency setting

PubMed Central

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

2016-01-01

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

An aerial radiological survey of the Durango, Colorado uranium mill tailings site and surrounding area

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

Hilton, L.K.

1981-06-01

An aerial radiological survey of Durango, Colorado, including the inactive uranium mill tailings piles located southwest of the town, was conducted during August 25--29, 1980, for the Department of Energy's Environmental and Safety Engineering Division. Areas of radiation exposure rates higher than the local background, which was about 15 microrentgens per hour ({mu}R/h), were observed directly over and to the south of the mill tailings piles, over a cemetery, and at two spots near the fairgrounds. The rapidly changing radiation exposure rates at the boundaries of the piles preclude accurate extrapolation of aerial radiological data to ground level exposure ratesmore » in their immediate vicinity. Estimated radiation exposure rates close to the piles, however, approached 30 times background, or about 450 {mu}R/h. Radiation exposure rates in a long area extending south from the tailings piles were about 25 {mu}R/h.« less

International Outdoor Experiments and Models for Outdoor Radiological Dispersal Devices

DOE PAGES

Blumenthal, Daniel J.; Musolino, Stephen V.

2016-05-01

With the advent of nuclear reactors and the technology to produce radioactive materials in large quantities, concern arose about the use of radioactivity as a poison in warfare, and hence, consideration was given to defensive measures (Smyth 1945). Approximately forty years later, the interest in the environmental- and health effects caused by a deliberate dispersal was renewed, but this time, from the perspective of a malevolent act of radiological terrorism in an urban area. For many years there has been international collaboration in scientific research to understand the range of effects that might result from a device that could bemore » constructed by a sub-national group. In this paper, scientists from government laboratories in Australia, Canada, the United Kingdom, and the United States collectively have conducted a myriad of experiments to understand and detail the phenomenology of an explosive radiological dispersal device.« less

Errors in imaging patients in the emergency setting.

PubMed

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

2016-01-01

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

[Certified quality management according to DIN ISO 9001 in a radiology department at a university hospital: measurable changes in academic quality indicators?].

PubMed

Lorenzen, J; Habermann, C; Utler, C; Grzyska, U; Weber, C; Adam, G; Koops, A

2009-10-01

To evaluate the changes in academic quality indicators after implementation of a quality management system according to DIN ISO 9001:2000. After implementation and certification of a quality management system, the actual state based on quality indicators from the fields of student teaching, research, continuing education and the satisfaction of referring physician was determined. After implementation of an action plan for the individual areas, the temporal changes in the ratios were documented in the follow-up. The evaluation of teaching performance obtained by questionnaire among the students of the radiology course showed a steady increase in satisfaction (mean value 2003: 2.7; 2007: 3.9). In the field of research an increase in scientific output was achieved based on the number of an internal publication score (2002: 99 points; 2006: 509). Repeated opinion surveys among our referring physicians found improvements in indicators for the appointment of investigations, consulting service and waiting times for the investigation, while the waiting times for internal transport service did not improve. Exemplary measurements of the success of the advanced training of the staff demonstrated the need for continuing education for quality improvement. The evaluation of quality indicators showed over time a measurable positive impact on processes of a radiological University Hospital after implementation of a QM system according to DIN ISO 9001:2000. Georg Thieme Verlag KG Stuttgart-New York.

A method for radiological characterization based on fluence conversion coefficients

NASA Astrophysics Data System (ADS)

Froeschl, Robert

2018-06-01

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

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.

Building a leadership team that works.

PubMed

Blomenberg, Emily M

2005-01-01

Radiology administrators often are challenged to do more with less. In today's fast-paced work environment, leaders must be creative. They must surround themselves with good people in order to successfully achieve their organizations' goals. Once a radiology administrator is satisfied and comfortable that he or she has, the right staff involved, a leadership team can be formally establislished. Howard Regional Health System established an Imaging Services Leadership Team with a vision to provide leaders for the staff to "follow," just as team members learn from the radiology administrator. In addition, team members are vital in assisting the radiology administrator in managing the department The process of building the team consisted of 3 steps: selecting team members (the most challenging and time-consuming component), formalizing a functional team, and putting the team into action. Finding the right people, holding regular meetings, and making those team meetings meaningful are keys to a successful leadership team. The implementation of the team has had a positive effect on imaging services: the number of procedures has increased, the team is used as a communication tool for front-line staff, front-line staff are becoming more comfortable with making decisions.

Is there a benefit to operating on patients (bedridden or in wheelchairs) with advanced stage cervical spondylotic myelopathy?

PubMed

Scardino, Fabrizio Borges; Rocha, Leonardo Poubel; Barcelos, Alécio Cristino Evangelista Santos; Rotta, José Marcus; Botelho, Ricardo Vieira

