WorldWideScience

Sample records for clinical diagnostic imaging

  1. Thymic hyperplasia - clinical course and imaging diagnostic

    International Nuclear Information System (INIS)

    Drebov, R.; Panov, M.; Totev, M.; Deliverski, T.; Tcandev, I.; Velkovski, I.

    2006-01-01

    The real thymic hyperplasia is benign disease sometimes simulating malignant tumours. The aim of this study is to analyse the clinical symptoms of real thymic hyperplasia and the results from imaging diagnostic based on our clinical material. Clinical material include 27 children, aged from two months to 15 years, admitted in department of thoracic surgery, for a period of 20 years (1985 - 2004). We retrospectively analyze the clinical signs and results from X-ray investigation, CT (Siemens Somatom DRG and Philips Secura) and echocardiography (Acuson TX, 5 and 7 MHz). We discuss the diagnostic value of different methods as well as typical and atypical findings. (authors)

  2. Cancer imaging phenomics toolkit: quantitative imaging analytics for precision diagnostics and predictive modeling of clinical outcome.

    Science.gov (United States)

    Davatzikos, Christos; Rathore, Saima; Bakas, Spyridon; Pati, Sarthak; Bergman, Mark; Kalarot, Ratheesh; Sridharan, Patmaa; Gastounioti, Aimilia; Jahani, Nariman; Cohen, Eric; Akbari, Hamed; Tunc, Birkan; Doshi, Jimit; Parker, Drew; Hsieh, Michael; Sotiras, Aristeidis; Li, Hongming; Ou, Yangming; Doot, Robert K; Bilello, Michel; Fan, Yong; Shinohara, Russell T; Yushkevich, Paul; Verma, Ragini; Kontos, Despina

    2018-01-01

    The growth of multiparametric imaging protocols has paved the way for quantitative imaging phenotypes that predict treatment response and clinical outcome, reflect underlying cancer molecular characteristics and spatiotemporal heterogeneity, and can guide personalized treatment planning. This growth has underlined the need for efficient quantitative analytics to derive high-dimensional imaging signatures of diagnostic and predictive value in this emerging era of integrated precision diagnostics. This paper presents cancer imaging phenomics toolkit (CaPTk), a new and dynamically growing software platform for analysis of radiographic images of cancer, currently focusing on brain, breast, and lung cancer. CaPTk leverages the value of quantitative imaging analytics along with machine learning to derive phenotypic imaging signatures, based on two-level functionality. First, image analysis algorithms are used to extract comprehensive panels of diverse and complementary features, such as multiparametric intensity histogram distributions, texture, shape, kinetics, connectomics, and spatial patterns. At the second level, these quantitative imaging signatures are fed into multivariate machine learning models to produce diagnostic, prognostic, and predictive biomarkers. Results from clinical studies in three areas are shown: (i) computational neuro-oncology of brain gliomas for precision diagnostics, prediction of outcome, and treatment planning; (ii) prediction of treatment response for breast and lung cancer, and (iii) risk assessment for breast cancer.

  3. Clinics in diagnostic imaging (179). Severe rhabdomyolysis complicated by myonecrosis.

    Science.gov (United States)

    Kok, Shi Xian Shawn; Tan, Tien Jin

    2017-08-01

    A 32-year-old man presented to the emergency department with severe right lower limb pain and swelling of three days' duration. He had multiple prior admissions for recurrent seizures and suicide attempts. Markedly elevated serum creatine kinase levels and urine myoglobinuria were consistent with a diagnosis of rhabdomyolysis. Initial magnetic resonance imaging of the right lower limb revealed diffuse muscle oedema and features of myositis in the gluteal muscles and the adductor, anterior and posterior compartments of the thigh. Follow-up magnetic resonance imaging performed 11 days later showed interval development of areas of myonecrosis and haemorrhage. The causes, clinical presentation and imaging features of rhabdomyolysis are discussed. Copyright: © Singapore Medical Association.

  4. From Clinical Symptoms to MR Imaging: Diagnostic Steps in Adenomyosis

    Directory of Open Access Journals (Sweden)

    H. Krentel

    2017-01-01

    Full Text Available Adenomyosis or endometriosis genitalis interna is a frequent benign disease of women in fertile age. It causes symptoms like bleeding disorders and dysmenorrhea and seems to have a negative effect on fertility. Adenomyosis can be part of a complex genital and extragenital endometriosis but also can be found as a solitary uterine disease. While peritoneal endometriosis can be easily diagnosed by laparoscopy with subsequent biopsy, the determination of adenomyosis is difficult. In the following literature review, the diagnostic methods clinical history and symptoms, gynecological examination, 2D and 3D transvaginal ultrasound, MRI, hysteroscopy, and laparoscopy will be discussed step by step in order to evaluate their predictive value in the diagnosis of adenomyosis.

  5. Companion diagnostics and molecular imaging-enhanced approaches for oncology clinical trials.

    Science.gov (United States)

    Van Heertum, Ronald L; Scarimbolo, Robert; Ford, Robert; Berdougo, Eli; O'Neal, Michael

    2015-01-01

    In the era of personalized medicine, diagnostic approaches are helping pharmaceutical and biotechnology sponsors streamline the clinical trial process. Molecular assays and diagnostic imaging are routinely being used to stratify patients for treatment, monitor disease, and provide reliable early clinical phase assessments. The importance of diagnostic approaches in drug development is highlighted by the rapidly expanding global cancer diagnostics market and the emergent attention of regulatory agencies worldwide, who are beginning to offer more structured platforms and guidance for this area. In this paper, we highlight the key benefits of using companion diagnostics and diagnostic imaging with a focus on oncology clinical trials. Nuclear imaging using widely available radiopharmaceuticals in conjunction with molecular imaging of oncology targets has opened the door to more accurate disease assessment and the modernization of standard criteria for the evaluation, staging, and treatment responses of cancer patients. Furthermore, the introduction and validation of quantitative molecular imaging continues to drive and optimize the field of oncology diagnostics. Given their pivotal role in disease assessment and treatment, the validation and commercialization of diagnostic tools will continue to advance oncology clinical trials, support new oncology drugs, and promote better patient outcomes.

  6. [Diagnostic imaging of high-grade astrocytoma: heterogeneity of clinical manifestation, image characteristics, and histopathological findings].

    Science.gov (United States)

    Okajima, Kaoru; Ohta, Yoshio

    2012-10-01

    Recent developments in diagnostic radiology, which have enabled accurate differential diagnoses of brain tumors, have been well described in the last three decades. MR and PET imaging can also provide information to predict histological grades and prognoses that might influence treatment strategies. However, high-grade astrocytomas consist of many different subtypes that are associated with different imaging and histological characteristics. Hemorrhage and necrosis results in a variety of imaging features, and infiltrative tumor growth entrapping normal neurons may cause different clinical manifestations. We reviewed patients with high-grade astrocytomas that showed various imaging characteristics, with special emphasis on initial symptoms and histological features. Clinicopathological characteristics of astrocytomas were also compared with other malignant tumors. Neurological deficits were not notable in patients with grade 3-4 astrocytomas when they showed infiltrative tumor growth, while brain metastases with compact cellular proliferation caused more neurological symptoms. Infiltrative tumors did not show any enhancing masses on MR imaging, but these tumors may show intratumor heterogeneity. Seizures were reported to be more frequent in low-grade glioma and in secondary glioblastoma. Tumor heterogeneity was also reported in molecular genetic profile, and investigators identified some subsets of astrocytomas. They investigated IHD1/2 mutation, EGFR amplification, TP53 mutation, Ki-67 index, etc. In summary, high-grade astrocytomas are not homogenous groups of tumors, and this is associated with the heterogeneity of clinical manifestation, image characteristics, and histopathological findings. Molecular studies may explain the tumor heterogeneity in the near future.

  7. Effective choices for diagnostic imaging in clinical practice. Excerpts from a report of a WHO Scientific Group on Clinical Diagnostic Imaging

    International Nuclear Information System (INIS)

    1992-01-01

    There are so many different methods of diagnostic imaging that medical practitioners may need guidance to choose the best through the maze of options for each clinical problem. Advice may be required for more than just the first choice, because the first imaging procedure does not always give the desired answer and, depending on the results, further imaging may have to undertaken. The alternative is to submit the patient to a barrage of imaging and hope that one type, at least provides the diagnosis. This is a quite unacceptable way to practice medicine because of the cost and the risk of radiation damage from unnecessary examinations. The choice of the most effective imaging is often difficult and frequently controversial. The sequence to be followed vries with many factors: the equipment available, the skills of the practitioner, the expected quality of the results, the quality of interpretation, and conclusion which can be drawn

  8. Diagnostic Accuracy of Clinical Examination and Imaging Findings for Identifying Subacromial Pain.

    Science.gov (United States)

    Cadogan, Angela; McNair, Peter J; Laslett, Mark; Hing, Wayne A

    2016-01-01

    The diagnosis of subacromial pathology is limited by the poor accuracy of clinical tests for specific pathologies. The aim of this study was to estimate the diagnostic accuracy of clinical examination and imaging features for identifying subacromial pain (SAP) defined by a positive response to diagnostic injection, and to evaluate the influence of imaging findings on the clinical diagnosis of SAP. In a prospective, diagnostic accuracy design, 208 consecutive patients presenting to their primary healthcare practitioner for the first time with a new episode of shoulder pain were recruited. All participants underwent a standardized clinical examination, shoulder x-ray series and diagnostic ultrasound scan. Results were compared with the response to a diagnostic block of xylocaineTM injected into the SAB under ultrasound guidance using ≥80% post-injection reduction in pain intensity as the positive anaesthetic response (PAR) criterion. Diagnostic accuracy statistics were calculated for combinations of clinical and imaging variables demonstrating the highest likelihood of a PAR. A PAR was reported by 34% of participants. In participants with no loss of passive external rotation, combinations of three clinical variables (anterior shoulder pain, strain injury, absence of symptoms at end-range external rotation (in abduction)) demonstrated 100% specificity for a PAR when all three were positive (LR+ infinity; 95%CI 2.9, infinity). A full-thickness supraspinatus tear on ultrasound increased the likelihood of a PAR irrespective of age (specificity 98% (95%CI 94, 100); LR+ 6.2; 95% CI 1.5, 25.7)). Imaging did not improve the ability to rule-out a PAR. Combinations of clinical examination findings and a full-thickness supraspinatus tear on ultrasound scan can help confirm, but not exclude, the presence of subacromial pain. Other imaging findings were of limited value for diagnosing SAP.

  9. Optimising the diagnostic imaging process through clinical history documentation

    International Nuclear Information System (INIS)

    Egan, I.; Baird, M.

    2003-01-01

    In the United Kingdom the 1990s were characterised by radiographer role extension including radiographic reporting and the performance of a variety of contrast examinations. In Australia where a privatised health system constrains the role of radiographers, other ways need to be found to improve professional practice and enhance patient care. One such way is for radiographers to develop knowledge and skills in clinical history taking. The paper advocates the development of a formalised approach to clinical history taking that portrays the radiographer as a professional and advocate of patient rights and welfare. The paper examines history taking approaches used by other health care professionals and proposes a clinical history template using five key areas of interview: area and type of symptoms, current history, past history, special considerations and psychosocial/occupational history. Copyright (2003) Australian Institute of Radiography

  10. Impact of molecular imaging on the diagnostic process in a memory clinic.

    Science.gov (United States)

    Ossenkoppele, Rik; Prins, Niels D; Pijnenburg, Yolande A L; Lemstra, Afina W; van der Flier, Wiesje M; Adriaanse, Sofie F; Windhorst, Albert D; Handels, Ron L H; Wolfs, Claire A G; Aalten, Pauline; Verhey, Frans R J; Verbeek, Marcel M; van Buchem, Mark A; Hoekstra, Otto S; Lammertsma, Adriaan A; Scheltens, Philip; van Berckel, Bart N M

    2013-07-01

    [(11)C]Pittsburgh compound B ([(11)C]PIB) and [(18)F]-2-fluoro-2-deoxy-D-glucose ([(18)F]FDG) PET measure fibrillar amyloid-β load and glucose metabolism, respectively. We evaluated the impact of these tracers on the diagnostic process in a memory clinic population. One hundred fifty-four patients underwent paired dynamic [(11)C]PIB and static [(18)F]FDG PET scans shortly after completing a standard dementia screening. Two-year clinical follow-up data were available for 39 patients. Parametric PET images were assessed visually and results were reported to the neurologists responsible for the initial diagnosis. Outcome measures were (change in) clinical diagnosis and confidence in that diagnosis before and after disclosing PET results. [(11)C]PIB scans were positive in 40 of 66 (61%) patients with a clinical diagnosis of Alzheimer's disease (AD), 5 of 18 (28%) patients with frontotemporal dementia (FTD), 4 of 5 (80%) patients with Lewy body dementia, and 3 of 10 (30%) patients with other dementias. [(18)F]FDG uptake patterns matched the clinical diagnosis in 38 of 66 (58%) of AD patients, and in 6 of 18 (33%) FTD patients. PET results led to a change in diagnosis in 35 (23%) patients. This only occurred when prior diagnostic certainty was Diagnostic confidence increased from 71 ± 17% before to 87 ± 16% after PET (p diagnostic work-up, especially when prior diagnostic confidence is low. Copyright © 2013 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

  11. MO-C-BRB-06: Translating NIH / NIBIB funding to clinical reality in quantitative diagnostic imaging

    International Nuclear Information System (INIS)

    Jackson, E.

    2015-01-01

    Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, and the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration

  12. MO-C-BRB-06: Translating NIH / NIBIB funding to clinical reality in quantitative diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, E. [University of Wisconsin (United States)

    2015-06-15

    Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, and the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration

  13. Clinical findings and diagnostic imaging of small intestinal rupture due to blunt abdominal trauma

    International Nuclear Information System (INIS)

    Takahashi, Hitoshi; Sakata, Ikuhiro; Ogawa, Masaaki; Izumoto, Gentaro; Kim, Akio; Maeda, Shigenari; Yasutomi, Masayuki; Yamamoto, Toshio

    1987-01-01

    Eight patients with small intestinal rupture due to blunt abdominal trauma were analyzed by their clinical findings and diagnostic imaging (plain film, ultrasound and computed tomography). Computed tomography was most useful for identification of intraabdominal extraluminal free air (pneumoperitoneum) and this finding was obtained in seven out of the eight patients (87.5 %). Intraabdominal fluid collection was observed in All the patients and was most clearly detectable by ultrasound and computed tomography. These examinations may be applied to identification of properties of the fluid collection. All the patients eventually developed peritonitis when laparotomy was decided. Thus, close follow up observation of abdominal physical signs was also of critical importance. (author)

  14. Lumbar spinal imaging in radicular pain and related conditions. Understanding diagnostic images in a clinical context

    International Nuclear Information System (INIS)

    Wilmink, Jan T.

    2010-01-01

    There is general agreement that lumbosacral nerve root compression is a prime factor in the pathogenesis of sciatica and neurogenic claudication, although humoral and vascular factors certainly play a role as well. This book focuses on imaging of the various ways in which nerve root compression can come about, and assessing which anatomic features are reliably associated with the occurrence of radicular pain, as opposed to morphologic findings which are probably coincidental. After a discussion of the nature of radicular pain and related symptoms, spinal imaging techniques and options are reviewed, with emphasis on the role of MR myelography in assessing the condition of the intradural nerve roots. A chapter on normal topographic, sectional, and functional (dynamic) radiologic anatomy is followed by a presentation on pathologic anatomy, addressing the various mechanisms of nerve root compression. In the chapter on pre- and postoperative imaging, features which may help to predict the evolution of the symptoms are discussed, with an eye to selecting candidates for surgical treatment. This is followed by a discussion of the role and limitations of imaging studies in various adverse postoperative conditions. In illustrations involving patient studies, imaging features are linked where possible to the clinical symptoms and history of the individuals involved. (orig.)

  15. Lumbar spinal imaging in radicular pain and related conditions. Understanding diagnostic images in a clinical context

    Energy Technology Data Exchange (ETDEWEB)

    Wilmink, Jan T. [University Hospital Maastricht (Netherlands). Dept. Radiology

    2010-07-01

    There is general agreement that lumbosacral nerve root compression is a prime factor in the pathogenesis of sciatica and neurogenic claudication, although humoral and vascular factors certainly play a role as well. This book focuses on imaging of the various ways in which nerve root compression can come about, and assessing which anatomic features are reliably associated with the occurrence of radicular pain, as opposed to morphologic findings which are probably coincidental. After a discussion of the nature of radicular pain and related symptoms, spinal imaging techniques and options are reviewed, with emphasis on the role of MR myelography in assessing the condition of the intradural nerve roots. A chapter on normal topographic, sectional, and functional (dynamic) radiologic anatomy is followed by a presentation on pathologic anatomy, addressing the various mechanisms of nerve root compression. In the chapter on pre- and postoperative imaging, features which may help to predict the evolution of the symptoms are discussed, with an eye to selecting candidates for surgical treatment. This is followed by a discussion of the role and limitations of imaging studies in various adverse postoperative conditions. In illustrations involving patient studies, imaging features are linked where possible to the clinical symptoms and history of the individuals involved. (orig.)

  16. Clinical neuroanatomy and diagnostic imaging of the skull. 2. rev. and enlarged ed.

    International Nuclear Information System (INIS)

    Kretschmann, H.J.; Weinrich, W.

    1991-01-01

    In the last few years, the techniques of CT, MRI, PET and utrasonography have been improved in their diagnostic efficiency, but in spite of the much enhanced resolution achievable with the new techniques, a large part of the neurofunctional systems that are of great significance to clinical diagnostic evaluation remains in the dark. The local structure of the neurofunctional systems is derived from the data describing the position of the conductive structures such as cerebral ventricles or typical cerebral sulci or gyri. A good knowledge of the three-dimensional topography of the neuroanatomy in the skull is required for this purpose, and this is what the book at hand is intended to confer. The arteries and their vascular environment are shown in the frontal, sagittal and axial plane and are compared with drawings produced from angiographies. The information given covers the cranium viscerale, the craniocervical neighbouring areas, and the motor innervation areas of the skull. The term 'diagnostic imaging of the skull' comprises the whole head and the transitional zones. The illustration of the neurofunctional system anatomy in the tomogram presented in this book is a source of information that may serve as a guide for pathfinding in CT, MRI, PET and ultrasonography. In addition, the knowledge found in the book will help to assign clinical data to pathologic findings revealed by CT or MRI. (orig.) With 596 mostly coloured figs [de

  17. Temporomandibular disorders – validity of clinical diagnostics compared to magnetic resonance imaging

    OpenAIRE

    BADEL, TOMISLAV; MAROTTI, MILJENKO; SAVIĆ PAVIČIN, IVANA; DULČIĆ, NIKŠA; ZADRAVEC, DIJANA; KERN, JOSIPA

    2011-01-01

    Background and Purpose: Orthopedic examination techniques of the musculoskeletal system contribute to the successful diagnostics of temporomandibular disorders (TMD). The purpose of this study is to determine the validity of TMD clinical diagnostics by comparing the findings of manual functional analysis (MFA) and the results of MRI of temporomandibular joint (TMJ). The diagnostic significance of limited mouth opening and pain upon passive mouth opening were taken into consideration. M...

  18. DIAGNOSTIC IMAGING IN A DIRECT-ACCESS SPORTS PHYSICAL THERAPY CLINIC: A 2-YEAR RETROSPECTIVE PRACTICE ANALYSIS.

    Science.gov (United States)

    Crowell, Michael S; Dedekam, Erik A; Johnson, Michael R; Dembowski, Scott C; Westrick, Richard B; Goss, Donald L

    2016-10-01

    While advanced diagnostic imaging is a large contributor to the growth in health care costs, direct-access to physical therapy is associated with decreased rates of diagnostic imaging. No study has systematically evaluated with evidence-based criteria the appropriateness of advanced diagnostic imaging, including magnetic resonance imaging (MRI), when ordered by physical therapists. The primary purpose of this study was to describe the appropriateness of magnetic resonance imaging (MRI) or magnetic resonance arthrogram (MRA) exams ordered by physical therapists in a direct-access sports physical therapy clinic. Retrospective observational study of practice. Greater than 80% of advanced diagnostic imaging orders would have an American College of Radiology (ACR) Appropriateness Criteria rating of greater than 6, indicating an imaging order that is usually appropriate. A 2-year retrospective analysis identified 108 MRI/MRA examination orders from four physical therapists. A board-certified radiologist determined the appropriateness of each order based on ACR appropriateness criteria. The principal investigator and co-investigator radiologist assessed agreement between the clinical diagnosis and MRI/surgical findings. Knee (31%) and shoulder (25%) injuries were the most common. Overall, 55% of injuries were acute. The mean ACR rating was 7.7; scores from six to nine have been considered appropriate orders and higher ratings are better. The percentage of orders complying with ACR appropriateness criteria was 83.2%. Physical therapist's clinical diagnosis was confirmed by MRI/MRA findings in 64.8% of cases and was confirmed by surgical findings in 90% of cases. Physical therapists providing musculoskeletal primary care in a direct-access sports physical therapy clinic appropriately ordered advanced diagnostic imaging in over 80% of cases. Future research should prospectively compare physical therapist appropriateness and utilization to other groups of providers and

  19. Diagnostic imaging capabilities of the Ocelot -Optical Coherence Tomography System, ex-vivo evaluation and clinical relevance

    International Nuclear Information System (INIS)

    Dohad, Suhail; Shao, John; Cawich, Ian; Kankaria, Manish; Desai, Arjun

    2015-01-01

    Optical coherence tomography (OCT) is a high-resolution sub-surface imaging modality using near-infrared light to provide accurate and high contrast intra-vascular images. This enables accurate assessment of diseased arteries before and after intravascular intervention. This study was designed to corroborate diagnostic imaging equivalence between the Ocelot and the Dragonfly OCT systems with regards to the intravascular features that are most important in clinical management of patients with atherosclerotic vascular disease. These intravascular features were then corroborated in vivo during treatment of peripheral arterial disease (PAD) pathology using the Ocelot catheter. In order to compare the diagnostic information obtained by Ocelot (Avinger Inc., Redwood City, CA) and Dragonfly (St. Jude Medical, Minneapolis, MN) OCT systems, we utilized ex-vivo preparations of arterial segments. Ocelot and Dragonfly catheters were inserted into identical cadaveric femoral peripheral arteries for image acquisition and interpretation. Three independent physician interpreters assessed the images to establish accuracy and sensitivity of the diagnostic information. Histologic evaluation of the corresponding arterial segments provided the gold standard for image interpretation. In vivo clinical images were obtained during therapeutic interventions that included crossing of peripheral chronic total occlusions (CTOs) using the Ocelot catheter. Strong concordance was demonstrated when matching image characteristics between both OCT systems and histology. The Dragonfly and Ocelot system’s vessel features were interpreted with high sensitivity (91.1–100 %) and specificity (86.7–100 %). Inter-observer concordance was documented with excellent correlation across all vessel features. The clinical benefit that the Ocelot OCT system provided was demonstrated by comparable procedural images acquired at the point of therapy. The study demonstrates equivalence of image acquisition and

  20. What, why, and when we image: considerations for diagnostic imaging and clinical research in the Children's Oncology Group

    International Nuclear Information System (INIS)

    Reaman, Gregory H.

    2009-01-01

    Success in improving treatment outcomes in childhood cancer has been achieved almost exclusively through multicenter and multidisciplinary clinical and applied research over several decades. While biologically rational as well as empirical approaches have led to combination chemotherapy and multimodality approaches to therapy, which have given rise to evidence-based practice standards, similar scientific rigor has not always been as evidently applied to modalities utilized to assess initial disease burden and, more important, response to investigational approaches to therapy. As the empirical approach to therapeutic advances has likely maximized its benefit, future progress will require translation of biologic discovery most notably from the areas of genomics and proteomics. Hence, attempts to improve efficacy of therapy will require a parallel effort to minimize collateral damage of future therapeutic approaches, and such a parallel approach will mandate the continued dependence on advances in diagnostic imaging for improvements in staging methodologies to best define risk groups for risk-adjusted therapy. In addition, anatomic and functional assessment of response and surveillance for disease recurrence will require improved understanding of the biology as well as natural history of individual diseases, which one hopes will better inform investigators in designing trials. Clinical and research expertise is urgently needed in the selection of specific imaging studies and frequencies that best assess a response as well as to define disease-free intervals. Despite limited resources to develop sufficient infrastructure, emphasis on enabling early assessment of new technology to minimize risks associated with treatment advances and with those critical diagnostic and staging procedures must continue to be a focus of pediatric cancer clinical research. (orig.)

  1. Evolution of modern nuclear medicine tumor-imaging diagnostics in clinical oncology

    International Nuclear Information System (INIS)

    Piperkova, E.

    2000-01-01

    The evolution of current nuclear medicine diagnostic is closely related to the technical progress in imaging equipment development, and application of radiopharmaceuticals (Rphs) with a different tumor-uptake mechanism. It is the aim of the study to present groups of tumor-imaging Rphs differing by tumor uptake mechanisms, used in clinical oncology. The obtained results are described, and compared with the ones reported by other researchers. Sensitivity and specificity of Rphs for cardio-scintigraphy with 99m Tc - MIBI and 201 Tl are relatively high, amounting to 93.7% and 60% respectively, in the various tumors. These indicators depend on the stage, location, histopathology, level of malignancy and biological activity of the neoplasm. 99m Tc - MIBI scintigraphy is endowed with considerable diagnostic potential for assaying multiple drug resistance (MDR), and is also a good criterion for its elimination following anti-MDR therapy. The obtained results show that radioimmunoscintigraphy (RIS) using different radiolabeled monoclonal antibodies (MoAb) have high sensitivity and specificity respectively: 86% and 80% in ovarian carcinoma with B72.3 antiTAG; 68.6% and 92.5% in colorectal carcinoma with B73.2 antiTAG, antiCEA, antiCA 19-9; 92% and 83% in breast cancer with antiCEA, 86.8% and 67-69% in malignant melanoma with 225.28s. Receptor scintigraphy may reach up to 86% sensitivity and 100% specificity in tumors saturated with somatostatin receptors. Positron emission tomography (PET) with 18F-FDG enhances the metabolic activity of tumor cells, and attains tumor-detecting rate amounting to 97%. Tumor imaging evolution characterized by the introduction and practical implementation of different Rphs, visualizing the functional and biochemical activity of tumor cells in the primary neoplasm, sentinel lymph nodes and distant metastases. radiolabelling of a variety of new biochemical substances, including DNA and RNA, drugs and lysosomes contributes to a successful imaging

  2. Imaging systems for medical diagnostics

    International Nuclear Information System (INIS)

    Krestel, E.

    1990-01-01

    This book provides physicians and clinical physicists with detailed information on today's imaging modalities and assists them in selecting the optimal system for each clinical application. Physicists, engineers and computer specialists engaged in research and development and sales departments will also find this book to be of considerable use. It may also be employed at universities, training centers and in technical seminars. The physiological and physical fundamentals are explained in part 1. The technical solutions contained in part 2 illustrate the numerous possibilities available in X-ray diagnostics, computed tomography, nuclear medical diagnostics, magnetic resonance imaging, sonography and biomagnetic diagnostics. (orig.)

  3. Radiation exposure and image quality in x-Ray diagnostic radiology physical principles and clinical applications

    CERN Document Server

    Aichinger, Horst; Joite-Barfuß, Sigrid; Säbel, Manfred

    2012-01-01

    The largest contribution to radiation exposure to the population as a whole arises from diagnostic X-rays. Protecting the patient from radiation is a major aim of modern health policy, and an understanding of the relationship between radiation dose and image quality is of pivotal importance in optimising medical diagnostic radiology. In this volume the data provided for exploring these concerns are partly based on X-ray spectra, measured on diagnostic X-ray tube assemblies, and are supplemented by the results of measurements on phantoms and simulation calculations.

  4. Encyclopedia of diagnostic imaging

    International Nuclear Information System (INIS)

    Baert, A.L.

    2008-01-01

    The simple A to Z format provides easy access to relevant information in the field of imaging. Extensive cross references between keywords and related articles enable efficient searches in a user-friendly manner. Fully searchable and hyperlinked electronic online edition. The aim of this comprehensive encyclopedia is to provide detailed information on diagnostic radiology contributing to the broad field of imaging. The wide range of entries are written by leading experts. They will provide basic and clinical scientists in academia, practice and industry with valuable information about the field of diagnostic imaging. Those in related fields, students, teachers, and interested laypeople will also benefit from the important and relevant information on the most recent developments. Please note that this publication is available as print only or online only or print + online set. Save 75% of the online list price when purchasing the bundle. For more information on the online version please type the publication title into the search box above, then click on the eReference version in the results list. (orig.)

  5. Clinical diagnostic ultrasound

    International Nuclear Information System (INIS)

    Barnett, E.; Morley, P.

    1986-01-01

    This textbook on diagnostic ultrasound covers the main systems, with emphasis being placed on the clinical application of diagnostic ultrasound in everyday practice. It provides not only a textbook for postgraduates (particularly FRCR candidates), but also a reference work for practitioners of clinical ultrasound and clinicians generally

  6. Radiation exposure and image quality in X-ray diagnostic radiology. Physical principles and clinical applications. 2. ed.

    International Nuclear Information System (INIS)

    Saebel, Manfred; Aichinger, Horst; Dierker, Joachim; Joite-Barfuss, Sigrid

    2012-01-01

    Diagnostic X-rays are the largest contributor to radiation exposure to the general population, and protecting the patient from radiation damage is a major aim of modern health policy. Once the decision has been taken to use ionising radiation for imaging in a particular patient, it is necessary to optimize the image acquisition process taking into account the diagnostic quality of the images and the radiation dose to the patient. Both image quality and radiation dose are affected by a number of parameters, knowledge of which permits scientifically based decision making. The authors of this second edition of Radiation Exposure and Image Quality in X-ray Diagnostic Radiology have spent many years studying the optimization of radiological imaging. In this book they present in detail the basic physical principles of diagnostic radiology and their application to clinical problems. Particular attention is devoted to evaluation of the dose to the patient, the influence of scattered radiation on image quality, the use of antiscatter grids, and optimization of image quality and dose. The final section is a supplement containing tables of data and graphical depictions of X-ray spectra, interaction coefficients, characteristics of X-ray beams, and other aspects relevant to patient dose calculations. In addition, a complementary CD-ROM contains a user-friendly Excel file database covering these aspects that can be used in the reader's own programs. Since the first edition, the text, figures, tables, and references have all been thoroughly updated, and more detailed attention is now paid to image quality and radiation exposure when using digital imaging and computed tomography. This book will be an invaluable aid to medical physicists when performing calculations relating to patient dose and image quality, and will also prove useful for diagnostic radiologists and engineers. (orig.)

  7. Diagnostic yield of preoperative computed tomography imaging and the importance of a clinical decision for lung cancer surgery

    International Nuclear Information System (INIS)

    Sato, Shuichi; Koike, Teruaki; Yamato, Yasushi

    2010-01-01

    This study aimed to evaluate the diagnostic yield of preoperative computed tomography (CT) imaging and the validity of surgical intervention based on the clinical decision to perform surgery for lung cancer or suspected lung cancer. We retrospectively evaluated 1755 patients who had undergone pulmonary resection for lung cancer or suspected lung cancer. CT scans were performed on all patients. Surgical intervention to diagnose and treat was based on a medical staff conference evaluation for the suspected lung cancer patients who were pathologically undiagnosed. We evaluated the relation between resected specimens and preoperative CT imaging in detail. A total of 1289 patients were diagnosed with lung cancer by preoperative pathology examination; another 466 were not pathologically diagnosed preoperatively. Among the 1289 patients preoperatively diagnosed with lung cancer, the diagnoses were confirmed postoperatively in 1282. Among the 466 patients preoperatively undiagnosed, 435 were definitively diagnosed with lung cancer, and there were 383 p-stage I disease patients. There were 38 noncancerous patients who underwent surgery with a diagnosis of confirmed or suspected lung cancer. Among the 1755 patients who underwent surgery, 1717 were pathologically confirmed with lung cancer, and the diagnostic yield of preoperative CT imaging was 97.8%. Among the 466 patients who were preoperatively undiagnosed, 435 were compatible with the predicted findings of lung cancer. Diagnostic yields of preoperative CT imaging based on clinical evaluation are sufficiently reliable. Diagnostic surgical intervention was acceptable when the clinical probability of malignancy was high and the malignancy was pathologically undiagnosed. (author)

  8. MALDI TOF imaging mass spectrometry in clinical pathology: a valuable tool for cancer diagnostics (review).

    Science.gov (United States)

    Kriegsmann, Jörg; Kriegsmann, Mark; Casadonte, Rita

    2015-03-01

    Matrix-assisted laser desorption/ionization (MALDI) time-of-flight (TOF) imaging mass spectrometry (IMS) is an evolving technique in cancer diagnostics and combines the advantages of mass spectrometry (proteomics), detection of numerous molecules, and spatial resolution in histological tissue sections and cytological preparations. This method allows the detection of proteins, peptides, lipids, carbohydrates or glycoconjugates and small molecules.Formalin-fixed paraffin-embedded tissue can also be investigated by IMS, thus, this method seems to be an ideal tool for cancer diagnostics and biomarker discovery. It may add information to the identification of tumor margins and tumor heterogeneity. The technique allows tumor typing, especially identification of the tumor of origin in metastatic tissue, as well as grading and may provide prognostic information. IMS is a valuable method for the identification of biomarkers and can complement histology, immunohistology and molecular pathology in various fields of histopathological diagnostics, especially with regard to identification and grading of tumors.

  9. Clinical diagnostic criteria of multiple sclerosis: the role of magnetic resonance imaging

    International Nuclear Information System (INIS)

    Belair, M.; Girard, M.

    2004-01-01

    The objective of this article is to summarize the diagnostic criteria recommended by the International Panel on the Diagnosis of Multiple Sclerosis in 2001. The recommendations of another working group, the Consortium of Multiple Sclerosis Centers Consensus Meeting, which met in Vancouver in 2001, concerning the diagnosis and follow-up of patients with multiple sclerosis are also presented in an effort to standardize the protocols for magnetic resonance imaging of these patients. (author)

  10. Diagnostic Imaging Workshop

    International Nuclear Information System (INIS)

    Sociedad Argentina de Fisica Medica

    2012-01-01

    The American Association of Physicist in Medicine (AAPM), the International Organization for Medical Physics (IOMP) and the Argentina Society of Medical Physics (SAFIM) was organized the Diagnostic Imaging Workshop 2012, in the city of Buenos Aires, Argentina. This workshop was an oriented training and scientific exchange between professionals and technicians who work in medical physics, especially in the areas of diagnostic imaging, nuclear medicine and radiotherapy, with special emphasis on the use of multimodal imaging for radiation treatment, planning as well of quality assurance associates.

  11. Moyamoya disease: Diagnostic imaging

    International Nuclear Information System (INIS)

    Tarasów, Eugeniusz; Kułakowska, Alina; Łukasiewicz, Adam; Kapica-Topczewska, Katarzyna; Korneluk-Sadzyńska, Alicja; Brzozowska, Joanna; Drozdowski, Wiesław

    2011-01-01

    Moyamoya disease is a progressive vasculopathy leading to stenosis of the main intracranial arteries. The incidence of moyamoya disease is high in Asian countries; in Europe and North America, the prevalence of the disease is considerably lower. Clinically, the disease may be of ischaemic, haemorrhagic and epileptic type. Cognitive dysfunction and behavioral disturbance are atypical symptoms of moyamoya disease. Characteristic angiographic features of the disease include stenosis or occlusion of the arteries of the circle of Willis, as well as the development of collateral vasculature. Currently, magnetic resonance angiography and CT angiography with multi-row systems are the main imaging methods of diagnostics of the entire range of vascular changes in moyamoya disease. The most common surgical treatment combines the direct arterial anastomosis between the superficial temporal artery and middle cerebral, and the indirect synangiosis involving placement of vascularised tissue in the brain cortex, in order to promote neoangiogenesis. Due to progressive changes, correct and early diagnosis is of basic significance in selecting patients for surgery, which is the only effective treatment of the disease. An appropriate qualification to surgery should be based on a comprehensive angiographic and imaging evaluation of brain structures. Despite the rare occurrence of moyamoya disease in European population, it should be considered as one of causes of ischaemic or haemorrhagic strokes, especially in young patients

  12. Limited diagnostic accuracy of magnetic resonance imaging and clinical tests for detecting partial-thickness tears of the rotator cuff.

    Science.gov (United States)

    Brockmeyer, Matthias; Schmitt, Cornelia; Haupert, Alexander; Kohn, Dieter; Lorbach, Olaf

    2017-12-01

    The reliable diagnosis of partial-thickness tears of the rotator cuff is still elusive in clinical practise. Therefore, the purpose of the study was to determine the diagnostic accuracy of MR imaging and clinical tests for detecting partial-thickness tears of the rotator cuff as well as the combination of these parameters. 334 consecutive shoulder arthroscopies for rotator cuff pathologies performed during the time period between 2010 and 2012 were analyzed retrospectively for the findings of common clinical signs for rotator cuff lesions and preoperative MR imaging. These were compared with the intraoperative arthroscopic findings as "gold standard". The reports of the MR imaging were evaluated with regard to the integrity of the rotator cuff. The Ellman Classification was used to define partial-thickness tears of the rotator cuff in accordance with the arthroscopic findings. Descriptive statistics, sensitivity, specificity, positive and negative predictive value were calculated. MR imaging showed 80 partial-thickness and 70 full-thickness tears of the rotator cuff. The arthroscopic examination confirmed 64 partial-thickness tears of which 52 needed debridement or refixation of the rotator cuff. Sensitivity for MR imaging to identify partial-thickness tears was 51.6%, specificity 77.2%, positive predictive value 41.3% and negative predictive value 83.7%. For the Jobe-test, sensitivity was 64.1%, specificity 43.2%, positive predictive value 25.9% and negative predictive value 79.5%. Sensitivity for the Impingement-sign was 76.7%, specificity 46.6%, positive predictive value 30.8% and negative predictive value 86.5%. For the combination of MR imaging, Jobe-test and Impingement-sign sensitivity was 46.9%, specificity 85.4%, positive predictive value 50% and negative predictive value 83.8%. The diagnostic accuracy of MR imaging and clinical tests (Jobe-test and Impingement-sign) alone is limited for detecting partial-thickness tears of the rotator cuff. Additionally

  13. A Diagnostic Ultrasound Imaging System

    International Nuclear Information System (INIS)

    Lee, Seong Woo

    1999-01-01

    The ability to see the internal organs of the human body in a noninvasive way is a powerful diagnostic tool of modern medicine. Among these imaging modalities such as X-ray, MRI, and ultrasound. MRI and ultrasound are presenting much less risk of undesirable damage of both patient and examiner. In fact, no deleterious effects have been reported as a result of clinical examination by using MRI and ultrasound diagnostic equipment. As a result, their market volume has been rapidly increased. MRI has a good resolution. but there are a few disadvantages such as high price. non-real-time imaging capability. and expensive diagnostic cost. On the other hand, the ultrasound imaging system has inherently poor resolution as compared with X-ray and MRI. In spite of its poor resolution, the ultrasound diagnostic equipment is lower in price and has an ability of real-time imaging as compared with the others. As a result, the ultrasound imaging system has become general and essential modality for imaging the internal organs of human body. In this review various researches and developments to enhance the resolution of the ultrasound images are explained and future trends of the ultrasound imaging technology are described

  14. Cushing Syndrome: Diagnostic Workup and Imaging Features, With Clinical and Pathologic Correlation.

    Science.gov (United States)

    Wagner-Bartak, Nicolaus A; Baiomy, Ali; Habra, Mouhammed Amir; Mukhi, Shalini V; Morani, Ajaykumar C; Korivi, Brinda R; Waguespack, Steven G; Elsayes, Khaled M

    2017-07-01

    Cushing syndrome (CS) is a constellation of clinical signs and symptoms resulting from chronic exposure to excess cortisol, either exogenous or endogenous. Exogenous CS is most commonly caused by administration of glucocorticoids. Endogenous CS is subdivided into two types: adrenocorticotropic hormone (ACTH) dependent and ACTH independent. Cushing disease, which is caused by a pituitary adenoma, is the most common cause of ACTH-dependent CS for which pituitary MRI can be diagnostic, with bilateral inferior petrosal sinus sampling useful in equivocal cases. In ectopic ACTH production, which is usually caused by a tumor in the thorax (e.g., small cell lung carcinoma, bronchial and thymic carcinoids, or medullary thyroid carcinoma) or abdomen (e.g., gastroenteropancreatic neuroendocrine tumors or pheochromocytoma), CT, MRI, and nuclear medicine tests are used for localizing the source of ACTH. In ACTH-independent CS, which is caused by various adrenal abnormalities, adrenal protocol CT or MRI is usually diagnostic.

  15. 3D diagnostic imaging of retinoblastoma with a novel optical coherence tomography clinical system

    NARCIS (Netherlands)

    Nadyarnykh, O.; Moll, Annette C; De Boer, Johannes F.

    Purpose : Reliable in-vivo differentiation between the vital tumor / benign masses, and side effects is the main challenge for retinoblastoma, a retinal malignancy occurring in infancy. We have started an observational clinical study using our novel swept source OCT imaging system operating at

  16. Diagnostic imaging of craniopharyngioma

    International Nuclear Information System (INIS)

    Gradzki, J.; Nowak, S.; Paprzycki, W.

    1993-01-01

    40 patients have been examined with operational and histological confirmation of craniopharyngioma. CT image and X-ray plane of skull were performed in case all of these patients. TMR was conformed to examine 4 patients. X-ray planes was compared to CT. CT permits tumor cyst detection. The efficacy of mentioned above diagnostic techniques was compared with surgical findings. (author)

  17. Risks to the fetus from diagnostic imaging during pregnancy: review and proposal of a clinical protocol

    International Nuclear Information System (INIS)

    Gomes, Mafalda; Matias, Alexandra; Macedo, Filipe

    2015-01-01

    Every day, medical practitioners face the dilemma of exposing pregnant or possibly pregnant patients to radiation from diagnostic examinations. Both doctors and patients often have questions about the risks of radiation. The most vulnerable period is between the 8th and 15th weeks of gestation. Deterministic effects like pregnancy loss, congenital malformations, growth retardation and neurobehavioral abnormalities have threshold doses above 100-200 mGy. The risk is considered negligible at 50 mGy and in reality no diagnostic examination exceeds this limit. The risk of carcinogenesis is slightly higher than in the general population. Intravenous iodinated contrast is discouraged, except in highly selected patients. Considering all the possible noxious effects of radiation exposure, measures to diminish radiation are essential and affect the fetal outcome. Nonionizing procedures should be considered whenever possible and every radiology center should have its own data analysis on fetal radiation exposure. In this review, we analyze existing literature on fetal risks due to radiation exposure, producing a clinical protocol to guide safe radiation use in a clinical setting. (orig.)

  18. Risks to the fetus from diagnostic imaging during pregnancy: review and proposal of a clinical protocol.

    Science.gov (United States)

    Gomes, Mafalda; Matias, Alexandra; Macedo, Filipe

    2015-12-01

    Every day, medical practitioners face the dilemma of exposing pregnant or possibly pregnant patients to radiation from diagnostic examinations. Both doctors and patients often have questions about the risks of radiation. The most vulnerable period is between the 8th and 15th weeks of gestation. Deterministic effects like pregnancy loss, congenital malformations, growth retardation and neurobehavioral abnormalities have threshold doses above 100-200 mGy. The risk is considered negligible at 50 mGy and in reality no diagnostic examination exceeds this limit. The risk of carcinogenesis is slightly higher than in the general population. Intravenous iodinated contrast is discouraged, except in highly selected patients. Considering all the possible noxious effects of radiation exposure, measures to diminish radiation are essential and affect the fetal outcome. Nonionizing procedures should be considered whenever possible and every radiology center should have its own data analysis on fetal radiation exposure. In this review, we analyze existing literature on fetal risks due to radiation exposure, producing a clinical protocol to guide safe radiation use in a clinical setting.

  19. Risks to the fetus from diagnostic imaging during pregnancy: review and proposal of a clinical protocol

    Energy Technology Data Exchange (ETDEWEB)

    Gomes, Mafalda; Matias, Alexandra [University of Porto, Faculty of Medicine, Porto (Portugal); Macedo, Filipe [SMIC, Porto (Portugal)

    2015-12-15

    Every day, medical practitioners face the dilemma of exposing pregnant or possibly pregnant patients to radiation from diagnostic examinations. Both doctors and patients often have questions about the risks of radiation. The most vulnerable period is between the 8th and 15th weeks of gestation. Deterministic effects like pregnancy loss, congenital malformations, growth retardation and neurobehavioral abnormalities have threshold doses above 100-200 mGy. The risk is considered negligible at 50 mGy and in reality no diagnostic examination exceeds this limit. The risk of carcinogenesis is slightly higher than in the general population. Intravenous iodinated contrast is discouraged, except in highly selected patients. Considering all the possible noxious effects of radiation exposure, measures to diminish radiation are essential and affect the fetal outcome. Nonionizing procedures should be considered whenever possible and every radiology center should have its own data analysis on fetal radiation exposure. In this review, we analyze existing literature on fetal risks due to radiation exposure, producing a clinical protocol to guide safe radiation use in a clinical setting. (orig.)

  20. Diagnostic Imaging in Snakes and Lizards

    OpenAIRE

    Banzato , Tommaso

    2013-01-01

    The increasing popularity of snakes and lizards as pets has led to an increasing demand of specialised veterinary duties in these animals. Diagnostic imaging is often a fundamental step of the clinical investigation. The interpretation of diagnostic images is complex and requires a broad knowledge of anatomy, physiology and pathology of the species object of the clinical investigation. Moreover, in order to achieve a correct diagnosis, the comparison between normal and abnormal diagnostic im...

  1. Diagnostic imaging in internal medicine

    International Nuclear Information System (INIS)

    Eisenberg, R.L.

    1985-01-01

    This book examines medical diagnostic techniques. Topics considered include biological considerations in the approach to clinical medicines; infectious diseases; disorders of the heart; disorders of the vascular system; disorders of the respiratory system; diseases of the kidneys and urinary tract; disorders of the alimentary tract; disorders of the hepatobiliary system and pancreas; disorders of the hematopoietic system; disorders of bone and bone mineralization; disorders of the joints, connective tissues, and striated muscles; disorders of the nervous system; miscellaneous disorders; and procedures in diagnostic imaging

  2. Clinics in diagnostic imaging (171). Caecal volvulus with underlying intestinal malrotation.

    Science.gov (United States)

    Ooi, Su Kai Gideon; Tan, Tien Jin; Ngu, James Chi Yong

    2016-11-01

    A 46-year-old Chinese woman with a history of cholecystectomy and appendicectomy presented to the emergency department with symptoms of intestinal obstruction. Physical examination revealed central abdominal tenderness but no clinical features of peritonism. Plain radiography of the abdomen revealed a grossly distended large bowel loop with the long axis extending from the right lower abdomen toward the epigastrium, and an intraluminal air-fluid level. These findings were suspicious for an acute caecal volvulus, which was confirmed on subsequent contrast-enhanced computed tomography (CT) of the abdomen and pelvis. CT demonstrated an abnormal positional relationship between the superior mesenteric vein and artery, indicative of an underlying intestinal malrotation. This case highlights the utility of preoperative imaging in establishing the diagnosis of an uncommon cause of bowel obstruction. It also shows the importance of recognising the characteristic imaging features early, so as to ensure appropriate and expedient management, thus reducing patient morbidity arising from complications. Copyright: © Singapore Medical Association.

  3. Diagnostic imaging of compression neuropathy

    International Nuclear Information System (INIS)

    Weishaupt, D.; Andreisek, G.

    2007-01-01

    Compression-induced neuropathy of peripheral nerves can cause severe pain of the foot and ankle. Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although clinical examination combined with electrophysiological studies remain the cornerstone of the diagnostic work-up, in certain cases, imaging may provide key information with regard to the exact anatomic location of the lesion or aid in narrowing the differential diagnosis. In other patients with peripheral neuropathies of the foot and ankle, imaging may establish the etiology of the condition and provide information crucial for management and/or surgical planning. MR imaging and ultrasound provide direct visualization of the nerve and surrounding abnormalities. Bony abnormalities contributing to nerve compression are best assessed by radiographs and CT. Knowledge of the anatomy, the etiology, typical clinical findings, and imaging features of peripheral neuropathies affecting the peripheral nerves of the foot and ankle will allow for a more confident diagnosis. (orig.) [de

  4. Diagnostic imaging in child abuse

    International Nuclear Information System (INIS)

    Stoever, B.

    2007-01-01

    Diagnostic imaging in child abuse plays an important role and includes the depiction of skeletal injuries, soft tissue lesions, visceral injuries in ''battered child syndrome'' and brain injuries in ''shaken baby syndrome''. The use of appropriate imaging modalities allows specific fractures to be detected, skeletal lesions to be dated and the underlying mechanism of the lesion to be described. The imaging results must be taken into account when assessing the clinical history, clinical findings and differential diagnoses. Computed tomography (CT) and magnetic resonance imaging (MRI) examinations must be performed in order to detect lesions of the central nervous system (CNS) immediately. CT is necessary in the initial diagnosis to delineate oedema and haemorrhages. Early detection of brain injuries in children with severe neurological symptoms can prevent serious late sequelae. MRI is performed in follow-up investigations and is used to describe residual lesions, including parenchymal findings. (orig.) [de

  5. A clinical study of thallium-201 SPECT in the diagnostic imaging of oral squamous cell carcinomas

    International Nuclear Information System (INIS)

    Satoh, Hitoshi

    2003-01-01

    Recently the usefulness of thallium 201 chloride (201Tl) as a tumor imaging agent for various tumors has been reported. However, the application of 201Tl SPECT to oral squamous cell carcinomas has not been established. The purpose of this study is to investigate the usefulness of 201Tl SPECT in the assessment of malignancy or in the differential diagnosis of oral squamous cell carcinomas from inflammatory diseases. Thirty-two patients with 33 primary oral squamous cell carcinomas and 4 patients with inflammatory disease were studied. SPECT images were acquired 15 minutes (early image) and 3 hours (delayed image) after the intravenous injection with 74 MBq 201Tl, and then early uptake ratio (ER), delayed uptake ratio (DR), and retention index (RI) were measured. The relations between these parameters and the size, the site, the degree of differentiation and the mode of invasion of the primary tumor were analyzed statistically. 201Tl SPECT correctly identified 32 of the 33 tumors, with 32 patients having oral squamous cell carcinoma, making the positive rate 97%. Significant negative correlation was observed between RI and major or minor axis of tumors; therefore, this study revealed that RI was influenced by the size of a tumor. In comparison with the average value of RI according to histopathological diagnosis, there was statistically significant difference (p=0.011) between carcinomas (0.80±0.16, n=30) and inflammatory diseases (0.58±0.04, n=4); thus, it was supposed that differential diagnosis between them could be possible. About the tumors with the range of minor-axis 20 mm-40 mm for little influence of tumor size to the RI, the tendency to decrease for the RI of well-differentiated group or low-invasive group was seen. For oral squamous cell carcinomas, 201Tl SPECT had a high positive rate. The application was suggested for use in the differential diagnosis between inflammatory disease and carcinomas, where clinical usefulness could be expected. (author)

  6. WE-FG-207A-05: Dedicated Breast CT as a Diagnostic Imaging Tool: Physics and Clinical Feasibility

    International Nuclear Information System (INIS)

    Karellas, A.

    2016-01-01

    investigating dedicated breast CT. The development of large-area flat-panel detectors with field-of-view sufficient to image the entire breast in each projection enabled development of flat-panel cone-beam breast CT. More recently, the availability of complimentary metal-oxide semiconductor (CMOS) detectors with lower system noise and finer pixel pitch, combined with the development of x-ray tubes with focal spot dimensions similar to mammography systems, has shown improved spatial resolution and could improve visualization of microcalcifications. These technological developments promise clinical translation of low-dose cone-beam breast CT. Dedicated photon-counting breast CT (pcBCT) systems represent a novel detector design, which provide high spatial resolution (∼ 100µm) and low mean glandular dose (MGD). The CdTe-based direct conversion detector technology was previously evaluated and confirmed by simulations and basic experiments on laboratory setups [Kalender et al., Eur Radiol 22: 1–8, 2012]. Measurements of dose, technical image quality parameters, and surgical specimens on a pcBCT scanner have been completed. Comparative evaluation of surgical specimens showed that pcBCT outperformed mammography and digital breast tomosynthesis with respect to 3D spatial resolution, detectability of calcifications, and soft tissue delineation. Major barriers to widespread clinical use of BCT relate to radiation dose, imaging of microcalcifications, and adequate coverage of breast tissue near the chest wall. Adequate chest wall coverage is also technically challenging but recent progress in x-ray tube, detector and table design now enables full breast coverage in the majority of patients. At this time, BCT has been deemed to be suitable for diagnostic imaging but not yet for screening. The mean glandular dose (MGD) from BCT has been reported to be between 5.7 to 27.8 mGy, and this range is comparable to, and within the range of, the MGD of 2.6 to 31.6 mGy in diagnostic mammography

  7. WE-FG-207A-05: Dedicated Breast CT as a Diagnostic Imaging Tool: Physics and Clinical Feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Karellas, A. [University of Massachusetts Medical School (United States)

    2016-06-15

    investigating dedicated breast CT. The development of large-area flat-panel detectors with field-of-view sufficient to image the entire breast in each projection enabled development of flat-panel cone-beam breast CT. More recently, the availability of complimentary metal-oxide semiconductor (CMOS) detectors with lower system noise and finer pixel pitch, combined with the development of x-ray tubes with focal spot dimensions similar to mammography systems, has shown improved spatial resolution and could improve visualization of microcalcifications. These technological developments promise clinical translation of low-dose cone-beam breast CT. Dedicated photon-counting breast CT (pcBCT) systems represent a novel detector design, which provide high spatial resolution (∼ 100µm) and low mean glandular dose (MGD). The CdTe-based direct conversion detector technology was previously evaluated and confirmed by simulations and basic experiments on laboratory setups [Kalender et al., Eur Radiol 22: 1–8, 2012]. Measurements of dose, technical image quality parameters, and surgical specimens on a pcBCT scanner have been completed. Comparative evaluation of surgical specimens showed that pcBCT outperformed mammography and digital breast tomosynthesis with respect to 3D spatial resolution, detectability of calcifications, and soft tissue delineation. Major barriers to widespread clinical use of BCT relate to radiation dose, imaging of microcalcifications, and adequate coverage of breast tissue near the chest wall. Adequate chest wall coverage is also technically challenging but recent progress in x-ray tube, detector and table design now enables full breast coverage in the majority of patients. At this time, BCT has been deemed to be suitable for diagnostic imaging but not yet for screening. The mean glandular dose (MGD) from BCT has been reported to be between 5.7 to 27.8 mGy, and this range is comparable to, and within the range of, the MGD of 2.6 to 31.6 mGy in diagnostic mammography

  8. Clinical diagnostic study by means of magnetic resonance imaging for lesions of the major salivary gland region

    International Nuclear Information System (INIS)

    Iihama, Tsuyoshi; Mataga, Izumi; Kato, Joji

    1994-01-01

    The diagnostic value of magnetic resonance imaging (MRI) for lesions situated in the major salivary glands was clinically discussed in this study. A total of 46 patients with salivary gland disorders treated in our department over the past five years were assessed by mean of MRI, and in 11 patients the findings were compared with the histopathological features of lesions sectioned at the same level postoperatively. In addition, preliminary investigations to introduce a new qualitative diagnostic procedure for estimation of salivary gland function in geriatric patients were attempted. In this investigation, T 1 and T 2 values, and signal intensity ratios of the submandibular gland were measured in elderly patients complaining of dry mouth and in healthy controls. Likewise, salivary gland function was examined by taste stimulation induced by applying citric acid to the tongue surface just before starting MRI. MRI clearly demonstrated lesions in the salivary glands. The histopathological diagnosis could not be accurately predicted by signal intensity. However, benign tumors showed higher intensity signals than did malignant tumors on T 2 -weighted images. Cystic lesions could be differentiated from tumors by signal intensity. Histopathological features of salivary gland tumors corresponded to the MRI signal intensity. Relaxation times of T 1 and T 2 values and signal intensity in each major salivary gland were diminished in elderly patients in a resting condition. Only T 1 values in healthy subjects remarkably responded to taste stimulation. These results suggest that MRI is useful and beneficial not only in the qualitative diagnosis of tumors arising from salivary glands but also in the estimation of salivary gland function. MRI should therefore be included in routine diagnostic examinations for salivary gland disorders. (author)

  9. The Downside of Diagnostic Imaging

    Science.gov (United States)

    An article about radiation exposure during computed tomography and nuclear imaging procedures and the risk of cancer. Several studies released in 2009 have helped to quantify the risk and the growing use of these diagnostic imaging methods.

  10. Diagnostic imaging of the hand

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, Rainer [Hospital for Cardiovascular Diseases, Bad Neustadt an der Saale (Germany). Dept. of Radiology; Lanz, Ulrich [Perlach Hospital, Munich (Germany). Dept. of Hand Surgery

    2008-07-01

    With its complex anatomy and specialized biomechanics, the human hand has always presented physicians with a unique challenge when it comes to diagnosing and treating the diseases that afflict it. And while recent decades have seen a rapid increase in the number of therapeutic options, many diseases and injuries of the hand are still commonly misinterpreted. In diagnostic imaging of the hand, an interdisciplinary team, comprisingspecialists in radiology, surgery, and rheumatology, presents a comprehensive,reliable guide to this topographically intricate area. Highlights include: - More than 1000 high-quality illustrations - All state-of-the-art imaging modalities-including multidetector CT, with 2D displays and 3D reconstructions, and contrast-enhanced MRI with multi-channel, phased-array coils - An overview of all currently used methods of examination - A detailed presentation of the anatomic and functional foundations necessary for diagnosis - Full coverage of all disorders of the hand - Systematic treatment of each disease's definition, pathogenesis, and clinical symptoms, according to a graduated diagnostic plan - Easy-to-use format, featuring crisp images and line drawings seamlessly integrated with concise text, summary tables, and handy checklists - A heavily cross-referenced appendix of differential diagnosis tables - Emphasis on interdisciplinary consultation throughout designed to help both radiologists and clinicians develop the most efficient and effective strategies for evaluating and treating patients, Diagnostic imaging of the hand will leave specialists of all levels with a fresh appreciation for - and a richer understanding of - the expanding array of cutting-edge alternatives for diagnosing and treating disorders of the hand. (orig.)

  11. Diagnostic imaging of the hand

    International Nuclear Information System (INIS)

    Schmitt, Rainer; Lanz, Ulrich

    2008-01-01

    With its complex anatomy and specialized biomechanics, the human hand has always presented physicians with a unique challenge when it comes to diagnosing and treating the diseases that afflict it. And while recent decades have seen a rapid increase in the number of therapeutic options, many diseases and injuries of the hand are still commonly misinterpreted. In diagnostic imaging of the hand, an interdisciplinary team, comprisingspecialists in radiology, surgery, and rheumatology, presents a comprehensive,reliable guide to this topographically intricate area. Highlights include: - More than 1000 high-quality illustrations - All state-of-the-art imaging modalities-including multidetector CT, with 2D displays and 3D reconstructions, and contrast-enhanced MRI with multi-channel, phased-array coils - An overview of all currently used methods of examination - A detailed presentation of the anatomic and functional foundations necessary for diagnosis - Full coverage of all disorders of the hand - Systematic treatment of each disease's definition, pathogenesis, and clinical symptoms, according to a graduated diagnostic plan - Easy-to-use format, featuring crisp images and line drawings seamlessly integrated with concise text, summary tables, and handy checklists - A heavily cross-referenced appendix of differential diagnosis tables - Emphasis on interdisciplinary consultation throughout designed to help both radiologists and clinicians develop the most efficient and effective strategies for evaluating and treating patients, Diagnostic imaging of the hand will leave specialists of all levels with a fresh appreciation for - and a richer understanding of - the expanding array of cutting-edge alternatives for diagnosing and treating disorders of the hand. (orig.)

  12. Clinical neuroanatomy and diagnostic imaging of the skull. Computerized tomography and nmr imaging. 2. rev. and enlarged ed. Klinische Neuroanatomie und kranielle Bilddiagnostik. Computertomographie und Magnetresonanztomographie

    Energy Technology Data Exchange (ETDEWEB)

    Kretschmann, H.J. (Medizinische Hochschule Hannover (Germany). Abt. Neuroanatomie); Weinrich, W. (Krankenhaus Nordstadt, Hannover (Germany). Neurologische Klinik)

    1991-01-01

    In the last few years, the techniques of CT, MRI, PET and utrasonography have been improved in their diagnostic efficiency, but in spite of the much enhanced resolution achievable with the new techniques, a large part of the neurofunctional systems that are of great significance to clinical diagnostic evaluation remains in the dark. The local structure of the neurofunctional systems is derived from the data describing the position of the conductive structures such as cerebral ventricles or typical cerebral sulci or gyri. A good knowledge of the three-dimensional topography of the neuroanatomy in the skull is required for this purpose, and this is what the book at hand is intended to confer. The arteries and their vascular environment are shown in the frontal, sagittal and axial plane and are compared with drawings produced from angiographies. The information given covers the cranium viscerale, the craniocervical neighbouring areas, and the motor innervation areas of the skull. The term 'diagnostic imaging of the skull' comprises the whole head and the transitional zones. The illustration of the neurofunctional system anatomy in the tomogram presented in this book is a source of information that may serve as a guide for pathfinding in CT, MRI, PET and ultrasonography. In addition, the knowledge found in the book will help to assign clinical data to pathologic findings revealed by CT or MRI. (orig.) With 596 mostly coloured figs.

  13. Clinics in diagnostic imaging (133). Retained placenta from an intra-abdominal pregnancy.

    Science.gov (United States)

    Win, T; Tang, P H; Lim, T Y

    2011-01-01

    A 29-year-old Indonesian woman presented with abdominal pain seven months after an intra-abdominal pregnancy. Ultrasonography revealed a cystic mass in the pelvis and magnetic resonance imaging showed an umbilical stump within it, indicating a retained placenta. This was removed surgically, and on histology, an infarcted placenta was confirmed.

  14. Picosecond image-converter diagnostics

    International Nuclear Information System (INIS)

    Schelev, M.Ya.

    1975-01-01

    A brief review is presented of the improvements in picosecond image-converter diagnostics carried out since the previous Congress in 1972. The account is given under the following headings: picosecond image converter cameras for visible and x-ray radiation diagnostics; Nd:glass and ruby mode-locked laser measurements; x-ray plasma emission diagnostics; computer treatment of pictures produced by picosecond cameras. (U.K.)

  15. Clinics in diagnostic imaging (164). Morel-Lavallée lesion.

    Science.gov (United States)

    Cheong, Sook Chuei Wendy; Wong, Bak Siew Steven

    2016-01-01

    A 31-year-old male motorcyclist presented with prepatellar swelling of the left knee after a collision with a car. Magnetic resonance imaging of the knee showed no bony or ligamentous injury to the knee. Instead, a well-defined, thin-walled, T2-weighted hyperintense fluid collection with internal septations was identified in a prefascial location overlying the left patella and patellar tendon. The findings were in keeping with those of a Morel-Lavallée lesion, a closed internal degloving injury. Morel-Lavallée lesions are occasionally encountered after a blunt soft-tissue trauma. The presentation and imaging features are discussed. Copyright © Singapore Medical Association.

  16. Dose management as a measurable criteria into the quality control programme of an imaging diagnostic clinic

    International Nuclear Information System (INIS)

    Kirova, G.; Georgiev, E.; Zasheva, C.; Georgiev, S.

    2014-01-01

    In the Radiology Department of Tokuda Hospital Sofia, a strong control over the radiation dose for all patients was accepted with the implementation of the Dose Watch software. The system allows bad practices to be discovered and improves the efficiency and quality of the CT procedures performed in the department. The article will briefly demonstrate the main steps, which have been done, and the results, which have been achieved. The purpose is to identify the challenges, the available tools, and the opportunities for improving the patients' dose in the CT sector of a general Radiology Department. Collected data was based on the information concerning the radiation dose absorbed by individual patients undergoing MDCT examinations in a general radiology department with an overall annual rate of around 7000 MDCT examinations. All of them were carried out using a single 64row MDCT system. The hospital logbook was used to identify the number of CT examinations and dose levels associated with some typical diagnostic procedures in order to make an analysis. The information was taken form the PACS and Dose Watch software and was analyzed. The article draws some measures towards improving the organization and reducing the dose, keeping the quality of the performed exams. Thanks to the supportive software for dose tracking, analyzing and reporting, some problems have been solved and some reasonable measures have been implemented into the daily practice. (authors) Key words: RADIATION DOSE. MDCT. DOSE REDUCTION. REFERRAL GUIDELINES.CTDI. DLP

  17. The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study

    International Nuclear Information System (INIS)

    Breen, Micheal; O'Neill, Siobhan B.; O'Donovan, Joanne P.; McWilliams, Sebastian; Murphy, Kevin P.; Maher, Michael M.; Desmond, Alan N.; Shanahan, Fergus; Quigley, Eamonn M.

    2014-01-01

    The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs. We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period. Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 ± 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %. Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed 'probably significant' and 14.7 % (92/625) 'significant'. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded 'significant' abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years. This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify 'probably significant' or 'significant' findings, including neoplasms. (orig.)

  18. Does MR imaging effectively replace diagnostic arthroscopy

    International Nuclear Information System (INIS)

    Ruwe, P.; McCarthy, S.; Wright, J.; Randall, L.; Lynch, K.; Jokyl, P.

    1990-01-01

    This paper determines if MR imaging reduces the number of diagnostic arthroscopic procedures required in patients with knee complaints and if MR imaging is cost-effective compared with diagnostic arthroscopy. The cohort analysis consists of 100 patients seen in a sports medicine clinic by two orthopedic surgeons who agreed on well-defined criteria for performing MR imaging and arthroscopy. Each orthopedic surgeon referring a patient for MR imaging checked a form regarding the plans for arthroscopy. Outcome analysis was conducted at 6 months

  19. Radiological diagnostics of abdomen and thorax. Image interpretation considering anatomical landmarks and clinical symptoms; Radiologische Diagnostik Abdomen und Thorax. Bildinterpretation unter Beruecksichtigung anatomischer Landmarken und klinischer Symptome

    Energy Technology Data Exchange (ETDEWEB)

    Krombach, Gabriele A. [Universitaetsklinikum Giessen (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Mahnken, Andreas H. (ed.) [Universitaetsklinikum Marburg (Germany). Diagnostische und Interventionelle Radiologie

    2015-07-01

    The book on radiological diagnostics of abdomen and thorax - image interpretation considering anatomical landmarks and clinical symptoms - includes three chapters: (1) imaging of different parts of the body: thorax and abdomen. (II) Thorax: head and neck; mediastinum; heard and pericardium; large vessels; lungs and pleura; mamma. (III) Abdomen: liver; gall bladder and biliary tract; pancreas; gastrointestinal tract; spleen and lymphatic system; adrenal glands; kidneys and urinary tract; female pelvis; male pelvis.

