Sample records for radiologic non-vascular intervention

  1. Safety and effectiveness of moderate sedation for radiologic non-vascular intervention

    Kim, Tae-Hoon [Dankook University Hospital, Chungju (Korea, Republic of)


    The purpose of this study was to prospectively characterize the safety and effectiveness of moderate sedation/analgesia for performing radiologic non-vascular abdominal intervention. During a 3-month period, a total of 63 adult patients with a mean age of 64 years (range:27-82) underwent moderate sedation for 72 radiologic non-vascular interventional procedures. A combination of fentanyl citrate and midazolam hydrochloride, based on the patient's body weight, was intravenously administered until the patient was drowsy and tranquil. The adverse events associated with this moderate sedation were assessed. The visual analog scale format was used to measure the subjective feelings of the patient's pre-pro- cedural anxiety and intraprocedural pain. The mean total dose per kilogram of body weight of fentanyl used in PTBD was 1.148 {mu}g. The mean total dose per kilogram of body weight of midazolam was 0.035 mg in PTBD, PTGBD, AD, PCN, DJS, GS and FRA, 0.039 mg in TDC, and 0.043 mg in BS. A temporary reduction of systolic blood pressure to less than 80 mmHg was observed during 5 procedures (6.9%), whereas a temporary elevation of systolic blood pressure above 150 mmHg was observed during 10 procedures (13.8%). A reduction of arterial oxygen saturation to less than 90% was observed during 14 procedures (19.4%). None of the patients required pharmacologic reversal agents or cardiopulmonary resuscitation. The mean anxiety score recorded before all procedures was 5.2 (distressing). The mean pain score during the procedure, which was recorded after all procedures, was 2.9 (mild). Moderate sedation allows performance of safe and effective radiologic non-vascular intervention, and it is also easy for an interventional radiologist to use. The patients should be continuously monitored to check their vital signs and arterial oxygen saturation during the procedures.

  2. Interventional radiology

    Steinbrich, W. (ed.) (Basel Univ. (Switzerland). Inst. fuer Medizinische Radiologie); Gross-Fengels, W. (ed.) (Allgemeines Krankenhaus Harburg, Hamburg (Germany). Abt. fuer Klinische Radiologie)


    In interventional radiology adjunctive medical therapy can increase patient's comfort, and should further reduce the risks of the procedures. In order to fulfill the responsibility of the interventionist to the patients and to increase the success rate of the interventions, a profound knowledge of certain drugs is indispensable. This includes, for example, sedatives, analgesics, cardiovascular drugs and agents to prevent infections, thromboembolic complications or restenoses. Moreover, a good monitoring system during complex procedures will increase the safety of radiological interventions. These topics and several more are presented in this book. (orig.). 32 figs.

  3. Society of Interventional Radiology


  4. Interventional Radiology: Stroke


  5. Society of Interventional Radiology

    ... Search Patient information Membership Directory (SIR login) Interventional Radiology General News Multiple procedure payment reduction (MPPR) rate ... contact Eleanore Moye . Learn more . American Board of Radiology Announces Maintenance of Certification Part 3: ABR diplomates ...

  6. Interventional radiology procedures in adult patients who underwent liver transplantation

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


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

  7. Diagnostic and interventional radiology

    Vogl, Thomas J. [Klinikum der Johann Wolfgang Goethe-Universitaet, Frankfurt am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Reith, Wolfgang [Universitaetsklinikum des Saarlandes, Homburg/Saar (Germany). Klinik fuer Diagnostische und Interventionelle Neuroradiologie; Rummeny, Ernst J. (ed.) [Technische Univ. Muenchen Klinikum rechts der Isar, Muenchen (Germany). Inst. fuer Radiologie


    This exceptional book covers all aspects of diagnostic and interventional radiology within one volume, at a level appropriate for the specialist. From the basics through diagnosis to intervention: the reader will find a complete overview of all areas of radiology. The clear, uniform structure, with chapters organized according to organ system, facilitates the rapid retrieval of information. Features include: Presentation of the normal radiological anatomy Classification of the different imaging procedures according to their diagnostic relevance Imaging diagnosis with many reference images Precise description of the interventional options The inclusion of many instructive aids will be of particular value to novices in decision making: Important take home messages and summaries of key radiological findings smooth the path through the jungle of facts Numerous tables on differential diagnosis and typical findings in the most common diseases offer a rapid overview and orientation Diagnostic flow charts outline the sequence of diagnostic evaluation All standard procedures within the field of interventional radiology are presented in a clinically relevant and readily understandable way, with an abundance of illustrations. This is a textbook, atlas, and reference in one: with more than 2500 images for comparison with the reader's own findings. This comprehensive and totally up-to-date book provides a superb overview of everything that the radiology specialist of today needs to know.

  8. Paediatric musculoskeletal interventional radiology

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


    Interventional radiology technique is now well established and widely used in the adult population. Through minimally invasive procedures, it increasingly replaces surgical interventions that involve higher percentages of invasiveness and, consequently, of morbidity and mortality. For these advantageous reasons, interventional radiology in recent years has spread to the paediatric age as well. The aim of this study was to review the literature on the development, use and perspectives of these procedures in the paediatric musculoskeletal field. Several topics are covered: osteomuscle neoplastic malignant and benign pathologies treated with invasive diagnostic and/or therapeutic procedures such as radiofrequency ablation in the osteoid osteoma; invasive and non-invasive procedures in vascular malformations; treatment of aneurysmal bone cysts; and role of interventional radiology in paediatric inflammatory and rheumatic inflammations. The positive results that have been generated with interventional radiology procedures in the paediatric field highly encourage both the development of new ad hoc materials, obviously adapted to young patients, as well as the improvement of such techniques, in consideration of the fact that childrens' pathologies do not always correspond to those of adults. In conclusion, as these interventional procedures have proven to be less invasive, with lower morbidity and mortality rates as well, they are becoming a viable and valid alternative to surgery in the paediatric population. PMID:26235144

  9. Poul Erik Andersen's radiological work on Osteochondrodysplasias and interventional radiology

    Andersen, Poul Erik


    Hospital. His significant experience and extensive scientific work has led to many posts in the Danish Society of Interventional Radiology, the European Society of Radiology and the Cardiovascular and Interventional Radiological Society of Europe, where he is a fellow and has passed the European Board...... of Interventional Radiology - The European qualification in Interventional Radiology....

  10. Interventional radiology for paediatric trauma

    Sidhu, Manrita K. [Everett Clinic, AIC, Seattle Radiologists, Seattle, WA (United States); University of Washington School of Medicine, Radiology Department, Children' s Hospital and Regional Medical Center, Seattle, WA (United States); Hogan, Mark J. [The Ohio State University, Section of Vascular and Interventional Radiology, Nationwide Children' s Hospital, Columbus, OH (United States); Shaw, Dennis W.W. [University of Washington School of Medicine, Radiology Department, Children' s Hospital and Regional Medical Center, Seattle, WA (United States); Burdick, Thomas [University of Washington School of Medicine, Interventional Radiology, Harborview Medical Center, Seattle, WA (United States)


    Paediatric interventional radiology plays a cornerstone role in the management of paediatric trauma. In the acute setting, interventional radiology techniques allow minimally invasive control of haemorrhage or re-establishment of blood flow. Percutaneous stenting and drainage can allow disruptions in urinary or biliary systems to heal without the need for further surgery. Interventional radiology techniques also have a significant role in treating delayed complications of trauma, including embolization of arterial pseudoaneurysms and pulmonary embolism prophylaxis in individuals immobilized due to the trauma or its operative treatment. (orig.)

  11. White Paper: Curriculum in Interventional Radiology.

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


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

  12. Computational radiology for orthopaedic interventions

    Li, Shuo


    This book provides a cohesive overview of the current technological advances in computational radiology, and their applications in orthopaedic interventions. Contributed by the leading researchers in the field, this volume covers not only basic computational radiology techniques such as statistical shape modeling, CT/MRI segmentation, augmented reality and micro-CT image processing, but also the applications of these techniques to various orthopaedic interventional tasks. Details about following important state-of-the-art development are featured: 3D preoperative planning and patient-specific instrumentation for surgical treatment of long-bone deformities, computer assisted diagnosis and planning of periacetabular osteotomy and femoroacetabular impingement, 2D-3D reconstruction-based planning of total hip arthroplasty, image fusion for  computer-assisted bone tumor surgery, intra-operative three-dimensional imaging in fracture treatment, augmented reality based orthopaedic interventions and education, medica...

  13. Interventional neuroradiology techniques in interventional radiology

    Murphy, Kieran; Robertson, Fergus; Watkinson, Anthony


    This book provides accessible technique-specific information on interventional radiology procedures, in a format suitable for reference in the IR treatment room or as a carry-around guide. Offers step-by-step points, key point summaries and illustrations.

  14. Interventional radiology neck procedures.

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L


    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation.

  15. [Interventional radiology: current problems and new directions].

    Santos Martín, E; Crespo Vallejo, E


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

  16. The interventional radiology business plan.

    Beheshti, Michael V; Meek, Mary E; Kaufman, John A


    Strategic planning and business planning are processes commonly employed by organizations that exist in competitive environments. Although it is difficult to prove a causal relationship between formal strategic/business planning and positive organizational performance, there is broad agreement that formal strategic and business plans are components of successful organizations. The various elements of strategic plans and business plans are not common in the vernacular of practicing physicians. As health care becomes more competitive, familiarity with these tools may grow in importance. Herein we provide an overview of formal strategic and business planning, and offer a roadmap for an interventional radiology-specific plan that may be useful for organizations confronting competitive and financial threats.

  17. Radiation exposure and radiological protection in interventional radiological procedures with special attention to neurointerventional radiology

    Okamoto, Kouichirou; Sakai, Kunio [Niigata Univ. (Japan). School of Medicine; Yoshimura, Shutaro; Oka, Tetsuya; Ito, Jusuke


    It is necessary to interventional radiologists to understand the system of radiological protection recommended by the International Commission on Radiological Protection: justification, optimization, and individual dose and risk limits. Estimation and measurements of the radiation exposure to patients and personnel are important for radiological protection to avoid radiation injuries, such as temporal epilation and cataract. The practical principle of ALARA (as low as reasonably achievable) should be kept in any interventional radiological procedure. (author)

  18. Radiological interventions in malignant biliary obstruction

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


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

  19. Interventional radiology in pediatric oncology

    Hoffer, Fredric A. [Division of Diagnostic Imaging, Department of Radiological Sciences, St. Jude Children' s Research Hospital, 332 N. Lauderdale St., Memphis, TN 38105 (United States)]. E-mail:


    There are many radiological interventions necessary for pediatric oncology patients, some of which may be covered in other articles in this publication. I will discuss a number of interventions including percutaneous biopsy for solid tumor and hematological malignancy diagnosis or recurrence, for the diagnosis of graft versus host disease after stem cell or bone marrow transplantation, and for the diagnosis of complications of immunosuppression such as invasive pulmonary aspergillosis. In the past, tumor localization techniques have been necessary to biopsy or resect small lesions. However improved guidance techniques have allowed for more precise biopsy and the use of thermal ablation instead of excision for local tumor control. A percutaneously placed radio frequency, microwave, laser or cryogen probe can ablate the primary and metastatic tumors of the liver, lung, bone, kidney and other structures in children. This is an alternative treatment for the local control of tumors that may not be amenable to surgery, chemotherapy or radiotherapy. I will also describe how chemoembolization can be used to treat primary or metastatic tumors of the liver that have failed other therapies. This treatment delivers chemotherapy in the hepatic artery infused with emboli to increase the dwell time and concentration of the agents.

  20. Interventional radiology in the lacrimal drainage system

    Ilgit, Erhan T. [Department of Radiology, School of Medicine, Gazi University, Besevler 06510, Ankara (Turkey)]. E-mail:; Oenal, Baran [Department of Radiology, School of Medicine, Gazi University, Besevler 06510, Ankara (Turkey); Coskun, Bilgen [Department of Radiology, School of Medicine, Gazi University, Besevler 06510, Ankara (Turkey)


    This article presents a review of the interventional radiological procedures in the lacrimal drainage system. Balloon dacryocystoplasty and nasolacrimal polyurethane stent placement are the main fluoroscopically guided interventions for the treatment of epiphora by recanalizing the obstructed LDS. These procedures can also be used for dacryolith removal and lacrimal sac abscess treatment.

  1. Acute radiologic intervention in gastrointestinal bleeding

    Lesak, F.


    A case of embolization of the gastroduodenal artery in a 38-year old man with chronic pancreatitis and uncontrollable bleeding is presented. The advantage of this interventional radiologic procedure is discussed and in selective cases it seems to be the choice of treatment.

  2. The role of interventional radiology in trauma

    Douglas M. Coldwell


    @@ Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient. In all hospitals, regardless of size, the Interventional Radiologist must consider their relationships with the trauma service in order to quickly and efficiently render aid to the trauma victim. Such consideration should take place in the light of day as it seems that most trauma occurs in the middle of the night or another inconvenient time. The watchwords of trauma IR are speed and efficiency.

  3. Training in Radiation Protection for Interventional Radiology

    Vano, E.; Guibelalde, E.


    Several potential problems have been detected in the safety aspects for the practice of interventional radiology procedures: a) An important increase in the number cases and their complexity and the corresponding increase of installations and specialists involved; b) New X ray systems more sophisticated, with advanced operational possibilities, requiring special skills in the operators to obtain the expected benefits;c) New medical specialists arriving to the interventional arena to profit the benefits of the interventional techniques without previous experience in radiation protection. For that reason, education and training is one of the basic areas in any optimisation programme in radiation protection (RP). the medical field and especially interventional radiology requires actions to promote and to profit the benefit of the new emerging technologies for training (Internet, electronic books, etc). The EC has recently sponsored the MARTIR programme (Multimedia and Audio-visual Radiation Protection Training in Interventional Radiology) with the production of two videos on basic aspects of RP and quality control and one interactive CD-ROM to allow tailored individual training programmes. those educational tools are being distributed cost free in the main European languages. To go ahead with these actions, the EC has decided to promote during 2002, a forum with the main Medical European Societies involved in these interventional procedures. (Author)

  4. Interventional Radiology of Male Varicocele: Current Status

    Iaccarino, Vittorio, E-mail:; Venetucci, Pietro [University of Naples ' Federico II' , Diagnostic Imaging Department-Cardiovascular and Interventional Radiology, School of Medicine (Italy)


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

  5. Interventional radiology: a half century of innovation.

    Baum, Richard A; Baum, Stanley


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

  6. Vascular Closure Devices in Interventional Radiology Practice.

    Patel, Rafiuddin; Muller-Hulsbeck, Stefan; Morgan, Robert; Uberoi, Raman


    Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient.

  7. Vascular Closure Devices in Interventional Radiology Practice

    Patel, Rafiuddin, E-mail: [John Radcliffe Hospital, Department of Radiology (United Kingdom); Muller-Hulsbeck, Stefan, E-mail: [Diakonissen Hospital, Diagnostic and Interventional Radiology/Neuroradiology (Germany); Morgan, Robert, E-mail: [St George’s Hospital, Department of Radiology (United Kingdom); Uberoi, Raman, E-mail: [John Radcliffe Hospital, Department of Radiology (United Kingdom)


    Manual compression (MC) is a well-established technique for haemostasis following percutaneous arterial intervention. However, MC is labour and time intensive with potential limitations, particularly for patients who are coagulopathic, unable to comply with bed rest or obese and when large sheaths or anti-coagulants are used. There are a variety of vascular closure devices (VCDs) available to overcome these limitations. This review gives an overview of current VCDs, their mechanism of action, individual strengths and weaknesses, evidence base and utility in interventional radiology (IR) practice. The majority of the published evidence on VCDs is derived from patients undergoing cardiac interventions, which should be borne in mind when considering the applicability and transfer of this data for general IR practice. Overall, the evidence suggests that most VCDs are effective in achieving haemostasis with a similar rate of complications to MC although the complication profile associated with VCDs is distinct to that of MC. There is insufficient evidence to comparatively analyse the different types of VCDs currently available or reliably judge their cost-effectiveness. The interventional radiologist should have a thorough understanding of the available techniques for haemostasis and be able to identify and utilise the most appropriate strategy and closure technique for the individual patient.

  8. Navigational Tools for Interventional Radiology and Interventional Oncology Applications

    Chehab, Monzer A.; Brinjikji, Waleed; Copelan, Alexander; Venkatesan, Aradhana M.


    The interventional radiologist is increasingly called upon to successfully access challenging biopsy and ablation targets, which may be difficult based on poor visualization, small size, or the proximity of vulnerable regional anatomy. Complex therapeutic procedures, including tumor ablation and transarterial oncologic therapies, can be associated with procedural risk, significant procedure time, and measurable radiation time. Navigation tools, including electromagnetic, optical, laser, and robotic guidance systems, as well as image fusion platforms, have the potential to facilitate these complex interventions with the potential to improve lesion targeting, reduce procedure time, and radiation dose, and thus potentially improve patient outcomes. This review will provide an overview of currently available navigational tools and their application to interventional radiology and oncology. A summary of the pertinent literature on the use of these tools to improve safety and efficacy of interventional procedures compared with conventional techniques will be presented. PMID:26622105

  9. Interventional radiology robot for CT and MRI guided percutaneous interventions.

    Hungr, Nikolai; Fouard, Céline; Robert, Adeline; Bricault, Ivan; Cinquin, Philippe


    This paper introduces a new patient-mounted CT and MRI guided interventional radiology robot for percutaneous needle interventions. The 5 DOF robot uses ultrasonic motors and pneumatics to position the needle and then insert it progressively. The needle position and inclination can be registered in the images using two strategically placed fiducials visible in both imaging modalities. A first prototype is presented and described in terms of its sterilization, CT and MRI compatibility, and precision. Tests showed that 1) it is entirely sterilizable with hydrogen peroxide gas, 2) no image artifacts or deformations are noticeable in the CT and MRI images, 3) does not affect the SNR of MR images, and 4) its mechanical error is less than 5mm.

  10. Role of Interventional Radiology in Endocrine Diseases- Review Article

    Hossein GHANAATI


    Full Text Available Recently, a number of procedures for interventional radiology diagnosis and treatment have been developed by the radiologists. The ‘Interventional Radiology’ refers to the therapeutic procedures performed under imaging guidance. The emergence of this specialty has been made possible by a lot of advances in the technology, imaging systems, and radiologists experience. Interventional radiologists are physicians who are experienced in minimally invasive procedures and targeted treatments which have less risk, less pain and less recovery time in comparison with the surgery. Minimizing the patient discomfort, avoid of general anesthesia, lower incidence of morbidity and mortality, and decreases the length and cost of hospitalization are some advantages of interventional radiology procedures. Similar to all medical fields, interventional procedures have been introduced and developed for the diagnosis and treatment of endocrinology procedures. In this article we aim to review and report our experience about the role of interventional radiology in venous sampling for endocrine diseases (such as parathyroid venous sampling, inferior petrosal sinus sampling, adrenal venous sampling, and venous sampling for islet cell tumors. In addition, interventional treatments of neuroendocrine cancer metastases to the liver, percutaneous ethanol injection therapy for secondary hyperparathyroidism, treatment of hyperfunctioning thyroid nodules by percutaneous ethanol injection, radiofrequency ablation of the adrenal gland neoplasms, and also establishing a cGMP pancreatic islet processing facility have been discussed in this article. Keywords: Interventional radiology, Endocrine diseases, Endovascular, Treatment

  11. Physical and cognitive task analysis in interventional radiology

    Johnson, S. [School of Psychology, University of Liverpool, Liverpool (United Kingdom)]. E-mail:; Healey, A. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Evans, J. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Murphy, M. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Crawshaw, M. [Department of Psychology, University of Hull, Hull (United Kingdom); Gould, D. [Royal Liverpool University Hospital, Liverpool (United Kingdom)


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

  12. [Gastrointestinal bleeding. Diagnostics and therapy by interventional radiology].