2010-05-01

Surgical treatment of cervical spondylotic myelopathy (CSM) aims to prevent or delay the progression of the disease. Many patients are diagnosed in advanced stages of the disease, presenting severe functional disability and extensive radiologic changes, which suggests clinical irreversibility. There are doubts about the real benefit of surgery in patients who are seriously ill, bedridden or in a wheelchair. The objective of the study is to evaluate the effects of surgical treatment in the clinical outcomes of patients severely affected by CSM. We analyzed patients with CSM who received an operation at a single institution between 1996 and 2008. Cases with a preoperative Nurick score equal to 5 were studied. We describe postoperative clinical improvement and compare the demographics and clinical data between the patients who improved and those who had no improvement. Radiological findings were also analyzed. We evaluated 55 patients operated on. Nine presented with preoperative Nurick score of 5 (16.3%). The mean age was 69.77 +/- 6.6 years (95% CI 64.65-79.90). The mean follow-up was 53.44 +/- 35.09 months (CI 26.46-80.42). Six patients (66.6%) achieved functional improvement when assessed by the Nurick scale, regaining the ability to walk. All patients improved on the JOAm scale, except one. The mean preoperative Nurick score was 5, while the mean postoperative Nurick score was 4.11 +/- 0.92 (95% CI 3.39-4.82) (Wilcoxon p = 0.027). The mean preoperative JOAm score was 6.4, and postoperative was 9.88 +/- 2.31 (CI 95% 8.10-11.66) (Wilcoxon p = 0.011). All spinal cords presented high-intensity signal on T2-weighted images. There was no correlation between the number of spinal cord high-intensity signal levels and clinical improvement. Three out of seven patients (whose image was adequate for analysis) had evident spinal cord atrophy, and two of them did not improve clinically. In the whole sample of patients, the mean length of disease for those who improved was 9.25 +/- 7.31 months (95% CI 1.56-16.93), and for those who did not improve was 38.00 +/- 19.28 months (95% CI 9.91-85.91) (Mann-Whitney p = 0.02). In conclusion, two-thirds of patients with CSM Nurick scores of 5 who were either bedridden or in wheelchairs at the time of diagnosis improved at least one degree on the Nurick scale after surgical treatment, thus returning to walking. The JOAm scale was more sensitive to clinical changes than the Nurick scale. Patients with longer lengths of disease had worse outcomes.

Radiology Undergraduate and Resident Curricula: A Narrative Review of the Literature

PubMed Central

Linaker, Kathleen L.

2015-01-01

Objective The purpose of this study was to examine the literature regarding radiology curricula for both undergraduates and residents. Methods A review of the literature was performed using relevant key words. Articles were retrieved through December 2012 using PubMed, ScienceDirect, ERIC, Proquest, and ICL databases along with a manual review of references. Results Of the 4716 unique abstracts reviewed by the author, 142 were found to be relevant to the purpose of this study. Undergraduate radiology education, radiology curriculum, and radiology pedagogy vary widely between disciplines and between colleges within disciplines. Formal radiology education is not taught at all medical programs and little radiology training is incorporated into non-radiology residencies. This results in some medical graduates not being taught how to interpret basic radiology images and not learning contraindications and indications for ordering diagnostic imaging tests. There are no definitive studies examining how to incorporate radiology into the curriculum, how to teach radiology to either undergraduates or residents, or how to assess this clinical competency. Conclusions This review shows that radiology education is perceived to be important in undergraduate and residency programs. However, some programs do not include radiology training, thus graduates from those programs do not learn radiology essentials. PMID:26770172

The Impact Factor of Radiological Journals: Associations with Journal Content and Other Characteristics Over a Recent 12-Year Period.

PubMed

Rosenkrantz, Andrew B; Ayoola, Abimbola

2016-06-01

The aim of this study was to evaluate the trends in the impact factor (IF) of radiological journals over a recent 12-year period, including associations between IF and journal topic. Journal Citation Reports (JCR) was used to identify all biomedical journals and all radiological journals (assigned a JCR category of "Radiology, Nuclear Medicine, & Medical Imaging"), along with journal IF, in 2003 and 2014. Radiological journals were manually classified by topic. Trends in median IF (mIF) were assessed. The number of radiological journals increased from 83 (2003) to 125 (2014) (all biomedical journals: 5907 to 8718, respectively). mIF of radiological journals increased from 1.42 (2003) to 1.75 (2014) (all biomedical journals: 0.93 to 1.46, respectively). The most common topic among new radiological journals was general (nonspecialized) radiology (8). Five new radiological journals in 2014 were in topics (cancer imaging and molecular imaging) having no journals in 2003. mIF of general radiological journals was 1.49. Topics having highest mIF were cardiac imaging (2.94), optics (2.86), molecular imaging (2.77), radiation oncology (2.60), and neuroradiology (2.25). Topics with lowest mIF were ultrasound (1.19) and interventional radiology (1.44). Topics with the largest increase in mIF were cardiac imaging (from 1.17 to 2.94) and neuroradiology (from 1.07 to 2.25). Radiological journals exhibited higher mIF than biomedical journals overall. Among radiological journals, subspecialty journals had highest mIF. While a considerable number of new radiological journals since 2003 were general radiology journals having relatively low IF, there were also new journal topics representing emerging areas of subspecialized radiological research. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The Interventional Radiology (IR) Gender Gap: A Prospective Online Survey by the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

PubMed

Wah, Tze Min; Belli, Anna Maria

2018-05-22

A prospective online survey was conducted by the Cardiovascular Interventional Radiological Society of Europe (CIRSE) to evaluate the gender gap within interventional radiology (IR) and the barriers facing women in IR. A questionnaire ("Appendix") was devised by the authors and the CIRSE communication and publication team and sent electronically to 750 identifiable female members of CIRSE. Responses were collected from 7 August to 24 August 2017. The response rate was 19.9% (n = 149) with highest responses from UK (18%), Italy (11%), Germany (11%), Spain (7%), Netherlands (5%), France (5%), Sweden (4%), USA (4%). 91% of the respondents were between 31 and 46 years, 83% work full time, 62% spend > 50% of their working time in IR, and 67% practice in a university or tertiary referral institution. 85% were in the minority in their department. 52% had no leadership role in their department, but 67% expressed willingness to consider a leadership position. Their main concerns were work/family life balance, the risks of radiation exposure, the effect of pregnancy on training and practice and the male-dominated work environment. This survey highlights issues experienced by women in IR. Clear guidance on concerns regarding radiation exposure particularly during pregnancy is needed. Structured and supportive training is required for female IRs who may wish to train or work flexibly. The male-dominated environment is discouraging, and a scheme to promote female IRs would encourage women to take on senior leadership positions and attract more women into the specialty.

[Digital teaching archive. Concept, implementation, and experiences in a university setting].