  20. What, why, and when we image: considerations for diagnostic imaging and clinical research in the Children's Oncology Group

    Energy Technology Data Exchange (ETDEWEB)

    Reaman, Gregory H. [The George Washington University, School of Medicine and Health Sciences, Division of Hematology Oncology, Children' s National Medical Center, Washington, DC (United States)

    2009-02-15

    Success in improving treatment outcomes in childhood cancer has been achieved almost exclusively through multicenter and multidisciplinary clinical and applied research over several decades. While biologically rational as well as empirical approaches have led to combination chemotherapy and multimodality approaches to therapy, which have given rise to evidence-based practice standards, similar scientific rigor has not always been as evidently applied to modalities utilized to assess initial disease burden and, more important, response to investigational approaches to therapy. As the empirical approach to therapeutic advances has likely maximized its benefit, future progress will require translation of biologic discovery most notably from the areas of genomics and proteomics. Hence, attempts to improve efficacy of therapy will require a parallel effort to minimize collateral damage of future therapeutic approaches, and such a parallel approach will mandate the continued dependence on advances in diagnostic imaging for improvements in staging methodologies to best define risk groups for risk-adjusted therapy. In addition, anatomic and functional assessment of response and surveillance for disease recurrence will require improved understanding of the biology as well as natural history of individual diseases, which one hopes will better inform investigators in designing trials. Clinical and research expertise is urgently needed in the selection of specific imaging studies and frequencies that best assess a response as well as to define disease-free intervals. Despite limited resources to develop sufficient infrastructure, emphasis on enabling early assessment of new technology to minimize risks associated with treatment advances and with those critical diagnostic and staging procedures must continue to be a focus of pediatric cancer clinical research. (orig.)

  1. The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Breen, Micheal; O' Neill, Siobhan B.; O' Donovan, Joanne P.; McWilliams, Sebastian [Cork University Hospital, Department of Radiology, Cork (Ireland); Murphy, Kevin P.; Maher, Michael M. [Cork University Hospital, Department of Radiology, Cork (Ireland); University College Cork, Department of Radiology, Cork (Ireland); Desmond, Alan N. [Cork University Hospital, Department of Medicine, Cork (Ireland); Shanahan, Fergus; Quigley, Eamonn M. [Cork University Hospital, Department of Medicine, Cork (Ireland); University College Cork, Alimentary Pharmabiotic Center, Cork (Ireland)

    2014-12-15

    The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs. We investigated the utilisation of AIS (site, modality, diagnostic yield/significance) at a tertiary FGID clinic over an 11-year period. Of 1,621 patients, 507 (31 %; 67.5 % women, mean age 43.9 ± 17.37 years) referred from primary care had 997 AIS (1.7 per patient): ultrasonography (US) 36.1 %, fluoroscopy (FLS) 28.8 %, computed tomography (CT) 19.6 %, plain radiography (PR) 13.5 %, nuclear medicine (NM) 1 %. Of the 997 AIS, 55.6 % (554/997) were normal. Of the AIS with positive findings, 9.9 % (62/625) were deemed 'probably significant' and 14.7 % (92/625) 'significant'. Of the CT and FLS studies, 12.3 % and 13.6 %, respectively, yielded 'significant' abnormalities compared to 2.2 % of the US studies and 2.1 % of the PR studies. CT identified five of seven neoplasms, associated with male sex, increasing age and symptom onset after age 50 years. This study confirmed low use of AIS in tertiary FGID clinics and a high proportion of normal studies. Barium swallow/meal and CT were more likely to identify 'probably significant' or 'significant' findings, including neoplasms. (orig.)

  2. Quality of referral: What information should be included in a request for diagnostic imaging when a patient is referred to a clinical radiologist?

    Science.gov (United States)

    G Pitman, Alexander

    2017-06-01

    Referral to a clinical radiologist is the prime means of communication between the referrer and the radiologist. Current Australian and New Zealand government regulations do not prescribe what clinical information should be included in a referral. This work presents a qualitative compilation of clinical radiologist opinion, relevant professional recommendations, governmental regulatory positions and prior work on diagnostic error to synthesise recommendations on what clinical information should be included in a referral. Recommended requirements on what clinical information should be included in a referral to a clinical radiologist are as follows: an unambiguous referral; identity of the patient; identity of the referrer; and sufficient clinical detail to justify performance of the diagnostic imaging examination and to confirm appropriate choice of the examination and modality. Recommended guideline on the content of clinical detail clarifies when the information provided in a referral meets these requirements. High-quality information provided in a referral allows the clinical radiologist to ensure that exposure of patients to medical radiation is justified. It also minimises the incidence of perceptual and interpretational diagnostic error. Recommended requirements and guideline on the clinical detail to be provided in a referral to a clinical radiologist have been formulated for professional debate and adoption. © 2017 The Royal Australian and New Zealand College of Radiologists.

  3. [Diagnostic imaging and acute abdominal pain].

    Science.gov (United States)

    Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-19

    Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

  4. Child abuse. Diagnostic imaging of skeletal injuries

    International Nuclear Information System (INIS)

    Stenzel, Martin; Mentzel, Hans-Joachim

    2012-01-01

    Diagnostic imaging, besides medical history and clinical examination, is a major component in assessment of cases of suspected physical child abuse. Performance of proper imaging technique, and knowledge of specific injury patterns is required for accurate image interpretation by the radiologist, and serves protection of the child in case of proven abuse. On the other side, it is essential to protect the family in unjustified accusations. The reader will be familiarised with essentials of the topic 'Physical child abuse', in order to be able to correctly assess quality, completeness, and results of X-ray films. Moreover, opportunities and limitations of alternative diagnostic modalities will be discussed. (orig.)

  5. Ultrasound-guided image fusion with computed tomography and magnetic resonance imaging. Clinical utility for imaging and interventional diagnostics of hepatic lesions

    International Nuclear Information System (INIS)

    Clevert, D.A.; Helck, A.; Paprottka, P.M.; Trumm, C.; Reiser, M.F.; Zengel, P.

    2012-01-01

    Abdominal ultrasound is often the first-line imaging modality for assessing focal liver lesions. Due to various new ultrasound techniques, such as image fusion, global positioning system (GPS) tracking and needle tracking guided biopsy, abdominal ultrasound now has great potential regarding detection, characterization and treatment of focal liver lesions. Furthermore, these new techniques will help to improve the clinical management of patients before and during interventional procedures. This article presents the principle and clinical impact of recently developed techniques in the field of ultrasound, e.g. image fusion, GPS tracking and needle tracking guided biopsy and discusses the results based on a feasibility study on 20 patients with focal hepatic lesions. (orig.) [de

  6. A recommender system for medical imaging diagnostic.

    Science.gov (United States)

    Monteiro, Eriksson; Valente, Frederico; Costa, Carlos; Oliveira, José Luís

    2015-01-01

    The large volume of data captured daily in healthcare institutions is opening new and great perspectives about the best ways to use it towards improving clinical practice. In this paper we present a context-based recommender system to support medical imaging diagnostic. The system relies on data mining and context-based retrieval techniques to automatically lookup for relevant information that may help physicians in the diagnostic decision.

  7. Diagnostic imaging in medicine. 2. ed.

    International Nuclear Information System (INIS)

    Reba, R.C.; Goodenough, D.J.

    1984-01-01

    This book describes to practitioners the evolutionary progression of new non-invasive diagnostic imaging techniques. The utility of the procedures is also described in a series of state-of-the-art lectures given by outstanding international clinical investigators from NATO countries. Subjects of the papers include the following: advances in source and detector technology, acoustical imaging, NMR and microwave imaging, positron and single photon emission tomography, digital radiography and image processing and display techniques. Fundamental papers describing the theory of non-invasive procedures are included along with papers describing clinical examinations. Examples of utility and studies of diseases of the abdomen and pelvis, heart and lung, and central nervous system are included. Cost-effective and cost-benefit assessment of the new high technology procedures, as well as the use of diagnostic imaging techniques in developing countries are also presented. An index of leading topics completes the volume. (orig.)

  8. Diagnostic imaging in medicine. 2nd ed

    Energy Technology Data Exchange (ETDEWEB)

    Reba, R C; Goodenough, D J; Davidson, H F

    1984-01-01

    This book describes to practitioners the evolutionary progression of new non-invasive diagnostic imaging techniques. The utility of the procedures is also described in a series of state-of-the-art lectures given by outstanding international clinical investigators from NATO countries. Subjects of the papers include the following: advances in source and detector technology, acoustical imaging, NMR and microwave imaging, positron and single photon emission tomography, digital radiography and image processing and display techniques. Fundamental papers describing the theory of non-invasive procedures are included along with papers describing clinical examinations. Examples of utility and studies of diseases of the abdomen and pelvis, heart and lung, and central nervous system are included. Cost-effective and cost-benefit assessment of the new high technology procedures, as well as the use of diagnostic imaging techniques in developing countries are also presented. An index of leading topics completes the volume.

  9. The emergence of diagnostic imaging technologies in breast cancer: discovery, regulatory approval, reimbursement, and adoption in clinical guidelines.

    Science.gov (United States)

    Gold, Laura S; Klein, Gregory; Carr, Lauren; Kessler, Larry; Sullivan, Sean D

    2012-01-25

    In this article, we trace the chronology of developments in breast imaging technologies that are used for diagnosis and staging of breast cancer, including mammography, ultrasonography, magnetic resonance imaging, computed tomography, and positron emission tomography. We explore factors that affected clinical acceptance and utilization of these technologies from discovery to clinical use, including milestones in peer-reviewed publication, US Food and Drug Administration approval, reimbursement by payers, and adoption into clinical guidelines. The factors driving utilization of new imaging technologies are mainly driven by regulatory approval and reimbursement by payers rather than evidence that they provide benefits to patients. Comparative effectiveness research can serve as a useful tool to investigate whether these imaging modalities provide information that improves patient outcomes in real-world settings.

  10. Consultation in diagnostic imaging

    International Nuclear Information System (INIS)

    Scott, W.W. Jr.; Scott, P.P.

    1985-01-01

    This book's organization follows traditional lines; abdomen, chest, bone, OB/GYN, neuroradiology, interventional radiology. It provides the rationale for selecting or avoiding a particular imaging study. The inclusion of decision trees in this book is especially helpful in radiology where careful planning can prevent unnecessary radiation exposure, invasive measures, and extraordinary costs

  11. Clinical and diagnostic aspects of lymphedema.

    Science.gov (United States)

    Keo, Hong H; Gretener, Silvia B; Staub, Daniel

    2017-07-01

    Lymphedema is a chronic, progressive, and common but often unrecognized condition. The diagnosis of lymphatic disease on clinical grounds alone remains a challenge. Without proper diagnosis, therapy is often delayed, allowing disease progression. There is a need for a practical diagnostic algorithm and its imaging technique to guide clinical decision-making. The aim of this topical review is to provide a practical approach for assessing patients with suspected lymphedema and to give a critical appraisal of currently available imaging modalities that are applied in clinical practice to diagnose and map lymphatic disease.

  12. Diagnostic imaging in ophthalmology

    International Nuclear Information System (INIS)

    Gonzalez, C.F.; Becker, M.H.; Flanagan, J.C.

    1986-01-01

    There are three sections in the book. The first section is a discussion of imaging techniques, which includes plain film radiography and multidirectional tomography of the orbit, computed tomography (CT) of the orbit and its use in the evaluation of ocular motility disorders, ultrasonography of the eye and orbit, investigation of the orbit by contrast techniques (which includes a brief review of angiography), the lachrimal drainage system, foreign body localization, and magnetic resonance imaging of the eye and orbit. There is extensive discussion of CT throughout the book. The second section is devoted to the role of these imaging methods in the evaluation of ophthalmic disorders. A discussion of congenital anomalies is useful for those centers that are exposed to unusual congenital anomalies and syndromes. Also included is evaluation of exophthalmous and thyroid ophthamalopathy, orbital tumors, lesions involving the visual pathways, CT assessment of paraorbital pathology (including basal and squamous cell tumors of the face), infection of the orbit, and orbital trauma. The third section is an overview of radiation therapy and malignant intraoccular tumors

  13. Radiogenomics: Creating a link between molecular diagnostics and diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rutman, Aaron M. [Department of Radiology, University of California San Diego Medical Center, San Diego, CA 92103 (United States); Kuo, Michael D. [Department of Radiology, University of California San Diego Medical Center, San Diego, CA 92103 (United States); Center for Translational Medical Systems, University of California San Diego Medical Center, San Diego, CA 92103 (United States)], E-mail: mkuo@ucsd.edu

    2009-05-15

    Studies employing high-throughput biological techniques have recently contributed to an improved characterization of human cancers, allowing for novel sub-classification, better diagnostic accuracy, and more precise prognostication. However, requirement of surgical procurement of tissue among other things limits the clinical application of such methods in everyday patient care. Radiographic imaging is routine in clinical practice but is currently histopathology based. The use of routine radiographic imaging provides a potential platform for linking specific imaging traits with specific gene expression patterns that inform the underlying cellular pathophysiology; imaging features could then serve as molecular surrogates that contribute to the diagnosis, prognosis, and likely gene-expression-associated treatment response of various forms of human cancer. This review focuses on high-throughput methods such as microarray analysis of gene expression, their role in cancer research, and in particular, on novel methods of associating gene expression patterns with radiographic imaging phenotypes, known as 'radiogenomics.' These findings underline a potential future role of both diagnostic and interventional radiologists in genetic assessment of cancer patients with radiographic imaging studies.

  14. Radiogenomics: Creating a link between molecular diagnostics and diagnostic imaging

    International Nuclear Information System (INIS)

    Rutman, Aaron M.; Kuo, Michael D.

    2009-01-01

    Studies employing high-throughput biological techniques have recently contributed to an improved characterization of human cancers, allowing for novel sub-classification, better diagnostic accuracy, and more precise prognostication. However, requirement of surgical procurement of tissue among other things limits the clinical application of such methods in everyday patient care. Radiographic imaging is routine in clinical practice but is currently histopathology based. The use of routine radiographic imaging provides a potential platform for linking specific imaging traits with specific gene expression patterns that inform the underlying cellular pathophysiology; imaging features could then serve as molecular surrogates that contribute to the diagnosis, prognosis, and likely gene-expression-associated treatment response of various forms of human cancer. This review focuses on high-throughput methods such as microarray analysis of gene expression, their role in cancer research, and in particular, on novel methods of associating gene expression patterns with radiographic imaging phenotypes, known as 'radiogenomics.' These findings underline a potential future role of both diagnostic and interventional radiologists in genetic assessment of cancer patients with radiographic imaging studies.

  15. Workload measurement: diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Nuss, Wayne [The Prince Charles Hospital, Chermside, QLD (Australia). Dept. of Medical Imaging

    1993-06-01

    Departments of medical imaging, as with many other service departments in the health industry, are being asked to develop performance indicators. No longer are they assured that annual budget allocations will be forthcoming without justification or some output measurement indicators that will substantiate a claim for a reasonable share of resources. The human resource is the most valuable and the most expensive to any department. This paper provides a brief overview of the research and implementation of a radiographer workload measurement system that was commenced in the Brisbane North Health Region. 2 refs., 10 tabs.

  16. Diagnostic imaging in COPD

    International Nuclear Information System (INIS)

    Owsijewitsch, Michael; Ley-Zaporozhan, Julia; Eichinger, Monika

    2011-01-01

    COPD is a heterogeneous disease defined by expiratory airflow limitation. Airflow limitation is caused by a variable combination of emphysematous destruction of lung parenchyma and small airway obstruction. Only advanced emphysema can be diagnosed by chest X-ray. Less severe emphysema and changes in small airways are commonly diagnosed by computed tomography. Typical visual appearance of pathologic changes in lung parenchyma and airways of COPD patients are presented, furthermore methods for quantitative assessment of these changes and the crucial role of imaging for surgical and bronchoscopic treatment in COPD are discussed. (orig.)

  17. A revolution in diagnostic imaging.

    Science.gov (United States)

    Mamula, Paul W

    2003-03-01

    In November 1966, Sandy Koufax, the star left-handed pitcher of the Los Angeles Dodgers, retired after spending his final season coping with traumatic arthritis in his elbow, the compounded effects of a sliding injury to his pitching arm the previous season and 12 years of hard throwing.1 Had his career begun a few years later, he might have been able to benefit from the advances in diagnostic imaging and treatment that were introduced at that time. Modern arthroscopy and computed tomography (CT) did not become available until the mid 1970s,2 and the first elbow reconstruction was done by Frank Jobe, MD, about 10 years after Koufax retired.1 Arthroscopy was first used as a diagnostic tool, but it later became a surgical tool, affecting treatment of knees, then, later, shoulders. Since 1973, when The Physician and Sportsmedicine was launched, we have witnessed a revolution in diagnostic imaging and are continuing to see an evolution of modalities.

  18. Diagnostic imaging of exotic pets

    International Nuclear Information System (INIS)

    Silverman, S.

    1993-01-01

    Radiographic, ultrasonographic, and computed tomographic (CT) imaging are important diagnostic modalities in exotic pets. The use of appropriate radiographic equipment, film-screen combinations, and radiographic projections enhances the information obtained from radiographs. Both normal findings and common radiographic abnormalities are discussed. The use of ultrasonography and CT scanning for exotic small mammals and reptiles is described

  19. Diagnostic imaging of shoulder impingement

    International Nuclear Information System (INIS)

    Merl, T.; Weinhardt, H.; Oettl, G.; Lenz, M.; Riel, K.A.

    1996-01-01

    Magnetic resonance imaging is a method that has been advancing in the last few years to the modality of choice for diagnostic evaluation of the bone joints, as the method is capable of imaging not only the ossous but also the soft tissue components of the joint. MRI likewise has become an accepted method for diagnostic evaluation of syndromes of the shoulder, with high diagnostic accuracy in detecting rotator cuff lesions, or as an efficient MRI arthrography for evaluation of the instability or lesions of the labrocapsular complex. In the evaluation of early stages of shoulder impingement, the conventional MRI technique as a static technique yields indirect signs which in many cases do not provide the diagnostic certainty required in order to do justice to the functional nature of the syndrome. In these cases, functional MRI for imaging of the arm in abducted position and in rotational movement may offer a chance to early detect impingement and thus identify patients who will profit from treatment at an early stage [de

  20. Rationale diagnostic approach to biliary tract imaging

    International Nuclear Information System (INIS)

    Helmberger, H.; Huppertz, A.; Ruell, T.; Zillinger, C.; Ehrenberg, C.; Roesch, T.

    1998-01-01

    Since the introduction of MR cholangiography (MRC) diagnostic imaging of the biliary tract has been significantly improved. While percutaneous ultrasonography is still the primary examination, computed tomography (CT), conventional magnetic resonance imaging (MRI), as well as the direct imaging modalities of the biliary tract - iv cholangiography, endoscopic-retrograde-cholangiography (ERC), and percutaneous-transhepatic-cholangiography (PTC) are in use. This article discusses the clinical value of the different diagnostic techniques for the various biliary pathologies with special attention to recent developments in MRC techniques. An algorithm is presented offering a rational approach to biliary disorders. With further technical improvement shifts from ERC(P) to MRC(P) for biliary imaging could be envisioned, ERCP further concentrating on its role as a minimal invasive treatment option. (orig.) [de

  1. Diagnostic imaging in focal epilepsy

    International Nuclear Information System (INIS)

    Zlatareva, D.

    2013-01-01

    Focal epilepsies account for 60% of all seizure disorders worldwide. In this review the classic and new classification system of epileptic seizures and syndromes as well as genetic forms are discussed. Magnetic resonance (MR) is the technique of choice for diagnostic imaging in focal epilepsy because of its sensitivity and high tissue contrast. The review is focused on the lack of consensus of imaging protocols and reported findings in refractory epilepsy. The most frequently encountered MRI findings in epilepsy are reported and their imaging characteristics are depicted. Diagnosis of hippocampal sclerosis and malformations of cortical development as two major causes of refractory focal epilepsy is described in details. Some promising new techniques as positron emission tomography computed tomography (PET/CT) and MR and PET/CT fusion are briefly discussed. Also the relevance of adequate imaging in focal epilepsy, some practical points in imaging interpretation and differential diagnosis are highlighted. (author)

  2. Diagnostic reference levels in medical imaging

    International Nuclear Information System (INIS)

    Rosenstein, M.

    2001-01-01

    The paper proposes additional advice to national or local authorities and the clinical community on the application of diagnostic reference levels as a practical tool to manage radiation doses to patients in diagnostic radiology and nuclear medicine. A survey was made of the various approaches that have been taken by authoritative bodies to establish diagnostic reference levels for medical imaging tasks. There are a variety of ways to implement the idea of diagnostic reference levels, depending on the medical imaging task of interest, the national or local state of practice and the national or local preferences for technical implementation. The existing International Commission on Radiological Protection (ICRP) guidance is reviewed, the survey information is summarized, a set of unifying principles is espoused and a statement of additional advice that has been proposed to ICRP Committee 3 is presented. The proposed advice would meet a need for a unifying set of principles to provide a framework for diagnostic reference levels but would allow flexibility in their selection and use. While some illustrative examples are given, the proposed advice does not specify the specific quantities to be used, the numerical values to be set for the quantities or the technical details of how national or local authorities should implement diagnostic reference levels. (author)

  3. Appropriate use of diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, P.E.S.; Cockshott, W.P.

    1984-11-16

    This article discusses ways in which more appropriate use can be made of roentgenography with a resulting decrease in radiation doses to the patient population. The authors recommend that fewer films be made and that traditional roentgenography be replaced with endoscopy, ultrasound, computerized tomography, or angiography where appropriate. They also recommend that medical schools and medical subspecialty groups study the World Health Organization document which provides indications for diagnostic imaging, the choice of procedure and the limitations of each.

  4. Diagnostic imaging of the pancreas

    International Nuclear Information System (INIS)

    Araki, Tsutomu; Itai, Yuji

    1981-01-01

    Diagnostic imaging of the pancreas, ultrasonography (US), computed tomography (CT), radionuclide (RN) scintigraphy, angiography, and endoscopic retrograde pancreaticography (ERP). First three noninvasive methods, were the most effective to diagnose psudo-cyst or cystoadenoma. Especially, CT gives the clear image of inflammation and shows pancreatic stones and calcification, with high sensitivity. As for pancreatic carcinomas there was no noninvasive methods to apply at an early stage. In order to diagnose the cancer the combination of angiography and ERP was preferable. The problem was how to select the candidates for the investigation of combined method out of the patients with negative CT or US. (Tsunoda, M.)

  5. Advantages of digital imaging for radiological diagnostic

    International Nuclear Information System (INIS)

    Trapero, M. A.; Gonzalez, S.; Albillos, J. C.; Martel, J.; Rebollo, M.

    2006-01-01

    The advantages and limitations of radiological digital images in comparison with analogic ones are analyzed. We discuss three main topics: acquisition, post-procedure manipulation, and visualization, archive and communication. Digital acquisition with computed radiology systems present a global sensitivity very close to conventional film for diagnostic purposes. However, flat panel digital systems seems to achieve some advantages in particular clinical situations. A critical issue is the radiation dose-reduction that can be accomplished without reducing image quality nor diagnostic exactitude. The post-procedure manipulation allows, particularly in multiplanar modalities like CT or MR, to extract all implicit diagnostic information in the images: Main procedures are multiplanar and three-dimensional reformations, dynamic acquisitions, functional studies and image fusion. The use of PACS for visualization, archive and communication of images, improves the effectiveness and the efficiency of the workflow, allows a more comfortable diagnosis for the radiologist and gives way to improvements in the communication of images, allowing tele consulting and the tele radiology. (Author) 6 refs

  6. Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Patients With Carcinoma of the Nasopharynx: Diagnostic Accuracy and Impact on Clinical Management

    International Nuclear Information System (INIS)

    Gordin, Arie; Golz, Avishay; Daitzchman, Marcello; Keidar, Zohar; Bar-Shalom, Rachel; Kuten, Abraham; Israel, Ora

    2007-01-01

    Purpose: To assess the value of 18 F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in patients with nasopharyngeal carcinoma as compared with PET and conventional imaging (CI) alone, and to assess the impact of PET/CT on further clinical management. Methods and Materials: Thirty-three patients with nasopharyngeal carcinoma had 45 PET/CT examinations. The study was a retrospective analysis. Changes in patient care resulting from the PET/CT studies were recorded. Results: Positron emission tomography/computed tomography had sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 92%, 90%, 90%, 90%, and 91%, respectively, as compared with 92%, 65%, 76%, 86%, and 80% for PET and 92%, 15%, 60%, 60%, and 60% for CI. Imaging with PET/CT altered further management of 19 patients (57%). Imaging with PET/CT eliminated the need for previously planned diagnostic procedures in 11 patients, induced a change in the planned therapeutic approach in 5 patients, and guided biopsy to a specific metabolically active area inside an edematous region in 3 patients, thus decreasing the chances for tissue sampling errors and avoiding damage to nonmalignant tissue. Conclusions: In cancer of the nasopharynx, the diagnostic performance of PET/CT is better than that of stand-alone PET or CI. Positron emission tomography/computed tomography had a major impact on further clinical management in 57% of patients

  7. Diagnostic value and clinical problems of MR imaging in congenital anomalies of the central nervous system, 1

    International Nuclear Information System (INIS)

    Oi, Shizuo; Asano, Noboru; Urui, Seishiro; Masumura, Michio; Shose, Yoshiteru; Matsumoto, Satoshi.

    1987-01-01

    Various forms of cerebral dysgenesis were studied by means of MR Imaging (MRI) in order to determine the diagnostic efficacy of MRI in comparison with conventional diagnostic procedures. All subjects have been diagnosed during the last 16 months at the National Kagawa Children's Hospital with conventional methods and then referred to MRI study at the Shinsuma Hospital, where a MRI system of a regular-conducting magnet operating at a field strength of 1.5 KG (Picker International Corp., U.S.A.) has been installed. Using the two-dimensional Fourier transform technique, three radiofrequency pulse sequences; inversion recovery: IR 2100/500, and spin-echo: SE 2100/40 or 2100/80, were routinely applied. Compared with X-ray CT, MR proved to be advantageous in the more precise detection of the pathoanatomical relation and in providing information about the myelinating process. The analysis of the myelinating process by MRI in such cerebral dysgeneses as lissencephaly, frontal-lobe dysgenesis, agenesis of the corpus callosum, and microcephalic hydrocephalus was very important for the detection of further functional cerebral developments. The pathoanatomical analysis by MRI, in particular with the midline sagittal view, is extremely advantageous in the diagnosis of Chiari malformation, holoprosencephaly, the Dandy-Walker syndrome, congenital dermal sinus, syringobulbia, and others. The disadvantages or weak points of MRI were also identified in this study. The CSF dynamics in both the major and minor fluid pathways as analyzed by metrizamide CT cisternography or ventriculography is much superior to the information revealed by MRI, although the SE technique can demonstrate some fluid distribution in the brain parenchyma and a different signal intensity in the fluid movements. The information about the bony structure in dysraphic states and calcifications in associated anomalies was also poor. (J.P.N.)

  8. Imaging diagnostics of the foot; Bildgebende Diagnostik des Fusses

    Energy Technology Data Exchange (ETDEWEB)

    Szeimies, Ulrike; Staebler, Axel [Radiologie in Muenchen-Harlaching, Muenchen (Germany); Walther, Markus (eds.) [Schoen-Klinik Muenchen-Harlaching, Muenchen (Germany). Zentrum fuer Fuss- und Sprunggelenkchirurgie

    2012-11-01

    The book on imaging diagnostics of the foot contains the following chapters: (1) Imaging techniques. (2) Clinical diagnostics. (3) Ankle joint and hind foot. (4) Metatarsus. (5) Forefoot. (6) Pathology of plantar soft tissue. (7) Nervous system diseases. (8) Diseases without specific anatomic localization. (9) System diseases including the foot. (10) Tumor like lesions. (11) Normative variants.

  9. Image-based medical expert teleconsultation in acute care of injuries. A systematic review of effects on information accuracy, diagnostic validity, clinical outcome, and user satisfaction.

    Directory of Open Access Journals (Sweden)

    Marie Hasselberg

    Full Text Available OBJECTIVE: To systematically review the literature on image-based telemedicine for medical expert consultation in acute care of injuries, considering system, user, and clinical aspects. DESIGN: Systematic review of peer-reviewed journal articles. DATA SOURCES: Searches of five databases and in eligible articles, relevant reviews, and specialized peer-reviewed journals. ELIGIBILITY CRITERIA: Studies were included that covered teleconsultation systems based on image capture and transfer with the objective of seeking medical expertise for the diagnostic and treatment of acute injury care and that presented the evaluation of one or several aspects of the system based on empirical data. Studies of systems not under routine practice or including real-time interactive video conferencing were excluded. METHOD: The procedures used in this review followed the PRISMA Statement. Predefined criteria were used for the assessment of the risk of bias. The DeLone and McLean Information System Success Model was used as a framework to synthesise the results according to system quality, user satisfaction, information quality and net benefits. All data extractions were done by at least two reviewers independently. RESULTS: Out of 331 articles, 24 were found eligible. Diagnostic validity and management outcomes were often studied; fewer studies focused on system quality and user satisfaction. Most systems were evaluated at a feasibility stage or during small-scale pilot testing. Although the results of the evaluations were generally positive, biases in the methodology of evaluation were concerning selection, performance and exclusion. Gold standards and statistical tests were not always used when assessing diagnostic validity and patient management. CONCLUSIONS: Image-based telemedicine systems for injury emergency care tend to support valid diagnosis and influence patient management. The evidence relates to a few clinical fields, and has substantial methodological

  10. Image-based medical expert teleconsultation in acute care of injuries. A systematic review of effects on information accuracy, diagnostic validity, clinical outcome, and user satisfaction.

    Science.gov (United States)

    Hasselberg, Marie; Beer, Netta; Blom, Lisa; Wallis, Lee A; Laflamme, Lucie

    2014-01-01

    To systematically review the literature on image-based telemedicine for medical expert consultation in acute care of injuries, considering system, user, and clinical aspects. Systematic review of peer-reviewed journal articles. Searches of five databases and in eligible articles, relevant reviews, and specialized peer-reviewed journals. Studies were included that covered teleconsultation systems based on image capture and transfer with the objective of seeking medical expertise for the diagnostic and treatment of acute injury care and that presented the evaluation of one or several aspects of the system based on empirical data. Studies of systems not under routine practice or including real-time interactive video conferencing were excluded. The procedures used in this review followed the PRISMA Statement. Predefined criteria were used for the assessment of the risk of bias. The DeLone and McLean Information System Success Model was used as a framework to synthesise the results according to system quality, user satisfaction, information quality and net benefits. All data extractions were done by at least two reviewers independently. Out of 331 articles, 24 were found eligible. Diagnostic validity and management outcomes were often studied; fewer studies focused on system quality and user satisfaction. Most systems were evaluated at a feasibility stage or during small-scale pilot testing. Although the results of the evaluations were generally positive, biases in the methodology of evaluation were concerning selection, performance and exclusion. Gold standards and statistical tests were not always used when assessing diagnostic validity and patient management. Image-based telemedicine systems for injury emergency care tend to support valid diagnosis and influence patient management. The evidence relates to a few clinical fields, and has substantial methodological shortcomings. As in the case of telemedicine in general, user and system quality aspects are poorly

  11. Diagnostic imaging in pregraduate integrated curricula

    International Nuclear Information System (INIS)

    Kainberger, F.; Kletter, K.

    2007-01-01

    Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula. (orig.)

  12. [Diagnostic imaging in pregraduate integrated curricula].

    Science.gov (United States)

    Kainberger, F; Kletter, K

    2007-11-01

    Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula.

  13. Digital imaging in diagnostic radiology

    International Nuclear Information System (INIS)

    Newell, J.D. Jr.; Kelsey, C.A.

    1990-01-01

    This monograph on digital imaging provides a basic overview of this field at the present time. This paper covers clinical application, including subtraction angiography; chest radiology; genitourinary, gastrointestinal, and breast radiology; and teleradiology. The chest section also includes an explanation of multiple beam equalization radiography. The remaining chapters discuss some of the technical aspects of digital radiology. It includes the basic technology of digital radiography, image compression, and reconstruction information on the economics of digital radiography

  14. Recent Advancements in Microwave Imaging Plasma Diagnostics

    International Nuclear Information System (INIS)

    Park, H.; Chang, C.C.; Deng, B.H.; Domier, C.W.; Donni, A.J.H.; Kawahata, K.; Liang, C.; Liang, X.P.; Lu, H.J.; Luhmann, N.C. Jr.; Mase, A.; Matsuura, H.; Mazzucato, E.; Miura, A.; Mizuno, K.; Munsat, T.; Nagayama, K.; Nagayama, Y.; Pol, M.J. van de; Wang, J.; Xia, Z.G.; Zhang, W-K.

    2002-01-01

    Significant advances in microwave and millimeter wave technology over the past decade have enabled the development of a new generation of imaging diagnostics for current and envisioned magnetic fusion devices. Prominent among these are revolutionary microwave electron cyclotron emission imaging (ECEI), microwave phase imaging interferometers, imaging microwave scattering and microwave imaging reflectometer (MIR) systems for imaging electron temperature and electron density fluctuations (both turbulent and coherent) and profiles (including transport barriers) on toroidal devices such as tokamaks, spherical tori, and stellarators. The diagnostic technology is reviewed, and typical diagnostic systems are analyzed. Representative experimental results obtained with these novel diagnostic systems are also presented

  15. [Diagnostic imaging of breast cancer : An update].

    Science.gov (United States)

    Funke, M

    2016-10-01

    Advances in imaging of the female breast have substantially influenced the diagnosis and probably also the therapy and prognosis of breast cancer in the past few years. This article gives an overview of the most important imaging modalities in the diagnosis of breast cancer. Digital mammography is considered to be the gold standard for the early detection of breast cancer. Digital breast tomosynthesis can increase the diagnostic accuracy of mammography and is used for the assessment of equivocal or suspicious mammography findings. Other modalities, such as ultrasound and contrast-enhanced magnetic resonance imaging (MRI) play an important role in the diagnostics, staging and follow-up of breast cancer. Percutaneous needle biopsy is a rapid and minimally invasive method for the histological verification of breast cancer. New breast imaging modalities, such as contrast-enhanced spectral mammography, diffusion-weighted MRI and MR spectroscopy can possibly further improve breast cancer diagnostics; however, further studies are necessary to prove the advantages of these methods so that they cannot yet be recommended for routine clinical use.

  16. Complications in diagnostic imaging. 2. ed.

    International Nuclear Information System (INIS)

    Ansell, G.; Wilkins, R.A.; Medical Research Council, Harrow

    1987-01-01

    Thirty-seven chapters review various complications which may arise for patients and staff in medical diagnostic imaging. Five of these chapters are indexed separately covering topics on the complications of using radiopharmaceuticals, safety considerations in magnetic resonance imaging, radiation hazards of diagnostic radiology and medico-legal problems involving diagnostic radiology in both the UK and the USA. (UK)

  17. Diagnostic imaging in fertility disorders

    International Nuclear Information System (INIS)

    Winfield, A.C.; Fleischer, A.C.

    1987-01-01

    Some 10%-15% of married couples are affected by a fertility disorder. The number of infertile couples seeking medical assistance has increased dramatically in the past decade. The roles of diagnostic imaging with radiography and US (conventional and transvaginal) is emphasized in the assessment of couples with fertility disorders and an unexpectedly higher incidence of fetal wastage secondary to unsuspected uterine anomalies. The most frequently utilized radiographic examination in infertile patients is hysterosalpingography (HSG). Techniques and complications of HSG are illustrated. The normal anatomy, variants, and congenital anomalies of the uterus and fallopian tubes are demonstrated, as are the numerous abnormalities such as filling defects of the uterine cavity, synechiae, effects of maternal diethylstilbestrol exposure, inflammatory tubal disease, and the more common HSG findings following uterine and tubal surgery. The role of diagnostic imaging in male infertility, including vasography and varicocele detection, are addressed. Conventional and transvaginal US in the management of gynecologic fertility disorders are examined, with an emphasis on follicular monitoring, guided follicular aspirations, endometrial evaluations, and evaluation of other disorders (such as endometriosis) associated with infertility

  18. Diagnostic value of brain chronic black holes on T1-weighted MR images in clinically isolated syndromes.

    Science.gov (United States)

    Mitjana, Raquel; Tintoré, Mar; Rocca, Maria A; Auger, Cristina; Barkhof, Frederik; Filippi, Massimo; Polman, Chris; Fazekas, Franz; Huerga, Elena; Montalban, Xavier; Rovira, Alex

    2014-10-01

    Non-enhancing black holes (neBHs) are more common in multiple sclerosis (MS) patients with longer disease durations and progressive disease subtypes. Our aim was to analyse the added value of neBHs in patients with clinically isolated syndromes (CISs) for predicting conversion to clinically definite MS (CDMS). Patients were classified based on the presence or absence of neBHs and on the number of Barkhof-Tintoré (B-T) criteria fulfilled. Dissemination in space (DIS) was defined as the presence of at least three of the four B-T criteria. Dissemination in time (DIT)1 was defined by simultaneous presence of enhancing and non-enhancing lesions. DIT2 was defined by simultaneous presence of neBHs and T2 lesions not apparent on T1-weighted images. Focal T2-hyperintense brain lesions were identified in 87.7% of the 520 CIS patients, and 41.4% of them presented at least one neBH. Patients meeting DIS, DIT1, and DIT2 had a significantly higher rate of conversion to CDMS. After adjusting for DIS, only patients who fulfilled DIT1 preserved a significant increase in CDMS conversion. Non-enhancing black holes in CIS patients are associated with a higher risk of conversion to CDMS. However, the predictive value of this finding is lost when added to the DIS criteria. © The Author(s) 2014.

  19. Diagnostic imaging in neonatal stroke

    International Nuclear Information System (INIS)

    Kuhle, S.; Ipsiroglu, O.; Weninger, M.

    2000-01-01

    A cerebral artery infarction is an important differential diagnosis in the newborn with neurological abnormalities. Based on clinical data, its incidence is estimated to be 1 in 4000 newborns. Since the course is often subclinical, the true incidence is probably higher. Diagnosis: Cerebral ultrasound and Doppler sonography as readily available screening tools play a central role in the initial diagnosis of neonatal cerebral infarction. Definitive diagnosis is made by computed tomography or magnetic resonance imaging. Beside symptomatic anticonvulsive therapy, treatment aims at the prevention of secondary ischemic injury. Discussion: Three term infants with different clinical courses of neonatal stroke are presented to sensitize the clinician and the radiologist for this probably underdiagnosed entity. The role of imaging modalities in the diagnosis and follow-up of neonatal cerebral infarction is discussed. (orig.) [de

  20. Diagnostic imaging in pediatric renal inflammatory disease

    International Nuclear Information System (INIS)

    Sty, J.R.; Wells, R.G.; Schroeder, B.A.; Starshak, R.J.

    1986-01-01

    Some form of imaging procedure should be used to document the presence of infection of the upper urinary tract in troublesome cases in children. During the past several years, sonography, nuclear radiology, and computed tomography (CT) have had a significant influence on renal imaging. The purpose of this article is to reevaluate the noninvasive imaging procedures that can be used to diagnose pediatric renal inflammatory disease and to assess the relative value of each modality in the various types of renal infection. The authors will not discuss the radiologic evaluation of the child who has had a previous renal infection, in whom cortical scarring or reflux nephropathy is a possibility; these are different clinical problems and require different diagnostic evaluation

  1. Clinical imaging of the pancreas

    International Nuclear Information System (INIS)

    May, G.; Gardiner, R.

    1987-01-01

    Featuring more than 300 high-quality radiographs and scan images, clinical imaging of the pancreas systematically reviews all appropriate imaging modalities for diagnosing and evaluating a variety of commonly encountered pancreatic disorders. After presenting a succinct overview of pancreatic embryology, anatomy, and physiology, the authors establish the clinical indications-including postoperative patient evaluation-for radiologic examination of the pancreas. The diagnostic capabilities and limitations of currently available imaging techniques for the pancreas are thoroughly assessed, with carefully selected illustrations depicting the types of images and data obtained using these different techniques. The review of acute and chronic pancreatitis considers the clinical features and possible complications of their variant forms and offers guidance in selecting appropriate imaging studies

  2. Diagnostic imaging of the acutely injured patient

    International Nuclear Information System (INIS)

    Berquist, T.H.

    1985-01-01

    This book provides an analysis of pathophysiologic concepts of trauma and reviews the effectiveness of the available imaging modalities in acute trauma of various organ system. Topics covered are chest injuries; abdominal trauma; fractures of long bones; the foot and ankle; the knee; hand and wrist; the elbow; the shoulder; the pelvis hips; the spine; the skull and facial trauma and the clinical assessment of multiple injuries patients. Comparative evaluation of diagnostic techniques of radiography is discussed. Normal anatomy and bone fractures along with soft-tissue injuries are described

  3. [Diagnostic imaging and radiation hazards].

    Science.gov (United States)

    Claudon, Michel; Guillaume, Luc

    2015-01-01

    For the last 20 years, the exposure of the population to medical radiation has been increased by 600%, mainly due to the extension of new imaging modalities such as CT or interventional radiology. The risk for radio-induced hazards is especially marked for children, because of the high sensivity of tissues to radiation especially during the first decade of the life. Two main ways allow to better control and reduce the mean effective dose per patient in diagnostic imaging: the introduction of recent technical improvement (i.e. low dose CT scans using iterative reconstruction algorithms, low dose technique for pediatric spine), and the substitution to non-radiating techniques such as ultrasound and MRI. The French National institute of Radioprotection and Nuclear Safety periodically publishes dose reference levels for conventional films and CT examinations, for both adults and pediatric patients. A close relationship between clinicians and radiologists remains essential for a better appreciation of the risk/benefit ratio of each individual examination using X-Rays.

  4. Clinical dosimetry in diagnostic and interventional radiology

    International Nuclear Information System (INIS)

    Dimcheva, M.; Sergieva, S.; Jovanovska, A.

    2012-01-01

    Full text: Introduction: Diagnostic and interventional procedures involving x-rays are the most significant contributor to total population dose form man made sources of ionizing radiation. Purpose and aim: X-ray imaging generally covers a diverse range of examination types, many of which are increasing in frequency and technical complexity. Materials and methods: The European Directives 96/29 and 97/43 EURATOM stress the importance of accurate dosimetry and require calibration of all measuring equipment related to application of ionizing radiation in medicine. Results: The paper gives and overview of current system of dosimetry of ionizing radiations that is relevant for metrology and clinical applications. It also reflects recently achieved international harmonization in the field promoted by International Atomic Energy Agency (IAEA). Discussion: Objectives of clinical dose measurements in diagnostic and interventional radiology are multiple, as assessment of equipment performance, or assessment of risk emerging from use of ionizing radiation Conclusion: Therefore, from the clinical point of view, the requirements for dosimeters and procedures to assess dose to standard dosimetry phantoms and patients in clinical diverse modalities, as computed tomography are presented

  5. Diagnostic imaging of lipoma arborescens

    International Nuclear Information System (INIS)

    Martin, S.; Hernandez, L.; Romero, J.; Lafuente, J.; Poza, A.I.; Ruiz, P.; Jimeno, M.

    1998-01-01

    Objective. The imaging characteristics of lipoma arborescens using plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are described. Design and patients. Five patients with a diagnosis of lipoma arborescens are presented. Three had monoarticular involvement of the knee joint. In the remaining two patients both knees and both hips, respectively, were affected. All patients were examined using plain radiographs and MRI. CT was employed in two cases. Results and conclusions. A conclusive diagnosis with exclusion of other synovial pathologies having similar clinical and radiological behaviour can be achieved on the basis of the MRI characteristics of lipoma arborescens. The aetiology of lipoma arborescens remains unknown, but its association with previous pathology of the affected joints in all our patients supports the theory of a non-neoplastic reactive process involving the synovial membrane. (orig.)

  6. Clinical features of congenital cystic disease of the mediastinum. Diagnostic usefulness of computed tomography and magnetic resonance imaging

    International Nuclear Information System (INIS)

    Bando, Masashi; Ishii, Yoshiki; Sugiyama, Yukihiko; Furuse, Makoto; Murayama, Fumio; Sohara, Yasunori

    2000-01-01

    We describe 18 cases of congenital mediastinal cysts, including 4 bronchogenic cysts, 5 pericardial cysts, and 9 thymic cysts. Fifteen of the 18 patients (62.5%) were asymptomatic, and the cysts were found incidentally on a chest radiograph conducted as a part of a physical screening. In 2 of the 4 cases of bronchogenic cysts, the cystic lesions were located in the posterior mediastinum and in the cephalad recess of the azgos vein (CRAzV). In 3 of the 5 cases of pericardial cysts, the lesions were located in the right cardio-phrenic region. In the remaining 2 cases, the cysts were located in the CRAzV and in the posterior mediastinum. Seventeen patients who had histologically proven mediastinal cysts were investigated by magnetic resonance (MR) imaging. In all 3 cases of bronchogenic cysts, MR signals of the cysts were of higher intensity than those of muscle on T1-weighted images. Neither the pericardial cysts nor the thymic cysts showed high signal intensity on T1-weighted images. Macroscopically, the intracystic fluids in all of the bronchogenic cysts contained viscid mucus that probably caused high signal intensities on the T1-weighted images. MR imaging is not only useful in revealing the location of mediastinal cysts, but also in the differential diagnosis of congenital mediastinal cysts. (author)

  7. RANZAR Body Systems Framework of diagnostic imaging examination descriptors

    International Nuclear Information System (INIS)

    Pitman, Alexander D.; Penlington, Lisa; Doromal, Darren; Vukolova, Natalia; Slater, Gregory

    2014-01-01

    A unified and logical system of descriptors for diagnostic imaging examinations and procedures is a desirable resource for radiology in Australia and New Zealand and is needed to support core activities of RANZCR. Existing descriptor systems available in Australia and New Zealand (including the Medicare DIST and the ACC Schedule) have significant limitations and are inappropriate for broader clinical application. An anatomically based grid was constructed, with anatomical structures arranged in rows and diagnostic imaging modalities arranged in columns (including nuclear medicine and positron emission tomography). The grid was segregated into five body systems. The cells at the intersection of an anatomical structure row and an imaging modality column were populated with short, formulaic descriptors of the applicable diagnostic imaging examinations. Clinically illogical or physically impossible combinations were ‘greyed out’. Where the same examination applied to different anatomical structures, the descriptor was kept identical for the purposes of streamlining. The resulting Body Systems Framework of diagnostic imaging examination descriptors lists all the reasonably common diagnostic imaging examinations currently performed in Australia and New Zealand using a unified grid structure allowing navigation by both referrers and radiologists. The Framework has been placed on the RANZCR website and is available for access free of charge by registered users. The Body Systems Framework of diagnostic imaging examination descriptors is a system of descriptors based on relationships between anatomical structures and imaging modalities. The Framework is now available as a resource and reference point for the radiology profession and to support core College activities.

  8. Diagnostic image workstations ofr PACS

    International Nuclear Information System (INIS)

    Meyer-Ebrecht, D.; Fasel, B.; Dahm, M.; Kaupp, A.; Schilling, R.

    1990-01-01

    Image workstations will be the 'window' to the complex infrastructure of PACS with its intertwined image modalities (image sources, image data bases and image processing devices) and data processing modalities (patient data bases, departmental and hospital information systems). They will serve for user-to-system dialogues, image display and local processing of data as well as images. Their hardware and software structures have to be optimized towards an efficient throughput and processing of image data. (author). 10 refs

  9. The utilisation and diagnostic yield of radiological imaging in a specialist functional GI disorder clinic: an 11-year retrospective study.

    LENUS (Irish Health Repository)

    Breen, Micheal

    2014-07-25

    The term functional gastrointestinal disorders (FGID) describes various aggregations of chronic gastrointestinal (GI) symptoms not explained by identifiable organic pathology; accordingly, their diagnosis rests on symptom-based criteria and a process of exclusion. Evidence is lacking on the appropriate use of abdominal imaging studies (AIS) in FGIDs.

  10. Clinical neuroanatomy and diagnostic imaging and evaluation of the brain. MRI and CT atlas. 3. new rev. and enl. ed.

    International Nuclear Information System (INIS)

    Kretschmann, H.J.; Weinrich, W.

    2003-01-01

    New features of this 3rd German edition are: - Number of the MR and CT images almost doubled, all pictures now in large format, displaying much more brain structures. - New knowledge and insight incorporated in the text and pictures. (orig./CB) [de

  11. Clinical applications of SONIALVISION 100 digital diagnostic table system

    International Nuclear Information System (INIS)

    Shiomi, Takeshi; Shimizu, Tatsuya; Iinuma, Masao; Takemoto, Hajime; Tanaka, Shuji

    2003-01-01

    This report refers to the clinical applications of our newly developed SONIALVISION 100 fully digitalized X-ray diagnostic table system. The main design concept of the SONIALVISION 100 system is the improvement of workflow in various clinical fields. The development of digital imaging technologies has come to allow fully digitalized X-ray diagnostic table systems to be widely utilized in various clinical applications, including interventional radiology (IVR) and examinations using contrast medium. This report mainly refers to the clinical applications of the Shimadzu SONIALVISION 100 digitalized X-ray diagnostic table system, also presenting some typical image data demonstrating the high efficiency, made available through the use of this new system, in high-speed spot imaging and digital tomography. (author)

  12. Role of teleradiology in modern diagnostic imaging

    International Nuclear Information System (INIS)

    Chrzan, R.; Urbanik, A.; Wyrobek -Renczynska, M.; Podsiadlo, L.

    2004-01-01

    Teleradiology is a dynamically expanding technology of electronic transmission of radiologic images. History of teleradiology development, methods of obtaining images in digital form, media used for their transmission, factors affecting time of transmission, methods of visualization of transmitted images, attempts at standardization of new technology and at last typical applications of teleradiology were presented. Teleradiology from the position of technical curiosity advanced to the role of everyday work tool. Possibility of specialist diagnostic imaging assurance in poorly developed regions, not possessing sufficient number of radiologists, turned out particularly important. Cooperation of regional hospitals with specialist centers of diagnostic images reporting and archiving created a chance for making better use of owned equipment and reducing the costs of diagnostics. For the sake of broader and broader access to teleradiology not only over the world but also in Poland it is advisable to familiarize with its possibilities by both radiologists and clinicists using the results of diagnostic imaging. (author)

  13. Usefulness of diagnostic imaging in primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Sekiyama, Kazuya; Akakura, Koichiro; Mikami, Kazuo; Mizoguchi, Ken-ichi; Tobe, Toyofusa; Nakano, Koichi; Numata, Tsutomu; Konno, Akiyoshi; Ito, Haruo

    2003-01-01

    In patients with primary hyperparathyroidism, prevention of urinary stone recurrence can be achieved by surgical removal of the enlarged parathyroid gland. To ensure the efficacy of surgery for primary hyperparathyroidism, preoperative localization of the enlarged gland is important. In the present study, usefulness of diagnostic imaging for localization of the enlarged gland was investigated in primary hyperparathyroidism. We retrospectively examined the findings of imaging studies and clinical records in 79 patients (97 glands) who underwent surgical treatment for primary hyperparathyroidism at Chiba University Hospital between 1976 and 2000. The detection rates of accurate localization were investigated for imaging techniques, such as ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI) thallium-201 and technetium-99m pertechnetate (Tl-Tc) subtraction scintigraphy and 99m Tc-methoxyisobutylisonitrile (MIBI) scintigraphy, and analysed in relation to the size and weight of the gland and pathological diagnosis. The detection rates by US, CT, MRI, Tl-Tc subtraction scintigraphy and MIBI scintigraphy were 70%, 67%, 73%, 38% and 78%, respectively. The overall detection rate changed from 50% to 88% before and after 1987. The detection rate of MIBI scintigraphy was superior to Tl-Tc subtraction scintigraphy. In primary hyperparathyroidism, improvement of accurate localization of an enlarged parathyroid gland was demonstrated along with recent advances in imaging techniques including MIBI scintigraphy. (author)

  14. Diagnostic imaging of skeletal metastases

    International Nuclear Information System (INIS)

    Scutellari, P. N.; Addonisio, G.; Righi, R.; Giganti, M.

    2000-01-01

    Purpose of this article is to present an algorithm for detection and diagnosis of skeletal metastases, which may be applied differently in symptomatic and asymptomatic cancer patients. February to March 1999 it was randomly selected and retrospectively reviewed the clinical charts of 100 cancer patients (70 women and 30 men; mean age: 63 years, range: 55-87). All the patients had been staged according to TNM criteria and had undergone conventional radiography and bone scan; when findings were equivocal, CT and MRI had been performed too. The primary lesions responsible for bone metastases were sited in the: breast (51 cases), colon (30 cases: 17 men and 13 women), lung (7 cases: 6 men and 1 woman), stomach (4 cases: 2 men and 2 women), skin (4 cases: 3 men and 1 woman), kidney (2 men), pleura (1 woman), and finally liver (1 man). The most frequent radiographic pattern was the lytic type (52%), followed by osteosclerotic, mixed, lytic vs mixed and osteosclerotic vs lytic patterns. The patients were divided into two groups: group A patients were asymptomatic and group B patients had local symptoms and/or pain. Skeletal metastases are the most common malignant bone tumors: the spine and the pelvis are the most frequent sites of metastasis, because of the presence of high amounts of red (hematopoietic active) bone marrow. Pain is the main symptom, even though many bone metastases are asymptomatic. Pathological fractures are the most severe consequences. With the algorithm for detection and diagnosis of skeletal metastases two different diagnostic courses are available for asymptomatic and symptomatic patients. Bone scintigraphy remains the technique of choice in asymptomatic patients in whom skeletal metastases are suspected. However this technique, though very sensitive, is poorly specific, and thus a negative bone scan finding is double-checked with another physical examination: if the findings remain negative, the diagnostic workup is over. On the contrary, in

  15. Eagle Syndrome: diagnostic imaging and therapy

    International Nuclear Information System (INIS)

    Nickel, J.; Andresen, R.; Sonnenburg, M.; Scheufler, O.

    2004-01-01

    In the case of clinical symptoms such as dysphagia, foreign-body sensation and chronic neck or facial pain close to the ear, an Eagle syndrome should be considered in the differential diagnosis. Rational diagnostics and therapy are elucidated on the basis of four case reports. Four patients presented in the out-patients clinic with chronic complaints on chewing and a foreign-body sensation in the tonsil region. Upon specific palpation below the mandibular angle, pain radiating into the ear region intensified. In all patients, local anaesthesia with lidocaine only led to a temporary remission of symptoms. Imaging diagnostics then performed initially included cranial survey radiograms according to Clementschitsch as well as in the lateral ray path and an OPTG. An axial spiral-CT was then performed using the thin-layer technique with subsequent 3-D reconstruction. Therapy consisted of elective resection with a lateral external incision from the retromandibular. From a symptomatic point of view, the cranial survey radiograms and the OPTG revealed hypertrophic styloid processes. The geometrically corrected addition of the axial CT images produced an absolute length of 51-58 mm. The 3-D reconstruction made it possible to visualise the exact spatial orientation of the styloid processes. An ossification of the stylohyoid ligament could definitely be ruled out on the basis of the imaging procedures. After resection of the megastyloid, the patients were completely free of symptoms. Spiral-CT with subsequent 3-D reconstruction is the method of choice for exact determination of the localisation and size of a megastyloid, while cranial survey radiograms according to Clementschitsch and in the lateral ray path or an OPTG can provide initial information. The therapy of choice is considered to be resection of the megastyloid, whereby an external lateral incision has proved effective. (orig.) [de

  16. Diagnostic imaging of hypertrophic pyloric stenosis (HPS)

    International Nuclear Information System (INIS)

    Frkovic, M.; Seronja Kuhar, M.; Perhoc, Z.; Barbaric-Babic, V.; Molnar, M.; Vukovic, J.

    2001-01-01

    Background. Imaging of the abdomen in children with suspected hypertrophic pyloric stenosis has been traditionally performed by plain film radiography and upper gastrointestinal contrast studies. In many clinical situations, this approach has been modified or replaced by ultrasound examination. The authors aimed to analyse the value of diagnostic algorithm in children with hypertrophic pyloric stenosis confirmed at surgery in our hospital. Patients and methods. The authors made a five year retrospective review of hospital records of all children operated on for HPS in Clinical Hospital Centre Zagreb - Rebro and found out that 14 boys, between 2 (17 days) and 10 weeks of life (75 days) underwent surgery due to HPS. Results. Specific radiographic signs were: string sign, double track sign, elongation and narrowing of pyloric canal, mushroom sign, gastric distension with fluid and beak sign. Ultrasound was performed in 9 patients, one of them was false negative (sonographer admitted that he had no experience), the rest were positive. Conclusions. If the physical examination is negative or equivocal, sonography by an experienced sonographer must be performed. If the ultrasound finding is negative, than the infant should undergo to barium upper gastrointestinal studies (UGI). If HPS isn't a primary diagnostic question, it's better to perform UGI first in order to make a correct diagnosis. (author)

  17. Structured diagnostic imaging in patients with multiple trauma

    International Nuclear Information System (INIS)

    Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M.; Kanz, K.G.

    2002-01-01

    Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [de

  18. Trends in utilization: has extremity MR imaging replaced diagnostic arthroscopy?

    International Nuclear Information System (INIS)

    Glynn, Nicole; Morrison, William B.; Parker, Laurence; Schweitzer, Mark E.; Carrino, John A.

    2004-01-01

    To examine the relative change in utilization of magnetic resonance (MR) imaging of the extremities versus diagnostic and therapeutic arthroscopy. Using the 1993, 1996, and 1999 nationwide Medicare Part B databases, utilization rates (per 100,000) were determined for upper and lower extremity MR imaging, diagnostic arthroscopy and therapeutic arthroscopy using CPT-4 codes. Utilization of extremity MR imaging was compared with that of diagnostic and therapeutic arthroscopy in 10 geographic regions of the United States and tracked over time. Combined lower and upper extremity MR imaging utilization per 100,000 increased from 393 to 1,056 in 1999 (+168.7%). Utilization of diagnostic arthroscopy of the extremities decreased from 18 in 1993 to 8 in 1999 (-55.6%); therapeutic arthroscopy rates increased from 461 in 1993 to 636 in 1999 (+40.0%). Specifically, from 1993 to 1999, utilization of lower extremity MR imaging increased from 270 to 661 (+144.8%). Utilization of diagnostic arthroscopy of the knee over the same time period decreased from 11 to 5 (-54.5%); therapeutic arthroscopy increased from 394 to 501 (+27.2%). Similarly, utilization rates for upper extremity MR imaging increased from 123 to 395 (+221.1%). Utilization of diagnostic arthroscopy of the shoulder over the same time period decreased from 7 to 2 (-71.4%); therapeutic arthroscopy increased from 44 to 104 (+136.4%). No specific geographic trends were ascertained. The utilization of MR imaging of the extremities has markedly increased from 1993 to 1999. During the same time period the utilization of diagnostic arthroscopy has decreased and that of therapeutic arthroscopy has increased. These findings support the hypothesis that there is increased reliance of clinical practitioners on the diagnostic information provided by MR imaging in preoperative clinical decision-making. (orig.)

  19. Diagnostic imaging of acute aortic dissection

    International Nuclear Information System (INIS)

    Ohya, Tohru; Kumazaki, Tatsuo

    1991-01-01

    One hundred and nineteen patients with aortic dissection who underwent diagnostic imaging were reviewed and angiographic findings as well as those of CT were analysed. Thirty eight cases (43.1%) had non-contrast opacified false lumen, the type of which we call 'thrombosed type aortic dissection'. A comparative study of the thrombosed type with the patent type of false lumens was made particularly from the stand point of the characteristic diagnostic imagings (CT and angiography). At the same time, the pitfalls of these imagings in thrombosed type aortic dissection were studied. At the onset the average age of thrombosed type was 62.3 years old, while that of the patent type was 57.3. A statistical significance between the two groups was p<0.05. Thrombosed type in all cases was caused by atherosclerosis, whereas patent type was caused by the Marfan's syndrome in 11 cases. Other clinical findings, such as initial symptoms and blood pressure revealed no significant differences between the two groups. Pre-contrast CT in acute thrombosed type aortic dissection showed 'hyperdense crescent sign' in 89.4%. However, in 3 cases with thrombosed type in which the pre-contrast CT showed 'hyperdense crescent sign' contrast-enhanced CT detected no clear evidence of aortic dissection in the same site. This was due to obscurity induced by contrast medium. Angiographic findings of thrombosed type were classified into 3 groups: normal type, stenosed true lumen type and ulcer-like projection type. The incidence of normal type was estimated to be 48.4%, whereas stenosed true lumen type was 24.2% and ulcer-like projection was 27.7%. The present study concluded that thrombosed type is not rare in acute aortic dissection and contrast-enhanced CT as well as pre-contrast CT, is of great value in diagnosing thrombosed type. 'Hyperdense crescent sign' in pre-contrast CT is characteristic of intramural hematoma. (author)

  20. Diagnostic imaging of the hand. 2. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Schmitt, R.

    2004-01-01

    The second edition contains the following new features: Focus on cogenital, degenerative, inflammatory, tumourous, neurogenic and vascular diseases of the hands; new images of multiline spiral CT including 2D pictures and 3D reconstructions; new MRT images with examination protocols; synoptic presentation of all diseases according to their pathoanatomy, clinical symptoms, diagnostic imaging, differential diagnosis, therapeutic options; checklists for the doctor's everyday work. (orig.)

  1. Electronic viewbox: An integrated image diagnostic working station

    International Nuclear Information System (INIS)

    Minato, K.; Komori, M.; Hirakawa, A.; Kuwahara, M.; Yonekura, Y.; Torizuka, K.; Brill, A.B.

    1985-01-01

    Recent development in medical imaging technology have been introducing variety of digital images in clinical medicine, and handling these multi-modality digital images in one place is needed for efficient clinical diagnosis. The authors proposed a concept of an integrated image diagnostic working station, in which a physician can look into all clinical images, can select any key image for diagnosis and can read it in detail. A prototype working station named ''Electronic Viewbox'' has been developed for this purpose. It has three distinctive features. 1. The stored images of a patient are shown at a glance. In order to achieve this function, each original image is attached to a small image, where the data are compressed to reserve the essence of the image, and many of these small images are displayed on a CRT screen. This small image is used as an index for picking up a key image in the archived clinical images. 2. The working station is compact enough to be set on a desk. Only two CRTs and a pointing device are assembled. These two CRT screens are used mutually for retrieving key images and for displaying the original images. 3. All operations can be done interactively using cursor and icons

  2. Comparison Of Clinical, Parasitological And Serological Diagnostic ...

    African Journals Online (AJOL)

    Comparison Of Clinical, Parasitological And Serological Diagnostic Methods For The Definitive ... Consideringthe relative significance of these methods in the diagnosis of onchocerciasis, we ... http://dx.doi.org/10.4314/ari.v1i3.40835.

  3. Diagnostic accuracy of clinical tests for the diagnosis of hip femoroacetabular impingement/labral tear

    DEFF Research Database (Denmark)

    Reiman, M P; Goode, A P; Cook, C E

    2015-01-01

    BACKGROUND: Surgery for hip femoroacetabular impingement/acetabular labral tear (FAI/ALT) is exponentially increasing despite lacking investigation of the accuracy of various diagnostic measures. Useful clinical utility of these measures is necessary to support diagnostic imaging and subsequent...

  4. Diagnostic imaging of child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Oguma, Eiji; Aihara, Toshinori [Saitama Children' s Medical Center, Iwatsuki (Japan)

    2002-04-01

    The major role of imaging in cases of suspected child abuse is to identify the physical injuries and to confirm the occurrence of abuse. In severely abused infants, the imaging findings may be the only evidence for a diagnosis of inflicted injury. Imaging may be the first clue to abuse in children seen with apparent other conditions and lead to appropriate measures to protect them from the risk of more serious injury. The radiologist must be familiar with imaging findings of inflicted injuries to fulfill these roles. (author)

  5. Diagnostic imaging of child abuse

    International Nuclear Information System (INIS)

    Oguma, Eiji; Aihara, Toshinori

    2002-01-01

    The major role of imaging in cases of suspected child abuse is to identify the physical injuries and to confirm the occurrence of abuse. In severely abused infants, the imaging findings may be the only evidence for a diagnosis of inflicted injury. Imaging may be the first clue to abuse in children seen with apparent other conditions and lead to appropriate measures to protect them from the risk of more serious injury. The radiologist must be familiar with imaging findings of inflicted injuries to fulfill these roles. (author)

  6. Diagnostic imaging in intensive care patients

    International Nuclear Information System (INIS)

    Afione, Cristina; Binda, Maria del C.

    2004-01-01

    Purpose: To determine the role of imaging diagnostic methods in the location of infection causes of unknown origin in the critical care patient. Material and methods: A comprehensive medical literature search has been done. Recommendations for the diagnostic imaging of septic focus in intensive care patients are presented for each case, with analysis based on evidence. The degree of evidence utilized has been that of Oxford Center for Evidence-based Medicine. Results: Nosocomial infection is the most frequent complication in the intensive care unit (25 to 33%) with high sepsis incidence rate. In order to locate the infection focus, imaging methods play an important role, as a diagnostic tool and to guide therapeutic procedures. The most frequent causes of infection are: ventilation associated pneumonia, sinusitis, intra-abdominal infections and an acute acalculous cholecystitis. This paper analyses the diagnostic imaging of hospital infection, with the evaluation of choice methods for each one and proposes an algorithm to assess the septic patient. Conclusion: There are evidences, with different degrees of recommendation, for the use of diagnostic imaging methods for infectious focuses in critical care patients. The studies have been selected based on their diagnostic precision, on the capacity of the medical team and on the availability of resources, considering the risk-benefit balance for the best safety of the patient. (author)

  7. Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley's, McMurray's and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis.

    Science.gov (United States)

    Blyth, Mark; Anthony, Iain; Francq, Bernard; Brooksbank, Katriona; Downie, Paul; Powell, Andrew; Jones, Bryn; MacLean, Angus; McConnachie, Alex; Norrie, John

    2015-08-01

    Reliable non-invasive diagnosis of meniscal tears is difficult. Magnetic resonance imaging (MRI) is often used but is expensive and incidental findings are problematic. There are a number of physical examination tests for the diagnosis of meniscal tears that are simple, cheap and non-invasive. To determine the diagnostic accuracy of the Thessaly test and to determine if the Thessaly test (alone or in combination with other physical tests) can obviate the need for further investigation by MRI or arthroscopy for patients with a suspected meniscal tear. Single-centre prospective diagnostic accuracy study. Although the study was performed in a secondary care setting, it was designed to replicate the results that would have been achieved in a primary care setting. Two cohorts of patients were recruited: patients with knee pathology (n = 292) and a control cohort with no knee pathology (n = 75). Sensitivity, specificity and diagnostic accuracy of the Thessaly test in determining the presence of meniscal tears. Participants were assessed by both a primary care clinician and a musculoskeletal clinician. Both clinicians performed the Thessaly test, McMurray's test, Apley's test, joint line tenderness test and took a standardised clinical history from the patient. The Thessaly test had a sensitivity of 0.66, a specificity of 0.39 and a diagnostic accuracy of 54% when utilised by primary care clinicians. This compared with a sensitivity of 0.62, a specificity of 0.55 and diagnostic accuracy of 59% when used by musculoskeletal clinicians. The diagnostics accuracy of the other tests when used by primary care clinicians was 54% for McMurray's test, 53% for Apley's test, 54% for the joint line tenderness test and 55% for clinical history. For primary care clinicians, age and past history of osteoarthritis were both significant predictors of MRI diagnosis of meniscal tears. For musculoskeletal clinicians age and a positive diagnosis of meniscal tears on clinical history

  8. Managing digitally formatted diagnostic image data

    International Nuclear Information System (INIS)

    Templeton, A.W.; Dwyer, S.J.