    Wingen, M; Günther, R W


    Modern imaging modalities such as (multislice) helical CT allow new diagnostic strategies for gastrointestinal hemorrhage. Today, interventional radiology with superselective transcatheter embolization or TIPS procedures allow minimally invasive therapeutic management which can support or replace surgery. This review is a synopsis of the possibilities and relative merits of diagnostic and therapeutic radiological procedures for gastrointestinal bleeding. Which of them to use should be decided collaboratively by gastroenterologist, surgeon, and radiologist depending on local availability, personal experience, and individual patient factors.

  13. Guide for intervention levels in radiological accidents

    Lee, Jong Tai; Khang, Byung Oui; Lee, Goan Yup; Han, Gee Yang [Korea Atomic Energy Resesrch Institute, Taejon (Korea, Republic of)


    Based on IAEA SS109 and ICRP63, intervention levels and action levels are derived using cost-benefit approach method. Intervention levels are optimized so that the net benefit from protective measures will be maximized. Evacuation, sheltering, relocation, permanent resettlement, administration of stable iodine and food restriction are included in protective measures. Intervention levels are calculated using site specific parameters in Korea. As a results of calculation, general intervention levels are similar to IAEA recommendation and action levels for food restriction are a little higher than IAEA recommendation and Japan guide. Guide on intervention levels in Korea is also suggested based on the calculated results.

  14. Role of Interventional Radiology in Endocrine Diseases- Review Article

    Ghanaati, Hossein; Firouznia, Kavous; Larijani,Bagher; Jalali, Amir Hossein


    Recently, a number of procedures for interventional radiology diagnosis and treatment have been developed by the radiologists. The ‘Interventional Radiology’ refers to the therapeutic procedures performed under imaging guidance. The emergence of this specialty has been made possible by a lot of advances in the technology, imaging systems, and radiologists experience. Interventional radiologists are physicians who are experienced in minimally invasive procedures and targeted treatments which h...

  15. Nanotechnology and its relationship to interventional radiology. Part I: imaging.

    Power, Sarah


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

  16. Nanotechnology and its relationship to interventional radiology. Part I: imaging.

    Power, Sarah


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

  17. Evaluation of medical radiation exposure in pediatric interventional radiology procedures

    Navarro, Valeria Coelho Costa; Navarro, Marcus Vinicius Teixeira; Oliveira, Aline da Silva Pacheco, E-mail: [Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia (IFBA), Salvador, BA (Brazil); Maia, Ana Figueiredo [Universidade Federal de Sergipe (UFS), Aracaju, SE (Brazil); Oliveira, Adriano Dias Dourado [Sociedade Brasileira de Hemodinamica e Cardiologia Intervencionista, Salvador, BA (Brazil)


    Objective: To evaluate pediatric radiation exposure in procedures of interventional radiology in two hospitals in the Bahia state, aiming at contributing to delineate the scenario at the state and national levels. The knowledge of exposure levels will allow an evaluation of the necessity of doses optimization, considering that peculiarities of radiology and pediatrics become even more significant in interventional radiology procedures which involve exposure to higher radiation doses. Materials and Methods: A total of 32 procedures were evaluated in four rooms of the two main hospitals performing pediatric interventional radiology procedures in the Bahia state. Air kerma rate and kerma-area product were evaluated in 27 interventional cardiac and 5 interventional brain procedures. Results: Maximum values for air kerma rate and kerma-area product and air kerma obtained in cardiac procedures were, respectively, 129.9{sup 2} and 947.0 mGy; and, for brain procedures were 83.3{sup 2} and 961.0 mGy. Conclusion: The present study results showed exposure values up to 14 times higher than those found in other foreign studies, and approximating those found for procedures in adults. Such results demonstrate excessive exposure to radiation, indicating the need for constant procedures optimization and evaluation of exposure rates. (author)

  18. 100 classic papers of interventional radiology: A citation analysis

    Matthew; T; Crockett; Ronan; FJ; Browne; Peter; J; Mac; Mahon; Leo; Lawler


    AIM: To define the 100 citation classic papers of interventional radiology.METHODS: Using the database of Journal Citation Reports the 40 highest impact factor radiology journals were chosen. From these journals the 100 most cited interventional radiology papers were chosen and analysed.RESULTS: The top paper received 2497 citations and the 100 th paper 200 citations. The average number of citations was 320. Dates of publication ranged from 1953- 2005. Most papers originated in the United States(n = 67) followed by Italy(n = 20) and France(n = 10). Harvard University(n = 18) and Osped Civile(n = 11) were the most prolific institutions. Ten journals produced all of the top 100 papers with "Radiology" and "AJR" making up the majority. SN Goldberg and T Livraghi were the most prolific authors. Nearly two thirds of the papers(n = 61) were published after 1990.CONCLUSION: This analysis identifies many of the landmark interventional radiology papers and provides a fascinating insight into the changing discourse within the field. It also identifies topics, authors and institutions which have impacted greatly on the specialty.

  19. Slovenian experience from diagnostic angiography to interventional radiology

    Pavcnik Dusan


    Full Text Available Background. The purpose of writing this article is to document the important events and people in the first 50 years of diagnostic angiography and interventional radiology in Slovenia. During this period not only did the name of the institutions and departments change, but also its governance.

  20. Interventional radiological treatment in complications of pancreatitis

    Memis, Ahmet E-mail:; Parildar, Mustafa


    Percutaneous interventional therapy plays an important role in treating complications of acute and chronic pancreatitis. With the development of cross-sectional imaging and advanced interventional techniques, percutaneous drainage has become the preferred treatment for pancreatic fluid collections such as acute collections, pseudocysts and abscesses. Abscess and pancreatic hemorrhage are the most life threatening complications of pancreatitis. Massive hemorrhage is rare but frequently lethal. As a rule, bleeding complications of pancreatitis require prompt diagnosis and an aggressive surgical approach. In unstable patients with a severely bleeding pseudoaneurysm, hemostasis can be obtained by occlusion with mechanical devices.

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

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


    Paediatric patients have a higher average risk of developing cancer compared with adults receiving the same dose. The longer life expectancy in children allows more time for any harmful effects of radiation to manifest, and developing organs and tissues are more sensitive to the effects of radiation. This publication aims to provide guiding principles of radiological protection for referring clinicians and clinical staff performing diagnostic imaging and interventional procedures for paediatric patients. It begins with a brief description of the basic concepts of radiological protection, followed by the general aspects of radiological protection, including principles of justification and optimisation. Guidelines and suggestions for radiological protection in specific modalities - radiography and fluoroscopy, interventional radiology, and computed tomography - are subsequently covered in depth. The report concludes with a summary and recommendations. The importance of rigorous justification of radiological procedures is emphasised for every procedure involving ionising radiation, and the use of imaging modalities that are non-ionising should always be considered. The basic aim of optimisation of radiological protection is to adjust imaging parameters and institute protective measures such that the required image is obtained with the lowest possible dose of radiation, and that net benefit is maximised to maintain sufficient quality for diagnostic interpretation. Special consideration should be given to the availability of dose reduction measures when purchasing new imaging equipment for paediatric use. One of the unique aspects of paediatric imaging is with regards to the wide range in patient size (and weight), therefore requiring special attention to optimisation and modification of equipment, technique, and imaging parameters. Examples of good radiographic and fluoroscopic technique include attention to patient positioning, field size and adequate collimation, use

  2. Basic interventional radiology in the abdomen.

    Calero García, R; Garcia-Hidalgo Alonso, M I


    This article describes the different basic nonvascular interventional techniques in the abdomen that all general radiologists should be familiar with. It explains the indications and approaches for the different procedures (punctures, biopsies, drainage of collections, cholecystostomies, and nephrostomies). It also discusses the advantages and disadvantages of the different imaging techniques that can be used to guide these procedures (ultrasound, CT, and fluoroscopy) as well as the possible complications that can develop from each procedure. Finally, it shows the importance of following up patients clinically and of taking care of catheters.

  3. Traumatic injuries: radiological hemostatic intervention at admission

    Dondelinger, R.F.; Trotteur, G.; Ghaye, B.; Szapiro, D. [Department of Medical Imaging, University Hospital Sart Tilman, Liege (Belgium)


    Blunt trauma victims and selected patients with penetrating trauma are systematically investigated after resuscitation and hemodynamic stabilization with cross-sectional imaging. Computed tomography is a good predictor of the need for hemostatic arteriographic embolization, based on contrast medium extravasation observed on CT. In centers admitting polytrauma patients, the CT and angiography units should be installed together within the emergency environment. Trauma-dedicated interventional radiologists should be on call for optimal patient management. Posttraumatic retroperitoneal and pelvic bleeding is a primary indication for angiographic hemostasis, together with orthopedic fixation of pelvic bone fractures. Angiography should be carried out rapidly, before the patient decompensates for considerable blood loss. In patients with visceral bleeding, arterial embolization can obviate primary surgery or potentializes surgical intervention and contributes to changing hierarchy of injuries to be treated surgically. Failure to achieve primary hemostasis may occur according to the type of specific organ injury and coagulation and metabolic parameters of the patient. Postembolization complications are few and are usually non-life-threatening and rarely carry definitive sequelae. (orig.)

  4. Radiation protection of patients in interventional radiology; Radioprotection du patient en radiologie interventionnelle

    Roche, A. [Departement d' imagerie, Institut Gustave Roussy, 94 - Villejuif (France)


    The purpose of this article is to provide radiologists with key elements of radiation protection for interventional radiology patients. The following points will be discussed: standards of the fluoroscopy units, dedicated dosimetry, risks (especially cutaneous) and means to reduce them, optimization of interventional radiology dose protocols, and national and international regulations. Appropriateness criteria in interventional radiology are national guidelines that should be implemented. (author)

  5. Massive hemoptysis caused by tracheal hemangioma treated with interventional radiology.

    Zambudio, Antonio Ríos; Calvo, Maria Jose Roca; Lanzas, Juan Torres; Medina, J García; Paricio, Pascual Parrilla


    Capillary hemangiomas of the tracheobronchial tree are extremely rare in adults, with hemoptysis being one of the most serious forms of presentation. An operation has been the treatment of choice, although it does involve high rates of morbidity and mortality, especially in emergency situations such as massive hemoptysis, which has led to the search for other therapeutic alternatives. There is no experience with embolization by interventional radiology when the hemoptysis is tracheal in origin, caused partly because the infrequency of this pathology; however, the foundations for it have been laid with the development of embolization for bronchopulmonary pathology. We report a case of a tracheal capillary hemangioma in a 66-year-old woman diagnosed with idiopathic thrombopenic purpura, which began as a massive hemoptysis and was treated successfully with embolization by interventional radiology. There has been no recurrence of the bleeding after 1 year's follow-up, and the patient's control fibrobronchoscopy is normal.

  6. The current status of interventional radiology in Canada: results of a survey by the Canadian Interventional Radiology Association

    Millward, S.F.; Holley, M.L. [Univ. of Western Ontario, London Health Sciences Centre, Dept. of Radiology, London, Ontario (Canada)


    To evaluate the current status of interventional radiology in Canada. A questionnaire was sent to 28 Canadian interventional radiologists (defined as a physician who performs any type of interventional procedure, including biopsies, but excluding interventional neuroradiology) practising in both tertiary and community hospitals in the major centres in all provinces except Prince Edward Island. Twenty-two (79%) of 28 surveys were completed and returned, providing data about 86 interventional radiologists (IRs). IRs were performing almost all of the following procedures at their institutions: inferior vena cava filter placement, venous angioplasty, dialysis fistula angioplasty, diagnostic and therapeutic pulmonary and bronchial artery procedures, diagnostic and therapeutic procedures of the lower extremity and renal arteries, percutaneous abscess and biliary drainage procedures, percutaneous nephrostomy, and fibroid embolization. A second group of procedures, performed by both IRs and non-radiologists in most institutions, included: all types of central venous catheter placements, pleural drainage, and gastrostomy tube placement. Procedures not being performed by anyone in a number of institutions included: dialysis graft thrombolysis, varicocele embolization, transjugular intrahepatic portosystemic shunts, palliative stenting of the gastrointestinal tract, fallopian tube recannalization, and liver and prostate tumour treatments. The factors most often limiting the respondents' ability to provide a comprehensive interventional service were the interventional radiology inventory budget and the availability of interventional radiology rooms; 50% of respondents indicated the number of available nurses, technologists and IRs was also an important limiting factor. IRs in Canada still play a major role in many of the most commonly performed procedures. However, limited availability of resources and personnel in many institutions may be hampering the ability of IRs to

  7. 介入放射学%Interventional Radiology

    翟仁友; 魏宝杰


    @@ 介入放射学(Interventional Radiology,IVR)是以影像诊断为基础,在医学影像诊断设备(DSA、US、CT、MRI等)的引导下,利用穿刺针、导管及其他介入器材,对疾病进行治疗或采集组织学、细菌学及生理、生化资料进行诊断的学科.

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

    Mori, Hiroshige


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

  9. Patient Safety in Interventional Radiology: A CIRSE IR Checklist.


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

  10. Vascular interventional radiology. Current evidence in endovascular surgery. 2. ed.

    Cowling, Mark G. (ed.) [Univ. Hospital North Staffordshire, Stoke-on-Trent (United Kingdom). Dept. of Radiology


    Succinct chapters that will allow readers to identify quickly the information that they need. Ideally sized book for storage and use in the interventional suite. Contains sufficient detail for trainees in endovascular therapy/interventional radiology to gain a thorough grasp of the relevant issues. Fully updated to reflect recent advances. This new edition of Vascular Interventional Radiology: Current Evidence in Endovascular Surgery provides a thorough yet succinct and accessible review of the latest knowledge in the field of endovascular surgery. All chapters have been updated to reflect the advances that have occurred during the past five years, and new chapters are included on carotid artery stenting and day case intervention. The chapter on lower limb veno-occlusive disease has been expanded to include management of deep venous thrombosis. Among the other topics considered are the endovascular treatment options in different arterial territories, aneurysm repair techniques, and the management of venous stenosis and venous insufficiency. The aim throughout is to tackle issues of evidence-based practice in order to assist trainees and experienced practitioners in making and implementing treatment decisions. This book will be an invaluable source of information for both interventional radiologists and vascular surgeons with an interest in endovascular techniques.

  11. [Interventional Radiological Treatment of Intercostal Artery Bleedings - a Retrospective Analysis].

    Kupczyk, Patrick; Meyer, Carsten; Thomas, Daniel; Schild, Hans Heinz; Pieper, Claus Christian


    Background Intercostal artery bleedings are potentially fatal injuries. Apart from conservative and surgical treatment options, emergency interventional radiological treatment can also be performed. We report our experience with emergency intercostal artery embolisation. Materials and Methods Patients with acute arterial bleedings from the intercostal artery who were treated interventionally over a period of 7 years were identified retrospectively. Technical and clinical success, clinical and procedural parameters as well as overall survival were analysed. Results Between 2010 and 2017, a total of 27 embolisation procedures was performed in 24 patients (14 male, mean age 65.7 ± 13.9 years). The majority of patients suffered from iatrogenic intercostal artery bleedings (n = 17; 70.1%; especially after thoracocentesis). In five cases, thoracoscopic surgery was attempted prior to intervention but was unsuccessful. Primary technical success was obtained in 25/27 interventions. In two cases, there was re-bleeding via collateral arteries so that re-intervention became necessary (secondary technical success). In 15 cases, secondary surgery after successful interventional treatment was necessary to evacuate the haematoma/haemothorax. Intercostal artery embolisation was clinically successful in 23/24 patients. One patient died despite technically successful embolisation, due to extensive haemothorax. One case of spinal ischaemia was observed as a major complication. Conclusion Intercostal artery embolisation is an effective interventional radiological emergency measure in patients with acute bleeding and is an alternative to surgical treatment even after attempted, unsuccessful surgery. Because of potentially severe complications, the interventional procedure should be performed by an experienced interventionalist. Georg Thieme Verlag KG Stuttgart · New York.

  12. Fatal mediastinal biopsy: How interventional radiology saves the day

    Y Yaacob


    Full Text Available This was a case of a 35-year-old man with mediastinal mass requiring computed tomography (CT-guided biopsy for tissue diagnosis. A posterior approach with an 18-gauge biopsy needle was used to obtain tissue sample. Post biopsy, patient condition deteriorated and multiphase CT study detected active bleeding in arterial phase at the biopsy site with massive hemothorax. Subsequent angiography showed arterial bleeder arising from the apical branch of the right pulmonary artery. Selective endovascular embolization with NBCA (n-Butyl cyanoacrylate was successful. Patient survived the complication. The case highlighted a rare complication in a common radiology procedure and the value of the interventional radiology unit in avoiding a fatal outcome.

  13. Current Trends in Heparin Use During Arterial Vascular Interventional Radiology

    Durran, Alexandra C., E-mail: [Peninsula Radiology Academy, Plymouth International Business Park (United Kingdom); Watts, Christopher, E-mail: [Salisbury District Hospital (United Kingdom)


    Purpose: This study was designed to assess the current use of heparinized saline and bolus doses of heparin in non-neurological interventional radiology and to determine whether consensus could be reached to produce guidance for heparin use during arterial vascular intervention. Methods: An interactive electronic questionnaire was distributed to members of the British Society of Interventional Radiology regarding their current practice in the use, dosage, and timing of heparin boluses and heparinized flushing solutions.ResultsA total of 108 completed questionnaires were received. More than 80% of respondents used heparinized saline with varying concentrations; the most prevalent was 1,000 IU/l (international units of heparin per liter) and 5,000 IU/l. Fifty-one percent of interventionalists use 3,000 IU as their standard bolus dose; however, the respondents were split regarding the timing of bolus dose with {approx}60% administering it after arterial access is obtained and 40% after crossing the lesion. There was no consensus on altering dose according to body weight, and only 4% monitored clotting parameters. Conclusions: There seems to be some coherence among practicing interventionalists regarding heparin administration. We hypothesize that heparinized saline should be used at a recognized standard concentration of 1,000 IU/l as a flushing concentration in all arterial vascular interventions and that 3,000 IU bolus is considered the standard dose for straightforward therapeutic procedures and 5000 IU for complex, crural, and endovascular aneurysm repair work. The bolus should be given after arterial access is obtained to allow time for optimal anticoagulation to be achieved by the time of active intervention and stenting. Further research into clotting abnormalities following such interventional procedures would be an interesting quantifiable follow-up to this initial survey of opinions and practice.