PubMed

Trumm, C; Dugas, M; Wirth, S; Treitl, M; Lucke, A; Küttner, B; Pander, E; Clevert, D-A; Glaser, C; Reiser, M

2005-08-01

Film-based teaching files require a substantial investment in human, logistic, and financial resources. The combination of computer and network technology facilitates the workflow integration of distributing radiologic teaching cases within an institution (intranet) or via the World Wide Web (Internet). A digital teaching file (DTF) should include the following basic functions: image import from different sources and of different formats, editing of imported images, uniform case classification, quality control (peer review), a controlled access of different user groups (in-house and external), and an efficient retrieval strategy. The portable network graphics image format (PNG) is especially suitable for DTFs because of several features: pixel support, 2D-interlacing, gamma correction, and lossless compression. The American College of Radiology (ACR) "Index for Radiological Diagnoses" is hierarchically organized and thus an ideal classification system for a DTF. Computer-based training (CBT) in radiology is described in numerous publications, from supplementing traditional learning methods to certified education via the Internet. Attractiveness of a CBT application can be increased by integration of graphical and interactive elements but makes workflow integration of daily case input more difficult. Our DTF was built with established Internet instruments and integrated into a heterogeneous PACS/RIS environment. It facilitates a quick transfer (DICOM_Send) of selected images at the time of interpretation to the DTF and access to the DTF application at any time anywhere within the university hospital intranet employing a standard web browser. A DTF is a small but important building block in an institutional strategy of knowledge management.

No associations between self-reported knee joint instability and radiographic features in knee osteoarthritis patients prior to Total Knee Arthroplasty: A cross-sectional analysis of the Longitudinal Leiden Orthopaedics Outcomes of Osteo-Arthritis study (LOAS) data.

PubMed

Leichtenberg, Claudia S; Meesters, Jorit J L; Kroon, Herman M; Verdegaal, Suzan H M; Tilbury, Claire; Dekker, Joost; Nelissen, Rob G H H; Vliet Vlieland, Thea P M; van der Esch, Martin

2017-08-01

To describe the prevalence of self-reported knee joint instability in patients with pre-surgery knee osteoarthritis (OA) and to explore the associations between self-reported knee joint instability and radiological features. A cross-sectional study including patients scheduled for primary Total Knee Arthroplasty (TKA). Self-reported knee instability was examined by questionnaire. Radiological features consisted of osteophyte formation and joint space narrowing (JSN), both scored on a 0 to three scale. Scores >1 are defined as substantial JSN or osteophyte formation. Regression analyses were provided to identify associations of radiological features with self-reported knee joint instability. Two hundred and sixty-five patients (mean age 69years and 170 females) were included. Knee instability was reported by 192 patients (72%). Substantial osteophyte formation was present in 78 patients (41%) reporting and 33 patients (46%) not reporting knee joint instability. Substantial JSN was present in 137 (71%) and 53 patients (73%), respectively. Self-reported knee instability was not associated with JSN (relative to score 0, odds ratios (95% CI) of score 1, 2 and 3 were 0.87 (0.30-2.54), 0.98 (0.38-2.52), 0.68 (0.25-1.86), respectively) or osteophyte formation (relative to score 0, odds ratios (95% CI) of score 1, 2 and 3 were 0.77 (0.36-1.64), 0.69 (0.23-1.45), 0.89 (0.16-4.93), respectively). Stratified analysis for pain, age and BMI showed no associations between self-reported knee joint instability and radiological features. Self-reported knee joint instability is not associated with JSN or osteophyte formation. Copyright © 2017 Elsevier B.V. All rights reserved.

Development of a mobile device optimized cross platform-compatible oral pathology and radiology spaced repetition system for dental education.

PubMed

Al-Rawi, Wisam; Easterling, Lauren; Edwards, Paul C

2015-04-01

Combining active recall testing with spaced repetition increases memory retention. The aim of this study was to evaluate and compare students' perception and utilization of an electronic spaced repetition oral pathology-radiology system in dental hygiene education and predoctoral dental education. The study employed an open-source suite of applications to create electronic "flashcards" that can be individually adjusted for frequency of repetition, depending on a user's assessment of difficulty. Accessible across multiple platforms (iOS, Android, Linux, OSX, Windows) as well as via any web-based browser, this framework was used to develop an oral radiology-oral pathology database of case-based questions. This system was introduced in two courses: sophomore oral pathology for dental students and sophomore radiology for dental hygiene students. Students were provided free software and/or mobile tablet devices as well as a database of 300 electronic question cards. Study participants were surveyed on frequency and extent of use. Perception-based surveys were used to evaluate their attitudes towards this technology. Of the eligible students, 12 of 22 (54.5%) dental hygiene and 49 of 107 (45.8%) dental students responded to the surveys. Adoption rates and student feedback were compared between the two groups. Among the respondents, acceptance of this technology with respect to educational usefulness was similar for the dental and dental hygiene students (median=5 on a five-point scale; dental hygiene interquartile range (IQR)=0; dental IQR=1). Only a minority of the survey respondents (25% dental, 33% dental hygiene) took advantage of one of the main benefits of this technology: automated spaced repetition.

Cervical arthroplasty for moderate to severe disc degeneration: clinical and radiological assessments after a minimum follow-up of 18 months--Pfirrmann grade and cervical arthroplasty.