    1985-01-01

    Diagnostic radiologists are very comfortable using analog radiographic film and interpreting its recorded images. To improve patient care, the radiologist has sought the finest quality radiographic film for use with the best radiographic imaging systems. The proper choice and use of x-ray tubes, generators, film-screen combinations, and contrast media has occupied the professional attention of the radiologist since the inception of radiology. Image quality can be significantly improved with digitally formatted diagnostic imaging systems by providing dynamic ranges in excess of those possible with analog x-ray films. In a CT scanner, the digital acquisition and reconstruction system can obtain a dynamic range (contrast resolution) of 10,000 to 1. Digital subtraction angiography systems achieve 10-bit dynamic ranges for each of the acquired television frames. Increases in the dynamic ranges of the various imaging modalities have been coupled with improved spatial resolution. A digitally formatted image is a two-dimensional, numerical array of discrete image elements. Each picture element is called a pixel. Each pixel has a discrete size. Figure 15.1 illustrates a digitally formatted image depicting the spatial resolution, array size, and quantization or numerical range of the pixel values. Currently, 512 x 512 image arrays are standard. Development of 1024 x 1024 digital arrays are underway. Significant improvements have also been achieved in the rates at which digital diagnostic imaging data can be acquired, manipulated, and archived

  9. Diagnostic Imaging and Problems of Schizencephaly

    International Nuclear Information System (INIS)

    Stopa, Joanna; Kucharska-Miąsik, Iwona; Dziurzyńska-Białek, Ewa; Kostkiewicz, Agnieszka; Solińska, Anna; Zając-Mnich, Monika; Guz, Wiesław; Samojedny, Antoni

    2014-01-01

    Schizencephaly is a rare developmental malformation of the central nervous system associated with cell migration disturbances. Schizencephaly can be uni- or bilateral and is divided into two morphological types. The cleft is defined as type I (“closed lips”) if there are fused clefts in cerebral mantle. In type II (“open lips”) the clefts are separated and filled with cerebrospinal fluid connecting lateral ventricle with the subarachnoid space. We retrospectively analysed data of patients hospitalized in the Clinical Pediatric Neurology Department of Provincial Hospital No. 2 in Rzeszow between 1998–2011. Clinical data and imaging exams were analysed in the group of children with confirmed schizencephaly. Schizencephaly was recognized in 32 children. Diagnosis was made in children at the ages between 2 weeks and 15 years – the majority of older children were born before the year 2000. Diagnostic imaging, most often magnetic resonance imaging, was performed in all of the children. In most cases coexistence of other CNS malformations was discovered. In only one patient there were no neurological symptoms, most of the children presented different developmental disorders and neurological symptoms – most often cerebral palsy and epilepsy. In the group of children with bilateral and type II schizencephaly certain symptoms occurred more often. Schizencephaly is a rare central nervous system developmental disorder, which is very often associated with other severe brain malformations and in most of the cases subsequent multiple neurological symptoms. The method of choice in diagnosis of schizencephaly is magnetic resonance, which shows the degree and type of cleft, coexisting abnormalities and allows differential diagnosis. With the increased availability of this method it is possible to recognize schizencephaly more often and earlier

  10. The neutron imaging diagnostic at NIF (invited).

    Science.gov (United States)

    Merrill, F E; Bower, D; Buckles, R; Clark, D D; Danly, C R; Drury, O B; Dzenitis, J M; Fatherley, V E; Fittinghoff, D N; Gallegos, R; Grim, G P; Guler, N; Loomis, E N; Lutz, S; Malone, R M; Martinson, D D; Mares, D; Morley, D J; Morgan, G L; Oertel, J A; Tregillis, I L; Volegov, P L; Weiss, P B; Wilde, C H; Wilson, D C

    2012-10-01

    A neutron imaging diagnostic has recently been commissioned at the National Ignition Facility (NIF). This new system is an important diagnostic tool for inertial fusion studies at the NIF for measuring the size and shape of the burning DT plasma during the ignition stage of Inertial Confinement Fusion (ICF) implosions. The imaging technique utilizes a pinhole neutron aperture, placed between the neutron source and a neutron detector. The detection system measures the two dimensional distribution of neutrons passing through the pinhole. This diagnostic has been designed to collect two images at two times. The long flight path for this diagnostic, 28 m, results in a chromatic separation of the neutrons, allowing the independently timed images to measure the source distribution for two neutron energies. Typically the first image measures the distribution of the 14 MeV neutrons and the second image of the 6-12 MeV neutrons. The combination of these two images has provided data on the size and shape of the burning plasma within the compressed capsule, as well as a measure of the quantity and spatial distribution of the cold fuel surrounding this core.

  11. The neutron imaging diagnostic at NIF (invited)

    Energy Technology Data Exchange (ETDEWEB)

    Merrill, F. E.; Clark, D. D.; Danly, C. R.; Drury, O. B.; Fatherley, V. E.; Gallegos, R.; Grim, G. P.; Guler, N.; Loomis, E. N.; Martinson, D. D.; Mares, D.; Morley, D. J.; Morgan, G. L.; Oertel, J. A.; Tregillis, I. L.; Volegov, P. L.; Wilde, C. H.; Wilson, D. C. [Los Alamos National Laboratory, Los Alamos, New Mexico 87544 (United States); Bower, D.; Dzenitis, J. M. [Livermore National Laboratory, Livermore, California 94550 (United States); and others

    2012-10-15

    A neutron imaging diagnostic has recently been commissioned at the National Ignition Facility (NIF). This new system is an important diagnostic tool for inertial fusion studies at the NIF for measuring the size and shape of the burning DT plasma during the ignition stage of Inertial Confinement Fusion (ICF) implosions. The imaging technique utilizes a pinhole neutron aperture, placed between the neutron source and a neutron detector. The detection system measures the two dimensional distribution of neutrons passing through the pinhole. This diagnostic has been designed to collect two images at two times. The long flight path for this diagnostic, 28 m, results in a chromatic separation of the neutrons, allowing the independently timed images to measure the source distribution for two neutron energies. Typically the first image measures the distribution of the 14 MeV neutrons and the second image of the 6-12 MeV neutrons. The combination of these two images has provided data on the size and shape of the burning plasma within the compressed capsule, as well as a measure of the quantity and spatial distribution of the cold fuel surrounding this core.

  12. RANZCR Body Systems Framework of diagnostic imaging examination descriptors.

    Science.gov (United States)

    Pitman, Alexander G; Penlington, Lisa; Doromal, Darren; Slater, Gregory; Vukolova, Natalia

    2014-08-01

    A unified and logical system of descriptors for diagnostic imaging examinations and procedures is a desirable resource for radiology in Australia and New Zealand and is needed to support core activities of RANZCR. Existing descriptor systems available in Australia and New Zealand (including the Medicare DIST and the ACC Schedule) have significant limitations and are inappropriate for broader clinical application. An anatomically based grid was constructed, with anatomical structures arranged in rows and diagnostic imaging modalities arranged in columns (including nuclear medicine and positron emission tomography). The grid was segregated into five body systems. The cells at the intersection of an anatomical structure row and an imaging modality column were populated with short, formulaic descriptors of the applicable diagnostic imaging examinations. Clinically illogical or physically impossible combinations were 'greyed out'. Where the same examination applied to different anatomical structures, the descriptor was kept identical for the purposes of streamlining. The resulting Body Systems Framework of diagnostic imaging examination descriptors lists all the reasonably common diagnostic imaging examinations currently performed in Australia and New Zealand using a unified grid structure allowing navigation by both referrers and radiologists. The Framework has been placed on the RANZCR website and is available for access free of charge by registered users. The Body Systems Framework of diagnostic imaging examination descriptors is a system of descriptors based on relationships between anatomical structures and imaging modalities. The Framework is now available as a resource and reference point for the radiology profession and to support core College activities. © 2014 The Royal Australian and New Zealand College of Radiologists.

  13. Preparing diagnostic 3D images for image registration with planning CT images

    International Nuclear Information System (INIS)

    Tracton, Gregg S.; Miller, Elizabeth P.; Rosenman, Julian; Chang, Sha X.; Sailer, Scott; Boxwala, Azaz; Chaney, Edward L.

    1997-01-01

    Purpose: Pre-radiotherapy (pre-RT) tomographic images acquired for diagnostic purposes often contain important tumor and/or normal tissue information which is poorly defined or absent in planning CT images. Our two years of clinical experience has shown that computer-assisted 3D registration of pre-RT images with planning CT images often plays an indispensable role in accurate treatment volume definition. Often the only available format of the diagnostic images is film from which the original 3D digital data must be reconstructed. In addition, any digital data, whether reconstructed or not, must be put into a form suitable for incorporation into the treatment planning system. The purpose of this investigation was to identify all problems that must be overcome before this data is suitable for clinical use. Materials and Methods: In the past two years we have 3D-reconstructed 300 diagnostic images from film and digital sources. As a problem was discovered we built a software tool to correct it. In time we collected a large set of such tools and found that they must be applied in a specific order to achieve the correct reconstruction. Finally, a toolkit (ediScan) was built that made all these tools available in the proper manner via a pleasant yet efficient mouse-based user interface. Results: Problems we discovered included different magnifications, shifted display centers, non-parallel image planes, image planes not perpendicular to the long axis of the table-top (shearing), irregularly spaced scans, non contiguous scan volumes, multiple slices per film, different orientations for slice axes (e.g. left-right reversal), slices printed at window settings corresponding to tissues of interest for diagnostic purposes, and printing artifacts. We have learned that the specific steps to correct these problems, in order of application, are: Also, we found that fast feedback and large image capacity (at least 2000 x 2000 12-bit pixels) are essential for practical application

  14. Computer applications in diagnostic imaging.

    Science.gov (United States)

    Horii, S C

    1991-03-01

    This article has introduced the nature, generation, use, and future of digital imaging. As digital technology has transformed other aspects of our lives--has the reader tried to buy a conventional record album recently? almost all music store stock is now compact disks--it is sure to continue to transform medicine as well. Whether that transformation will be to our liking as physicians or a source of frustration and disappointment is dependent on understanding the issues involved.

  15. Case studies in diagnostic imaging

    International Nuclear Information System (INIS)

    Nisbet, A.P.; Gedroyc, W.M.W.; Rankin, S.C.

    1987-01-01

    This book presents short clinical histories and selected radiographs in a quiz format to enable readers to attempt their own diagnosis. Overleaf specimen answers, recommendations for further management and, where appropriate, further confirmatory films are displayed. The book is intended to be a tutor for candidates sitting postgraduate medical examinations, providing a means of testing themselves and obtaining an immediate answer for comparison

  16. Serumferritin - diagnostic relevance and clinical usefulness

    Energy Technology Data Exchange (ETDEWEB)

    Linkesch, W [Vienna Univ. (Austria). 2. Medizinische Klinik

    1984-01-01

    The introduction of a WHO Standard for serumferritin effected a standardisation of different methods, improving quality and security for clinical routine diagnostic purposes. Therefore the clinical evaluation of serumferritin gained even more importance. For evaluation of iron stores of children, pregnant women, population studies, patients on hemodialysis or patients with rheumatoid arthritis low serumferritin values give safe results. In addition serumferritin is of clinical usefulness in monitoring therapy of both iron deficiency and iron overload. Evaluating a single serumferritin value one should consider the total clinical situation of the patient. As some tumors can produce and secrete serumferritin, e.g. acute myeloblastic leukemia, germ cell tumors, malignant melanoma, serumferritin might be helpful in monitoring the malignant disease. The ongoing characterization of tissue isoferritin, especially acidic isoferritin, may eventually lead to a clinically significant diagnostic marker of neoplasia.

  17. Serumferritin - diagnostic relevance and clinical usefulness

    International Nuclear Information System (INIS)

    Linkesch, W.

    1984-01-01

    The introduction of a WHO Standard for serumferritin effected a standardisation of different methods, improving quality and security for clinical routine diagnostic purposes. Therefore the clinical evaluation of serumferritin gained even more importance. For evaluation of iron stores of children, pregnant women, population studies, patients on hemodialysis or patients with rheumatoid arthritis low serumferritin values give safe results. In addition serumferritin is of clinical usefulness in monitoring therapy of both iron deficiency and iron overload. Evaluating a single serumferritin value on should consider the total clinical situation of the patient. As some tumors can produce and secrete serumferritin, e. g. acute myeloblastic leukemia, germ cell tumors, malignant melanoma, serumferritin might be helpful in monitoring the malignant disease. The ongoing characterization of tissue isoferritin, especially acidic isoferritin, may eventually lead to a clinically significant diagnostic marker of neoplasia. (Author)

  18. Advanced microarray technologies for clinical diagnostics

    NARCIS (Netherlands)

    Pierik, Anke

    2011-01-01

    DNA microarrays become increasingly important in the field of clinical diagnostics. These microarrays, also called DNA chips, are small solid substrates, typically having a maximum surface area of a few cm2, onto which many spots are arrayed in a pre-determined pattern. Each of these spots contains

  19. Diagnostic imaging in psychiatry; Bildgebende Verfahren in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Stoppe, G.; Hentschel, F.; Munz, D.L. (eds.)

    2000-07-01

    The textbook presents an exhaustive survey of diagnostic imaging methods available for clinical evaluation of the entire range of significant psychiatric symptoms via imaging of the anatomy and functions of the brain. The chapters discuss: The methods and their efficient use for given diagnostic objectives, image analysis, description and interpretation of findings with respect to the clinical symptoms. Morphology and functional correlation of findings. The book is intended to help psychiatrists and neurologists as well as doctors in the radiology and nuclear medicine departments. (orig./CB) [German] Die Entwicklung der modernen Bildgebung ermoeglicht faszinierende Einblicke in Anatomie und Funktionen des Gehirns und ihre Veraenderungen bei psychiatrischen Erkrankungen. Die Methodik der Untersuchungsverfahren und die Befunde bei allen wichtigen psychiatrischen Krankheitsbildern sind in diesem Buch systematisch und umfassend beschrieben: - gezielter und effizienter Einsatz der Verfahren, - Bildanalyse und Befundbeschreibung, - Bewertung der Befunde und Beziehung zum klinischen Bild, - morphologische und funktionelle Korrelate der Befunde. Psychiater und Neurologen werden ebenso angesprochen wie Radiologen und Nuklearmediziner. (orig.)

  20. Meniscal tear. Diagnostic errors in MR imaging

    International Nuclear Information System (INIS)

    Barrera, M. C.; Recondo, J. A.; Gervas, C.; Fernandez, E.; Villanua, J. A.M.; Salvador, E.

    2003-01-01

    To analyze diagnostic discrepancies found between magnetic resonance (MR) and arthroscopy, and the determine the reasons that they occur. Two-hundred and forty-eight MR knee explorations were retrospectively checked. Forty of these showed diagnostic discrepancies between MR and arthroscopy. Two radiologists independently re-analyzed the images from 29 of the 40 studies without knowing which diagnosis had resulted from which of the two techniques. Their interpretations were correlated with the initial MR diagnosis, MR images and arthroscopic results. Initial errors in MR imaging were classified as either unavoidable, interpretive, or secondary to equivocal findings. Eleven MR examinations could not be checked since their corresponding imaging results could not be located. Of 34 errors found in the original diagnoses, 12 (35.5%)were classified as unavoidable, 14 (41.2%) as interpretative and 8 (23.5%) as secondary to equivocal findings. 41.2% of the errors were avoided in the retrospective study probably due to our department having greater experience in interpreting MR images, 25.5% were unavailable even in the retrospective study. A small percentage of diagnostic errors were due to the presence of subtle equivocal findings. (Author) 15 refs

  1. Diagnostic imaging of lymphomas in pediatric patients

    International Nuclear Information System (INIS)

    Petrova, A.

    2010-01-01

    Lymphoma is the third most common malignancy in children, after leukemias and brain tumors, most commonly during early childhood before 14 years. In definite stages cancer can engage all organs and systems. These conditions associate with immunodeficiency, increased susceptibility to infections and second neoplasms. The social importance of the problem requires early diagnosis, accurate staging, and assessment of the treatment and determination of the risk for relapse of the disease. The aim of the present review is to represent the role of the modern methods of diagnostic imaging - ultrasonography (US), Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Positron Emisson Tomography (PET) scan in the process of diagnostics, in the decision of therapeutic strategy and the follow-up of children with lymphomas

  2. Digital imaging in diagnostic radiology. Image quality - radiation exposure

    International Nuclear Information System (INIS)

    Schmidt, T.; Stieve, F.E.

    1996-01-01

    The publication contains the 37 lectures of the symposium on digital imaging in diagnostic radiology, held in November 1995 at Kloster Seeon, as well as contributions enhancing the information presented in the lectures. The publication reflects the state of the art in this subject field, discusses future trends and gives recommendations and information relating to current practice in radiology. In-depth information is given about R and D activities for the digitalisation of X-ray pictures and the image quality required to meet the purposes of modern diagnostics. Further aspects encompass radiological protection and dose optimization as well as optimization of examination methods. (vhe) [de

  3. Diagnostic imaging of craniopharyngioma; Diagnostyka obrazowa czaszkogardlakow

    Energy Technology Data Exchange (ETDEWEB)

    Gradzki, J.; Nowak, S.; Paprzycki, W. [Akademia Medyczna, Poznan (Poland)

    1993-12-31

    40 patients have been examined with operational and histological confirmation of craniopharyngioma. CT image and X-ray plane of skull were performed in case all of these patients. TMR was conformed to examine 4 patients. X-ray planes was compared to CT. CT permits tumor cyst detection. The efficacy of mentioned above diagnostic techniques was compared with surgical findings. (author). 7 refs, 5 figs, 2 tabs.

  4. Primary mammary tuberculosis: Clinical diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Sunder Goyal

    2015-09-01

    Conclusion: Breast Tuberculous is uncommon in countries where incidence of pulmonary and extrapulmonary tuberculosis is very high. It continues to pose a diagnostic challenge due to its rarity, atypical clinical features and non confirmatory radiological modalities. Unnecessary mastectomy can be avoided if we keep this rare but medically treatable condition on back of our mind. [Arch Clin Exp Surg 2015; 4(3.000: 153-156

  5. Imaging mammary diagnostics. Diagnostic techniques, archetypical findings, differential diagnostcs and interventions. 2. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Heywang-Koebrunner, S.; Schreer, I.

    2008-01-01

    The book includes the following chapters: I. Methodology: anamnesis and interview; clinical evidence, mammography, sonography, magnetic resonance tomography, new imaging techniques (scintigraphy, PET), transcutaneous biopsy, pre-operative marking; II. phenotypes: normal mammary glands, mastopathics, cysts, benign tumors, inflammatory diseases, in-situ carcinomas, invasive carcinomas, lymphomas, other semi-malign and malign tumors, post-traumatic, post-surgical and post-therapeutic changes, skin changes, male mamma, screening, continuative diagnostics of screening evidence and problem solving for symptomatic patients

  6. Clinical X-ray diagnostics. v. 2

    International Nuclear Information System (INIS)

    Baudisch, E.; Becker, T.

    1981-01-01

    Principles of the general procedure in radiographic examination are the subject of the introduction. Following anatomico-clinical preliminary notes and suggestions concerning radiographic examination methods and proceeding from normal findings of the bones and from the general radiographic symptomatology of skeletal diseases, developmental disturbances, system diseases, radiogenic injuries, aseptic necroses, metabolic osteopathies, damages, inflammations and tumors as well as less frequently occuring diseases are discussed. Their pathology, clinic, diagnostics, diagnosis and differential diagnosis, their therapy and prognosis are dealt with from the clinico-radiographical point of view. The diseases of the joints of the radiographically demonstrable diseases of the soft parts of the limbs are also treated

  7. Clinical software for MR imaging system, 4

    International Nuclear Information System (INIS)

    Shimizu, Koji; Kasai, Akira; Okamura, Shoichi

    1992-01-01

    Magnetic resonance imaging continues to elicit new application software through the recent technological advances of MR equipment. This paper describes several applications of our newly developed clinical software. The fast SE sequence (RISE) has proved to reduce routine examination time and to improve image quality, and ultra-fast FE sequence (SMASH) was found to extend the diagnostic capabilities in the field of cardiac study. Diffusion/perfusion imaging achieved in our MR system showed significant promise for providing novel information regarding tissue characterization. Furthermore, Image quality and practicalities of MR angiography have been improved by advanced imaging sequences and sophisticated post-processing software. (author)

  8. Skeletal diseases. Diagnostic clinical radiology and differential diagnostics. 2. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Freyschmidt, J.

    1997-01-01

    The book focuses on the diagnostic evaluation of idiopathic diseases of the skeleton and bone joints, also including the fundamental healing processes of bone fractures, particularly of stress-induced and pathologic fractures. Ample space has been given to the description and imaging of the course of diseases under treatment by up-to-date therapies, as e.g. for ostitis deformans Paget's disease, or skeletal metastases. This second edition of the book incorporates the progress achieved over the last five years in skeletal diagnostics. The advances in this field have been resulting from basic research work, for instance in molecular biology, or from a variety of completed studies relating to clinical medicine, laboratory chemistry, histopathology and radiology of skeletal diseases, and from experience obtained with the diagnostic radiology methods and techniques, with the potentials and constraints of magnetic resonance imaging (MRI) today being more critically assessed than five years ago. MRI is a modality currently meeting with interest in the context of search for additional diagnostic information, new definition of complete pictures of diseases, or false or overinterpretation of diagnostic findings. (orig./MG). 431 figs [de

  9. Clinical communication in diagnostic imaging studies: mixed-method study of pre- and post-implementation of a hospital information system.

    Science.gov (United States)

    Pirnejad, H; Niazkhani, Z; Bal, R

    2013-01-01

    To examine how and why the quality of clinical communication between radiologists and referring physicians was changed in the inpatient imaging process after implementation of a hospital information system (HIS). A mixed-method study of the chest X-ray (CXR) requests and reports, and their involved processes within a pre- and post-HIS implementation setting. Documentation of patient age, patient ward, and name and signature of requesting physician decreased significantly in post-HIS CXR requests (Pcommunication loop between physicians and radiologists after the implementation resulted in extra steps in the workflow and more workload for them. To cope with the new workload, they adopted different workarounds that could explain the results seen in the quantitative study. The HIS improved communication of administrative and identification information but did not improve communication of clinically relevant information. The reason was traced to the complications that the inappropriate implementation of the system brought to clinical workflow and communication loop.

  10. Beyond Diagnostic Accuracy: The Clinical Utility of Diagnostic Tests

    NARCIS (Netherlands)

    Bossuyt, Patrick M. M.; Reitsma, Johannes B.; Linnet, Kristian; Moons, Karel G. M.

    2012-01-01

    Like any other medical technology or intervention, diagnostic tests should be thoroughly evaluated before their introduction into daily practice. Increasingly, decision makers, physicians, and other users of diagnostic tests request more than simple measures of a test's analytical or technical

  11. Active imaging for monitoring and technical diagnostics

    Directory of Open Access Journals (Sweden)

    Marek Piszczek

    2014-08-01

    Full Text Available The article presents the results of currently running work in the field of active imaging. The term active refers to both the image acquisition methods, so-called methods of the spatio-temporal framing and active visualization method applying augmented reality. Also results of application of the HMD and 6DoF modules as well as the experimental laser photography device are given. The device works by methods of spatio-temporal framing and it has been developed at the IOE WAT. In terms of image acquisition - active imaging involves the use of illumination of the observed scene. In the field of information visualization - active imaging directly concerns the issues of interaction human-machine environment. The results show the possibility of using the described techniques, among others, rescue (fire brigade, security of mass events (police or the protection of critical infrastructure as well as broadly understood diagnostic problems. Examples presented in the article show a wide range of possible uses of the methods both in observational techniques and measurement. They are relatively innovative solutions and require elaboration of series of hardware and algorithmic issues. However, already at this stage it is clear that active acquisition and visualization methods indicate a high potential for this type of information solutions.[b]Keywords[/b]: active imaging, augmented reality, digital image processing

  12. Ultrasound-guided image fusion with computed tomography and magnetic resonance imaging. Clinical utility for imaging and interventional diagnostics of hepatic lesions; Ultraschallgestuetzte Bildfusion mittels CT und MRT. Klinische Bedeutung fuer die bildgebende und interventionelle Diagnostik von Leberlaesionen

    Energy Technology Data Exchange (ETDEWEB)

    Clevert, D.A.; Helck, A.; Paprottka, P.M.; Trumm, C.; Reiser, M.F. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Zengel, P. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Klinik fuer Hals-, Nasen- und Ohrenheilkunde, Muenchen (Germany)

    2012-01-15

    Abdominal ultrasound is often the first-line imaging modality for assessing focal liver lesions. Due to various new ultrasound techniques, such as image fusion, global positioning system (GPS) tracking and needle tracking guided biopsy, abdominal ultrasound now has great potential regarding detection, characterization and treatment of focal liver lesions. Furthermore, these new techniques will help to improve the clinical management of patients before and during interventional procedures. This article presents the principle and clinical impact of recently developed techniques in the field of ultrasound, e.g. image fusion, GPS tracking and needle tracking guided biopsy and discusses the results based on a feasibility study on 20 patients with focal hepatic lesions. (orig.) [German] Bei der Bildfusion von Ultraschall mit anderen schnittbildgebenden Verfahren (CT, MRT) handelt es sich um ein relativ neuartiges Verfahren, welches unter Studienbedingungen jedoch bereits erfolgreich eingesetzt wurde. In der folgenden Machbarkeitsstudie soll der Nutzen weiterfuehrender Anwendungen der sonographischen Bildfusion, dem so genannten Global-Positioning-System- (GPS-) und Needle-Tracking, untersucht werden. Dabei handelt es sich um Instrumente, die insbesondere die Diagnostik und das Staging (GPS-Tracking) bzw. die bioptische Abklaerung (Needle-Tracking) von Patienten mit fokalen Leberlaesionen erleichtern. In diesem Artikel werden das Prinzip und die Anwendungsmoeglichkeiten dieser neuen Techniken anhand konkreter Beispiele in einem Kollektiv von 20 Patienten mit fokalen Leberlaesionen vorgestellt und erlaeutert. (orig.)

  13. Image enhancement of digital periapical radiographs according to diagnostic tasks

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Jin Woo; Han, Won Jeong; Kim, Eun Kyung [Dept. of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan (Korea, Republic of)

    2014-03-15

    his study was performed to investigate the effect of image enhancement of periapical radiographs according to the diagnostic task. Eighty digital intraoral radiographs were obtained from patients and classified into four groups according to the diagnostic tasks of dental caries, periodontal diseases, periapical lesions, and endodontic files. All images were enhanced differently by using five processing techniques. Three radiologists blindly compared the subjective image quality of the original images and the processed images using a 5-point scale. There were significant differences between the image quality of the processed images and that of the original images (P<0.01) in all the diagnostic task groups. Processing techniques showed significantly different efficacy according to the diagnostic task (P<0.01). Image enhancement affects the image quality differently depending on the diagnostic task. And the use of optimal parameters is important for each diagnostic task.

  14. Image enhancement of digital periapical radiographs according to diagnostic tasks

    International Nuclear Information System (INIS)

    Choi, Jin Woo; Han, Won Jeong; Kim, Eun Kyung

    2014-01-01

    his study was performed to investigate the effect of image enhancement of periapical radiographs according to the diagnostic task. Eighty digital intraoral radiographs were obtained from patients and classified into four groups according to the diagnostic tasks of dental caries, periodontal diseases, periapical lesions, and endodontic files. All images were enhanced differently by using five processing techniques. Three radiologists blindly compared the subjective image quality of the original images and the processed images using a 5-point scale. There were significant differences between the image quality of the processed images and that of the original images (P<0.01) in all the diagnostic task groups. Processing techniques showed significantly different efficacy according to the diagnostic task (P<0.01). Image enhancement affects the image quality differently depending on the diagnostic task. And the use of optimal parameters is important for each diagnostic task.

  15. A survey of medical diagnostic imaging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  16. A survey of medical diagnostic imaging technologies

    Energy Technology Data Exchange (ETDEWEB)

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today`s more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities.

  17. A survey of medical diagnostic imaging technologies

    International Nuclear Information System (INIS)

    Heese, V.; Gmuer, N.; Thomlinson, W.

    1991-10-01

    The fields of medical imaging and medical imaging instrumentation are increasingly important. The state-of-the-art continues to advance at a very rapid pace. In fact, various medical imaging modalities are under development at the National Synchrotron Light Source (such as MECT and Transvenous Angiography.) It is important to understand how these techniques compare with today's more conventional imaging modalities. The purpose of this report is to provide some basic information about the various medical imaging technologies currently in use and their potential developments as a basis for this comparison. This report is by no means an in-depth study of the physics and instrumentation of the various imaging modalities; instead, it is an attempt to provide an explanation of the physical bases of these techniques and their principal clinical and research capabilities

  18. Electronic roentgenographic images in presurgical X-ray diagnostics

    International Nuclear Information System (INIS)

    Haendle, J.; Hohmann, D.; Maass, W.; Siemens A.G., Erlangen

    1981-01-01

    An essential part of radiation exposure in surgery is due to devices and results from the required radiation time interval for continuous X-ray play-back up to the point at which all diagnostically relevant information can be retrieved from the screening image. With single-image storage and short exposure times as well as instant image play-back, this superfluous i.e. redundant radiation can be avoided. The electronic X-ray image is realized by means of a laboratory prototype and evaluated in hospitals. There is a report on clinical results and new technical developments. Remarkable are: the high radiation reduction that could be obtained, the problem - free instant image technique, and especially the advantages of automated exposure in direct film settings. The positive results yield the basis for the product development. (orig./MG) [de

  19. Image quality - physical and diagnostic parameters. The radiologist's viewpoint

    International Nuclear Information System (INIS)

    Stender, H.St.

    1985-01-01

    The quality of a radiograph is determined by the diagnostic information it provides. This depends upon the visual detection of diagnostically relevant structures. The technical radiographic requirements are dependent upon the physical measurements and the physiological and optical conditions. Such physical factors as spatial resolution, contrast and noise are quantitative measurements, which must be oriented to the qualitative visual characteristics of the radiograph. The influence of subjective perception and complexity of structural noise on the detectability of details and structures particularly demands attention. Since radiographic quality depends upon the detection of diagnostically relevant structure and features, it is important to define these parameters on the basis of extensive radiographic analysis and the corresponding clinical findings. The diagnostically relevant radiographic parameters and image details and critical structures have been worked out for the examination of the lungs, colon, stomach, urinary tract and skeleton. Good image quality requires coordination of the physical-technical parameters with the visual ability of the observer, since only in this way can the diagnostic information be represented with sufficient clarity. (author)

  20. Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease

    Science.gov (United States)

    Kallenberg, K.; Summers, D. M.; Romero, C.; Taratuto, A.; Heinemann, U.; Breithaupt, M.; Varges, D.; Meissner, B.; Ladogana, A.; Schuur, M.; Haik, S.; Collins, S. J.; Jansen, Gerard H.; Stokin, G. B.; Pimentel, J.; Hewer, E.; Collie, D.; Smith, P.; Roberts, H.; Brandel, J. P.; van Duijn, C.; Pocchiari, M.; Begue, C.; Cras, P.; Will, R. G.; Sanchez-Juan, P.

    2009-01-01

    Several molecular subtypes of sporadic Creutzfeldt–Jakob disease have been identified and electroencephalogram and cerebrospinal fluid biomarkers have been reported to support clinical diagnosis but with variable utility according to subtype. In recent years, a series of publications have demonstrated a potentially important role for magnetic resonance imaging in the pre-mortem diagnosis of sporadic Creutzfeldt–Jakob disease. Magnetic resonance imaging signal alterations correlate with distinct sporadic Creutzfeldt–Jakob disease molecular subtypes and thus might contribute to the earlier identification of the whole spectrum of sporadic Creutzfeldt–Jakob disease cases. This multi-centre international study aimed to provide a rationale for the amendment of the clinical diagnostic criteria for sporadic Creutzfeldt–Jakob disease. Patients with sporadic Creutzfeldt–Jakob disease and fluid attenuated inversion recovery or diffusion-weight imaging were recruited from 12 countries. Patients referred as ‘suspected sporadic Creutzfeldt–Jakob disease’ but with an alternative diagnosis after thorough follow up, were analysed as controls. All magnetic resonance imaging scans were assessed for signal changes according to a standard protocol encompassing seven cortical regions, basal ganglia, thalamus and cerebellum. Magnetic resonance imaging scans were evaluated in 436 sporadic Creutzfeldt–Jakob disease patients and 141 controls. The pattern of high signal intensity with the best sensitivity and specificity in the differential diagnosis of sporadic Creutzfeldt–Jakob disease was identified. The optimum diagnostic accuracy in the differential diagnosis of rapid progressive dementia was obtained when either at least two cortical regions (temporal, parietal or occipital) or both caudate nucleus and putamen displayed a high signal in fluid attenuated inversion recovery or diffusion-weight imaging magnetic resonance imaging. Based on our analyses, magnetic

  1. Diagnostic accuracy of new imaging techniques in breast diseases

    Energy Technology Data Exchange (ETDEWEB)

    Gordenne, W; Bauduin, E [Liege Univ. (Belgium)

    1989-01-01

    During the last decade, the hypothetical carcinogenic effects of mammography have lead to new technical developments in X-ray diagnosis and to use of other imaging techniques such as ultrasonography (US), transillumination, magnetic resonance imaging (MRI). Many preliminary studies were published but few clinical trials are really convincing. According to the definition of a diagnostic tool, none of these new modalities is supposed to supplant mammography in the diagnosis of breast cancer. Improvements are expected by digital mammography in the near future. (Authors).

  2. THE PROBLEMS OF EARLY CLINICAL DEFECTOLOGICAL DIAGNOSTICS

    Directory of Open Access Journals (Sweden)

    Aleksandar CORDIC

    1997-06-01

    Full Text Available Clinical defectological diagnostics, related to diagnostics of each individual's impairment of his cognitive and socializing abilities, has been applied in our country for a long time. Since it is a new area in the clinical defectological work and a new form of research in defectology, it poses a series of problems which have not been met so far. We shall to recognize some of them in this paper and to aim at their solution.This time we shall consider only the most prominent problems towards which we direct our interventions:· When does defectological diagnostics take part in diagnosis as treatment of impairments of the handicapped person? When does it function in the process of rehabilitation? For example, is working with a dyslexic child treatment or rehabilitation?· When does the early diagnostics reveal a problem arising from inappropriate intersection of different development courses, which can sometimes be solved without any particular treatment (early stuttering, various convulsions, and when does it reveal actual condition, such as oligophrenia or autism. Thereby we ask ourselves if early stimulative treatment of oligophrenic children or children with early childhood psychosis is treatment or rehabilitation.We tried to classify end explain the problems of diagnostics in the context of treatment and rehabilitation and to define the theoretical grounds for our standpoints.We wanted to point out the unity of the process of any impairment of the handicapped person from early childhood to the end of his life. Treatment and rehabilitation should be a united process and follow the course of development of early disorders which sometimes end up as handicaps, and sometimes, thanks to the treatment, may end up in successful socialization, for example, persons with impaired hearing or sight.We establish defectology as a complete theoretical standpoint and expert procedure which is parallel to and complementary with medicine. The only difference we

  3. Diagnostic and clinical benefit of combined coronary calcium and perfusion assessment in patients undergoing PET/CT myocardial perfusion stress imaging.

    Science.gov (United States)

    Bybee, Kevin A; Lee, John; Markiewicz, Richard; Longmore, Ryan; McGhie, A Iain; O'Keefe, James H; Hsu, Bai-Ling; Kennedy, Kevin; Thompson, Randall C; Bateman, Timothy M

    2010-04-01

    A limitation of stress myocardial perfusion imaging (MPI) is the inability to detect non-obstructive coronary artery disease (CAD). One advantage of MPI with a hybrid CT device is the ability to obtain same-setting measurement of the coronary artery calcium score (CACS). Utilizing our single-center nuclear database, we identified 760 consecutive patients with: (1) no CAD history; (2) a normal clinically indicated Rb-82 PET/CT stress perfusion study; and (3) a same-setting CAC scan. 487 of 760 patients (64.1%) had subclinical CAD based on an abnormal CACS. Of those with CAC, the CACS was > or =100, > or =400, and > or =1000 in 47.0%, 22.4%, and 8.4% of patients, respectively. Less than half of the patients with CAC were receiving aspirin or statin medications prior to PET/CT imaging. Patients with CAC were more likely to be initiated or optimized on proven medical therapy for CAD immediately following PET/CT MPI compared to those without CAC. Subclinical CAD is common in patients without known CAD and normal myocardial perfusion assessed by hybrid PET/CT imaging. Identification of CAC influences subsequent physician prescribing patterns such that those with CAC are more likely to be treated with proven medical therapy for the treatment of CAD.

  4. High speed imaging system for nuclear diagnostics

    International Nuclear Information System (INIS)

    Eyer, H.H.

    1976-01-01

    A high speed imaging system based on state-of-the-art photosensor arrays has been designed for use in nuclear diagnostics. The system is comprised of a front-end rapid-scan solid-state camera, a high speed digitizer, and a PCM line driver in a downhole package and a memory buffer system in a uphole trailer. The downhole camera takes a ''snapshot'' of a nuclear device created flux stream, digitizes the image and transmits it to the uphole memory system before being destroyed. The memory system performs two functions: it retains the data for local display and processing by a microprocessor, and it buffers the data for retransmission at slower rates to the LLL computational facility (NADS). The impetus for such a system as well as its operation are discussed. Also discussed are new systems under development which incorporate higher data rates and more resolution

  5. Diagnostic imaging of the diabetic foot

    International Nuclear Information System (INIS)

    Ranachowska, C.; Lass, P.; Korzon-Burakowska, A.; Dobosz, M.

    2010-01-01

    Diabetic foot syndrome is a significant complication of diabetes. Diagnostic imaging is a crucial factor determining surgical decision and extent of surgical intervention. At present the gold standard is MRI scanning, whilst the role of bone scanning is decreasing, although in some cases it brings valuable information. In particular, in early stages of osteitis and Charcot neuro-osteoarthropathy, radionuclide imaging may be superior to MRI. Additionally, a significant contribution of inflammation-targeted scintigraphy should be noted. Probably the role of PET scanning will grow, although its high cost and low availability may be a limiting factor. In every case, vascular status should be determined, at least with Doppler ultrasound, with following conventional angiography or MR angiography. (authors)

  6. High speed imaging system for nuclear diagnostics

    International Nuclear Information System (INIS)

    Eyer, H.H.

    1976-01-01

    A high speed imaging system based on state-of-the-art photosensor arrays has been designed for use in nuclear diagnostics. The system is comprised of a front-end rapid-scan solid-state camera, a high speed digitizer, and a PCM line driver in a downhole package and a memory buffer system in an uphole trailer. The downhole camera takes a ''snapshot'' of a nuclear device created flux stream, digitizes the image and transmits it to the uphole memory system before being destroyed. The memory system performs two functions: it retains the data for local display and processing by a microprocessor, and it buffers the data for retransmission at slower rates to the LLL computational facility (NADS). The impetus for such a system as well as its operation is discussed. Also discussed are new systems under development which incorporate higher data rates and more resolution

  7. [Advances of Molecular Diagnostic Techniques Application in Clinical Diagnosis.

    Science.gov (United States)

    Ying, Bin-Wu

    2016-11-01

    Over the past 20 years,clinical molecular diagnostic technology has made rapid development,and became the most promising field in clinical laboratory medicine.In particular,with the development of genomics,clinical molecular diagnostic methods will reveal the nature of clinical diseases in a deeper level,thus guiding the clinical diagnosis and treatments.Many molecular diagnostic projects have been routinely applied in clinical works.This paper reviews the advances on application of clinical diagnostic techniques in infectious disease,tumor and genetic disorders,including nucleic acid amplification,biochip,next-generation sequencing,and automation molecular system,and so on.

  8. Bladder outlet obstruction due to a small midline prostatic cyst - diagnostic imaging and interventional radiological treatment

    International Nuclear Information System (INIS)

    Hueppe, T.; Kopka, L.; Friedrich, M.; Kuehn, M.

    1992-01-01

    We describe a rare case of a bladder outlet obstruction due to a midline prostatic cyst. In the following clinical apperance, diagnostic imaging and therapy by CT-guided punction are reported. Differential diagnosis and therapy are discussed. (orig.) [de

  9. Cellular mesoblastic nephroma (infantile renal fibrosarcoma): institutional review of the clinical, diagnostic imaging, and pathologic features of a distinctive neoplasm of infancy

    International Nuclear Information System (INIS)

    Bayindir, Petek; Guillerman, Robert Paul; Hicks, M.J.; Chintagumpala, M.M.

    2009-01-01

    Cellular mesoblastic nephroma has been associated with a more aggressive course than classic mesoblastic nephroma, including local recurrences and metastases. To define the clinicopathologic and imaging features distinguishing cellular from classic mesoblastic nephroma. Retrospective review of clinical charts and imaging studies of ten children with mesoblastic nephroma from 1996 to 2007 at a large children's hospital. In six children the mesoblastic nephroma was pure cellular, in two mixed, and in two classic. The mean ages at diagnosis were 107 days for those with the cellular form, and 32 days for those with the classic form. Hypoechoic or low-attenuation regions representing necrosis or hemorrhage were found in all children with the cellular form and in none of those with the classic form. Hypertension was present in 70% and hypercalcemia in 20% of the children and resolved following nephrectomy. Two cellular tumors encased major abdominal vessels. Local recurrence and metastases occurred within 6 months of tumor resection in two children with the cellular form. Intraspinal extension and intratumoral pseudoaneurysm were seen in one child with the cellular form. The cellular tumors shared histopathologic features with infantile fibrosarcoma (IFS), and RT-PCR testing in two children with the cellular form revealed the t(12;15) ETV6-NTRK3 gene fusion common to IFS. Distinct from the classic form, cellular mesoblastic nephroma is more heterogeneous in appearance on imaging, tends to be larger and present later in infancy, and can exhibit aggressive behavior including vascular encasement and metastasis. Intraspinal extension and intratumoral pseudoaneurysm are previously unreported findings encountered in our cellular mesoblastic nephroma series. The shared histopathology and translocation gene fusion support the concept of cellular mesoblastic nephroma as the renal form of IFS. (orig.)

  10. Requesting diagnostic imaging examinations: a position paper of the Canadian Association of Radiologists. Special article

    International Nuclear Information System (INIS)

    Stolberg, H.O.; Hynes, D.M.; Rainbow, A.J.; Moran, L.A.

    1997-01-01

    The present document is directed at physicians who request diagnostic imaging examinations. Many of the imaging examinations currently requested are not useful in managing clinical problems. The intention is to provide general guidelines for the prescription of appropriate imaging examinations. This document does not address the use of specific imaging modalities in particular clinical situations. The purpose is to help doctors make the best use of the imaging examination by providing general guidelines to assist in deciding upon the most appropriate situation in which to use the examination. Similar guidelines for the prescription of diagnostic x-ray examinations have been suggested previously. (author). 19 refs.,

  11. Diagnostic image quality of video-digitized chest images

    International Nuclear Information System (INIS)

    Winter, L.H.; Butler, R.B.; Becking, W.B.; Warnars, G.A.O.; Haar Romeny, B. ter; Ottes, F.P.; Valk, J.-P.J. de

    1989-01-01

    The diagnostic accuracy obtained with the Philips picture archiving and communications subsystem was investigated by means of an observer performance study using receiver operating characteristic (ROC) analysis. The image qualities of conventional films and video digitized images were compared. The scanner had a 1024 x 1024 x 8 bit memory. The digitized images were displayed on a 60 Hz interlaced display monitor 1024 lines. Posteroanterior (AP) roetgenograms of a chest phantom with superimposed simulated interstitial pattern disease (IPD) were produced; there were 28 normal and 40 abnormal films. Normal films were produced by the chest phantom alone. Abnormal films were taken of the chest phantom with varying degrees of superimposed simulated intersitial disease (PND) for an observer performance study, because the results of a simulated interstitial pattern disease study are less likely to be influenced by perceptual capabilities. The conventional films and the video digitized images were viewed by five experienced observers during four separate sessions. Conventional films were presented on a viewing box, the digital images were displayed on the monitor described above. The presence of simulated intersitial disease was indicated on a 5-point ROC certainty scale by each observer. We analyzed the differences between ROC curves derived from correlated data statistically. The mean time required to evaluate 68 digitized images is approximately four times the mean time needed to read the convential films. The diagnostic quality of the video digitized images was significantly lower (at the 5% level) than that of the conventional films (median area under the curve (AUC) of 0.71 and 0.94, respectively). (author). 25 refs.; 2 figs.; 4 tabs

  12. Visible Imaging Diagnostic on Tore-Supra

    Energy Technology Data Exchange (ETDEWEB)

    Dachicourt, R.; Monier Garbet, P.; Beaute, A.; Habib-Naiim, M. [Association Euratom-CEA, CEA/DSM/IRFM, CEA Cadarache (France); Marandet, Y. [PIIM, CNRS-Universite de Provence, Marseille (France)

    2011-07-01

    Full text of publication follows: Research for thermonuclear fusion aims at energy production using fusion reactions between deuterium and tritium nuclei. To this end, a deuterium/tritium mixture has to be heated to a very high temperature (about 100 millions degrees). Chemical and physical sputtering erodes the plasma facing components (PFC), leading to an impurity influx to the plasma. Estimating this erosion source is important both for the PFC lifetime and the quality of the confinement. In fact, impurities reaching the plasma core radiate energy and dilute the fuel. In this contribution, we describe an erosion diagnostic operated on the Tore Supra tokamak, consisting in the combination of visible spectroscopy and filtered imaging over a full TPL (Toroidal Pumped Limiter) sector. Quantitative measurements of spectral lines brightness on four spectrometer chords monitoring the TPL top are used to process the corresponding filtered images, namely to remove background emission or unwanted lines. The particle influx from the TPL's vicinity is obtained from photon fluxes measurements [1], which require absolute calibration in intensity of the system. Filtered images provide the spatial pattern of erosion, from which the total eroded carbon flux is reconstructed. The variation of the particle influx with the input power is studied by analyzing a dedicated experimental campaign. References: [1] Behringer K. et al. Plasma Physics and Controlled Fusion, Vol. 31, No. 14, pp. 2059 to 2099, 1989. (authors)

  13. Functional brain imaging - baric and clinical questions

    International Nuclear Information System (INIS)

    Mager, T.; Moeller, H.J.

    1997-01-01

    The advancing biological knowledge of disease processes plays a central part in the progress of modern psychiatry. An essential contribution comes from the functional and structural brain imaging techniques (CT, MRI, SPECT, PET). Their application is important for biological oriented research in psychiatry and there is also a growing relevance in clinical aspects. This development is taken into account by recent diagnostic classification systems in psychiatry. The capabilities and limitations of functional brain imaging in the context of research and clinic will be presented and discussed by examples and own investigations. (orig.) [de

  14. Diagnostic imaging and radiation therapy equipment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1990-05-01

    This is the third edition of CSA Standard C22.2 No. 114 (now CAN/CSA-C22.2 No. 114), which is one of a series of standards issued by the Canadian Standards Association under Part II of the Canadian Electrical Code. This edition marks an important shift towards harmonization of Canadian requirements with those of the European community and the United States. Also important to this edition is the expansion of its scope to include the complete range of diagnostic imaging and radiation therapy equipment, rather than solely radiation-emitting equipment. In so doing, equipment previously addressed by CSA Standard C22.2 No. 125, Electromedical Equipment, specifically lasers for medical applications and diagnostic ultrasound units, is now dealt with in the new edition. By virtue of this expanded scope, many of the technical requirements in the electromedical equipment standard have been introduced to the new edition, thereby bringing CSA Standard C22.2 No. 114 up to date. 14 tabs., 16 figs.

  15. Diagnostic imaging and radiation therapy equipment

    International Nuclear Information System (INIS)

    1990-05-01

    This is the third edition of CSA Standard C22.2 No. 114 (now CAN/CSA-C22.2 No. 114), which is one of a series of standards issued by the Canadian Standards Association under Part II of the Canadian Electrical Code. This edition marks an important shift towards harmonization of Canadian requirements with those of the European community and the United States. Also important to this edition is the expansion of its scope to include the complete range of diagnostic imaging and radiation therapy equipment, rather than solely radiation-emitting equipment. In so doing, equipment previously addressed by CSA Standard C22.2 No. 125, Electromedical Equipment, specifically lasers for medical applications and diagnostic ultrasound units, is now dealt with in the new edition. By virtue of this expanded scope, many of the technical requirements in the electromedical equipment standard have been introduced to the new edition, thereby bringing CSA Standard C22.2 No. 114 up to date. 14 tabs., 16 figs

  16. OPTIMIZATION OF DIAGNOSTIC IMAGING IN BREAST CANCER

    Directory of Open Access Journals (Sweden)

    S. A. Velichko

    2015-01-01

    Full Text Available The paper presents the results of breast imaging for 47200 women. Breast cancer was detected in 862 (1.9% patients, fibroadenoma in 1267 (2.7% patients and isolated breast cysts in 1162 (2.4% patients. Different types of fibrocystic breast disease (adenosis, diffuse fibrocystic changes, local fibrosis and others were observed in 60.1% of women. Problems of breast cancer visualization during mammography, characterized by the appearance of fibrocystic mastopathy (sclerosing adenosis, fibrous bands along the ducts have been analyzed. Data on the development of diagnostic algorithms including the modern techniques for ultrasound and interventional radiology aimed at detecting early breast cancer have been presented.  

  17. Clinical approach to obscure GI bleeding - Diagnostic testing and management

    Directory of Open Access Journals (Sweden)

    Prashanth Prabakaran

    2013-01-01

    Full Text Available Obscure gastrointestinal bleeding (OGIB can present as a diagnostic dilemma and management can be challenging. The search for causes of OGIB is usually centered on visualizing the small bowel, and in the past decade, the technology to visualize the entire small bowel has significantly advanced. Moreover, small bowel endoscopic imaging has replaced, in many instances, prior radiographic evaluation for obscure GI bleeding. These new modalities, such as small bowel capsule endoscopy (CE, balloon-assisted deep enteroscopy [double balloon enteroscopy (DBE and single balloon enteroscopy (SBE], and overtube-assisted deep enteroscopy (spiral enteroscopy, are paving the way toward more accurately identifying and treating patients with OGIB. We will review the diagnostic modalities available in evaluating a patient with OGIB and also propose the management based on clinical and endoscopic findings.

  18. The clinician's guide to diagnostic imaging: Cost effective pathways

    International Nuclear Information System (INIS)

    Grossman, Z.D.; Chew, F.S.; Ellis, D.A.; Brigham, S.C.

    1987-01-01

    This book presents logical, step-by-step imaging sequences for 47 medical, surgical, and pediatric problems. Topics considered include breast cancer screening, acute spinal trauma, search for primary cancer of unknown origin, acute anuria, blunt chest trauma, new onset seizures, and spinal cord compression from metastases. Other chapters have been rewritten to enhance the clarity of presentation and to incorporate new techniques such as magnetic resonance imaging, dipyridamole stress testing, and single photon emission computed tomography. The book highlights the expanding role of CT in evaluation of thoracic and abdominal problems, the emergence of magnetic resonance imaging as a vital diagnostic tool for the central nervous system, and the clinical utility of many newly developed radiopharmaceuticals

  19. Optimum image compression rate maintaining diagnostic image quality of digital intraoral radiographs

    International Nuclear Information System (INIS)

    Song, Ju Seop; Koh, Kwang Joon

    2000-01-01

    The aims of the present study are to determine the optimum compression rate in terms of file size reduction and diagnostic quality of the images after compression and evaluate the transmission speed of original or each compressed images. The material consisted of 24 extracted human premolars and molars. The occlusal surfaces and proximal surfaces of the teeth had a clinical disease spectrum that ranged from sound to varying degrees of fissure discoloration and cavitation. The images from Digora system were exported in TIFF and the images from conventional intraoral film were scanned and digitalized in TIFF by Nikon SF-200 scanner(Nikon, Japan). And six compression factors were chosen and applied on the basis of the results from a pilot study. The total number of images to be assessed were 336. Three radiologists assessed the occlusal and proximal surfaces of the teeth with 5-rank scale. Finally diagnosed as either sound or carious lesion by one expert oral pathologist. And sensitivity and specificity and kappa value for diagnostic agreement was calculated. Also the area (Az) values under the ROC curve were calculated and paired t-test and oneway ANOVA test was performed. Thereafter, transmission time of the image files of the each compression level were compared with that of the original image files. No significant difference was found between original and the corresponding images up to 7% (1:14) compression ratio for both the occlusal and proximal caries (p<0.05). JPEG3 (1:14) image files are transmitted fast more than 10 times, maintained diagnostic information in image, compared with original image files. 1:14 compressed image file may be used instead of the original image and reduce storage needs and transmission time.

  20. Computer-aided assessment of diagnostic images for epidemiological research

    Directory of Open Access Journals (Sweden)

    Gange Stephen J

    2009-11-01

    Full Text Available Abstract Background Diagnostic images are often assessed for clinical outcomes using subjective methods, which are limited by the skill of the reviewer. Computer-aided diagnosis (CAD algorithms that assist reviewers in their decisions concerning outcomes have been developed to increase sensitivity and specificity in the clinical setting. However, these systems have not been well utilized in research settings to improve the measurement of clinical endpoints. Reductions in bias through their use could have important implications for etiologic research. Methods Using the example of cortical cataract detection, we developed an algorithm for assisting a reviewer in evaluating digital images for the presence and severity of lesions. Available image processing and statistical methods that were easily implementable were used as the basis for the CAD algorithm. The performance of the system was compared to the subjective assessment of five reviewers using 60 simulated images. Cortical cataract severity scores from 0 to 16 were assigned to the images by the reviewers and the CAD system, with each image assessed twice to obtain a measure of variability. Image characteristics that affected reviewer bias were also assessed by systematically varying the appearance of the simulated images. Results The algorithm yielded severity scores with smaller bias on images where cataract severity was mild to moderate (approximately ≤ 6/16ths. On high severity images, the bias of the CAD system exceeded that of the reviewers. The variability of the CAD system was zero on repeated images but ranged from 0.48 to 1.22 for the reviewers. The direction and magnitude of the bias exhibited by the reviewers was a function of the number of cataract opacities, the shape and the contrast of the lesions in the simulated images. Conclusion CAD systems are feasible to implement with available software and can be valuable when medical images contain exposure or outcome information for

  1. Strategic planning for radiology: opening an outpatient diagnostic imaging center.

    Science.gov (United States)

    Leepson, Evan

    2003-01-01

    Launching a new diagnostic imaging center involves very specific requirements and roadmaps, including five major areas of change that have a direct impact on planning: Imaging and communication technology Finances and reimbursement Ownership structure of imaging entities Critical workforce shortages Imaging is moving outside radiology First, planning must focus on the strategic level of any organization, whether it is a multi-national corporation or a six-person radiology group. Think of all organizations as a triangle with three horizontal levels: strategic, managerial and operational. The strategic level of decision-making is at the top of the triangle, and here is where planning must take place. For strategic planning to work, there must be focused time and energy spent on this activity, usually away from the reading room and imaging center. There are five planning strategies, which must have the explicit goal of developing and growing the imaging center. The five strategies are: Clinical and quality issues, Governance and administration, Technology, Relationships, Marketing and business development. The best way to plan and implement these strategies is to create work groups of radiologists, technologists, and administrative and support staff. Once the group agrees on the strategy and tactic, it takes responsibility for implementation. Embarking on the launch of a new outpatient diagnostic imaging center is no small undertaking, and anyone who has struggled with such an endeavor can readily attest to the associated challenges and benefits. Success depends on many things, and one of the most important factors relates to the amount of time and the quality of effort spent on strategic planning at the outset. Neglecting or skimping on this phase may lead to unforeseen obstacles that could potentially derail the project.

  2. Dose classification scheme for digital imaging techniques in diagnostic radiology

    International Nuclear Information System (INIS)

    Hojreh, A.

    2002-04-01

    Purpose: image quality in diagnostic radiology is determined in crucial extent by the signal-noise-ratio, which is proportional to the applied x-ray dose. Onward technological developments in the diagnostic radiology are therefore frequently connected with a dose increase, which subjectively is hardly or even not perceptible. The aim of this work was to define reproducible standards for image quality as a function of dose and expected therapeutical consequence in case of computed tomography of the paranasal sinuses and the upper and lower jaw (dental CT), whereby practical-clinical purposes are considered. Materials and methods: the image quality of computed tomography of the paranasal sinuses and dental CT was determined by standard deviation of the CT-numbers (pixel noise) in a region of interest of the phantom of American Association of Physicists in Medicine (AAPM phantom) and additionally in the patients CT images. The diagnostic quality of the examination was classified on the basis of patients CT images in three dose levels (low dose, standard dose and high dose). Results: the pixel noise of CT of the paranasal sinuses with soft tissue reconstruction amounts to 19.3 Hounsfield units (HU) for low dose, 8.8 HU for standard dose, and below 8 HU for high dose. The pixel noise of the dental CT with bone (high resolution) reconstruction amounts to 344 HU for low dose, 221 HU for standard dose, and below 200 HU for high dose. Suitable indications for low dose CT are the scanning of body regions with high contrast differences, like the bony delimitations of air-filled spaces of the facial bones, and radiological follow-up examinations with dedicated questions such as axis determination in dental implantology, as well as the images of objects with small diameter such as in case of children. The standard dose CT can be recommended for all cases, in which precise staging of the illness plays an indispensable role for the diagnosis and therapy planning. With high dose

  3. [Clinical use of interventional MR imaging].

    Science.gov (United States)

    Kahn, Thomas; Schulz, Thomas; Moche, Michael; Prothmann, Sascha; Schneider, Jens-Peter

    2003-01-01

    The integration of diagnostic and therapeutic procedures by MRI is based on the combination of excellent morphologic and functional imaging. The spectrum of MR-guided interventions includes biopsies, thermal ablation procedures, vascular applications, and intraoperative MRI. In all these applications, different scientific groups have obtained convincing results in basic developments as well as in clinical use. Interventional MRI (iMRI) is expected to attain an important role in interventional radiology, minimal invasive therapy, and monitoring of surgical procedures.

  4. Different clinical presentations, diagnostic difficulties, and management of cecal duplication.

    Science.gov (United States)

    Temiz, Abdulkerim; Oğuzkurt, Pelin; Ezer, Semire Serin; İnce, Emine; Gezer, Hasan Özkan; Hiçsönmez, Akgün

    2013-03-01

    Cecal duplications (CDs) are very rare, representing 0.4% of all gastrointestinal duplications. This study evaluates the variable clinical presentations, imaging workup, and surgical management of CDs. The records of 7 patients who underwent surgery between April 2001 and December 2011 for CD were retrospectively reviewed. Sex, age, duration of complaints, diagnostic studies, surgical intervention, and pathologic findings were recorded. The median age was 8 months, and mean age was 1.65 ± 2.88 years. Complaints were abdominal pain, rectal bleeding, vomiting, cough and dyspnea, and a prenatally detected cystic mass. The patients were referred with the diagnosis of appendicular abscess, necrotizing enterocolitis, gastrointestinal lymphoma, and intraabdominal cystic mass. Abdominal distention, signs of peritonitis, substernal retraction, fullness at right lower quadrant, and normal findings were detected on physical examination. Diagnostic imaging included plain abdominal radiography (7), ultrasonography (7), computed tomography (3), and magnetic resonance imaging (2). A cystic mass was reported on radiologic studies in 6 patients and appendicular abscess in 1. Cyst and cecum were resected, ileocolostomy was performed in 6 patients, and cyst excision was performed in 1. The diagnosis of duplication cyst was made by pathologic examination in all patients. Cecal duplications may be detected incidentally; however, they may mimic appendicular abscess, a tumor mass, or necrotizing enterocolitis. Whether cystic lesions are symptomatic, they should be excised when detected because of possible complications. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Diagnostic imaging of lymphoma of the kidney

    International Nuclear Information System (INIS)

    Grzesiakowska, U.; Smorczewska, M.; Huczynska-Szubert, E.

    2010-01-01

    Purpose. The aim of this paper is to discuss both the clinical and radiological signs and the diagnostic principles of lymphomatous infiltrations of the kidney. Materials and methods. The studied group consisted of 20 patients (9 women, 11 men) aged 18-79 years. The follows-up varied from 2 to 156 months. All patients underwent CT and ultrasound investigations, while only 1 patient had an MRI examination. In 7 cases surgical treatment was performed, while the remaining 13 patients received chemotherapy. One patient died, 12 are in remission and seven are under observation and considered cured. Results. The radiological signs of kidney lymphoma may be divided into groups: a) kidney enlargement, obliteration of the cortex-core differentiation and obliteration of the outline; b) heterogenous kidney structure with undefined hypodense fociand lack of enhancement after the administration of contrasting material; c) presence of a well-defined tumor within the renal pelvis and external infiltration of the kidney, d) infiltration of the kidney originating from the retroperitoneal space encompassing the organ from the outside. Conclusions. The radiological signs of lymphoma differ in the kidney and exhibit a characteristic set of features. Radiology results combined with clinical symptoms may suggest lymphoma in the kidney and thus advocate the necessity of pathological evaluation prior to surgical treatment. (authors)

  6. Basic artefacts of diagnostic imaging by the magnetic resonance method

    International Nuclear Information System (INIS)

    Vitak, T.; Seidl, Z.; Obenberger, J.; Vaneckova, M.; Danes, J.; Krasensky, J.; Peterkova, V

    2000-01-01

    Artefacts in diagnostic imaging are defined as a geometric or anatomic misrepresentation of the reality by the image formed. The article deals with artefacts due to field and frequency shifts, in particular due to the water-fat chemical shift and due to magnetic susceptibility. The physical nature of the artefacts is explained and their diagnostic significance is discussed. (P.A.)

  7. MR imaging diagnostic protocol for unilocular lesions of the jaw

    Directory of Open Access Journals (Sweden)

    Hironobu Konouchi

    2012-08-01

    Using our MR imaging diagnostic protocol to diagnose 31 cases, we obtained a positivity rate of 71.0%. The use of our MR imaging diagnostic protocol for unilocular lesions, which are especially difficult to differentiate by radiography, would improve the morphological and qualitative diagnosis of soft tissue lesions.

  8. Analysis of licensed South African diagnostic imaging equipment ...

    African Journals Online (AJOL)

    Analysis of licensed South African diagnostic imaging equipment. ... Pan African Medical Journal ... Introduction: Objective: To conduct an analysis of all registered South Africa (SA) diagnostic radiology equipment, assess the number of equipment units per capita by imaging modality, and compare SA figures with published ...

  9. Visualization, imaging and new preclinical diagnostics in radiation oncology

    International Nuclear Information System (INIS)

    Cyran, Clemens C; Reiser, Maximilian F; Belka, Claus; Niyazi, Maximilian; Paprottka, Philipp M; Eisenblätter, Michel; Clevert, Dirk A; Rist, Carsten; Nikolaou, Konstantin; Lauber, Kirsten; Wenz, Frederik; Hausmann, Daniel

    2014-01-01

    Innovative strategies in cancer radiotherapy are stimulated by the growing knowledge on cellular and molecular tumor biology, tumor pathophysiology, and tumor microenvironment. In terms of tumor diagnostics and therapy monitoring, the reliable delineation of tumor boundaries and the assessment of tumor heterogeneity are increasingly complemented by the non-invasive characterization of functional and molecular processes, moving preclinical and clinical imaging from solely assessing tumor morphology towards the visualization of physiological and pathophysiological processes. Functional and molecular imaging techniques allow for the non-invasive characterization of tissues in vivo, using different modalities, including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, positron emission tomography (PET) and optical imaging (OI). With novel therapeutic concepts combining optimized radiotherapy with molecularly targeted agents focusing on tumor cell proliferation, angiogenesis, and cell death, the non-invasive assessment of tumor microcirculation and tissue water diffusion, together with strategies for imaging the mechanisms of cellular injury and repair is of particular interest. Characterizing the tumor microenvironment prior to and in response to irradiation will help to optimize the outcome of radiotherapy. These novel concepts of personalized multi-modal cancer therapy require careful pre-treatment stratification as well as a timely and efficient therapy monitoring to maximize patient benefit on an individual basis. Functional and molecular imaging techniques are key in this regard to open novel opportunities for exploring and understanding the underlying mechanisms with the perspective to optimize therapeutic concepts and translate them into a personalized form of radiotherapy in the near future

  10. MR imaging for diagnostic evaluation of encephalopathy in the newborn.

    Science.gov (United States)

    Shroff, Manohar M; Soares-Fernandes, João P; Whyte, Hilary; Raybaud, Charles

    2010-05-01

    Magnetic resonance (MR) imaging is used with increasing frequency to evaluate the neonatal brain because it can provide important diagnostic and prognostic information that is needed for optimal treatment and appropriate counseling. Special care must be taken in preparing encephalopathic neonates for an MR study, transporting them from the intensive care unit, monitoring their vital signs, and optimizing MR sequences and protocols. Moreover, to accurately interpret the findings, specific knowledge is needed about the normal MR imaging appearances of the physiologic processes of myelination, cell migration, and sulcation, as well as patterns of injury, in the neonatal brain at various stages of gestational development. Hypoxic-ischemic injury, the most common cause of neonatal encephalopathy, has characteristic appearances that depend on the severity and duration of the insult as well as the stage of brain development. Diffusion-weighted MR imaging and MR spectroscopy depict abnormalities earlier than do conventional MR imaging sequences. However, diffusion-weighted imaging, if performed in the first 24 hours after the insult, might lead to underestimation of the extent of injury. When the MR findings are atypical, the differential diagnosis of neonatal encephalopathy also should include congenital and metabolic disorders and infectious diseases. Despite recent advances in the MR imaging-based characterization of these conditions, the clinical history must be borne in mind to achieve an accurate diagnosis.

  11. Infectious myocarditis (Clinic, diagnostics, principles of treatment

    Directory of Open Access Journals (Sweden)

    Yu. P. Finogeev

    2016-01-01

    Full Text Available Infective myocarditis can be considered as a case of myocardial damage caused by different infectious agents. Traditionally discusses the questions of diagnostics and treatment infectious myocarditis. The paper has repeatedly stressed the difficulty of clinical diagnosis, and the laboriousness and economic costs of laboratory tests and additional researches. Endomyocardial biopsy findings remain the gold standard for unequivocally establishing the diagnosis. However, it is technically extremely invasive test and can be performed only in specialized cardiology centers. The paper analyzes in detail not only own materials, but also results of researches published in numerous domestic and foreign sources of literature. Publication of «Infectious myocarditis» is necessary due to the fact that patients with a diagnosis of «Myocarditis » account for 11% of all cardiovascular disease in the world. Article is timely and necessary for many professionals, senior students of medical universities.