  14. Radiation dose to physicians’ eye lens during interventional radiology

    Bahruddin, N. A.; Hashim, S.; Karim, M. K. A.; Sabarudin, A.; Ang, W. C.; Salehhon, N.; Bakar, K. A.


    The demand of interventional radiology has increased, leading to significant risk of radiation where eye lens dose assessment becomes a major concern. In this study, we investigate physicians' eye lens doses during interventional procedures. Measurement were made using TLD-100 (LiF: Mg, Ti) dosimeters and was recorded in equivalent dose at a depth of 0.07 mm, Hp(0.07). Annual Hp(0.07) and annual effective dose were estimated using workload estimation for a year and Von Boetticher algorithm. Our results showed the mean Hp(0.07) dose of 0.33 mSv and 0.20 mSv for left and right eye lens respectively. The highest estimated annual eye lens dose was 29.33 mSv per year, recorded on left eye lens during fistulogram procedure. Five physicians had exceeded 20 mSv dose limit as recommended by international commission of radiological protection (ICRP). It is suggested that frequent training and education on occupational radiation exposure are necessary to increase knowledge and awareness of the physicians’ thus reducing dose during the interventional procedure.

  15. Brief history of interventional radiology%介入放射学简史

    唐振良; 贾爱芹; 李荦芸; 李春雨


    In 1923,angiography was first successively used for the human body.In 1953,a Swedish doctor Sven-Ivar Seldinger pioneered the Seldinger technique,which laid down the foundation of interventional radiology.In 1963,Charles Dotter first proposed the idea of interventional radiology.In 1964,Charles Dotter opened a new era of percutaneous angioplasty through accidental operation,marking the formation of interventional radiology.On this basis,the techniques of balloon catheter dilation and metal stent implantation was developed.Endovascular stent was proposed in 1969.In 1973,the percutaneous angioplasty has been a breakthrough with the emergence of soft double-lumen balloon catheter.Percutaneous coronary angioplasty is applied in 1977.Since the 1990s,balloon angioplasty relegated to secondary status with the emergence of metal stent.Currently,endovascular stent have entered a new stage with the emergence of temporary stent and stent grafts and biological stent.Transcatheter arterial embolization had been one of the most important basic techniques for interventional radiology since 1965,it had also been a corresponding development with the improvement of embolic agents and catheter technology for the treatment of diseases now.Transjugular intrahepatic portosystemic stent-shunt is a comprehensive interventional radiology technology since 1967,in which the biliary system can be reached through a jugular vein,and the improvement appeared with balloon expandable stent in 1986.Since 1972,non-vascular interventional techniques was another important branch of interventional radiology.Currently,it is applied in the diagnosis and treatment of many diseases of the internal organs like the pancreas,liver,kidney,spinal cord,Fallopian tubes,esophagus and other organs.In 1973,Chinese radiologist first conducted the angiography test.Interventional radiology was introduced into China in the 1980s,it was readily developed through the sponsoring of training class (1981) and academic

  16. Is hair loss a reality in neuro-interventional radiology?

    Gavagan, L


    Reports in the literature of radiation-induced hair loss are becoming increasingly common. This work describes a retrospective dose study of patients (n = 958) undergoing diagnostic (primarily cerebral angiograms) and therapeutic (primarily cerebral embolisation) procedures in a neuro-interventional suite. A comparison of patient doses as dose area product (DAP) readings from a single-plane image intensifier system (mean DAP value of 8772 cGy cm(2)) were compared with patient doses from a flat panel biplane system (mean DAP value of 7855 cGy cm(2)). Over 80 % of patients requiring neuro-interventional procedures were found to undergo two procedures or more. An estimated 7 % of therapeutic procedures were found to reach the International Commission on Radiological Protection threshold for temporary epilation.

  17. Virtual simulation as a learning method in interventional radiology

    Avramov Predrag


    Full Text Available Introduction. Radiology is the fastest growing discipline of medicine thanks to the implementation of new technologies and very rapid development of imaging diagnostic procedures in the last few decades. On the other hand, the development of imaging diagnostic procedures has put aside the traditional gaining of experience by working on real patients, and the need for other alternatives of learning interventional radiology procedures has emerged. A new method of virtual approach was added as an excellent alternative to the currently known methods of training on physical models and animals. Virtual reality represents a computer- generated reconstruction of anatomical environment with tactile interactions and it enables operators not only to learn on their own mistakes without compromising the patient’s safety, but also to enhance their knowledge and experience. Discussion. It is true that studies published so far on the validity of endovascular simulators have shown certain improvement of operator’s technical skills and reduction in time needed for the procedure, but on the other hand, it is still a question whether these skills are transferable to the real patients in the angio room. Conclusion. With further improvement of technology, shortcomings of virtual approach to interventional procedures learning will be less significant and this procedure is likely to become the only method of learning in the near future.

  18. Radiation protection in interventional radiology; Strahlenschutz in der interventionellen Radiologie

    Adamus, R.; Loose, R.; Galster, M. [Klinikum Nuernberg Nord, Institut fuer Diagnostische und Interventionelle Radiologie, Nuernberg (Germany); Wucherer, M. [Klinikum Nuernberg Nord, Institut fuer Medizinische Physik, Nuernberg (Germany); Uder, M. [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Institut fuer Radiologie, Erlangen (Germany)


    The application of ionizing radiation in medicine seems to be a safe procedure for patients as well as for occupational exposition to personnel. The developments in interventional radiology with fluoroscopy and dose-intensive interventions require intensified radiation protection. It is recommended that all available tools should be used for this purpose. Besides the options for instruments, x-ray protection at the intervention table must be intensively practiced with lead aprons and mounted lead glass. A special focus on eye protection to prevent cataracts is also recommended. The development of cataracts might no longer be deterministic, as confirmed by new data; therefore, the International Commission on Radiological Protection (ICRP) has lowered the threshold dose value for eyes from 150 mSv/year to 20 mSv/year. Measurements show that the new values can be achieved by applying all X-ray protection measures plus lead-containing eyeglasses. (orig.) [German] Die Anwendung ionisierender Strahlung in der Medizin scheint sowohl fuer Patienten als auch fuer beruflich exponierte Personen sicher zu sein. Die interventionellen Entwicklungen der letzten Jahre mit sehr durchleuchtungs- und dosisintensiven Eingriffen erfordern allerdings eine Intensivierung des Strahlenschutzes. Es empfiehlt sich, die zur Verfuegung stehenden Moeglichkeiten auszuschoepfen. Neben den Geraeteoptionen muss der Strahlenschutz am Eingriffstisch durch Bleilamellenaufstecker und montiertes Bleiglas intensiv betrieben werden. Besonderen Fokus muss auf den Schutz der Augen zur Kataraktvermeidung gelegt werden. Da dessen Ausbildung nach neuen Erkenntnissen moeglicherweise nicht mehr deterministisch zu sehen ist, hat die Internationale Strahlenschutzkommission (IRCP) den Grenzwert von 150 auf 20 Mikrosievert (mSv)/Jahr erniedrigt. Messungen belegen, dass unter Einhaltung aller Strahlenschutzmassnahmen plus Bleiglasbrille dieser einzuhalten ist. (orig.)

  19. Needlestick Injuries in Interventional Radiology Are Common and Underreported.

    Deipolyi, Amy R; Prabhakar, Anand M; Naidu, Sailendra; Oklu, Rahmi


    Purpose To determine the prevalence of and risk factors for needlesticks in interventional radiology physicians, as well as the attitudes, behaviors, and conditions that promote or interfere with reporting of these injuries. Materials and Methods A total of 3889 interventional radiologists from academic and private practice in the United States were surveyed by emailing all interventional radiologist members of the Society of Interventional Radiology, including attending-level physicians and trainees (April-August 2016). The institutional review board waived the need for consent. Questions inquired about the nature, frequency, and type of needlestick and sharps injuries and whether and to whom these incidents were reported. Stepwise regression was used to determine variables predicting whether injuries were reported. Results In total, 908 (23%) interventional radiologists completed at least a portion of the survey. Eight hundred fourteen (91%) of 895 respondents reported a prior needlestick injury, 583 (35%) of 895 reported at least one injury while treating an HIV-positive patient, and 626 (71%) of 884 reported prior training regarding needlestick injury. There was, on average, one needlestick for every 5 years of practice. Most needlestick or sharps injuries were self inflicted (711 [87%] of 817) and involved a hollow-bore device (464 [56%] of 824). Only 566 (66%) of 850 injuries were reported. The most common reasons for not reporting included perceived lack of utility of reporting (79 [28%] of 282), perceived low risk for injury (56 [20%] of 282), noncontaminated needle (53 [19%] of 282), too-lengthy reporting process (37 [13%] of 282), and associated stigma (23 [8%] of 282). Only 156 (25%) of 624 respondents informed their significant other. Stepwise regression assessing variables affecting the likelihood of reporting showed that male sex (P = .009), low-risk patient (P < .0001), self injury (P = .010), trainee status (P < .0001), and the total number of prior

  20. Reconciling quality and cost: A case study in interventional radiology.

    Zhang, Li; Domröse, Sascha; Mahnken, Andreas


    To provide a method to calculate delay cost and examine the relationship between quality and total cost. The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 € to 294 €, and marginal delay costs from approximately 2000 € to 500 €, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 €. The yearly delay cost saved was approximately 150,000 €. With increased revenue of 10,000 € in project phase 2, the yearly total cost saved was approximately 290,000 €. Optimal daily capacity of 4.2 procedures was determined. An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. • Improving quality in terms of safety, outcome, efficiency and timeliness reduces cost. • Mismatch of demand and capacity is detrimental to quality and cost. • Full system utilization with random demand results in long waiting periods and increased cost.

  1. Competitiveness of the match for interventional radiology and neuroradiology fellowships.

    Chen, Jim Y; Agarwal, Vikas; Orons, Philip D


    Overall resident interest in certain subspecialties changes with time. We sought to investigate the latest 6-year trend in interventional radiology (IR) and neuroradiology fellowship applications and how it has affected competitiveness in obtaining a position. We analyzed statistics published by the National Resident Matching Program in Results and Data: Specialties Matching Service from 2008 to 2013. From these data, we calculated the positions per IR applicant (PPIRA) and positions per neuroradiology applicant (PPNRA) for each year. The number of positions per applicant is one way to assess specialty competitiveness on a supply-and-demand basis. A lower PPIRA or PPNRA indicates a more competitive year. PPIRA has decreased every year, from 1.71 to the present 0.84, and contributed to 52 applicants being unmatched in 2013, up from 9 in 2008. Accordingly, the number of unfilled positions has decreased from 86 in 2008 to 8 in 2013. PPNRA waxed and waned from 2008 to 2010 but stabilized at around 1.15 thereafter. The number of unfilled positions has never dropped below 46. The number of unmatched applicants was consistently in the teens, except in 2011, when it increased to 23. Interest in IR fellowship has increased significantly over the past 6 years, whereas interest in neuroradiology fellowships has plateaued. IR fellowships have become increasingly competitive, leading to many unmatched residents. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  2. Reconciling quality and cost: A case study in interventional radiology

    Zhang, Li; Mahnken, Andreas [University Hospital Giessen and Marburg, Philipps University of Marburg, Department of Diagnostic and Interventional Radiology, Baldinger Strasse, Marburg (Germany); Domroese, Sascha [University Hospital Giessen and Marburg, Philipps University of Marburg, Division of Controlling, Baldinger Strasse, Marburg (Germany)


    To provide a method to calculate delay cost and examine the relationship between quality and total cost. The total cost including capacity, supply and delay cost for running an interventional radiology suite was calculated. The capacity cost, consisting of labour, lease and overhead costs, was derived based on expenses per unit time. The supply cost was calculated according to actual procedural material use. The delay cost and marginal delay cost derived from queueing models was calculated based on waiting times of inpatients for their procedures. Quality improvement increased patient safety and maintained the outcome. The average daily delay costs were reduced from 1275 EUR to 294 EUR, and marginal delay costs from approximately 2000 EUR to 500 EUR, respectively. The one-time annual cost saved from the transfer of surgical to radiological procedures was approximately 130,500 EUR. The yearly delay cost saved was approximately 150,000 EUR. With increased revenue of 10,000 EUR in project phase 2, the yearly total cost saved was approximately 290,000 EUR. Optimal daily capacity of 4.2 procedures was determined. An approach for calculating delay cost toward optimal capacity allocation was presented. An overall quality improvement was achieved at reduced costs. (orig.)

  3. Celiac artery stenosis/occlusion treated by interventional radiology

    Ikeda, Osamu [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)], E-mail:; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)


    Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

  4. Pediatric interventional radiology and dose-reduction techniques.

    Johnson, Craig; Martin-Carreras, Teresa; Rabinowitz, Deborah


    The pediatric interventional radiology community has worked diligently in recent years through education and the use of technology to incorporate numerous dose-reduction strategies. This article seeks to describe different strategies where we can significantly lower the dose to the pediatric patient undergoing a diagnostic or therapeutic image-guided procedure and, subsequently, lower the dose several fold to the staff and ourselves in the process. These strategies start with patient selection, dose awareness and monitoring, shielding, fluoroscopic techniques, and collimation. Advanced features such as cone-beam technology, dose-reduction image processing algorithms, overlay road mapping, and volumetric cross-sectional hybrid imaging are also discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Value of levels of complexity in the estimation of the risk in interventional radiology procedures; Valor de los indices de complejidad en la estimacion del riesgo en procedimientos de radiologia intervencionista

    Ruiz Cruces, R.; Vano, E.; Hernandez Armas, J.; Carrera Magarino, F.; Rosales, F.; Galan, P.; Solar, M. M.; Perez Martinez, M.; Sanchez Casanueva, R.; Moreno Saiz, C.; Caudepon, F.; Diaz, F.; Gallego Solar, J. J.; Martin-Palanca, A.; Ruiz Munoz-Canela, J. J.; Moreno Rodriguez, F.; Gonzalez de Garay, M.; Canis, M.; Lopez Medina, A.; Moreno Sachez, T.; Pastor Vega, J. M.


    The interventional Radiology (IR) refers to guided procedures with X rays, to develop a diagnostic and/or therapeutic action both in vascular diseases as non-vascular. The progressive increase in the complexity and diversity of interventional procedures make it difficult to objectify the criteria about the dosage provided to patients who are these techniques. Control of radiation doses administered to patients to limit the risks associated with the use of x-rays is not more than one way of improving procedures. For this reason, already completed the ERRAPRI project, we have developed complexity rates to better assess the radiological risk associated with the procedures carried out in a sample of Spanish hospitals. (Author)

  6. Off label use of devices and drugs in interventional radiology

    Zvavanjanja, R.C., E-mail: [Royal Liverpool University Hospital, Liverpool (United Kingdom); Odetoyinbo, T.O.; Rowlands, P.C.; Healey, A.; Abdelsalam, H.; Powell, S.; Evans, J.C.; Hughes, M.L.; Gould, D.A.; McWilliams, R.G. [Royal Liverpool University Hospital, Liverpool (United Kingdom)


    Aim: To establish how often off-label device and drug use occurs in interventional radiology (IR) in a UK tertiary referral hospital and consider the wider implications for the interventional radiologist. Materials and methods: Prospective data were collected during interventional procedures for 1 working week in a university hospital. Out-of-hours procedures and procedures outside the department were excluded. Operators were asked to record the drugs and devices used, the indication, and method of use. The instructions for use/summary of product characteristics were then studied for each device/drug used to assess if the use was on or off-label. Results: During the study period 52 cases were performed and data were available on 26 cases (50%). In 22 of the 26 cases (84%) there was evidence of off-label use of devices or drugs. Off-label use of drugs included treatment of venous malformations with Fibrovein{sup Copyright-Sign} (sodium tetradecyl sulphate), which is licensed for the treatment of varicose veins in the leg, and intra-arterial injection of heparin, which is licensed for intravenous and subcutaneous use. Off-label device use included placing vascular sheaths in the urinary tract, using angiographic catheters to guide wires in the urinary tract, using sheaths for thrombosuction, reshaping of the tip of most guidewires, and using angioplasty balloons to dislodge the arterial plug at fistula thrombectomy. Conclusion: Off-label device and drugs use is common in a UK tertiary hospital IR department and literature suggests this is common in the wider IR community. There are important clinical and legal implications for off-label use for patients and physicians.

  7. Entrance surface dose in cerebral interventional radiology procedures

    Barrera-Rico, M.; Lopez-Rendon, X.; Rivera-Ordonez, C. E.; Gamboa-deBuen, I. [Instituto de Ciencias Nucleares, Universidad Nacional Autonoma de Mexico, 04510 DF (Mexico); Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, 14269 DF (Mexico); Instituto de Ciencias Nucleares, Universidad Nacional Autonoma de Mexico, 04510 DF (Mexico)


    At the Instituto Nacional de Neurologia y Neurocirugia (INNN) diagnostic as well as therapeutic procedures of interventional radiology are carried out. Since the procedures can last from some minutes to several hours, the absorbed dose for the patient could increase dangerously. An investigation had begun in order to determine the entrance surface dose (ESD) using 25 thermoluminiscent dosimeters TLD-100 and 8 strips of 15 Multiplication-Sign 1 cm{sup 2} of Gafchromic XR-QA2 film bound in a holder of 15 Multiplication-Sign 15 cm{sup 2} in the posteroanterior (PA) and lateral (LAT) positions during all the procedure. The results show that maximum ESD could be from 0.9 to 2.9 Gy for the PA position and between 1.6 and 2.5 Gy for the lateral position. The average ESD was between 0.7 and 1.3 Gy for the PA position, and from 0.44 to 1.1 Gy for the lateral position in a therapeutic procedure.

  8. Interventional Radiology Procedures after Pancreatic Resections for Pancreatic and Periampullary Diseases

    Riccardo Casadei


    Full Text Available Context The use of interventional radiology has increased as the first-line management of complications after pancreatic resections. Methods Patients in whom interventional radiology was performed were compared with those in whom interventional radiology was not performed as regards type of pancreatic resection, diagnosis, postoperative mortality and morbidity, postoperative pancreatic fistula postpancreatectomy haemorrhage, bile leakage, reoperation rate and length of hospital stay. Our aim was to evaluate the usefulness of interventional radiology in the treatment of complications after pancreatic resection. Results One hundred and eighty-two (62.8% out of 290 patients experienced postoperative complications. Interventional radiology procedures were performed in 37 cases (20.3%: percutaneous drainage in 28, transhepatic biliary drainage in 8 and arterial embolisation in 3 cases. Technical success was obtained in all casesand clinical success in 75.7%. Reoperation was avoided in 86.5%. In patients with major complications, clinically relevant postoperative pancreatic fistula and bile leaks as well as those with late postpancreatectomy haemorrhage (P=0.030 and patients with postpancreatectomy haemorrhage grade C (P=0.029, interventional radiology was used (P0.001, P0.001 ad P=0.009, respectively significantly more frequently than in the remaining patients. The reoperation and mortality rates were similar in the two groups (P=0.885 and P=0.100,respectively while patients treated with interventional radiology procedures had a significant longer length of hospital stay than those in the non-iterventional radiology group (37.5 ± 23.4 vs. 18.7 ± 11.7 days; P<0.001. Conclusions Interventional radiology procedures were useful, especially for patients with postoperative pancreatic fistulas and bile leaks in whom reoperation was very often avoided.