PubMed

Oh, Chang Hyun; Kim, Do Yeon; Ji, Gyu Yeul; Kim, Yeo Ju; Yoon, Seung Hwan; Hyun, Dongkeun; Kim, Eun Young; Park, Hyeonseon; Park, Hyeong-Chun

2014-07-01

Clinical outcomes and radiologic results after cervical arthroplasty have been reported in many articles, yet relatively few studies after cervical arthroplasty have been conducted in severe degenerative cervical disc disease. Sixty patients who underwent cervical arthroplasty (Mobi-C®) between April 2006 and November 2011 with a minimum follow-up of 18 months were enrolled in this study. Patients were divided into two groups according to Pfirrmann classification on preoperative cervical MR images: group A (Pfirrmann disc grade III, n=38) and group B (Pfirrmann disc grades IV or V, n=22). Visual analogue scale (VAS) scores of neck and arm pain, modified Oswestry Disability Index (mODI) score, and radiological results including cervical range of motion (ROM) were assessed before and after surgery. VAS and mean mODI scores decreased after surgery from 5.1 and 57.6 to 2.7 and 31.5 in group A and from 6.1 and 59.9 to 3.7 and 38.4 in group B, respectively. In both groups, VAS and mODI scores significantly improved postoperatively (p<0.001), although no significant intergroup differences were found. Also, cervical dynamic ROM was preserved or gradually improved up to 18 months after cervical arthroplasty in both groups. Global, segmental and adjacent ROM was similar for both groups during follow-up. No cases of device subsidence or extrusion were recorded. Clinical and radiological results following cervical arthroplasty in patients with severe degenerative cervical disc disease were no different from those in patients with mild degenerative cervical disc disease after 18 months of follow-up.

An assessment of the feasibility and effectiveness of an e-learning module in delivering a curriculum in radiation protection to undergraduate medical students.

PubMed

Leong, Sum; Mc Laughlin, Patrick; O'Connor, Owen J; O'Flynn, Siun; Maher, Michael M

2012-03-01

Integrating radiation protection (RP) education in the undergraduate medical curriculum is gaining importance and is mandatory in certain jurisdictions. An e-learning module for RP was developed at the authors' medical school and was integrated into year 4 of the 5-year undergraduate medical program. The aim of this study was to investigate its impact on RP knowledge, student preferences for various teaching methods, self-assessment of RP knowledge, and perceptions of career prospects in radiology. Likert-type 5-point scale evaluations and general comments about the RP module and various methods of teaching were also obtained. An e-learning module in RP was designed and presented to year 4 medical undergraduates. All students were required to complete premodule and postmodule questionnaires. Eighty-nine percent (n = 113) and 99% (n = 126) of the 127 medical students successfully completed and returned the premodule and postmodule questionnaires, respectively. After the e-learning module, students' postmodule RP knowledge had improved significantly. Analysis of postmodule RP knowledge suggested that a favorable self-assessment of knowledge of RP, perception of career prospects in radiology, and completion of the e-learning module with an increased number of sessions were factors predictive of improved RP knowledge. Students expressed a preference for didactic lectures and clinical attachment for instruction in RP over e-learning. The development of an e-learning module in RP is feasible and results in improved knowledge of RP among medical undergraduates. Combining e-learning and more traditional educational programs such as a clinical radiology rotation is likely to improve student experience. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

PubMed

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

2018-01-30

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

The use of real-time elastography in the assessment of gallbladder polyps: preliminary observations.

PubMed

Teber, Mehmet Akif; Tan, Sinan; Dönmez, Uğur; İpek, Ali; Uçar, Ali Erkan; Yıldırım, Halil; Aslan, Ahmet; Arslan, Halil

2014-12-01

Gallbladder polyps often have a benign nature. Current guidelines suggest surgical removal of polyps greater than 10 mm. However, the accuracy of the size criteria is limited because neoplasia can be found in gallbladder polyps less than 10 mm. The aim of this study was to evaluate the feasibility of real time elastography for gallbladder polyps and to demonstrate the elasticity properties of the polyps. Fifty-three polypoid lesions of the gallbladder were prospectively examined with real-time elastography. Of these patients, 52 had a diagnosis of benign gallbladder polyps and one patient was accepted as a gallbladder carcinoma due to its clinical and radiological findings. B-mode and real-time elastographic images were simultaneously presented as a two-panel image, and the elastogram was displayed in a color scale that ranged from red (greatest strain, softest component), to green (average strain, intermediate component), to blue (no strain, hardest component). The mean size for benign gallbladder polyps was 7.2 +/- 3 mm (range, 5-21 mm). All benign gallbladder polyps on consecutive real-time elastographic images appeared as having a high-strain elastographic pattern. Only one patient who was accepted with gallbladder carcinoma had a gallbladder polyp with low elasticity properties. Our study showed that real time elastography of gallbladder polyps is feasible. This novel approach may be useful for the characterization of polypoid lesions of the gallbladder.

Asian Radiology Forum 2016 for Promoting Radiology Together in the Asian-Oceanian Region: Roles of the Asian-Oceanian Society of Radiology and Its Member Societies

PubMed Central

Kim, Ho Sung; Choi, Jung-Ah

2018-01-01

According to the reports presented at the second Asian Radiology Forum (ARF) 2016, organized by the Korean Society of Radiology (KSR) during the Korean Congress of Radiology (KCR) in September 2016 in Seoul, there is an increasing need for the Asian-Oceanian Society of Radiology (AOSR) and its member societies to promote radiology together in the Asian-Oceanian region. In ARF 2016, the national delegates of the Asian-Oceanian radiological partner societies primarily discussed their societies' activities and contributions in international and regional societies including AOSR, expectations for AOSR, recommendations and suggestions for AOSR, and their societies' support of AOSR. PMID:29520175

Comprehensive Health Care Economics Curriculum and Training in Radiology Residency.

PubMed

Keiper, Mark; Donovan, Timothy; DeVries, Matthew

2018-06-01

To investigate the ability to successfully develop and institute a comprehensive health care economics skills curriculum in radiology residency training utilizing didactic lectures, case scenario exercises, and residency miniretreats. A comprehensive health care economics skills curriculum was developed to significantly expand upon the basic ACGME radiology residency milestone System-Based Practice, SBP2: Health Care Economics requirements and include additional education in business and contract negotiation, radiology sales and marketing, and governmental and private payers' influence in the practice of radiology. A health care economics curriculum for radiology residents incorporating three phases of education was developed and implemented. Phase 1 of the curriculum constituted basic education through didactic lectures covering System-Based Practice, SBP2: Health Care Economics requirements. Phase 2 constituted further, more advanced didactic lectures on radiology sales and marketing techniques as well as government and private insurers' role in the business of radiology. Phase 3 applied knowledge attained from the initial two phases to real-life case scenario exercises and radiology department business miniretreats with the remainder of the radiology department. A health care economics skills curriculum in radiology residency is attainable and essential in the education of future radiology residents in the ever-changing climate of health care economics. Institution of more comprehensive programs will likely maximize the long-term success of radiology as a specialty by identifying and educating future leaders in the field of radiology. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A practical description and student perspective of the integration of radiology into lower limb musculoskeletal anatomy.