  12. Medical image computing for computer-supported diagnostics and therapy. Advances and perspectives.

    Science.gov (United States)

    Handels, H; Ehrhardt, J

    2009-01-01

    Medical image computing has become one of the most challenging fields in medical informatics. In image-based diagnostics of the future software assistance will become more and more important, and image analysis systems integrating advanced image computing methods are needed to extract quantitative image parameters to characterize the state and changes of image structures of interest (e.g. tumors, organs, vessels, bones etc.) in a reproducible and objective way. Furthermore, in the field of software-assisted and navigated surgery medical image computing methods play a key role and have opened up new perspectives for patient treatment. However, further developments are needed to increase the grade of automation, accuracy, reproducibility and robustness. Moreover, the systems developed have to be integrated into the clinical workflow. For the development of advanced image computing systems methods of different scientific fields have to be adapted and used in combination. The principal methodologies in medical image computing are the following: image segmentation, image registration, image analysis for quantification and computer assisted image interpretation, modeling and simulation as well as visualization and virtual reality. Especially, model-based image computing techniques open up new perspectives for prediction of organ changes and risk analysis of patients and will gain importance in diagnostic and therapy of the future. From a methodical point of view the authors identify the following future trends and perspectives in medical image computing: development of optimized application-specific systems and integration into the clinical workflow, enhanced computational models for image analysis and virtual reality training systems, integration of different image computing methods, further integration of multimodal image data and biosignals and advanced methods for 4D medical image computing. The development of image analysis systems for diagnostic support or

  13. Roentgen signs in diagnostic imaging. Vol. 2

    International Nuclear Information System (INIS)

    Meschan, I.

    1988-01-01

    The introductory chapter presents terminology and definitions of current use in the field of roentgen pathology and also gives a short list of terms relating to the application of the novel imaging methods. The first chapter explains the fundamentals of radiological evaluation of the bone joints and skeleton, and chapters two and three discuss fractures and luxations of the extremities and the available treatment methods. The fourth chapter deals with congenital and hereditary bone lesions and the relevant roentgen signs such as reduced contrast or modifications in size or shape. The chapters five and six deal with specific bone lesions of a particular bone or skeletal area, or a particular extremity, also characterised by reduced contrast. Other bone lesions showing enhanced density, expansive processes or other massive change are discussed in chapter seven, and roen tgen signs of the bone joints in chapter eight. The last chapter deals with computed tomography for diagnostic evaluation of the appendicular skeleton. (MG) With 1803 figs., 29 tabs [de

  14. Diagnostic imaging in oncology: New challenges and changing strategies

    International Nuclear Information System (INIS)

    Castellino, Ronald A.; Schwartz, Lawrence H.

    1997-01-01

    Diagnostic radiology and nuclear medicine studies, both imaging and therapeutic, play important roles in screening, staging, monitoring of treatment, and in long term surveillance of oncologic patients. Frequently, information from these studies, as well as from ancillary data (such as the clinical examination and laboratory studies) overlap, and it is sometimes unclear which tests and examinations to perform. Current changes in the delivery and funding of health care are prompting all specialties to evaluate their patterns of care. Some of the important questions to be addressed in medical imaging include: Which studies are pertinent at initial staging, e.g., those that impact patient management, serve as important baselines for comparison with subsequent studies, etc? How sensitive and specific are these studies, e.g., when can they obviate the need for more invasive confirmatory exams? What are the critical questions in monitoring response to therapy, e.g., the significance of the 'post treatment residual mass' and ways to elucidate its etiology? Which tests should be performed in surveillance for disease relapse, and how frequently should they be done? Purpose/Objective: To develop a set of guidelines for developing rational approaches for utilizing diagnostic imaging studies

  15. Diagnostic imaging in oncology: New challenges and changing strategies

    International Nuclear Information System (INIS)

    Castellino, Ronald; Schwartz, Lawrence H.

    1996-01-01

    Purpose/Objective: To develop a set of guidelines for developing rational approaches for utilizing diagnostic imaging studies. Diagnostic radiology and nuclear medicine studies, both imaging and therapeutic, play important roles in screening, staging, monitoring of treatment, and in long term surveillance of oncologic patients. Frequently, information from these studies, as well as from ancillary data (such as the clinical examination and laboratory studies) overlap, and it is sometimes unclear which tests and examinations to perform. Current changes in the delivery and funding of health care are prompting all specialties to evaluate their patterns of care. Some of the important questions to be addressed in medical imaging include: Which studies are pertinent at initial staging, e.g., those that impact patient management, serve as important baselines for comparison with subsequent studies, etc? How sensitive and specific are these studies, e.g., when can they obviate the need for more invasive confirmatory exams? What are the critical questions in monitoring response to therapy, e.g., the significance of the 'post treatment residual mass' and ways to elucidate its etiology? Which tests should be performed in surveillance for disease relapse, and how frequently should they be done?

  16. Diagnostic imaging in companion animal theriogenology

    International Nuclear Information System (INIS)

    Root, C.R.; Spaulding, K.A.

    1994-01-01

    Clinical assessment of reproductive problems in companion animals is greatly enhanced by the availability of various imaging modalities. Specifically, survey radiography, contrast radiography, real-time ultrasonography, and ultrasound-guided biopsy and/or aspiration cytology, alone or in various combinations, offer sophisticated methods of extension of the physical examination of the reproductive systems of dogs and cats. In particular, real-time ultrasonography offers invaluable assistance. It is nonionizing, largely noninvasive, rapid, and capable of providing certain dynamic information that is not conveniently available in any other way. Judging from its rapid growth in recent years, it has apparently become an integral part of the complete reproductive assessment of domestic animals. This is not to slight the importance of some of the contrast radiographic procedures that have been developed and refined. Some of them, such as maximum distention retrograde urothrocystography, provide unique information not available with presently routinely used ultrasound techniques. Other imaging modalities, such as magnetic resonance imaging, have heretofore provided limited benefit to theriogenology; that will probably change in years to come

  17. Diagnostic imaging of lung cancer with In-111-MDEGD

    International Nuclear Information System (INIS)

    Nakajima, Susumu; Hayashi, Hideo; Maeda, Tomio

    1987-01-01

    Indium-111-mono DTPA-ethyleneglycol Ga deuterporphyrin (In-111-MDEGD) is a new tumor imaging agent in lung cancer. The agent has been studied with golden hamsters bearing adenocarcinoma, C57 black mice bearing Lewis lung adenocarcinoma, and nude mice bearing human lung adenocarcinoma xerografts. It has been revealed that the tumor-to-lung, tumor-to-kidney, and tumor-to-blood ratios are higher for In-111-MDEGD than for Ga-67 citrate widely used in imaging tumors, and that the agent is not accumulated in inflammatory lesions. The results were encouraging enough to start clinical diagnostic trials in lung cancer. In this paper, an overview of In-111-MDEGD, along with its preliminary data, is given. (Namekawa, K.)

  18. Ordering of diagnostic information in encoded medical images. Accuracy progression

    Science.gov (United States)

    Przelaskowski, A.; Jóźwiak, R.; Krzyżewski, T.; Wróblewska, A.

    2008-03-01

    A concept of diagnostic accuracy progression for embedded coding of medical images was presented. Implementation of JPEG2000 encoder with a modified PCRD optimization algorithm was realized and initially verified as a tool for accurate medical image streaming. Mean square error as a distortion measure was replaced by other numerical measures to revise quality progression according to diagnostic importance of successively encoded image information. A faster increment of image diagnostic importance during reconstruction of initial packets of code stream was reached. Modified Jasper code was initially tested on a set of mammograms containing clusters of microcalcifications and malignant masses, and other radiograms. Teleradiologic applications were considered as the first area of interests.

  19. Practical Considerations for Clinical PET/MR Imaging.

    Science.gov (United States)

    Galgano, Samuel; Viets, Zachary; Fowler, Kathryn; Gore, Lael; Thomas, John V; McNamara, Michelle; McConathy, Jonathan

    2018-01-01

    Clinical PET/MR imaging is currently performed at a number of centers around the world as part of routine standard of care. This article focuses on issues and considerations for a clinical PET/MR imaging program, focusing on routine standard-of-care studies. Although local factors influence how clinical PET/MR imaging is implemented, the approaches and considerations described here intend to apply to most clinical programs. PET/MR imaging provides many more options than PET/computed tomography with diagnostic advantages for certain clinical applications but with added complexity. A recurring theme is matching the PET/MR imaging protocol to the clinical application to balance diagnostic accuracy with efficiency. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Image diagnostic of colonic diseases - controversial questions

    International Nuclear Information System (INIS)

    Pomakov, P.; Rizov, A.; Stancheva, I.

    2013-01-01

    In the system of colonic diseases' diagnostic algorithm, fibrocolonoscopy (FCS) is defined as 'Golden Standard'. By this reason some X-ray diagnostic methods - irrigography, etc. are currently not being used in a number of health institutions. The aim of this study is a comparative analysis of FCS and irrigography diagnostic efficacy in various colonic diseases. For 10-years period, in cooperation with a gastroenterologist-gastroscopist, 2151 patients with various colonic diseases were evaluated by FCS and irrigography with pharmaco-diagnostics/when necessary. Advantage of FCS was established in diagnosing diseases with patho-morfologic changes on the inner surface of the colon - benign and malignant neoplastic processes, chronic inflammatory diseases, etc. At the same time functional changes - irritated colon syndrome, changes in defecation act, etc., are not an object of diagnosis through FCS. Correction in colonic diseases diagnostic algorithm is necessary. FCS should be mandatory. If result is negative - irrigography with pharmaco-diagnostics should be done. (authors)

  1. Diagnostic information management system for the evaluation of medical images

    Energy Technology Data Exchange (ETDEWEB)

    Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina

    1985-04-01

    A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions.

  2. Diagnostic information management system for the evaluation of medical images

    International Nuclear Information System (INIS)

    Higa, Toshiaki; Torizuka, Kanji; Minato, Kotaro; Komori, Masaru; Hirakawa, Akina.

    1985-01-01

    A practical, small and low-cost diagnostic information management system has been developed for a comparative study of various medical imaging procedures, including ordinary radiography, X-ray computed tomography, emission computed tomography, and so forth. The purpose of the system is to effectively manage the original image data files and diagnostic descriptions during the various imaging procedures. A diagnostic description of each imaging procedure for each patient is made on a hand-sort punched-card with line-drawings and ordinary medical terminology and then coded and computerized using Index for Roentgen Diagnoses (American College of Radiology). A database management software (DB Master) on a personal computer (Apple II) is used for searching for patients' records on hand-sort punched-cards and finally original medical images. Discussed are realistic use of medical images and an effective form of diagnostic descriptions. (author)

  3. A quantitative non-invasive assessment of femoroacetabular impingement with CT-based dynamic simulation - Cadaveric validation study Clinical diagnostics and imaging

    NARCIS (Netherlands)

    M.L. Röling (Maarten); M.I. Visser (Monique I); E.H.G. Oei (Edwin); P. Pilot (Peter); G.J. Kleinrensink (Gert Jan); R.M. Bloem (Rolf)

    2015-01-01

    textabstractBackground: Femoroacetabular impingement (FAI) is caused by an anatomic deviation of the acetabular rim or proximal femur, which causes chronic groin pain. Radiological identification of FAI can be challenging. Advances in imaging techniques with the use of computed tomography (CT) scan

  4. Clinical photoacoustic imaging of cancer

    Energy Technology Data Exchange (ETDEWEB)

    Valluru, Keerthi S.; Willmann, Juergen K. [Dept. of Radiology, Molecular Imaging Program at Stanford, Stanford University School of Medicine, Stanford (United States)

    2016-08-15

    Photoacoustic imaging is a hybrid technique that shines laser light on tissue and measures optically induced ultrasound signal. There is growing interest in the clinical community over this new technique and its possible clinical applications. One of the most prominent features of photoacoustic imaging is its ability to characterize tissue, leveraging differences in the optical absorption of underlying tissue components such as hemoglobin, lipids, melanin, collagen and water among many others. In this review, the state-of-the-art photoacoustic imaging techniques and some of the key outcomes pertaining to different cancer applications in the clinic are presented.

  5. Diagnostic imaging learning resources evaluated by students and recent graduates.

    Science.gov (United States)

    Alexander, Kate; Bélisle, Marilou; Dallaire, Sébastien; Fernandez, Nicolas; Doucet, Michèle

    2013-01-01

    Many learning resources can help students develop the problem-solving abilities and clinical skills required for diagnostic imaging. This study explored veterinary students' perceptions of the usefulness of a variety of learning resources. Perceived resource usefulness was measured for different levels of students and for academic versus clinical preparation. Third-year (n=139) and final (fifth) year (n=105) students and recent graduates (n=56) completed questionnaires on perceived usefulness of each resource. Resources were grouped for comparison: abstract/low complexity (e.g., notes, multimedia presentations), abstract/high complexity (e.g., Web-based and film case repositories), concrete/low complexity (e.g., large-group "clicker" workshops), and concrete/high complexity (e.g., small-group interpretation workshops). Lower-level students considered abstract/low-complexity resources more useful for academic preparation and concrete resources more useful for clinical preparation. Higher-level students/recent graduates also considered abstract/low-complexity resources more useful for academic preparation. For all levels, lecture notes were considered highly useful. Multimedia slideshows were an interactive complement to notes. The usefulness of a Web-based case repository was limited by accessibility problems and difficulty. Traditional abstract/low-complexity resources were considered useful for more levels and contexts than expected. Concrete/high-complexity resources need to better represent clinical practice to be considered more useful for clinical preparation.

  6. Accreditation of diagnostic imaging services in developing countries.

    Science.gov (United States)

    Jiménez, Pablo; Borrás, Cari; Fleitas, Ileana

    2006-01-01

    In recent decades, medical imaging has experienced a technological revolution. After conducting several surveys to assess the quality and safety of diagnostic imaging services in Latin America and the Caribbean, the Pan American Health Organization (PAHO) developed a basic accreditation program that can be implemented by the ministry of health of any developing country. Patterned after the American College of Radiology's accreditation program, the PAHO program relies on a national accreditation committee to establish and maintain accreditation standards. The process involves a peer review evaluation of: (1) imaging and processing equipment, (2) physician and technologist staff qualifications, (3) quality control and quality assurance programs, and (4) image quality and, where applicable, radiation dose. Public and private conventional radiography/fluoroscopy, mammography, and ultrasound services may request accreditation. The radiography/fluoroscopy accreditation program has three modules from which to choose: chest radiography, general radiography, and fluoroscopy. The national accreditation committee verifies compliance with the standards. On behalf of the ministry of health, the accreditation committee also issues a three-year accreditation certificate. As needed, the accreditation committee consults with foreign technical and clinical experts.

  7. Image quality, radiation dose, and diagnostic accuracy of prospectively ECG-triggered high-pitch coronary CT angiography at 70 kVp in a clinical setting: comparison with invasive coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Long Jiang; Qi, Li; Zhou, Chang Sheng; Zhao, Yan E.; Li, Xie; Lu, Guang Ming [Jinling Hospital, Medical School of Nanjing University, Department of Medical Imaging, Nanjing, Jiangsu (China); Wang, Yining; Cao, Jian; Jin, Zhengyu [Peking Union Medical College Hospital, Department of Radiology, Beijing (China); Schoepf, U.J. [Jinling Hospital, Medical School of Nanjing University, Department of Medical Imaging, Nanjing, Jiangsu (China); Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Meinel, Felix G. [Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Ludwig-Maximilians-University Hospital, Institute for Clinical Radiology, Munich (Germany); Bayer, Richard R. [Medical University of South Carolina, Division of Cardiovascular Imaging, Charleston, SC (United States); Gong, Jian Bin [Jinling Hospital, Medical School of Nanjing University, Department of Cardiology, Nanjing, Jiangsu (China)

    2016-03-15

    To investigate image quality, radiation dose, and diagnostic performance of prospectively ECG-triggered high-pitch coronary CT angiography (CCTA) at 70 kVp compared to invasive coronary angiography (ICA) as reference standard. Forty-three patients underwent prospectively ECG-triggered high-pitch CCTA at 70 kVp using 30 cc (11 g iodine) contrast medium and ICA. Subjective and objective image quality was evaluated for each CCTA study. CCTA performance for diagnosing ≥50 % stenosis was assessed. Results were stratified according to heart rate (HR), body mass index (BMI), Agatston score, and image quality. At CCTA, 94.3 % (500/530) of coronary segments were of diagnostic quality. Using ICA as reference standard, sensitivity and accuracy were 100 % and 93.0 % on a per-patient basis. Per-vessel and per-segment performances were 92.2 % and 89.5 %; 79.5 % and 88.3 %, respectively. No differences were found in diagnostic accuracy between different HR, BMI, and calcification subgroups (all P > 0.05) on a per-patient basis. However, low image quality reduced diagnostic accuracy on a per-patient, per-vessel and per-segment basis (all P < 0.05). The mean effective radiation dose was 0.2 ± 0.0 mSv. Our presented protocol results in an effective radiation dose of 0.2 mSv and high diagnostic accuracy for stenosis detection in a selected, non-obese population. (orig.)

  8. Diagnostic imaging procedure volume in the United States

    International Nuclear Information System (INIS)

    Johnson, J.L.; Abernathy, D.L.

    1983-01-01

    Comprehensive data on 1979 and 1980 diagnostic imaging procedure volume were collected from a stratified random sample of U.S. short-term general-care hospitals and private practices of radiologists, cardiologists, obstetricians/gynecologists, orthopedic surgeons, and neurologists/neurosurgeons. Approximately 181 million imaging procedures (within the study scope) were performed in 1980. Despite the rapidly increasing use of newer imaging methods, plain film radiography (140.3 million procedures) and contrast studies (22.9 million procedures) continue to comprise the vast majority of diagnostic imaging volume. Ultrasound, computed tomography, nuclear medicine, and special procedures make up less than 10% of total diagnostic imaging procedures. Comparison of the data from this study with data from an earlier study indicates that imaging procedure volume in hospitals expanded at an annual growth rate of almost 8% from 1973 to 1980

  9. Overuse of Diagnostic Imaging for Work-Related Injuries.

    Science.gov (United States)

    Clendenin, Brianna Rebecca; Conlon, Helen Acree; Burns, Candace

    2017-02-01

    Overuse of health care in the United States is a growing concern. This article addresses the use of diagnostic imaging for work-related injuries. Diagnostic imaging drives substantial cost for increases in workers' compensation. Despite guidelines published by the American College of Radiology and the American College of Occupational Medicine and the Official Disability Guidelines, practitioners are prematurely ordering imaging sooner than recommended. Workers are exposed to unnecessary radiation and are incurring increasing costs without evidence of better outcomes. Practitioners caring for workers and submitting workers' compensation claims should adhere to official guidelines, using their professional judgment to consider financial impact and health outcomes of diagnostic imaging including computed tomography, magnetic resonance imaging, nuclear medicine imaging, radiography, and ultrasound.

  10. Fast, fat-suppressed diagnostic imaging of the breast

    International Nuclear Information System (INIS)

    Metzger, G.J.; Weatherall, P.

    1999-01-01

    Maximum sensitivity and diagnostic precision of MR imaging of the breast can be achieved only with fat-suppressed diagnostic scans with high resolution. Optimal results were obtained with a 3D-FFE sequence and excitation by a binomial pulse and an amplitude-modulated binomial pulse. (orig./CB) [de

  11. Diagnostic value of imaging in infective endocarditis : a systematic review

    NARCIS (Netherlands)

    Gomes, Anna; Glaudemans, Andor W J M; Touw, Daan J; van Melle, Joost P; Willems, Tineke P; Maass, Alexander H; Natour, Ehsan; Prakken, Niek H J; Borra, Ronald J H; van Geel, Peter Paul; Slart, Riemer H J A; van Assen, Sander; Sinha, Bhanu

    Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of

  12. Quantitative Methods for Molecular Diagnostic and Therapeutic Imaging

    OpenAIRE

    Li, Quanzheng

    2013-01-01

    This theme issue provides an overview on the basic quantitative methods, an in-depth discussion on the cutting-edge quantitative analysis approaches as well as their applications for both static and dynamic molecular diagnostic and therapeutic imaging.

  13. Spectroscopic and imaging diagnostics of pulsed laser deposition laser plasmas

    International Nuclear Information System (INIS)

    Thareja, Raj K.

    2002-01-01

    An overview of laser spectroscopic techniques used in the diagnostics of laser ablated plumes used for thin film deposition is given. An emerging laser spectroscopic imaging technique for the laser ablation material processing is discussed. (author)

  14. Methodology for quantitative evaluation of diagnostic medical imaging

    International Nuclear Information System (INIS)

    Metz, C.

    1980-01-01

    This report deals with the evaluation of the performance of diagnostic medical imaging procedures using the Receiver Operating Characteristic or ROC analysis. The development of new tests for the statistical significance of apparent differences between ROC curves is discussed

  15. Clinical advances of nanocarrier-based cancer therapy and diagnostics.

    Science.gov (United States)

    Luque-Michel, Edurne; Imbuluzqueta, Edurne; Sebastián, Víctor; Blanco-Prieto, María J

    2017-01-01

    Cancer is a leading cause of death worldwide and efficient new strategies are urgently needed to combat its high mortality and morbidity statistics. Fortunately, over the years, nanotechnology has evolved as a frontrunner in the areas of imaging, diagnostics and therapy, giving the possibility of monitoring, evaluating and individualizing cancer treatments in real-time. Areas covered: Polymer-based nanocarriers have been extensively studied to maximize cancer treatment efficacy and minimize the adverse effects of standard therapeutics. Regarding diagnosis, nanomaterials like quantum dots, iron oxide nanoparticles or gold nanoparticles have been developed to provide rapid, sensitive detection of cancer and, therefore, facilitate early treatment and monitoring of the disease. Therefore, multifunctional nanosystems with both imaging and therapy functionalities bring us a step closer to delivering precision/personalized medicine in the cancer setting. Expert opinion: There are multiple barriers for these new nanosystems to enter the clinic, but it is expected that in the near future, nanocarriers, together with new 'targeted drugs', could replace our current treatments and cancer could become a nonfatal disease with good recovery rates. Joint efforts between scientists, clinicians, the pharmaceutical industry and legislative bodies are needed to bring to fruition the application of nanosystems in the clinical management of cancer.

  16. Diagnostic imaging of shoulder rotator cuff lesions

    Directory of Open Access Journals (Sweden)

    Nogueira-Barbosa Marcello Henrique

    2002-01-01

    Full Text Available Shoulder rotator cuff tendon tears were evaluated with ultrasonography (US and magnetic resonance imaging (MRI. Surgical or arthroscopical correlation were available in 25 cases. Overall costs were also considered. Shoulder impingement syndrome diagnosis was done on a clinical basis. Surgery or arthroscopy was considered when conservative treatment failure for 6 months, or when rotator cuff repair was indicated. Ultrasound was performed in 22 patients and MRI in 17 of the 25 patients. Sensitivity, specificity and accuracy were 80%, 100% and 90.9% for US and 90%, 100% and 94.12% for MRI, respectively. In 16 cases both US and MRI were obtained and in this subgroup statistical correlation was excellent (p< 0.001. We concluded that both methods are reliable for rotator cuff full thickness tear evaluation. Since US is less expensive, it could be considered as the screening method when rotator cuff integrity is the main question, and when well trained radiologists and high resolution equipment are available.

  17. Application of Nanoparticles in Diagnostic Imaging via ...

    African Journals Online (AJOL)

    ... ability to image quantitatively both morphological and physiological functions of the tissue, ... Several types of contrast media are used in medical imaging and they can ... which is still widely used to examine internal organs of the body and ...

  18. Musculoskeletal desmoid tumours: Diagnostic imaging appearances

    International Nuclear Information System (INIS)

    Liu, Daniel; Perera, Warren; Schlicht, Stephen; Choong, Peter; Slavin, John; Pianta, Marcus

    2015-01-01

    This study aimed to discuss the role medical imaging has on diagnosis of musculoskeletal desmoid tumours and to describe their radiological appearances on various imaging modalities. Imaging of histologically proven cases of desmoid tumours at St. Vincent's Hospital Melbourne were obtained via picture archiving communication system (PACS) and then assessed by two musculoskeletal radiologists. Suitable imagings were obtained from PACS. All imaging chosen was de-identified. Desmoid tumours can occur in many areas of the body. Imaging plays an important role in the diagnosis of these tumours and magnetic resonance imaging has been the gold standard for imaging and is the most accurate in terms of assessing tumour margins and involvement of surrounding structure.

  19. Clinical confrontation results of diagnostics and treatment of skin cancer

    International Nuclear Information System (INIS)

    Zikiryakhodjaev, D.Z.; Sanginov, D.R.

    2001-01-01

    In this chapter of book authors investigated the clinical confrontation results of diagnostics and treatment of skin cancer. They noted that diagnostic of skin cancer have to foresee the determination morphologic implements and degree of malignancy tumorous process why in general depend prognosis of illness

  20. Analysis and clinical usefullness of cardiac ECT images

    International Nuclear Information System (INIS)

    Hayashi, Makoto; Kagawa, Masaaki; Yamada, Yukinori

    1983-01-01

    We estimated basically and clinically myocardial ECT image and ECG gated cardiac blood-pool ECT image. ROC curve is used for the evaluation of the accuracy in diagnostic myocardial infarction. The accuracy in diagnostic of MI is superior in myocardial ECT image and ECT estimation is unnecessary skillfulness and experience. We can absene the whole defect of MI than planar image by using ECT. LVEDV between estimated volume and contrast volume is according to it and get one step for automatic analysis of cardiac volume. (author)

  1. Roentgen signs in diagnostic imaging. Vol. 1

    International Nuclear Information System (INIS)

    Meschan, I.

    1988-01-01

    This book is a new edition under a different title of a part of the three-volume publication 'Analysis of X-ray pictures'. The book primarily deals with X-ray diagnostics and covers four chapters on the following subjects: plain radiographs of the abdomen, the urinary tract, obstetrics including gynaecology, and the biliary tract. Diagnostic ultrasonography is discussed in greater detail in the chapter on obstetrics and gynaecology as it is a method of first choice in this field. (MG) With 944 figs., 33 tabs [de

  2. Diagnostic imaging of compression neuropathy; Bildgebende Diagnostik von Nervenkompressionssyndromen

    Energy Technology Data Exchange (ETDEWEB)

    Weishaupt, D.; Andreisek, G. [Universitaetsspital, Institut fuer Diagnostische Radiologie, Zuerich (Switzerland)

    2007-03-15

    Compression-induced neuropathy of peripheral nerves can cause severe pain of the foot and ankle. Early diagnosis is important to institute prompt treatment and to minimize potential injury. Although clinical examination combined with electrophysiological studies remain the cornerstone of the diagnostic work-up, in certain cases, imaging may provide key information with regard to the exact anatomic location of the lesion or aid in narrowing the differential diagnosis. In other patients with peripheral neuropathies of the foot and ankle, imaging may establish the etiology of the condition and provide information crucial for management and/or surgical planning. MR imaging and ultrasound provide direct visualization of the nerve and surrounding abnormalities. Bony abnormalities contributing to nerve compression are best assessed by radiographs and CT. Knowledge of the anatomy, the etiology, typical clinical findings, and imaging features of peripheral neuropathies affecting the peripheral nerves of the foot and ankle will allow for a more confident diagnosis. (orig.) [German] Kompressionsbedingte Schaedigungen peripherer Nerven koennen die Ursache hartnaeckiger Schmerzen im Bereich des Sprunggelenks und Fusses sein. Eine fruehzeitige Diagnose ist entscheidend, um den Patienten der richtigen Therapie zuzufuehren und potenzielle Schaedigungen zu vermeiden oder zu verringern. Obschon die klinische Untersuchung und die elektrophysiologische Abklaerungen die wichtigsten Elemente der Diagnostik peripherer Nervenkompressionssyndrome sind, kann die Bildgebung entscheidend sein, wenn es darum geht, die Hoehe des Nervenschadens festzulegen oder die Differenzialdiagnose einzugrenzen. In gewissen Faellen kann durch Bildgebung sogar die Ursache der Nervenkompression gefunden werden. In anderen Faellen ist die Bildgebung wichtig bei der Therapieplanung, insbesondere dann, wenn die Laesion chirurgisch angegangen wird. Magnetresonanztomographie (MRT) und Sonographie ermoeglichen eine

  3. Diagnostic imaging in child abuse; Bildgebende Diagnostik der Kindesmisshandlung

    Energy Technology Data Exchange (ETDEWEB)

    Stoever, B. [Charite, Campus Virchow-Klinikum, Universitaetsmedizin Berlin, Abteilung Paediatrische Radiologie, CC6, Diagnostische und interventionelle Radiologie und Nuklearmedizin, Berlin (Germany)

    2007-11-15

    Diagnostic imaging in child abuse plays an important role and includes the depiction of skeletal injuries, soft tissue lesions, visceral injuries in 'battered child syndrome' and brain injuries in 'shaken baby syndrome'. The use of appropriate imaging modalities allows specific fractures to be detected, skeletal lesions to be dated and the underlying mechanism of the lesion to be described. The imaging results must be taken into account when assessing the clinical history, clinical findings and differential diagnoses. Computed tomography (CT) and magnetic resonance imaging (MRI) examinations must be performed in order to detect lesions of the central nervous system (CNS) immediately. CT is necessary in the initial diagnosis to delineate oedema and haemorrhages. Early detection of brain injuries in children with severe neurological symptoms can prevent serious late sequelae. MRI is performed in follow-up investigations and is used to describe residual lesions, including parenchymal findings. (orig.) [German] In der Diagnostik der Kindesmisshandlung ist die Bildgebung ein wesentlicher Faktor. Trotz scheinbar leerer Anamnese gelingt es, typische Verletzungsmuster als Misshandlungsfolge zu erkennen, sowohl im Bereich des Skeletts, der Weichteile, des Abdomens ('battered child syndrome', heute: 'non accidental injury', NAI) als auch im ZNS ('shaken baby syndrome'). Den klinischen Symptomen entsprechend, wird im Verdachtsfall ein adaequates diagnostisches Verfahren eingesetzt, das erwartete charakteristische Befunde nachweist, den Mechanismus der Verletzung aufzeigt und das Alter der Laesionen annaehernd festlegt. Radiologische Skelettbefunde werden hinsichtlich ihrer Spezifitaet fuer eine Misshandlung bewertet. Alle Resultate der Bildgebung sind zusammen mit Anamnese und klinischen Befunden zu deuten. Bei schwerer Misshandlung ohne aeussere Verletzungszeichen ist das rechtzeitige Erfassen einer ZNS

  4. Clinical and diagnostic importance of proteinuria: A review | Oni ...

    African Journals Online (AJOL)

    Clinical and diagnostic importance of proteinuria: A review. ... shown that diabetis mellitus, cardiovascular disease and hypertension could provoke secondary ... Proteinuria is also significant in some non-pathological cases such as pregnancy

  5. Diagnostic utility of clinical and biochemical parameters in ...

    African Journals Online (AJOL)

    Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy ... Department of Surgery, Sir Run Run Shaw Hospital College of Medicine, Zhejiang University, ..... technical review on the epidemiology, diagnosis, and.

  6. Tree-structured vector quantization of CT chest scans: Image quality and diagnostic accuracy

    International Nuclear Information System (INIS)

    Cosman, P.C.; Tseng, C.; Gray, R.M.; Olshen, R.A.; Moses, L.E.; Davidson, H.C.; Bergin, C.J.; Riskin, E.A.

    1993-01-01

    The quality of lossy compressed images is often characterized by signal-to-noise ratios, informal tests of subjective quality, or receiver operating characteristic (ROC) curves that include subjective appraisals of the value of an image for a particular application. The authors believe that for medical applications, lossy compressed images should be judged by a more natural and fundamental aspect of relative image quality: their use in making accurate diagnoses. They apply a lossy compression algorithm to medical images, and quantify the quality of the images by the diagnostic performance of radiologists, as well as by traditional signal-to-noise ratios and subjective ratings. The study is unlike previous studies of the effects of lossy compression in that they consider non-binary detection tasks, simulate actual diagnostic practice instead of using paired tests or confidence rankings, use statistical methods that are more appropriate for non-binary clinical data than are the popular ROC curves, and use low-complexity predictive tree-structured vector quantization for compression rather than DCT-based transform codes combined with entropy coding. Their diagnostic tasks are the identification of nodules (tumors) in the lungs and lymphadenopathy in the mediastinum from computerized tomography (CT) chest scans. For the image modality, compression algorithm, and diagnostic tasks they consider, the original 12 bit per pixel (bpp) CT image can be compressed to between 1 bpp and 2 bpp with no significant changes in diagnostic accuracy

  7. Child abuse. Diagnostic imaging of skeletal injuries; Kindesmisshandlung. Radiologische Diagnostik skelettaler Verletzungsfolgen

    Energy Technology Data Exchange (ETDEWEB)

    Stenzel, Martin; Mentzel, Hans-Joachim [Universitaetsklinikum Jena (Germany). Sektion Paediatrische Radiologie

    2012-06-15

    Diagnostic imaging, besides medical history and clinical examination, is a major component in assessment of cases of suspected physical child abuse. Performance of proper imaging technique, and knowledge of specific injury patterns is required for accurate image interpretation by the radiologist, and serves protection of the child in case of proven abuse. On the other side, it is essential to protect the family in unjustified accusations. The reader will be familiarised with essentials of the topic 'Physical child abuse', in order to be able to correctly assess quality, completeness, and results of X-ray films. Moreover, opportunities and limitations of alternative diagnostic modalities will be discussed. (orig.)

  8. A study of diagnostic imaging in pancreatic trauma

    International Nuclear Information System (INIS)

    Hirota, Masashi; Kanazumi, Naohito; Kato, Koichi; Eguchi, Takehiko; Kobayashi, Hironobu; Suzuki, Yuichi; Kimura, Jiro; Ishii, Masataka

    2002-01-01

    Pancreatic trauma treatment depends on pancreatic ductal injury. We examined the usefulness and problems of diagnostic imaging, such as enhanced CT, ERP, and CT after ERP, in pancreatic trauma. Subjects were 12 patients with pancreatic trauma treated in our hospital between April 1993 and March 2000. Enhanced CT was performed in 6 patients undergoing diagnostic imagings and ERP in 4 of the 6. Overall diagnostic accuracy of pancreatic ductal injury in enhanced CT was 16.7% and accuracy in ERP with CT after ERP was 100%. Intraoperative diagnosis of main pancreatic ductal injury was difficult in 1 of 2 patients in whom ERP failed. The importance of preoperative diagnostic imaging is thus clear. We expect that MRCP, recently evaluated in pancreatic disease diagnosis, will become a new pancreatic trauma modality. (author)

  9. diagnostic imaging of acute head trauma

    International Nuclear Information System (INIS)

    Prayer, D.; Rametsteiner, C.

    2001-01-01

    Computed tomography (CT) is the primary modality of choice for imaging patients with acute head trauma. Lesions of the soft tissues and of the bones can be assessed more precisely than with other imaging modalities. With magnetic resonance imaging (MRI) additional information may be gained especially in subacute and chronic posttraumatic conditions. Urgent indication to perform a CT examination depends on the patient's history and on the mechanism of trauma. Imaging interpretation has been performed in the context of typical pathologic effects of trauma and with respect to potential therapy. (author)

  10. Oncologic applications of diagnostic imaging techniques

    International Nuclear Information System (INIS)

    Forrest, L.J.; Thrall, D.E.

    1995-01-01

    Before appropriate therapy can be instituted for a cancer patient, the presence and extent of tumor must be evaluated. Deciding which imaging technique to use depends on tumor location, type, and biologic behavior. Conventional radiography provides important information at a relatively low cost compared with other imaging modalities. Ultrasound is a valuable adjunct to radiography, but does not replace it because both imaging modalities provide unique information. Nuclear medicine procedures contribute additional, unique data by providing physiological information, but specificity is lacking. Both CT and MRI provide images with exquisite anatomic detail, but availability and cost prohibit their general use

  11. Diagnostic imaging in undergraduate medical education: an expanding role

    International Nuclear Information System (INIS)

    Miles, K.A.

    2005-01-01

    Radiologists have been involved in anatomy instruction for medical students for decades. However, recent technical advances in radiology, such as multiplanar imaging, 'virtual endoscopy', functional and molecular imaging, and spectroscopy, offer new ways in which to use imaging for teaching basic sciences to medical students. The broad dissemination of picture archiving and communications systems is making such images readily available to medical schools, providing new opportunities for the incorporation of diagnostic imaging into the undergraduate medical curriculum. Current reforms in the medical curriculum and the establishment of new medical schools in the UK further underline the prospects for an expanding role for imaging in medical education. This article reviews the methods by which diagnostic imaging can be used to support the learning of anatomy and other basic sciences

  12. Artificial intelligence as a diagnostic adjunct in cardiovascular nuclear imaging

    International Nuclear Information System (INIS)

    Duncan, J.S.

    1988-01-01

    The radiologist and/or nuclear medicine physician is literally bombarded with information from today's diagnostic imaging technologies. As a consequence of this, whereas a decade ago the emphasis in medical image analysis was on improving the extraction of diagnostic information by developing and using more sophisticated imaging modalities, today those working on the development of medical imaging technology are struggling to find ways to handle all gathered information effectively. This chapter gives an introduction to the area of artificial intelligence, with an emphasis on the research ongoing in cardiovascular nuclear imaging. This chapter has reviewed the place of artificial intelligence in cardiovascular nuclear imaging. It is intended to provide a general sense of this new and emerging field, an insight into some of its specific methodologies and applications, and a closer look at the several AI approaches currently being applied in cardiovascular nuclear imaging

  13. Feasibility of streamlining an interactive Bayesian-based diagnostic support tool designed for clinical practice

    Science.gov (United States)

    Chen, Po-Hao; Botzolakis, Emmanuel; Mohan, Suyash; Bryan, R. N.; Cook, Tessa

    2016-03-01

    In radiology, diagnostic errors occur either through the failure of detection or incorrect interpretation. Errors are estimated to occur in 30-35% of all exams and contribute to 40-54% of medical malpractice litigations. In this work, we focus on reducing incorrect interpretation of known imaging features. Existing literature categorizes cognitive bias leading a radiologist to an incorrect diagnosis despite having correctly recognized the abnormal imaging features: anchoring bias, framing effect, availability bias, and premature closure. Computational methods make a unique contribution, as they do not exhibit the same cognitive biases as a human. Bayesian networks formalize the diagnostic process. They modify pre-test diagnostic probabilities using clinical and imaging features, arriving at a post-test probability for each possible diagnosis. To translate Bayesian networks to clinical practice, we implemented an entirely web-based open-source software tool. In this tool, the radiologist first selects a network of choice (e.g. basal ganglia). Then, large, clearly labeled buttons displaying salient imaging features are displayed on the screen serving both as a checklist and for input. As the radiologist inputs the value of an extracted imaging feature, the conditional probabilities of each possible diagnosis are updated. The software presents its level of diagnostic discrimination using a Pareto distribution chart, updated with each additional imaging feature. Active collaboration with the clinical radiologist is a feasible approach to software design and leads to design decisions closely coupling the complex mathematics of conditional probability in Bayesian networks with practice.

  14. Magnetic resonance imaging of the shoulder: a review of potential sources of diagnostic errors

    International Nuclear Information System (INIS)

    Carroll, K.W.; Helms, C.A.

    2002-01-01

    Shoulder magnetic resonance (MR) imaging and MR arthrography are frequently utilized in the evaluation of shoulder pain and instability. The clinical scenario and imaging findings may be confusing to clinicians and radiologists and may present diagnostic challenges for those involved in evaluating and treating shoulder pathology. Often rotator cuff and labral abnormalities may be coexistent, clinical manifestations of denervation syndromes may be confusing to clinicians, and normal anatomic variations, imaging pitfalls, and various artifacts may cause dilemmas for the radiologist. This article will review the most frequently encountered mimickers and pitfalls of MR imaging of the shoulder. (orig.)

  15. [Tinnitus: algorithm of diagnostics and clinical management].

    Science.gov (United States)

    Boiko, N V

    Hearing of sound, or tinnitus, can be a symptom of different diseases. The differential diagnosis should be based on the identification of subgroups with confirmed causes of the disease. Subjective and objective tinnitus groups should be isolated. Objective tinnitus can be vascular or muscular. In making a diagnosis of tinnitus, it is important to know its characteristics, laterality, circumstances of onset, duration, comorbidity with other symptoms: headache, hearing decline, dizziness, depression, etc. Urgent diagnostic and treatment measures are needed after the identification of 'red flags': acute pulsatile tinnitus, in particular after the brain injury, combination of tinnitus with acute hearing loss and depression.

  16. Ultrasound Image Quality Assessment: A framework for evaluation of clinical image quality

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Pedersen, Mads Møller; Nikolov, Svetoslav Ivanov

    2010-01-01

    Improvement of ultrasound images should be guided by their diagnostic value. Evaluation of clinical image quality is generally performed subjectively, because objective criteria have not yet been fully developed and accepted for the evaluation of clinical image quality. Based on recommendation 50...... information, which is fast enough to get sufficient number of scans under realistic operating conditions, so that statistical evaluation is valid and reliable....

  17. Radiation exposure from diagnostic imaging among patients with gastrointestinal disorders.

    LENUS (Irish Health Repository)

    Desmond, Alan N

    2012-03-01

    There are concerns about levels of radiation exposure among patients who undergo diagnostic imaging for inflammatory bowel disease (IBD), compared with other gastrointestinal (GI) disorders. We quantified imaging studies and estimated the cumulative effective dose (CED) of radiation received by patients with organic and functional GI disorders. We also identified factors and diagnoses associated with high CEDs.

  18. Measures to Improve Diagnostic Safety in Clinical Practice.

    Science.gov (United States)

    Singh, Hardeep; Graber, Mark L; Hofer, Timothy P

    2016-10-20

    Timely and accurate diagnosis is foundational to good clinical practice and an essential first step to achieving optimal patient outcomes. However, a recent Institute of Medicine report concluded that most of us will experience at least one diagnostic error in our lifetime. The report argues for efforts to improve the reliability of the diagnostic process through better measurement of diagnostic performance. The diagnostic process is a dynamic team-based activity that involves uncertainty, plays out over time, and requires effective communication and collaboration among multiple clinicians, diagnostic services, and the patient. Thus, it poses special challenges for measurement. In this paper, we discuss how the need to develop measures to improve diagnostic performance could move forward at a time when the scientific foundation needed to inform measurement is still evolving. We highlight challenges and opportunities for developing potential measures of "diagnostic safety" related to clinical diagnostic errors and associated preventable diagnostic harm. In doing so, we propose a starter set of measurement concepts for initial consideration that seem reasonably related to diagnostic safety and call for these to be studied and further refined. This would enable safe diagnosis to become an organizational priority and facilitate quality improvement. Health-care systems should consider measurement and evaluation of diagnostic performance as essential to timely and accurate diagnosis and to the reduction of preventable diagnostic harm.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  19. Gold Nanoconstructs for Multimodal Diagnostic Imaging and Photothermal Cancer Therapy

    Science.gov (United States)

    Coughlin, Andrew James

    Cancer accounts for nearly 1 out of every 4 deaths in the United States, and because conventional treatments are limited by morbidity and off-target toxicities, improvements in cancer management are needed. This thesis further develops nanoparticle-assisted photothermal therapy (NAPT) as a viable treatment option for cancer patients. NAPT enables localized ablation of disease because heat generation only occurs where tissue permissive near-infrared (NIR) light and absorbing nanoparticles are combined, leaving surrounding normal tissue unharmed. Two principle approaches were investigated to improve the specificity of this technique: multimodal imaging and molecular targeting. Multimodal imaging affords the ability to guide NIR laser application for site-specific NAPT and more holistic characterization of disease by combining the advantages of several diagnostic technologies. Towards the goal of image-guided NAPT, gadolinium-conjugated gold-silica nanoshells were engineered and demonstrated to enhance imaging contrast across a range of diagnostic modes, including T1-weighted magnetic resonance imaging, X-Ray, optical coherence tomography, reflective confocal microscopy, and two-photon luminescence in vitro as well as within an animal tumor model. Additionally, the nanoparticle conjugates were shown to effectively convert NIR light to heat for applications in photothermal therapy. Therefore, the broad utility of gadolinium-nanoshells for anatomic localization of tissue lesions, molecular characterization of malignancy, and mediators of ablation was established. Molecular targeting strategies may also improve NAPT by promoting nanoparticle uptake and retention within tumors and enhancing specificity when malignant and normal tissue interdigitate. Here, ephrinA1 protein ligands were conjugated to nanoshell surfaces for particle homing to overexpressed EphA2 receptors on prostate cancer cells. In vitro, successful targeting and subsequent photothermal ablation of

  20. Image quality enhancement for skin cancer optical diagnostics

    Science.gov (United States)

    Bliznuks, Dmitrijs; Kuzmina, Ilona; Bolocko, Katrina; Lihachev, Alexey

    2017-12-01

    The research presents image quality analysis and enhancement proposals in biophotonic area. The sources of image problems are reviewed and analyzed. The problems with most impact in biophotonic area are analyzed in terms of specific biophotonic task - skin cancer diagnostics. The results point out that main problem for skin cancer analysis is the skin illumination problems. Since it is often not possible to prevent illumination problems, the paper proposes image post processing algorithm - low frequency filtering. Practical results show diagnostic results improvement after using proposed filter. Along that, filter do not reduces diagnostic results' quality for images without illumination defects. Current filtering algorithm requires empirical tuning of filter parameters. Further work needed to test the algorithm in other biophotonic applications and propose automatic filter parameter selection.

  1. Angiomatous nasal polyp: Clinical diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Sunder Goyal

    2015-03-01

    Full Text Available Angiomatous polyp (Angiectatic nasal polyps is rare and its incidence is 4-5% of all nasal polyps. As it occurs with variable clinical features and there is no confirmatory preoperative investigation, clinical diagnosis can be a dilemma. Clinical picture of angiofibroma, simple antrochoanal polyp and inverted papilloma may resemble with each other. As polyps invade surrounding bone, these should be distinguished from a malignant mass. We present an interesting case of an infarcted angiectatic nasal polyp with extensive surrounding bony destruction. Correct preoperative radiological diagnosis is important to avoid unnecessary extensive surgery. Histopathological evaluation of polyps is mandatory since they require different treatment due to difference in the prognosis.

  2. Patient dosimetry and image quality in conventional diagnostic radiology. An experience from a local Serbian hospital

    International Nuclear Information System (INIS)

    Olivera Ciraj-Bjelac; Milojko Kovacevic; Dusko Kosutic; Milan Loncar; Dajana Veljkovic

    2007-01-01

    Complete test of publication follows. The optimization of image quality vs. patient dose ins an important task in medical imaging. Maximal validity of optimization has to be based on clinical images. Simultaneous measurement of patient dose levels and image quality assessment is used to investigate possibilities for dose reduction and maintain image quality. The survey was conducted in a local hospital performing more than 60000 images annually and representing typical Serbian practice. For four most frequent diagnostic procedures (seven projections) patient exposure was measured using kerma area product meter. Image quality was assessed by experienced radiologists using 'European Guidelines on Quality Criteria for Diagnostic Radiographic Images'. Following examination types were included into the survey: chest PA, chest LAT, pelvis AP, lumbar spine AP, lumbar spine LAT and LSJ, skull PA and skull LAT. Comparing actual radiographic technique with recommended technique in European Guidelines, modification of practice was proposed and implemented and image quality was re-assessed. At least 10 adult patients were followed for each projection, before and after corrective actions. Large dose saving without compromising diagnostic information were found for some examination types, showing that this simple method is very efficient dose reduction tool in conventional diagnostic radiology. Also, need for staff training and difficulties related to practical implementation of optimization methods in Serbia were discussed.

  3. Diagnostic imaging analysis of the impacted mesiodens

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Jeong Jun; Choi, Bo Ram; Jeong, Hwan Seok; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2010-06-15

    The research was performed to predict the three dimensional relationship between the impacted mesiodens and the maxillary central incisors and the proximity with the anatomic structures by comparing their panoramic images with the CT images. Among the patients visiting Seoul National University Dental Hospital from April 2003 to July 2007, those with mesiodens were selected (154 mesiodens of 120 patients). The numbers, shapes, orientation and positional relationship of mesiodens with maxillary central incisors were investigated in the panoramic images. The proximity with the anatomical structures and complications were investigated in the CT images as well. The sex ratio (M : F) was 2.28 : 1 and the mean number of mesiodens per one patient was 1.28. Conical shape was 84.4% and inverted orientation was 51.9%. There were more cases of anatomical structures encroachment, especially on the nasal floor and nasopalatine duct, when the mesiodens was not superimposed with the central incisor. There were, however, many cases of the nasopalatine duct encroachment when the mesiodens was superimpoised with the apical 1/3 of central incisor (52.6%). Delayed eruption (55.6%), crown rotation (66.7%) and crown resorption (100%) were observed when the mesiodens was superimposed with the crown of the central incisor. It is possible to predict three dimensional relationship between the impacted mesiodens and the maxillary central incisors in the panoramic images, but more details should be confirmed by the CT images when necessary.

  4. Clinical diagnostic potentials of thyroid ultrasonography and scintigraphy; An evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Torizuka, Tatsuo; Kasagi, Kanji; Hatabu, Hiroto; Misaki, Takashi; Iida, Yasuhiro; Konishi, Junji (Kyoto Univ. (Japan). Hospital); Endo, Keigo

    1993-06-01

    This prospective study was designed to evaluate the potential contributions of high resolution ultrasonography (US) and Tc-99m scintigraphy in the routine diagnosis of thyroid disease. The diagnostic impacts of US and Tc-99m scintigraphy results in 177 patients visiting our thyroid clinic were assessed and scored according to the following criteria: when the information provided by either test supported, confirmed or changed the initial clinical diagnosis, they received scores of 2, 3 and 4 respectively, while score 1 was given when the test itself was useless for the differential diagnosis. US identified focal lesions that both palpation and scintigraphy had failed to detect in 14 (12.1%) of 116 patients with diffuse thyroid diseases, suggesting the necessity of Hashimoto's thyroiditis, adenoma, adenocarcinoma and adenomatous goiter, and vice versa in the diagnosis of hyperthyroid and euthyroid Graves's diseases. Thus, the advantages of US over scintigraphy for morphological evaluation were confirmed. US was particularly useful for the differential diagnosis of adenomatous goiter from Hashimoto's thyroiditis or a single nodular disease. In contrast, scintigraphy gave functional images, being especially helpful for the differential diagnosis of thyrotoxicosis. (author).

  5. Clinical blood pool MR Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Leiner, Tim [Maastrich University Medical Center (Netherlands). Dept. of Radiology; Goyen, Martin [University Medical Center Hamburg-Eppendorf (Germany); Rohrer, Mathias [Bayer Schering Pharma AG, Berlin (Germany). European Business Unit Diagnostic Imaging; Schoenberg, Stefan O. (eds.) [University Hospital Mannheim Medical Faculty Mannheim - Heidelberg Univ. (Germany). Dept. of Clinical Radiology and Nuclear Medicine

    2008-07-01

    Clinical Blood Pool MR Imaging - This excellent treatise on Vasovist {sup registered} created by a team of exceptional faculty who are pioneers in MR Angiography covers the basic techniques, safety, efficacy, image processing and pharmaco-economic details to successfully implement a new level of MRA image quality with this new contrast agent. Martin Prince, Cornell University, New York The editors and authors have made groundbreaking contributions towards establishing MR angiography in various investigative settings, rendering it more precise and applying it for diverse indications. The work presented here is founded upon the extensive experience of the editors, as well as the broad range of experience from other scientific working groups. Maximilian Reiser, Ludwig Maximilian University, Munich Vasovist {sup registered} (Gadofosveset), worldwide the first blood pool agent, has only recently become available for clinical use, but has already gained wide acceptance as a tool to improve magnetic resonance angiography. This book presents the first in-depth introduction to the basic physicochemical aspects of the agent, the application of Vasovist {sup registered} in clinical MRA, as well as potential clinical applications beyond MRA and patient management-related aspects. The first part of the book explains basic and technical properties of the agent and the differences of Vasovist {sup registered} compared to currently available extracellular agents. The second part contains detailed chapters on safety and efficacy. In the third part the focus is on MR angiographic applications, and in the fourth part of the book potential clinical fields beyond MRA are explored. All clinical chapters feature ready-to-use clinical protocols and a series of take home messages that concisely summarize the current role of blood pool imaging for each specific indication. (orig.)

  6. Clinical and Diagnostic Aspects of Diabetic Ketoacidosis

    Directory of Open Access Journals (Sweden)

    Z.P. Nizhynska-Аstapenko

    2016-05-01

    Full Text Available Background. Leading criteria for laboratory diagnosis and determination of diabetic ketoacidosis severity are considered to be the levels of glucose, blood pH and blood bicarbonate. Technological capabilities of a family doctor are very limited. Therefore, knowledge of detailed clinical symptoms will help the physician to establish correctly a provisional diagnosis and refer a patient to a specialized institution. The aim of our study was to determine the prevalence and special features of certain clinical symptoms and basic laboratory parameters in order to establish the severity level of diabetic ketoacidosis (DKA and to reveal certain correlation between clinical symptoms and laboratory changes in the blood in patients with DKA. Materials and methods. The study involved 123 patients with acute critical decompensated diabetes aged from 9 to 65 years old. We studied the clinical symptoms, measured biochemical changes in blood, blood gas and acid-base state. Results. There was not determined the correlation between severity of diabetic ketoacidosis and clinical parameters and acid-base balance in patients. There were determined the peculiarities electrolyte changes and the emergence gas metabolic changes on the cell level under ketosis, which further deepened with the development of ketoacidosis. The results of the study indicate the need for a comparison of clinical symptoms and laboratory parameters of pathogenic treatment, taking into account the cumulative data. These recommendations in the protocols are often attached to a single laboratory value and can not always fully comply with the severity of the condition. Conclusions. Blood gas is the most sensitive criterion of metabolic changes in case of diabetic ketoacidosis. The level of blood potassium can be used as an indicator of DKA severity. The level of blood potassium at admission to hospital does not really reflect its deficiency in the tissues.

  7. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    International Nuclear Information System (INIS)

    Choi, Bo Ram; Choi, Da Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Choi, Soon Chul; Bae, Kwang Hak; Lee, Sam Sun

    2012-01-01

    The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

  8. PACS and diagnostic imaging service delivery-A UK perspective

    International Nuclear Information System (INIS)

    Sutton, Laurence N.

    2011-01-01

    This review sets out the current position with regard to the implementation of PACS throughout the United Kingdom and the impact this has had on improving patient care. In December 2007 England had implemented full hospital-wide PACS in all hospitals: a major achievement in the relatively short time period of three years. The different approaches used by each country of the UK to achieve full national PACS are described in addition to the current issues with the sharing of images and reports across different healthcare organisations with regard to technical solutions, clinical safety and governance. The review gives insight into the changing methods of service delivery to address increasing demand pressures on diagnostic imaging services and how the national PACS implementation, specifically in England, has made a significant contribution to measures to improve efficiencies. The role of Teleradiology is discussed in the context of supporting local patient services rather than undermining them and the concept of cross-healthcare reporting 'Grids' is described. Finally, in the summary it is recognised that the vast wealth of knowledge accumulated during the national implementations has placed the UK in a strong position to facilitate full national data sharing across all healthcare organisations to improve patient care.

  9. Augmented Reality: Advances in Diagnostic Imaging

    Directory of Open Access Journals (Sweden)

    David B. Douglas

    2017-11-01

    Full Text Available In recent years, advances in medical imaging have provided opportunities for enhanced diagnosis and characterization of diseases including cancer. The improved spatial resolution provides outstanding detail of intricate anatomical structures, but has challenged physicians on how to effectively and efficiently review the extremely large datasets of over 1000 images. Standard volume rendering attempts to tackle this problem as it provides a display of 3D information on a flat 2D screen, but it lacks depth perception and has poor human–machine interface (HMI. Most recently, Augmented Reality/Virtual Reality (AR/VR with depth 3-dimensional (D3D imaging provides depth perception through binocular vision, head tracking for improved HMI and other key AR features. In this article, we will discuss current and future medical applications of AR including assessing breast cancer. We contend that leveraging AR technology may enhance diagnosis, save cost and improve patient care.

  10. Diagnostic Imaging for Dental Implant Therapy

    Directory of Open Access Journals (Sweden)

    Aishwarya Nagarajan

    2014-01-01

    Full Text Available Dental implant is a device made of alloplastic (foreign material implanted into the jaw bone beneath the mucosal layer to support a fixed or removable dental prosthesis. Dental implants are gaining immense popularity and wide acceptance because they not only replace lost teeth but also provide permanent restorations that do not interfere with oral function or speech or compromise the self-esteem of a patient. Appropriate treatment planning for replacement of lost teeth is required and imaging plays a pivotal role to ensure a satisfactory outcome. The development of pre-surgical imaging techniques and surgical templates helps the dentist place the implants with relative ease. This article focuses on various types of imaging modalities that have a pivotal role in implant therapy.

  11. Vibrational spectroscopy: a clinical tool for cancer diagnostics.

    Science.gov (United States)

    Kendall, Catherine; Isabelle, Martin; Bazant-Hegemark, Florian; Hutchings, Joanne; Orr, Linda; Babrah, Jaspreet; Baker, Rebecca; Stone, Nicholas

    2009-06-01

    Vibrational spectroscopy techniques have demonstrated potential to provide non-destructive, rapid, clinically relevant diagnostic information. Early detection is the most important factor in the prevention of cancer. Raman and infrared spectroscopy enable the biochemical signatures from biological tissues to be extracted and analysed. In conjunction with advanced chemometrics such measurements can contribute to the diagnostic assessment of biological material. This paper also illustrates the complementary advantage of using Raman and FTIR spectroscopy technologies together. Clinical requirements are increasingly met by technological developments which show promise to become a clinical reality. This review summarises recent advances in vibrational spectroscopy and their impact on the diagnosis of cancer.

  12. Circulating tumor cell isolation and diagnostics: toward routine clinical use

    NARCIS (Netherlands)

    Stolpe, van de A.; Pantel, K.; Sleijfer, S.; Terstappen, L.W.; Toonder, den J.M.J.

    2011-01-01

    From February 7–11, 2011, the multidisciplinary Lorentz Workshop Circulating Tumor Cell (CTC) Isolation and Diagnostics: Toward Routine Clinical Use was held in Leiden (The Netherlands) to discuss progress and define challenges and potential solutions for development of clinically useful circulating

  13. Patient dose with quality image under diagnostic reference levels

    International Nuclear Information System (INIS)

    Akula, Suresh Kumar; Singh, Gurvinder; Chougule, Arun

    2016-01-01

    Need to set Diagnostic Reference Level (DRL) for locations for all diagnostic procedures in local as compared to National. The review of DRL's should compare local with national or referenced averages and a note made of any significant variances to these averages and the justification for it. To survey and asses radiation doses to patient and reduce the redundancy in patient imaging to maintain DRLs

  14. Diagnostic imaging of craniofacial trauma and fractures and their sequelae

    International Nuclear Information System (INIS)

    Buitrago-Tellez, C.H.; Kunz, C.

    2001-01-01

    The value and applications of the CT modalities are on the rise, particularly since the availability of spiral CT techniques, while conventional native diagnostics is increasingly used for special imaging purposes. Multiplanar spiral CT enables high-quality coronary 2D reconstructions which, in the acute phase, make redundant primary coronary imaging modalities. Exact knowledge of typical fracture patterns facilitates the analysis of images of the relevant facial areas. 3D reconstructions are indispensable in pin-pointed surgery planning, generation of stereolithographic models, and image-guided interventions for examination of post-traumatic deformities. Since a secondary correction only very rarely leads to restitutio ad integrum, it is necessary to detect the therapy-relevant injuries very early, during acute diagnostic imaging, in order to lay the basis for subsequent therapy and restoration of the craniofacial structures and functions. (orig./CB) [de

  15. From 'Image Gently' to image intelligently: a personalized perspective on diagnostic radiation risk

    International Nuclear Information System (INIS)

    Guillerman, R.P.

    2014-01-01

    The risk of ionizing radiation from diagnostic imaging has been a popular topic in the radiology literature and lay press. Communicating the magnitude of risk to patients and caregivers is problematic because of the uncertainty in estimates derived principally from epidemiological studies of large populations, and alternative approaches are needed to provide a scientific basis for personalized risk estimates. The underlying patient disease and life expectancy greatly influence risk projections. Research into the biological mechanisms of radiation-induced DNA damage and repair challenges the linear no-threshold dose-response assumption and reveals that individuals vary in sensitivity to radiation. Studies of decision-making psychology show that individuals are highly susceptible to irrational biases when judging risks. Truly informed medical decision-making that respects patient autonomy requires appropriate framing of radiation risks in perspective with other risks and with the benefits of imaging. To follow the principles of personalized medicine and treat patients according to their specific phenotypic and personality profiles, diagnostic imaging should optimally be tailored not only to patient size, body region and clinical indication, but also to underlying disease conditions, radio-sensitivity and risk perception and preferences that vary among individuals. (orig.)

  16. Diagnostic imaging of tibial periosteal ganglion

    International Nuclear Information System (INIS)

    Valls, R.; Melloni, P.; Darnell, A.; Munoz, J.; Canalies, J.

    1997-01-01

    A case of a soft tissue tumor situated in the anterior surface of the proximal end of the tibia in an adult patient is demonstrated by conventional radiographs, CT, and MRI. The lesion was well defined with respect to the adjacent soft tissue. The CT exam showed a soft tissue mass with external cortical erosion and thick spicules by periosteal reaction. On T1-weighted images the mass was homogeneous and of low signal intensity, whereas on T2-weighted images it showed a high signal intensity, with some septa in the mass. The differential considerations include a periosteal chondroma, a lipoma, a subperiosteal hematoma, an inflammatory process, a giant cell tumor of tendon sheath, and a parosteal osteosarcoma. The CT and MR features of these entities are reviewed as an aid in differential diagnosis of the periosteal ganglion. (orig.). With 4 figs

  17. Plenoptic Imaging for Three-Dimensional Particle Field Diagnostics.

    Energy Technology Data Exchange (ETDEWEB)

    Guildenbecher, Daniel Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hall, Elise Munz [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-06-01

    Plenoptic imaging is a promising emerging technology for single-camera, 3D diagnostics of particle fields. In this work, recent developments towards quantitative measurements of particle size, positions, and velocities are discussed. First, the technique is proven viable with measurements of the particle field generated by the impact of a water drop on a thin film of water. Next, well cont rolled experiments are used to verify diagnostic uncertainty. Finally, an example is presented of 3D plenoptic imaging of a laboratory scale, explosively generated fragment field.

  18. Diagnostic imaging, a 'parallel' discipline. Can current technology provide a reliable digital diagnostic radiology department

    International Nuclear Information System (INIS)

    Moore, C.J.; Eddleston, B.

    1985-01-01

    Only recently has any detailed criticism been voiced about the practicalities of the introduction of generalised, digital, imaging complexes in diagnostic radiology. Although attendant technological problems are highlighted the authors argue that the fundamental causes of current difficulties are not in the generation but in the processing, filing and subsequent retrieval for display of digital image records. In the real world, looking at images is a parallel process of some complexity and so it is perhaps untimely to expect versatile handling of vast image data bases by existing computer hardware and software which, by their current nature, perform tasks serially. (author)

  19. Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 2: the bony disorders.

    Science.gov (United States)

    Vanderperren, Katrien; Saunders, Jimmy H

    2009-08-01

    The metacarpophangeal/metatarsophalangeal (fetlock) joint in the horse is commonly associated with equine lameness and diagnostic imaging is routinely used to investigate disorders of the joint and its surrounding tissues. This review describes the osseous disorders of the fetlock as well as the technical aspects of taking radiographic and ultrasonographic images of the different lesions. In current clinical practice, a combination of radiography and ultrasonography is still the most frequently used approach to arrive at a diagnosis.

  20. [Diagnostic of secondary hypertension in clinical practice].

    Science.gov (United States)

    Somlóová, Z; Rosa, J; Petrák, O; Strauch, B; Zelinka, T; Holaj, R; Widimský, J

    2011-09-01

    Arterial hypertension is a common worldwide disease with a prevalence of approximately 26%. Secondary cause is known in 5-10% of patients with hypertension. We should think of secondary hypertension in all patients with resistant hypertension, in patients with sudden deterioration in the control of hypertension and in patients with laboratory and clinical signs of diseases associated with secondary hypertension. It is important to distinguish between secondary hypertension and pseudo-resistance (noncompliance to treatment, white coat syndrome). Secondary causes of hypertension can be divided into endocrine (primary aldosteronism, pheochromocytoma, hypercortisolism, hyperparathyreoidism), renal - renovascular and renal parenchymal hypertension, and other causes as sleep apnoe syndrome, hypertension in pregnancy, coarctation of the aorta and intracranial tumors.

  1. Consideration on the diagnostic ability of various imaging techniques in relation to renal tumor

    International Nuclear Information System (INIS)

    Ike, Katsushi

    1984-01-01

    Radiological diagnosis of renal tumors is being improved with the increased imaging accuracy which has resulted from advancement in the various equipment used and improvement in techniques. However, at the clinical level, diagnostic procedures based on the characteristics of the delineated images are not yet established and the diverse diagnostic procedures are being conducted currently in a stereotyped manner. In this study, the images of 61 cases diagnosed as renal tumor were analysed retrospectively with the purpose of establishing the imaging accuracy, capacity for diagnosis based on image characteristics and a subseguent proper diagnostic procedure. It was found that CT and Angio gave similar diagnostic accuracy. It was further revealed that US images enabled to differentiate renal tumors from the more commonly experienced renal cystic disease. For determination of tunica involucrum infiltration, which is essential to diagnose Stage I and II renal tumors, CT was proved to be superior to Angio. CT and US were also to be so in the determination of metastasis to para-aortic lymph nodes which is a Stage III criterion. In recent years, CT and US imaging accuracies have increased, hence the improvement in the capacity to diagnose non-observable renal tumors is highly expected. (author)

  2. Cognitive development, clinical knowledge, and clinical experience related to diagnostic ability.

    Science.gov (United States)

    Aquilino, M L

    1997-01-01

    To examine the relationship among cognitive development, clinical knowledge, and clinical experience in nursing students. A survey of junior and senior baccalaureate nursing students from three Midwestern colleges (N = 55). Students' diagnostic ability increased as they gained clinical experience and clinical knowledge. However, students failed to identify many nursing diagnoses and demonstrated only moderate levels of cognitive development. Nurse educators and nursing students need to change their approaches to teaching and learning to enhance students' diagnostic ability and cognitive development.

  3. Diagnostic imaging of the kidney and the urinary tract in infancy

    International Nuclear Information System (INIS)

    Troeger, J.; Darge, K.; Rohrschneider, W.