  9. Nanotechnology and its Relationship to Interventional Radiology. Part II: Drug Delivery, Thermotherapy, and Vascular Intervention.

    Power, Sarah


    Nanotechnology can be defined as the design, creation, and manipulation of structures on the nanometer scale. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part 2 of the article concentrates on drug delivery, thermotherapy, and vascular intervention. In oncology, advances in drug delivery allow for improved efficacy, decreased toxicity, and greater potential for targeted therapy. Magnetic nanoparticles show potential for use in thermotherapy treatments of various tumours, and the effectiveness of radiofrequency ablation can be enhanced with nanoparticle chemotherapy agents. In vascular intervention, much work is focused on prevention of restenosis through developments in stent technology and systems for localised drug delivery to vessel walls. Further areas of interest include applications for thrombolysis and haemostasis.

  10. Nanotechnology and its relationship to interventional radiology. Part II: Drug Delivery, Thermotherapy, and Vascular Intervention.

    Power, Sarah


    Nanotechnology can be defined as the design, creation, and manipulation of structures on the nanometer scale. This two-part review is intended to acquaint the interventionalist with the field of nanotechnology, and provide an overview of potential applications, while highlighting advances relevant to interventional radiology. Part 2 of the article concentrates on drug delivery, thermotherapy, and vascular intervention. In oncology, advances in drug delivery allow for improved efficacy, decreased toxicity, and greater potential for targeted therapy. Magnetic nanoparticles show potential for use in thermotherapy treatments of various tumours, and the effectiveness of radiofrequency ablation can be enhanced with nanoparticle chemotherapy agents. In vascular intervention, much work is focused on prevention of restenosis through developments in stent technology and systems for localised drug delivery to vessel walls. Further areas of interest include applications for thrombolysis and haemostasis.

  11. Imaging and radiology

    Interventional radiology; Diagnostic radiology; X-ray imaging ... DIAGNOSTIC RADIOLOGY Diagnostic radiology helps health care professionals see structures inside your body. Doctors that specialize in the interpretation ...

  12. The clinical practice of interventional radiology: a European perspective.

    Keeling, Aoife N


    The purpose of this study was to determine the current clinical environment in which interventional radiology (IR) is practiced throughout Europe. A survey, comprising 12 questions on IR clinical practice, was sent to 1800 CIRSE members. Members were asked to return one survey per department. Two hundred seventy-four departments returned completed questionnaires, 22% from the United Kingdom (n = 60), 11% from Germany (n = 30), 8% from Austria (n = 23), and the remainder spread over Europe. Experts, with more than 10 years of IR experience, comprised 74% of the survey group. Almost one-third of the radiologists dedicated more than 80% of their clinical sessions to IR alone (27%; n = 75), with two-thirds practicing in a university teaching hospital setting (66%; n = 179). Few institutions have dedicated IR inpatient hospital beds (17%; n = 46), however, to compensate, day case beds are available (31%), IR admitting rights are in place (64% overall, 86% for in-patients, and 89% for day cases), and elective IR admissions can be made through other clinicians (87%). IR outpatient clinics are run at 26% of departments, with an average of two sessions per week. Dedicated nurses staff the majority of IR suites (82%), but clinical junior doctors are lacking (46%). Hospital management\\'s refusing access to beds was the most commonly cited reason for not developing a clinical IR service (41%). In conclusion, there is marked variation across European centers in the current practice of IR. Half do not have dedicated junior doctors and only a small minority have inpatient hospital beds. If IR is to be maintained as a dedicated clinical specialty, these issues need to be addressed urgently.

  13. The Radiologist Is in, but Was it Worth the Wait? Radiology Resident Note Quality in an Outpatient Interventional Radiology Clinic.

    Abboud, Salim E; Soriano, Stephanie; Abboud, Rayan; Patel, Indravadan; Davidson, Jon; Azar, Nami R; Nakamoto, Dean A


    Preprocedural evaluation of patients in an interventional radiology (IR) clinic is a complex synthesis of physical examination and imaging findings, and as IR transitions to an independent clinical specialty, such evaluations will become an increasingly critical component of a successful IR practice and quality patient care. Prior research suggests that preprocedural evaluations increased patient's perceived quality of care and may improve procedural technical success rates. Appropriate documentation of a preprocedural evaluation in the medical record is also paramount for an interventional radiologist to add value and function as an effective member of a larger IR service and multidisciplinary health care team. The purpose of this study is to examine the quality of radiology resident notes for patients seen in an outpatient IR clinic at a single academic medical center before and after the adoption of clinic note template with reminders to include platelet count, international normalized ratio, glomerular filtration rate, and plan for periprocedural coagulation status. Before adoption of the template, platelet count, international normalized ratio, glomerular filtration rate and an appropriate plan for periprocedural coagulation status were documented in 72%, 82%, 42%, and 33% of patients, respectively. After adoption of the template, appropriate documentation of platelet count, international normalized ratio, and glomerular filtration rate increased to 96%, and appropriate plan for periprocedural coagulation status was documented in 83% of patients. Patient evaluation and clinical documentation skills may not be adequately practiced during radiology residency, and tools such as templates may help increase documentation quality by radiology residents.

  14. Staff lens doses in interventional urology. A comparison with interventional radiology, cardiology and vascular surgery values.

    Vano, E; Fernandez, J M; Resel, L E; Moreno, J; Sanchez, R M


    The purpose of this work is to evaluate radiation doses to the lens of urologists during interventional procedures and to compare them with values measured during interventional radiology, cardiology and vascular surgery. The measurements were carried out in a surgical theatre using a mobile C-arm system and electronic occupational dosimeters (worn over the lead apron). Patient and staff dose measurements were collected in a sample of 34 urology interventions (nephrolithotomies). The same dosimetry system was used in other medical specialties for comparison purposes. Median and 3rd quartile values for urology procedures were: patient doses 30 and 40 Gy cm(2); personal dose equivalent Hp(10) over the apron (μSv/procedure): 393 and 848 (for urologists); 21 and 39 (for nurses). Median values of over apron dose per procedure for urologists resulted 18.7 times higher than those measured for radiologists and cardiologists working with proper protection (using ceiling suspended screens) in catheterisation laboratories, and 4.2 times higher than the values measured for vascular surgeons at the same hospital. Comparison with passive dosimeters worn near the eyes suggests that dosimeters worn over the apron could be a reasonable conservative estimate for ocular doses for interventional urology. Authors recommend that at least the main surgeon uses protective eyewear during interventional urology procedures.

  15. Role of interventional radiology in the management of acute gastrointestinal bleeding

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


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

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


    to cause cataracts [5, 6]. Statistical analysis of the available data suggests absence of a threshold dose, although if one does exist, it is possible...hands must be near the radiation field (e.g., management of dialysis fistulas and grafts, biliary and genitourinary interventions) [43]. Personal...Radiat Res 167:233–243 7. Nakashima E, Neriishi K, Minamoto A (2006) A reanalysis of atomic-bomb cataract data, 2000–2002: a threshold analysis . Health

  17. Evaluation of radiation protection in interventional radiology; Evaluation de la radioprotection en radiologie interventionnelle

    Le Pape, I.; Aget, H. [Centre Hospitalie Universitaire de Tours, 37 (France); Rondeau du Royer, C. [Inspection Regional du Travail de la region Centre (France)


    The interventional radiology, relatively to the conventional radiology exposes particularly to ionizing radiations, because of the time of utilisation of the radioscopy. It is important to optimize the risk according to the ALARA principle. The efforts must be made on the following fields: the radiation protection means, the periodic and systematic monitoring of material, a regular evaluation of operators irradiation, the training of non radiologist operators, the respect of the legislation on the maximum permissible dose equivalents. (N.C.)

  18. Central venous catheterization: comparison between interventional radiological procedure and blind surgical reocedure

    Song, Won Gyu; Jin, Gong Yong; Han, Young Min; Yu, He Chul [Chonbuk National University Medical School, Chonju (Korea, Republic of)


    To determine the usefulness and safety of radiological placement of a central venous catheter by prospectively comparing the results of interventional radiology and blind surgery. For placement of a central venous catheter, the blind surgical method was used in 78 cases (77 patients), and the interventional radiological method in 56 cases (54 patients). The male to female ratio was 66:68, and the patients' mean age was 48 (range, 18-80) years. A tunneled central venous catheter was used in 74 cases, and a chemoport in 60. We evaluated the success and duration of the procedures, the number of punctures required, and ensuing complications, comparing the results of the two methods. The success rates of the interventional radiological and the blind surgical procedure were 100% and 94.8%, respectively. The duration of central catheterization was 3-395 (mean, 120) day, that of chemoport was 160.9 days, and that of tunneled central venous catheter was 95.1 days. The mean number of punctures of the subclavian vein was 1.2 of interventional radiology, and 2.1 for blind surgery. The mean duration of the interventional radiology and the blind surgical procedure was, respectively, 30 and 40 minutes. The postprocedure complication rate was 27.6% (37 cases). Early complications occurred in nine cases (6.7%): where interventional radiology was used, there was one case of hematoma, and blind surgery gave rise to hematoma (n=2), pneumothorax (n=2), and early deviation of the catheter (n=4). Late complications occurred in 32 cases (23.9%). Interventional radiology involved infection (n=4), venous thrombosis (n=1), catheter displacement (n=2) and catheter obstruction (n=5), while the blind surgical procedure gave rise to infection (n=5), venous thrombosis (n=3), catheter displacement (n=4) and catheter obstruction (n=8). The success rate of interventional radiological placement of a central venous catheter was high and the complication rate was low. In comparison with the blind

  19. Radiology

    Vassallo, Pierre


    Radiology is the fastest developing field of medicine and these unprecedented advances have been mainly due to improving computer technology. Digital imaging is a technology whereby images are acquired in a computer format, so that they can be easily stored and recalled for display on any computer workstation. Digital image acquisition has been used in ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) from the start. The use of digital imaging in conventional X-rays, k...

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

    Belli, Anna-Maria, E-mail: [St. George’s Hospital, Department of Radiology (United Kingdom); Reekers, Jim A., E-mail: [Academic Medical Centre, Department of Radiology (Netherlands); Lee, Michael, E-mail: [Beaumont Hospital, Department of Radiology (Ireland)


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

  1. The Changing Face of Vascular Interventional Radiology: The Future Role of Pharmacotherapies and Molecular Imaging

    Tapping, Charles R., E-mail:; Bratby, Mark J., E-mail: [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom)


    Interventional radiology has had to evolve constantly because there is the ever-present competition and threat from other specialties within medicine, surgery, and research. The development of new technologies, techniques, and therapies is vital to broaden the horizon of interventional radiology and to ensure its continued success in the future. In part, this change will be due to improved chronic disease prevention altering what we treat and in whom. The most important of these strategies are the therapeutic use of statins, Beta-blockers, angiotensin-converting enzyme inhibitors, and substances that interfere with mast cell degeneration. Molecular imaging and therapeutic strategies will move away from conventional techniques and nano and microparticle molecular technology, tissue factor imaging, gene therapy, endothelial progenitor cells, and photodynamic therapy will become an important part of interventional radiology of the future. This review looks at these new and exciting technologies.

  2. Application of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional procedures%C臂CT引导经皮靶向穿刺术在非血管介入诊疗中的应用

    何玉圣; 周春泽; 吕维富


    Objective To investigate the clinical value of C-arm CT-guided targeted puncturing technique in performing non-vascular interventional procedures.Methods DSA-guided percutaneous puncturing biopsy or interventional therapy was performed in 33 patients, and the clinical effect and complication were observed and analyzed.Results Percutaneous puncturing interventional therapy was performed successfully in 15 patients,and percutaneous puncturing biopsy was performed in 18 patients and pathological results were obtained in 17 pa-tients.Conclusion The percutaneous targeted puncturing technique with C-arm CT-guidance combines the advantages of both CT and X-ray,which can meet the need of accuracy,efficiency and safety in non-vascular interventional therapy.%目的:探讨C臂CT引导下靶向穿刺技术在非血管介入诊疗中的应用价值。方法33例患者在DSA引导下行经皮穿刺活检术或经皮穿刺介入治疗,观察分析临床效果、并发症等。结果经皮穿刺介入治疗15例,均取得成功,另外18例为经皮穿刺病理活检,17例取得明确病理结果。结论 C臂CT引导下靶向穿刺技术实现了CT和X线透视优势互补,达到精确、高效、安全的非血管介入诊疗要求,值得推广应用。

  3. Sedation and patient monitoring in vascular and interventional radiology

    McDermott, V.G.M.; Chapman, M.E.; Gillespie, I. (Royal Infirmary, Edinburgh (United Kingdom))


    A postal survey of British and Irish interventional radiologists was carried out in 1991 to assess current practice with respect to sedation and monitoring of patients during angiography and interventional procedures. The response rate was 65%, 49% of patients are fasted prior to angiography and 68% prior to interventional procedures. Radiologists participate in obtaining consent in 60% of cases. Patients are often (50%) sedated for angiography and usually (62-94% depending on the procedure) sedated for interventional procedures. Nurses are present for most procedures, but are given the task of monitoring the patient's vital signs in only 49% of cases. Anaesthetists are present for less than 10% of interventional procedures. The findings indicate a wide variation in practice and a need to standardize practice at a uniform high level. (author).

  4. In the Lead Again Horizontal-Ellipsis [Journal of Cardiovascular and Interventional Radiology

    Vorwerk, Dierk, E-mail: [Ingolstadt Hospital, Department of Diagnostic and Interventional Radiology (Germany)


    The 2013 ISI journal rankings are out and it is my pleasure to inform our readership that CVIR ranks 43/120 (2012: 46/118) journals in the field of radiology. The 2013 impact factor further improved to 2.138 (2012: 2.093). This means that Cardiovascular and Interventional Radiology again continues to be the highest ranked journal dedicated to the field of interventional radiology in 2013.This is mainly due to the great support we achieve by you as authors and readers of CVIR, your dedication to the profession, and your loyalty both to the journal and to CIRSE. For all of this, we owe you our thanks and respect.

  5. Estimation of staff lens doses during interventional procedures. Comparing cardiology, neuroradiology and interventional radiology.

    Vano, E; Sanchez, R M; Fernandez, J M


    The purpose of this article is to estimate lens doses using over apron active personal dosemeters in interventional catheterisation laboratories (cardiology IC, neuroradiology IN and radiology IR) and to investigate correlations between occupational lens doses and patient doses. Active electronic personal dosemeters placed over the lead apron were used on a sample of 204 IC procedures, 274 IN and 220 IR (all performed at the same university hospital). Patient dose values (kerma area product) were also recorded to evaluate correlations with occupational doses. Operators used the ceiling-suspended screen in most cases. The median and third quartile values of equivalent dose Hp(10) per procedure measured over the apron for IC, IN and IR resulted, respectively, in 21/67, 19/44 and 24/54 µSv. Patient dose values (median/third quartile) were 75/128, 83/176 and 61/159 Gy cm(2), respectively. The median ratios for dosemeters worn over the apron by operators (protected by the ceiling-suspended screen) and patient doses were 0.36; 0.21 and 0.46 µSv Gy(-1) cm(-2), respectively. With the conservative approach used (lens doses estimated from the over apron chest dosemeter) we came to the conclusion that more than 800 procedures y(-1) and per operator were necessary to reach the new lens dose limit for the three interventional specialties. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  6. The role of interventional radiology in the treatment of hepatocellular carcinoma.

    Steiner, K.; Papadopoulou, A.; Yu, D.


    The incidence of hepatocellular carcinoma (HCC) in the UK is increasing. The role of interventional radiology in the treatment of HCC is well established. We discuss the minimally invasive treatment options that are available. It is important that procedures are undertaken in and postprocedure imagi

  7. Imaging diagnosis and interventional radiology in systemic vasculitis with particular emphasis on Takayasu arteritis: Part 2

    Ichiro SAKAMOTO; Kuniaki HAYASHI; Naofumi MATSUNAGA; Kazuto ASHIZAWA; Yohjiro MATSUOKA; Masataka UETANI


    In part 1 of this article, clinical features and imaging findings of Takayasu arteritis (also known as aortitis syndrome) were described in detail. In part 2, treatment of Takayasu arteritis will be first described and discussed. This will be followed by description of clinical features and imaging findings of other systemic vasculitis. Comments on interventional radiology for systemic vasculitis will also be made.

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

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


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

  9. Interventional radiological treatment of renal transplant complications: A pictorial review

    Lezzi, Roberto; La, Torre Michele fabio; Santoro, Marco; Dattesi, Robrta; Nestola, Massimiliano; Posa, Alessandro; Romagnoli, Jacopo; CItterio, Franco; Bonomo, Lorenzo [' A. Gemelli' Hospital - Catholic University, Rome (Italy)


    Renal transplantation is the treatment of choice for patients with chronic renal failure, which produces a dramatic improvement in the quality of life and survival rates, in comparison to long-term dialysis. Nowadays, new imaging modalities allow early diagnosis of complications, and thanks to the recent developments of interventional techniques, surgery may be avoided in most cases. Knowledge in the types of renal transplant complications is fundamental for a correct pre-operative planning. In this article, we described the most common or clinically relevant renal transplant complications and explained their interventional management.

  10. Cone-beam CT-guidance in Interventional Radiology

    Braak, S.J.