PubMed

Davy, S; O'Keeffe, G W; Mahony, N; Phelan, N; Barry, D S

2017-05-01

Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need. We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions. The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions. Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool. The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice.

Clinical and radiologic distinctions between secondary bronchiolitis obliterans organizing pneumonia and cryptogenic organizing pneumonia.

PubMed

Vasu, Tajender S; Cavallazzi, Rodrigo; Hirani, Amyn; Sharma, Dinesh; Weibel, Sandra B; Kane, Gregory C

2009-08-01

Bronchiolitis obliterans organizing pneumonia (BOOP) is a distinct pattern of reaction of the lung to injury. It may be idiopathic or secondary to a variety of injuries. The term cryptogenic organizing pneumonia (COP) is used for patients with idiopathic BOOP. In this study we describe clinical and radiologic features of patients with BOOP. The medical records of 33 patients with diagnosis of BOOP on surgical lung biopsy over a 10-year time period were reviewed retrospectively. We obtained data on clinical and radiologic manifestations, etiology, and outcome of these patients. Dyspnea was the most common symptom, followed by dry cough and fever. Crackles was the most common physical finding. Mean age at diagnosis of BOOP was 59 years, and 42% were females. The main radiologic manifestation was bilateral patchy consolidation. Most patients had favorable prognosis; however, 17% did not respond to treatment. Female sex was more common in COP than in secondary BOOP (P = .004). Patients with COP had longer symptom duration before the diagnosis than secondary BOOP (P = .01). Patients with secondary BOOP reported fever more frequently, compared to COP (P = .005). Pleural effusion was present in 60% of patients with secondary BOOP, whereas none of the patients with COP had effusion (P = .004). COP and secondary BOOP have diverse clinical and radiologic manifestations. Patients with secondary BOOP are more symptomatic. Both COP and secondary BOOP patients have good prognosis, and most respond to treatment with corticosteroids or by discontinuing the injurious drug.

Reference Levels for Patient Radiation Doses in Interventional Radiology: Proposed Initial Values for U.S. Practice1

PubMed Central

Miller, Donald L.; Kwon, Deukwoo; Bonavia, Grant H.

2009-01-01

Purpose: To propose initial values for patient reference levels for fluoroscopically guided procedures in the United States. Materials and Methods: This secondary analysis of data from the Radiation Doses in Interventional Radiology Procedures (RAD-IR) study was conducted under a protocol approved by the institutional review board and was HIPAA compliant. Dose distributions (percentiles) were calculated for each type of procedure in the RAD-IR study where there were data from at least 30 cases. Confidence intervals for the dose distributions were determined by using bootstrap resampling. Weight banding and size correction methods for normalizing dose to patient body habitus were tested. Results: The different methods for normalizing patient radiation dose according to patient weight gave results that were not significantly different (P > .05). The 75th percentile patient radiation doses normalized with weight banding were not significantly different from those that were uncorrected for body habitus. Proposed initial reference levels for various interventional procedures are provided for reference air kerma, kerma-area product, fluoroscopy time, and number of images. Conclusion: Sufficient data exist to permit an initial proposal of values for reference levels for interventional radiologic procedures in the United States. For ease of use, reference levels without correction for body habitus are recommended. A national registry of radiation-dose data for interventional radiologic procedures is a necessary next step to refine these reference levels. © RSNA, 2009 Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.2533090354/-/DC1 PMID:19789226

A kinematic model to estimate the effective dose of radioactive isotopes in the human body for radiological protection

NASA Astrophysics Data System (ADS)

Sasaki, S.; Yamada, T.

2013-12-01

The great earthquake attacked the north-east area in Japan in March 11, 2011. The system of electrical facilities to control Fukushima Daiichi nuclear power station was completely destroyed by the following tsunamis. From the damaged reactor containment vessels, an amount of radioactive substances had leaked and been diffused in the vicinity of this station. Radiological internal exposure becomes a serious social issue both in Japan and all over the world. The present study provides an easily understandable, kinematic-based model to estimate the effective dose of radioactive substances in a human body by simplified the complicated mechanism of metabolism. International Commission on Radiological Protection (ICRP) has developed an exact model, which is well-known as a standard method to calculate the effective dose for radiological protection. However, owing to that the above method accord too much with the actual mechanism of metabolism in human bodies, it becomes rather difficult for non-professional people of radiology to gasp the whole images of the movement and the influences of radioactive substances in a human body. Therefore, in the present paper we propose a newly-derived and easily-understandable model to estimate the effective dose. The present method is very similar with the traditional and conventional hydrological tank model. Ingestion flux of radioactive substances corresponds to rain intensity and the storage of radioactive substances to the water storage in a basin in runoff analysis. The key of this method is to estimate the energy radiated from the radioactive nuclear disintegration of an atom by using classical theory of E. Fermi of beta decay and special relativity for various kinds of radioactive atoms. The parameters used in this study are only physical half-time and biological half-time, and there are no intentional and operational parameters of coefficients to adjust our theoretical runoff to observation of ICRP. Figure.1 compares time series of effective cesium-137 dose according to age calculated by ICRP software with calculated by the present method. Plots are calculated values by ICRP, the solid line is analytic solution given from the present method. It should be noted that the present study does not consider complicated mechanism, but it could give equally accurate results comparing to existing research. Time series of effective Cs-137 dose according to age when food contains 1 Bq/year is ingested for 1 year. (Plots are calculated values by ICRP. The solid line is analytic solution given from the present method)

Recursive partitioning analysis (RPA) classification predicts survival in patients with brain metastases from sarcoma.