    1999-01-01

    Imaging flow charts differ in pediatric and general radiology. The reasons are: Different illnesses, different consequences arising out of imaging results and different sequence of imaging methods. Ultrasound is always the first imaging method of the urinary tract in infancy and childhood starts with ultrasound with the exception of severe abdominal trauma which is investigated by computertomography. The decision 'normal or abnormal' is possible using ultrasound in the most pediatric cases. The diagnostic value and significance of ultrasound in infancy and childhood is far better than in general radiology because of the higher resolution of the high-frequency units taken. The result of the ultrasound examination should be the basis for the following imaging procedures. We will describe diagnostic flow charts starting with three important clinical symptoms: Prenatal pathology, urinary tract obstruction and urinary tract infection. (orig.) [de

  4. Diagnostic imagings and embolotherapy for the superior mesenteric vein-inferior vena cava shunt

    International Nuclear Information System (INIS)

    Morita, Yutaka; Yamada, Masataka; Miyata, Mutsuhiko; Kubo, Kohzo.

    1994-01-01

    Diagnostic imaging and embolization therapy for the uncommon portal and mesenteric vein-inferior vena cave shunt (PV·SMV-IVC shunt) are reported. As the frequency of clinical symptoms such as hematemesis, melena and confusion caused by gastrointestinal varices, or hepatoencephalopathy was about 40%, it was important for this disease entity to be diagnosed with noninvasive diagnostic images. The careful examination of the area around the right renal vein was able to overcome the low diagnostic rate of 20-40% obtained with US and CT images. In cases of simple PV·SMV-IVC shut without gastrointestinal varices, embolization therapy using steel coils and done by the intravenous approach is easy and noninvasive. On the other hand, in cases of complex PV-SMV-IVC shunt with gastrointestinal varices, dual balloon occluded embolization therapy using a liquid sclerosing agent and done by the intravenous and portal approaches is preferable. (author)

  5. Molecular diagnostics clinical utility strategy: a six-part framework.

    Science.gov (United States)

    Frueh, Felix W; Quinn, Bruce

    2014-09-01

    The clinical utility of a molecular test rises proportional to a favorable regulatory risk/benefit assessment, and clinical utility is the driver of payer coverage decisions. Although a great deal has been written about clinical utility, debates still center on its 'definition.' We argue that the definition (an impact on clinical outcomes) is self-evident, and improved communications should focus on sequential steps in building and proving an adequate level of confidence for the diagnostic test's clinical value proposition. We propose a six-part framework to facilitate communications between test developers and health technology evaluators, relevant to both regulatory and payer decisions.

  6. From molecular imaging to systems diagnostics: Time for another paradigm shift?

    International Nuclear Information System (INIS)

    Li, King C.P.

    2009-01-01

    The term 'Molecular Imaging' has hit the consciousness of radiologists only in the past decade although many of the concepts that molecular imaging encompasses has been practiced in biomedical imaging, especially in nuclear medicine, for many decades. Many new imaging techniques have allowed us to interrogate biologic events at the cellular and molecular level in vivo in four dimensions but the challenge now is to translate these techniques into clinical practice in a way that will enable us to revolutionize healthcare delivery. The purpose of this article is to introduce the term 'Systems Diagnostics' and examine how radiologists can become translators of disparate sources of information into medical decisions and therapeutic actions.

  7. Diagnostic value of imaging in infective endocarditis: a systematic review.

    Science.gov (United States)

    Gomes, Anna; Glaudemans, Andor W J M; Touw, Daan J; van Melle, Joost P; Willems, Tineke P; Maass, Alexander H; Natour, Ehsan; Prakken, Niek H J; Borra, Ronald J H; van Geel, Peter Paul; Slart, Riemer H J A; van Assen, Sander; Sinha, Bhanu

    2017-01-01

    Sensitivity and specificity of the modified Duke criteria for native valve endocarditis are both suboptimal, at approximately 80%. Diagnostic accuracy for intracardiac prosthetic material-related infection is even lower. Non-invasive imaging modalities could potentially improve diagnosis of infective endocarditis; however, their diagnostic value is unclear. We did a systematic literature review to critically appraise the evidence for the diagnostic performance of these imaging modalities, according to PRISMA and GRADE criteria. We searched PubMed, Embase, and Cochrane databases. 31 studies were included that presented original data on the performance of electrocardiogram (ECG)-gated multidetector CT angiography (MDCTA), ECG-gated MRI, 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT, and leucocyte scintigraphy in diagnosis of native valve endocarditis, intracardiac prosthetic material-related infection, and extracardiac foci in adults. We consistently found positive albeit weak evidence for the diagnostic benefit of 18 F-FDG PET/CT and MDCTA. We conclude that additional imaging techniques should be considered if infective endocarditis is suspected. We propose an evidence-based diagnostic work-up for infective endocarditis including these non-invasive techniques. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Primary ureteral carcinoma: MRI diagnosis and comparison with other diagnostic imaging facilities

    International Nuclear Information System (INIS)

    An Ningyu; Jiang Bo; Cai Youquan; Liang Yan

    2004-01-01

    Objective: To investigate MRI examination methods and imaging manifestations of primary ureteral carcinoma, and to evaluate its clinical values when comparing with other diagnostic imaging facilities. Methods: Eighty-seven cases of primary ureteral carcinoma who were operated within recent 8 years came into the study, among which, 35 cases had MRI examinations. For MRI examination, coronal heavy T 2 WI (water imaging) was performed to show the dilated ureter, then axial T 2 WI and T 1 WI were scanned at the obstruction level. 11 cases underwent additional Gd-DTPA dynamic contrast enhanced scans. The original pre-operative diagnostic reports of various imaging facilities were analyzed comparing with the results of operation and pathology. Results: MRI showed ureteral dilatation in 33 of 35 cases, no abnormal appearance in 1 case, and only primary kidney atrophy post renal transplantation in 1 case. Among the 33 cases with ureteral obstruction, soft mass at the obstruction level was detected on axial scans in 32 cases. The lesions showed gradual and homogeneous mild to moderate enhancement on contrast MRI. The overall employment rate of imaging facilities was as follows: ultrasound (94.3%), IVU (59.8%), CT (52.9%), MRI (40.2%), and RUP (35.6%). The accurate diagnostic rate was as follows :MRI (91.4%), RUP (80.6%), CT (63.0%), ultrasound (47.6%), and IVU (11.5%). Conclusion: Combination of MR water imaging and conventional sequences can demonstrate most primary ureteral carcinoma lesions and has a highest diagnostic accuracy among the current diagnostic imaging facilities. It should be taken as the first diagnostic imaging method of choice when primary ureteral carcinoma is suspected after ultrasound screening

  9. Hashimoto thyroiditis: clinical and diagnostic criteria.

    Science.gov (United States)

    Caturegli, P; De Remigis, A; Rose, N R

    2014-01-01

    Hashimoto thyroiditis (HT), now considered the most common autoimmune disease, was described over a century ago as a pronounced lymphoid goiter affecting predominantly women. In addition to this classic form, several other clinico-pathologic entities are now included under the term HT: fibrous variant, IgG4-related variant, juvenile form, Hashitoxicosis, and painless thyroiditis (sporadic or post-partum). All forms are characterized pathologically by the infiltration of hematopoietic mononuclear cells, mainly lymphocytes, in the interstitium among the thyroid follicles, although specific features can be recognized in each variant. Thyroid cells undergo atrophy or transform into a bolder type of follicular cell rich in mitochondria called Hürthle cell. Most HT forms ultimately evolve into hypothyroidism, although at presentation patients can be euthyroid or even hyperthyroid. The diagnosis of HT relies on the demonstration of circulating antibodies to thyroid antigens (mainly thyroperoxidase and thyroglobulin) and reduced echogenicity on thyroid sonogram in a patient with proper clinical features. The treatment remains symptomatic and based on the administration of synthetic thyroid hormones to correct the hypothyroidism as needed. Surgery is performed when the goiter is large enough to cause significant compression of the surrounding cervical structures, or when some areas of the thyroid gland mimic the features of a nodule whose cytology cannot be ascertained as benign. HT remains a complex and ever expanding disease of unknown pathogenesis that awaits prevention or novel forms of treatment. Copyright © 2014 Elsevier B.V. All rights reserved.

  10. Coherence imaging spectro-polarimetry for magnetic fusion diagnostics

    International Nuclear Information System (INIS)

    Howard, J

    2010-01-01

    This paper presents an overview of developments in imaging spectro-polarimetry for magnetic fusion diagnostics. Using various multiplexing strategies, it is possible to construct optical polarization interferometers that deliver images of underlying physical parameters such as flow speed, temperature (Doppler effect) or magnetic pitch angle (motional Stark and Zeeman effects). This paper also describes and presents first results for a new spatial heterodyne interferometric system used for both Doppler and polarization spectroscopy.

  11. Diagnostic imaging of the nose and paranasal sinuses

    International Nuclear Information System (INIS)

    Lloyd, G.A.S.

    1988-01-01

    This book offers extensively illustrated and comprehensive coverage of diagnostic imaging techniques of the nose and paranasal sinuses. The important feature of the work is the way it correlates histology with CT and MRI and includes magnetic resonance contrast studies using Gadolinium DTPA. Furthermore, it is the first text to treat the imaging of the various types of tumors of the nose and paranasal sinuses on an individual basis

  12. Diagnostic imaging techniques in Rubinstein-Taybi syndrome

    International Nuclear Information System (INIS)

    Albanese, A.; Carcione, A.; Benenati, A.; Albano, S.; Rubino, F.P.; Reina, C.; Verde, V.; Giuffre, L.; Corsello, G.; Cammarata, M.; Piccione, M.

    1991-01-01

    Both etiology and pathogenesis of Rubinstein-Taybi syndrome (RTS) are still questionable, even though a genetic factor seems to be certain. A typical face, psychomotor delay, and thumb and halluces abnormalities (big, prevalently short, and often 'spoon-like' toes) are the main characteristic patterns of RTS. Eight subjects (4 male and 3 female children aged 26 days-7 years, and a 31-year old woman, mother of 1 of the affected children) with different signs of RTS were studied over the last 3 years. The results are here reported, with a special emphasis on malformations detected with conventional radiography (Rx), Computerized Tomography (CT), and ultrasound (US). Evaluated parameters were thumbs and halluces (Rx), bone age and skeleton (Rx), cranium (Rx) and encephalon (US, CT), cryptochidism (US, CT), and urogical (Rx, US) and carciovascolar (US) system. Atypical face and psycomotor delay were found in all cases, while thumb and halluces abnormalities were observed only in 6 cases. Among several clinical signs of RTS, we found: severe (<3rd centile) bone maturation delay in 4 cases; skull volume reduction (<50th centile) in 3 subjects and microcrania in 4; skeletal abnormalities in 7 cases (5 of them positive for bilateral coxofemoral abnormalities); urinary tract (4 cases) and cardiovascular (3 cases) malformation; and cryptorcidism in 3 of 4 males. A case was diagnosed during neonatal period (within the first month of life) it was a rare case associated with a variant form of Dandy-Walker anomaly; semiologic similarities were observed between mother and daughter patients. X-rays, US and CT rarely play an important role in the diagnosis of RTS, considering the several clinical signs, mainly tha face, affecting the patients. However, diagnostic imaging techniques help diagnose hidden malformations and confirm and integrate clinical signs

  13. Diagnostic accuracy of imaging modalities for internal derangements of temporomandibular joint

    International Nuclear Information System (INIS)

    Kobayashi, Kaoru; Igarashi, Chinami; Yuasa, Masao; Imanaka, Masahiro; Kondoh, Toshirou

    1998-01-01

    The purpose of this study was to evaluate and review the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of imaging diagnosis for temporomandibular disorders. The role of diagnostic imaging is to detect and document specific anatomic abnormalities associated with the signs and symptoms in the temporomandibular joint. Magnetic resonance imaging (MR imaging) can accurately depict disc displacement and disc deformity. MR imaging is our first choice among the various imaging modalities for the patients with clinical signs and symptoms. However, it has been shown that intra-capsular adhesions and perforations of the disc and retrodiscal tissue are sometimes not detected by MR imaging. To improve the diagnostic technique for adhesions and perforations, double-contrast arthrotomography with fluoroscopy should be employed. The irregular surface of the eminences and the glenoid fossae shown by MR imaging and tomography are correlated with subchondral bone exposure by arthroscopy. Erosion of the condyles detected by MR imaging, tomography and rotational panoramic radiography is correlated with subchondral bone exposure detected by arthroscopy. (author). 69 refs

  14. Diagnostic imaging of pulmonary lymphangiosis carcinomatosa

    International Nuclear Information System (INIS)

    Rehbock, B.; Hieckel, H.G.

    2004-01-01

    The diagnosis of pulmonary lymphangiosis carcinomatosa (PLC) is of great importance for the prognostically-oriented therapy stratification of tumor patients. In this field, high-resolution computed tomography (HRCT) is the state of the art in imaging. Using HRCT, it is possible to identify pulmonary parenchymal structures in a detailed fashion to evaluate interstitial patterns. This step is preceded by an x-ray of the thorax that detects pathological findings and rules out other diseases. The typical characteristics of PLC are described with particular attention to HR-phenomenology, and discussed in comparison with the literature regarding anatomy and pathogenesis. Finally, conclusions are drawn for differential diagnosis and supported by characteristic cases. (orig.) [de

  15. The clinician's guide to diagnostic imaging: Cost-effective pathways. Second edition

    International Nuclear Information System (INIS)

    Grossman, Z.D.; Chew, F.S.; Ellis, D.A.; Brigham, S.C.

    1987-01-01

    The authors developed a cost-effective approach to imaging studies, based on initial selection of an exam that best addresses the specific clinical problem and obviates the need for additional diagnostic tests. Tightly reasoned arguments compare available imaging options with respect to diagnostic yield, feasibility, risk, and cost. To aid the clinician in making cost comparisons, each paper of the Second Edition lists the dollar cost of relevant imaging studies. The Second Edition has been thoroughly revised to reflect the important advances in diagnostic imaging of the past three years, highlighting CT's expanding role in thoracic and abdominal problems, magnetic resonance imaging as a spectacular diagnostic tool for the central nervous system, and the clinical application of many newly-developed radiopharmaceuticals. New chapters cover breast cancer screening, acute spinal trauma, search for primary cancer of unknown origin, acute anuria, blunt chest trauma, new onset seizures, and spinal cord compression from metastases. Other papers have been rewritten for greater clarity and to incorporate new techniques, like dipyridamole stress testing. A glossary and an introduction define and explain the capabilities and limitations of current techniques

  16. How does additional diagnostic testing influence the initial diagnosis in patients with cognitive complaints in a memory clinic setting?

    NARCIS (Netherlands)

    Meijs, A.P.; Claassen, J.A.H.R.; Olde Rikkert, M.G.M.; Schalk, B.W.M; Meulenbroek, O.V.; Kessels, R.P.C.; Melis, R.J.F.

    2015-01-01

    Background: patients suspected of dementia frequently undergo additional diagnostic testing (e.g. brain imaging or neuropsychological assessment) after standard clinical assessment at a memory clinic. This study investigates the use of additional testing in an academic outpatient memory clinic and

  17. How does additional diagnostic testing influence the initial diagnosis in patients with cognitive complaints in a memory clinic setting?

    NARCIS (Netherlands)

    Meijs, A.P.; Claassen, J.A.; Olde Rikkert, M.G.M.; Schalk, B.W.M; Meulenbroek, O.V.; Kessels, R.P.C.; Melis, R.J.F.

    2015-01-01

    BACKGROUND: patients suspected of dementia frequently undergo additional diagnostic testing (e.g. brain imaging or neuropsychological assessment) after standard clinical assessment at a memory clinic. This study investigates the use of additional testing in an academic outpatient memory clinic and

  18. 3D ultrasound imaging for prosthesis fabrication and diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Morimoto, A.K.; Bow, W.J.; Strong, D.S. [and others

    1995-06-01

    The fabrication of a prosthetic socket for a below-the-knee amputee requires knowledge of the underlying bone structure in order to provide pressure relief for sensitive areas and support for load bearing areas. The goal is to enable the residual limb to bear pressure with greater ease and utility. Conventional methods of prosthesis fabrication are based on limited knowledge about the patient`s underlying bone structure. A 3D ultrasound imaging system was developed at Sandia National Laboratories. The imaging system provides information about the location of the bones in the residual limb along with the shape of the skin surface. Computer assisted design (CAD) software can use this data to design prosthetic sockets for amputees. Ultrasound was selected as the imaging modality. A computer model was developed to analyze the effect of the various scanning parameters and to assist in the design of the overall system. The 3D ultrasound imaging system combines off-the-shelf technology for image capturing, custom hardware, and control and image processing software to generate two types of image data -- volumetric and planar. Both volumetric and planar images reveal definition of skin and bone geometry with planar images providing details on muscle fascial planes, muscle/fat interfaces, and blood vessel definition. The 3D ultrasound imaging system was tested on 9 unilateral below-the- knee amputees. Image data was acquired from both the sound limb and the residual limb. The imaging system was operated in both volumetric and planar formats. An x-ray CT (Computed Tomography) scan was performed on each amputee for comparison. Results of the test indicate beneficial use of ultrasound to generate databases for fabrication of prostheses at a lower cost and with better initial fit as compared to manually fabricated prostheses.

  19. Microwave imaging for plasma diagnostics and its applications

    International Nuclear Information System (INIS)

    Mase, A.; Kogi, Y.; Ito, N.

    2007-01-01

    Microwave to millimeter-wave diagnostic techniques such as interferometry, reflectometry, scattering, and radiometry have been powerful tools for diagnosing magnetically confined plasmas. Important plasma parameters were measured to clarify the physics issues such as stability, wave phenomena, and fluctuation-induced transport. Recent advances in microwave and millimeter-wave technology together with computer technology have enabled the development of advanced diagnostics for visualization of 2D and 3D structures of plasmas. Microwave/millimeter-wave imaging is expected to be one of the most promising diagnostic methods for this purpose. We report here on the representative microwave diagnostics and their industrial applications as well as application to magnetically-confined plasmas. (author)

  20. MRI-based diagnostic imaging of the intratemporal facial nerve

    International Nuclear Information System (INIS)

    Kress, B.; Baehren, W.

    2001-01-01

    Detailed imaging of the five sections of the full intratemporal course of the facial nerve can be achieved by MRI and using thin tomographic section techniques and surface coils. Contrast media are required for tomographic imaging of pathological processes. Established methods are available for diagnostic evaluation of cerebellopontine angle tumors and chronic Bell's palsy, as well as hemifacial spasms. A method still under discussion is MRI for diagnostic evaluation of Bell's palsy in the presence of fractures of the petrous bone, when blood volumes in the petrous bone make evaluation even more difficult. MRI-based diagnostic evaluation of the idiopatic facial paralysis currently is subject to change. Its usual application cannot be recommended for routine evaluation at present. However, a quantitative analysis of contrast medium uptake of the nerve may be an approach to improve the prognostic value of MRI in acute phases of Bell's palsy. (orig./CB) [de

  1. [EYECUBE as 3D multimedia imaging in macular diagnostics].

    Science.gov (United States)

    Hassenstein, Andrea; Scholz, F; Richard, G

    2011-11-01

    In the new generation of EYECUBE devices, the angiography image and the OCT are included in a 3D illustration as an integration. Other diagnostic procedures such as autofluorescence and ICG can also be correlated to the OCT. The aim was to precisely classify various two-dimensional findings in relation to each other. The new generation of OCT devices enables imaging with a low incidence of motion artefacts with very good fundus image quality - and with that, permits a largely automatic classification. The feature enabling the integration of the EYECUBE was further developed with new software, so that not only the topographic image (red-free, autofluorescence) can be correlated to the Cirrus OCT, but also all other findings gathered within the same time frame can be correlated to each other. These were brightened and projected onto the cube surface in a defined interval. The imaging procedures can be selected in a menu toolbar. Topographic volumetry OCT images can be overlayed. The practical application of the new method was tested on patients with macular disorders. By lightening up the results from various diagnostic procedures, it is possible of late to directly compare pathologies to each other and to the OCT results. In all patients (n = 45 eyes) with good single-image quality, the automated integration into the EYECUBE was possible (to a great extent). The application is not dependent on a certain type of device used in the procedures performed. The increasing level of precision in imaging procedures and the handling of large data volumes has led to the possibility of examining each macular diagnostics procedure from the comparative perspective: imaging (photo) with perfusion (FLA, ICG) and morphology (OCT). The exclusion of motion artefacts and the reliable scan position in the course of the imaging process increases the informative value of OCT. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Radiology and diagnostic images in the gastric cancer

    International Nuclear Information System (INIS)

    Duarte, Alfonso; Acosta, Nelson; Alvarez R, Alfonso and others

    1992-01-01

    This article deals with the chapter about diagnostic imaging included in the document of the first practical seminar about gastric carcinoma which took place at Betania (Huila) in the first few days of April 1992. This seminar was organized by the Colombian society of gastroenterology in coordination with other organization

  3. Present practice of diagnostic imaging in the newborn infants

    International Nuclear Information System (INIS)

    Akamatsu, Hiroshi

    1994-01-01

    The present practice of diagnostic imaging in our NICU (which includes premature unit) was studied, surveying the total 637 admitted newborn infants during the year of 1992. The total number of diagnostic imaging performed other than scout radiography was 939. The number of ultrasonography of the heart and the brain, and brain CT was 752 or 80.0% of the total. These were done more frequently in the cases of very low birth weight infants. In our NICU, ultrasonography including pulse-doppler method, is performed for diagnosis of structural and functional abnormality of the cardiopulmonary systems and also for finding intracranial lesion, on the basis of finding in plain chest films. In spite of various limitation, we are performing, as the necessity commands, fluoroscopic contrast study, angiography, scintigraphy and MRI for the low birth weight (≥1,500g) and mature infants. Some of the actual cases in which diagnostic imaging was helpful were presented. Recently, upon admittance to the NICU for the specific abnormality of the newborn and premature infants, orginally, asymptomatic diseases are often found and diagnosed. This should be the results of progress in diagnostic imaging in recent years. (author)

  4. Magnetic resonance imaging of the wrist: Diagnostic performance statistics

    International Nuclear Information System (INIS)

    Hobby, Jonathan L.; Tom, Brian D.M.; Bearcroft, Philip W.P.; Dixon, Adrian K.

    2001-01-01

    AIM: To review the published diagnostic performance statistics for magnetic resonance imaging (MRI) of the wrist for tears of the triangular fibrocartilage complex, the intrinsic carpal ligaments, and for osteonecrosis of the carpal bones. MATERIALS AND METHODS: We used Medline and Embase to search the English language literature. Studies evaluating the diagnostic performance of MRI of the wrist in living patients with surgical confirmation of MR findings were identified. RESULTS: We identified 11 studies reporting the diagnostic performance of MRI for tears of the triangular fibrocartilage complex for a total of 410 patients, six studies for the scapho-lunate ligament (159 patients), six studies for the luno-triquetral ligament (142 patients) and four studies (56 patients) for osteonecrosis of the carpal bones. CONCLUSIONS: Magnetic resonance imaging is an accurate means of diagnosing tears of the triangular fibrocartilage and carpal osteonecrosis. Although MRI is highly specific for tears of the intrinsic carpal ligaments, its sensitivity is low. The diagnostic performance of MRI in the wrist is improved by using high-resolution T2* weighted 3D gradient echo sequences. Using current imaging techniques without intra-articular contrast medium, magnetic resonance imaging cannot reliably exclude tears of the intrinsic carpal ligaments. Hobby, J.L. (2001)

  5. Diagnostic Medical Imaging in Pediatric Patients and Subsequent Cancer Risk.

    Science.gov (United States)

    Mulvihill, David J; Jhawar, Sachin; Kostis, John B; Goyal, Sharad

    2017-11-01

    The use of diagnostic medical imaging is becoming increasingly more commonplace in the pediatric setting. However, many medical imaging modalities expose pediatric patients to ionizing radiation, which has been shown to increase the risk of cancer development in later life. This review article provides a comprehensive overview of the available data regarding the risk of cancer development following exposure to ionizing radiation from diagnostic medical imaging. Attention is paid to modalities such as computed tomography scans and fluoroscopic procedures that can expose children to radiation doses orders of magnitude higher than standard diagnostic x-rays. Ongoing studies that seek to more precisely determine the relationship of diagnostic medical radiation in children and subsequent cancer development are discussed, as well as modern strategies to better quantify this risk. Finally, as cardiovascular imaging and intervention contribute substantially to medical radiation exposure, we discuss strategies to enhance radiation safety in these areas. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  6. Evaluation of compression ratio using JPEG 2000 on diagnostic images in dentistry

    International Nuclear Information System (INIS)

    Jung, Gi Hun; Han, Won Jeong; Yoo, Dong Soo; Kim, Eun Kyung; Choi, Soon Chul

    2005-01-01

    To find out the proper compression ratios without degrading image quality and affecting lesion detectability on diagnostic images used in dentistry compressed with JPEG 2000 algorithm. Sixty Digora peri apical images, sixty panoramic computed radiographic (CR) images, sixty computed tomography (CT) images, and sixty magnetic resonance (MR) images were compressed into JPEG 2000 with ratios of 10 levels from 5:1 to 50:1. To evaluate the lesion detectability, the images were graded with 5 levels (1 : definitely absent ; 2 : probably absent ; 3 : equivocal ; 4 : probably present ; 5 : definitely present), and then receiver operating characteristic analysis was performed using the original image as a gold standard. Also to evaluate subjectively the image quality, the images were graded with 5 levels (1 : definitely unacceptable ; 2 : probably unacceptable ; 3 : equivocal ; 4 : probably acceptable ; 5 : definitely acceptable), and then paired t-test was performed. In Digora, CR panoramic and CT images, compressed images up to ratios of 15:1 showed nearly the same lesion detectability as original images, and in MR images, compressed images did up to ratios of 25:1. In Digora and CR panoramic images, compressed images up to ratios of 5:1 showed little difference between the original and reconstructed images in subjective assessment of image quality. In CT images, compressed images did up to ratios of 10:1 and in MR images up to ratios of 15:1. We considered compression ratios up to 5:1 in Digora and CR panoramic images, up to 10:1 in CT images, up to 15:1 in MR images as clinically applicable compression ratios.

  7. Contemporary diagnostic imaging approaches in treatment of urolithiasis

    International Nuclear Information System (INIS)

    Velichkov, B.; Naoumov, N.

    2004-01-01

    Based on an extensive review of the literature and on their own clinical experience, authors attempts to present clear guidelines for the management of urolithiasis. Ninety-eight per cent of stones can be successfully fragmented by the application of shock-waves, but the ability of the kidney and ureter to clear the resulting fragments is far more important in terms of successful treatment outcome. Extracorporeal shock-waves lithotripsy (ESWL) is a safe procedure for the treatment of urolithiasis; nevertheless some problems remain. In ureteric stones, ureteroscopy (rigid or flexible device) allows a rate of stone-free patients better than ESWL. For treatment of large staghorn calculi combined approach of Percutaneous Nephrolithotripsy (PCNL) and ESWL is preferred. For stones located at lower calyx, the stone-free rate in patients treated by ESWL fell to 50%, when unfavourable anatomy is present. Ultimate goal of treating stones by whatever means is to get the patient stone-free and prevent recurrence. The good technique of performing and interpretation of diagnostic imaging modalities is of critical importance in terms of diagnosing, successful treatment and follow up of results of treatment of urolithiasis

  8. Diagnostic imaging over the last 50 years: research and development in medical imaging science and technology

    International Nuclear Information System (INIS)

    Doi, Kunio

    2006-01-01

    Over the last 50 years, diagnostic imaging has grown from a state of infancy to a high level of maturity. Many new imaging modalities have been developed. However, modern medical imaging includes not only image production but also image processing, computer-aided diagnosis (CAD), image recording and storage, and image transmission, most of which are included in a picture archiving and communication system (PACS). The content of this paper includes a short review of research and development in medical imaging science and technology, which covers (a) diagnostic imaging in the 1950s, (b) the importance of image quality and diagnostic performance, (c) MTF, Wiener spectrum, NEQ and DQE, (d) ROC analysis, (e) analogue imaging systems, (f) digital imaging systems, (g) image processing, (h) computer-aided diagnosis, (i) PACS, (j) 3D imaging and (k) future directions. Although some of the modalities are already very sophisticated, further improvements will be made in image quality for MRI, ultrasound and molecular imaging. The infrastructure of PACS is likely to be improved further in terms of its reliability, speed and capacity. However, CAD is currently still in its infancy, and is likely to be a subject of research for a long time. (review)

  9. The improvement of diagnostic and therapeutic imaging in Africa

    International Nuclear Information System (INIS)

    2015-02-01

    The 8. Pan-African Congress of Radiology and Imaging on the improvement of diagnostic and therapeutic imaging in Africa was hosted in Nairobi Kenya. The conference focusses on Review of Radiation Safety in Medical X-Ray Diagnosis, Medical Practitioners of Radiology & Imaging in the Dock. It also addresses issues Knowledge, Attitude, and Practice of Clinicians, Practicing at the Kenyatta National Hospital on Ionizing Radiation and Procurement in the Imaging Department. The Need for Understanding Technical Specifications,Students Experience in Radiography, Radioiodine Therapy for Graves’ Disease, Role of ultrasound in the diagnosis and management of gestational trophoblastic disease in Rural health facilities were areas interest. Diabetes Mellitus and the Musculoskeletal System, Imaging the Traumatized Spine ‘Clearing the Cervical Spine’, The Radiation Safety Culture: Image Gently and Radiation Protection of the Young Patient: Kenya perspective were discussed during the conference

  10. Doctoral theses in diagnostic imaging: a study of Spanish production between 1976 and 2011.

    Science.gov (United States)

    Machan, K; Sendra Portero, F

    2018-05-15

    To analyze the production of doctoral theses in diagnostic imaging in Spain in the period comprising 1976 through 2011 with the aim of a) determining the number of theses and their distribution over time, b) describing the production in terms of universities and directors, and c) analyzing the content of the theses according to the imaging technique, anatomic site, and type of research used. The TESEO database was searched for "radiología" and/or "diagnóstico por imagen" and for terms related to diagnostic imaging in the title of the thesis. A total of 1036 theses related to diagnostic imaging were produced in 37 Spanish universities (mean, 29.6 theses/year; range, 4-59). A total of 963 thesis directors were identified; 10 of these supervised 10 or more theses. Most candidates and directors were men, although since the 2000-2001 academic year the number of male and female candidates has been similar. The anatomic regions most often included in diagnostic imaging theses were the abdomen (22.5%), musculoskeletal system (21.8%), central nervous system (16.4%), and neck and face (15.6%). The imaging techniques most often included were ultrasonography in the entire period (25.5%) and magnetic resonance imaging in the last 5 years. Most theses (63.8%) were related to clinical research. Despite certain limitations, the TESEO database makes it possible to analyze the production of doctoral theses in Spain effectively. The annual mean production of theses in diagnostic imaging is higher than in other medical specialties. This analysis reflects the historic evolution of imaging techniques and research in radiology as well as the development of Spanish universities. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Should we confirm our clinical diagnostic certainty by autopsies?

    Science.gov (United States)

    Podbregar, M; Voga, G; Krivec, B; Skale, R; Pareznik, R; Gabrscek, L

    2001-11-01

    To evaluate the frequency of diagnostic errors assessed by autopsies. Retrospective review of medical and pathological records in an 11-bed closed medical intensive care unit (ICU) at a 860-bed general hospital. Patients who died in the ICU between January 1998 and December 1999. Medical diagnoses were rated into three levels of clinical diagnostic certainty: complete certainty (group L1), minor diagnostic uncertainty (group L2), and major diagnostic uncertainty (group L3). The patients were divided into three error groups: group A, the autopsy confirmed the clinical diagnosis; group B, the autopsy demonstrated a new relevant diagnosis which would probably not have influenced the therapy and outcome; group C, the autopsy demonstrated a new relevant diagnosis which would probably have changed the therapy and outcome. The overall mortality was 20.3% (270/1331 patients). Autopsies were performed in 126 patients (46.9% of deaths), more often in younger patients (66.6+/-13.9 years vs 72.7+/-12.0 years, p<0.001), in patients with shorter ICU stay (4.7+/-5.6 days vs 6.7+/-8.7 days, p=0.054), and in patients in group L3 without chronic diseases (15/126 vs 1/144, p<0.001). Fatal but potentially treatable errors [group C, 12 patients (9.5%)] were found in 8.7%, 10.0%, and 10.5% of patients in groups L1, L2, and L3, respectively (NS between groups). An ICU length of stay shorter than 24 h was not related to the frequency of group C errors. Autopsies are performed more often in younger patients without chronic disease and in patients with a low clinical diagnostic certainty. No level of clinical diagnostic certainty could predict the pathological findings.

  12. Teaching perceptual skills in clinical diagnostics using digital media

    NARCIS (Netherlands)

    Scheiter, Katharina; Jarodzka, Halszka

    2011-01-01

    Scheiter, K., & Jarodzka, H. (2011, May). Teaching perceptual skills in clinical diagnostics using digital media. Presentation at the 2nd International Conference “Research in Medical Education”: Shaping diamonds from bench to bedside, Universität Tübingen.

  13. Diagnostic utility of clinical and biochemical parameters in ...

    African Journals Online (AJOL)

    Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy patients with normal carbohydrate antigen 19-9 levels. Xiaoli Jin1, Yulian Wu2. 1. Department of Surgery, Sir Run Run Shaw Hospital College of Medicine, Zhejiang University, 3 Qingchun. Road East, Hangzhou, Zhejiang Province ...

  14. Three dimensional imaging technique for laser-plasma diagnostics

    International Nuclear Information System (INIS)

    Jiang Shaoen; Zheng Zhijian; Liu Zhongli

    2001-01-01

    A CT technique for laser-plasma diagnostic and a three-dimensional (3D) image reconstruction program (CT3D) have been developed. The 3D images of the laser-plasma are reconstructed by using a multiplication algebraic reconstruction technique (MART) from five pinhole camera images obtained along different sight directions. The technique has been used to measure the three-dimensional distribution of X-ray of laser-plasma experiments in Xingguang II device, and the good results are obtained. This shows that a CT technique can be applied to ICF experiments

  15. Three dimensional imaging technique for laser-plasma diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Shaoen, Jiang; Zhijian, Zheng; Zhongli, Liu [China Academy of Engineering Physics, Chengdu (China)

    2001-04-01

    A CT technique for laser-plasma diagnostic and a three-dimensional (3D) image reconstruction program (CT3D) have been developed. The 3D images of the laser-plasma are reconstructed by using a multiplication algebraic reconstruction technique (MART) from five pinhole camera images obtained along different sight directions. The technique has been used to measure the three-dimensional distribution of X-ray of laser-plasma experiments in Xingguang II device, and the good results are obtained. This shows that a CT technique can be applied to ICF experiments.

  16. Evaluating online diagnostic decision support tools for the clinical setting.

    Science.gov (United States)

    Pryor, Marie; White, David; Potter, Bronwyn; Traill, Roger

    2012-01-01

    Clinical decision support tools available at the point of care are an effective adjunct to support clinicians to make clinical decisions and improve patient outcomes. We developed a methodology and applied it to evaluate commercially available online clinical diagnostic decision support (DDS) tools for use at the point of care. We identified 11 commercially available DDS tools and assessed these against an evaluation instrument that included 6 categories; general information, content, quality control, search, clinical results and other features. We developed diagnostically challenging clinical case scenarios based on real patient experience that were commonly missed by junior medical staff. The evaluation was divided into 2 phases; an initial evaluation of all identified and accessible DDS tools conducted by the Clinical Information Access Portal (CIAP) team and a second phase that further assessed the top 3 tools identified in the initial evaluation phase. An evaluation panel consisting of senior and junior medical clinicians from NSW Health conducted the second phase. Of the eleven tools that were assessed against the evaluation instrument only 4 tools completely met the DDS definition that was adopted for this evaluation and were able to produce a differential diagnosis. From the initial phase of the evaluation 4 DDS tools scored 70% or more (maximum score 96%) for the content category, 8 tools scored 65% or more (maximum 100%) for the quality control category, 5 tools scored 65% or more (maximum 94%) for the search category, and 4 tools score 70% or more (maximum 81%) for the clinical results category. The second phase of the evaluation was focused on assessing diagnostic accuracy for the top 3 tools identified in the initial phase. Best Practice ranked highest overall against the 6 clinical case scenarios used. Overall the differentiating factor between the top 3 DDS tools was determined by diagnostic accuracy ranking, ease of use and the confidence and

  17. Anterolateral ankle impingement: findings and diagnostic accuracy with ultrasound imaging

    International Nuclear Information System (INIS)

    McCarthy, C.L.; Wilson, D.J.; Coltman, T.P.

    2008-01-01

    The objective was to evaluate the findings and diagnostic accuracy of ultrasound in antero-lateral ankle impingement (ALI) with clinical and arthroscopic correlation. Seventeen elite footballers with chronic ankle pain were referred for ultrasound with a clinical diagnosis of ALI (n = 8) or a control condition (n = 9; lateral mechanical instability, osteochondral defect, intra-articular bodies and osteoarthritis). Ultrasound examination included the antero-lateral gutter for abnormal synovial tissue (synovitic lesion), lateral ligament integrity, tibiotalar joint and osseous spurs of the distal tibia and talus. Ultrasound findings were correlated with subsequent arthroscopic appearance. Ultrasound examination detected a synovitic mass in the antero-lateral gutter in all 8 footballers with clinical ALI (100%) and in 2 patients with a control diagnosis (22%). Arthroscopic correlation of antero-lateral synovitis and fibrosis was present in all 10 cases (100%). The synovitic lesion was seen at ultrasound as a nodular soft tissue mass of mixed echogenicity within the antero-lateral gutter, which extruded anteriorly with manual compression of the distal fibula against the tibia. Increased blood supply was detected using power Doppler imaging in only 1 patient. The synovitic lesion measured >10 mm in its maximum dimension in 7 footballers with clinical ALI and <10 mm in the control group. Additional ultrasound findings in patients with abnormal antero-lateral synovial tissue included an anterior talofibular ligament injury in all patients (n = 10), a tibiotalar joint effusion (n = 6) and osseous spurs (n = 4). Antero-lateral synovitic tissue was accurately identified at ultrasound in the absence of an effusion (n = 4). No synovitic lesion was detected at ultrasound or arthroscopy in the remaining 7 patients with a control diagnosis. Ultrasound is accurate in detecting synovitic lesions within the antero-lateral gutter, demonstrating associated ligamentous injuries and in

  18. NMR clinical imaging and spectroscopy: Its impact on nuclear medicine

    International Nuclear Information System (INIS)

    1990-01-01

    This is a collection of four papers describing aspects of past and future use of nuclear magnetic resonance as a clinical diagnostic tool. The four papers are entitled (1) What Does NMR Offer that Nuclear Medicine Does Not? by Jerry W. Froelich, (2) Oncological Imaging: Now, Future and Impact Jerry W. Froelich, (3) Magnetic Resonance Spectroscopy/Spectroscopic Imaging and Nuclear Medicine: Past, Present and Future by H. Cecil Charles, and (4) MR Cardiology: Now, Future and Impact by Robert J. Herfkens

  19. Neuro-Behcet's disease: diagnostic usefulness of MR imaging

    International Nuclear Information System (INIS)

    Kim, Song Soo; Song, Chang June; Lee, Ae Young; Pak, Chung Ho

    2000-01-01

    To suggest the characteristic MR features and to evaluate the usefulness of MR imaging for the diagnosis of neuro-Behcet's disease. We retrospectively reviewed the MR findings of clinically confirmed neuro-Behcet's disease in eight patients (M:F =3D 7:1) ranging in age from 28 to 47 (average, 36) years. The findings were analyzed in terms of the most frequently occurring sites, signal intensities, contrast enhancement, and the changing patterns seen on follow-up MR examination. Seven of the eight patients had parenchymal brain lesions and the other had dural sinus thrombosis without brain parenchymal brain abnormality. In descending order of frequency, lesions involved the pons, midbrain, medulla oblongata, internal capsule, basal ganglia, thalamus, temporal lobe, and corpus callosum. The brain stem was involved in six patients, five of whom showed extensive involvement of the entire stem. In five patients, brain stem lesions showed supratentorial involvement, and in one, involvement of this region only was noted. Signal intensities of the lesions were poorly defined and extensive, especially in the brain stem, usually showed prolongation of both T1 and T2 relaxation time. Three patients underwent follow-up examination, and this showed that while most lesions had disappeared in time, some had become small and cavitary. Initial MR examination showed that three patients had newly developed lesions as well as cavitary foci, suggesting the recurrence of disease. Contrast enhancement was noted in five of seven patients (71%), and various types, including nodular, linear, marginal, and ring. The MR features of neuro-Behcet's disease were fairly characteristic, and in clinically unsuspicious patients might be diagnostically useful. (author)

  20. Image standards in Tissue-Based Diagnosis (Diagnostic Surgical Pathology

    Directory of Open Access Journals (Sweden)

    Vollmer Ekkehard

    2008-04-01

    Full Text Available Abstract Background Progress in automated image analysis, virtual microscopy, hospital information systems, and interdisciplinary data exchange require image standards to be applied in tissue-based diagnosis. Aims To describe the theoretical background, practical experiences and comparable solutions in other medical fields to promote image standards applicable for diagnostic pathology. Theory and experiences Images used in tissue-based diagnosis present with pathology – specific characteristics. It seems appropriate to discuss their characteristics and potential standardization in relation to the levels of hierarchy in which they appear. All levels can be divided into legal, medical, and technological properties. Standards applied to the first level include regulations or aims to be fulfilled. In legal properties, they have to regulate features of privacy, image documentation, transmission, and presentation; in medical properties, features of disease – image combination, human – diagnostics, automated information extraction, archive retrieval and access; and in technological properties features of image acquisition, display, formats, transfer speed, safety, and system dynamics. The next lower second level has to implement the prescriptions of the upper one, i.e. describe how they are implemented. Legal aspects should demand secure encryption for privacy of all patient related data, image archives that include all images used for diagnostics for a period of 10 years at minimum, accurate annotations of dates and viewing, and precise hardware and software information. Medical aspects should demand standardized patients' files such as DICOM 3 or HL 7 including history and previous examinations, information of image display hardware and software, of image resolution and fields of view, of relation between sizes of biological objects and image sizes, and of access to archives and retrieval. Technological aspects should deal with image

  1. Investigation of CT diagnostic imaging of 'Eosinophilic chronic rhinosinusitis'

    International Nuclear Information System (INIS)

    Ogino, Nobuhiro; Matsuwaki, Yoshinori; Ojiri, Hiroya; Kanou, Asami; Fukuda, Kunihiko

    2011-01-01

    'Eosinophilic chronic rhinosinusitis (ECRS)' is a newly developed entity of chronic rhinosinusitis, which shows resistance against conventional treatment and poor prognosis. Pathologically, ECRS is manifested by high-degree of eosinophilic infiltration in the paranasal sinus mucosa. We structure the CT diagnostic criteria of ECRS and assess its availability. This diagnostic criteria consists of disease distribution (bilateral and predominant in the ethmoid sinus), existence of nasal polyp (s) and high attenuation which suggestive of allergic mucine. We retrospectively review CT of clinically diagnosed 14 ECRS cases to see if CT features of each case fit the criteria or not. The current CT diagnostic criteria of ECRS were proven to be useful to evaluate cases with clinical suspicion of ECRS. (author)

  2. Imaging nuclear medicine techniques for diagnostic evaluation of arterial hypertension

    International Nuclear Information System (INIS)

    Eisenberg, B.M.; Linss, G.

    1989-01-01

    Arterial hypertension may be caused by a malfunction of organs and in turn may lead to secondary organic lesions. Modern diagnostic nuclear medicine is applied for function studies in order to detect or exclude secondary hypertension and functional or perfusion disturbances due to hypertension, or to assess and follow up hemodynamic conditions and cardiac functions prior to and during therapy. The article presents a survey of imaging diagnostic nuclear medicine techniques for the eamination of the heart, the brain, the kidneys and endocrine glands in patients with arterial hypertension, discussing the methods with a view to obtainable information, limits of detection, and indications. (orig.) [de

  3. A Methodology for Anatomic Ultrasound Image Diagnostic Quality Assessment

    DEFF Research Database (Denmark)

    Hemmsen, Martin Christian; Lange, Theis; Brandt, Andreas Hjelm

    2017-01-01

    are presented. Earlier uses of the methodology has shown that it ensures validity of the assessment, as it separates the influences between developer, investigator, and assessor once a research protocol has been established. This separation reduces confounding influences on the result from the developer......This paper discusses methods for assessment of ultrasound image quality based on our experiences with evaluating new methods for anatomic imaging. It presents a methodology to ensure a fair assessment between competing imaging methods using clinically relevant evaluations. The methodology...... to properly reveal the clinical value. The paper exemplifies the methodology using recent studies of Synthetic Aperture Sequential Beamforming tissue harmonic imaging....

  4. Diagnostic value of radiological imaging pre- and post-drainage of pleural effusions.

    Science.gov (United States)

    Corcoran, John P; Acton, Louise; Ahmed, Asia; Hallifax, Robert J; Psallidas, Ioannis; Wrightson, John M; Rahman, Najib M; Gleeson, Fergus V

    2016-02-01

    Patients with an unexplained pleural effusion often require urgent investigation. Clinical practice varies due to uncertainty as to whether an effusion should be drained completely before diagnostic imaging. We performed a retrospective study of patients undergoing medical thoracoscopy for an unexplained effusion. In 110 patients with paired (pre- and post-drainage) chest X-rays and 32 patients with paired computed tomography scans, post-drainage imaging did not provide additional information that would have influenced the clinical decision-making process. © 2015 Asian Pacific Society of Respirology.

  5. Combining a thermal-imaging diagnostic with an existing imaging VISAR diagnostic at the National Ignition Facility (NIF)

    International Nuclear Information System (INIS)

    Robert M, Malone; John R, Celesteb; Peter M, Celliers; Brent C, Froggeta; Robert L, Guyton; Morris I, Kaufman; Tony L, Lee; Brian J, MacGowan; Edmund W, Ng; Imants P, Reinbachs; Ronald B, Robinson; Lynn G, Seppala; Tom W, Tunnell; Phillip W, Watts

    2005-01-01

    Optical diagnostics are currently being designed to analyze high-energy density physics experiments at the National Ignition Facility (NIF). Two independent line-imaging Velocity Interferometer System for Any Reflector (VISAR) interferometers have been fielded to measure shock velocities, breakout times, and emission of targets having sizes of 1-5 mm. An 8-inch-diameter, fused silica triplet lens collects light at f/3 inside the 30-foot-diameter NIF vacuum chamber. VISAR recordings use a 659.5-nm probe laser. By adding a specially coated beam splitter to the interferometer table, light at wavelengths from 540 to 645 nm is spilt into a thermal-imaging diagnostic. Because fused silica lenses are used in the first triplet relay, the intermediate image planes for different wavelengths separate by considerable distances. A corrector lens on the interferometer table reunites these separated wavelength planes to provide a good image. Thermal imaging collects light at f/5 from a 2-mm object placed at Target Chamber Center (TCC). Streak cameras perform VISAR and thermal-imaging recording. All optical lenses are on kinematic mounts so that pointing accuracy of the optical axis may be checked. Counter-propagating laser beams (orange and red) are used to align both diagnostics. The red alignment laser is selected to be at the 50 percent reflection point of the beam splitter. This alignment laser is introduced at the recording streak cameras for both diagnostics and passes through this special beam splitter on its way into the NIF vacuum chamber

  6. Diagnostic imaging of the hand. 3. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Schmitt, Rainer; Lanz, Ulrich

    2015-01-01

    The book on diagnostic imaging of the hand covers the following issues: projection radiography, cinematography, MRT and CR arthrography, arthroscopy, arteriography, skeleton scintiscanning, sonography, computerized tomography, magnetic resonance tomography, anatomy of forearm and carpus, anatomy of metacarpus and fingers, carpal function and morphometry, postoperative X-ray diagnostic, growing hand skeleton, normative variants, malformations and deformities, trauma of the distal forearm, lesions of the ulnocarpal complex (TFCC), scaphoid fractures, scaphoid arthrosis, fractures of other carpus bones, carpal luxations and luxation fractures, carpal instabilities, fractures of the metacarpalla, finger fractures, arthrosis deformans, enthesiopathies, sport induced soft tissue lesions, osteonecrosis, impingement syndromes, osteopenic skeletal diseases, metabolis diseases, crystal-induced osteoarthropaties, rheumatoid arthritis, spondyloarthritis, rheumatic fever, collagenoses, infective arthritis, osteomyelitis, soft tissue infections, cystoids bone lesions, skeletal tumors, soft tissue tumors, carpal tunnel syndrome, nerve compression syndrome, arterial perfusion disturbances, differential diagnostic tables on hand lesions.

  7. Imaging and Data Acquisition in Clinical Trials for Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    FitzGerald, Thomas J., E-mail: Thomas.Fitzgerald@umassmed.edu [Imaging and Radiation Oncology Core Rhode Island, University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Bishop-Jodoin, Maryann [Imaging and Radiation Oncology Core Rhode Island, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Followill, David S. [Imaging and Radiation Oncology Core Houston, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Galvin, James [Imaging and Radiation Oncology Core Philadelphia, Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Knopp, Michael V. [Imaging and Radiation Oncology Core Ohio, Wexner Medical Center, Ohio State University, Columbus, Ohio (United States); Michalski, Jeff M. [Imaging and Radiation Oncology Core St. Louis, Washington University School of Medicine, St. Louis, Missouri (United States); Rosen, Mark A. [Imaging and Radiation Oncology Core Philadelphia, University of Pennsylvania Health System, Philadelphia, Pennsylvania (United States); Bradley, Jeffrey D. [Washington University School of Medicine–Radiation Oncology, St. Louis, Missouri (United States); Shankar, Lalitha K. [National Cancer Institute, Clinical Radiation Oncology Branch, Rockville, Maryland (United States); Laurie, Fran [Imaging and Radiation Oncology Core Rhode Island, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Cicchetti, M. Giulia; Moni, Janaki [Imaging and Radiation Oncology Core Rhode Island, University of Massachusetts Memorial Medical Center, University of Massachusetts Medical School, Worcester, Massachusetts (United States); Coleman, C. Norman; Deye, James A.; Capala, Jacek; Vikram, Bhadrasain [National Cancer Institute, Clinical Radiation Oncology Branch, Rockville, Maryland (United States)

    2016-02-01

    Cancer treatment evolves through oncology clinical trials. Cancer trials are multimodal and complex. Assuring high-quality data are available to answer not only study objectives but also questions not anticipated at study initiation is the role of quality assurance. The National Cancer Institute reorganized its cancer clinical trials program in 2014. The National Clinical Trials Network (NCTN) was formed and within it was established a Diagnostic Imaging and Radiation Therapy Quality Assurance Organization. This organization is Imaging and Radiation Oncology Core, the Imaging and Radiation Oncology Core Group, consisting of 6 quality assurance centers that provide imaging and radiation therapy quality assurance for the NCTN. Sophisticated imaging is used for cancer diagnosis, treatment, and management as well as for image-driven technologies to plan and execute radiation treatment. Integration of imaging and radiation oncology data acquisition, review, management, and archive strategies are essential for trial compliance and future research. Lessons learned from previous trials are and provide evidence to support diagnostic imaging and radiation therapy data acquisition in NCTN trials.

  8. Imaging and Data Acquisition in Clinical Trials for Radiation Therapy

    International Nuclear Information System (INIS)

    FitzGerald, Thomas J.; Bishop-Jodoin, Maryann; Followill, David S.; Galvin, James; Knopp, Michael V.; Michalski, Jeff M.; Rosen, Mark A.; Bradley, Jeffrey D.; Shankar, Lalitha K.; Laurie, Fran; Cicchetti, M. Giulia; Moni, Janaki; Coleman, C. Norman; Deye, James A.; Capala, Jacek; Vikram, Bhadrasain

    2016-01-01

    Cancer treatment evolves through oncology clinical trials. Cancer trials are multimodal and complex. Assuring high-quality data are available to answer not only study objectives but also questions not anticipated at study initiation is the role of quality assurance. The National Cancer Institute reorganized its cancer clinical trials program in 2014. The National Clinical Trials Network (NCTN) was formed and within it was established a Diagnostic Imaging and Radiation Therapy Quality Assurance Organization. This organization is Imaging and Radiation Oncology Core, the Imaging and Radiation Oncology Core Group, consisting of 6 quality assurance centers that provide imaging and radiation therapy quality assurance for the NCTN. Sophisticated imaging is used for cancer diagnosis, treatment, and management as well as for image-driven technologies to plan and execute radiation treatment. Integration of imaging and radiation oncology data acquisition, review, management, and archive strategies are essential for trial compliance and future research. Lessons learned from previous trials are and provide evidence to support diagnostic imaging and radiation therapy data acquisition in NCTN trials.

  9. Implementation of Targeted Next Generation Sequencing in Clinical Diagnostics

    DEFF Research Database (Denmark)

    Larsen, Martin Jakob; Burton, Mark; Thomassen, Mads

    Accurate mutation detection is essential in clinical genetic diagnostics of monogenic hereditary diseases. Targeted next generation sequencing (NGS) provides a promising and cost-effective alternative to Sanger sequencing and MLPA analysis currently used in most diagnostic laboratories. One...... of mutation positive controls previously characterized by Sanger/MLPA analysis. Agilent SureSelect Target-Enrichment kits were used for capturing a set of genes associated with hereditary breast and ovarian cancer syndrome and a compilation of genes involved in multiple rare single gene disorders......, respectively. For diagnostics, the sequencing coverage is essential, wherefore a minimum coverage of 30x per nucleotide in the coding regions was used as our primary quality criterion. For the majority of the included genes, we obtained adequate gene coverage, in which we were able to detect 100% of the known...

  10. Brain imaging with synthetic MR in children: clinical quality assessment

    Energy Technology Data Exchange (ETDEWEB)

    Betts, Aaron M.; Serai, Suraj [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Leach, James L.; Jones, Blaise V. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); University of Cincinnati College of Medicine, Cincinnati, OH (United States); Zhang, Bin [Cincinnati Children' s Hospital Medical Center, Biostatistics and Epidemiology, Cincinnati, OH (United States)

    2016-10-15

    Synthetic magnetic resonance imaging is a quantitative imaging technique that measures inherent T1-relaxation, T2-relaxation, and proton density. These inherent tissue properties allow synthesis of various imaging sequences from a single acquisition. Clinical use of synthetic MR imaging has been described in adult populations. However, use of synthetic MR imaging has not been previously reported in children. The purpose of this study is to report our assessment of diagnostic image quality using synthetic MR imaging in children. Synthetic MR acquisition was obtained in a sample of children undergoing brain MR imaging. Image quality assessments were performed on conventional and synthetic T1-weighted, T2-weighted, and FLAIR images. Standardized linear measurements were performed on conventional and synthetic T2 images. Estimates of patient age based upon myelination patterns were also performed. Conventional and synthetic MR images were evaluated on 30 children. Using a 4-point assessment scale, conventional imaging performed better than synthetic imaging for T1-weighted, T2-weighted, and FLAIR images. When the assessment was simplified to a dichotomized scale, the conventional and synthetic T1-weighted and T2-weighted images performed similarly. However, the superiority of conventional FLAIR images persisted in the dichotomized assessment. There were no statistically significant differences between linear measurements made on T2-weighted images. Estimates of patient age based upon pattern of myelination were also similar between conventional and synthetic techniques. Synthetic MR imaging may be acceptable for clinical use in children. However, users should be aware of current limitations that could impact clinical utility in the software version used in this study. (orig.)

  11. Synthetic Microwave Imaging Reflectometry diagnostic using 3D FDTD Simulations

    Science.gov (United States)

    Kruger, Scott; Jenkins, Thomas; Smithe, David; King, Jacob; Nimrod Team Team

    2017-10-01

    Microwave Imaging Reflectometry (MIR) has become a standard diagnostic for understanding tokamak edge perturbations, including the edge harmonic oscillations in QH mode operation. These long-wavelength perturbations are larger than the normal turbulent fluctuation levels and thus normal analysis of synthetic signals become more difficult. To investigate, we construct a synthetic MIR diagnostic for exploring density fluctuation amplitudes in the tokamak plasma edge by using the three-dimensional, full-wave FDTD code Vorpal. The source microwave beam for the diagnostic is generated and refelected at the cutoff surface that is distorted by 2D density fluctuations in the edge plasma. Synthetic imaging optics at the detector can be used to understand the fluctuation and background density profiles. We apply the diagnostic to understand the fluctuations in edge plasma density during QH-mode activity in the DIII-D tokamak, as modeled by the NIMROD code. This work was funded under DOE Grant Number DE-FC02-08ER54972.

  12. A Versatile Image Processor For Digital Diagnostic Imaging And Its Application In Computed Radiography

    Science.gov (United States)

    Blume, H.; Alexandru, R.; Applegate, R.; Giordano, T.; Kamiya, K.; Kresina, R.

    1986-06-01

    In a digital diagnostic imaging department, the majority of operations for handling and processing of images can be grouped into a small set of basic operations, such as image data buffering and storage, image processing and analysis, image display, image data transmission and image data compression. These operations occur in almost all nodes of the diagnostic imaging communications network of the department. An image processor architecture was developed in which each of these functions has been mapped into hardware and software modules. The modular approach has advantages in terms of economics, service, expandability and upgradeability. The architectural design is based on the principles of hierarchical functionality, distributed and parallel processing and aims at real time response. Parallel processing and real time response is facilitated in part by a dual bus system: a VME control bus and a high speed image data bus, consisting of 8 independent parallel 16-bit busses, capable of handling combined up to 144 MBytes/sec. The presented image processor is versatile enough to meet the video rate processing needs of digital subtraction angiography, the large pixel matrix processing requirements of static projection radiography, or the broad range of manipulation and display needs of a multi-modality diagnostic work station. Several hardware modules are described in detail. For illustrating the capabilities of the image processor, processed 2000 x 2000 pixel computed radiographs are shown and estimated computation times for executing the processing opera-tions are presented.

  13. Fear of knowledge: Clinical hypotheses in diagnostic and prognostic reasoning.

    Science.gov (United States)

    Chiffi, Daniele; Zanotti, Renzo

    2017-10-01

    Patients are interested in receiving accurate diagnostic and prognostic information. Models and reasoning about diagnoses have been extensively investigated from a foundational perspective; however, for all its importance, prognosis has yet to receive a comparable degree of philosophical and methodological attention, and this may be due to the difficulties inherent in accurate prognostics. In the light of these considerations, we discuss a considerable body of critical thinking on the topic of prognostication and its strict relations with diagnostic reasoning, pointing out the distinction between nosographic and pathophysiological types of diagnosis and prognosis, underlying the importance of the explication and explanation processes. We then distinguish between various forms of hypothetical reasoning applied to reach diagnostic and prognostic judgments, comparing them with specific forms of abductive reasoning. The main thesis is that creative abduction regarding clinical hypotheses in diagnostic process is very unlikely to occur, whereas this seems to be often the case for prognostic judgments. The reasons behind this distinction are due to the different types of uncertainty involved in diagnostic and prognostic judgments. © 2016 John Wiley & Sons, Ltd.

  14. Software for 3D diagnostic image reconstruction and analysis

    International Nuclear Information System (INIS)

    Taton, G.; Rokita, E.; Sierzega, M.; Klek, S.; Kulig, J.; Urbanik, A.

    2005-01-01

    Recent advances in computer technologies have opened new frontiers in medical diagnostics. Interesting possibilities are the use of three-dimensional (3D) imaging and the combination of images from different modalities. Software prepared in our laboratories devoted to 3D image reconstruction and analysis from computed tomography and ultrasonography is presented. In developing our software it was assumed that it should be applicable in standard medical practice, i.e. it should work effectively with a PC. An additional feature is the possibility of combining 3D images from different modalities. The reconstruction and data processing can be conducted using a standard PC, so low investment costs result in the introduction of advanced and useful diagnostic possibilities. The program was tested on a PC using DICOM data from computed tomography and TIFF files obtained from a 3D ultrasound system. The results of the anthropomorphic phantom and patient data were taken into consideration. A new approach was used to achieve spatial correlation of two independently obtained 3D images. The method relies on the use of four pairs of markers within the regions under consideration. The user selects the markers manually and the computer calculates the transformations necessary for coupling the images. The main software feature is the possibility of 3D image reconstruction from a series of two-dimensional (2D) images. The reconstructed 3D image can be: (1) viewed with the most popular methods of 3D image viewing, (2) filtered and processed to improve image quality, (3) analyzed quantitatively (geometrical measurements), and (4) coupled with another, independently acquired 3D image. The reconstructed and processed 3D image can be stored at every stage of image processing. The overall software performance was good considering the relatively low costs of the hardware used and the huge data sets processed. The program can be freely used and tested (source code and program available at

  15. Diagnostic Imaging of Reproductive Tract Disorders in Reptiles.

    Science.gov (United States)

    Gumpenberger, Michaela

    2017-05-01

    Diagnostic imaging of the reproductive tract in reptiles is used for gender determination, evaluation of breeding status, detection of pathologic changes, and supervising treatment. Whole-body radiographs provide an overview and support detection of mineralized egg shells. Sonography is used to evaluate follicles, nonmineralized eggs, and the salpinx in all reptiles. Computed tomography is able to overcome imaging limitations in chelonian species. This article provides detailed information about the performance of different imaging techniques. Multiple images demonstrate the physiologic appearance of the male and female reproductive tract in various reptile species and pathologic changes. Advantages and disadvantages of radiography, sonography, and computed tomography are described. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Diagnostic radiology of apoplexy - imaging of cerebral ischemia

    International Nuclear Information System (INIS)

    Rieber, A.; Tomczak, R.; Brambs, H.J.

    1998-01-01

    The recent enhancements achieved in CT and MR imaging techniques have launched a debate about the techniques preferrably to be applied for diagnostic evaluation of acute cerebral stroke. At present, CT still is the modality of choice for primary evaluation of cerebral ischemia, due to relative cost-effectiveness, high availability, and the capability to reliably differentiate ischemia from hemorrhage. MRI on the other hand is superior to CT in detecting and imaging the infarction area within the first few hours, especially if the technique of diffusion-weighted sequencing is applied. Current research focuses on determining whether MRI with perfusion and diffusion-weighted sequencing will yield images distinctly showing the penumbra on the one hand, and the damaged brain tissue on the other. It remains to be seen whether improved tomographic imaging will lead to novel approaches for therapy. (orig./CB) [de

  17. Traumatic cervical root injury: Diagnostic value of MR imaging

    International Nuclear Information System (INIS)

    Lee, Seon Kyu; Chang, Kee Hyun; Han, Moon Hee; Kim, Ho Chul; Kim, Jea Seung; Cha, Sang Hoon

    1993-01-01

    Although superior soft tissue contrast and direct multiplanar imaging capability of MRI are well recognized, myelography has been the imaging modality of choice in evaluation cervical root injury. We assessed the role of MRI and compared its diagnostic accuracy with myelography in the evaluation of cervical root injury. MR imagings of cervical root injury in ten patients (55 roots) were retrospectively reviewed. In 26 explored roots (6 patients). MR findings were compared with myelography and surgical results. In 29 roots (8 patients), which were confirmed by myelography or exploration, the MR findings were focal extradural CSF collections (pseudomeningocele) in 21/29 (72.4%, 8 patients), thickening of extradural roots in 4/29 (13.6%, 5 patients), and thickening of dura in 12/29 (41.4%, 6 patients) roots. T2-weighted axial image was superior to T1-weighted and protein-density- weighted images for delineation root avulsion. The sensitivity and specificity of MRI were 72.7% and 93.3% respectively, while those of myelography were 83% and 90%. Overall diagnostic accuracy of MRI and myelography were comparable (84.6% vs 87.5%). In conclusion, myelography is still considered as the modality of choice in the preoperative evaluation of the cervical root avulsion because of its higher sensitivity. MRI, however, may obviate the myelography with some technical refinements

  18. Parkinson's disease: diagnostic utility of volumetric imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Wei-Che; Chen, Meng-Hsiang [Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Diagnostic Radiology, Kaohsiung (China); Chou, Kun-Hsien [National Yang-Ming University, Brain Research Center, Taipei (China); Lee, Pei-Lin [National Yang-Ming University, Department of Biomedical Imaging and Radiological Sciences, Taipei (China); Tsai, Nai-Wen; Lu, Cheng-Hsien [Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Neurology, Kaohsiung (China); Chen, Hsiu-Ling [Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Diagnostic Radiology, Kaohsiung (China); National Yang-Ming University, Department of Biomedical Imaging and Radiological Sciences, Taipei (China); Hsu, Ai-Ling [National Taiwan University, Institute of Biomedical Electronics and Bioinformatics, Taipei (China); Huang, Yung-Cheng [Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Nuclear Medicine, Kaohsiung (China); Lin, Ching-Po [National Yang-Ming University, Brain Research Center, Taipei (China); National Yang-Ming University, Department of Biomedical Imaging and Radiological Sciences, Taipei (China)

    2017-04-15

    This paper aims to examine the effectiveness of structural imaging as an aid in the diagnosis of Parkinson's disease (PD). High-resolution T{sub 1}-weighted magnetic resonance imaging was performed in 72 patients with idiopathic PD (mean age, 61.08 years) and 73 healthy subjects (mean age, 58.96 years). The whole brain was parcellated into 95 regions of interest using composite anatomical atlases, and region volumes were calculated. Three diagnostic classifiers were constructed using binary multiple logistic regression modeling: the (i) basal ganglion prior classifier, (ii) data-driven classifier, and (iii) basal ganglion prior/data-driven hybrid classifier. Leave-one-out cross validation was used to unbiasedly evaluate the predictive accuracy of imaging features. Pearson's correlation analysis was further performed to correlate outcome measurement using the best PD classifier with disease severity. Smaller volume in susceptible regions is diagnostic for Parkinson's disease. Compared with the other two classifiers, the basal ganglion prior/data-driven hybrid classifier had the highest diagnostic reliability with a sensitivity of 74%, specificity of 75%, and accuracy of 74%. Furthermore, outcome measurement using this classifier was associated with disease severity. Brain structural volumetric analysis with multiple logistic regression modeling can be a complementary tool for diagnosing PD. (orig.)

  19. Development of an EMC3-EIRENE Synthetic Imaging Diagnostic

    Science.gov (United States)

    Meyer, William; Allen, Steve; Samuell, Cameron; Lore, Jeremy

    2017-10-01

    2D and 3D flow measurements are critical for validating numerical codes such as EMC3-EIRENE. Toroidal symmetry assumptions preclude tomographic reconstruction of 3D flows from single camera views. In addition, the resolution of the grids utilized in numerical code models can easily surpass the resolution of physical camera diagnostic geometries. For these reasons we have developed a Synthetic Imaging Diagnostic capability for forward projection comparisons of EMC3-EIRENE model solutions with the line integrated images from the Doppler Coherence Imaging diagnostic on DIII-D. The forward projection matrix is 2.8 Mpixel by 6.4 Mcells for the non-axisymmetric case we present. For flow comparisons, both simple line integral, and field aligned component matrices must be calculated. The calculation of these matrices is a massive embarrassingly parallel problem and performed with a custom dispatcher that allows processing platforms to join mid-problem as they become available, or drop out if resources are needed for higher priority tasks. The matrices are handled using standard sparse matrix techniques. Prepared by LLNL under Contract DE-AC52-07NA27344. This material is based upon work supported by the U.S. DOE, Office of Science, Office of Fusion Energy Sciences. LLNL-ABS-734800.