    OBJECTIVE. CBCT-guidance (CBCT-guidance) is a new stereotactic technique for needle interventions, combining 3D soft-tissue cone-beam CT, needle planningsoftware, and real-time fluoroscopy. Our objective was to evaluate the use, feasibility and outcome of this technique. To determine the effectiv

  11. Sedoanalgesia in interventional radiology; Analgosedierung in der interventionellen Radiologie

    Linsenmaier, U.; Pfeifer, K.J.; Reiser, M. [Klinikum der Universitaet Muenchen, Muenchen (Germany). Inst. fuer Klinische Radiologie; Wagner, P. [Klinikum der Universitaet Muenchen, Muenchen (Germany). Inst. fuer Anaesthesiologie und Intensivmedizin; Ambulantes Operationszentrum, Muenchen Pasing (Germany)


    Purpose: Development of a save and effective protocol for analgosedation of patients undergoing painful interventional procedures. Material and Methods: In a prospective trial a consecutive series of 72 adult patients underwent analgosedation during painful interventions. A radiologist performed the analgosedation, the patients received a combination of a shortly effective piperidine derivative (Alfentanil [Rapifen {sup trademark} ]; 7.5-15 {mu}g/kg body weight) and Benzodiazepine (midazolam [Dormicum {sup trademark} ]; 20 {mu}g/kg body weight). After pre-procedure oxygenation patients were continuously monitored. Pain and discomfort were scored using an established visual-analog pain score (0-10). A control group (n=24) had received midazolam, pentazocine or fentanyl according to the study protocol. Results: All procedures could be carried out by an interventional radiologist and a nurse and/or technologist only. In 69/72 cases adequate analgosedation could be achieved. Injection of alfentanil was titrated, with a rapid onset and short acting effect of the analgesia. Patients reported an average pain score of 2.6 vs. 4.5 in the control group. Over 55% experienced no or mild pain (score 0-3), in the control group only 8% reached this level. Conclusion: A combination of shortly effective alfentanil and midazolam allows interventional radiologists to perform major procedures alone under effective analgosedation. This medication scheme is superior to the medication upon demand. (orig.) [German] Ziel: Die Entwicklung eines einfach zu handhabenden Protokolls fuer Radiologen zur Analgosedierung bei schmerzhaften interventionellen Eingriffen. Methoden: Prospektiv wurden 72 konsekutive Patienten zusammengefasst, bei denen schmerzhafte interventionelle Eingriffe geplant waren. Die Anlagosedierung erfolgte mit einer Kombinationsmedikation aus kurzwirksamem Piperidinderivat (Alfentanil [Rapifen {sup trademark} ]; 7,5-15 {mu}g/kg KG) und Benzodiazepin (Midazolam [Dormicum {sup

  12. Radiologic management of haemoptysis. Diagnostic and interventional bronchial arterial embolisation

    Ittrich, H.; Adam, G. [Univ. Medical Center Hamburg, Hamburg (Germany). Diagnostic and Interventional Radiology Dept. and Clinic; Klose, H. [Univ. Medical Center Hamburg, Hamburg (Germany). Section Pneumology


    Hemoptysis can be a life-threatening pulmonary emergency with high mortality, is symptomatic of an underlying severe pulmonary disease and requires immediate diagnosis and treatment. Diagnostically, bronchoscopy, conventional chest x-ray and contrast-enhanced multislice computed tomography (MSCT) with CT angiography (CTA) provide information regarding the underlying pulmonary disease, bleeding site, the vascular anatomy of the bronchial arteries (BA) and extrabronchial branches, as well a basis for planning of endovascular intervention. Therapeutically, bronchial artery embolization (BAE) is a safe and effective technique in the hands of an experienced interventionist with profound knowledge of the BA anatomy and possible pitfalls as well as experience with first-line therapy of recurrent and massive hemoptysis or as an intervention prior to elective surgery. Recurrent episodes of hemoptysis are not uncommon and require a prompt repeat BAE after exclusion of extrabronchial systemic and pulmonary artery bleeding sources. This review article should give an overview of the history, anatomical and pathophysiological basics and the clinical context of hemoptysis and diagnosis, as well as a survey of management, treatment and results of BAE.

  13. Needs-Based Innovation in Interventional Radiology: The Biodesign Process.

    Steinberger, Jonathan D; Denend, Lyn; Azagury, Dan E; Brinton, Todd J; Makower, Josh; Yock, Paul G


    There are many possible mechanisms for innovation and bringing new technology into the marketplace. The Stanford Biodesign innovation process is based in a deep understanding of clinical unmet needs as the basis for focused ideation and development. By identifying and vetting a compelling unmet need, the aspiring innovator can "derisk" a project and maximize chances for successful development in an increasingly challenging regulatory and economic environment. As a specialty founded by tinkerers, with a history of disruptive innovation that has yielded countless new ways of delivering care with minimal invasiveness, lower morbidity, and lower cost, interventional radiologists are uniquely well positioned to identify unmet needs and develop novel solutions free of dogmatic convention. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Thermal and hydrodynamic modelling of active catheters for interventional radiology.

    Marchandise, Emilie; Flaud, Patrice; Royon, Laurent; Blanc, Raphaël; Szewczyk, Jérome


    Interventional radiologists desire to improve their operating tools such as catheters. Active catheters in which the tip is moved using shape memory alloy actuators activated using the Joule effect present a promising approach for easier navigation in the small vessels. However, the increase in temperature caused by this Joule effect must be controlled in order to prevent damage to blood cells and tissues. This paper is devoted to the simulation and experimental validation of a fluid-thermal model of an active catheter prototype. Comparisons between computer-predicted and experimentally measured temperatures are presented for both experiments in air and water at 37°C. Good agreement between the computational and experimental results is found, demonstrating the validity of the developed computer model. These comparisons enable us to highlight some important issues in the modelling process and to determine the optimal current for the activation of the catheter.

  15. A survey of interventional radiology awareness among final-year medical students in a European country.

    Leong, Sum


    Interventional radiology (IR) is a rapidly expanding specialty that is facing the challenges of turf wars and personnel shortages. Appropriate exposure of medical students to this field can be vital to recruitment of potential future trainees or referring physicians. The aim of this study was to determine the knowledge and views of final-year medical students in a single EU country regarding various aspects of IR. An electronic survey was sent via e-mail to all final-year medical students in a European country. The students were given a month to respond to the questionnaire. A total of 234 students of 675 (34.5%) replied to the survey. Of the respondents, 35% had previously completed an attachment to the radiology department. The majority of students (63%) thought their knowledge in radiology in general was poor. The percentage of students who correctly identified procedures performed by interventional radiologists was 69% for Hickman line insertion, 79% for fibroid embolization, and 67.5% for lower limb angioplasty. Sixty percent, 30%, and 47% thought that interventional radiologists perform cardiac angioplasties, perform arterial bypasses, and create AV fistulas, respectively. Forty-nine percent felt that interventional radiologists are surgically trained. Eighty-three percent of students were first made aware of angioplasty by a cardiologist. Thirty-one percent thought that interventional radiologists do ward rounds, 24% thought that interventional radiologists have admitting rights, and 26% felt that interventional radiologists run an outpatient practice. A significant number of students (76%) thought that the job prospects in IR are good or excellent but only 40.5% were willing to consider a career in IR. In conclusion, this study indicates that IR remains a nascent but attractive specialty to the majority of medical students. Further development of the existing informal undergraduate curriculum to address shortcomings will ensure that IR continues to attract

  16. Evaluation of patient radiation doses using DAP meter in interventional radiology procedures

    Kang, Byung Sam [Dept. of Radiological Technology. Shingu University, Sungnam (Korea, Republic of); Yoon, Yong Su [Dept. of Health Sciences, Graduate School of Medical Sciences, Kyushu Univeristy, Kyushu (Japan)


    The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipment in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effective of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were 237.7 Gy·cm{sup 2} in TACE, 17.3 Gy·cm{sup 2} in AVF, 114.1 Gy·cm{sup 2} in LE PTA and STENT, 188.5 Gy·cm{sup 2} in TFCA, 383.5 Gy·cm{sup 2} in Aneurysm Coil, 64.6 Gy·cm{sup 2} in PTBD, 64.6 Gy·cm{sup 2} in Biliary Stent, 22.4 Gy·cm{sup 2} in PCN, 4.3 Gy·cm{sup 2} in Hickman, 2.8 Gy·cm{sup 2} in Chemo-port, 4.4 Gy·cm{sup 2} in Perm-Cather, 17.1 Gy·cm{sup 2} in PCD, and 357.9 Gy·cm{sup 2} in Vis, EMB. Dose reference level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipment and procedures in the interventional radiology procedures, further studies and monitoring are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

  17. Lessons from surgery and anaesthesia: evaluation of non-technical skills in interventional radiology

    Patel, Salil B; Pilkington, Nicola


    In the medical profession, surgery and anaesthesia are leading the way in identifying human errors that negatively affect patient safety. Evidence suggests that the implementation of non-technical skills assessments reduces such errors. Interventional Radiology is a procedural based speciality and therefore may also benefit from formal assessment of non-technical skills. This literature review supports the use of standardised assessment tools used in surgery and anaesthesia. Using the Downing framework of internal validity, the tools demonstrated good internal consistency but a spectrum of inter-rater variability, which can be partially improved with training. At present, a formal Interventional Radiology non-technical skills assessment tool is probably not suitable to be a stand-alone ‘high stakes’ assessment, but may be a useful adjunct to the existing array of workplace-based assessments. PMID:26664733

  18. Patient dose in interventional radiology examinations for one year; Dosis a pacientes en exploraciones de radiologia intervencionista durante un ano

    Minambres Moro, A.; Fernandez Leton, P.; Garcia Ruiz-Zorrilla, J.; Perez Moreno, J. M.; Zucca Aparicio, D.


    Interventional radiology procedures are radiology tests involving higher dose to patient and can cause the onset of deterministic effects. The aim of this paper is to estimate the dose-area product (PDA) and fluoroscopy time of such examinations performed at our hospital for a year and compare them with published results for other centers.

  19. Interventional radiologic placement of tunneled central venous catheters : results and complications in 557 cases

    Kim, Chan Kyo; Do, Young Soo; Paik, Chul H. [Samsung Medical Center, Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)] (and others)


    To evaluate prospectively the results of interventional radiologic placement of tunneled central venous catheters, and subsequent complications. Between April 1997 and April 1998, a total of 557 tunneled central venous catheters were percutaneously placed in 517 consecutive patients in an interventional radiology suite. The indications were chemotherapy in 533 cases, total parenteral nutrition in 23 and transfusion in one. Complications were evaluated prospectively by means of a chart review, chest radiography, central vein angiography and blood/catheter culture. The technical success rate for tunneled central venous catheter placement was 100% (557/557 cases). The duration of catheter placement ranged from 4 to 356 (mean, 112{+-}4.6) days; Hickman catheters were removed in 252 cases during follow-up. Early complications included 3 cases of pneumothorax(0.5%), 4 cases of local bleeding/hematoma(0.7%), 2 cases of primary malposition(0.4%), and 1 case of catheter leakage(0.2%). Late complications included 42 cases of catheter-related infection(7.5%), 40 cases of venous thrombosis (7.2%), 18 cases of migration (3.2%), 5 cases of catheter / pericatheter of occlusion(0.8%), and 1 case of pseudoaneurysm(0.2%). The infection rate and thrombosis rate per 1000 days were 1.57 and 1.50, respectively. The technical success rate of interventional radiologic placement of tunneled central venous catheters was high. In comparison to conventional surgical placement, it is a more reliable method and leads to fewer complications.

  20. Diagnostic reference levels and complexity indices in interventional radiology: a national programme

    Ruiz-Cruces, R.; Perez-Martinez, M.; Pastor-Vega, J.M.; Canete, S. [University of Malaga, School of Medicine, Malaga (Spain); Vano, E.; Fernandez-Soto, J.M.; Sanchez-Casanueva, R.; Gallego-Beuter, J.J. [Complutense University, San Carlos Hospital, Medical School, Madrid (Spain); Carrera-Magarino, F.; Moreno-Rodriguez, F.; Moreno-Sanchez, T. [Juan Ramon Jimenez University Hospital, Huelva (Spain); Soler-Cantos, M.M.; Canis-Lopez, M. [Reina Sofia University Hospital, Cordoba (Spain); Hernandez-Armas, J.; Diaz-Romero, F.J. [University Hospital of Canary Islands, Tenerife (Spain); Rosales-Espizua, F.; Lopez-Medina, A.; Gonzalez-de-Garay, M. [Basurto Hospital, Bilbao (Spain); Martin-Palanca, A. [Virgen de la Victoria University Hospital, Malaga (Spain); Gil-Agudo, A.; Zarca-Diaz, M.A.; Zapata-Jimenez, J.C. [General University Hospital, Ciudad Real (Spain); Parra-Osorio, V.; Munoz Ruiz-Canela, J.J.; Moreno-Saiz, C.; Galan-Montenegro, P. [Carlos Haya University Hospital, Malaga (Spain)


    To propose national diagnostic reference levels (DRLs) for interventional radiology and to evaluate the impact of the procedural complexity on patient doses. Eight interventional radiology units from Spanish hospitals were involved in this project. The participants agreed to undergo common quality control procedures for X-ray systems. Kerma area product (KAP) was collected from a sample of 1,649 procedures. A consensus document established the criteria to evaluate the complexity of seven types of procedures. DRLs were set as the 3rd quartile of KAP values. The KAP (3rd quartile) in Gy cm{sup 2} for the procedures included in the survey were: lower extremity arteriography (n = 784) 78; renal arteriography (n = 37) 107; transjugular hepatic biopsies (THB) (n = 30) 45; biliary drainage (BD) (n = 314) 30; uterine fibroid embolization (UFE) (n = 56) 214; colon endoprostheses (CE) (n = 31) 169; hepatic chemoembolization (HC) (n = 269) 303; femoropopliteal revascularization (FR) (n = 62) 119; and iliac stent (n = 66) 170. The complexity involved the increases in the following KAP factors from simple to complex procedures: THB x4; BD x13; UFE x3; CE x3; HC x5; FR x5 and IS x4. The evaluation of the procedure complexity in patient doses will allow the proper use of DRLs for the optimization of interventional radiology. (orig.)

  1. Interventional radiography and mortality risks in U.S. radiologic technologists

    Linet, Martha S.; Freedman, D.M.; Sigurdson, Alice J.; Doody, Michele M. [National Cancer Institute, Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Hauptmann, Michael [National Cancer Institute, Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Bethesda, MD (United States); Alexander, Bruce H. [University of Minnesota, Division of Environmental Health Sciences, Minneapolis, MN (United States); Miller, Jeremy [Information Management Services, Inc., Rockville, MD (United States)


    With the exponential increase in minimally invasive fluoroscopically guided interventional radiologic procedures, concern has increased about the health effects on staff and patients of radiation exposure from these procedures. There has been no systematic epidemiologic investigation to quantify serious disease risks or mortality. To quantify all-cause, circulatory system disease and cancer mortality risks in U.S. radiologic technologists who work with interventional radiographic procedures, we evaluated mortality risks in a nationwide cohort of 88,766 U.S. radiologic technologists (77% female) who completed a self-administered questionnaire during 1994-1998 and were followed through 31 December 2003. We obtained information on work experience, types of procedures (including fluoroscopically guided interventional procedures), and protective measures plus medical, family cancer history, lifestyle, and reproductive information. Cox proportional hazards regression models were used to compute relative risks (RRs) with 95% confidence intervals (CIs). Between completion of the questionnaire and the end of follow-up, there were 3,581 deaths, including 1,209 from malignancies and 979 from circulatory system diseases. Compared to radiologic technologists who never or rarely performed or assisted with fluoroscopically guided interventional procedures, all-cause mortality risks were not increased among those working on such procedures daily. Similarly, there was no increased risk of mortality resulting from all circulatory system diseases combined, all cancers combined, or female breast cancer among technologists who daily performed or assisted with fluoroscopically guided interventional procedures. Based on small numbers of deaths (n=151), there were non-significant excesses (40%-70%) in mortality from cerebrovascular disease among technologists ever working with these procedures. The absence of significantly elevated mortality risks in radiologic technologists reporting the

  2. Radiological intervention in postoperative complications following liver transplantation; Interventionelle radiologische Verfahren bei postoperativen Komplikationen nach Lebertransplantation

    Berger, H. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern, Univ. Muenchen (Germany); Staebler, A. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern, Univ. Muenchen (Germany); Kunzfeld, A. [Inst. fuer Radiologische Diagnostik, Klinikum Grosshadern, Univ. Muenchen (Germany); Zuelke, C. [Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Univ. Muenchen (Germany); Anthuber, M. [Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Univ. Muenchen (Germany); Kraemling, H.J. [Chirurgische Klinik und Poliklinik, Klinikum Grosshadern, Univ. Muenchen (Germany)


    Purpose: Postoperative complications contribute significantly to the morbidity and mortality of liver transplant patients. The management of these complications requires a multidisciplinary approach in which interventional radiology plays an integral role. Indications, techniques, and results of radiological interventions in the management of the liver transplant patient are presented. Material and methods: During a 10-year period, 52 out of 420 liver transplant recipients underwent radiological interventions, including angioplasty (n=20), embolization (n=2), percutaneous drainage (n=11), and biliary interventions (n=19). Results: Nine out of ten arterial stenoses located at the anastomoses (n=8), within the liver (n=1) and in the coeliac trunk (n=1) were successfully treated by balloon dilatation. Angioplasty of supra- or infrahepatic anastomotic stenoses of the IVC (n=5) provided long-term success only in combination with stent implantation. Portal vein stenoses and chronic thrombosis were treated by balloon dilatation and stent insertion via transhepatic catheterization of the portal vein. Late strictures of bile-duct anastomoses can be managed by ante- or retrograde interventions. If biliary complications are related to inflammatory or septic problems, the prognosis of graft survival is poor. Conclusion: Interventional radiological procedures are very useful in the management of vascular and biliary complications after liver transplantation. These techniques provide a cure in many situations, and thus, surgical interventions may be avoided in selected cases. (orig.) [Deutsch] Die komplexe chirurgisch-technische Operation sowie immunologische und ischaemieverursachte Probleme tragen zur relativ hohen Komplikationsrate nach Lebertransplantation bei, die grundsaetzlich organ- bzw. lebensbedrohlich fuer den Patienten sind. Interventionelle radiologische Techniken sind aufgrund ihres minimal-invasiven Charakters in der klinischen Versorgung dieser Komplikationen

  3. Dosimetry with slow films in Interventional Radiology; Dosimetria con peliculas lentas en Radiologia Intervencionista

    Ten, J.I.; Guibelalde, E.; Fernandez, J.M.; Canevaro, L.; Ramirez, R.; Vano, E. [Grupo de Fisica Medica. Departamento de Radiologia. Facultad de Medicina. Universidad Complutense de Madrid. Martin Lagos s/n CP 28040, Madrid (Spain)


    In this work it is presented a method for evaluation of patients doses in Interventional Radiology (RI). The method proposed in this work allows the simultaneous valoration of the product dose-area (PDA), the dose in the patient skin (DES) and the distribution of the irradiated fields, all of they together with their corresponding dose levels. The latter sometimes can be essential since the possible damages in skin depend not only of the doses, but also the irradiated area. The method has been resulted adequate for to evaluate doses to patients in Interventional Radiology procedures. It was possible to apply it as a routine form seeing that its not interfering significantly in the normal development of the medical intervention. The fundamental advantages of this dosimetric method in relation with the unique PDA measure or with the utilization of TLD is that it provide information about the total irradiated area, distribution and length of fields, collimation and wedge used besides that allow to determine the most irradiated zone. The visualization of the irradiated regions and the length fields utilized suggest the possibility to optimize the realization protocols of the interventional procedure in the cases in which it is considered that the doses have been very elevated. (Author)