PubMed

Grossman, Rachel; Ram, Zvi

2014-12-01

Sarcoma rarely metastasizes to the brain, and there are no specific treatment guidelines for these tumors. The recursive partitioning analysis (RPA) classification is a well-established prognostic scale used in many malignancies. In this study we assessed the clinical characteristics of metastatic sarcoma to the brain and the validity of the RPA classification system in a subset of 21 patients who underwent surgical resection of metastatic sarcoma to the brain We retrospectively analyzed the medical, radiological, surgical, pathological, and follow-up clinical records of 21 patients who were operated for metastatic sarcoma to the brain between 1996 and 2012. Gliosarcomas, sarcomas of the head and neck with local extension into the brain, and metastatic sarcomas to the spine were excluded from this reported series. The patients' mean age was 49.6 ± 14.2 years (range, 25-75 years) at the time of diagnosis. Sixteen patients had a known history of systemic sarcoma, mostly in the extremities, and had previously received systemic chemotherapy and radiation therapy for their primary tumor. The mean maximal tumor diameter in the brain was 4.9 ± 1.7 cm (range 1.7-7.2 cm). The group's median preoperative Karnofsky Performance Scale was 80, with 14 patients presenting with Karnofsky Performance Scale of 70 or greater. The median overall survival was 7 months (range 0.2-204 months). The median survival time stratified by the Radiation Therapy Oncology Group RPA classes were 31, 7, and 2 months for RPA class I, II, and III, respectively (P = 0.0001). This analysis is the first to support the prognostic utility of the Radiation Therapy Oncology Group RPA classification for sarcoma brain metastases and may be used as a treatment guideline tool in this rare disease. Copyright © 2014 Elsevier Inc. All rights reserved.

SIRT-FILTER v1.0.0

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

PELT, DANIEL

2017-04-21

Small Python package to compute tomographic reconstructions using a reconstruction method published in: Pelt, D.M., & De Andrade, V. (2017). Improved tomographic reconstruction of large-scale real-world data by filter optimization. Advanced Structural and Chemical Imaging 2: 17; and Pelt, D. M., & Batenburg, K. J. (2015). Accurately approximating algebraic tomographic reconstruction by filtered backprojection. In Proceedings of The 13th International Meeting on Fully Three-Dimensional Image Reconstruction in Radiology and Nuclear Medicine (pp. 158-161).

The American Board of Radiology Perspective on Maintenance of Certification: Part IV: Practice quality improvement in radiologic physics.

PubMed

Frey, G Donald; Ibbott, Geoffrey S; Morin, Richard L; Paliwal, Bhudatt R; Thomas, Stephen R; Bosma, Jennifer

2007-11-01

Recent initiatives of the American Board of Medical Specialties (ABMS) in the area of maintenance of certification (MOC) have been reflective of the response of the medical community to address public concerns regarding quality of care, medical error reduction, and patient safety. In March 2000, the 24 member boards of the ABMS representing all medical subspecialties in the USA agreed to initiate specialty-specific maintenance of certification (MOC) programs. The American Board of Radiology (ABR) MOC program for diagnostic radiology, radiation oncology, and radiologic physics has been developed, approved by the ABMS, and initiated with full implementation for all three disciplines beginning in 2007. The overriding objective of MOC is to improve the quality of health care through diplomate-initiated learning and quality improvement. The four component parts to the MOC process are: Part I: Professional standing, Part II: Evidence of life long learning and periodic self-assessment, Part III: Cognitive expertise, and Part IV: Evaluation of performance in practice (with the latter being the focus of this paper). The key components of Part IV require a physicist-based response to demonstrate commitment to practice quality improvement (PQI) and progress in continuing individual competence in practice. Diplomates of radiologic physics must select a project to be completed over the ten-year cycle that potentially can improve the quality of the diplomate's individual or systems practice and enhance the quality of care. Five categories have been created from which an individual radiologic physics diplomate can select one required PQI project: (1) Safety for patients, employees, and the public, (2) accuracy of analyses and calculations, (3) report turnaround time and communication issues, (4) practice guidelines and technical standards, and (5) surveys (including peer review of self-assessment reports). Each diplomate may select a project appropriate for an individual, participate in a project within a clinical department, participate in a peer review of a self-assessment report, or choose a qualified national project sponsored by a society. Once a project has been selected, the steps are: (1) Collect baseline data relevant to the chosen project, (2) review and analyze the data, (3) create and implement an improvement plan, (4) remeasure and track, and (5) report participation to the ABR, using the template provided by the ABR. These steps begin in Year 2, following training in Year 1. Specific examples of individual PQI projects for each of the three disciplines of radiologic physics are provided. Now, through the MOC programs, the relationship between the radiologic physicist and the ABR will be continuous through the diplomate's professional career. The ABR is committed to providing an effective infrastructure that will promote and assist the process of continuing professional development including the enhancement of practice quality improvement for radiologic physicists.

Radiological controls integrated into design

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

Kindred, G.W.