  20. Dose and diagnostic image quality in digital tomosynthesis imaging of facial bones in pediatrics

    Science.gov (United States)

    King, J. M.; Hickling, S.; Elbakri, I. A.; Reed, M.; Wrogemann, J.

    2011-03-01

    The purpose of this study was to evaluate the use of digital tomosynthesis (DT) for pediatric facial bone imaging. We compared the eye lens dose and diagnostic image quality of DT facial bone exams relative to digital radiography (DR) and computed tomography (CT), and investigated whether we could modify our current DT imaging protocol to reduce patient dose while maintaining sufficient diagnostic image quality. We measured the dose to the eye lens for all three modalities using high-sensitivity thermoluminescent dosimeters (TLDs) and an anthropomorphic skull phantom. To assess the diagnostic image quality of DT compared to the corresponding DR and CT images, we performed an observer study where the visibility of anatomical structures in the DT phantom images were rated on a four-point scale. We then acquired DT images at lower doses and had radiologists indicate whether the visibility of each structure was adequate for diagnostic purposes. For typical facial bone exams, we measured eye lens doses of 0.1-0.4 mGy for DR, 0.3-3.7 mGy for DT, and 26 mGy for CT. In general, facial bone structures were visualized better with DT then DR, and the majority of structures were visualized well enough to avoid the need for CT. DT imaging provides high quality diagnostic images of the facial bones while delivering significantly lower doses to the lens of the eye compared to CT. In addition, we found that by adjusting the imaging parameters, the DT effective dose can be reduced by up to 50% while maintaining sufficient image quality.

  1. Innovation in diagnostic imaging services: assessing the potential for value-based reimbursement.

    Science.gov (United States)

    Garrison, Louis P; Bresnahan, Brian W; Higashi, Mitchell K; Hollingworth, William; Jarvik, Jeffrey G

    2011-09-01

    Innovation in the field of diagnostic imaging is based primarily on the availability of new and improved equipment that opens the door for new clinical applications. Payments for these imaging procedures are subject to complex Medicare price control schemes, affecting incentives for appropriate use and innovation. Achieving a "dynamically efficient" health care system-one that elicits a socially optimal amount of innovation-requires that innovators be rewarded in relation to the value they add and can demonstrate with evidence. The authors examine how and whether value-based reimbursement for diagnostic imaging services might better reward innovation explicitly for expected improvements in health and economic outcomes. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

  2. Diagnostic imaging of the equine tarsal region using radiography and ultrasonography. Part 1: the soft tissues.

    Science.gov (United States)

    Vanderperren, Katrien; Raes, Els; Hoegaerts, Michel; Saunders, Jimmy H

    2009-02-01

    The equine tarsus is the most commonly affected hindlimb region associated with lameness. Diagnostic imaging is routinely applied but because of its complexity, being composed of 10 multifaceted bones and different joints, multiple ligaments, tendons and bursae, imaging this region can be a challenge. This is the first part of a two-part review of the structures and disorders of the equine tarsus. It describes the principal disorders affecting the soft tissues of the tarsal region and addresses some of the technical aspects in taking radiographic, ultrasonographic and scintigraphic images of the different soft tissue lesions. Where applicable, comments on the diagnostic use of contrast radiography, arthroscopy and tenoscopy are made. In current clinical practice a combination of radiography and ultrasonography is still most frequently used to arrive at a diagnosis.

  3. Balloon-assisted enteroscopy for suspected Meckel’s diverticulum and indefinite diagnostic imaging workup

    Science.gov (United States)

    Gomes, Guilherme Francisco; Bonin, Eduardo Aimore; Noda, Rafael William; Cavazzola, Leandro Totti; Bartholomei, Thiago Ferreira

    2016-01-01

    Meckel’s diverticulum (MD) is estimated to affect 1%-2% of the general population, and it represents a clinically silent finding of a congenital anomaly in up to 85% of the cases. In adults, MD may cause symptoms, such as overt occult lower gastrointestinal bleeding. The diagnostic imaging workup includes computed tomography scan, magnetic resonance imaging enterography, technetium 99m scintigraphy (99mTc) using either labeled red blood cells or pertechnetate (known as the Meckel’s scan) and angiography. The preoperative detection rate of MD in adults is low, and many patients ultimately undergo exploratory laparoscopy. More recently, however, endoscopic identification of MD has been possible with the use of balloon-assisted enteroscopy via direct luminal access, which also provides visualization of the diverticular ostium. The aim of this study was to review the diagnosis by double-balloon enteroscopy of 4 adults with symptomatic MD but who had negative diagnostic imaging workups. These cases indicate that balloon-assisted enteroscopy is a valuable diagnostic method and should be considered in adult patients who have suspected MD and indefinite findings on diagnostic imaging workup, including negative Meckel’s scan. PMID:27803776

  4. Predicting diagnostic error in Radiology via eye-tracking and image analytics: Application in mammography

    Energy Technology Data Exchange (ETDEWEB)

    Voisin, Sophie [ORNL; Pinto, Frank M [ORNL; Morin-Ducote, Garnetta [University of Tennessee, Knoxville (UTK); Hudson, Kathy [University of Tennessee, Knoxville (UTK); Tourassi, Georgia [ORNL

    2013-01-01

    Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels. Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from 4 Radiology residents and 2 breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADs images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated. Results: Diagnostic error can be predicted reliably by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model (AUC=0.79). Personalized user modeling was far more accurate for the more experienced readers (average AUC of 0.837 0.029) than for the less experienced ones (average AUC of 0.667 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features. Conclusions: Diagnostic errors in mammography can be predicted reliably by leveraging the radiologists gaze behavior and image content.

  5. Predicting diagnostic error in radiology via eye-tracking and image analytics: Preliminary investigation in mammography

    Energy Technology Data Exchange (ETDEWEB)

    Voisin, Sophie; Tourassi, Georgia D. [Biomedical Science and Engineering Center, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 (United States); Pinto, Frank [School of Engineering, Science, and Technology, Virginia State University, Petersburg, Virginia 23806 (United States); Morin-Ducote, Garnetta; Hudson, Kathleen B. [Department of Radiology, University of Tennessee Medical Center at Knoxville, Knoxville, Tennessee 37920 (United States)

    2013-10-15

    Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists’ gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels.Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from four Radiology residents and two breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADS images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated.Results: Machine learning can be used to predict diagnostic error by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model [area under the ROC curve (AUC) = 0.792 ± 0.030]. Personalized user modeling was far more accurate for the more experienced readers (AUC = 0.837 ± 0.029) than for the less experienced ones (AUC = 0.667 ± 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features.Conclusions: Diagnostic errors in mammography can be predicted to a good extent by leveraging the radiologists’ gaze behavior and image content.

  6. Predicting diagnostic error in radiology via eye-tracking and image analytics: Preliminary investigation in mammography

    International Nuclear Information System (INIS)

    Voisin, Sophie; Tourassi, Georgia D.; Pinto, Frank; Morin-Ducote, Garnetta; Hudson, Kathleen B.

    2013-01-01

    Purpose: The primary aim of the present study was to test the feasibility of predicting diagnostic errors in mammography by merging radiologists’ gaze behavior and image characteristics. A secondary aim was to investigate group-based and personalized predictive models for radiologists of variable experience levels.Methods: The study was performed for the clinical task of assessing the likelihood of malignancy of mammographic masses. Eye-tracking data and diagnostic decisions for 40 cases were acquired from four Radiology residents and two breast imaging experts as part of an IRB-approved pilot study. Gaze behavior features were extracted from the eye-tracking data. Computer-generated and BIRADS images features were extracted from the images. Finally, machine learning algorithms were used to merge gaze and image features for predicting human error. Feature selection was thoroughly explored to determine the relative contribution of the various features. Group-based and personalized user modeling was also investigated.Results: Machine learning can be used to predict diagnostic error by merging gaze behavior characteristics from the radiologist and textural characteristics from the image under review. Leveraging data collected from multiple readers produced a reasonable group model [area under the ROC curve (AUC) = 0.792 ± 0.030]. Personalized user modeling was far more accurate for the more experienced readers (AUC = 0.837 ± 0.029) than for the less experienced ones (AUC = 0.667 ± 0.099). The best performing group-based and personalized predictive models involved combinations of both gaze and image features.Conclusions: Diagnostic errors in mammography can be predicted to a good extent by leveraging the radiologists’ gaze behavior and image content

  7. Automatic volumetry on MR brain images can support diagnostic decision making

    Directory of Open Access Journals (Sweden)

    Aviv Richard I

    2008-05-01

    Full Text Available Abstract Background Diagnostic decisions in clinical imaging currently rely almost exclusively on visual image interpretation. This can lead to uncertainty, for example in dementia disease, where some of the changes resemble those of normal ageing. We hypothesized that extracting volumetric data from patients' MR brain images, relating them to reference data and presenting the results as a colour overlay on the grey scale data would aid diagnostic readers in classifying dementia disease versus normal ageing. Methods A proof-of-concept forced-choice reader study was designed using MR brain images from 36 subjects. Images were segmented into 43 regions using an automatic atlas registration-based label propagation procedure. Seven subjects had clinically probable AD, the remaining 29 of a similar age range were used as controls. Seven of the control subject data sets were selected at random to be presented along with the seven AD datasets to two readers, who were blinded to all clinical and demographic information except age and gender. Readers were asked to review the grey scale MR images and to record their choice of diagnosis (AD or non-AD along with their confidence in this decision. Afterwards, readers were given the option to switch on a false-colour overlay representing the relative size of the segmented structures. Colorization was based on the size rank of the test subject when compared with a reference group consisting of the 22 control subjects who were not used as review subjects. The readers were then asked to record whether and how the additional information had an impact on their diagnostic confidence. Results The size rank colour overlays were useful in 18 of 28 diagnoses, as determined by their impact on readers' diagnostic confidence. A not useful result was found in 6 of 28 cases. The impact of the additional information on diagnostic confidence was significant (p Conclusion Volumetric anatomical information extracted from brain

  8. Textile foreign body in a Green Iguana (Iguana iguana): Diagnostic imaging for localisation.

    Science.gov (United States)

    Lebens, M; Länger, B; Günther, P; Fehr, M; Mathes, K A

    2016-11-01

    This case report includes different diagnostic imaging methods for localization of textile foreign bodies in reptiles and shows the limitations and advantages of these methods. A six-year-old, male, green iguana was presented to our clinic after ingesting a sock 5 days earlier. Ultrasound, contrast x-ray, computed tomography and endoscopy were used to locate the foreign body before surgery. Attempts to remove the sock endoscopically failed. The sock was surgically removed via celiotomy and enterotomy.

  9. Clinical image quality evaluation for panoramic radiography in Korean dental clinics

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Ram; Choi, Da Hye; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Choi, Soon Chul; Bae, Kwang Hak; Lee, Sam Sun [School of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    2012-09-15

    The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

  10. MDS clinical diagnostic criteria for Parkinson's disease in China.

    Science.gov (United States)

    Li, Jun; Jin, Miao; Wang, Li; Qin, Bin; Wang, Kang

    2017-03-01

    The Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (MDS-PD Criteria) was introduced by the Movement Disorder Society in 2015 for research purposes. However, its use for clinical diagnosis of Parkinson disease still needs further revision. This study compares the UK-Criteria versus MDS-PD Criteria in the clinical diagnosis of Parkinson disease referred to the China-Japan Friendship Hospital of Beijing, China. To compare the MDS-PD Criteria with the UK-Criteria and discuss the feasibility of the clinical application of MDS-PD Criteria as a general guide to clinical diagnosis of PD in Chinese PD patients. 150 patients of neurology clinic of China-Japan Friendship Hospital of Beijing were recruited in our research. They were divided into three groups: UK-Criteria group, MDS-PD Criteria group and a combined group of UK and MDS-PD Criteria. Clinical history was collected while physical and auxiliary examinations were done by a trained neurologist according to the corresponding criteria. An interrater reliability analysis using the Kappa statistic claimed substantial agreement (κ = 0.626) between the MDS-PD Criteria and the UK-Criteria. The differences between the diagnostic results of these two criteria were statistically significant by paired Chi-square test (p = 0.000). It was found that levodopa-induced dyskinesia had a good positive predictive value, while early bulbar impairment and inspiratory dysfunction presented a negative predictive value. The MDS-PD Criteria emphasize the importance of non-motor symptoms, keeping the motor symptoms as the core for the clinical diagnosis of PD, and establish categories of diagnosis features and levels of certainty which are more complete and organized to be used and replicated by non specialized physicians to evaluated patients with Parkinsonism. The higher sensitivity of MDS-PD Criteria compared with UK-Criteria is worth being widely used in clinical work.

  11. Image-guided pleural biopsy: diagnostic yield and complications

    International Nuclear Information System (INIS)

    Benamore, R.E.; Scott, K.; Richards, C.J.; Entwisle, J.J.

    2006-01-01

    Background: Pleural biopsy and cytology are standard procedures for the investigation of pleural disease. Recent medical literature has suggested that image-guided pleural biopsy shows improved sensitivity for the diagnosis of pleural malignancy, when compared with the more commonly performed reverse bevel needle biopsy such as Abrams' needle. In our centre there has been an increasing trend towards performing image-guided pleural biopsies, and to our knowledge there is no large published series documenting the complication rate and diagnostic yield. Methods: The radiology and pathology databases were searched for all image-guided [computed tomography (CT) and ultrasound (US)] pleural biopsies from January 2001 to December 2004. All imaging and histology were reviewed, and final diagnostic information about patients was obtained from the respiratory multidisciplinary team database and patient notes. A record was made of complications following biopsy, presence of pleura in the biopsy, and adequacy of tissue for histological diagnosis. Results: A total of 82 patients underwent 85 image-guided pleural biopsies over a 4-year period. 80 cases were performed under CT and five under US guidance. The rate of new pneumothorax detected by chest radiography was 4.7%. No patient required a chest drain or blood transfusion to treat complications. In 10 (12%) cases, there was inadequate tissue to reach a confident histological diagnosis and in eight (9%) of these, no pleura was present. Assuming all suspicious and inadequate biopsies are treated as benign, which is the worst case scenario, image-guided pleural biopsy has a sensitivity and specificity of 76% and 100%, respectively, for the diagnosis of malignant disease. Conclusions: Image-guided pleural biopsy is a safe procedure with few associated complications and has a higher sensitivity than previously published series for reverse cutting needle biopsy in the diagnosis of malignant pleural disease

  12. Image-guided pleural biopsy: diagnostic yield and complications

    Energy Technology Data Exchange (ETDEWEB)

    Benamore, R.E. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom)]. E-mail: rachelbenamore@doctors.org.uk; Scott, K. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom); Richards, C.J. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom); Entwisle, J.J. [Department of Radiology and Department of Histopathology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester (United Kingdom)

    2006-08-15

    Background: Pleural biopsy and cytology are standard procedures for the investigation of pleural disease. Recent medical literature has suggested that image-guided pleural biopsy shows improved sensitivity for the diagnosis of pleural malignancy, when compared with the more commonly performed reverse bevel needle biopsy such as Abrams' needle. In our centre there has been an increasing trend towards performing image-guided pleural biopsies, and to our knowledge there is no large published series documenting the complication rate and diagnostic yield. Methods: The radiology and pathology databases were searched for all image-guided [computed tomography (CT) and ultrasound (US)] pleural biopsies from January 2001 to December 2004. All imaging and histology were reviewed, and final diagnostic information about patients was obtained from the respiratory multidisciplinary team database and patient notes. A record was made of complications following biopsy, presence of pleura in the biopsy, and adequacy of tissue for histological diagnosis. Results: A total of 82 patients underwent 85 image-guided pleural biopsies over a 4-year period. 80 cases were performed under CT and five under US guidance. The rate of new pneumothorax detected by chest radiography was 4.7%. No patient required a chest drain or blood transfusion to treat complications. In 10 (12%) cases, there was inadequate tissue to reach a confident histological diagnosis and in eight (9%) of these, no pleura was present. Assuming all suspicious and inadequate biopsies are treated as benign, which is the worst case scenario, image-guided pleural biopsy has a sensitivity and specificity of 76% and 100%, respectively, for the diagnosis of malignant disease. Conclusions: Image-guided pleural biopsy is a safe procedure with few associated complications and has a higher sensitivity than previously published series for reverse cutting needle biopsy in the diagnosis of malignant pleural disease.

  13. Clinical impact of diagnostic SPET investigations with a dopamine re-uptake ligand

    International Nuclear Information System (INIS)

    Loekkegaard, Annemette; Werdelin, Lene M.; Friberg, Lars

    2002-01-01

    The diagnosis of Parkinson's disease is based on clinical features with pathological verification. However, autopsy has been found to confirm a specialist diagnosis in only about 75% of cases. Especially early in the course of the disease, the clinical diagnosis can be difficult. Imaging of presynaptic dopamine transporters (DAT receptors) has provided a possible diagnostic probe in the evaluation of Parkinson's disease. The cocaine analogue [ 123 I]-2-β-carboxymethoxy-3-β(4-iodophenyl)tropane ([ 123 I]-β-CIT) is one of several radioligands that have been developed for single-photon emission tomography (SPET). The purpose of this study was to evaluate the impact of [ 123 I]-β-CIT SPET on the diagnosis and clinical management of patients with a primary, tentative diagnosis of parkinsonism. We undertook a retrospective evaluation of the clinical records of 90 consecutive patients referred to [ 123 I]-β-CIT SPET from the neurological department, Bispebjerg Hospital. In 58 subjects the scans revealed altered tracer uptake consistent with Parkinson's disease, progressive supranuclear palsy and multiple system atrophy. A significant change in the management or treatment because of the scan was found in 25 patients (28%). The sensitivity of the examination was 97% and the specificity 83%. In conclusion, a significant clinical impact of DAT receptor SPET imaging was found. DAT receptor imaging is a useful diagnostic probe in patients with a possible diagnosis of parkinsonism. (orig.)

  14. Ulnar-sided wrist pain. II. Clinical imaging and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Atsuya; Souza, Felipe [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Vezeridis, Peter S.; Blazar, Philip [Brigham and Women' s Hospital, Department of Orthopaedic Surgery, Boston, MA (United States); Yoshioka, Hiroshi [Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); University of California-Irvine, Department of Radiological Sciences, Irvine, CA (United States); UC Irvine Medical Center, Department of Radiological Sciences, Orange, CA (United States)

    2010-09-15

    Pain at the ulnar aspect of the wrist is a diagnostic challenge for hand surgeons and radiologists due to the small and complex anatomical structures involved. In this article, imaging modalities including radiography, arthrography, ultrasound (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography are compared with regard to differential diagnosis. Clinical imaging findings are reviewed for a more comprehensive understanding of this disorder. Treatments for the common diseases that cause the ulnar-sided wrist pain including extensor carpi ulnaris (ECU) tendonitis, flexor carpi ulnaris (FCU) tendonitis, pisotriquetral arthritis, triangular fibrocartilage complex (TFCC) lesions, ulnar impaction, lunotriquetral (LT) instability, and distal radioulnar joint (DRUJ) instability are reviewed. (orig.)

  15. Diagnostic value of sectional images obtained by emission tomography

    International Nuclear Information System (INIS)

    Roucayrol, J.C.

    1981-01-01

    It is now possible to obtain clear images of the various planes in and around a structure with ultra-sounds (echotomography), X-rays (computerized tomography) and recently, gamma-rays from radioactive substances (emission tomography). Axial transverse tomography, which is described here, is to conventional scintigraphy what CT scan is to radiography. It provides images of any structure capable of concentrating sufficiently a radioactive substance administered intravenously. These images are perpendicular to the longitudinal axis of the body. As shown by examples in the liver, lungs and myocardium, lesions which had passed unnoticed with other exploratory techniques can now be demonstrated, and the location, shape and extension of known lesions can be more accurately assessed. Emission tomography already has its place in modern diagnostic procedures side by side with echotomography and CT scan [fr

  16. Diagnostic Performance of Three Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Hyun Woo; Paeng, Jin Chul; Nahm, Francins Sahngun; Kim, Seog Gyun; Zehra, Tanzeel; Oh, So Won; Lee, Hyo Sang; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2011-12-15

    Although the three phase bone scan (TBPS) is one of the widely used imaging studies for diagnosing complex regional pain syndrome type 1 (CRPS 1), there is some controversy regarding the TPBS image criteria for CRPS 1. In this study, we modified the image criteria using image pattern and quantitative analysis in the patients diagnosed using the most recent consensus clinical diagnostic criteria. The study included 140 patients with suspected CRPS 1 (CRPS 1, n=79; non CRPS, n=61; mean age 39{+-}15 years) who underwent TPBS. The clinical diagnostic criteria for CRPS 1 revised by the Budapest consensus group were used for confirmative diagnosis. Patients were classified according to flow/pool and delayed uptake (DU) image patterns, and the time interval between the initiating event and TPBS (TI{sup eventscan)}. Quantitative analysis for lesion to contralateral ratio (LCR) was performed. Modified TPBS image criteria were created and evaluated for optimal diagnostic performance. Both increased and decreased periarticular DU were significant image findings for CRPS 1 (CRPS 1 positive rate=73% in the increased DU group, 75% in the decreased DU group). The TI{sup eventscand}id not differ significantly between the different image pattern groups. Quantitative analysis revealed an LCR of 1.43 was the optimal cutoff value for CRPS 1 and diagnostic performance was significantly improved in the increased DU group (area under the curve=0.732). Given the modified image criteria, the sensitivity and specificity of TPBS for diagnosing CRPS 1 were 80% and 72%, respectively. Optimally modified TPBS image criteria for CRPS 1 were suggested using image pattern and quantitative analysis. With the criteria, TPBS is an effective imaging study for CRPS 1 even with the most recent consensus clinical diagnostic criteria.

  17. Diagnostic Performance of Three Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

    International Nuclear Information System (INIS)

    Kwon, Hyun Woo; Paeng, Jin Chul; Nahm, Francins Sahngun; Kim, Seog Gyun; Zehra, Tanzeel; Oh, So Won; Lee, Hyo Sang; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo

    2011-01-01

    Although the three phase bone scan (TBPS) is one of the widely used imaging studies for diagnosing complex regional pain syndrome type 1 (CRPS 1), there is some controversy regarding the TPBS image criteria for CRPS 1. In this study, we modified the image criteria using image pattern and quantitative analysis in the patients diagnosed using the most recent consensus clinical diagnostic criteria. The study included 140 patients with suspected CRPS 1 (CRPS 1, n=79; non CRPS, n=61; mean age 39±15 years) who underwent TPBS. The clinical diagnostic criteria for CRPS 1 revised by the Budapest consensus group were used for confirmative diagnosis. Patients were classified according to flow/pool and delayed uptake (DU) image patterns, and the time interval between the initiating event and TPBS (TI eventscan) . Quantitative analysis for lesion to contralateral ratio (LCR) was performed. Modified TPBS image criteria were created and evaluated for optimal diagnostic performance. Both increased and decreased periarticular DU were significant image findings for CRPS 1 (CRPS 1 positive rate=73% in the increased DU group, 75% in the decreased DU group). The TI eventscand id not differ significantly between the different image pattern groups. Quantitative analysis revealed an LCR of 1.43 was the optimal cutoff value for CRPS 1 and diagnostic performance was significantly improved in the increased DU group (area under the curve=0.732). Given the modified image criteria, the sensitivity and specificity of TPBS for diagnosing CRPS 1 were 80% and 72%, respectively. Optimally modified TPBS image criteria for CRPS 1 were suggested using image pattern and quantitative analysis. With the criteria, TPBS is an effective imaging study for CRPS 1 even with the most recent consensus clinical diagnostic criteria.

  18. Prostate cancer diagnostics: Clinical challenges and the ongoing need for disruptive and effective diagnostic tools.

    Science.gov (United States)

    Sharma, Shikha; Zapatero-Rodríguez, Julia; O'Kennedy, Richard

    The increased incidence and the significant health burden associated with carcinoma of the prostate have led to substantial changes in its diagnosis over the past century. Despite technological advancements, the management of prostate cancer has become progressively more complex and controversial for both early and late-stage disease. The limitations and potential harms associated with the use of prostate-specific antigen (PSA) as a diagnostic marker have stimulated significant investigation of numerous novel biomarkers that demonstrate varying capacities to detect prostate cancer and can decrease unnecessary biopsies. However, only a few of these markers have been approved for specific clinical settings while the others have not been adequately validated for use. This review systematically and critically assesses ongoing issues and emerging challenges in the current state of prostate cancer diagnostic tools and the need for disruptive next generation tools based on analysis of combinations of these biomarkers to enhance predictive accuracy which will benefit clinical diagnostics and patient welfare. Copyright © 2016. Published by Elsevier Inc.

  19. Imaging of chest trauma: radiological patterns of injury and diagnostic algorithms

    International Nuclear Information System (INIS)

    Lomoschitz, Fritz M.; Eisenhuber, Edith; Linnau, Ken F.; Peloschek, Philipp; Schoder, Maria; Bankier, Alexander A.

    2003-01-01

    In patients after chest trauma, imaging plays a key role for both, the primary diagnostic work-up, and the secondary assessment of potential treatment. Despite its well-known limitations, the anteroposterior chest radiograph remains the starting point of the imaging work-up. Adjunctive imaging with computed tomography, that recently is increasingly often performed on multidetector computed tomography units, adds essential information not readily available on the conventional radiograph. This allows better definition of trauma-associated thoracic injuries not only in acute traumatic aortic injury, but also in pulmonary, tracheobronchial, cardiac, diaphragmal, and thoracic skeletal injuries. This article reviews common radiographic findings in patients after chest trauma, shows typical imaging features resulting from thoracic injury, presents imaging algorithms, and recalls to the reader less common but clinically relevant entities encountered in patients after thoracic trauma

  20. Executive summary of the Diagnostic Criteria for Temporomandibular Disorders for clinical and research applications.

    Science.gov (United States)

    Schiffman, Eric; Ohrbach, Richard

    2016-06-01

    In this executive summary, the authors describe a protocol for assessing patients with temporomandibular disorder (TMD). It is based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications. The DC/TMD was developed using published Axis I physical diagnoses for the most common TMDs. Axis I diagnostic criteria were derived from pertinent clinical TMD signs and symptoms. Axis II consists of psychosocial and behavioral questionnaires already in the public domain. A panel of experts vetted and modified the Axis I and Axis II diagnostic protocols. Recommended changes were assessed for diagnostic accuracy by using the Validation Project's data set, which formed the basis for the development of the DC/TMD. Axis I diagnostic criteria for TMD pain-related disorders have acceptable validity and provide definitive diagnoses for pain involving the temporomandibular joint (TMJ) and masticatory muscles. Axis I diagnostic criteria for the most common TMJ intra-articular disorders are appropriate for screening purposes only. A definitive diagnosis for TMJ intra-articular disorders requires computed tomography or magnetic resonance imaging. Axis II questionnaires provide valid assessment of psychosocial and behavioral factors that can affect management of TMD. The DC/TMD provides a questionnaire for the pain history in conjunction with validated clinical examination criteria for diagnosing the most common TMDs. In addition, it provides Axis II questionnaires for assessing psychosocial and behavioral factors that may contribute to the onset and perpetuation of the patient's TMD. The DC/TMD is appropriate for use in clinical and research settings to allow for a comprehensive assessment of patients with TMD. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  1. Diagnostic and Prognostic Significance of Methionine Uptake and Methionine Positron Emission Tomography Imaging in Gliomas

    Directory of Open Access Journals (Sweden)

    Kamalakannan Palanichamy

    2017-11-01

    Full Text Available The present most common image diagnostic tracer in clinical practice for glioma is 18F-fluorodeoxyglucose (FDG positron emission tomography (PET for brain tumors diagnosis and prognosis. PET is a promising molecular imaging technique, which provides real-time information on the metabolic behavior of the tracer. The diffusive nature of glioblastoma (GBM and heterogeneity often make the radiographic detection by FDG-PET inaccurate, and there is no gold standard. FDG-PET often leads to several controversies in making clinical decisions due to their uptake by normal surrounding tissues, and pose a challenge in delineating treatment-induced necrosis, edema, inflammation, and pseudoprogression. Thus, it is imperative to find new criteria independent of conventional morphological diagnosis to demarcate normal and tumor tissues. We have provided proof of concept studies for 11C methionine-PET (MET-PET imaging of gliomas, along with prognostic and diagnostic significance. MET-PET is not widely used in the United States, though clinical trials from Japan and Germany suggesting the diagnostic ability of MET-PET imaging are superior to FDG-PET imaging for brain tumors. A major impediment is the availability of the onsite cyclotron and isotopic carbon chemistry facilities. In this article, we have provided the scientific rationale and advantages of the use of MET-PET as GBM tracers. We extend our discussion on the expected pitfalls of using MET-PET and ways to overcome them by incorporating a translational component of profiling gene status in the methionine metabolic pathway. This translational correlative component to the MET-PET clinical trials can lead to a better understanding of the existing controversies and can enhance our knowledge for future randomization of GBM patients based on their tumor gene signatures to achieve better prognosis and treatment outcome.

  2. Clinical Training of Medical Physicists Specializing in Diagnostic Radiology

    International Nuclear Information System (INIS)

    2010-01-01

    The application of radiation in human health, for both diagnosis and treatment of disease, is an important component of the work of the IAEA. The responsibility for the increasing technical aspects of this work is undertaken by the medical physicist. To ensure good practice in this vital area, structured clinical training programmes are required to complement academic learning. This publication is intended to be a guide to the practical implementation of such a programme for diagnostic radiology. There is a general and growing awareness that radiation medicine is increasingly dependent on well trained medical physicists based in the clinical setting. However, an analysis of the availability of medical physicists indicates a large shortfall of qualified and capable professionals. This is particularly evident in developing countries. While strategies to increase academic educational opportunities are critical to such countries, the need for guidance on structured clinical training was recognized by the members of the Regional Cooperative Agreement (RCA) for Research, Development and Training related to Nuclear Sciences for Asia and the Pacific. Consequently, a technical cooperation regional project (RAS6038) under the RCA programme was formulated to address this need in the Asia-Pacific region by developing suitable material and establishing its viability. Development of a clinical training guide for medical physicists specializing in diagnostic radiology started in 2007 with the appointment of a core drafting committee of regional and international experts. The publication drew on the experiences of clinical training programmes in Australia and New Zealand, the UK and the USA, and was moderated by physicists working in the Asian region. This publication follows the approach of the IAEA publication Training Course Series No. 37, Clinical Training of Medical Physicists specializing in Radiation Oncology. This approach to clinical training has been successfully tested

  3. Clinical images. Atypical midcycle pain.

    LENUS (Irish Health Repository)

    Alsinnawi, Mazen

    2012-01-31

    A 16-year-old female presented with acute-onset abdominal pain and an initial diagnosis of midcycle pain. Subsequent pelvic ultrasound and diagnostic laparoscopy showed a large mass in the pouch of Douglas. The patient underwent a laparotomy and excision of a mass from a loop of jejunum. This case highlights the difficulties in diagnostic differentiation relating to large pelvic masses in young females.

  4. Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Mallee, Wouter H.; Henny, Erik P.; van Dijk, C. Niek; Kamminga, Sjoerd P.; van Enst, Wynanda A.; Kloen, Peter

    2014-01-01

    To provide an overview of available clinical evaluation tests for scaphoid fractures and to compare their diagnostic accuracies. PWe performed a systematic review of all studies assessing diagnostic characteristics of clinical evaluation in scaphoid fractures by searching MEDLINE, EMBASE, Cochrane,

  5. Glioblastomas vs. lymphomas. More diagnostic certainty by using susceptibility-weighted imaging (SWI)

    Energy Technology Data Exchange (ETDEWEB)

    Peters, S.; Knoess, N.; Wodarg, F.; Cnyrim, C.; Jansen, O. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Inst. fuer Neuroradiologie

    2012-08-15

    Purpose: It can be difficult to differentiate glioblastomas from lymphomas using only standard MR images. There are references suggesting that it might be possible to differentiate these tumors using susceptibility-weighted imaging (SWI). The purpose of this study is to prove the diagnostic benefit using susceptibility-weighted images. Material and Methods: Three neuroradiologists tried to differentiate 4 histologically verified lymphomas from 11 glioblastomas in retrospect. They first viewed the conventional MR images and declared a diagnosis with a grade of certainty. Afterwards they additionally reviewed the susceptibility-weighted images. Results: Glioblastomas have a clearly higher grade of susceptibility signals than lymphomas. By additionally using susceptibility-weighted images, the radiologists determined the correct diagnosis in 82.2 % of the cases. Without susceptibility-weighted images, the diagnosis was correct in 75.5 % of the cases. The subjective gain of certainty was 16.5 %. If there were no intratumoral susceptibility signals (ITSS) (grade 1), the sensitivity for diagnosing a lymphoma was 70 % and the specificity was 100 %. The sensitivity for diagnosing a glioblastoma was 90.5 % and the specificity was 100 % if there was a high rate of intratumoral susceptibility signals (grade 3). Conclusion: Susceptibility-weighted images are an additional tool in clinical practice for determining the correct diagnosis. The differentiation between glioblastomas and lymphomas and the certainty of the determined diagnosis are better. Therefore, we recommend adding susceptibility-weighted imaging to the clinical MR tumor protocol. (orig.)

  6. Glioblastomas vs. lymphomas: more diagnostic certainty by using susceptibility-weighted imaging (SWI).

    Science.gov (United States)

    Peters, S; Knöß, N; Wodarg, F; Cnyrim, C; Jansen, O

    2012-08-01

    It can be difficult to differentiate glioblastomas from lymphomas using only standard MR images. There are references suggesting that it might be possible to differentiate these tumors using susceptibility-weighted imaging (SWI). The purpose of this study is to prove the diagnostic benefit using susceptibility-weighted images. Three neuroradiologists tried to differentiate 4 histologically verified lymphomas from 11 glioblastomas in retrospect. They first viewed the conventional MR images and declared a diagnosis with a grade of certainty. Afterwards they additionally reviewed the susceptibility-weighted images. Glioblastomas have a clearly higher grade of susceptibility signals than lymphomas. By additionally using susceptibility-weighted images, the radiologists determined the correct diagnosis in 82.2 % of the cases. Without susceptibility-weighted images, the diagnosis was correct in 75.5 % of the cases. The subjective gain of certainty was 16.5 %. If there were no intratumoral susceptibility signals (ITSS) (grade 1), the sensitivity for diagnosing a lymphoma was 70 % and the specificity was 100 %. The sensitivity for diagnosing a glioblastoma was 90.5 % and the specificity was 100 % if there was a high rate of intratumoral susceptibility signals (grade 3). Susceptibility-weighted images are an additional tool in clinical practice for determining the correct diagnosis. The differentiation between glioblastomas and lymphomas and the certainty of the determined diagnosis are better. Therefore, we recommend adding susceptibility-weighted imaging to the clinical MR tumor protocol. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Glioblastomas vs. lymphomas. More diagnostic certainty by using susceptibility-weighted imaging (SWI)

    International Nuclear Information System (INIS)

    Peters, S.; Knoess, N.; Wodarg, F.; Cnyrim, C.; Jansen, O.

    2012-01-01

    Purpose: It can be difficult to differentiate glioblastomas from lymphomas using only standard MR images. There are references suggesting that it might be possible to differentiate these tumors using susceptibility-weighted imaging (SWI). The purpose of this study is to prove the diagnostic benefit using susceptibility-weighted images. Material and Methods: Three neuroradiologists tried to differentiate 4 histologically verified lymphomas from 11 glioblastomas in retrospect. They first viewed the conventional MR images and declared a diagnosis with a grade of certainty. Afterwards they additionally reviewed the susceptibility-weighted images. Results: Glioblastomas have a clearly higher grade of susceptibility signals than lymphomas. By additionally using susceptibility-weighted images, the radiologists determined the correct diagnosis in 82.2 % of the cases. Without susceptibility-weighted images, the diagnosis was correct in 75.5 % of the cases. The subjective gain of certainty was 16.5 %. If there were no intratumoral susceptibility signals (ITSS) (grade 1), the sensitivity for diagnosing a lymphoma was 70 % and the specificity was 100 %. The sensitivity for diagnosing a glioblastoma was 90.5 % and the specificity was 100 % if there was a high rate of intratumoral susceptibility signals (grade 3). Conclusion: Susceptibility-weighted images are an additional tool in clinical practice for determining the correct diagnosis. The differentiation between glioblastomas and lymphomas and the certainty of the determined diagnosis are better. Therefore, we recommend adding susceptibility-weighted imaging to the clinical MR tumor protocol. (orig.)

  8. Implementation of a companion diagnostic in the clinical laboratory

    DEFF Research Database (Denmark)

    Mancini, Irene; Pinzani, Pamela; Simi, Lisa

    2015-01-01

    A companion diagnostic test provides information that is essential for the safe and effective use of a corresponding therapeutic product as indicated in the drug instructions. The implementation of a companion diagnostic follows the rules of a molecular test for somatic mutations in a routine...... clinical laboratory environment and needs guidance on practical aspects, including the choice of the proper analytical method and the procedures for internal and external quality controls. Selection of the appropriate assay for detection of genetic alterations depends on several factors: the type...... on restrictions of the method used. In relation to these aspects herein we report an opinion paper of the Working Group Personalized Laboratory Medicine jointly constituted by the European Federation of Laboratory Medicine (EFLM) and by the European Society of Pharmacogenomics and Theranostics (ESPT) using...

  9. PERICARDITIS: ETIOLOGY, CLASSIFICATION, CLINIC, DIAGNOSTICS, TREATMENT. PART II

    Directory of Open Access Journals (Sweden)

    A.B. Sugak

    2009-01-01

    Full Text Available Pericarditis maybe caused by different agents: viruses, bacteria, tuberculosis, and it may be autoimmune. All these types of diseases have similar clinical signs, but differ by prevalence, prognosis and medical tactics. Due to achievements of radial methods of visualization, molecular biology, and immunology, we have an opportunity to provide early specific diagnostics and etiological treatment of inflammatory diseases of pericardium. The second part of lecture presents main principles of differential diagnostics of specific types of pericarditis, gives characteristics of several often accruing types of disease, and describes treatment and tactics of management of patients with pericarditis.Key words: children, pericarditis.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(3:76-81

  10. Imaging and diagnostic criteria for multiple sclerosis: are we there yet?

    International Nuclear Information System (INIS)

    Josey, Lawrence; Curley, Michael; Mousavi, Foroogh Jafari; Taylor, Bruce V.; Lucas, Robyn; Coulthard, Alan

    2012-01-01

    Excluding post traumatic injury, Multiple Sclerosis (MS) is the most common disabling neurological disorder of young adults. Although the effect on mortality is limited, the association of a young demographic and significant morbidity combine to make MS a devastating disease. Since MS was given its first detailed description in 1868, diagnostic criteria continue to evolve. Recently, there has been an international commitment to combine both clinical and paraclinical tests to arrive at an earlier diagnosis. Widespread acceptance of the use of MRI in diagnosis, monitoring and research has made the role of the radiologist more critical than ever in this disease. The primary diagnostic criteria for MS are the International Panel criteria, commonly referred to as the McDonald criteria and it is essential that the radiology community is aware of the work preceding these criteria, so that they are understood in the correct context and the importance acknowledged. Literature review utilising key word search to obtain the historical and current context of magnetic resonance imaging in the diagnosis of MS. A succinct description of the evolution of criteria for the diagnosis of MS. Radiologists must recognise that there are specific diagnostic criteria for MS that continue to evolve as a result of new research, improved technology and clinical experience and it is crucial that these criteria be applied in daily practice. It should be evident that diagnostic imaging criteria for MS will be most effective when combined with standardised MRI protocols such as those published by the international Consortium of Multiple Sclerosis Centres.

  11. Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 1: Soft tissues.

    Science.gov (United States)

    Vanderperren, Katrien; Saunders, Jimmy H

    2009-08-01

    The equine fetlock is the joint most commonly associated with lameness. Although the fetlock is regarded as a simple joint, diagnosis of a fetlock disorder can be a challenge and various imaging modalities are routinely used to arrive at an accurate diagnosis. This review describes the principal disorders affecting the soft tissues of the fetlock region and addresses some of the technical aspects involved in taking radiographic and ultrasonographic images of the different soft tissue lesions. A combination of radiography and ultrasonography is still the most commonly used diagnostic approach in clinical practice.

  12. Irritable bowel syndrome: diagnostic approaches in clinical practice

    Directory of Open Access Journals (Sweden)

    Eugene J Burbige

    2010-09-01

    Full Text Available Eugene J BurbigeDivision of Gastroenterology, Gastrointestinal and Liver Research, John Muir Medical Center, Concord, CA, USABackground: Irritable bowel syndrome (IBS, a functional gastrointestinal disorder long considered a diagnosis of exclusion, has chronic symptoms that vary over time and overlap with those of non-IBS disorders. Traditional symptom-based criteria effectively identify IBS patients but are not easily applied in clinical practice, leaving >40% of patients to experience symptoms up to 5 years before diagnosis.Objective: To review the diagnostic evaluation of patients with suspected IBS, strengths and weaknesses of current methodologies, and newer diagnostic tools that can augment current symptom-based criteria.Methods: The peer-reviewed literature (PubMed was searched for primary reports and reviews using the limiters of date (1999–2009 and English language and the search terms irritable bowel syndrome, diagnosis, gastrointestinal disease, symptom-based criteria, outcome, serology, and fecal markers. Abstracts from Digestive Disease Week 2008–2009 and reference lists of identified articles were reviewed.Results: A disconnect is apparent between practice guidelines and clinical practice. The American Gastroenterological Association and American College of Gastroenterology recommend diagnosing IBS in patients without alarm features of organic disease using symptom-based criteria (eg, Rome. However, physicians report confidence in a symptom-based diagnosis without further testing only up to 42% of the time; many order laboratory tests and perform sigmoidoscopies or colonoscopies despite good evidence showing no utility for this work-up in uncomplicated cases. In the absence of diagnostic criteria easily usable in a busy practice, newer diagnostic methods, such as stool-form examination, fecal inflammatory markers, and serum biomarkers, have been proposed as adjunctive tools to aid in an IBS diagnosis by increasing physicians

  13. Diagnostic imaging in pregraduate integrated curricula; Radiologie in einem praegraduellen problembasiert-integrierten Medizincurriculum

    Energy Technology Data Exchange (ETDEWEB)

    Kainberger, F.; Kletter, K. [Universitaetsklinik fuer Radiodiagnostik, Medizinische Univ. Wien (Austria)

    2007-11-15

    Pregraduate medical curricula are currently undergoing a reform process that is moving away from a traditional discipline-related structure and towards problem-based integrated forms of teaching. Imaging sciences, with their inherently technical advances, are specifically influenced by the effects of paradigm shifts in medical education. The teaching of diagnostic radiology should be based on the definition of three core competencies: in vivo visualization of normal and abnormal morphology and function, diagnostic reasoning, and interventional treatment. On the basis of these goals, adequate teaching methods and e-learning tools should be implemented by focusing on case-based teaching. Teaching materials used in the fields of normal anatomy, pathology, and clinical diagnosis may help diagnostic radiology to play a central role in modern pregraduate curricula. (orig.)

  14. Incidental ferumoxytol artifacts in clinical brain MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bowser, Bruce A.; Campeau, Norbert G.; Carr, Carrie M.; Diehn, Felix E.; McDonald, Jennifer S.; Miller, Gary M.; Kaufmann, Timothy J. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

    2016-11-15

    Ferumoxytol (Feraheme) is a parenteral therapy approved for treatment of iron deficiency anemia. The product insert for ferumoxytol states that it may affect the diagnostic ability of MRI for up to 3 months. However, the expected effects may not be commonly recognized among clinical neuroradiologists. Our purpose is to describe the artifacts we have seen at our institution during routine clinical practice. We reviewed the patients at our institution that had brain MRI performed within 90 days of receiving intravenous ferumoxytol. The imaging was reviewed for specific findings, including diffusion-weighted imaging vascular susceptibility artifact, gradient-echo echo-planar T2*-weighted vascular susceptibility artifact, SWI/SWAN vascular susceptibility artifact, hypointense vascular signal on T2-weighted images, pre-gadolinium contrast vascular enhancement on magnetization-prepared rapid acquisition gradient echo (MPRAGE) imaging, and effects on post-gadolinium contrast T1 imaging. Multiple artifacts were observed in patients having a brain MRI within 3 days of receiving intravenous ferumoxytol. These included susceptibility artifact on DWI, GRE, and SWAN/SWI imaging, pre-gadolinium contrast increased vascular signal on MPRAGE imaging, and decreased expected enhancement on post-gadolinium contrast T1-weighted imaging. Ferumoxytol can create imaging artifacts which complicate clinical interpretation when brain MRI is performed within 3 days of administration. Recognition of the constellation of artifacts produced by ferumoxytol is important in order to obviate additional unnecessary examinations and mitigate errors in interpretation. (orig.)

  15. Digital image intensifier radiography: A new diagnostic procedure in traumatology?

    International Nuclear Information System (INIS)

    Schmidt, C.; Deininger, H.K.; Staedtische Kliniken Darmstadt

    1990-01-01

    Digital image intensifier radiography visualises all traumatological changes of clinical relevance and can therefore be used in traumatology. However, the quality of conventional radiographs cannot be attained as yet. Radiation exposure is markedly reduced, and radiographs are obtained directly after exposure, so that this is an extremely rapid radiographic procedure. Images can be quickly transmitted by video cable to the relevant departments and working places. (orig.) [de

  16. Parotid lymphomas - clinical and computed tomogrphic imaging ...

    African Journals Online (AJOL)

    Parotid lymphomas - clinical and computed tomogrphic imaging features. ... South African Journal of Surgery ... Lymphoma has a clinical presentation similar ... CT scanning is a useful adjunctive investigation to determine the site and extent of ...

  17. Diagnostic Approaches to Sjögren’s Syndrome: a Literature Review and Own Clinical Experience

    Directory of Open Access Journals (Sweden)

    Pedro de Sousa Gomes

    2012-03-01

    Full Text Available Objectives: The purpose of present paper is to critically address the recent advances on diagnostic procedures of Sjögren’s syndrome, taking into account the attained local and systemic features of the disease. Material and Methods: A comprehensive review of the available literature regarding to the diagnostic approaches to Sjögren’s syndrome was conducted. Eligible studies were identified by searching the electronic literature PubMed, Medline, Embase, and ScienceDirect databases for relevant reports (last search update January 2012 combining the MESH heading term “Sjögren’s syndrome”, with the words "diagnosis, diagnostic procedures, salivary gland function, ocular tests, histopathology, salivary gland imaging, serology". The authors checked the references of the selected articles to identify additional eligible publications and contacted the authors, if necessary. Results: Presented article addresses the established diagnostic criteria for Sjögren’s syndrome and critically evaluates the most commonly used diagnostic procedures, presenting data from author’s own clinical experience. Diagnostic criteria for Sjögren’s syndrome are required both by healthcare professionals and patients, namely in order to provide a rational basis for the assessment of the symptoms, establish an individual disease prognosis, and orientate the therapeutic intervention. Conclusions: Sjögren’s syndrome is quite a common autoimmune disease of which the diagnosis and treatment are not easily established. Due to its systemic involvement, it can exhibit a wide range of clinical manifestations that contribute to confusion and delay in diagnosis. The use of proper diagnostic modalities will help to reduce the time to diagnosis and preserve the health and quality of life of patients with Sjögren’s syndrome.

  18. Prostate cancer - epidemiology, etiology, diagnostics, clinical symptoms, screening

    International Nuclear Information System (INIS)

    Ondrus, D.

    2006-01-01

    Prostate cancer presents a real important medical and social problem at present. It is one of the most common malignancy in males. In global point of view it means permanent incidence increase of this disease. Despite improvement of prostate cancer diagnosis and complex treatment mortality does not decreased significantly. Knowledge of etiological factors are relatively limited. Important factors are: genetic disposition, age, life style, race, positive familial history, circulated androgens. Diagnostics is well known, based on routine clinical methods: digital rectal examination, measurement of PSA a transrectal ultrasound. Benefit of prostate cancer screening is until now unclear, controversial. (author)

  19. Structured diagnostic imaging in patients with multiple trauma; Strukturierte radiologische Diagnostik beim Polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Linsenmaier, U.; Rieger, J.; Rock, C.; Pfeifer, K.J.; Reiser, M. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen, Innenstadt (Germany); Kanz, K.G. [Chirurgische Klinik, Klinikum der Universitaet Muenchen, Innenstadt (Germany)

    2002-07-01

    Purpose. Development of a concept for structured diagnostic imaging in patients with multiple trauma.Material and methods. Evaluation of data from a prospective trial with over 2400 documented patients with multiple trauma. All diagnostic and therapeutic steps, primary and secondary death and the 90 days lethality were documented.Structured diagnostic imaging of multiple injured patients requires the integration of an experienced radiologist in an interdisciplinary trauma team consisting of anesthesia, radiology and trauma surgery. Radiology itself deserves standardized concepts for equipment, personnel and logistics to perform diagnostic imaging for a 24-h-coverage with constant quality.Results. This paper describes criteria for initiation of a shock room or emergency room treatment, strategies for documentation and interdisciplinary algorithms for the early clinical care coordinating diagnostic imaging and therapeutic procedures following standardized guidelines. Diagnostic imaging consists of basic diagnosis, radiological ABC-rule, radiological follow-up and structured organ diagnosis using CT. Radiological trauma scoring allows improved quality control of diagnosis and therapy of multiple injured patients.Conclusion. Structured diagnostic imaging of multiple injured patients leads to a standardization of diagnosis and therapy and ensures constant process quality. (orig.) [German] Fragestellung. Entwicklung eines strukturierten Konzeptes zur radiologischen Diagnostik polytraumatisierter Patienten.Methodik. Die Datenevaluation erfolgte auf Basis einer prospektiven interdisziplinaere Polytraumastudie mit ueber 2400 Patienten. Alle diagnostischen und therapeutischen Schritte werden jeweils unter Angabe von Zeitpunkt und auftretenden Komplikationen erfasst, ein primaeres oder sekundaeres Versterben und die 90-Tage-Letalitaet werden dokumentiert.Die strukturierte radiologische Diagnostik von Mehrfachverletzen verlangt die Integration eines erfahrenen Radiologen in

  20. Problems of early clinical diagnostics of pseudoexfoliation syndrome

    Directory of Open Access Journals (Sweden)

    A. Yu. Brezhnev

    2012-01-01

    Full Text Available Purpose: to study the informativeness of pseudoexfoliation syndrome (PES signs for early diagnosis improvement.Methods: 250 patients with PES were included in the study. Exclusion criteria consisted of aphakia, pseudophakia, previous eye surgery and diseases which can complicate PES diagnostics (uveitis, corneal pathology, ocular injury etc.. Each patient underwent complete ophthalmic examination, including slit-lamp examination under mydriasis, gonioscopy. Confocal microscopy was used as an additional diagnostic method in several patients (Confoscan-4, Nidek.Results: Pseudoexfoliation material was found at the pupillary margin in 64.8% of patients, and on the lens capsule (central disc in 71% of the test subjects. Peripheral depositions were present in almost all PES patients under mydriasis. Pupil dilation has been allowed to establish the diagnosis of PES additionally in 16% of patients. At the «mini-PES»-stage PES material was most frequently found in the superior-nasal quadrant of lens capsule (85.6%. Clinical asymmetry of several signs (pupil diameter, anterior chamber angle pigmentation, IOP level should be taken into consideration in early PES diagnostics.Conclusion: Examination under mydriasis and knowledge of PES micro-signs in some cases has been allowed to suspect PESeven at the preclinical stage.

  1. Advanced synchronous luminescence imaging for chemical and medical diagnostics

    Science.gov (United States)

    Vo-Dinh, Tuan

    2006-09-05

    A diagnostic method and associated system includes the steps of exposing at least one sample location with excitation radiation through a single optical waveguide or a single optical waveguide bundle, wherein the sample emits emission radiation in response to the excitation radiation. The same single optical waveguide or the single optical waveguide bundle receives at least a portion of the emission radiation from the sample, thus providing co-registration of the excitation radiation and the emission radiation. The wavelength of the excitation radiation and emission radiation is synchronously scanned to produce a spectrum upon which an image can be formed. An increased emission signal is generated by the enhanced overlap of the excitation and emission focal volumes provided by co-registration of the excitation and emission signals thus increasing the sensitivity as well as decreasing the exposure time necessary to obtain an image.

  2. Assessing the value of diagnostic imaging: the role of perception

    Science.gov (United States)

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

    2000-04-01

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

  3. How doctors generate diagnostic hypotheses: a study of radiological diagnosis with functional magnetic resonance imaging.

    Directory of Open Access Journals (Sweden)

    Marcio Melo

    Full Text Available In medical practice, diagnostic hypotheses are often made by physicians in the first moments of contact with patients; sometimes even before they report their symptoms. We propose that generation of diagnostic hypotheses in this context is the result of cognitive processes subserved by brain mechanisms that are similar to those involved in naming objects or concepts in everyday life.To test this proposal we developed an experimental paradigm with functional magnetic resonance imaging (fMRI using radiological diagnosis as a model. Twenty-five radiologists diagnosed lesions in chest X-ray images and named non-medical targets (animals embedded in chest X-ray images while being scanned in a fMRI session. Images were presented for 1.5 seconds; response times (RTs and the ensuing cortical activations were assessed. The mean response time for diagnosing lesions was 1.33 (SD ±0.14 seconds and 1.23 (SD ±0.13 seconds for naming animals. 72% of the radiologists reported cogitating differential diagnoses during trials (3.5 seconds. The overall pattern of cortical activations was remarkably similar for both types of targets. However, within the neural systems shared by both stimuli, activation was significantly greater in left inferior frontal sulcus and posterior cingulate cortex for lesions relative to animals.Generation of diagnostic hypotheses and differential diagnoses made through the immediate visual recognition of clinical signs can be a fast and automatic process. The co-localization of significant brain activation for lesions and animals suggests that generating diagnostic hypotheses for lesions and naming animals are served by the same neuronal systems. Nevertheless, diagnosing lesions was cognitively more demanding and associated with more activation in higher order cortical areas. These results support the hypothesis that medical diagnoses based on prompt visual recognition of clinical signs and naming in everyday life are supported by similar

  4. Computer-aided diagnosis and artificial intelligence in clinical imaging.

    Science.gov (United States)

    Shiraishi, Junji; Li, Qiang; Appelbaum, Daniel; Doi, Kunio

    2011-11-01

    Computer-aided diagnosis (CAD) is rapidly entering the radiology mainstream. It has already become a part of the routine clinical work for the detection of breast cancer with mammograms. The computer output is used as a "second opinion" in assisting radiologists' image interpretations. The computer algorithm generally consists of several steps that may include image processing, image feature analysis, and data classification via the use of tools such as artificial neural networks (ANN). In this article, we will explore these and other current processes that have come to be referred to as "artificial intelligence." One element of CAD, temporal subtraction, has been applied for enhancing interval changes and for suppressing unchanged structures (eg, normal structures) between 2 successive radiologic images. To reduce misregistration artifacts on the temporal subtraction images, a nonlinear image warping technique for matching the previous image to the current one has been developed. Development of the temporal subtraction method originated with chest radiographs, with the method subsequently being applied to chest computed tomography (CT) and nuclear medicine bone scans. The usefulness of the temporal subtraction method for bone scans was demonstrated by an observer study in which reading times and diagnostic accuracy improved significantly. An additional prospective clinical study verified that the temporal subtraction image could be used as a "second opinion" by radiologists with negligible detrimental effects. ANN was first used in 1990 for computerized differential diagnosis of interstitial lung diseases in CAD. Since then, ANN has been widely used in CAD schemes for the detection and diagnosis of various diseases in different imaging modalities, including the differential diagnosis of lung nodules and interstitial lung diseases in chest radiography, CT, and position emission tomography/CT. It is likely that CAD will be integrated into picture archiving and

  5. Magnetic nanoparticles in magnetic resonance imaging and diagnostics.

    Science.gov (United States)

    Rümenapp, Christine; Gleich, Bernhard; Haase, Axel

    2012-05-01

    Magnetic nanoparticles are useful as contrast agents for magnetic resonance imaging (MRI). Paramagnetic contrast agents have been used for a long time, but more recently superparamagnetic iron oxide nanoparticles (SPIOs) have been discovered to influence MRI contrast as well. In contrast to paramagnetic contrast agents, SPIOs can be functionalized and size-tailored in order to adapt to various kinds of soft tissues. Although both types of contrast agents have a inducible magnetization, their mechanisms of influence on spin-spin and spin-lattice relaxation of protons are different. A special emphasis on the basic magnetism of nanoparticles and their structures as well as on the principle of nuclear magnetic resonance is made. Examples of different contrast-enhanced magnetic resonance images are given. The potential use of magnetic nanoparticles as diagnostic tracers is explored. Additionally, SPIOs can be used in diagnostic magnetic resonance, since the spin relaxation time of water protons differs, whether magnetic nanoparticles are bound to a target or not.

  6. From molecular imaging to systems diagnostics: Time for another paradigm shift?

    Energy Technology Data Exchange (ETDEWEB)

    Li, King C.P. [Department of Radiology, Methodist Hospital, Weill Cornell Medical College, 6565 Fannin Street, D280 Houston, TX 77030 (United States)], E-mail: kli@tmhs.org

    2009-05-15

    The term 'Molecular Imaging' has hit the consciousness of radiologists only in the past decade although many of the concepts that molecular imaging encompasses has been practiced in biomedical imaging, especially in nuclear medicine, for many decades. Many new imaging techniques have allowed us to interrogate biologic events at the cellular and molecular level in vivo in four dimensions but the challenge now is to translate these techniques into clinical practice in a way that will enable us to revolutionize healthcare delivery. The purpose of this article is to introduce the term 'Systems Diagnostics' and examine how radiologists can become translators of disparate sources of information into medical decisions and therapeutic actions.

  7. Magnetic resonance imaging in the diagnostics of multiple sclerosis

    International Nuclear Information System (INIS)

    Larsen, J.P.; Tjoerstad, K.; Kaass, B.; Oedegaard, H.

    1987-01-01

    Multiple sclerosis is an important and frequent neurological disease and the diagnosis might be difficult. The clinical criteria of multiple sclerosis and the role of laboratory examinations in the diagnosis of the disease are discussed. In particular the help offered by the magnetic resonance imaging method is the subject of this paper. Three patients are reported and discussed

  8. Diagnostic imaging of psoriatic arthritis. Part II: magnetic resonance imaging and ultrasonography

    Directory of Open Access Journals (Sweden)

    Iwona Sudoł-Szopińska

    2016-06-01

    Full Text Available Plain radiography reveals specific, yet late changes of advanced psoriatic arthritis. Early inflammatory changes are seen both on magnetic resonance imaging and ultrasound within peripheral joints (arthritis, synovitis, tendons sheaths (tenosynovitis, tendovaginitis and entheses (enthesitis, enthesopathy. In addition, magnetic resonance imaging enables the assessment of inflammatory features in the sacroiliac joints (sacroiliitis, and the spine (spondylitis. In this article, we review current opinions on the diagnostics of some selective, and distinctive features of psoriatic arthritis concerning magnetic resonance imaging and ultrasound and present some hypotheses on psoriatic arthritis etiopathogenesis, which have been studied with the use of magnetic resonance imaging. The following elements of the psoriatic arthritis are discussed: enthesitis, extracapsular inflammation, dactylitis, distal interphalangeal joint and nail disease, and the ability of magnetic resonance imaging to differentiate undifferentiated arthritis, the value of whole-body magnetic resonance imaging and dynamic contrast-enhanced magnetic resonance imaging.

  9. Application of Next-generation Sequencing in Clinical Molecular Diagnostics

    Directory of Open Access Journals (Sweden)

    Morteza Seifi

    2017-05-01

    Full Text Available ABSTRACT Next-generation sequencing (NGS is the catch all terms that used to explain several different modern sequencing technologies which let us to sequence nucleic acids much more rapidly and cheaply than the formerly used Sanger sequencing, and as such have revolutionized the study of molecular biology and genomics with excellent resolution and accuracy. Over the past years, many academic companies and institutions have continued technological advances to expand NGS applications from research to the clinic. In this review, the performance and technical features of current NGS platforms were described. Furthermore, advances in the applying of NGS technologies towards the progress of clinical molecular diagnostics were emphasized. General advantages and disadvantages of each sequencing system are summarized and compared to guide the selection of NGS platforms for specific research aims.

  10. [Usher syndrome: clinical features, diagnostic options, and therapeutic prospects].

    Science.gov (United States)

    Seeliger, M W; Fischer, M D; Pfister, M

    2009-06-01

    Usher syndrome denotes a clinically and genetically heterogeneous combination of retinitis pigmentosa and sensorineural deafness. The division into subtypes I, II, and III is based on the degree of hearing loss: Type I is characterized by deafness from birth together with ataxia and retarded motor development, type II by a stationary deafness of a moderate degree, and type III by a progressive deafness with adult onset. In Germany, Usher syndrome currently bears particular relevance because in January 2009 a new compulsory screening of auditory function in newborn infants was introduced. Consequently, it can be expected that a higher number of patients with Usher syndrome will be identified in early childhood and referred to ophthalmologists. The focus of this work is to introduce the typical clinical picture of Usher syndrome, summarize diagnostic options, and give an overview of therapeutic strategies.

  11. Implications of caries diagnostic strategies for clinical management decisions

    DEFF Research Database (Denmark)

    Baelum, Vibeke; Hintze, Hanne; Wenzel, Ann

    2012-01-01

    -specificity) were calculated for each diagnostic strategy. RESULTS: Visual-tactile examination provided a true-positive rate of 34.2% and a false-positive rate of 1.5% for the detection of a cavity. The combination of a visual-tactile and a radiographic examination using the lesion in dentin threshold......OBJECTIVES: In clinical practice, a visual-tactile caries examination is frequently supplemented by bitewing radiography. This study evaluated strategies for combining visual-tactile and radiographic caries detection methods and determined their implications for clinical management decisions...... and cavitated lesions while the radiographic examination determined lesion depth. Direct inspection of the surfaces following tooth separation for the presence of cavitated or noncavitated lesions was the validation method. The true-positive rate (i.e. the sensitivity) and the false-positive rate (i.e. 1...

  12. Chronological alterations of diagnostic imaging of renal cell carcinoma

    International Nuclear Information System (INIS)

    Arima, Kiminobu; Sugimura, Yoshiki; Yanagawa, Makoto; Tochigi, Hiromi; Kawamura, Juichi

    1994-01-01

    A review of 156 cases of renal cell carcinoma diagnosed during a 20-year period demonstrated the changes of initial signs/symptoms and imaging modalities for detection and definition. According to the imaging modality used for diagnosing renal cell carcinoma, clinical pictures were chronologically examined over 4 periods: 1973 to 1979 (before CT era), 1980 to 1984 (early CT era), 1985 to 1987 (CT era) and 1988 to 1992 (CT/MRI era). With regards to initial signs or symptoms, the proportion of classical trials has gradually decreased, while that of tumors noted incidentally has increased. As for imaging modalities for detection, the proportion of IVP has gradually decreased and that of CT and US has increased over the periods. With regard to imaging modalities for definition, the proportion of angiography has decreased and that of CT has increased. From chronological changes in clinical pictures and imaging modalities, we suggested a decision tree of imaging modalities for detection and definition of renal cell carcinoma. (author)

  13. Diagnostic outcome following routine genetics clinic referral for the assessment of global developmental delay.

    LENUS (Irish Health Repository)

    Shahdadpuri, R

    2012-02-01

    The aim of this study was to ascertain the diagnostic yield following a routine genetics clinic referral for the assessment of global developmental delay. Detailed retrospective review of 119 complete consecutive case notes of patients referred to one single clinical geneticist over a 14 month time period was undertaken (n = 119; 54 males, 65 females). The age at initial review ranged from 2 months to 37 years 3 months (mean 8 y 3 mo [SD 7 y 10 mo]). We made a diagnosis in 36\\/119 (30%); 21\\/36 were new diagnoses and 15\\/36 were confirmations of diagnoses. We removed a wrong diagnostic label in 8\\/119 (7%). In 3\\/8 we were able to achieve a diagnosis but in 5\\/8 no alternative diagnosis was reached. We had a better diagnostic rate where the patients were dysmorphic (odds ratio [OR] 1.825; 95% confidence interval [CI] 1.065 to 3.128, p = 0.044). In the majority, the diagnosis was made by clinical examination only. Molecular diagnosis was reached in seven cases. Five cases were confirmed by cytogenetic analysis. Brain magnetic resonance imaging (MRI) revealed a diagnosis in three cases. This study confirms the importance of a clinical genetics assessment in the investigation of global developmental delay.

  14. Constructing diagnostic likelihood: clinical decisions using subjective versus statistical probability.

    Science.gov (United States)

    Kinnear, John; Jackson, Ruth

    2017-07-01

    Although physicians are highly trained in the application of evidence-based medicine, and are assumed to make rational decisions, there is evidence that their decision making is prone to biases. One of the biases that has been shown to affect accuracy of judgements is that of representativeness and base-rate neglect, where the saliency of a person's features leads to overestimation of their likelihood of belonging to a group. This results in the substitution of 'subjective' probability for statistical probability. This study examines clinicians' propensity to make estimations of subjective probability when presented with clinical information that is considered typical of a medical condition. The strength of the representativeness bias is tested by presenting choices in textual and graphic form. Understanding of statistical probability is also tested by omitting all clinical information. For the questions that included clinical information, 46.7% and 45.5% of clinicians made judgements of statistical probability, respectively. Where the question omitted clinical information, 79.9% of clinicians made a judgement consistent with statistical probability. There was a statistically significant difference in responses to the questions with and without representativeness information (χ2 (1, n=254)=54.45, pprobability. One of the causes for this representativeness bias may be the way clinical medicine is taught where stereotypic presentations are emphasised in diagnostic decision making. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Diagnostic accuracy of clinical dehydration scales in children.

    Science.gov (United States)

    Falszewska, Anna; Dziechciarz, Piotr; Szajewska, Hania

    2017-08-01

    The aim of this study was to evaluate the diagnostic accuracy of the Clinical Dehydration Scale (CDS), the World Health Organization (WHO) scale, and the Gorelick scale for dehydration assessment in children. A prospective, observational study was carried out between October 2014 and December 2016. Eligible participants were children aged 1 month to 5 years with acute diarrhea. After hospital admission, each patient's weight was recorded and the degree of dehydration based on three scales was assessed. The reference standard was the percentage weight change between the discharge and admission weights. The main outcomes were the sensitivity, specificity, positive likelihood ratio (LR), and negative LR. Of 128 children enrolled in the study, complete data were available from 118 patients for analysis. Most of children presented with no or mild dehydration. Only the CDS showed limited value in confirming a diagnosis of dehydration ≥6% (positive LR 3.9, 95% CI 1.1 to 9.1), with no value in ruling it out (negative LR 0.6, 95% CI 0.2 to 0.99). In our cohort, the CDS was of limited diagnostic value in ruling in severe dehydration in children with acute gastroenteritis. The WHO and Gorelick scales were not helpful in the assessment of dehydration. What is Known : • Treatment of acute gastroenteritis (AGE) is based on assessing and correcting the degree of dehydration. • Several scales combining various signs and symptoms have been developed, including the Clinical Dehydration Scale (CDS), and the World Health Organization (WHO) scale, and the Gorelick scale. None of these scales is internationally accepted for best accuracy in diagnosing dehydration in children. What is New: • The CDS was of limited diagnostic value in ruling in severe dehydration in children with AGE. • The WHO and Gorelick scales were not helpful in the assessment of dehydration.