  4. Auditing an Online Self-reported Interventional Radiology Adverse Event Database for Compliance and Accuracy.

    Burch, Ezra A; Shyn, Paul B; Chick, Jeffrey F; Chauhan, Nikunj R


    The purpose of this study was to determine whether auditing an online self-reported interventional radiology quality assurance database improves compliance with record entry or improves the accuracy of adverse event (AE) reporting and grading. Physicians were trained in using the database before the study began. An audit of all database entries for the first 3 months, or the first quarter, was performed, at which point physicians were informed of the audit process; entries for the subsequent 3 months, or the second quarter, were again audited. Results between quarters were compared. Compliance with record entry improved from the first to second quarter, but reminders were necessary to ensure 100% compliance with record entry. Knowledge of the audit process did not significantly improve self-reporting of AE or accuracy of AE grading. However, auditing significantly changed the final AE reporting rates and grades. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  5. Process mapping of PTA and stent placement in a university hospital interventional radiology department.

    de Bucourt, Maximilian; Busse, Reinhard; Güttler, Felix; Reinhold, Thomas; Vollnberg, Bernd; Kentenich, Max; Hamm, Bernd; Teichgräber, Ulf K


    To apply the process mapping technique in an interdisciplinary approach in order to visualize, better understand, and efficiently organize percutaneous transluminal angioplasty (PTA) and stent placement procedures in a university hospital's interventional radiology department. After providing an overview of seven established mapping techniques for medical professionals, the process mapping technique was chosen and applied in an interdisciplinary approach including referrers (physicians, nurses, and other staff in referring departments, e.g., vascular surgery), providers (interventional radiologists, nurses, technicians, and staff of the angiography suite), and specialists of the hospital's controlling department. A generally binding and standardized process map was created, describing the entire procedure for a patient in whom the radiological intervention of PTA or stent treatment is contemplated from admission to the department of vascular surgery until discharge after successful treatment. This visualization tool assists in better understanding (especially given natural staff fluctuation over time) and efficiently organizing PTA and stent procedures. Process mapping can be applied for streamlining workflow in healthcare, especially in interdisciplinary settings. By defining exactly what a business entity does, who is responsible, to what standard a process should be completed, and how the success can be assessed, this technique can be used to eliminate waste and inefficiencies from the workplace while providing high-quality goods and services easily, quickly, and inexpensively. Process mapping can be used in a university hospital's interventional radiology department. • Process mapping can describe the patient's entire process from admission to PTA/stent placement until discharge. • Process mapping can be used in interdisciplinary teams (e.g., referrers, providers, and controlling specialists). • Process mapping can be used in order to more efficiently

  6. Interventional radiological treatment of tumor pain; Interventionell-radiologische Behandlung des Tumorschmerzes

    Duex, M. [Krankenhaus Nordwest, Zentralinstitut fuer Radiologie und Neuroradiologie, Frankfurt/Main (Germany)


    Tumor pain occurs in 70-80 % of all cancer patients who have reached an advanced tumor stage. In the case of failure or poor response to chemotherapy and in cases of recurrence following radiotherapy, tumors will often become enlarged with infiltration of organs, nerve roots or bone which causes severe pain to the patient. Interventional radiological minimally invasive local tumor therapy is often the last resort for tumor patients suffering from severe pain. Interventional radiologists have several options to treat tumor pain but firstly the cause of the pain must be identified. This article presents a classification of patients suffering from tumor pain which can help therapists to decide on the correct form of treatment. Treatment options are discussed using typical case histories and it is shown that patients suffering from severe tumor pain must be treated sequentially, which means that treatment is carried out in multiple steps and each cycle of therapy has to be adapted to the stage of the disease. Local pain treatment is fundamentally based on individual case decisions which should be discussed within an interdisciplinary tumor board and the panel should arrive at a consensus decision. In addition, the radiologist performing the procedure should have many years of experience in interventional oncological radiology. By fulfilling these conditions the interventional radiologist can help the patient in a variety of ways because the available treatment options are effective and do not result in much distress for the patient. (orig.) [German] Tumorschmerzen treten bei 70-80 % der Patienten im fortgeschrittenen Stadium der Krebserkrankung auf. Bei Versagen oder schlechtem Ansprechen der systemischen Chemotherapie und bei ausbestrahlten Patienten kommt es haeufig zu einem Groessenprogress des Tumors mit Infiltration von Nachbarorganen, neurogenen Strukturen oder Knochen. Dadurch koennen staerkste Schmerzsyndrome entstehen. Interventionell-radiologische, minimal

  7. The pilot study of radiology nursing intervention in abdominal 3-T Magnetic Resonance examination

    Gui-qing Dong

    Full Text Available Abstract OBJECTIVE The aim of this study was to investigate the effect of radiology nursing intervention in abdominal examination at 3-T MRI. METHOD 60 patients with abdominal diseases were divided into two groups randomly: MR nursing intervention group and control group. All the patients underwent abdominal MR examination at 3-T. The MR nursing interventions were performed in nursing intervention group. The outcomes, including one-time success rate, the ratio of diagnosable MR images and the points of image quality, were compared between these two groups. RESULTS The one-time success rates in control group and MR nursing intervention group were 66.67% and 96.67% with significant difference ( χ2 =9.017, P<0.05. The ratios of diagnosable images in the two groups were 76.67% and 96.67% with significant difference (χ2 =5.192, P<0.05. The points of MR image quality in the two groups were 1.87±0.86 and 2.33±0.55, respectively. There was significant difference between these two groups (t=-2.508, P<0.05. CONCLUSION The effective nursing intervention can make the patients cooperation better in abdominal MR examination and improve the image quality significantly.

  8. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 2: Patient Preparation and Medications).

    Taslakian, Bedros; Sebaaly, Mikhael Georges; Al-Kutoubi, Aghiad


    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care. Patient care before and after an interventional procedure, identification, and management of early and delayed complications of various procedures are equal in importance to the procedure itself. In this second part, we complete the comprehensive, methodical review of pre-procedural care and patient preparation before vascular and interventional radiology procedures.

  9. Manipulation of mental models of anatomy in interventional radiology and its consequences for design of human–computer interaction

    Varga, E.; Pattynama, P.M.T.; Freudenthal, A.


    Interventional radiology procedures require extensive cognitive processing from the physician. A set of these cognitive functions are aimed to be replaced by technology in order to reduce the cognitive load. However, limited knowledge is available regarding mental processes in interventional radiolo

  10. Interventional radiological imaging and treatment of port catheter dysfunctions; Angiografische Diagnostik und interventionelle Therapie von Portdysfunktionen

    Kausche, S.; Nagel, S.N.; Teichgraeber, Ulf [Charite Universitaetsmedizin Berlin (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie


    To evaluate the impact of interventional radiological imaging and treatment of central venous port catheter complications. Materials and Methods: In this retrospective analysis 429 port catheter dysfunctions were evaluated in 393 port catheter systems for a total of 389 patients over a period of 10 years. The study included 193 (49.1 %) patients with radiologically implanted port catheter systems and 200 (50.9 %) referred patients with surgically implanted port systems. Port catheter dysfunctions were subdivided into early and late complications as well as into non-thrombotic and thrombotic events. After administration of contrast medium, the port system was visualized using digital subtraction angiography. Data were retrospectively collected from the in-house databases and then analyzed descriptively. Results: 429 contrast media injections via port catheters were performed in 393 port catheter systems. There were 359 (83.7 %) late complications and 70 (16.3 %) early complications. In 299 (69.7 %) cases thrombotic events occurred and 130 (30.3 %) non-thrombotic events were recorded. The most common reason for contrast media injection via port catheter system was port catheter-related thrombosis in 269 (62.7 %) cases. 70 (16.3 %) catheter migrations and 30 (7.0 %) fibrin sheath formations were detected. 18 (4.2 %) port needle malfunctions could be resolved through needle exchange. All 15 (3.5 %) catheter disconnections had to be revised in all cases. Also six port explantations were performed in 6 (1.4 %) catheter fractures. Conclusion: The possibilities of angiographic imaging and interventional radiological correction of port catheter dysfunctions must be exploited fully in order to avoid premature port explantation. (orig.)

  11. Assessment of the occupational eye lens dose for clinical staff in interventional radiology, cardiology and neuroradiology.

    Omar, Artur; Kadesjö, Nils; Palmgren, Charlotta; Marteinsdottir, Maria; Segerdahl, Tony; Fransson, Annette


    In accordance with recommendations by the International Commission on Radiological Protection, the current European Basic Safety Standards has adopted a reduced occupational eye lens dose limit of 20 mSv yr(-1). The radiation safety implications of this dose limit is of concern for clinical staff that work with relatively high dose x-ray angiography and interventional radiology. Presented in this work is a thorough assessment of the occupational eye lens dose based on clinical measurements with active personal dosimeters worn by staff during various types of procedures in interventional radiology, cardiology and neuroradiology. Results are presented in terms of the estimated equivalent eye lens dose for various medical professions. In order to compare the risk of exceeding the regulatory annual eye lens dose limit for the widely different clinical situations investigated in this work, the different medical professions were separated into categories based on their distinct work pattern: staff that work (a) regularly beside the patient, (b) in proximity to the patient and (c) typically at a distance from the patient. The results demonstrate that the risk of exceeding the annual eye lens dose limit is of concern for staff category (a), i.e. mainly the primary radiologist/cardiologist. However, the results also demonstrate that the risk can be greatly mitigated if radiation protection shields are used in the clinical routine. The results presented in this work cover a wide range of clinical situations, and can be used as a first indication of the risk of exceeding the annual eye lens dose limit for staff at other medical centres.

  12. Interventional radiological therapy of benign low back pain syndromes; Interventionell radiologische Therapie benigner lumbaler Schmerzsyndrome

    Huegli, R.W.; Jacob, A.L.; Steinbrich, W. [Universitaetsspital Basel (Switzerland). Interventionelle Radiologie


    Spinal affections belong to the most widespread sources of back pain. Beside medical history and clinical examination, the radiological investigation plays an important rote in the clinical workup especially with the modern Cross sectional imaging methods such as computed and magnetic resonance tomography. After exclusion of a malignant disease usually a conservative therapeutic approach is the first line treatment option. If the conservative treatment approach falls a minimalinvasive image guided diagnostic or therapeutic infiltration may be considered. Thereby the interventional radiologist should be a member of the team which decides the clinical strategy. This article describes epidemiology and pathophysiology, common pre-interventional diagnostic strategies, drugs, indications, possible complications and the impact of diagnostic and therapeutic minimally invasive image guided techniques in low back pain. In this context facet joint blockade, periradicular and peridural therapy as well as sacroiliac joint blockades are discussed.

  13. Interventional radiology and endovascular surgery in the treatment of ectopic pregnancies

    Fornazari, Vinicius Adami Vayego; Szejnfeld, Denis; Elito, Julio Júnior; Goldman, Suzan Menasce [Universidade Federal de São Paulo, São Paulo, SP (Brazil)


    The advent of interventional radiology enabled remarkable advances in diagnosis and treatment of several situations in obstetrics and gynecology. In the field of obstetrics, these advances include temporary occlusion of the iliac arteries to the management of placenta accreta and/or prior, arteriovenous fistulas after embolization of uterine curettage and management of ectopic uterine and extra-uterine pregnancies. The non-tubal ectopic pregnancy, either cervical, abdominal, ovarian or in a cesarean scar, often represents major therapeutic challenge, especially when exists a desire to maintain fertility. Despite the systemic methotrexate therapy and surgical resection of the ectopic gestational sac be the most used therapeutic options, the interventionist approach of non-tubal ectopic pregnancies, direct injection of methotrexate in the gestational sac and intra-arterial chemoembolization of uterine arteries constitute in the currently literature viable, safe, effective modalities with low morbidity, shorter hospital stay, and rapid clinical recovery. Because of little variety of materials used, and the increase in training of specialists in the area, the radiological intervention as a treatment option in ectopic pregnancies is financially viable and present considerable accessibility in the world and at most of Brazilian medical centers.

  14. Imaging and radiological interventions in extra-hepatic portal vein obstruction

    Sudheer S Pargewar; Saloni N Desai; S Rajesh; Vaibhav P Singh; Ankur Arora; Amar Mukund


    Extrahepatic portal vein obstruction(EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension(PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt(PSS) and revision of PSS.

  15. Imaging and radiological interventions in extra-hepatic portal vein obstruction.

    Pargewar, Sudheer S; Desai, Saloni N; Rajesh, S; Singh, Vaibhav P; Arora, Ankur; Mukund, Amar


    Extrahepatic portal vein obstruction (EHPVO) is a primary vascular condition characterized by chronic long standing blockage and cavernous transformation of portal vein with or without additional involvement of intrahepatic branches, splenic or superior mesenteric vein. Patients generally present in childhood with multiple episodes of variceal bleed and EHPVO is the predominant cause of paediatric portal hypertension (PHT) in developing countries. It is a pre-hepatic type of PHT in which liver functions and morphology are preserved till late. Characteristic imaging findings include multiple parabiliary venous collaterals which form to bypass the obstructed portal vein with resultant changes in biliary tree termed portal biliopathy or portal cavernoma cholangiopathy. Ultrasound with Doppler, computed tomography, magnetic resonance cholangiography and magnetic resonance portovenography are non-invasive techniques which can provide a comprehensive analysis of degree and extent of EHPVO, collaterals and bile duct abnormalities. These can also be used to assess in surgical planning as well screening for shunt patency in post-operative patients. The multitude of changes and complications seen in EHPVO can be addressed by various radiological interventional procedures. The myriad of symptoms arising secondary to vascular, biliary, visceral and neurocognitive changes in EHPVO can be managed by various radiological interventions like transjugular intra-hepatic portosystemic shunt, percutaneous transhepatic biliary drainage, partial splenic embolization, balloon occluded retrograde obliteration of portosystemic shunt (PSS) and revision of PSS.

  16. The novel application of Benford's second order analysis for monitoring radiation output in interventional radiology.

    Cournane, S; Sheehy, N; Cooke, J


    Benford's law is an empirical observation which predicts the expected frequency of digits in naturally occurring datasets spanning multiple orders of magnitude, with the law having been most successfully applied as an audit tool in accountancy. This study investigated the sensitivity of the technique in identifying system output changes using simulated changes in interventional radiology Dose-Area-Product (DAP) data, with any deviations from Benford's distribution identified using z-statistics. The radiation output for interventional radiology X-ray equipment is monitored annually during quality control testing; however, for a considerable portion of the year an increased output of the system, potentially caused by engineering adjustments or spontaneous system faults may go unnoticed, leading to a potential increase in the radiation dose to patients. In normal operation recorded examination radiation outputs vary over multiple orders of magnitude rendering the application of normal statistics ineffective for detecting systematic changes in the output. In this work, the annual DAP datasets complied with Benford's first order law for first, second and combinations of the first and second digits. Further, a continuous 'rolling' second order technique was devised for trending simulated changes over shorter timescales. This distribution analysis, the first employment of the method for radiation output trending, detected significant changes simulated on the original data, proving the technique useful in this case. The potential is demonstrated for implementation of this novel analysis for monitoring and identifying change in suitable datasets for the purpose of system process control.

  17. Current Status of Interventional Radiology in the Management of Gastro-Entero-Pancreatic Neuroendocrine Tumours (GEP-NETs)

    Orgera, Gianluigi [S. Andrea University Hospital “Sapienza”, Unit of Interventional Radiology (Italy); Krokidis, Miltiadis, E-mail: [Cambridge University Hospitals NHS Trust, Department of Radiology (United Kingdom); Cappucci, Matteo [S. Andrea University Hospital “Sapienza”, Unit of Interventional Radiology (Italy); Gourtsoyianni, Sofia [Guy’s and St Thomas’ NHS Foundation Trust, Department of Radiology (United Kingdom); Tipaldi, Marcello Andrea [S. Andrea University Hospital “Sapienza”, Unit of Interventional Radiology (Italy); Hatzidakis, Adam [University Hospital of Heraklion, Department of Radiology, Medical School of Crete (Greece); Rebonato, Alberto [Santa Maria della Misericordia University Hospital, University of Perugia, Department of Surgical and Biomedical Sciences (Italy); Rossi, Michele [S. Andrea University Hospital “Sapienza”, Unit of Interventional Radiology (Italy)


    Within the group of Gastro-Entero-Pancreatic Neuroendocrine tumours (GEP-NETs), several heterogeneous malignancies are included with a variety of clinical manifestations and imaging characteristics. Often these cases are inoperable and minimal invasive treatment offered by image-guided procedures appears to be the only option. Interventional radiology offers a valid solution in the management of primary and metastatic GEP-NETs. The purpose of this review article is to describe the current status of the role of Interventional Radiology in the management of GEP-NETs.

  18. Monte Carlo calculations for reporting patient organ doses from interventional radiology

    Huo, Wanli; Feng, Mang; Pi, Yifei; Chen, Zhi; Gao, Yiming; Xu, X. George


    This paper describes a project to generate organ dose data for the purposes of extending VirtualDose software from CT imaging to interventional radiology (IR) applications. A library of 23 mesh-based anthropometric patient phantoms were involved in Monte Carlo simulations for database calculations. Organ doses and effective doses of IR procedures with specific beam projection, filed of view (FOV) and beam quality for all parts of body were obtained. Comparing organ doses for different beam qualities, beam projections, patients' ages and patient's body mass indexes (BMIs) which generated by VirtualDose-IR, significant discrepancies were observed. For relatively long time exposure, IR doses depend on beam quality, beam direction and patient size. Therefore, VirtualDose-IR, which is based on the latest anatomically realistic patient phantoms, can generate accurate doses for IR treatment. It is suitable to apply this software in clinical IR dose management as an effective tool to estimate patient doses and optimize IR treatment plans.

  19. Risk for the patient in interventional radiology; Riesgo para el paciente en Radiologia Intevencionista

    Martinez, L. C.


    The growth that the number of procedures which can be classified as interventional radiology techniques has experienced in the last years, has been accompanied by the concern of professionals and public health authorities about the potential effects caused by the radiation employed. Nowadays, these procedures represent, among all the procedures employing radiation, the highest doses to patients, apart from the radiotherapy techniques. Since the early 1990s, some radiation-induced effects on the skin of patients undergoing some of these procedures, from transient erythema to more serious injuries, have been reported. this work reviews the most relevant aspects of the radiation related risks in this kind of procedures and the suggested strategies to minimize them. (Author) 33 refs.

  20. Risk of bleeding associated with interventional musculoskeletal radiology procedures. A comprehensive review of the literature

    Foremny, Gregory B.; Jose, Jean; Subhawong, Ty K. [University of Miami Miller School of Medicine, Department of Radiology, Jackson Memorial Hospital, Miami, FL (United States); Pretell-Mazzini, Juan [University of Miami Miller School of Medicine, Department of Orthopaedic Surgery-Division of Musculoskeletal Oncology, Miami, FL (United States)


    This review compiles the current literature on the bleeding risks in common musculoskeletal interventional procedures and attempts to provide guidance for practicing radiologists in making decisions regarding the periprocedural management of patients on antithrombotic therapy. The practitioner must weigh the risk of bleeding if therapy is continued against the possibility a thromboembolic occurring if anticoagulation therapy is withheld or reversed. Unfortunately, there is little empirical data to guide evidence-based decisions for many musculoskeletal interventions. However, a review of the literature shows that for low-risk procedures, such as arthrograms/arthrocenteses or muscle/tendon sheath injections, bleeding risks are sufficiently small that anticoagulants and antiplatelet therapies need not be withheld. Additionally, relatively higher-risk procedures, such as needle biopsies of bone and soft tissue, may be safely performed without holding antithrombotic therapy, provided pre-procedural INR is within therapeutic range. Thus, while a patient's particular clinical circumstances should dictate optimal individualized management, anticoagulation alone is not a general contraindication to most interventional musculoskeletal radiology procedures. (orig.)