1995-03-01

Radiological controls are required by law in the design of commercial nuclear power reactor facilities. These controls can be relatively minor or significant, relative to cost. To ensure that radiological controls are designed into a project, the health physicist (radiological engineer) must be involved from the beginning. This is especially true regarding keeping costs down. For every radiological engineer at a nuclear power plant there must be fifty engineers of other disciplines. The radiological engineer cannot be an expert on every discipline of engineering. However, he must be knowledgeable to the degree of how a design will impact the facilitymore » from a radiological perspective. This paper will address how to effectively perform radiological analyses with the goal of radiological controls integrated into the design package.« less

Honoring our helpers

PubMed Central

Talanow, Roland; Giesel, Frederik

2016-01-01

This special issue of the Journal of Radiology Case Reports honors the reviewers who donated their time and expertise throughout the year 2015 to the high quality and success of this journal. PMID:27200155

Honoring our helpers

PubMed Central

Talanow, Roland; Giesel, Frederik

2017-01-01

This special issue of the Journal of Radiology Case Reports honors the reviewers who donated their time and expertise throughout the year 2016 to the high quality and success of this journal. PMID:28580066

Validation of a Quality of Life Questionnaire for Bronchiectasis: psychometric analyses of the Spanish QOL-B-V3.0.

PubMed

Olveira, Casilda; Olveira, Gabriel; Espildora, Francisco; Giron, Rosa-Maria; Muñoz, Gerard; Quittner, Alexandra L; Martinez-Garcia, Miguel-Angel

2014-05-01

Bronchiectasis is a chronic disease, leading to worsening of health-related quality of life. This study evaluated the psychometric properties of a new patient-reported outcome for non-cystic fibrosis bronchiectasis, the Quality of Life Questionnaire Bronchiectasis, translated into Spanish (QOL-B-Sp-V3.0). This prospective study recruited clinically stable patients with non-cystic fibrosis bronchiectasis at 4 Spanish centers. Health status was assessed with multiple indicators (dyspnea, exacerbations, bronchorrhea, etc.), microbiological, radiological, spirometric, and anthropometric parameters plus St-George Respiratory Questionnaire (SGRQ). Psychometric analyses included internal consistency, test-retest reliability, convergent validity, predictive validity, and responsivity to change. The 207 stable patients (mean age 57.2 years) had a Bhalla score of 11.53 ± 7.39 and FEV1% of 68.3 ± 22.2 %. One hundred and sixty-one stable patients repeated the test 2 weeks later, and 80 patients who had an exacerbation within 6 months of the assessment also repeated it. Internal consistency was high across all scales (Cronbach's alpha >0.70). Thirty-six of 37 items correlated more strongly with their assigned scale than a competing scale. Test-retest coefficients were strong (intraclass correlations r = 0.68-0.88). All scales, except Treatment Burden, discriminated significantly between patients with mild, moderate, and severe disease according to FEV1% and other respiratory parameters. Strong convergence was found between the QOL-B-Sp-V3.0 and SGRQ. Significant correlations were found between QOL-B-Sp-V3.0 and various clinical, spirometric, radiological, and anthropometric variables. Significant differences were found on all QOL-B-Sp-V3.0 scales, except emotional functioning, between the baseline responses and onset of an exacerbation; robust sensitivity to change was observed on the Respiratory Symptoms scale. The QOL-B-Sp-V3.0 questionnaire demonstrated strong reliability and validity. Scores were reproducible after 2 weeks, and it discriminated between patients who varied in severity and was responsive to changes related to exacerbation.

The Neurologic Assessment in Neuro-Oncology (NANO) scale: a tool to assess neurologic function for integration into the Response Assessment in Neuro-Oncology (RANO) criteria

PubMed Central

DeAngelis, Lisa M.; Brandes, Alba A.; Peereboom, David M.; Galanis, Evanthia; Lin, Nancy U.; Soffietti, Riccardo; Macdonald, David R.; Chamberlain, Marc; Perry, James; Jaeckle, Kurt; Mehta, Minesh; Stupp, Roger; Muzikansky, Alona; Pentsova, Elena; Cloughesy, Timothy; Iwamoto, Fabio M.; Tonn, Joerg-Christian; Vogelbaum, Michael A.; Wen, Patrick Y.; van den Bent, Martin J.; Reardon, David A.

2017-01-01

Abstract Background. The Macdonald criteria and the Response Assessment in Neuro-Oncology (RANO) criteria define radiologic parameters to classify therapeutic outcome among patients with malignant glioma and specify that clinical status must be incorporated and prioritized for overall assessment. But neither provides specific parameters to do so. We hypothesized that a standardized metric to measure neurologic function will permit more effective overall response assessment in neuro-oncology. Methods. An international group of physicians including neurologists, medical oncologists, radiation oncologists, and neurosurgeons with expertise in neuro-oncology drafted the Neurologic Assessment in Neuro-Oncology (NANO) scale as an objective and quantifiable metric of neurologic function evaluable during a routine office examination. The scale was subsequently tested in a multicenter study to determine its overall reliability, inter-observer variability, and feasibility. Results. The NANO scale is a quantifiable evaluation of 9 relevant neurologic domains based on direct observation and testing conducted during routine office visits. The score defines overall response criteria. A prospective, multinational study noted a >90% inter-observer agreement rate with kappa statistic ranging from 0.35 to 0.83 (fair to almost perfect agreement), and a median assessment time of 4 minutes (interquartile range, 3–5). Conclusion. The NANO scale provides an objective clinician-reported outcome of neurologic function with high inter-observer agreement. It is designed to combine with radiographic assessment to provide an overall assessment of outcome for neuro-oncology patients in clinical trials and in daily practice. Furthermore, it complements existing patient-reported outcomes and cognition testing to combine for a global clinical outcome assessment of well-being among brain tumor patients. PMID:28453751

Response of the REWARD detection system to the presence of a Radiological Dispersal Device

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

Luis, R.; Baptista, M.; Barros, S.