  16. Late-onset hypogonadism: etiology, clinical features, diagnostics, treatment

    Directory of Open Access Journals (Sweden)

    E. Yu. Pashkova

    2015-04-01

    Full Text Available In a critical review of the literature current data concerning etiology, clinical features, diagnostics, treatment of late-onset hypogonadism (LOH are given. LOH is a multidisciplinary problem, because a patient with LOH can have osteoporosis, anemia, depression, obesity, diabetes mellitus, erectile dysfunction. Sometimes it is hard to realize that all this complaints are symptoms of LOH. LOH has a negative impact on a patient,s quality of life and it,s impossible to help without androgen replacement therapy. Furthermore doctors often have doubts about testosterone replacement therapy safety because of lack of accurate information. In a convenient for medical practitioners form clinical and laboratory diagnostic criteria of LOH are presented together with formulas for conversion from one measurement unit of main sex hormones into another. Based on latest ISSAM guidelines (International Society for the Study of the Aging Male modern treatment options of LOH are summarized, full information about available testosterone preparations (oral, transdermal, injectable with comparative analysis of advantages and disadvantages of each is given. A full description of indications and contraindications for androgen replacement treatment is presented, also treatment regimen and medical supervision algorithm during treatment are described. 

  17. Late-onset hypogonadism: etiology, clinical features, diagnostics, treatment

    Directory of Open Access Journals (Sweden)

    E. Yu. Pashkova

    2015-01-01

    Full Text Available In a critical review of the literature current data concerning etiology, clinical features, diagnostics, treatment of late-onset hypogonadism (LOH are given. LOH is a multidisciplinary problem, because a patient with LOH can have osteoporosis, anemia, depression, obesity, diabetes mellitus, erectile dysfunction. Sometimes it is hard to realize that all this complaints are symptoms of LOH. LOH has a negative impact on a patient,s quality of life and it,s impossible to help without androgen replacement therapy. Furthermore doctors often have doubts about testosterone replacement therapy safety because of lack of accurate information. In a convenient for medical practitioners form clinical and laboratory diagnostic criteria of LOH are presented together with formulas for conversion from one measurement unit of main sex hormones into another. Based on latest ISSAM guidelines (International Society for the Study of the Aging Male modern treatment options of LOH are summarized, full information about available testosterone preparations (oral, transdermal, injectable with comparative analysis of advantages and disadvantages of each is given. A full description of indications and contraindications for androgen replacement treatment is presented, also treatment regimen and medical supervision algorithm during treatment are described. 

  18. Image processing methods and architectures in diagnostic pathology.

    Directory of Open Access Journals (Sweden)

    Oscar DĂŠniz

    2010-05-01

    Full Text Available Grid technology has enabled the clustering and the efficient and secure access to and interaction among a wide variety of geographically distributed resources such as: supercomputers, storage systems, data sources, instruments and special devices and services. Their main applications include large-scale computational and data intensive problems in science and engineering. General grid structures and methodologies for both software and hardware in image analysis for virtual tissue-based diagnosis has been considered in this paper. This methods are focus on the user level middleware. The article describes the distributed programming system developed by the authors for virtual slide analysis in diagnostic pathology. The system supports different image analysis operations commonly done in anatomical pathology and it takes into account secured aspects and specialized infrastructures with high level services designed to meet application requirements. Grids are likely to have a deep impact on health related applications, and therefore they seem to be suitable for tissue-based diagnosis too. The implemented system is a joint application that mixes both Web and Grid Service Architecture around a distributed architecture for image processing. It has shown to be a successful solution to analyze a big and heterogeneous group of histological images under architecture of massively parallel processors using message passing and non-shared memory.

  19. NMR imaging of the head-neck region. Topography of function - clinical findings - imaging and spectroscopy

    International Nuclear Information System (INIS)

    Vogl, T.J.

    1991-01-01

    The book on nmr imaging in the head-neck region offers, on a total of 221 pages, 344 detailed representations with 141 figures and 44 tables. It provides information as to the relevant topography of function, presents clinical findings, explains imaging characteristics and also takes account of spectroscopic procedures. The multifarious methods of investigation are described and discussed in connection with the differential diagnoses. A score of suitable diagnostic measures is assigned to each region of examination. The method's value is assessed against that of other imaging techniques. (orig.) [de

  20. Distributed decision making in action: diagnostic imaging investigations within the bigger picture.

    Science.gov (United States)

    Makanjee, Chandra R; Bergh, Anne-Marie; Hoffmann, Willem A

    2018-03-01

    Decision making in the health care system - specifically with regard to diagnostic imaging investigations - occurs at multiple levels. Professional role players from various backgrounds are involved in making these decisions, from the point of referral to the outcomes of the imaging investigation. The aim of this study was to map the decision-making processes and pathways involved when patients are referred for diagnostic imaging investigations and to explore distributed decision-making events at the points of contact with patients within a health care system. A two-phased qualitative study was conducted in an academic public health complex with the district hospital as entry point. The first phase included case studies of 24 conveniently selected patients, and the second phase involved 12 focus group interviews with health care providers. Data analysis was based on Rapley's interpretation of decision making as being distributed across time, situations and actions, and including different role players and technologies. Clinical decisions incorporating imaging investigations are distributed across the three vital points of contact or decision-making events, namely the initial patient consultation, the diagnostic imaging investigation and the post-investigation consultation. Each of these decision-making events is made up of a sequence of discrete decision-making moments based on the transfer of retrospective, current and prospective information and its transformation into knowledge. This paper contributes to the understanding of the microstructural processes (the 'when' and 'where') involved in the distribution of decisions related to imaging investigations. It also highlights the interdependency in decision-making events of medical and non-medical providers within a single medical encounter. © 2017 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation

  1. Diagnostic imaging of injuries and overuse in soccer players

    International Nuclear Information System (INIS)

    Jonge, M.C. de; Maas, M.; Kuijk, C. van

    2002-01-01

    Soccer is one of the most popular sports worldwide. There is a high incidence of injuries in soccer in which several intrinsic and extrinsic factors play a part. Most injuries are minor, self-limiting and do not need extensive medical treatment or imaging. Imaging can be required for several reasons e.g. when the clinical findings are doubtful, to replace arthroscopy (i. e. of the knee) or for prognostic reasons. All imaging modalities available to the radiologist can be used but MRI is the most valuable imaging modality with its superior contrast resolution and multiplanar capabilities. Basically, injuries in the soccer player can occur anywhere in the body like in every sport. The lower extremities, more specific the knee and ankle, are however the most injured parts. (orig.) [de

  2. DIAGNOSTIC ACCURACY OF CLINICAL AND MAGNETIC RESONANCE IN KNEE MENISCI AND LIGAMENTOUS INJURIES

    Directory of Open Access Journals (Sweden)

    Nilesh

    2016-03-01

    Full Text Available OBJECTIVE The purpose of this study was to evaluate the reliability of clinical diagnosis compared to MRI findings in ligamentous and meniscal injuries with respect to arthroscopic confirmation as a gold standard. METHODS 485 patients with knee injuries were prospectively assessed by clinical evaluation and magnetic resonance imaging and correlated after therapeutic arthroscopy. The overall accuracy, clinically productive values of sensitivity and specificity was derived. The actual value of the test with respect to positive predictive and negative predictive value was also derived, taking arthroscopic findings as confirmatory. The overall partial and total agreement among the clinical, MRI and arthroscopy was documented. RESULTS The overall accuracy for clinical examination was 85, 92, 100 and 100 and accuracy for MRI was 90, 97, 97 and 97 for detecting medial meniscus, lateral meniscus, ACL and PCL tears respectively. Clinically lateral meniscus tears are difficult to diagnose clinically with negative predictive value (90 whereas ACL injuries do not need MRI for diagnosis as evident by a high negative predictive value (100 of clinical examination. Total agreement with the clinical findings confirmed by arthroscopy was 64.40% which was relatively high as compared to total agreement of MRI findings which was only 31.50%. We found similar total agreement versus total disagreement of both clinical and MRI to be only 2.74% indicating very high accuracy in clinical diagnosis of meniscal and ligamentous injuries combined. CONCLUSION The clinical evaluation alone is sufficient to diagnose meniscal and ACL/PCL pathologies and MRI should be considered only as a powerful negative diagnostic tool. The arthroscopy decision should not be heavily dependent on MRI for ligamentous injuries but reverse is true for meniscal lesions. MR evaluation functions as a powerful negative diagnostic tool to rule out doubtful and complex knee injuries.

  3. Validation of Diagnostic Imaging Based on Repeat Examinations. An Image Interpretation Model

    International Nuclear Information System (INIS)

    Isberg, B.; Jorulf, H.; Thorstensen, Oe.

    2004-01-01

    Purpose: To develop an interpretation model, based on repeatedly acquired images, aimed at improving assessments of technical efficacy and diagnostic accuracy in the detection of small lesions. Material and Methods: A theoretical model is proposed. The studied population consists of subjects that develop focal lesions which increase in size in organs of interest during the study period. The imaging modality produces images that can be re-interpreted with high precision, e.g. conventional radiography, computed tomography, and magnetic resonance imaging. At least four repeat examinations are carried out. Results: The interpretation is performed in four or five steps: 1. Independent readers interpret the examinations chronologically without access to previous or subsequent films. 2. Lesions found on images at the last examination are included in the analysis, with interpretation in consensus. 3. By concurrent back-reading in consensus, the lesions are identified on previous images until they are so small that even in retrospect they are undetectable. The earliest examination at which included lesions appear is recorded, and the lesions are verified by their growth (imaging reference standard). Lesion size and other characteristics may be recorded. 4. Records made at step 1 are corrected to those of steps 2 and 3. False positives are recorded. 5. (Optional) Lesion type is confirmed by another diagnostic test. Conclusion: Applied on subjects with progressive disease, the proposed image interpretation model may improve assessments of technical efficacy and diagnostic accuracy in the detection of small focal lesions. The model may provide an accurate imaging reference standard as well as repeated detection rates and false-positive rates for tested imaging modalities. However, potential review bias necessitates a strict protocol

  4. Diagnostic Consideration for Sinonasal Wegener's Granulomatosis Clinically Mistaken for Carcinoma

    Science.gov (United States)

    La Rosa, Cristina; Emmanuele, Carmela; Tranchina, Maria Grazia; Ippolito, Massimo; Cosentino, Sebastiano; Saita, Vincenzo; Fraggetta, Filippo

    2013-01-01

    We report a case of Wegener's granulomatosis clinically mistaken for carcinoma in a 21-year-old girl presenting with an ulcerated mass of the nasopharynx associated with enlarged laterocervical nodes. The lesion was clinically suspected as malignant on the basis of clinical and radiological findings (namely, computed tomography scan and positron emission tomography). However, multiple biopsies were not conclusive for malignancy showing histological change suggestive of Wegener's granulomatosis. A serum determination of cANCA supported the diagnosis of Wegener's granulomatosis. Clinical findings and image studies suggested an erroneous diagnosis of malignancy whereas a definitive diagnosis of Wegener's granulomatosis was achieved only after repeated biopsies thus leading to a correct therapeutic approach. The Wegener granulomatosis must be added to the list of the differential diagnoses of the masses of the nasopharynx associated with or without enlarged laterocervical nodes. PMID:24106630

  5. Laser imaging for clinical applications

    Science.gov (United States)

    Van Houten, John P.; Cheong, Wai-Fung; Kermit, Eben L.; King, Richard A.; Spilman, Stanley D.; Benaron, David A.

    1995-03-01

    Medical optical imaging (MOI) uses light emitted into opaque tissues in order to determine the interior structure and chemical content. These optical techniques have been developed in an attempt to prospectively identify impending brain injuries before they become irreversible, thus allowing injury to be avoided or minimized. Optical imaging and spectroscopy center around the simple idea that light passes through the body in small amounts, and emerges bearing clues about tissues through which it passed. Images can be reconstructed from such data, and this is the basis of optical tomography. Over the past few years, techniques have been developed to allow construction of images from such optical data at the bedside. We have used a time-of-flight system reported earlier to monitor oxygenation and image hemorrhage in neonatal brain. This article summarizes the problems that we believe can be addressed by such techniques, and reports on some of our early results.

  6. Diagnostic imaging features of normal anal sacs in dogs and cats.

    Science.gov (United States)

    Jung, Yechan; Jeong, Eunseok; Park, Sangjun; Jeong, Jimo; Choi, Ul Soo; Kim, Min-Su; Kim, Namsoo; Lee, Kichang

    2016-09-30

    This study was conducted to provide normal reference features for canine and feline anal sacs using ultrasound, low-field magnetic resonance imaging (MRI) and radiograph contrast as diagnostic imaging tools. A total of ten clinically normal beagle dogs and eight clinically normally cats were included. General radiography with contrast, ultrasonography and low-field MRI scans were performed. The visualization of anal sacs, which are located at distinct sites in dogs and cats, is possible with a contrast study on radiography. Most surfaces of the anal sacs tissue, occasionally appearing as a hyperechoic thin line, were surrounded by the hypoechoic external sphincter muscle on ultrasonography. The normal anal sac contents of dogs and cats had variable echogenicity. Signals of anal sac contents on low-field MRI varied in cats and dogs, and contrast medium using T1-weighted images enhanced the anal sac walls more obviously than that on ultrasonography. In conclusion, this study provides the normal features of anal sacs from dogs and cats on diagnostic imaging. Further studies including anal sac evaluation are expected to investigate disease conditions.

  7. Overuse of trauma in sports - clinical signs in the context with modern imaging techniques

    International Nuclear Information System (INIS)

    Wurnig, C.; Gollob, E.

    2001-01-01

    New insights in the fields of pathology and diagnostic radiology of sports injuries show that the borders between overuse syndromes and trauma are blurred. Techniques of diagnostic imaging are increasingly important for an objective documentation of morphologic changes of the musculoskeletal system. Typical sports-related syndromes exist and their clinical diagnosis is not always easy because pain cannot be located exactly. (author)

  8. The use of diagnostic imaging for identifying abnormal gas accumulations in cetaceans and pinnipeds.

    Directory of Open Access Journals (Sweden)

    Sophie eDennison

    2012-06-01

    Full Text Available Recent dogma suggested that marine mammals are not at risk of decompression sickness (DCS due to a number of evolutionary adaptations. Several proposed adaptations exist. Lung compression and alveolar collapse that terminate gas exchange before a depth is reached where supersaturation is significant and bradycardia with peripheral vasoconstriction affecting the distribution, and dynamics of blood and tissue nitrogen levels. Published accounts of gas and fat emboli and dysbaric osteonecrosis in marine mammals and theoretical modeling have challenged this view-point, suggesting that decompression-like symptoms may occur under certain circumstances, contrary to common belief. Diagnostic imaging modalities are invaluable tools for the non-invasive examination of animals for evidence of gas and have been used to demonstrate the presence of incidental decompression-related renal gas accumulations in some stranded cetaceans. Diagnostic imaging has also contributed to the recognition of clinically significant gas accumulations in live and dead cetaceans and pinnipeds. Understanding the appropriate application and limitations of the available imaging modalities is important for accurate interpretation of results. The presence of gas may be incidental and must be interpreted cautiously alongside all other available data including clinical examination, clinical laboratory testing, gas analysis, necropsy examination and histology results.

  9. Reliability of diagnostic imaging techniques in suspected acute appendicitis: proposed diagnostic protocol

    International Nuclear Information System (INIS)

    Cura del, J. L.; Oleaga, L.; Grande, D.; Vela, A. C.; Ibanez, A. M.

    2001-01-01

    To study the utility of ultrasound and computed tomography (CT) in case of suspected appendicitis. To determine the diagnostic yield in terms of different clinical contexts and patient characteristics. to assess the costs and benefits of introducing these techniques and propose a protocol for their use. Negative appendectomies, complications and length of hospital stay in a group of 152 patients with suspected appendicitis who underwent ultrasound and CT were compared with those of 180 patients who underwent appendectomy during the same time period, but had not been selected for the first group: these patients costs for each group were calculated. In the first group, the diagnostic value of the clinical signs was also evaluated. The reliability of the clinical signs was limited, while the results with ultrasound and CT were excellent. The incidence of negative appendectomy was 9.6% in the study group and 12.2% in the control group. Moreover, there were fewer complications and a shorter hospital stay in the first group. Among men, however, the rate of negative appendectomy was lower in the control group. The cost of using ultrasound and CT in the management of appendicitis was only slightly higher than that of the control group. Although ultrasound and CT are not necessary in cases in which the probability of appendicitis is low or in men presenting clear clinical evidence, the use of these techniques is indicated in the remaining cases in which appendicitis is suspected. In children, ultrasound is the technique of choice. In all other patients, if negative results are obtained with one of the two techniques, the other should be performed. (Author) 49 refs

  10. The Role of Clinical Cardiac Magnetic Resonance Imaging in China: Current Status and the Future

    Directory of Open Access Journals (Sweden)

    Shi Chen, MD

    2016-12-01

    Full Text Available Cardiac magnetic resonance (CMR imaging plays an important role in the diagnosis and management of cardiovascular diseases. The state-of-the-art CMR imaging has many advantages in cardiac imaging, including excellent spatial and temporal resolution, unrestricted imaging field, no exposure to ionizing radiation, excellent tissue contrast, and unique myocardial tissue characterization. Clinical CMR imaging is used during the cardiovascular diagnostic workup in the United States and some European countries. Use of CMR imaging is emerging in hospitals in China and has a promising future. This review briefly describes the real-world clinical application of CMR imaging in China and discuss obstacles for its future development.

  11. Characterizing POLG ataxia: clinics, electrophysiology and imaging.

    Science.gov (United States)

    Synofzik, Matthis; Srulijes, Karin; Godau, Jana; Berg, Daniela; Schöls, Ludger

    2012-12-01

    Mutations in the mitochondrial DNA polymerase gamma (POLG) cause a highly pleomorphic disease spectrum, and reports about their frequencies in ataxia populations yield equivocal results. This leads to uncertainties about the role of POLG genetics in the workup of patients with unexplained ataxia. A comprehensive characterization of POLG-associated ataxia (POLG-A) will help guide genetic diagnostics and advance our understanding of the disease processes underlying POLG-A. Thirteen patients with POLG-A were assessed by standardized clinical investigation, nerve conduction studies, motor-evoked potentials, magnetic resonance imaging (MRI) and transcranial sonography (TCS). The findings were compared with 13 matched patients with Friedreich's ataxia (FA). In addition to the well-known POLG-associated features of chronic external ophthalmoplegia (100 %), areflexia to the lower extremity (100 %), impaired vibration sense (100 %), bilateral ptosis (69 %) and epilepsy (38 %), also hyperkinetic movement disorders were frequent in POLG-A patients, including chorea (31 %), dystonia (31 %) and myoclonus (23 %). Similar to FA, polyneuropathy was of sensory axonal type (100 %). In contrast to FA, none of the POLG-A patients showed impaired central motor conduction. TCS demonstrated less enlargement of the fourth ventricle and more diffuse cerebellar hyperechogenicity in POLG-A. Corresponding to TCS, MRI revealed no or only mild cerebellar atrophy in most POLG-A patients (85 %). POLG ataxia presents with the clinical characteristics of both afferent and cerebellar ataxia. Cerebellar alterations diffusely involve various parts of the cerebellum, yet cerebellar atrophy is generally mild. POLG-A presents with a high load of distinct non-ataxia features, namely, sensory neuropathy, external ophthalmoplegia, ptosis, epilepsy and/or hyperkinetic movement disorders. Involvement of the corticospinal tract, however, is rare.

  12. [Future perspectives for diagnostic imaging in urology: from anatomic and functional to molecular imaging].

    Science.gov (United States)

    Macis, Giuseppe; Di Giovanni, Silvia; Di Franco, Davide; Bonomo, Lorenzo

    2013-01-01

    The future approach of diagnostic imaging in urology follows the technological progress, which made the visualization of in vivo molecular processes possible. From anatomo-morphological diagnostic imaging and through functional imaging molecular radiology is reached. Based on molecular probes, imaging is aimed at assessing the in vivo molecular processes, their physiology and function at cellular level. The future imaging will investigate the complex tumor functioning as metabolism, aerobic glycolysis in particular, angiogenesis, cell proliferation, metastatic potential, hypoxia, apoptosis and receptors expressed by neoplastic cells. Methods for performing molecular radiology are CT, MRI, PET-CT, PET-MRI, SPECT and optical imaging. Molecular ultrasound combines technological advancement with targeted contrast media based on microbubbles, this allowing the selective registration of microbubble signal while that of stationary tissues is suppressed. An experimental study was carried out where the ultrasound molecular probe BR55 strictly bound to prostate tumor results in strong enhancement in the early phase after contrast, this contrast being maintained in the late phase. This late enhancement is markedly significant for the detection of prostatic cancer foci and to guide the biopsy sampling. The 124I-cG250 molecular antibody which is strictly linked to cellular carbonic anhydrase IX of clear cell renal carcinoma, allows the acquisition of diagnostic PET images of clear cell renal carcinoma without biopsy. This WG-250 (RENCAREX) antibody was used as a therapy in metastatic clear cell renal carcinoma. Future advancements and applications will result in early cancer diagnosis, personalized therapy that will be specific according to the molecular features of cancer and leading to the development of catheter-based multichannel molecular imaging devices for cystoscopy-based molecular imaging diagnosis and intervention.

  13. Optimization of image quality in diagnostic radiology associated with exposure

    International Nuclear Information System (INIS)

    Fulea, C.; Ramboiu, S.

    1996-01-01

    Optimal parameters for a high quality image and minimal radiation risk for the patients were established. The characteristics that affect image quality speed, contrast factor, latitude, base density, fog density, reciprocity law failure and latent image fading were analyzed. Base density on the radiographic image was measured for Azoix film and it is 0.1 log units. Fog density is a function of development time and it will increase with 20% through the increase with 2 minutes of development time. The curve Hurter-Driffield was used to characterize photographic emulsion for Azoix film. The value of latitude of 0.7 log units is in the normally useful range of densities found in radiographs. The speed of Azoix film, as a function of the time interval between exposure and development, increase with 10% for the first 24 hours. The reduction in the patient exposure that could be effected by delaying the development of Azoix is so small, that it is far outweighed by the possible disadvantage of a delay in the acquisition of diagnostic information. Therefore, latent image fading is not very important from the point of view of patient exposure. The speeds evaluated for exposure times 0.08s, 0.16s, 0.64s were unmodified, that is reciprocity law failure was unimportant for Azoix film Perlux screen. The romania films Azoix used with Perlux screen and processed with original solutions are determined an optical density of 1.0 (average density of medical radiograph) with a minimum radiation exposure for the patient (59·10 -7 C/kg). (author)

  14. Analysis of utilization patterns and associated costs of the breast imaging and diagnostic procedures after screening mammography

    Directory of Open Access Journals (Sweden)

    Vlahiotis A

    2018-03-01

    Full Text Available Anna Vlahiotis,1 Brian Griffin,2 A Thomas Stavros,3 Jay Margolis1 1Value Based Care, Outcomes Research, Truven Health Analytics, an IBM Company, Bethesda, MD USA; 2Value Based Care, Outcomes Research, Truven Health Analytics, an IBM Company, Newark, NJ, USA; 3Seno Medical Instruments, Inc., San Antonio, TX, USA Background: Little data exist on real-world patterns and associated costs of downstream breast diagnostic procedures following an abnormal screening mammography or clinical exam.Objectives: To analyze the utilization patterns in real-world clinical settings for breast imaging and diagnostic procedures, including the frequency and volume of patients and procedures, procedure sequencing, and associated health care expenditures.Materials and methods: Using medical claims from 2011 to 2015 MarketScan Commercial and Medicare Databases, adult females with breast imaging/diagnostic procedures (diagnostic mammography, ultrasound, molecular breast imaging, tomosynthesis, magnetic resonance imaging, or biopsy other than screening mammography were selected. Continuous health plan coverage without breast diagnostic procedures was required for ≥13 months before the first found breast diagnostic procedure (index event, with a 13-month post-index follow-up period. Key outcomes included diagnostic procedure volumes, sequences, and payments. Results reported descriptively were projected to provide US national patient and procedure volumes.Results: The final sample of 875,526 patients was nationally projected to 12,394,432 patients annually receiving 8,732,909 diagnostic mammograms (53.3% of patients, 6,987,399 breast ultrasounds (42.4% of patients, and 1,585,856 biopsies (10.3% of patients. Following initial diagnostic procedures, 49.4% had second procedures, 20.1% followed with third procedures, and 10.0% had a fourth procedure. Mean (SD costs for diagnostic mammograms of US$349 ($493, ultrasounds US$132 ($134, and biopsies US$1,938 ($2,343 contributed

  15. The introduction of clinical magnetic resonance imaging in Australia

    International Nuclear Information System (INIS)

    Sorby, W.; Baddeley, H.

    1986-01-01

    Magnetic resonance imaging is a new, but expensive, modality that is being introduced into clinical use in Australia. While it promises increased safety and accuracy in many situations, its precise role when compared with computed tomography and other modalities is not fully established. Therefore, a Government financed evaluation of costs and efficacy of magnetic resonance imaging units in five teaching hospitals is to be conducted over two years (1986-1988). Experience with the introduction of computed tomography to Australia and other nations has revealed difficulties in the evaluation by conventional methods of a diagnostic technology that is improving rapidly; it is to be hoped that a systematic evaluation of the clinical applications of magnetic resonance imaging will be more achievable and useful

  16. The diagnostic value of three sacroiliac joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging

    DEFF Research Database (Denmark)

    Arnbak, B; Jurik, A G; Jensen, R K

    2017-01-01

    OBJECTIVES: The aim of the current study was to investigate the diagnostic value of three sacroiliac (SI) joint pain provocation tests for sacroiliitis identified by magnetic resonance imaging (MRI) and stratified by gender. METHOD: Patients without clinical signs of nerve root compression were...

  17. Added Diagnostic Value of 11C-PiB-PET in Memory Clinic Patients with Uncertain Diagnosis

    Directory of Open Access Journals (Sweden)

    K.S. Frederiksen

    2012-12-01

    Full Text Available Introduction: The added diagnostic value of 11C-PiB-PET for the assessment of the accumulation of cortical beta-amyloid in memory clinic patients with uncertain diagnosis remains undetermined. Methods: All patients who underwent PiB-PET at the Copenhagen Memory Clinic between March 2008 and November 2011 were included in this uncontrolled, retrospective study. The standard diagnostic evaluation program included physical and neurological examination, cognitive and functional assessment, a cranial CT or MRI, functional imaging and cerebrospinal fluid sampling. Based on anonymized case reports, three experienced clinicians reached a consensus diagnosis and rated their confidence in the diagnosis before and after disclosure of PiB-PET ratings. PiB-PET scans were rated as either positive or negative. Results: A total of 57 patients (17 females, 30 males; age 65.7 years, range 44.2–82.6 were included in the study. Twenty-seven had a positive PiB-PET scan. At the first diagnostic evaluation, 16 patients were given a clinical Alheimer’s disease diagnosis (14 PiB positive. Of the 57 patients, 13 (23% were diagnostically reclassified after PiB-PET ratings were disclosed. The clinicians’ overall confidence in their diagnosis increased in 28 (49% patients. Conclusion: PiB-PET adds to the specialist clinical evaluation and other supplemental diagnostic investigations in the diagnostic classification of patients with uncertain diagnosis in a specialized memory clinic.

  18. Additive diagnostic role of imaging in glaucoma: optical coherence tomography and retinal nerve fiber layer photography.

    Science.gov (United States)

    Kim, Ko Eun; Kim, Seok Hwan; Oh, Sohee; Jeoung, Jin Wook; Suh, Min Hee; Seo, Je Hyun; Kim, Martha; Park, Ki Ho; Kim, Dong Myung

    2014-11-20

    To investigate the additive diagnostic role of spectral-domain optical coherence tomography (SD-OCT) and red-free retinal nerve fiber layer photography (RNFLP) in making clinical glaucoma diagnosis. Four diagnostic combination sets, including the most recent image from each measurement of 196 glaucoma eyes (including the 44 preperimetric glaucoma eyes) and 101 healthy eyes, were prepared: (1) stereo disc photography and Humphrey visual field (SH), (2) SH and SD-OCT (SHO), (3) SH and RNFLP (SHR), and (4) SHR and SD-OCT (SHRO). Each randomly sorted set was serially presented at 1-month intervals to five glaucoma specialists who were asked to evaluate them in a subjective and independent manner. The specialists' glaucoma-diagnostic performances based on the sets were then compared. For each specialist, adding SD-OCT to SH or SHR increased the glaucoma-diagnostic sensitivity but not to a level of statistical significance. For one specialist, adding RNFLP to SH significantly increased the sensitivity. Each specialist showed a high level of specificity regardless of the diagnostic set. The overall sensitivity of all specialists' assessments was significantly increased by adding RNFLP or the combination of SD-OCT and RNFLP to SH (P < 0.001); however, adding SD-OCT to SH or SHR did not significantly increase the sensitivity. A similar relationship was noted also for the preperimetric glaucoma subgroup. In contrast to RNFLP, SD-OCT did not significantly enhance the diagnostic accuracy of detecting glaucoma or even of preperimetric glaucoma. Our results suggest that, at least for glaucoma specialists, the additive diagnostic role of OCT is limited. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  19. Clinical Applications of the Eosinophilic Esophagitis Diagnostic Panel

    Directory of Open Access Journals (Sweden)

    Ting Wen

    2017-07-01

    Full Text Available Eosinophilic esophagitis (EoE is a recently recognized upper gastrointestinal allergic disorder characterized by esophageal dysfunction (e.g., dysphagia and esophageal eosinophilia of ≥15 eosinophils/high-power field in patients who have persistent esophagitis even on proton pump inhibitor (PPI therapy. The histologic method is the gold standard of EoE diagnosis. However, EoE clinical symptoms do not always correlate with histology, and the histologic method has sensitivity and specificity issues due to the patchiness of EoE and the subjective nature of the method. The “EoE transcriptome” was initially discovered in 2006, which led to the invention of the EoE diagnostic panel (EDP. In addition to providing a definitive EoE diagnosis with high accuracy, the EDP has been useful in elucidating several key elements about the disease including the efficacy of specific drugs such as swallowed glucocorticoids and anti-IL-13 humanized antibody therapy, the relationship between EoE and PPI-responsive esophageal eosinophilia, and predicting the disease course and responsiveness to therapy. The EDP’s long-term potential arises from its plasticity to incorporate new genes and uncover novel disease pathogenesis. We expect that the EDP will be increasingly helpful for personalized medicine approaches and improved diagnostics and disease monitoring.

  20. Pulmonary embolism. Clinical relevance, requirements for diagnostic and therapeutic strategies

    International Nuclear Information System (INIS)

    Nowak, F.G.; Halbfass, P.; Hoffmann, E.

    2007-01-01

    In the population the annual incidence of pulmonary embolism amounts to 1.3-2.8 per 1000 at the age of 65-89 years. Mortality reaches about 17% within the first 3 months. Acute pulmonary embolism is characterized by an increase in pulmonary arterial pressure and an impairment of the pulmonary gas exchange. Elevation of the right cardiac pressure up to right heart decompensation may follow. In addition, hypoxemia, hyperventilation, dead space ventilation, right to left shunting, bronchoconstriction, and vasoconstriction may occur. Clinical examination, ECG, laboratory findings such as elevated D-dimer, blood gas analysis, ultrasound examination of the veins of the lower extremities, and transthoracic echocardiography are acutely available diagnostic methods of an emergency department. In addition, extensive diagnostic procedures like pulmonary scintigraphy and pulmonary angiography may be required. The aim is to get a definite diagnosis as quickly as possible to direct therapy. In acute pulmonary embolism with cardiac shock, monitoring and stabilization of the circulatory function as well as an appropriate anticoagulant therapy are essential. In some cases surgery or a local fibrinolytic intervention is indicated. (orig.) [de

  1. Phase contrast imaging diagnostic for the Wendelstein 7-X stellarator

    Energy Technology Data Exchange (ETDEWEB)

    Boettger, Lukas-Georg; Grulke, Olaf [Max Planck Institute for Plasma Physics, 17491 Greifswald (Germany)

    2016-07-01

    The phase contrast imaging (PCI) diagnostic allows for non-invasive measurements of density fluctuations in high temperature plasmas. Since the index of refraction in a plasma is a function of the electron density, an incoming laser beam experiences a phase shift, which can be converted to intensity variations via interference after passing a phase plate. Generally speaking, the signal contains only the line-integrated information along the beam path. This limitation can be circumvented by using the fact that the density fluctuations form filamentary structures that are well aligned with the local magnetic field. If the magnetic field direction significantly varies along the beam path, optical filtering allows for localization of the density fluctuations. In order to identify the best diagnostic position regarding localization performance three figures of merit are introduced. They allow for quantitative comparison of different lines of sight and different magnetic field configurations. The results of the optimization process and a comparison with other fusion experiments are shown in this contribution.

  2. Targeting SR-BI for cancer diagnostics, imaging and therapy

    Directory of Open Access Journals (Sweden)

    Maneesha Amrita Rajora

    2016-09-01

    Full Text Available Scavenger receptor class B type I (SR-BI plays an important role in trafficking cholesteryl esters between the core of high density lipoprotein and the liver. Interestingly, this integral membrane protein receptor is also implicated in the metabolism of cholesterol by cancer cells, whereby overexpression of SR-BI has been observed in a number of tumours and cancer cell lines, including breast and prostate cancers. Consequently, SR-BI has recently gained attention as a cancer biomarker and exciting target for the direct cytosolic delivery of therapeutic agents. This brief review highlights these key developments in SR-BI-targeted cancer therapies and imaging probes. Special attention is given to the exploration of high density lipoprotein nanomimetic platforms that take advantage of upregulated SR-BI expression to facilitate targeted drug-delivery and cancer diagnostics, and promising future directions in the development of these agents.

  3. Biomedical nanotechnology for molecular imaging, diagnostics, and targeted therapy.

    Science.gov (United States)

    Nie, Shuming

    2009-01-01

    Biomedical nanotechnology is a cross-disciplinary area of research in science, engineering and medicine with broad applications for molecular imaging, molecular diagnosis, and targeted therapy. The basic rationale is that nanometer-sized particles such as semiconductor quantum dots and iron oxide nanocrystals have optical, magnetic or structural properties that are not available from either molecules or bulk solids. When linked with biotargeting ligands such as monoclonal antibodies, peptides or small molecules, these nanoparticles can be used to target diseased cells and organs (such as malignant tumors and cardiovascular plaques) with high affinity and specificity. In the "mesoscopic" size range of 5-100 nm diameter, nanoparticles also have large surface areas and functional groups for conjugating to multiple diagnostic (e.g., optical, radioisotopic, or magnetic) and therapeutic (e.g., anticancer) agents.

  4. Valuation of the paranasal sinus by means of diagnostic images

    International Nuclear Information System (INIS)

    Lozano Alfonso, Javier; Araque, Julio Mario

    1997-01-01

    The development and popularization of the surgery functional endoscopy, a bigger understanding of the anatomy and physiology of the mucociliary system of the superior airway and new techniques in diagnostics images, have allowed a better understanding of the pathology of the paranasal cavities, facilitating to make an early diagnosis and a more effective treatment. The complexity in the handling of the illnesses that affect the pearliness cavities makes obligatory that the doctors have clear concepts on the indication of each one of the modalities and the alternative in the diagnosis and pursuit of the different alterations. The paper includes topics as development and anatomy, physiology, radiology, tomography, magnetic resonance, protocol of exams and conclusions

  5. Quantitative imaging biomarkers: the application of advanced image processing and analysis to clinical and preclinical decision making.

    Science.gov (United States)

    Prescott, Jeffrey William

    2013-02-01

    The importance of medical imaging for clinical decision making has been steadily increasing over the last four decades. Recently, there has also been an emphasis on medical imaging for preclinical decision making, i.e., for use in pharamaceutical and medical device development. There is also a drive towards quantification of imaging findings by using quantitative imaging biomarkers, which can improve sensitivity, specificity, accuracy and reproducibility of imaged characteristics used for diagnostic and therapeutic decisions. An important component of the discovery, characterization, validation and application of quantitative imaging biomarkers is the extraction of information and meaning from images through image processing and subsequent analysis. However, many advanced image processing and analysis methods are not applied directly to questions of clinical interest, i.e., for diagnostic and therapeutic decision making, which is a consideration that should be closely linked to the development of such algorithms. This article is meant to address these concerns. First, quantitative imaging biomarkers are introduced by providing definitions and concepts. Then, potential applications of advanced image processing and analysis to areas of quantitative imaging biomarker research are described; specifically, research into osteoarthritis (OA), Alzheimer's disease (AD) and cancer is presented. Then, challenges in quantitative imaging biomarker research are discussed. Finally, a conceptual framework for integrating clinical and preclinical considerations into the development of quantitative imaging biomarkers and their computer-assisted methods of extraction is presented.

  6. Transcriptomics in cancer diagnostics: developments in technology, clinical research and commercialization.

    Science.gov (United States)

    Sager, Monica; Yeat, Nai Chien; Pajaro-Van der Stadt, Stefan; Lin, Charlotte; Ren, Qiuyin; Lin, Jimmy

    2015-01-01

    Transcriptomic technologies are evolving to diagnose cancer earlier and more accurately to provide greater predictive and prognostic utility to oncologists and patients. Digital techniques such as RNA sequencing are replacing still-imaging techniques to provide more detailed analysis of the transcriptome and aberrant expression that causes oncogenesis, while companion diagnostics are developing to determine the likely effectiveness of targeted treatments. This article examines recent advancements in molecular profiling research and technology as applied to cancer diagnosis, clinical applications and predictions for the future of personalized medicine in oncology.

  7. Retroperitoneal schwannoma: diagnostic imaging findings in 5 patients

    International Nuclear Information System (INIS)

    Baltazar, Alberto; Santamarina, Mario; Scalise, Gabriela; Ponce de Leon, Valeria; Bello, Lorena

    2003-01-01

    Purpose: To evaluate the different imaging findings (US, CT and MRI) in retroperitoneal schwannoma. Materials and methods: 5 patients (3 male and 2 females) with a diagnosis of retroperitoneal schwannoma were retrospectively evaluated. Ages ranged from 33 to 63 years (means 54 years). The images (US, CT and MR) were analyzed and correlated to histopathologic results. Results: The most frequent clinical finding was abdominal pain (60%). A presumptive diagnosis prior to surgery was suggested in 3/5 cases that had well-defined masses with a predominant cystic appearance. All patients underwent surgery with tumoral resection. Only 2 patients (40%) had recurrence within a three years period of follow-up. Conclusion: Retroperitoneal schwannoma is an infrequent tumor. In our series, no pathognomotic features were observed on US, CT or MRI. However, 3/5 tumors showed high signal intensity on T2-weighted images due to cystic areas. (author)

  8. [Child sexual abuse. Epidemiology, clinical diagnostics, therapy, and prevention].

    Science.gov (United States)

    Fegert, J M; Hoffmann, U; Spröber, N; Liebhardt, H

    2013-02-01

    The article provides an overview of the research on sexual abuse and the current political developments in Germany. First, the terminology of sexual child abuse is discussed, followed by the presentation of epidemiological data. The section on diagnostics and therapy shows that--because of mostly nonspecific indicators--the diagnosis of child sexual abuse is very difficult to define. Child sexual abuse is discussed as a traumatic experience for children and adolescents with different psychiatric and physical diseases. Current studies have shown that especially cognitive behavioral therapeutic-oriented approaches are effective in curing posttraumatic stress disorders. Based on the new German Child Protection Act, the focus lies on the clarification of confidentiality for medical professionals and their right to consulting services for child protection. In conclusion, guidelines and minimum standards for a child prevention and protection model are presented as well as institutional recommendations addressed to all institutions (also clinical) that take care of or treat children and adolescents.

  9. Diagnostic clinical parasitology: IV. Identification of the blood parasites?

    Science.gov (United States)

    Garcia, L S; Voge, M

    1981-01-01

    This is the fourth article in a series of articles entitled "Diagnostic Clinical Parasitology" and contains information on the recovery and identification of human blood parasites. The organisms covered include those that cause the diseases malaria, babesiosis, leishmaniasis, and trypanosomiasis. Some of the filarial worms, which can be considered "blood parasites," have been discussed in the third article in the series, "Identification of the Helminths." Although some of these organisms may rarely be encountered in the laboratory in clinical specimens, they will probably have to be identified in proficiency testing specimens, some of which may not always be representative of patient clinical material. The differences between potential organism recovery from patients coming from endemic areas and from those individuals who become infected with no prior exposure to the organism will also be emphasized. Often, for a number of different reasons, organism recovery and subsequent identification may be more difficult than the textbook imply. It is very important for the technologist to recognize this fact, particularly when dealing with a possibly fatal infection, ie, Plasmodium falciparum.

  10. Brigham and Women's Hospital handbook of diagnostic imaging

    International Nuclear Information System (INIS)

    McNeil, B.J.; Abrams, H.L.

    1985-01-01

    Basically there are 62 sections on some of the most common dilemmas dealt with. These are followed by four interesting appendixes. The clinical sections are grouped under eight headings: abdominal disease (12 sections), genito-urinary disease (seven), chest disease (seven), neurologic disease (nine), thyroid disease (one), bone disease (eight), peripheral vascular disease (one) and, finally, malignant disease (17). The four appendixes are on definitions, magnetic resonance imaging, radiation dose, and information about the range of the charges for individual studies

  11. The inextricable axis of targeted diagnostic imaging and therapy: An immunological natural history approach

    International Nuclear Information System (INIS)

    Cope, Frederick O.; Abbruzzese, Bonnie; Sanders, James; Metz, Wendy; Sturms, Kristyn; Ralph, David; Blue, Michael; Zhang, Jane; Bracci, Paige; Bshara, Wiam; Behr, Spencer; Maurer, Toby; Williams, Kenneth; Walker, Joshua; Beverly, Allison; Blay, Brooke; Damughatla, Anirudh; Larsen, Mark; Mountain, Courtney; Neylon, Erin

    2016-01-01

    Summary: In considering the challenges of approaches to clinical imaging, we are faced with choices that sometimes are impacted by rather dogmatic notions about what is a better or worse technology to achieve the most useful diagnostic image for the patient. For example, is PET or SPECT most useful in imaging any particular disease dissemination? The dictatorial approach would be to choose PET, all other matters being equal. But is such a totalitarian attitude toward imaging selection still valid? In the face of new receptor targeted SPECT agents one must consider the remarkable specificity and sensitivity of these agents. 99m Tc-Tilmanocept is one of the newest of these agents, now approved for guiding sentinel node biopsy (SLNB) in several solid tumors. Tilmanocept has a K d of 3 × 10 −11 M, and it specificity for the CD206 receptor is unlike any other agent to date. This coupled with a number of facts, that specific disease-associated macrophages express this receptor (100 to 150 thousand receptors), that the receptor has multiple binding sites for tilmanocept (> 2 sites per receptor) and that these receptors are recycled every 15 min to bind more tilmanocept (acting as intracellular “drug compilers” of tilmanocept into non-degraded vesicles), gives serious pause as to how we select our approaches to diagnostic imaging. Clinically, the size of SLNs varies greatly, some, anatomically, below the machine resolution of SPECT. Yet, with tilmanocept targeting, the SLNs are highly visible with macrophages stably accruing adequate 99m Tc-tilmanocept counting statistics, as high target-to-background ratios can compensate for spatial resolution blurring. Importantly, it may be targeted imaging agents per se, again such as tilmanocept, which may significantly shrink any perceived chasm between the imaging technologies and anchor the diagnostic considerations in the targeting and specificity of the agent rather than any lingering dogma about the hardware as the basis

  12. Detection rates in pediatric diagnostic imaging: a picture archive and communication system compared with a web-based imaging system

    International Nuclear Information System (INIS)

    McDonald, L.; Cramer, B.; Barrett, B.

    2006-01-01

    This prospective study assesses whether there are differences in accuracy of interpretation of diagnostic images among users of a picture archive and communication system (PACS) diagnostic workstation, compared with a less costly Web-based imaging system on a personal computer (PC) with a high resolution monitor. One hundred consecutive pediatric chest or abdomen and skeletal X-rays were selected from hospital inpatient and outpatient studies over a 5-month interval. They were classified as normal (n = 32), obviously abnormal (n = 33), or having subtle abnormal findings (n = 35) by 2 senior radiologists who reached a consensus for each individual case. Subsequently, 5 raters with varying degrees of experience independently viewed and interpreted the cases as normal or abnormal. Raters viewed each image 1 month apart on a PACS and on the Web-based PC imaging system. There was no relation between accuracy of detection and the system used to evaluate X-ray images (P = 0.92). The total percentage of incorrect interpretations on the Web-based PC imaging system was 23.2%, compared with 23.6% on the PACS (P = 0.92). For all raters combined, the overall difference in proportion assessed incorrectly on the PACS, compared with the PC system, was not significant at 0.4% (95%CI, -3.5% to 4.3%). The high-resolution Web-based imaging system via PC is an adequate alternative to a PACS clinical workstation. Accordingly, the provision of a more extensive network of workstations throughout the hospital setting could have potentially significant cost savings. (author)

  13. Does improved access to diagnostic imaging results reduce hospital length of stay? A retrospective study

    Directory of Open Access Journals (Sweden)

    Hurlen Petter

    2010-09-01

    Full Text Available Abstract Background One year after the introduction of Information and Communication Technology (ICT to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT reports in the Electronic Medical Record (EMR was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS. Methods Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups. Results There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence. Conclusion Our results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction.

  14. Diagnostic yield of lumbosacral magnetic resonance imaging requested by paediatric urology consultations.

    Science.gov (United States)

    Fernández-Ibieta, M; Rojas Ticona, J; Villamil, V; Guirao Piñera, M J; López García, A; Zambudio Carmona, G

    2017-11-01

    In the historical series, the diagnostic yield of lumbosacral magnetic resonance imaging to rule out occult spinal dysraphism (or occult myelodysplasia), requested by paediatric urology, ranged from 2% to 15%. The aim of this study was to define our cost-effectiveness in children with urinary symptoms and to define endpoints that increase the possibility of finding occult spinal dysraphism. A screening was conducted on patients with urinary dysfunction for whom an magnetic resonance imaging was requested by the paediatric urology clinic, for persistent symptoms after treatment, voiding dysfunction or other clinical or urodynamic findings. We analysed clinical (UTI, daytime leaks, enuresis, voiding dysfunction, urgency, renal ultrasonography, lumbosacral radiography, history of acute urine retention, skin stigma and myalgia) and urodynamic endpoints (hyperactivity or areflexia, voiding dysfunction, interrupted pattern, accommodation value and maximum flow). A univariate analysis was conducted with SPSS 20.0. We analysed 21 patients during the period 2011-2015. The median age was 6 years (3-10). Three patients (14.3%) had occult spinal dysraphism: one spinal lipoma, one filum lipomatosus and one caudal regression syndrome with channel stenosis. The endpoints with statistically significant differences were the myalgias and the history of acute urine retention (66.7% vs. 5.6%, P=.04; OR= 34; 95%CI: 1.5-781 for both endpoints). The diagnostic yield of magnetic resonance imaging requested for children with urinary dysfunctions without skin stigma or neuro-orthopaedic abnormalities is low, although nonnegligible. In this group, the patients with a history of acute urine retention and muscle pain (pain, «cramps») can experience a greater diagnostic yield or positive predictive value. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Genomics, proteomics, MEMS and SAIF: which role for diagnostic imaging?

    Science.gov (United States)

    Grassi, R; Lagalla, R; Rotondo, A

    2008-09-01

    In these three words--genomics, proteomics and nanotechnologies--is the future of medicine of the third millennium, which will be characterised by more careful attention to disease prevention, diagnosis and treatment. Molecular imaging appears to satisfy this requirement. It is emerging as a new science that brings together molecular biology and in vivo imaging and represents the key for the application of personalized medicine. Micro-PET (positron emission tomography), micro-SPECT (single photon emission computed tomography), micro-CT (computed tomography), micro-MR (magnetic resonance), micro-US (ultrasound) and optical imaging are all molecular imaging techniques, several of which are applied only in preclinical settings on animal models. Others, however, are applied routinely in both clinical and preclinical setting. Research on small animals allows investigation of the genesis and development of diseases, as well as drug efficacy and the development of personalized therapies, through the study of biological processes that precede the expression of common symptoms of a pathology. Advances in molecular imaging were made possible only by collaboration among scientists in the fields of radiology, chemistry, molecular and cell biology, physics, mathematics, pharmacology, gene therapy and oncology. Although until now researchers have traditionally limited their interactions, it is only by increasing these connections that the current gaps in terminology, methods and approaches that inhibit scientific progress can be eliminated.

  16. Diagnostic imaging in the study of human hepatobiliary fascioliasis.

    Science.gov (United States)

    Cantisani, V; Cantisani, C; Mortelé, K; Pagliara, E; D'Onofrio, M; Fernandez, M; D'Ambrosio, U; Lombardi, V; Marigliano, C; Ricci, P

    2010-02-01

    Fascioliasis is a rare zoonotic disease caused by the trematode Fasciola hepatica. We present the typical patterns of hepatobiliary fascioliasis observed in ten patients studied with multimodality imaging. Between 2002 and 2005, ten women with fascioliasis were admitted to the Brigham and Women's Hospital, Harvard Medical School (BWH), with abdominal pain and mild fever. All imaging modalities, including ultrasound (US), computed tomography (CT), magnetic resonance (MR) imaging (n = 2) and endoscopic retrograde cholangiopancreatography (ERCP) (n = 1) were reviewed by two expert radiologists working in consensus. In all patients (10/10, 100%), US showed parenchymal heterogeneity characterised by multiple subcapsular and peribiliary hypoechoic nodular lesions that were ill-defined and coalesced into tubular or tortuous structures. In six patients (6/10, 60%), the lesions appeared hypoechoic, whereas in four patients (4/10, 40%), there was an alternation of hyperechoic and hypoechoic nodules. On CT, all patients (10/10, 100%) showed hypodense patchy lesions in subcapsular, peribiliary or periportal locations, which coalesced to form tubular structures and were more evident during the portal phase. Lesion diameter ranged from 2 cm to 7 cm. Capsular enhancement was seen in four cases on CT (4/10, 40%) and in one also at MR imaging. MR imaging, performed in two patients, confirmed the presence of the lesions, which appeared hyperintense on T2-weighted images and were characterised by mild peripheral enhancement after gadolinium administration. Four patients had gallbladder wall thickening (4/10, 40%), with parasites in the gallbladder lumen. Although rare, hepatobiliary fascioliasis should be considered in the differential diagnosis in the appropriate clinical scenario, especially in patients coming from endemic areas. The typical imaging pattern of fascioliasis is the presence of subcapsular, peribiliary or periportal nodules that are usually ill-defined and coalesce

  17. Molecular diagnostics of lung cancer in the clinic.

    Science.gov (United States)

    Sholl, Lynette

    2017-10-01

    According to current practice guidelines, all patients with advanced non-small cell lung cancer (NSCLC) should undergo predictive biomarker testing. For squamous cell carcinoma patients, PD-L1 immunohistochemistry is indicated to select patients for immunotherapy in the first line. For lung adenocarcinoma, all patients with advanced disease should undergo testing for epidermal growth factor receptor ( EGFR ) mutations, ALK and ROS1 rearrangements, and PD-L1 expression to predict response to EGFR, ALK, or ROS1 targeted inhibitors or immunotherapy, respectively. Besides these, a number of other biomarkers are under clinical investigation as predictors of response to targeted therapies, including BRAF , ERBB2 , MET splice mutations and amplification, and RET rearrangements. Successful testing for this complex array of molecular targets demands careful coordination between proceduralists, pathologists and molecular laboratories to ensure proper tumor tissue handling following biopsy as well as judicious use of diagnostic immunohistochemistry. Even so, sample failure rates due to inadequate tumor tissue are high in practice, particularly when using sequential testing methods. Use of next generation sequencing (NGS) in clinical practice can enable detection of multiple targets and multiple alteration types (mutation, gene copy change, and rearrangement) simultaneously even with small amounts of input nucleic acids, thus increasing molecular testing success rates. In patients with an established lung cancer diagnosis but with prohibitively limited amounts of tumor tissue or who are experiencing relapse, analyses of circulating tumor DNA (ctDNA) from the plasma can serve as an alternate testing substrate, however the more limited clinical sensitivity of this approach must be taken into account. This review will explore the indications for and pitfalls of routine NGS and plasma genotyping in the clinic, including the intersection of these technologies.

  18. Diagnostic imaging of blunt abdominal trauma in pediatric patients.

    Science.gov (United States)

    Miele, Vittorio; Piccolo, Claudia Lucia; Trinci, Margherita; Galluzzo, Michele; Ianniello, Stefania; Brunese, Luca

    2016-05-01

    Trauma is a leading cause of morbidity and mortality in childhood, and blunt trauma accounts for 80-90 % of abdominal injuries. The mechanism of trauma is quite similar to that of the adults, but there are important physiologic differences between children and adults in this field, such as the smaller blood vessels and the high vasoconstrictive response, leading to the spreading of a non-operative management. The early imaging of children undergoing a low-energy trauma can be performed by CEUS, a valuable diagnostic tool to demonstrate solid organ injuries with almost the same sensitivity of CT scans; nevertheless, as for as urinary tract injuries, MDCT remains still the technique of choice, because of its high sensitivity and accuracy, helping to discriminate between an intra-peritoneal form a retroperitoneal urinary leakage, requiring two different managements. The liver is the most common organ injured in blunt abdominal trauma followed by the spleen. Renal, pancreatic, and bowel injuries are quite rare. In this review we present various imaging findings of blunt abdominal trauma in children.

  19. [Transparency regime: semiotics of radiographical images in urological diagnostics].

    Science.gov (United States)

    Martin, M; Fangerau, H

    2012-10-01

    Shortly after Röntgen discovered x-rays urology became one of the main test fields for the application of this new technology. Initial scepticism among physicians, who were inclined to cling to traditional manual methods of diagnosing, was replaced by enthusiasm for radiographic technologies and the new method soon became the standard in, for example the diagnosis of concrements. Patients favoring radiographic procedures over the use of probes and a convincing documentation of stones in radiograms were factors that impacted the relatively rapid integration of radiology into urology. The radiographic representation of soft tissues and body cavities was more difficult and the development of contrast agents in particular posed a serious problem. Several patients died during this research. A new diagnostic dimension was revealed when radiography and cystography were combined to form the method of retrograde pyelography. However, the problem of how urologists could learn how to read the new images remained. In order to allow trainee physicians to practice interpreting radiograms atlases were produced which offered explanatory texts and drawings for radiographic images of the kidneys, the bladder etc. Thus, urologists developed a self-contained semiotics which facilitated the appropriation of a unique urological radiographical gaze.

  20. Diagnostic accuracy of postmortem imaging vs autopsy-A systematic review.

    Science.gov (United States)

    Eriksson, Anders; Gustafsson, Torfinn; Höistad, Malin; Hultcrantz, Monica; Jacobson, Stella; Mejare, Ingegerd; Persson, Anders

    2017-04-01

    Background Postmortem imaging has been used for more than a century as a complement to medico-legal autopsies. The technique has also emerged as a possible alternative to compensate for the continuous decline in the number of clinical autopsies. To evaluate the diagnostic accuracy of postmortem imaging for various types of findings, we performed this systematic literature review. Data sources The literature search was performed in the databases PubMed, Embase and Cochrane Library through January 7, 2015. Relevant publications were assessed for risk of bias using the QUADAS tool and were classified as low, moderate or high risk of bias according to pre-defined criteria. Autopsy and/or histopathology were used as reference standard. Findings The search generated 2600 abstracts, of which 340 were assessed as possibly relevant and read in full-text. After further evaluation 71 studies were finally included, of which 49 were assessed as having high risk of bias and 22 as moderate risk of bias. Due to considerable heterogeneity - in populations, techniques, analyses and reporting - of included studies it was impossible to combine data to get a summary estimate of the diagnostic accuracy of the various findings. Individual studies indicate, however, that imaging techniques might be useful for determining organ weights, and that the techniques seem superior to autopsy for detecting gas Conclusions and Implications In general, based on the current scientific literature, it was not possible to determine the diagnostic accuracy of postmortem imaging and its usefulness in conjunction with, or as an alternative to autopsy. To correctly determine the usefulness of postmortem imaging, future studies need improved planning, improved methodological quality and larger materials, preferentially obtained from multi-center studies. Copyright © 2016. Published by Elsevier B.V.

  1. Diagnostic accuracy at several reduced radiation dose levels for CT imaging in the diagnosis of appendicitis

    Science.gov (United States)

    Zhang, Di; Khatonabadi, Maryam; Kim, Hyun; Jude, Matilda; Zaragoza, Edward; Lee, Margaret; Patel, Maitraya; Poon, Cheryce; Douek, Michael; Andrews-Tang, Denise; Doepke, Laura; McNitt-Gray, Shawn; Cagnon, Chris; DeMarco, John; McNitt-Gray, Michael

    2012-03-01

    Purpose: While several studies have investigated the tradeoffs between radiation dose and image quality (noise) in CT imaging, the purpose of this study was to take this analysis a step further by investigating the tradeoffs between patient radiation dose (including organ dose) and diagnostic accuracy in diagnosis of appendicitis using CT. Methods: This study was IRB approved and utilized data from 20 patients who underwent clinical CT exams for indications of appendicitis. Medical record review established true diagnosis of appendicitis, with 10 positives and 10 negatives. A validated software tool used raw projection data from each scan to create simulated images at lower dose levels (70%, 50%, 30%, 20% of original). An observer study was performed with 6 radiologists reviewing each case at each dose level in random order over several sessions. Readers assessed image quality and provided confidence in their diagnosis of appendicitis, each on a 5 point scale. Liver doses at each case and each dose level were estimated using Monte Carlo simulation based methods. Results: Overall diagnostic accuracy varies across dose levels: 92%, 93%, 91%, 90% and 90% across the 100%, 70%, 50%, 30% and 20% dose levels respectively. And it is 93%, 95%, 88%, 90% and 90% across the 13.5-22mGy, 9.6-13.5mGy, 6.4-9.6mGy, 4-6.4mGy, and 2-4mGy liver dose ranges respectively. Only 4 out of 600 observations were rated "unacceptable" for image quality. Conclusion: The results from this pilot study indicate that the diagnostic accuracy does not change dramatically even at significantly reduced radiation dose.

  2. Clinical PET/MR Imaging in Oncology

    DEFF Research Database (Denmark)

    Kjær, Andreas; Torigian, Drew A.

    2016-01-01

    . The question, therefore, arises regarding what the future clinical applications of PET/MR imaging will be. In this article, the authors discuss ways in which PET/MR imaging may be used in future applications that justify the added cost, predominantly focusing on oncologic applications. The authors suggest...

  3. Diagnostic utility of intravenous contrast for MR imaging in pediatric appendicitis

    Energy Technology Data Exchange (ETDEWEB)

    Lyons, Gray R.; Renjen, Pooja; Kovanlikaya, Arzu [New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Radiology, New York, NY (United States); Askin, Gulce; Giambrone, Ashley E. [New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Biostatistics and Epidemiology, New York, NY (United States); Beneck, Debra [New York-Presbyterian Hospital/Weill Cornell Medicine, Department of Pathology, New York, NY (United States)

    2017-04-15

    Magnetic resonance imaging (MRI) is increasingly employed as a diagnostic modality for suspected appendicitis in children. However, there is uncertainty as to which MRI sequences are sufficient for safe, timely and accurate diagnosis. Several recent studies have described different MRI protocols, including exams both with and without the use of intravenous contrast. We hypothesized that intravenous contrast may be useful in some patients but could be safely omitted in others. All MRI examinations (n=112) performed at our institution for evaluating appendicitis in children were retrospectively reevaluated. Exams were reread by pediatric radiologists under three conditions: With postcontrast images, Without postcontrast images, and Without/With - selective use of postcontrast sequences only when needed for diagnostic certainty. Samples were scored as positive, negative or equivocal for appendicitis. Findings were compared to pathological or clinical follow-up in the medical record. Without the use of intravenous contrast yielded more equivocal results (12.4%) compared to With contrast (3.4%). By selectively using postcontrast sequences, the Without/With group yielded fewer equivocal results (1.1%) compared to Without while also reducing contrast use 79.8% compared to the With contrast group. No significant differences in conditional sensitivity or conditional specificity were detected among the three groups. MRI diagnosis of acute appendicitis can be performed without contrast for most patients; injection of contrast can be reserved for only those patients with equivocal non-contrast imaging. (orig.)

  4. Diagnostic sensitivity of radiography, ultrasonography, and magnetic resonance imaging for detecting shoulder osteochondrosis/osteochondritis dissecans in dogs.

    Science.gov (United States)

    Wall, Corey R; Cook, Cristi R; Cook, James L

    2015-01-01

    Radiography, magnetic resonance imaging (MRI), and ultrasonography are commonly used for diagnosis of shoulder osteochondrosis and osteochondritis dissecans (OC/OCD) in dogs, however there is a lack of published information on the relative diagnostic sensitivities of these modalities. The purpose of this prospective study was to compare diagnostic sensitivities of these modalities for detecting shoulder OC/OCD in a group of dogs, using arthroscopy as the reference standard. Inclusion criteria were history and clinical findings consistent with osteochondrosis and/or osteochondritis dissecans involving at least one shoulder. With informed client consent, both shoulders for all included dogs were examined using standardized radiography, ultrasonography, MRI, and arthroscopy protocols. One of three veterinary surgeons recorded clinical and arthroscopic findings without knowledge of diagnostic imaging findings. One of two veterinary radiologists recorded diagnostic imaging findings without knowledge of clinical and arthroscopic findings. Eighteen client-owned dogs (n = 36 shoulders) met inclusion criteria. Diagnostic sensitivity, specificity, and accuracy (correct classification rate) values for detecting presence or absence of shoulder osteochondrosis/osteochondritis dissecans were as follows: radiography (88.5%, 90%, 88.9%), ultrasonography (92%, 60%, 82.6%), and MRI (96%, 88.9%, 94.4%). Odds of a correct diagnosis for MRI were 3.2 times more than ultrasonography and two times more than radiography. For MRI detection of lesions, the sagittal T2 or PD-FAT SAT sequences were considered to be most helpful. For radiographic detection of lesions, the additional supinated-mediolateral and pronated-mediolateral projections were considered to be most helpful. Findings from the current study support more evidence-based diagnostic imaging recommendations for dogs with clinically suspected shoulder osteochondrosis or osteochondritis dissecans. © 2014 American College of

  5. Clinical-Diagnostic Features of Duchenne Muscular Dystrophy in Children

    Directory of Open Access Journals (Sweden)

    Umida T. Omonova

    2013-12-01

    Full Text Available Duchenne Muscular Dystrophy (DMD is a severe, progressive disease that affects about 1 out of every 5,000 male infants; this is the most destructive of all muscular dystrophies, which worsens rapidly. In this study, we performed a clinical analysis of 37 children with DMD. They ranged in age from 3 to 15 years, mean age being 7.8±0.48 years. The mean age at onset was 4.3±0.36 years and ranged from birth to 8 years. The biochemical examination included the determination of the serum levels of the following enzymes, AST, ALT, CPK-MM, and LDH. A genealogical analysis was conducted among 240 first-degree relatives of children with DMD. Electroneuromyography examination included registration of the biopotentials of the hand and foot muscles, measurement of the muscle response (M-wave and the late-evoked responses. The clinical-diagnostic features of DMD in children were characterized.

  6. Comparison of different phantoms used in digital diagnostic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Bor, Dogan, E-mail: bor@eng.ankara.edu.tr [Ankara University, Faculty of Engineering, Department of Engineering Physics. Tandogan, 06100 Ankara (Turkey); Unal, Elif, E-mail: elf.unall@gmail.com [Radat Dosimetry Laboratory Services, 06830, Golbasi, Ankara (Turkey); Uslu, Anil, E-mail: m.aniluslu@gmail.com [Radat Dosimetry Laboratory Services, 06830, Golbasi, Ankara (Turkey)

    2015-09-21

    The organs of extremity, chest, skull and lumbar were physically simulated using uniform PMMA slabs with different thicknesses alone and using these slabs together with aluminum plates and air gaps (ANSI Phantoms). The variation of entrance surface air kerma and scatter fraction with X-ray beam qualities was investigated for these phantoms and the results were compared with those measured from anthropomorphic phantoms. A flat panel digital radiographic system was used for all the experiments. Considerable variations of entrance surface air kermas were found for the same organs of different designs, and highest doses were measured for the PMMA slabs. A low contrast test tool and a contrast detail test object (CDRAD) were used together with each organ simulation of PMMA slabs and ANSI phantoms in order to test the clinical image qualities. Digital images of these phantom combinations and anthropomorphic phantoms were acquired in raw and clinically processed formats. Variation of image quality with kVp and post processing was evaluated using the numerical metrics of these test tools and measured contrast values from the anthropomorphic phantoms. Our results indicated that design of some phantoms may not be efficient enough to reveal the expected performance of the post processing algorithms.

  7. Leiomyosarcomas of the inferior vena cava: diagnostic features on cross-sectional imaging

    International Nuclear Information System (INIS)

    Ganeshalingam, S.; Rajeswaran, G.; Jones, R.L.; Thway, K.; Moskovic, E.

    2011-01-01

    Aim: To evaluate the cross-sectional radiological appearances and to review the clinical presentation and outcome of patients with leiomyosarcomas of the inferior vena cava (IVC LMS). These are rare aggressive tumours that present late with non-specific symptoms and have a poor prognosis. Materials and Methods: From January 2002 to December 2008, the radiological images of 23 sequential patients with pathologically proven IVC LMS were independently reviewed by two experienced radiologists. The clinical presentation, treatment including surgical details, and outcome were recorded. Results: There were 19 females and four males with a mean age of 53 years. CT typically demonstrated a large, lobulate, non-calcified heterogeneous mass with peripheral enhancement. T1-weighted magnetic resonance imaging (MRI) images demonstrated a mass with a low signal intensity and T2-weighted MRI images demonstrated a mass with a high signal intensity. Clinical presentation included leg oedema, back and abdominal pain with almost 50% of patients presenting with metastases. Eleven patients underwent ablative surgery. The mean survival time of all patients in the study was 34 months and that of the 11 post-surgical patients was 56 months. Conclusion: There are a variety of diagnostic features on both computed tomography (CT) and MRI which aid the diagnosis of this unusual vascular neoplasm. CT is vital in determining the location of the tumour within the IVC and MRI accurately depicts its extent and the potential for surgical resectability, which offers the only chance of survival.