  1. Interventional Radiological Treatment of Perihepatic Vascular Stenosis or Occlusion in Pediatric Patients After Liver Transplantation

    Uller, Wibke, E-mail: [University Medical Center Regensburg, Department of Radiology (Germany); Knoppke, Birgit [KUNO University Children' s Hospital Regensburg, University Medical Center Regensburg (Germany); Schreyer, Andreas G.; Heiss, Peter [University Medical Center Regensburg, Department of Radiology (Germany); Schlitt, Hans J. [University Medical Center Regensburg, Department of Surgery (Germany); Melter, Michael [KUNO University Children' s Hospital Regensburg, University Medical Center Regensburg (Germany); Stroszczynski, Christian [University Medical Center Regensburg, Department of Radiology (Germany); Zorger, Niels [Krankenhaus Barmherzige Brueder, Department of Radiology (Germany); Wohlgemuth, Walter A. [University Medical Center Regensburg, Department of Radiology (Germany)


    Purpose: Evaluation of the efficacy and safety of percutaneous treatment of vascular stenoses and occlusions in pediatric liver transplant recipients. Methods: Fifteen children (mean age 8.3 years) underwent interventional procedures for 18 vascular complications after liver transplantation. Patients had stenoses or occlusions of portal veins (n = 8), hepatic veins (n = 3), inferior vena cava (IVC; n = 2) or hepatic arteries (n = 5). Technical and clinical success rates were evaluated. Results: Stent angioplasty was performed in seven cases (portal vein, hepatic artery and IVC), and sole balloon angioplasty was performed in eight cases. One child underwent thrombolysis (hepatic artery). Clinical and technical success was achieved in 14 of 18 cases of vascular stenoses or occlusions (mean follow-up 710 days). Conclusion: Pediatric interventional radiology allows effective and safe treatment of vascular stenoses after pediatric liver transplantation (PLT). Individualized treatment with special concepts for each pediatric patient is necessary. The variety, the characteristics, and the individuality of interventional management of all kinds of possible vascular stenoses or occlusions after PLT are shown.

  2. Outcomes of patients with acute upper gastrointestinal nonvariceal hemorrhage referred to interventional radiology for potential embolotherapy.

    Sildiroglu, Onur; Muasher, Jamil; Arslan, Bulent; Sabri, Saher S; Saad, Wael E; Angle, John F; Matsumoto, Alan H; Turba, Ulku C


    To report the outcomes following catheter angiography with or without embolization in patients with acute upper gastrointestinal nonvariceal hemorrhage (UGINH). A review of electronic medical records was performed to identify all potential patients for this study between 2001 and 2011. Patients with first-time UGINH who required angiographic localization and endovascular treatment were included. Patients with variceal bleeding and prior surgical or endovascular intervention for the gastrointestinal system were excluded. Society of Interventional Radiology guidelines and American College of Radiology "appropriateness criteria" reporting standards were followed. We identified 74 patients (men/women=46/28) with a mean age of 60 years. Thirty-four patients were found to have active bleeding on angiography. One patient from this group did not undergo embolization because of an angiographic diagnosis of aortoenteric fistula. Technical failure was encountered in 2/34 patients; therefore, the technical success of embolization was 94%. Forty of 74 patients showed no angiographic evidence of active bleeding; 18 patients underwent prophylactic embolization using endoscopically placed clips as targets; and 22 patients had no embolotherapy. Thus, we grouped the patients into 3 groups: (1) therapeutic embolization; (2) prophylactic/empiric embolization; and (3) no embolotherapy groups. The clinical success of embolization was 67% to 68% in the therapeutic embolization group and 67% in the prophylactic embolization group. Early rebleeding rates were 33.8%, 51.6%, 33.3%, and 12% among all the patients, the therapeutic embolization group, the prophylactic embolization group, and the no endovascular treatment group, respectively. Mortality was significantly high in patients with advanced age (P=0.001), cerebrovascular disorders (P=0.037), and positive angiography (P=0.026), even when clinical success was achieved. Acute UGINH remains a clinical challenge with increased mortality

  3. Occupational radiation exposure of the personnel due to interventional radiology; Strahlenexposition des Personals bei interventionellen Massnahmen

    Wucherer, M. [Klinikum der Stadt Nuernberg (Germany). Inst. fuer Medizinische Physik; Schmidt, T.; Loose, R. [Klinikum Nuernberg-Nord (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie


    Applications of interventional radiology continue to be on an upward trend, some countries reporting a 100% increase within 2-4 years, so that the resulting radiation exposure of both patients and personnel is an issue of increasing importance. Whereas those applications in general are of advantage for the patients, they mean just a further health hazard for the medical personnel. It is therefore necessary to exploit all available means to reduce the occupational doses. Modern interventional radiology systems offer a range of measures for this purpose, as e.g. last-image-hold, or pulsed modes. Special attention has to be given to the exposure of hand and head. Particularly the hand is closest to the useful beam, and it should be a mandatory requirement to wear film rings. (orig./CB) [German] Interventionelle Massnahmen weisen immer noch eine Steigerungstendenz auf, teilweise wird in manchen Laendern von einer Verdopplungsrate von 2-4 Jahren berichtet. Eventuelle Folgen der interventionellen Massnahmen, naemlich die damit verbundene Strahlenexposition fuer Patient und Personal, werden zunehmend problematisiert. Waehrend der Patient einen unmittelbaren Nutzen von dem meist miminal invasiven Eingriff hat, ist dies beim Personal nicht der Fall. Es muessen deswegen, besonders beim Untersuchungspersonal, alle Moeglichkeiten ausgeschoepft werden, die Exposition zu reduzieren. Neben den ueblichen bekannten Methoden sind bei modernen Anlagen weitere Massnahmen moeglich. Hierzu zaehlen z.B. Speicherung des letzten Bildes, strahlungslose Einblendung, gepulste Durchleuchtung usw. In Einzelfaellen hat die Exposition des Personals die Jahresgrenzwerte erreicht. Besonderer Aufmerksamkeit ist bei interventionellen Massnahmen der Exposition von Hand und Kopf zu widmen. Die Hand ist, vor allem bei der Punktion und Kathetermanipulation, nahe dem Nutzstrahlenbuendel. Es ist deswegen zu fordern, dass bei den interventionellen Massnahmen Fingerringdosimeter getragen werden. (orig.)

  4. Characterization of a MOSkin detector for in vivo skin dose measurements during interventional radiology procedures

    Safari, M. J.; Wong, J. H. D.; Ng, K. H., E-mail: [Department of Biomedical Imaging, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia and University of Malaya Research Imaging Centre, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603 (Malaysia); Jong, W. L. [Clinical Oncology Unit, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603 (Malaysia); Cutajar, D. L.; Rosenfeld, A. B. [Centre for Medical Radiation Physics, University of Wollongong, Wollongong, NSW 2522 (Australia)


    Purpose: The MOSkin is a MOSFET detector designed especially for skin dose measurements. This detector has been characterized for various factors affecting its response for megavoltage photon beams and has been used for patient dose measurements during radiotherapy procedures. However, the characteristics of this detector in kilovoltage photon beams and low dose ranges have not been studied. The purpose of this study was to characterize the MOSkin detector to determine its suitability for in vivo entrance skin dose measurements during interventional radiology procedures. Methods: The calibration and reproducibility of the MOSkin detector and its dependency on different radiation beam qualities were carried out using RQR standard radiation qualities in free-in-air geometry. Studies of the other characterization parameters, such as the dose linearity and dependency on exposure angle, field size, frame rate, depth-dose, and source-to-surface distance (SSD), were carried out using a solid water phantom under a clinical x-ray unit. Results: The MOSkin detector showed good reproducibility (94%) and dose linearity (99%) for the dose range of 2 to 213 cGy. The sensitivity did not significantly change with the variation of SSD (±1%), field size (±1%), frame rate (±3%), or beam energy (±5%). The detector angular dependence was within ±5% over 360° and the dose recorded by the MOSkin detector in different depths of a solid water phantom was in good agreement with the Markus parallel plate ionization chamber to within ±3%. Conclusions: The MOSkin detector proved to be reliable when exposed to different field sizes, SSDs, depths in solid water, dose rates, frame rates, and radiation incident angles within a clinical x-ray beam. The MOSkin detector with water equivalent depth equal to 0.07 mm is a suitable detector for in vivo skin dosimetry during interventional radiology procedures.

  5. The role of interventional radiology in management of patients with end-stage renal disease

    Surlan, M.; Popovic, P


    The aim of the paper is to review the role of interventional radiology in the management of hemodialysis vascular access and complications in renal transplantation. The evaluation of patients with hemodialysis vascular access is complex. It includes the radiology/ultrasound (US) evaluation of the peripheral veins of the upper extremities with venous mapping and the evaluation of the central vein prior to the access placement and radiological detection and treatment of the stenosis and thrombosis in misfunctional dialysis fistulas. Preoperative screening enables the identification of a suitable vessel to create a hemodynamically-sound dialysis fistula. Clinical and radiological detection of the hemodynamically significant stenosis or occlusion demands fistulography and endovascular treatment. Endovascular prophylactic dilatation of stenosis greater than 50% with associated clinical abnormalities such as flow-rate reduction is warranted to prolong access patency. The technical success rates are over 90% for dilatation. One-year primary patency rate in forearm fistula is 51%, versus graft 40%. Stents are placed only in selected cases; routinely in central vein after dilatation, in ruptured vein and elastic recoil. Thrombosed fistula and grafts can be declotted by purely mechanical methods or in combination with a lytic drug. The success rate of the technique is 89-90%. Primary patency rate is 8-26% per year and secondary 75% per year. The most frequently radiologically evaluated and treated complications in renal transplantation are perirenal and renal fluid collection and abnormalities of the vasculature and collecting system. US is often the method of choice for the diagnostic evaluation and management of the percutaneous therapeutic procedures in early and late transplantation complications. Computed tomography and magnetic resonance are valuable alternatives when US is inconclusive. Renal and perirenal fluid collection are usually treated successfully with

  6. Angioplasty, embolization, biopsy, drainage. Interventional methods in medical radiology. Angioplastie, Embolisation, Punktion, Drainagen. Interventionelle Methoden der Radiologie

    Friedmann, G.; Steinbrich, W.; Gross-Fengels, W. (eds.)


    In the field of diagnostic radiology, interventional radiology has been emerging as a significant tool allowing treatments such as catherization, embolization, and vascular stenting, assisted by the rapid development of digital imaging methods. For this reason, interventional radiology has been chosen as a main topic of the '6th Cologne Symposium on Biomedical Imaging Methods', where interventional methods have been given large space for presentation by experienced specialists, and for a comprehensive survey ranging from basic principles and tools for the variety of applications, the relevant pre- and after-treatment, to specialized techniques for complex tasks. The proceedings give the full texts and illustrations of all papers presented to the symposium. The topcis discussed are as follows: Accompanying drug therapy (1 paper), vascular recanalization (7 papers), local fibrinolytic therapy (1 paper), vascular stenting (4 papers), biopsy and drainage (5 papers), embolization (3 papers), and present status and future direction of interventional radiology in the U.S.A. (1 paper).

  7. The removal of intravascular bullets by interventional radiology: the prevention of central migration by balloon occlusion--case report.

    Sclafani, S J; Shatzkes, D; Scalea, T


    A migratory intravascular bullet fragment located within the hypogastric vein was removed successfully with the aid of interventional radiologic techniques. The authors describe the use of the technique of balloon trapping as part of this procedure. A balloon should be inflated between the foreign body and the heart before retrieval is attempted in order to prevent migration back to the heart during the manipulation.

  8. Lean manufacturing and Toyota Production System terminology applied to the procurement of vascular stents in interventional radiology.

    de Bucourt, Maximilian; Busse, Reinhard; Güttler, Felix; Wintzer, Christian; Collettini, Federico; Kloeters, Christian; Hamm, Bernd; Teichgräber, Ulf K


    OBJECTIVES: To apply the economic terminology of lean manufacturing and the Toyota Production System to the procurement of vascular stents in interventional radiology. METHODS: The economic- and process-driven terminology of lean manufacturing and the Toyota Production System is first presented, including information and product flow as well as value stream mapping (VSM), and then applied to an interdisciplinary setting of physicians, nurses and technicians from different medical departments to identify wastes in the process of endovascular stent procurement in interventional radiology. RESULTS: Using the so-called seven wastes approach of the Toyota Production System (waste of overproducing, waiting, transport, processing, inventory, motion and waste of defects and spoilage) as well as further waste characteristics (gross waste, process and method waste, and micro waste), wastes in the process of endovascular stent procurement in interventional radiology were identified and eliminated to create an overall smoother process from the procurement as well as from the medical perspective. CONCLUSION: Economic terminology of lean manufacturing and the Toyota Production System, especially VSM, can be used to visualise and better understand processes in the procurement of vascular stents in interventional radiology from an economic point of view.

  9. Interventional radiology simulation and measurement of patient doses; Simulacion en radiologia intervencionista y medida de dosis a pacientes

    Herraiz Lablanca, M. d.; Diaz Romero, F.; Hernandez Armas, J.


    In this paper we propose a method of work to calculate the effective dose in any interventional radiology procedure using an Alderson Rando anthropomorphic phantom and dosimeters TLD 100 chip. We applied this method in the case of biliary drainage and allowed us to establish the dose value corresponding reference in the Hospital Universitario de Canarias (HUC).

  10. The Effect of Realtime Monitoring on Dose Exposure to Staff Within an Interventional Radiology Setting

    Baumann, Frederic, E-mail:; Katzen, Barry T. [Baptist Hospital of Miami, Miami Cardiac & Vascular Institute (MCVI) (United States); Carelsen, Bart [Philips HealthCare, Clinical Science Interventional X-ray (Netherlands); Diehm, Nicolas [Kantonsspital Aarau, Clinical and Interventional Angiology (Switzerland); Benenati, James F.; Peña, Constantino S. [Baptist Hospital of Miami, Miami Cardiac & Vascular Institute (MCVI) (United States)


    PurposeThe purpose of this study is to evaluate a new device providing real-time monitoring on radiation exposure during fluoroscopy procedures intending to reduce radiation in an interventional radiology setting.Materials and MethodsIn one interventional suite, a new system providing a real-time radiation dose display and five individual wireless dosimeters were installed. The five dosimeters were worn by the attending, fellow, nurse, technician, and anesthesiologist for every procedure taking place in that suite. During the first 6-week interval the dose display was off (closed phase) and activated thereafter, for a 6-week learning phase (learning phase) and a 10-week open phase (open phase). During these phases, the staff dose and the individual dose for each procedure were recorded from the wireless dosimeter and correlated with the fluoroscopy time. Further subanalysis for dose exposure included diagnostic versus interventional as well as short (<10 min) versus long (>10 min) procedures.ResultsA total of 252 procedures were performed (n = 88 closed phase, n = 50 learning phase, n = 114 open phase). The overall mean staff dose per fluoroscopic minute was 42.79 versus 19.81 µSv/min (p < 0.05) comparing the closed and open phase. Thereby, anesthesiologists were the only individuals attaining a significant dose reduction during open phase 16.9 versus 8.86 µSv/min (p < 0.05). Furthermore, a significant reduction of total staff dose was observed for short 51 % and interventional procedures 45 % (p < 0.05, for both).ConclusionA real-time qualitative display of radiation exposure may reduce team radiation dose. The process may take a few weeks during the learning phase but appears sustained, thereafter.

  11. The consent process in interventional radiology: the role of specialist nurses

    Davies, L.; Laasch, H.-U.; Wilbraham, L.; Marriott, A.; England, R.E.; Martin, D.F. E-mail:


    AIMS: To evaluate the impact of patient education by specialist nurses on patients' understanding of interventional procedures, their anxiety levels and satisfaction with the given information. MATERIALS AND METHODS: Sixty patients attending the radiology department for gastrointestinal interventional procedures were interviewed. Patients were assessed using a combination of categorical and visual analogue scales. Parameters were assessed on admission and after additional information had been given by specialist nurses. After the procedure patients were asked to rate the quality of information given and their overall satisfaction. RESULTS: Four of the 60 patients were excluded due to a Mini Mental Test score of <7. Only 35 (62.5%) claimed to have been given information by the referring consultant. Fifty-three patients received additional information before formally giving consent, 50 (96.2%) from the specialist nurses. Patient anxiety before and after information did not significantly change (p=0.52), but there was significant improvement in levels of satisfaction (p=0.001) and perceived understanding (p<0.001). Patients rated overall quality of information at an average of 9.2/10 and overall satisfaction was high (median=9.1/10). CONCLUSION: The use of specialist nurses to educate patients greatly increases patient understanding. The process of informed consent is improved and patient satisfaction is increased.

  12. Interventional radiology in the diagnosis, management, and follow-up of pseudoaneurysms.

    Keeling, A N


    Arterial wall disruption, as a consequence of inflammation\\/infection, trauma (penetrating or blunt), or iatrogenic causes, may result in pseudoaneurysm formation. Currently, iatrogenic causes are increasing as a result of the growth of endovascular intervention. The frequency of other causes also seems to be increasing, but this may simply be the result of increased diagnosis by better imaging techniques, such as multidetector contrast-enhanced computed tomography. Clinically, pseudoaneurysms may be silent, may present with local or systemic signs, or can rupture with catastrophic consequences. Open surgical repair, previously the mainstay of treatment, has largely been replaced by image-guided occlusion methods. On the basis of an experience of over 100 pseudoaneurysms, treatments at various anatomical sites, imaging modalities used for accurate diagnosis, current changing therapeutic options for pseudoaneurysm management, approved embolization agents, and clinical follow-up requirements to ensure adequate treatment will be discussed. Image-guided direct percutaneous and endovascular embolization of pseudoaneurysms are established treatment options with favorable success rates and minimal morbidity. The pendulum has now swung from invasive surgical repair of pseudoaneurysms to that of image-guided interventional radiology.

  13. A method to reduce patient's eye lens dose in neuro-interventional radiology procedures

    Safari, M. J.; Wong, J. H. D.; Kadir, K. A. A.; Sani, F. M.; Ng, K. H.