2015-07-01

In recent years an increased international concern has emerged about the radiological and nuclear (RN) threats associated with the illicit trafficking of nuclear and radioactive materials that could be potentially used for terrorist attacks. The objective of the REWARD (Real Time Wide Area Radiation Surveillance System) project, co-funded by the European Union 7. Framework Programme Security, consisted in building a mobile system for real time, wide area radiation surveillance, using a CdZnTe detector for gamma radiation and a neutron detector based on novel silicon technologies. The sensing unit includes a GPS system and a wireless communication interface to send themore » data remotely to a monitoring base station, where it will be analyzed in real time and correlated with historical data from the tag location, in order to generate an alarm when an abnormal situation is detected. Due to its portability and accuracy, the system will be extremely useful in many different scenarios such as nuclear terrorism, lost radioactive sources, radioactive contamination or nuclear accidents. This paper shortly introduces the REWARD detection system, depicts some terrorist threat scenarios involving radioactive sources and special nuclear materials and summarizes the simulation work undertaken during the past three years in the framework of the REWARD project. The main objective consisted in making predictions regarding the behavior of the REWARD system in the presence of a Radiological Dispersion Device (RDD), one of the reference scenarios foreseen for REWARD, using the Monte Carlo simulation program MCNP6. The reference scenario is characterized in detail, from the i) radiological protection, ii) radiation detection requirements and iii) communications points of view. Experimental tests were performed at the Fire Brigades Facilities in Rome and at the Naples Fire Brigades, and the results, which validate the simulation work, are presented and analyzed. The response of the REWARD detection system to the presence of an RDD is predicted and discussed. (authors)« less

Acceptance of technology-enhanced learning for a theoretical radiological science course: a randomized controlled trial.

PubMed

Nkenke, Emeka; Vairaktaris, Elefterios; Bauersachs, Anne; Eitner, Stephan; Budach, Alexander; Knipfer, Christoph; Stelzle, Florian

2012-03-30

Technology-enhanced learning (TEL) gives a view to improved education. However, there is a need to clarify how TEL can be used effectively. The study compared students' attitudes and opinions towards a traditional face-to-face course on theoretical radiological science and a TEL course where students could combine face-to-face lectures and e-learning modules at their best convenience. 42 third-year dental students were randomly assigned to the traditional face-to-face group and the TEL group. Both groups completed questionnaires before the beginning and after completion of the course on attitudes and opinions towards a traditional face-to-face lectures and technology-enhanced learning. After completion of the course both groups also filled in the validated German-language TRIL (Trierer Inventar zur Lehrevaluation) questionnaire for the evaluation of courses given at universities. Both groups had a positive attitude towards e-learning that did not change over time. The TEL group attended significantly less face-to-face lectures than the traditional group. However, both groups stated that face-to-face lectures were the basis for education in a theoretical radiological science course. The members of the TEL group rated e-mail reminders significantly more important when they filled in the questionnaire on attitudes and opinions towards a traditional face-to-face lectures and technology-enhanced learning for the second time after completion of the course. The members of the technology-enhanced learning group were significantly less confident in passing the exam compared to the members of the traditional group. However, examination results did not differ significantly for traditional and the TEL group. It seems that technology-enhanced learning in a theoretical radiological science course has the potential to reduce the need for face-to-face lectures. At the same time examination results are not impaired. However, technology-enhanced learning cannot completely replace traditional face-to-face lectures, because students indicate that they consider traditional teaching as the basis of their education.

Factors that elevate the internal radionuclide and chemical retention, dose and health risks to infants and children in a radiological-nuclear emergency.

PubMed

Richardson, Richard B

2009-06-01

The factors that influence the dose and risk to vulnerable population groups from exposure and internal uptake of chemicals are examined and, in particular, the radionuclides released in chemical, biological, radiological, nuclear and explosive events. The paper seeks to identify the areas that would benefit from further research. The intake and body burdens of carbon and calcium were assessed as surrogates for contaminants that either act like or bind to hydrocarbons (e.g. tritium and (14)C) or bone-seeking radionuclides (e.g. (90)Sr and (239)Pu). The shortest turnover times for such materials in the whole body were evaluated for the newborn: 11 d and 0.5 y for carbon and calcium, respectively. However, their biokinetic behaviour is complicated by a particularly high percentage of the gut-absorbed dietary intake of carbon (approximately 16%) and calcium (approximately 100%) that is incorporated into the soft tissue and skeleton of the growing neonate. The International Commission on Radiological Protection dose coefficients (Sv Bq(-1)) were examined for 14 radionuclides, including 9 of concern because of their potential use in radiological dispersal devices. The dose coefficients for a 3-month-old are greater than those for adults (2-56 times more for ingestion and 2-12 times for inhalation). The age-dependent dose and exposure assessment of contaminant intakes would improve by accounting for gender and growth where it is currently neglected. Health risk is evaluated as the product of the exposure and hazard factors, the latter being about 10-fold greater in infants than in adults. The exposure factor is also approximately 10-fold higher for ingestion by infants than by adults, and unity for inhalation varying with the contaminant. Qualitative and quantitative physiological and epidemiological evidence supports infants being more vulnerable to cancer and neurological deficit than older children.

Radiologic Monitoring of Faculty and Staff in an Electrophysiology Lab Using a Real-Time Dose Monitoring System

ERIC Educational Resources Information Center

Chardenet, Kathleen A.

2016-01-01

Purpose: A real-time dose management system was used to determine if radiation exposure levels would decrease when providers were privy to their real-time radiation exposure levels. Six aggregate categories of providers were first blinded (phase 1) and subsequently made aware of their radiation exposure levels during electrophysiology procedures…

[Radiological knowledge management with the help of departmental wikis].

PubMed

Schuster, A; Brachthäuser, D; Mansour, M; Alfke, H

2016-09-01

In times of RIS (radiology information system) and KIS (hospital information system) systems, patient-related data are at the radiologist's disposal at the push of a button. However, this is not the case for other important data. The increasing complexity of modern medicine demands that up-to-date information like protocols, SOPs (Standards of Practice), news and modifications are constantly accessible to all employees. This aspect of quality assurance becomes increasingly important in the context of certification. For such knowledge management purposes we have built a wiki in our department. Here we report our positive experiences with this technology.

Comprehensive analysis of a Radiology Operations Management computer system.

PubMed

Arenson, R L; London, J W

1979-11-01

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