  8. Leiomyosarcomas of the inferior vena cava: diagnostic features on cross-sectional imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ganeshalingam, S., E-mail: skandadas.ganeshalingam@nhs.ne [Department of Clinical Radiology, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Rajeswaran, G. [Department of Clinical Radiology, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Jones, R.L. [Department of Clinical Oncology, University of Washington and Hutchinson Cancer Research Center, Seattle, WA (United States); Thway, K. [Department of Histopathology, The Royal Marsden NHS Foundation Trust, London (United Kingdom); Moskovic, E. [Department of Clinical Radiology, The Royal Marsden NHS Foundation Trust, London (United Kingdom)

    2011-01-15

    Aim: To evaluate the cross-sectional radiological appearances and to review the clinical presentation and outcome of patients with leiomyosarcomas of the inferior vena cava (IVC LMS). These are rare aggressive tumours that present late with non-specific symptoms and have a poor prognosis. Materials and Methods: From January 2002 to December 2008, the radiological images of 23 sequential patients with pathologically proven IVC LMS were independently reviewed by two experienced radiologists. The clinical presentation, treatment including surgical details, and outcome were recorded. Results: There were 19 females and four males with a mean age of 53 years. CT typically demonstrated a large, lobulate, non-calcified heterogeneous mass with peripheral enhancement. T1-weighted magnetic resonance imaging (MRI) images demonstrated a mass with a low signal intensity and T2-weighted MRI images demonstrated a mass with a high signal intensity. Clinical presentation included leg oedema, back and abdominal pain with almost 50% of patients presenting with metastases. Eleven patients underwent ablative surgery. The mean survival time of all patients in the study was 34 months and that of the 11 post-surgical patients was 56 months. Conclusion: There are a variety of diagnostic features on both computed tomography (CT) and MRI which aid the diagnosis of this unusual vascular neoplasm. CT is vital in determining the location of the tumour within the IVC and MRI accurately depicts its extent and the potential for surgical resectability, which offers the only chance of survival.

  9. Autoimmune liver serology: current diagnostic and clinical challenges.

    Science.gov (United States)

    Bogdanos, Dimitrios-P; Invernizzi, Pietro; Mackay, Ian-R; Vergani, Diego

    2008-06-07

    Liver-related autoantibodies are crucial for the correct diagnosis and classification of autoimmune liver diseases (AiLD), namely autoimmune hepatitis types 1 and 2 (AIH-1 and 2), primary biliary cirrhosis (PBC), and the sclerosing cholangitis variants in adults and children. AIH-1 is specified by anti-nuclear antibody (ANA) and smooth muscle antibody (SMA). AIH-2 is specified by antibody to liver kidney microsomal antigen type-1 (anti-LKM1) and anti-liver cytosol type 1 (anti-LC1). SMA, ANA and anti-LKM antibodies can be present in de-novo AIH following liver transplantation. PBC is specified by antimitochondrial antibodies (AMA) reacting with enzymes of the 2-oxo-acid dehydrogenase complexes (chiefly pyruvate dehydrogenase complex E2 subunit) and disease-specific ANA mainly reacting with nuclear pore gp210 and nuclear body sp100. Sclerosing cholangitis presents as at least two variants, first the classical primary sclerosing cholangitis (PSC) mostly affecting adult men wherein the only (and non-specific) reactivity is an atypical perinuclear antineutrophil cytoplasmic antibody (p-ANCA), also termed perinuclear anti-neutrophil nuclear antibodies (p-ANNA) and second the childhood disease called autoimmune sclerosing cholangitis (ASC) with serological features resembling those of type 1 AIH. Liver diagnostic serology is a fast-expanding area of investigation as new purified and recombinant autoantigens, and automated technologies such as ELISAs and bead assays, become available to complement (or even compete with) traditional immunofluorescence procedures. We survey for the first time global trends in quality assurance impacting as it does on (1) manufacturers/purveyors of kits and reagents, (2) diagnostic service laboratories that fulfill clinicians' requirements, and (3) the end-user, the physician providing patient care, who must properly interpret test results in the overall clinical context.

  10. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale

    NARCIS (Netherlands)

    Laméris, Wytze; van Randen, Adrienne; Dijkgraaf, Marcel G. W.; Bossuyt, Patrick M. M.; Stoker, Jaap; Boermeester, Marja A.

    2007-01-01

    ABSTRACT: BACKGROUND: The acute abdomen is a frequent entity at the Emergency Department (ED), which usually needs rapid and accurate diagnostic work-up. Diagnostic work-up with imaging can consist of plain X-ray, ultrasonography (US), computed tomography (CT) and even diagnostic laparoscopy.

  11. Comparative diagnostic imaging of a partial patellar ligament tear in a dog

    Directory of Open Access Journals (Sweden)

    Mario Ricciardi

    2018-05-01

    Full Text Available Traumatic lesions of the patellar ligament (PL are rare in dogs. The resulting injury can be a complete or partial laceration, depending on the quantity of torn collagen fibres. Information obtained from imaging evaluation is of great value to the clinical approach towards PL injuries, because subsequent treatment options are affected by the distinction between complete or partial tears. Imaging diagnosis of PL damage in veterinary practice commonly relies on radiographic examination through the recognition of indirect signs, such as “patella alta”, bone fragments at the level of the patellar or tibial insertion, and soft tissue opacity at the cranial aspect of the joint. Although ultrasound (US and magnetic resonance imaging (MRI have been described as useful diagnostic tools for the assessment of PL tears in human patients, specific comparative data regarding the evaluation of PL rupture in dogs using different imaging modalities is lacking in the veterinary literature. This paper describes the radiographic, ultrasonographic, CT and MRI imaging findings of a partial PL tear in a dog and discusses the utility of these techniques in diagnosing this condition. CT provided more detailed information than X-ray examination in the assessment of the osteoligamentous junction, the exclusion of microfracture and distal PL avulsion, but did not add information regarding PL integrity. MRI and US provided the most useful information regarding intra-ligamentous damage and as such their combined use may be considered for the assessment of PL injuries after clinical examination and survey radiographs.

  12. Dental diagnostic clinical instrument ('Canary') development using photothermal radiometry and modulated luminescence

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, R J; Sivagurunathan, K; Garcia, J; Matvienko, A; Mandelis, A [Center for Advanced Diffusion Wave Technologies (CADIFT), Department of Mechanical and Industrial Engineering, University of Toronto, 5 King' s College Road, Toronto, Ontario, M5S 3G8 (Canada); Abrams, S, E-mail: mandelis@mie.utoronto.c [Quantum Dental Technologies, 748 Briar Hill Avenue, Toronto, Ontario, M6B 1L3 (Canada)

    2010-03-01

    Since 1999, our group at the CADIFT, University of Toronto, has developed the application of Frequency Domain Photothermal Radiometry (PTR) and Luminescence (LUM) to dental caries detection. Various cases including artificial caries detection have been studied and some of the inherent advantages of the adaptation of this technique to dental diagnostics in conjunction with modulated luminescence as a dual-probe technique have been reported. Based on these studies, a portable, compact diagnostic instrument for dental clinic use has been designed, assembled and tested. A semiconductor laser, optical fibers, a thermoelectric cooled mid-IR detector, and a USB connected data acquisition card were used. Software lock-in amplifier techniques were developed to compute amplitude and phase of PTR and LUM signals. In order to achieve fast measurement and acceptable signal-to-noise ratio (SNR) for clinical application, swept sine waveforms were used. As a result sampling and stabilization time for each measurement point was reduced to a few seconds. A sophisticated software interface was designed to simultaneously record intra-oral camera images with PTR and LUM responses. Preliminary results using this instrument during clinical trials in a dental clinic showed this instrument could detect early caries both from PTR and LUM signals.

  13. Dental diagnostic clinical instrument (Canary) development using photothermal radiometry and modulated luminescence

    International Nuclear Information System (INIS)

    Jeon, R J; Sivagurunathan, K; Garcia, J; Matvienko, A; Mandelis, A; Abrams, S

    2010-01-01

    Since 1999, our group at the CADIFT, University of Toronto, has developed the application of Frequency Domain Photothermal Radiometry (PTR) and Luminescence (LUM) to dental caries detection. Various cases including artificial caries detection have been studied and some of the inherent advantages of the adaptation of this technique to dental diagnostics in conjunction with modulated luminescence as a dual-probe technique have been reported. Based on these studies, a portable, compact diagnostic instrument for dental clinic use has been designed, assembled and tested. A semiconductor laser, optical fibers, a thermoelectric cooled mid-IR detector, and a USB connected data acquisition card were used. Software lock-in amplifier techniques were developed to compute amplitude and phase of PTR and LUM signals. In order to achieve fast measurement and acceptable signal-to-noise ratio (SNR) for clinical application, swept sine waveforms were used. As a result sampling and stabilization time for each measurement point was reduced to a few seconds. A sophisticated software interface was designed to simultaneously record intra-oral camera images with PTR and LUM responses. Preliminary results using this instrument during clinical trials in a dental clinic showed this instrument could detect early caries both from PTR and LUM signals.

  14. Advancing Porous Silicon Biosensor Technology for Use in Clinical Diagnostics

    Science.gov (United States)

    Bonanno, Lisa Marie

    Inexpensive and robust analytical techniques for detecting molecular recognition events are in great demand in healthcare, food safety, and environmental monitoring. Despite vast research in this area, challanges remain to develop practical biomolecular platforms that, meet the rigorous demands of real-world applications. This includes maintaining low-cost devices that are sensitive and specific in complex test specimens, are stable after storage, have short assay time, and possess minimal complexity of instrumentation for readout. Nanostructured porous silicon (PSi) material has been identified as an ideal candidate towards achieving these goals and the past decade has seen diverse proof-of-principle studies developing optical-based sensing techniques. In Part 1 of this thesis, the impact of surface chemistry and PSi morphology on detection sensitivity of target molecules is investigated. Initial proof-of-concept that PSi devices facilitate detection of protein in whole blood is demonstrated. This work highlights the importance of material stability and blocking chemistry for sensor use in real world biological samples. In addition, the intrinisic filtering capability of the 3-D PSi morphology is shown as an advantage in complex solutions, such as whole blood. Ultimately, this initial work identified a need to improve detection sensitivity of the PSI biosensor technique to facilitate clinical diagnostic use over relevant target concentration ranges. The second part of this thesis, builds upon sensitivity challenges that are highlighted in the first part of the thesis and development of a surface-bound competitive inhibition immunoassay facilitated improved detection sensitivity of small molecular weight targets (opiates) over a relevant clinical concentration range. In addition, optimization of assay protocol addressed issues of maintaining stability of sensors after storage. Performance of the developed assay (specificity and sensitivity) was then validated in a

  15. Indices of diagnostic algorithm in imaging diagnosis of the gastrointestinal tract

    International Nuclear Information System (INIS)

    Pomakov, P.

    2002-01-01

    The diagnostic algorithm (DA) is a method of consistent successive selection of the diagnostic imaging section in a given nosological entity. Depending on the diagnostic task undertaken one or more methods of consecutive investigation may be chosen - differing in scope, complexity and means of resolving the problem. The indices underlying the choice are divided up into two groups: primary effectiveness, accessibility, hazards and clinical relevance, and secondary - examiner, time, outfit and auxiliary means. For the purpose English terminology is used. The indices make part of the following formula: DA = RA (EOM) / DP (EOMT). In the numerator are included factors with positive effect, and in the denominator - factors with unfavourable effect. The primary factors are basic, leading and conclusive in nature, acting in all medical institutions and practicable in all nosological entities. Of the latter the most important is the obtained final result - R. The secondary factors are submitted in parenthesis. They vary within broad limits, changing in relatively short time intervals and having local relevance - only for the concrete medical facility where the imaging method is conducted. Not infrequently, the final outcome - diagnosis - is a function of the interaction between all the rest of the basic factors and those with local effect. (author)

  16. From 'Image Gently' to image intelligently: a personalized perspective on diagnostic radiation risk

    Energy Technology Data Exchange (ETDEWEB)

    Guillerman, R.P. [Department of Pediatric Radiology, Texas Children' s Hospital, Baylor College of Medicine, Houston, TX (United States)

    2014-10-15

    The risk of ionizing radiation from diagnostic imaging has been a popular topic in the radiology literature and lay press. Communicating the magnitude of risk to patients and caregivers is problematic because of the uncertainty in estimates derived principally from epidemiological studies of large populations, and alternative approaches are needed to provide a scientific basis for personalized risk estimates. The underlying patient disease and life expectancy greatly influence risk projections. Research into the biological mechanisms of radiation-induced DNA damage and repair challenges the linear no-threshold dose-response assumption and reveals that individuals vary in sensitivity to radiation. Studies of decision-making psychology show that individuals are highly susceptible to irrational biases when judging risks. Truly informed medical decision-making that respects patient autonomy requires appropriate framing of radiation risks in perspective with other risks and with the benefits of imaging. To follow the principles of personalized medicine and treat patients according to their specific phenotypic and personality profiles, diagnostic imaging should optimally be tailored not only to patient size, body region and clinical indication, but also to underlying disease conditions, radio-sensitivity and risk perception and preferences that vary among individuals. (orig.)

  17. Diagnostic ultrasound imaging for lateral epicondylalgia: a case-control study.

    Science.gov (United States)

    Heales, Luke James; Broadhurst, Nathan; Mellor, Rebecca; Hodges, Paul William; Vicenzino, Bill

    2014-11-01

    Lateral epicondylalgia (LE) is clinically diagnosed as pain over the lateral elbow that is provoked by gripping. Usually, LE responds well to conservative intervention; however, those who fail such treatment require further evaluation, including musculoskeletal ultrasound. Previous studies of musculoskeletal ultrasound have methodological flaws, such as lack of assessor blinding and failure to control for participant age, sex, and arm dominance. The purpose of this study was to assess the diagnostic use of blinded ultrasound imaging in people with clinically diagnosed LE compared with that in a control group matched for age, sex, and arm dominance. Participants (30 with LE and 30 controls) underwent clinical examination as the criterion standard test. Unilateral LE was defined as pain over the lateral epicondyle, which was provoked by palpation, resisted wrist and finger extension, and gripping. Controls without symptoms were matched for age, sex, and arm dominance. Ultrasound investigations were performed by two sonographers using a standardized protocol. Grayscale images were assessed for signs of tendon pathology and rated on a four-point ordinal scale. Power Doppler was used to assess neovascularity and rated on a five-point ordinal scale. The combination of grayscale and power Doppler imaging revealed an overall sensitivity of 90% and specificity of 47%. The positive and negative likelihood ratios for combined grayscale and power Doppler imaging were 1.69 and 0.21, respectively. Although ultrasound imaging helps confirm the absence of LE, when findings are negative for tendinopathic changes, the high prevalence of tendinopathic changes in pain-free controls challenges the specificity of the measure. The validity of ultrasound imaging to confirm tendon pathology in clinically diagnosed LE requires further study with strong methodology.

  18. Final Report - DOE Center for Laser Imaging and Cancer Diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Alfano, Robert R.; Koutcher, Jason A.

    2002-10-31

    This Final Report summarizes the significant progress made by the researchers, students and staff of the Center for Laser Imaging and Cancer Diagnostics (CLICD) from January 1998 through May 2002. During this period, the Center supported several projects. Most projects were proposed initially, some were added subsequently as their relevance and importance to the DOE mission became evident. DOE support has been leveraged to obtain continuing funding for some projects. Leveraged funds come from various sources, including NIH, Army, NSF and the Air Force. The goal of the Center was to develop laser-based instruments for use in the detection and diagnosis of major diseases, with an emphasis on detection and diagnosis of various cancers. Each of the supported projects is a collaborative effort between physicists and laser scientists and the City College of New York and noted physicians, surgeons, pathologists, and biologists located at medical centers in the Metropolitan area. The participating institutions were: City College of New York Institute for Ultrafast Lasers and Spectroscopy, Hackensack University Medical Center, Lawrence Livermore National Laboratory, Memorial Sloan Kettering Cancer Center, and New York Eye and Ear Institute. Each of the projects funded by the Center is grouped into one of four research categories: a) Disease Detection, b) Non-Disease Applications, c) New Diagnostic Tools, and, d) Education, Training, Outreach and Dissemination. The progress achieved by the multidisciplinary teams was reported in 51 publications and 32 presentations at major national conferences. Also, one U.S. patent was obtained and six U.S. patent applications have been filed for innovations resulting from the projects sponsored by the Center.

  19. 2D-3D image registration in diagnostic and interventional X-Ray imaging

    NARCIS (Netherlands)

    Bom, I.M.J. van der

    2010-01-01

    Clinical procedures that are conventionally guided by 2D x-ray imaging, may benefit from the additional spatial information provided by 3D image data. For instance, guidance of minimally invasive procedures with CT or MRI data provides 3D spatial information and visualization of structures that are

  20. Commentary: progress in optimization of patient dose and image quality in x-ray diagnostics

    International Nuclear Information System (INIS)

    Carlsson, G.A.; Chan, H.-P.

    1999-01-01

    X-ray diagnostics gives the largest contribution to the population dose from man-made radiation sources. Strategies for reduction of patient doses without loss of diagnostic accuracy are therefore of great interest to society and have been focussed in general terms by the ICRP (ICRP 1996) through the introduction of the concept of diagnostic reference levels. The European Union has stimulated research in the field, and, based on patient dose measurements and radiologists' appreciation of acceptable image quality, good radiographic techniques have been identified and recommended (EUR 1996a, b) for conventional screen-film imaging. These efforts have resulted in notable dose reductions in clinical practices (Hart et al 1996). In spite of 100 years of use of x-rays for diagnostics, the choice of technique parameters still relies to a great extent on experience. Scientific efforts to optimize the choice in terms of finding the parameter settings which yield sufficient image quality at the lowest possible cost in dose are still rare. True optimization requires (1) estimation of the image quality needed to make a correct diagnosis and (2) methods to investigate all possible means of achieving this image quality in order to be able to decide which of them gives the lowest dose. The paper by Tapiovaara, Sandborg and Dance published in this issue of Physics in Medicine and Biology (pages 537-559) addresses the optimization of paediatric fluoroscopy, a timely and important topic. Fluoroscopy procedures, used to guide x-ray examinations or interventional procedures, are little standardized and may result in high dose levels; radiation exposure in childhood is likely to result in a higher lifetime risk than the same exposure later in life. The authors represent an interesting mix of expertise within various scientific fields: the theory of medical imaging and assessment of image quality, the physics of diagnostic radiology and radiation dosimetry. They provide good insights

  1. Clinical utility of imaging for evaluation of hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Murakami T

    2014-07-01

    Full Text Available Takamichi Murakami,1 Masakatsu Tsurusaki,1 Tomoko Hyodo,1 Yasuharu Imai2 1Department of Radiology, Kinki University Faculty of Medicine, 2Department of Hepatology and Gastroenterology, Ikeda Municipal Hospital, Osaka, Japan Abstract: The hemodynamics of a hepatocellular nodule is the most important imaging parameter used to characterize various hepatocellular nodules in liver cirrhosis, because sequential changes occur in the feeding vessels and hemodynamic status during hepatocarcinogenesis. Therefore, the imaging criteria for hepatocellular carcinoma (HCC are also usually based on vascular findings, eg, early arterial uptake followed by washout in the portal venous and equilibrium phases. Contrast-enhanced ultrasonography, dynamic multidetector-row computed tomography (MDCT, and dynamic magnetic resonance (MR imaging with gadopentetate dimeglumine (Gd-DTPA are useful for detecting hypervascular HCC on the basis of vascular criteria but are not as useful for hypovascular HCC. Contrast-enhanced MR imaging with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA, a hepatocyte-specific MR contrast agent, is superior to dynamic MDCT and dynamic MR imaging with Gd-DTPA in detecting both hypervascular and hypovascular HCC. Moreover, Gd-EOB-DTPA-enhanced MR imaging can display each histologically differentiated HCC as hypointense relative to the liver parenchyma. 18F-fluorodeoxyglucose positron emission tomography imaging might not be suitable for the screening and detection of HCC, given its lower diagnostic performance. However, this technique plays an important role in determining whether HCC has spread beyond the liver. Keywords: hepatocellular carcinoma, evaluation, imaging, clinical utility

  2. Optimized T1- and T2-weighted volumetric brain imaging as a diagnostic tool in very preterm neonates

    International Nuclear Information System (INIS)

    Nossin-Manor, Revital; Chung, Andrew D.; Morris, Drew; Thomas, Bejoy; Shroff, Manohar M.; Soares-Fernandes, Joao P.; Cheng, Hai-Ling M.; Whyte, Hilary E.A.; Taylor, Margot J.; Sled, John G.

    2011-01-01

    T1- and T2-W MR sequences used for obtaining diagnostic information and morphometric measurements in the neonatal brain are frequently acquired using different imaging protocols. Optimizing one protocol for obtaining both kinds of information is valuable. To determine whether high-resolution T1- and T2-W volumetric sequences optimized for preterm brain imaging could provide both diagnostic and morphometric value. Thirty preterm neonates born between 24 and 32 weeks' gestational age were scanned during the first 2 weeks after birth. T1- and T2-W high-resolution sequences were optimized in terms of signal-to-noise ratio, contrast-to-noise ratio and scan time and compared to conventional spin-echo-based sequences. No differences were found between conventional and high-resolution T1-W sequences for diagnostic confidence, image quality and motion artifacts. A preference for conventional over high-resolution T2-W sequences for image quality was observed. High-resolution T1 images provided better delineation of thalamic myelination and the superior temporal sulcus. No differences were found for detection of myelination and sulcation using conventional and high-resolution T2-W images. High-resolution T1- and T2-W volumetric sequences can be used in clinical MRI in the very preterm brain to provide both diagnostic and morphometric information. (orig.)

  3. Differential diagnostic features of the radionuclide scrotal image

    Energy Technology Data Exchange (ETDEWEB)

    Mishkin, F.S.

    1977-01-01

    Differential diagnosis of scrotal lesions is aided by correlating radionuclide images with clinical findings. Subacute torsion is associated with peripheral hyperemia and can be mistaken for an inflammatory process; however, in a review of 128 studies, torsion and orchiectomy were the only processes encountered which had a center truly devoid of activity on the tissue phase compared to the normal side. Other lesions such as acute inflammation, abscess, hematoma, and hemorrhagic tumor may superficially appear to lack central activity but invariably contain at least as much activity when compared to the normal side.

  4. Differential diagnostic features of the radionuclide scrotal image

    International Nuclear Information System (INIS)

    Mishkin, F.S.

    1977-01-01

    Differential diagnosis of scrotal lesions is aided by correlating radionuclide images with clinical findings. Subacute torsion is associated with peripheral hyperemia and can be mistaken for an inflammatory process; however, in a review of 128 studies, torsion and orchiectomy were the only processes encountered which had a center truly devoid of activity on the tissue phase compared to the normal side. Other lesions such as acute inflammation, abscess, hematoma, and hemorrhagic tumor may superficially appear to lack central activity but invariably contain at least as much activity when compared to the normal side

  5. Functional brain imaging with SPECT in normal again and dementia. Methodological, pathophysiological, and diagnostic aspects

    International Nuclear Information System (INIS)

    Waldemar, G.

    1996-03-01

    New developments in instrumentation, radiochemistry, and data analysis, particularly the introduction of 99m Tc-labeled brain-retained tracers for perfusion studies, have opened up a new era of single photon emission computed tomography (SPECT). In this review critical methodological issues relating to the SPECT instrument, the radioactive tracers, the scanning procedure, the data analysis and interpretation of data, and subject selection are discussed together with the changes in regional cerebral blood flow (rCBF) observed in normal aging. An overview is given of the topography and the pathophysiological and diagnostic significance of focal rCBF deficits in Alzheimer's disease and in other dementia disorders, in which SPECT is capable of early or preclinical disease detection. In Alzheimer's disease, the diagnostic sensitivity and specificity of focal rCBF deficits measured with SPECT and brain-retained tracers are very high, in particular when combined with medial temporal lob atrophy on CT. Together with neuropsychological testing, SPECT serves to map the topography of brain dysfunction. Thus, in the clinical setting, SPECT provides information that is supplemental to that obtained in other studies. Future applications include neuroreceptor studies and treatment studies, in which SPECT may serve as a diagnostic aid in the selection of patients and as a potential mean for monitoring treatment effects. Although positron emission tomography is the best characterized tool for addressing some of these clinical and research issues in dementia, only the less expensive and technically simpler SPECT technique will have the potential of being available as a screening diagnostic instrument in the clinical setting. It is concluded that, properly approached, functional brain imaging with SPECT represents an important tool in the diagnosis, management, and research of dementia disorders. (au) 251 refs

  6. Quantitative imaging for clinical dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Bardies, Manuel [INSERM U601, 9 Quai Moncousu, 44093 Nantes (France)]. E-mail: manu@nantes.inserm.fr; Flux, Glenn [Department of Physics, Royal Marsden NHS Trust, Sutton (United Kingdom); Lassmann, Michael [Department of Nuclear Medicine, Julis-Maximilians University, Wuerzburg (Germany); Monsieurs, Myriam [Department of Health Physics, University of Ghent, 9000 Ghent (Belgium); Savolainen, Sauli [Department of Physical Sciences, University of Helsinki and HUS, Helsinki Medical Imaging Center, Helsinki University Central Hospital (Finland); Strand, Sven-Erik [Medical Radiation Physics, Department of Clinical Sciences Lund, Lund University (Sweden)

    2006-12-20

    Patient-specific dosimetry in nuclear medicine is now a legal requirement in many countries throughout the EU for targeted radionuclide therapy (TRT) applications. In order to achieve that goal, an increased level of accuracy in dosimetry procedures is needed. Current research in nuclear medicine dosimetry should not only aim at developing new methods to assess the delivered radiation absorbed dose at the patient level, but also to ensure that the proposed methods can be put into practice in a sufficient number of institutions. A unified dosimetry methodology is required for making clinical outcome comparisons possible.

  7. Study design for concurrent development, assessment, and implementation of new diagnostic imaging technology

    NARCIS (Netherlands)

    M.G.M. Hunink (Myriam); G.P. Krestin (Gabriel)

    2002-01-01

    textabstractWith current constraints on health care resources and emphasis on value for money, new diagnostic imaging technologies must be assessed and their value demonstrated. The state of the art in the field of diagnostic imaging technology assessment advocates a hierarchical

  8. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

    Full Text Available Nonsuicidal self-injury (NSSI is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls. Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

  9. Clinical utility of MR imaging in chronic progressive radiation myelopathy

    International Nuclear Information System (INIS)

    Melki, P.S.; Halimi, P.; Wibault, P.; Doyon, D.

    1990-01-01

    This paper defines the diagnostic and prognostic value of MR imaging in chronic progressive radiation myelopathy 9CPRM). In this series, MR imaging showed excellent sensitivity (199%) for the demonstration of radiation-induced lesions of the spinal cord. Fifty percent of the cases showed spinal cord hypertrophy (pseudotumoral, 33%; cystic, 17%) occurring within 8 months of the clinical onset of myelopathy. The remaining 50% showed spinal cord atrophy, which occurred more than 8 months following the onset of myelopathy. These medullary lesions were located at least partially in the radiation field but extended beyond its boundaries in 73% of the cases. MR imaging helped to establish disease prognosis: spinal cord hypertrophy was usually associated with neurologic deterioration and fatal outcome within a mean of 11.5 months; in spinal atrophy, neurologic deficit was often static and survival rates were better

  10. Indications, advantages and limitations of perinatal postmortem imaging in clinical practice

    International Nuclear Information System (INIS)

    Arthurs, Owen J.; Taylor, Andrew M.; Sebire, Neil J.

    2015-01-01

    Just as there is a range of paediatric imaging techniques available during life, a similar repertoire is available as part of the foetal and perinatal postmortem examination. In this article, we review the literature regarding the diagnostic utility of postmortem radiography, US, CT and MRI in this clinical setting. There is limited direct evidence on the diagnostic utility of any of these techniques, apart from postmortem MRI, which when combined with other noninvasive investigations, has been shown to be highly sensitive and specific for many foetal postmortem diagnoses. The main disadvantages of postmortem MRI include the longer duration of imaging, the need for appropriate training in the interpretation of normal postmortem changes, and possible non-diagnostic imaging examinations in early gestation fetuses. As less-invasive autopsy becomes increasingly available, the true utility of these techniques will evolve, and clinical guidelines for maximal diagnostic yield can be developed. (orig.)

  11. Indications, advantages and limitations of perinatal postmortem imaging in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Taylor, Andrew M. [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiorespiratory Division, London (United Kingdom); Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London (United Kingdom); Sebire, Neil J. [University College London, Institute of Child Health, London (United Kingdom); Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Histopathology, London (United Kingdom)

    2015-04-01

    Just as there is a range of paediatric imaging techniques available during life, a similar repertoire is available as part of the foetal and perinatal postmortem examination. In this article, we review the literature regarding the diagnostic utility of postmortem radiography, US, CT and MRI in this clinical setting. There is limited direct evidence on the diagnostic utility of any of these techniques, apart from postmortem MRI, which when combined with other noninvasive investigations, has been shown to be highly sensitive and specific for many foetal postmortem diagnoses. The main disadvantages of postmortem MRI include the longer duration of imaging, the need for appropriate training in the interpretation of normal postmortem changes, and possible non-diagnostic imaging examinations in early gestation fetuses. As less-invasive autopsy becomes increasingly available, the true utility of these techniques will evolve, and clinical guidelines for maximal diagnostic yield can be developed. (orig.)

  12. Hyperspectral imaging as a diagnostic tool for chronic skin ulcers

    Science.gov (United States)

    Denstedt, Martin; Pukstad, Brita S.; Paluchowski, Lukasz A.; Hernandez-Palacios, Julio E.; Randeberg, Lise L.

    2013-03-01

    The healing process of chronic wounds is complex, and the complete pathogenesis is not known. Diagnosis is currently based on visual inspection, biopsies and collection of samples from the wound surface. This is often time consuming, expensive and to some extent subjective procedures. Hyperspectral imaging has been shown to be a promising modality for optical diagnostics. The main objective of this study was to identify a suitable technique for reproducible classification of hyperspectral data from a wound and the surrounding tissue. Two statistical classification methods have been tested and compared to the performance of a dermatologist. Hyperspectral images (400-1000 nm) were collected from patients with venous leg ulcers using a pushbroom-scanning camera (VNIR 1600, Norsk Elektro Optikk AS).Wounds were examined regularly over 4 - 6 weeks. The patients were evaluated by a dermatologist at every appointment. One patient has been selected for presentation in this paper (female, age 53 years). The oxygen saturation of the wound area was determined by wavelength ratio metrics. Spectral angle mapping (SAM) and k-means clustering were used for classification. Automatic extraction of endmember spectra was employed to minimize human interaction. A comparison of the methods shows that k-means clustering is the most stable method over time, and shows the best overlap with the dermatologist's assessment of the wound border. The results are assumed to be affected by the data preprocessing and chosen endmember extraction algorithm. Results indicate that it is possible to develop an automated method for reliable classification of wounds based on hyperspectral data.

  13. Imaging techniques used in the diagnostic workup of acute venous thromboembolic disease.

    Science.gov (United States)

    Tilve-Gómez, A; Rodríguez-Fernández, P; Trillo-Fandiño, L; Plasencia-Martínez, J M

    Early diagnosis is one of the most important factors affecting the prognosis of pulmonary embolism (PE); however, the clinical presentation of PE is often very unspecific and it can simulate other diseases. For these reasons, imaging tests, especially computed tomography angiography (CTA) of the pulmonary arteries, have become the keystone in the diagnostic workup of PE. The wide availability and high diagnostic performance of pulmonary CTA has led to an increase in the number of examinations done and a consequent increase in the population's exposure to radiation and iodinated contrast material. Thus, other techniques such as scintigraphy and venous ultrasonography of the lower limbs, although less accurate, continue to be used in certain circumstances, and optimized protocols have been developed for CTA to reduce the dose of radiation (by decreasing the kilovoltage) and the dose of contrast agents. We describe the technical characteristics and interpretation of the findings for each imaging technique used to diagnose PE and discuss their advantages and limitations; this knowledge will help the best technique to be chosen for each case. Finally, we comment on some data about the increased use of CTA, its clinical repercussions, its "overuse", and doubts about its cost-effectiveness. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. CLINICAL PICTURE, DIAGNOSTICS AND TREATMENT OF GIARDIASIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    E.A. Kornienko

    2009-01-01

    Full Text Available According to the WHO, giardiasis incidence rate in children in the world is 15 to 20%. In Russia, over 130,000 cases of giardiasis are registered annually, of which children under 14 years account for more than 70%. The study of 124 children with giardiasis conducted by the authors has shown that giardiasis in children always triggers development of chronic duodenitis, in 55% of cases that coupled with lymphostasis, in 45% — that with atrophy of duodenum mucous lining. In 40% of cases, chronic duodenitis with giardiasis is accompanied with duodenogastric reflux, in 88% — with development of lactase deficiency, in 81% — by functional biliary system distress and in all cases with intestinal tract microbiocenosis distress. Along with clinical manifestations of the disease, the researchers have studied immunological modifications in children with giardiasis, and have evaluated the information content of various diagnostic techniques, efficiency of medication. The authors have demonstrated that mono therapy with any of anti giardiasis drugs (metronidazole, nifuratel, albendozole has low efficiency. Saccharomyces boulardii have a powerful comprehensive effect on many links of giardiasis pathogenesis.Key words: giardiasis, infestation, scatoscopy, Saccharomyces boulardii.

  15. BRIEF REPORT: Beyond Clinical Experience: Features of Data Collection and Interpretation That Contribute to Diagnostic Accuracy

    Science.gov (United States)

    Nendaz, Mathieu R; Gut, Anne M; Perrier, Arnaud; Louis-Simonet, Martine; Blondon-Choa, Katherine; Herrmann, François R; Junod, Alain F; Vu, Nu V

    2006-01-01

    BACKGROUND Clinical experience, features of data collection process, or both, affect diagnostic accuracy, but their respective role is unclear. OBJECTIVE, DESIGN Prospective, observational study, to determine the respective contribution of clinical experience and data collection features to diagnostic accuracy. METHODS Six Internists, 6 second year internal medicine residents, and 6 senior medical students worked up the same 7 cases with a standardized patient. Each encounter was audiotaped and immediately assessed by the subjects who indicated the reasons underlying their data collection. We analyzed the encounters according to diagnostic accuracy, information collected, organ systems explored, diagnoses evaluated, and final decisions made, and we determined predictors of diagnostic accuracy by logistic regression models. RESULTS Several features significantly predicted diagnostic accuracy after correction for clinical experience: early exploration of correct diagnosis (odds ratio [OR] 24.35) or of relevant diagnostic hypotheses (OR 2.22) to frame clinical data collection, larger number of diagnostic hypotheses evaluated (OR 1.08), and collection of relevant clinical data (OR 1.19). CONCLUSION Some features of data collection and interpretation are related to diagnostic accuracy beyond clinical experience and should be explicitly included in clinical training and modeled by clinical teachers. Thoroughness in data collection should not be considered a privileged way to diagnostic success. PMID:17105525

  16. Advanced imaging systems for diagnostic investigations applied to Cultural Heritage

    International Nuclear Information System (INIS)

    Peccenini, E; Bettuzzi, M; Brancaccio, R; Casali, F; Morigi, M P; Albertin, F; Petrucci, F

    2014-01-01

    The diagnostic investigations are an important resource in the studies on Cultural Heritage to enhance the knowledge on execution techniques, materials and conservation status of a work of art. In this field, due to the great historical and artistic value of the objects, preservation is the main concern; for this reason, new technological equipment has been designed and developed in the Physics Departments of the Universities of Ferrara and Bologna to enhance the non-invasive approach to the study of pictorial artworks and other objects of cultural interest. Infrared (IR) reflectography, X-ray radiography and computed tomography (CT), applied to works of art, are joined by the same goal: to get hidden information on execution techniques and inner structure pursuing the non-invasiveness of the methods, although using different setup and physical principles. In this work transportable imaging systems to investigate large objects in museums and galleries are presented. In particular, 2D scanning devices for IR reflectography and X-ray radiography, CT systems and some applications to the Cultural Heritage are described

  17. Advanced imaging systems for diagnostic investigations applied to Cultural Heritage

    Science.gov (United States)

    Peccenini, E.; Albertin, F.; Bettuzzi, M.; Brancaccio, R.; Casali, F.; Morigi, M. P.; Petrucci, F.

    2014-12-01

    The diagnostic investigations are an important resource in the studies on Cultural Heritage to enhance the knowledge on execution techniques, materials and conservation status of a work of art. In this field, due to the great historical and artistic value of the objects, preservation is the main concern; for this reason, new technological equipment has been designed and developed in the Physics Departments of the Universities of Ferrara and Bologna to enhance the non-invasive approach to the study of pictorial artworks and other objects of cultural interest. Infrared (IR) reflectography, X-ray radiography and computed tomography (CT), applied to works of art, are joined by the same goal: to get hidden information on execution techniques and inner structure pursuing the non-invasiveness of the methods, although using different setup and physical principles. In this work transportable imaging systems to investigate large objects in museums and galleries are presented. In particular, 2D scanning devices for IR reflectography and X-ray radiography, CT systems and some applications to the Cultural Heritage are described.

  18. Strategic planning in diagnostic imaging: meeting the challenge.

    Science.gov (United States)

    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.

  19. Current profile reconstruction using electron temperature imaging diagnostics

    International Nuclear Information System (INIS)

    Tritz, K.; Stutman, D.; Delgado-Aparicio, L.F.; Finkenthal, M.; Pacella, D.; Kaita, R.; Stratton, B.; Sabbagh, S.

    2004-01-01

    Flux surface shape information can be used to constrain the current profile for reconstruction of the plasma equilibrium. One method of inferring flux surface shape relies on plasma x-ray emission; however, deviations from the flux surfaces due to impurity and density asymmetries complicate the interpretation. Electron isotherm surfaces should correspond well to the plasma flux surfaces, and equilibrium constraint modeling using this isotherm information constrains the current profile. The KFIT code is used to assess the profile uncertainty and to optimize the number, location and SNR required for the Te detectors. As Te imaging detectors we consider tangentially viewing, vertically spaced, linear gas electron multiplier arrays operated in pulse height analysis (PHA) mode and multifoil soft x-ray arrays. Isoflux coordinate sets provided by T e measurements offer a strong constraint on the equilibrium reconstruction in both a stacked horizontal array configuration and a crossed horizontal and vertical beam system, with q 0 determined to within ±4%. The required SNR can be provided with either PHA or multicolor diagnostic techniques, though the multicolor system requires ∼x4 better statistics for comparable final errors

  20. Diagnostic image quality of mammograms in German outpatient medical care

    International Nuclear Information System (INIS)

    Pfandzelter, R.; Wuelfing, U.; Boedeker, B.

    2010-01-01

    Purpose: A total of 79 115 mammograms from statutory health insurance (SHI) physicians within German outpatient care were evaluated with respect to the diagnostic image quality. Materials and Methods: Mammograms were randomly selected between 2006 and 2008 by the regional Associations of Statutory Health Insurance Physicians and submitted to regional boards of experts for external evaluation. The mammogram quality was evaluated using a 3-point scale (adequate, borderline, failure) and documented using a nationally standardized protocol. Results: 87.6 % of the mammograms were classified as adequate, 11.0 % as borderline and 1.4 % as failure. Mediolateral oblique mammograms (mlo) had worse ratings than craniocaudal mammograms (cc). Main reasons for classifying the mammograms as borderline or failure were 'inframammary fold not adequately visualized' (mlo), 'pectoral muscle not in the correct angle or not to the level with the nipple' (mlo), 'the nipple not in profile' (mlo, cc) and 'breast not completely or not adequately visualized' (cc). Conclusion: The results show a good overall quality of mammograms in German outpatient medical care. Failures can be associated predominantly with incorrect positioning of the breast. More precisely defined quality criteria using objective measures are recommended, especially for craniocaudal mammograms (cc). (orig.)

  1. X-ray imaging spectroscopic diagnostics on Nike

    Science.gov (United States)

    Aglitskiy, Y.; Karasik, M.; Serlin, V.; Weaver, J. L.; Oh, J.; Obenschain, S. P.; Ralchenko, Yu.

    2017-10-01

    Electron temperature and density diagnostics of the laser plasma produced within the focal spot of the NRL's Nike laser are being explored with the help of X-ray imaging spectroscopy. Spectra of He-like and H-like ions were taken by Nike focusing spectrometers in a range of lower (1.8 kev, Si XIV) and higher (6.7 kev, Fe XXV) x-ray energies. Data that were obtained with spatial resolution were translated into the temperature and density as functions of distance from the target. As an example electron density was determined from He-like satellites to Ly-alpha in Si XIV. The dielectronic satellites with intensity ratios that are sensitive to collisional transfer of population between different triplet groups of double-excited states 2l2l' in Si XIII were observed with high spatial and spectral resolution Lineouts taken at different axial distances from the planar Si target show changing spectral shapes due to the different electron densities as determined by supporting non-LTE simulations. These shapes are relatively insensitive to the plasma temperature which was measured using different spectral lines. This work was supported by the US DOE/NNSA.

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

    Science.gov (United States)

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

    2017-09-01

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

  3. Diagnostic Accuracy of Imaging Modalities and Injection Techniques for the Diagnosis of Femoroacetabular Impingement/Labral Tear

    DEFF Research Database (Denmark)

    Reiman, Michael P.; Thorborg, Kristian; Goode, Adam P.

    2017-01-01

    Background: Diagnosing femoroacetabular impingement/acetabular labral tear (FAI/ALT) and subsequently making a decision regarding surgery are based primarily on diagnostic imaging and intra-articular hip joint injection techniques of unknown accuracy. Purpose: Summarize and evaluate the diagnostic...... probability of disease was demonstrated. Positive imaging findings increased the probability that a labral tear existed by a minimal to small degree with the use of magnetic resonance imaging/magnetic resonance angiogram (MRI/MRA) and ultrasound (US) and by a moderate degree for CTA. Negative imaging findings...... decreased the probability that a labral tear existed by a minimal degree with the use of MRI and US, a small to moderate degree with MRA, and a moderate degree with CTA. Clinical Relevance: Although findings of the included studies suggested potentially favorable use of these modalities for the diagnosis...

  4. Measuring diagnostic accuracy of imaging parameters in pelvic lipomatosis

    International Nuclear Information System (INIS)

    Zhang, Yudong; Wu, Shiliang; Xi, Zhijun; Wang, Xiaoying; Jiang, Xuexiang

    2012-01-01

    Objectives: To study whether the individual radiological findings can help predict diagnosis of pelvic lipomatosis (PL) or, specifically appreciate its progression. Methods: Data from 32 clinically proven cases of PL and 25 controls were collected. Two reviewers were recruited for a blinded evaluation, image features were recorded in terms of: (1) bladder shape; (2) bladder-rectosigmoid morphological indexes including ratio of superior–inferior to anterior–posterior length of bladder (SI/AP), angle between anterior and posterior wall (AAP), relative length of posterior urethra (rLPU), angle between bladder and seminal vesicle (ABS) and rectosigmoid morphological index (RMI); (3) secondary complications. Results were evaluated by an unpaired t test and ROC analysis. Results: The sensitivity and specificity were 40.6% and 100% for pear and banana-shaped bladder, 62.5% and 100% for SI/AP, 40.6% and 100% for AAP, 62.5% and 100% for ABS, 78.1% and 72% for rLPU, 59.4% and 96% for RMI, respectively. These radiological findings partially correlated with the severity of disease weighted by hydronephrosis and treatment grade. Image analysis demonstrated high prevalence of glandular cystitis (100%) and hydronephrosis (73.4%). Conclusion: We conclude that PL is a progressive disease involving multiple pelvic organs with high prevalence of intractable cystitis and hydronephrosis. The imaging characteristics can help predict diagnosis and, specifically appreciate progression.

  5. Measuring diagnostic accuracy of imaging parameters in pelvic lipomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Yudong, E-mail: pku_zyd06@163.com [Department of Radiology, Peking University First Hospital, Beijing (China); Wu, Shiliang, E-mail: wushiliangjsh@263.net [Department of Urology, Peking University First Hospital, Beijing (China); Xi, Zhijun, E-mail: xizhijun@hsc.pku.edu.cn [Department of Urology, Peking University First Hospital, Beijing (China); Wang, Xiaoying, E-mail: cjr.wangxiaoying@vip.163.com [Department of Radiology, Peking University First Hospital, Beijing (China); Jiang, Xuexiang, E-mail: cjr.jxx@vip.163.com [Department of Radiology, Peking University First Hospital, Beijing (China)

    2012-11-15

    Objectives: To study whether the individual radiological findings can help predict diagnosis of pelvic lipomatosis (PL) or, specifically appreciate its progression. Methods: Data from 32 clinically proven cases of PL and 25 controls were collected. Two reviewers were recruited for a blinded evaluation, image features were recorded in terms of: (1) bladder shape; (2) bladder-rectosigmoid morphological indexes including ratio of superior-inferior to anterior-posterior length of bladder (SI/AP), angle between anterior and posterior wall (AAP), relative length of posterior urethra (rLPU), angle between bladder and seminal vesicle (ABS) and rectosigmoid morphological index (RMI); (3) secondary complications. Results were evaluated by an unpaired t test and ROC analysis. Results: The sensitivity and specificity were 40.6% and 100% for pear and banana-shaped bladder, 62.5% and 100% for SI/AP, 40.6% and 100% for AAP, 62.5% and 100% for ABS, 78.1% and 72% for rLPU, 59.4% and 96% for RMI, respectively. These radiological findings partially correlated with the severity of disease weighted by hydronephrosis and treatment grade. Image analysis demonstrated high prevalence of glandular cystitis (100%) and hydronephrosis (73.4%). Conclusion: We conclude that PL is a progressive disease involving multiple pelvic organs with high prevalence of intractable cystitis and hydronephrosis. The imaging characteristics can help predict diagnosis and, specifically appreciate progression.

  6. The frequency of peritoneal tuberculosis using diagnostic laparoscopy in clinically suspected cases

    International Nuclear Information System (INIS)

    Sattar, Z.; Iqbal, M.

    2014-01-01

    Introduction: Diagnostic laparoscopy allows the visual examination and documentation of intra-abdominal organs in order to detect any pathology. It is an important tool for final minimally invasive exploration of patients with abdominal tuberculosis, the diagnosis of which remains uncertain despite employing the requisite laboratory and non-invasive imaging investigations. Objective: To determine the frequency of peritoneal tuberculosis using diagnostic laparoscopy in clinically suspected cases of peritoneal tuberculosis. Study Design: Cross sectional survey. Setting: The study was conducted in all the four Surgical Wards on surgical floor of Mayo Hospital Lahore. Duration of Study with Dates: Six months (1st July 2009 to 31st December 2009). Material and Methods: 35 Patients aged between 13-60 years with clinical suspicion of peritoneal tuberculosis were selected. The patients underwent the procedure accordingly. Per operative diagnosis of peritoneal tuberculosis made on the basis of presence of any or all of the operative (laparoscopic) findings such as multiple peritoneal adhesions, fibrous bands, whitish peritoneal tubercles, omental thickening and ascites. Diagnosis was confirmed with histopathology of peritoneal tissue biopsy. Also the biochemical analysis and culture sensitivity of ascetic fluid was routinely performed if any ascites is present. Results: Out of 35 patients, 40% were males and 60% females with mean age of 24.91+-6.69 years. The Laparoscopic findings of peritoneal tuberculosis were whitish peritoneal tubercles (57.2%) peritoneal adhesions (28.6%), ascites (17.2%), omental thickening (14.3%), fibrous bands (11.4%) and swollen edematous appendix (5.7%). Eighty percent were labeled with diagnosis of peritoneal tuberculosis on basis of diagnostic laparoscopy. These patients were confirmed to have peritoneal tuberculosis on histopathology of tissue biopsy. Conclusion: Diagnostic laparoscopy is useful in patients with suspected peritoneal

  7. Low back pain in school-age children: risk factors, clinical features and diagnostic managment.

    Science.gov (United States)

    Boćkowski, L; Sobaniec, W; Kułak, W; Smigielska-Kuzia, J; Sendrowski, K; Roszkowska, M

    2007-01-01

    Low back pain (LBP) is common in adult population, and it is becoming a serious health concern in adolescents. On surveys, about every fifth child in the school-age reports LBP. The study objective was to analysis the natural history, risk factors, clinical symptoms, causes and diagnostic management in school-age children hospitalized with LBP. The study group consisted of 36 patients at the age between 10 and 18 years, 22 girls and 14 boys suffering from LBP hospitalized in our Department of Pediatric Neurology and Rehabilitation in years 2000-2004. The mean age of clinical onset of LBP in our group was 14.7 years, earlier in girls, later in boys. We find the family history of LBP in 50% children. Most frequent factors associated with LBP were: spina bifida (16.7%) and incorrect posture (13.9%). Half of patients pointed the factor initialising LBP: rapid, incoordinated move (39%) or heavy load rise (11%). 58% of patients present the symptoms of ischialgia. Diagnostic imaging showed disc protrusion in 11 children (31%) 6 in computed tomography, 4 in magnetic resonance imaging and 1 in X-Ray examination only. Other causes of LBP included: spondylolysis in 2 patients, Scheuermann disease in one case and juvenile reumatoid arthritis in one case. Some school-age children suffering on low back pain, particulary with sciatic neuralgia symptoms seek medical care in hospital. Althought the main causes are mechanical, associated with lack of physical activity or strenous exercise, serious diagnostic managment is strongly recommended.

  8. SLAP lesions: Anatomy, clinical presentation, MR imaging diagnosis and characterization

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Debra [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); MedRay Imaging and Fraser Health Authority, Vancouver, BC (Canada)], E-mail: cbchung@ucsd.edu; Mohana-Borges, Aurea; Borso, Maya; Chung, Christine B. [University of California San Diego, Department of Radiology, 200 W. Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)

    2008-10-15

    ABSTRACT: Superior labral anterior posterior (SLAP) tears are an abnormality of the superior labrum usually centered on the attachment of the long head of the biceps tendon. Tears are commonly caused by repetitive overhead motion or fall on an outstretched arm. SLAP lesions can lead to shoulder pain and instability. Clinical diagnosis is difficult thus imaging plays a key diagnostic role. The normal anatomic variability of the capsulolabral complex can make SLAP lesions a diagnostic challenge. Concurrent shoulder injuries are often present including rotator cuff tears, cystic changes or marrow edema in the humeral head, capsular laxity, Hill-Sachs or Bankart lesion. The relevant anatomy, capsulolabral anatomic variants, primary and secondary findings of SLAP tears including MR arthrography findings, types of SLAP lesions and a practical approach to labral lesions are reviewed.

  9. New software for raw data mask processing increases diagnostic ability of myocardial SPECT imaging.

    Science.gov (United States)

    Tanaka, Ryo; Yoshioka, Katsunori; Seino, Kazue; Ohba, Muneo; Nakamura, Tomoharu; Shimada, Katsuhiko

    2011-05-01

    Increased activity of myocardial perfusion tracer technetium-99m in liver and hepatobiliary system causes streak artifacts, which may affect clinical diagnosis. We developed a mask-processing tool for raw data generated using technetium-99m as a myocardial perfusion tracer. Here, we describe improvements in image quality under the influence of artifacts caused by high accumulation in other organs. A heart phantom (RH-2) containing 15 MBq of pertechnetate was defined as model A. Model B was designed in the same phantom containing ten times of cardiac radioactivity overlapping with other organs. Variance in the vertical profile count in the lower part of the myocardial inferior wall and in the myocardial circumferential profile curve were investigated in a phantom and clinical cases using our raw data masking (RDM) software. The profile variances at lower parts of myocardial inferior walls were 965.43 in model A, 1390.11 in model B and 815.85 in B-RDM. The mean ± SD of myocardial circumferential profile curves were 83.91 ± 7.39 in model A, 69.61 ± 11.45 in model B and 82.68 ± 9.71 in model B-RDM. For 11 clinical images with streak artifacts, the average of the variance significantly differed between with and without RDM (3.95 vs. 21.05; P software. The waiting time between infusion and image acquisition should be decreased, thus reducing patient burden and improving the diagnostic ability of the procedure.

  10. Computerized method for evaluating diagnostic image quality of calcified plaque images in cardiac CT: Validation on a physical dynamic cardiac phantom

    International Nuclear Information System (INIS)

    King, Martin; Rodgers, Zachary; Giger, Maryellen L.; Bardo, Dianna M. E.; Patel, Amit R.

    2010-01-01

    Purpose: In cardiac computed tomography (CT), important clinical indices, such as the coronary calcium score and the percentage of coronary artery stenosis, are often adversely affected by motion artifacts. As a result, the expert observer must decide whether or not to use these indices during image interpretation. Computerized methods potentially can be used to assist in these decisions. In a previous study, an artificial neural network (ANN) regression model provided assessability (image quality) indices of calcified plaque images from the software NCAT phantom that were highly agreeable with those provided by expert observers. The method predicted assessability indices based on computer-extracted features of the plaque. In the current study, the ANN-predicted assessability indices were used to identify calcified plaque images with diagnostic calcium scores (based on mass) from a physical dynamic cardiac phantom. The basic assumption was that better quality images were associated with more accurate calcium scores. Methods: A 64-channel CT scanner was used to obtain 500 calcified plaque images from a physical dynamic cardiac phantom at different heart rates, cardiac phases, and plaque locations. Two expert observers independently provided separate sets of assessability indices for each of these images. Separate sets of ANN-predicted assessability indices tailored to each observer were then generated within the framework of a bootstrap resampling scheme. For each resampling iteration, the absolute calcium score error between the calcium scores of the motion-contaminated plaque image and its corresponding stationary image served as the ground truth in terms of indicating images with diagnostic calcium scores. The performances of the ANN-predicted and observer-assigned indices in identifying images with diagnostic calcium scores were then evaluated using ROC analysis. Results: Assessability indices provided by the first observer and the corresponding ANN performed

  11. Computerized method for evaluating diagnostic image quality of calcified plaque images in cardiac CT: Validation on a physical dynamic cardiac phantom

    Energy Technology Data Exchange (ETDEWEB)

    King, Martin; Rodgers, Zachary; Giger, Maryellen L.; Bardo, Dianna M. E.; Patel, Amit R. [Department of Radiology, Committee on Medical Physics, University of Chicago, 5841 South Maryland Avenue, MC 2026, Chicago, Illinois 60637 (United States); Department of Diagnostic Radiology, Oregon Health and Science University, 3181 Southwest Sam Jackson Park Road, Portland, Oregon 97239 (United States); Department of Medicine, University of Chicago, 5841 South Maryland Avenue, MC 5084, Chicago, Illinois 60637 (United States)

    2010-11-15

    Purpose: In cardiac computed tomography (CT), important clinical indices, such as the coronary calcium score and the percentage of coronary artery stenosis, are often adversely affected by motion artifacts. As a result, the expert observer must decide whether or not to use these indices during image interpretation. Computerized methods potentially can be used to assist in these decisions. In a previous study, an artificial neural network (ANN) regression model provided assessability (image quality) indices of calcified plaque images from the software NCAT phantom that were highly agreeable with those provided by expert observers. The method predicted assessability indices based on computer-extracted features of the plaque. In the current study, the ANN-predicted assessability indices were used to identify calcified plaque images with diagnostic calcium scores (based on mass) from a physical dynamic cardiac phantom. The basic assumption was that better quality images were associated with more accurate calcium scores. Methods: A 64-channel CT scanner was used to obtain 500 calcified plaque images from a physical dynamic cardiac phantom at different heart rates, cardiac phases, and plaque locations. Two expert observers independently provided separate sets of assessability indices for each of these images. Separate sets of ANN-predicted assessability indices tailored to each observer were then generated within the framework of a bootstrap resampling scheme. For each resampling iteration, the absolute calcium score error between the calcium scores of the motion-contaminated plaque image and its corresponding stationary image served as the ground truth in terms of indicating images with diagnostic calcium scores. The performances of the ANN-predicted and observer-assigned indices in identifying images with diagnostic calcium scores were then evaluated using ROC analysis. Results: Assessability indices provided by the first observer and the corresponding ANN performed

  12. Correlation of the clinical and physical image quality in chest radiography for average adults with a computed radiography imaging system.

    Science.gov (United States)

    Moore, C S; Wood, T J; Beavis, A W; Saunderson, J R

    2013-07-01

    The purpose of this study was to examine the correlation between the quality of visually graded patient (clinical) chest images and a quantitative assessment of chest phantom (physical) images acquired with a computed radiography (CR) imaging system. The results of a previously published study, in which four experienced image evaluators graded computer-simulated postero-anterior chest images using a visual grading analysis scoring (VGAS) scheme, were used for the clinical image quality measurement. Contrast-to-noise ratio (CNR) and effective dose efficiency (eDE) were used as physical image quality metrics measured in a uniform chest phantom. Although optimal values of these physical metrics for chest radiography were not derived in this work, their correlation with VGAS in images acquired without an antiscatter grid across the diagnostic range of X-ray tube voltages was determined using Pearson's correlation coefficient. Clinical and physical image quality metrics increased with decreasing tube voltage. Statistically significant correlations between VGAS and CNR (R=0.87, pchest CR images acquired without an antiscatter grid. A statistically significant correlation has been found between the clinical and physical image quality in CR chest imaging. The results support the value of using CNR and eDE in the evaluation of quality in clinical thorax radiography.

  13. Diagnostic assessment of painless microhematuria: prospective study comparing image quality, assessibility and diagnostic certainty of multidetector-row CT and intravenous pyelography within a single examination

    International Nuclear Information System (INIS)

    Boehm, T.; John, H.; Ruedi, C.; Marincek, B.; Wildermuth, S.; Michael, M.

    2005-01-01

    Purpose: The purpose of this study is to prospectively compare intravenous pyelography (IVP) and combined unenhanced and excretory phase multidetector-row CT (MDCT) with respect to image quality, diagnostic certainty and diagnostic concordance with the final clinical diagnosis in patients with painless microhematuria. Materials and Methods: Unenhanced MDCT, IVP and excretory phase MDCT were performed in 59 consecutive patients (21 women, 38 men, mean age 56±19 years, range 23-83 years) with painless microhematuria of unknown origin during a single examination with a single contrast media application (100 ml, non-ionic iodinate contrast media). Images were assessed by two experienced urogenital radiologists in consensus for image quality, diagnostic certainty of stone detection, obstruction, parenchymal lesions and morphological distinctive features. Imaging diagnoses of MDCT and IVP were compared with the final clinical diagnoses. In case of failure to detect an relevant pathology, the final clinical diagnosis was established after a mean follow-up period of 18±6 months (10 months to 2 years). Costs and radiation exposure of IVP and MDCT were compared. Results: MDCT scan performed better than IVP in terms of image quality for all regarded variables. Image quality of MDCT was rated in all parameters as very good or good; the image quality of IVP differed in a wide range. MDCT and IVP reached a sensitivity of 100% and 50% for stone detection (n=14, p=0.008), respectively. Two bladder stones were not detected by IVU but correctly seen with MDCT. MDCT and IVP were unsatisfactory for detecting transitional cell carcinomas (n=4, 2 of 4 detected with MDCT, 0 of 4 detected with IVU). One false positive transitional cell carcinoma was detected with IVP, none with MDCT. Additional relevant pathological changes (one teratoma, one abdominal aortic aneurysma and one abscess) were detected using MDCT but missed with IVP. In 38 of 59 patients (64%) imaging and clinical follow

  14. Diagnostic precision of PET imaging and functional MRI in disorders of consciousness

    DEFF Research Database (Denmark)

    Stender, Johan; Gosseries, Olivia; Bruno, Marie-Aurélie

    2014-01-01

    a validation study of two neuroimaging-based diagnostic methods: PET imaging and functional MRI (fMRI). METHODS: For this clinical validation study, we included patients referred to the University Hospital of Liège, Belgium, between January, 2008, and June, 2012, who were diagnosed by our unit...... with unresponsive wakefulness syndrome, locked-in syndrome, or minimally conscious state with traumatic or non-traumatic causes. We did repeated standardised clinical assessments with the Coma Recovery Scale-Revised (CRS-R), cerebral (18)F-fluorodeoxyglucose (FDG) PET, and fMRI during mental activation tasks. We...... state (48=traumatic, 78=non-traumatic; 110=chronic, 16=subacute). (18)F-FDG PET had high sensitivity for identification of patients in a minimally conscious state (93%, 95% CI 85-98) and high congruence (85%, 77-90) with behavioural CRS-R scores. The active fMRI method was less sensitive at diagnosis...

  15. Molecular Imaging of the Brain Using Multi-Quantum Coherence and Diagnostics of Brain Disorders

    CERN Document Server

    Kaila, M M

    2013-01-01

    This book examines multi-quantum magnetic resonance imaging methods and the diagnostics of brain disorders. It consists of two Parts. The part I is initially devoted towards the basic concepts of the conventional single quantum MRI techniques. It is supplemented by the basic knowledge required to understand multi-quantum MRI. Practical illustrations are included both on recent developments in conventional MRI and the MQ-MRI. This is to illustrate the connection between theoretical concepts and their scope in the clinical applications. The Part II initially sets out the basic details about quadrupole charge distribution present in certain nuclei and their importance about the functions they perform in our brain. Some simplified final mathematical expressions are included to illustrate facts about the basic concepts of the quantum level interactions between magnetic dipole and the electric quadrupole behavior of useful nuclei present in the brain. Selected practical illustrations, from research and clinical pra...

  16. Bi-photon imaging and diagnostics using ultra-small diagnostic probes engineered from semiconductor nanocrystals and single-domain antibodies

    Science.gov (United States)

    Hafian, Hilal; Sukhanova, Alyona; Chames, Patrick; Baty, Daniel; Pluot, Michel; Cohen, Jacques H. M.; Nabiev, Igor R.; Millot, Jean-Marc

    2012-10-01

    Semiconductor fluorescent quantum dots (QDs) have just demonstrated their numerous advantages over organic dyes in bioimaging and diagnostics. One of characteristics of QDs is a very large cross section of their twophoton absorption. A common approach to biodetection by means of QDs is to use monoclonal antibodies (mAbs) for targeting. Recently, we have engineered ultrasmall diagnostic nanoprobes (sdAb-QD) based on highly oriented conjugates of QDs with the single-domain antibodies (sdAbs) against cancer biomarkers. With a molecular weight of only 13 kDa (12-fold smaller than full-size mAbs) and extreme stability and capacity to refolding, sdAbs are the smallest functional Ab fragments capable of binding antigens with affinities comparable to those of conventional Abs. Ultrasmall diagnostic sdAb-QD nanoprobes were engineered through oriented conjugation of QDs with sdAbs. This study is the first to demonstrate the possibility of immunohistochemical imaging of colon carcinoma biomarkers with sdAb-QD conjugates by means of two-photon excitation. The optimal excitation conditions for imaging of the markers in clinical samples with sdAb-QD nanoprobes have been determined. The absence of sample autofluorescence significantly improves the sensitivity of biomarker detection with the use of the two-photon excitation diagnostic setup.

  17. Diagnostic accuracy of postmortem imaging vs autopsy—A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Eriksson, Anders, E-mail: anders.eriksson@rmv.se [Section of Forensic Medicine, Dept of Community Medicine and Rehabilitation, Umeå University, PO Box 7016, SE-907 12 Umeå (Sweden); Gustafsson, Torfinn [Section of Forensic Medicine, Dept of Community Medicine and Rehabilitation, Umeå University, PO Box 7016, SE-907 12 Umeå (Sweden); Höistad, Malin; Hultcrantz, Monica [Swedish Agency for Health Technology Assessment and Assessment of Social Services, PO Box 3657, SE-103 59 Stockholm (Sweden); Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, SE-171 77 Stockholm (Sweden); Jacobson, Stella; Mejare, Ingegerd [Swedish Agency for Health Technology Assessment and Assessment of Social Services, PO Box 3657, SE-103 59 Stockholm (Sweden); Persson, Anders [Department of Medical and Health Sciences, Center for Medical Image Science and Visualization (CMIV), Linköping University, SE-581 85, Linköping Sweden (Sweden)

    2017-04-15

    Highlights: • The search generated 340 possibly relevant publications, of which 49 were assessed as having high risk of bias and 22 as moderate risk. • Due to considerable heterogeneity of included studies it was impossible to estimate the diagnostic accuracy of the various findings. • Future studies need larger materials and improved planning and methodological quality, preferentially from multi-center studies. - Abstract: Background Postmortem imaging has been used for more than a century as a complement to medico-legal autopsies. The technique has also emerged as a possible alternative to compensate for the continuous decline in the number of clinical autopsies. To evaluate the diagnostic accuracy of postmortem imaging for various types of findings, we performed this systematic literature review. Data sources The literature search was performed in the databases PubMed, Embase and Cochrane Library through January 7, 2015. Relevant publications were assessed for risk of bias using the QUADAS tool and were classified as low, moderate or high risk of bias according to pre-defined criteria. Autopsy and/or histopathology were used as reference standard. Findings The search generated 2600 abstracts, of which 340 were assessed as possibly relevant and read in full-text. After further evaluation 71 studies were finally included, of which 49 were assessed as having high risk of bias and 22 as moderate risk of bias. Due to considerable heterogeneity – in populations, techniques, analyses and reporting – of included studies it was impossible to combine data to get a summary estimate of the diagnostic accuracy of the various findings. Individual studies indicate, however, that imaging techniques might be useful for determining organ weights, and that the techniques seem superior to autopsy for detecting gas Conclusions and Implications In general, based on the current scientific literature, it was not possible to determine the diagnostic accuracy of postmortem

  18. Diagnostic accuracy of postmortem imaging vs autopsy—A systematic review

    International Nuclear Information System (INIS)

    Eriksson, Anders; Gustafsson, Torfinn; Höistad, Malin; Hultcrantz, Monica; Jacobson, Stella; Mejare, Ingegerd; Persson, Anders

    2017-01-01

    Highlights: • The search generated 340 possibly relevant publications, of which 49 were assessed as having high risk of bias and 22 as moderate risk. • Due to considerable heterogeneity of included studies it was impossible to estimate the diagnostic accuracy of the various findings. • Future studies need larger materials and improved planning and methodological quality, preferentially from multi-center studies. - Abstract: Background Postmortem imaging has been used for more than a century as a complement to medico-legal autopsies. The technique has also emerged as a possible alternative to compensate for the continuous decline in the number of clinical autopsies. To evaluate the diagnostic accuracy of postmortem imaging for various types of findings, we performed this systematic literature review. Data sources The literature search was performed in the databases PubMed, Embase and Cochrane Library through January 7, 2015. Relevant publications were assessed for risk of bias using the QUADAS tool and were classified as low, moderate or high risk of bias according to pre-defined criteria. Autopsy and/or histopathology were used as reference standard. Findings The search generated 2600 abstracts, of which 340 were assessed as possibly relevant and read in full-text. After further evaluation 71 studies were finally included, of which 49 were assessed as having high risk of bias and 22 as moderate risk of bias. Due to considerable heterogeneity – in populations, techniques, analyses and reporting – of included studies it was impossible to combine data to get a summary estimate of the diagnostic accuracy of the various findings. Individual studies indicate, however, that imaging techniques might be useful for determining organ weights, and that the techniques seem superior to autopsy for detecting gas Conclusions and Implications In general, based on the current scientific literature, it was not possible to determine the diagnostic accuracy of postmortem