    Complex and prolonged neuro-interventional radiology procedures using the biplane angiography system increase the patient's risk of radiation-induced cataract. Physical collimation is the most effective way of reducing the radiation dose to the patient's eye lens, but in instances where collimation is not possible, an attenuator may be useful in protecting the eyes. In this study, an eye lens protector was designed and fabricated to reduce the radiation dose to the patients' eye lens during neuro-interventional procedures. The eye protector was characterised before being tested on its effectiveness in a simulated aneurysm procedure on an anthropomorphic phantom. Effects on the automatic dose rate control (ADRC) and image quality are also evaluated. The eye protector reduced the radiation dose by up to 62.1% at the eye lens. The eye protector is faintly visible in the fluoroscopy images and increased the tube current by a maximum of 3.7%. It is completely invisible in the acquisition mode and does not interfere with the clinical procedure. The eye protector placed within the radiation field of view was able to reduce the radiation dose to the eye lens by direct radiation beam of the lateral x-ray tube with minimal effect on the ADRC system.

  14. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 1: Patient Assessment and Laboratory Tests)

    Taslakian, Bedros, E-mail: [NYU Langone Medical Center, Department of Radiology (United States); Sebaaly, Mikhael Georges, E-mail:; Al-Kutoubi, Aghiad, E-mail: [American University of Beirut Medical Center, Department of Diagnostic Radiology (Lebanon)


    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care after the procedure is completed. After patient referral, contact with the referring physician and multidisciplinary team approach is vital. In addition, clinical history, physical examination, as well as full understanding of the pre-procedural laboratory results and imaging findings can guide the interventional radiologist to implement the most appropriate management plan, avoid unnecessary procedures, and prevent complications to achieve a successful outcome. We provide a comprehensive, methodical review of pre-procedural care and management in patients undergoing vascular and interventional radiology procedures.

  15. Patient Evaluation and Preparation in Vascular and Interventional Radiology: What Every Interventional Radiologist Should Know (Part 1: Patient Assessment and Laboratory Tests).

    Taslakian, Bedros; Georges Sebaaly, Mikhael; Al-Kutoubi, Aghiad


    Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care after the procedure is completed. After patient referral, contact with the referring physician and multidisciplinary team approach is vital. In addition, clinical history, physical examination, as well as full understanding of the pre-procedural laboratory results and imaging findings can guide the interventional radiologist to implement the most appropriate management plan, avoid unnecessary procedures, and prevent complications to achieve a successful outcome. We provide a comprehensive, methodical review of pre-procedural care and management in patients undergoing vascular and interventional radiology procedures.

  16. Experimental method for calculation of effective doses in interventional radiology; Metodo experimental para calculo de dosis efectivas en radiologia intervencionista

    Herraiz Lblanca, M. D.; Diaz Romero, F.; Casares Magaz, O.; Garrido Breton, C.; Catalan Acosta, A.; Hernandez Armas, J.


    This paper proposes a method that allows you to calculate the effective dose in any interventional radiology procedure using an anthropomorphic mannequin Alderson RANDO and dosimeters TLD 100 chip. This method has been applied to an angio Radiology procedure: the biliary drainage. The objectives that have been proposed are: to) put together a method that, on an experimental basis, allows to know dosis en organs to calculate effective dose in complex procedures and b) apply the method to the calculation of the effective dose of biliary drainage. (Author)

  17. Analysis and assessment of the detriment in interventional radiology using biological dosimetry methods

    Montoro, A.; Almonacid, M.; Villaescusa, J.I. [Hospital Univ. la Fe de Valen cian, Servicio de Proteccion Radiologica, Valencia (Spain); Barquinero, J.F.; Rodriguez, P. [Universitat Autonom a de Barcelona, Servicio de Dosimetria Biologica, Unidad de Antropologia, Departamento de Biologia Animal, Vegetal y Ecologia., Barcelona (Spain); Barrios, L. [Universidad Autonoma de Barcelona, Dept. de Biologia Celular y Fisiologia. Unidad de Biologia Celular, Barcelona (Spain); Verdu, G.; Ramos, M. [Universidad Politecnica de Valencia, Dept. de Ingenieria Quimica y Nuclear, Valencia, (Spain)


    Interventional radiologist and staff members usually are exposed to high levels of scattered radiation. As a result, the exposition to radiation procedures can produce detrimental effects that we would have to know. Effective dose is the quantity that better estimates the radiation risk. For this study we have realized an estimation of the radiological detriment to exposed workers of the Hospital la Fe de Valencia. For it, have been used physical doses registered in detectors T.L.D., and doses estimated by biological dosimetry in lymphocytes of peripheral blood. There has been estimated for every case the probability of effect of skin cancer and of non-solid cancers (leukaemia, lymphoma and myeloma), being compared with the baseline probability of natural effect. Biological doses were obtained by extrapolating the yield of dicentrics and translocations to their respective dose -effect curves. The discrepancies observed between physically recorded doses and biological estimated doses indicate that workers did not always wear their dosimeters or the dosimeters were not always in the radiation field. Cytogenetic studies should be extended to more workers to assess the risk derived from their occupational exposure. (authors)

  18. The Role of Interventional Radiology in the Diagnosis and Management of Male Impotence

    Spiliopoulos, Stavros [Patras University Hospital, Department of Radiology (Greece); Shaida, Nadeem [Cambridge University Hospitals NHS Trust, Addenbrooke' s University Hospital, Department of Radiology (United Kingdom); Katsanos, Konstantinos [Guy' s and St Thomas' NHS Trust, Department of Radiology (United Kingdom); Krokidis, Miltiadis, E-mail: [Cambridge University Hospitals NHS Trust, Addenbrooke' s University Hospital, Department of Radiology (United Kingdom)


    Erectile dysfunction (ED) is defined as the persistent inability to reach or maintain penile rigidity enough for sexual satisfaction. Nearly 30% of the men between ages 40 and 70 years are affected by ED. A variety of pathologies, including neurological, psychological, or endocrine disorders and drug side effects, may incite ED. A commonly identified cause of ED is vascular disease. Initial diagnostic workup includes a detailed physical examination and laboratory tests. Whilst duplex ultrasound is considered the first-line diagnostic modality, intra-arterial digital subtraction angiography is still considered the 'gold standard' for the diagnosis of arteriogenic impotence. Percutaneous endovascular treatment may be offered in patients with vasculogenic ED that has failed to respond to oral medical therapy as an alternative to penile prosthesis or open surgical repair. In arteriogenic ED balloon angioplasty of the aorto-iliac axis, and in veno-occlusive ED, percutaneous venous ablation using various embolization materials has been reported to be safe and to improve sexual performance. Recently, the ZEN study investigated the safety and feasibility of drug-eluting stents for the treatment of arteriogenic ED attributed to internal pudendal artery stenosis with promising preliminary results. This manuscript highlights the role of interventional radiology in the diagnosis and minimally invasive treatment of male impotence.

  19. Successful treatment of hypovascular advanced hepatocellular carcinoma with lipiodol-targetting intervention radiology


    We report a case of hypovascular advanced hepatocellular carcinoma (HCC) successfully treated with a novel combination therapy of percutaneous ethanollipiodol injection (PELI) and intervention radiology (IVR),lipiodol-targetting IVR (Lipi-IVR). The present case had a hypovascular HCC (3 cm in diameter) located in the S6 region of the liver. Although the tumor was not detectable at all by both of early and late phase of helical dynamic computed tomography (CT), it could be detected by ultrasonography (US) as a low echoic space occupying lesion (SOL) beside the gallbladder and right kidney. Serum levels of alpha fetoprotein (AFP)and AFP-L3 were extremely high. Combination therapy of PELI, firstly reported in our department, and IVR (PELI and IVR, lipiodol-targetting IVR) was performed twice for the treatment. PELI could effectively visualize the location of the tumor for IVR treatment and show the presence of a thin blood vessel branching from the right hepatic artery flowing into the lipiodol deposit.After treatment, the serum levels of AFP and AFP-L3 were rapidly decreased to normal and maintained for more than eight months. Thus, this case expressing the tremendous effect might give us insight into the effectiveness of the novel combination therapy of PELI and IVR for the treatment of hypovascular HCC.

  20. Simulators in catheter-based interventional radiology: training or computer games?

    Gould, D.A. [Department of Medical Imaging, University of Liverpool, Liverpool (United Kingdom)]. E-mail:; Kessel, D.O. [Department of Medical Imaging, University of Liverpool, Liverpool (United Kingdom); Healey, A.E. [Hospital for Sick Children, Toronto, Ont. (Canada); Johnson, S.J. [Department of Occupational Psychology, University of Liverpool, Liverpool (United Kingdom); Lewandowski, W.E


    Training in interventional radiology (IR) relies on a traditional apprenticeship; to protect patients, expert supervision is mandatory until knowledge, attitudes and practical skills have been certified as satisfactory. However, the current quality of IR training is threatened by reduced time for trainees to learn, as well as a loss of basic diagnostic, training cases to non-invasive imaging. At the same time, IR techniques are becoming a focus of interest to a range of other clinical specialities. To address this training shortfall there is a need to develop novel training alternatives such as simulator models. Few simulator models in any medical field have been successfully validated to show improved clinical skills in treating patients. To date no endovascular simulator has met this standard. A good simulator must be based around key performance measures (metrics) derived from careful analysis of the procedure to be replicated. Metrics can be determined by trained psychologists from a direct analysis of the content of the job or task to be tested. The identification of these critical measures of performance is a complex process which must be tailored to a training curriculum to be effective. Simulators based on flawed metrics will invariably lead to unsatisfactory assessment. It follows that simulator development must involve the statutory licensing authorities. Equally it is essential that we do not assume that training on a particular simulator will correlate with the ability to perform the task in the real world. This 'transfer of training' must be rigorously proven by validation studies.

  1. Exposures in interventional radiology using Monte Carlo simulation coupled with virtual anthropomorphic phantoms.

    Santos, William S; Neves, Lucio P; Perini, Ana P; Belinato, Walmir; Caldas, Linda V E; Carvalho, Albérico B; Maia, Ana F


    In this work we investigated the way in which conversion coefficients from air kerma-area product for effective doses (CCE) and entrance skin doses (CCESD) in interventional radiology (IR) are affected by variations in the filtration, projection angle of the X-ray beam, lead curtain attached to the surgical table, and suspended shield lead glass in regular conditions of medical practice. Computer simulations were used to model an exposure scenario similar to a real IR room. The patient and the physician were represented by MASH virtual anthropomorphic phantoms, inserted in the MCNPX 2.7.0 radiation transport code. In all cases, the addition of copper filtration also increased the CCE and CCESD values. The highest CCE values were obtained for lateral, cranial and caudal projections. In these projections, the X-ray tube was located above the table, and more scattered radiation reached the middle and upper portions of the physician trunk, where most of the radiosensitive organs are located. Another important result of this study was to show that the physician's protection is 358% higher when the lead curtain and suspended shield lead glasses are used. The values of CCE and CCESD, presented in this study, are an important resource for calculation of effective doses and entrance skin doses in clinical practice.

  2. [Estimation of personal dose based on the dependent calibration of personal dosimeters in interventional radiology].

    Mori, Hiroshige; Koshida, Kichiro; Ichikawa, Katsuhiro


    The purpose of present study is, in interventional radiology (IVR), to elucidate the differences between each personal dosimeter, and the dependences and calibrations of area or personal dose by measurement with electronic dosimeters in particular. We compare space dose rate distributions measured by an ionization survey meter with the value measured by personal dosimeter: an optically stimulated luminescence, two fluoroglass, and two electronic dosimeters. Furthermore, with electronic dosimeters, we first measured dose rate, energy, and directional dependences. Secondly, we calibrated the dose rate measured by electronic dosimeters with the results, and estimated these methods with coefficient of determination and Akaike's Information Criterion (AIC). The results, especially in electronic dosimeters, revealed that the dose rate measured fell by energy and directional dependences. In terms of methods of calibration, the method is sufficient for energy dependence, but not for directional dependence, because of the lack of stable calibration. This improvement poses a question for the future. The study suggested that these dependences of the personal dosimeter must be considered when area or personal dose is estimated in IVR.

  3. Active personal dosemeters in interventional radiology: tests in laboratory conditions and in hospitals.

    Clairand, I; Bordy, J-M; Daures, J; Debroas, J; Denozière, M; Donadille, L; Ginjaume, M; Itié, C; Koukorava, C; Krim, S; Lebacq, A-L; Martin, P; Struelens, L; Sans-Mercé, M; Tosic, M; Vanhavere, F


    The work package 3 of the ORAMED project, Collaborative Project (2008-11) supported by the European Commission within its seventh Framework Programme, is focused on the optimisation of the use of active personal dosemeters (APDs) in interventional radiology and cardiology (IR/IC). Indeed, a lack of appropriate APD devices is identified for these specific fields. Few devices can detect low-energy X rays (20-100 keV), and none of them are specifically designed for working in pulsed radiation fields. The work presented in this paper consists in studying the behaviour of some selected APDs deemed suitable for application in IR/IC. For this purpose, measurements under laboratory conditions, both with continuous and pulsed X-ray beams, and tests in real conditions on site in different European hospitals were performed. This study highlights the limitations of APDs for this application and the need of improving the APD technology so as to fulfil all needs in the IR/IC field.

  4. Doses to operators during interventional radiology procedures: focus on eye lens and extremity dosimetry.

    Koukorava, C; Carinou, E; Simantirakis, G; Vrachliotis, T G; Archontakis, E; Tierris, C; Dimitriou, P


    The present study is focused on the personnel doses during several types of interventional radiology procedures. Apart from the use of the official whole body dosemeters (thermoluminescence dosemeter type), measurements were performed to the extremities and the eyes using thermoluminescent loose pellets. The mean doses per kerma area product were calculated for the monitored anatomic regions and for the most frequent types of procedures. Higher dose values were measured during therapeutic procedures, especially embolisations. The maximum recorded doses during a single procedure were 1.8 mSv to the finger (nephrostomy), 2.1 mSv to the wrist (liver chemoembolisation), 0.6 mSv to the leg (brain embolisation) and 2.4 mSv to the eye (brain embolisation). The annual doses estimated for the operator with the highest workload according to the measurements and the system's log book were 90.4 mSv to the finger, 107.9 mSv to the wrist, 21.6 mSv to the leg and 49.3 mSv to the eye. Finally, the effect of the beam angulation (i.e. projection) and shielding equipment on the personnel doses was evaluated. The measurements were performed within the framework of the ORAMED (Optimization of RAdiation Protection for MEDical staff) project.

  5. Monte Carlo calculations on extremity and eye lens dosimetry for medical staff at interventional radiology procedures.

    Carinou, E; Ferrari, P; Koukorava, C; Krim, S; Struelens, L


    There are many factors that can influence the extremity and eye lens doses of the medical staff during interventional radiology and cardiology procedures. Numerical simulations can play an important role in evaluating extremity and eye lens doses in correlation with many different parameters. In the present study, the first results of the ORAMED (Optimisation of Radiation protection of MEDical staff) simulation campaign are presented. The parameters investigated for their influence on eye lens, hand, wrist and leg doses are: tube voltage, filtration, beam projection, field size and irradiated part of the patient's body. The tube voltage ranged from 60 to 110 kV(p), filtration from 3 to 6 mm Al and from 0 to 0.9 mm Cu. For all projections, the results showed that doses received by the operator decreased with increasing tube voltage and filtration. The magnitude of the influence of the tube voltage and the filtration on the doses depends on the beam projection and the irradiated part of the patient's body. Finally, the influence of the field size is significant in decreasing the doses.

  6. Functional phlebology. Phlebography, function studies, interventional radiology. Funktionelle Phlebologie. Phlebographie, Funktionstests, interventionelle Radiologie

    Weber, J.; May, R.; Biland, L.; Endert, G.; Gottlob, R.; Justich, E.; Luebcke, P.; Mignon, G.; Moltz, L.; Partsch, H.; Petter, A.; Ritter, H.; Soerensen, R.; Widmer, L.K.; Widmer, M.T.; Zemp, E.


    The book presents a complete survey of the problems occurring in the venous system of the legs, pelvis, and abdomen. The material is arranged in the following main chapters: (1) Introduction to the phlebology of the low-pressure system in the lower part of the body; (2) Phlebographic methods; (3) Instrumented function studies and methods; (4) Pathologic findings; (5) Diagnostic methods and vein therapy; (6) Interventional radiology; (7) Expert opinions on venous lesions including insurance aspects. The first chapter encompasses a section briefly discussing the available instrumented diagnostic imaging methods. In view of the novel imaging methods, namely digital subtraction phlebology, sonography, CT and MRI, the classical phlebography remains the gold standard, so to speak: all currently available phlebographic methods for imaging the venes in the legs, pelvis and abdomen are explained and comparatively evaluated. Instrumented function tests such as Doppler effect ultrasound testing, plethysmography, peripheral and central phlebodynamometry (venous pressure measurement) are analysed for their diagnostic value and as alternative or supplementing techniques in comparison to phlebology. (orig./MG) With 843 figs., 101 tabs.

  7. Radiological interventions in inflammatory bowel disease; Interventionelle Verfahren bei entzuendlichen Darmerkrankungen

    Krolak, C.; Rock, C.; Reiser, M. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen (Germany)


    Abscesses, fistulas,hemorrhages and stenoses are common complications of inflammatory bowel diseases.This study provides an overview on various methods of radiological intervention and the clinical usefulness of these methods is analyzed. The success rate of percutaneous abscess drainage (PAD), embolisation of hemorrhages and dilatation of bowel stenoses is reviewed and current literature is adressed.Success rate is defined in terms of cure rate and need for subsequent surgery. After PAD, surgery can be avoided during the observation period in about 50% of patients with abscesses due to Crohn's disease and diverticulitis.Preoperative PAD reduces the degree of invasiveness and thus the risk of surgery.Abscess recurrence is found with the same frecuency following surgery or PAD.Bowel dilatation can be performed both with radiological and with endoscopic guidance.Embolisation of GI-hemorrhage is technically feasible, but the indication should be limited to strictly selected cases. In treating abscesses and fistulas associated with Crohn's disease and diverticulitis, PAD is a valuable treatment option.Embolisation or dilatation are restricted to rare cares. (orig.) [German] Fragestellung Abszesse, Fisteln, Blutungen und Darmstenosen sind typische Komplikationen entzuendlicher Darmerkrankungen. Es werden verschiedene radiologisch-interventionelle Verfahren vorgestellt und ihre Wertigkeit fuer die Behandlung geprueft.Methodik Unter Beruecksichtigung der neueren Literatur werden der Erfolg der perkutanen Abszessdrainage (PAD) hinsichtlich der Ausheilung und Notwendigkeit einer folgenden OP, die perkutane Embolisation und die Dilatation von Darmstenosen bewertet.Ergebnisse Die PAD vermeidet bei 50% der Patienten mit Morbus Crohn und bei 20% der Patienten mit Divertikulitis eine OP im kurzfristigen Verlauf.Die PAD verringert die Invasivitaet einer nachfolgenden OP.Rezidivabszesse treten nach PAD und OP gleich haeufig auf.Die Dilatation entzuendlicher Darmstenosen

  8. Comparison of propofol-fentanyl with propofol-fentanyl-ketamine combination in pediatric patients undergoing interventional radiology procedures.

    Erden, I Aydin; Pamuk, A Gulsun; Akinci, Seda B; Koseoglu, Ayhan; Aypar, Ulku


    With an increase in the frequency of interventional radiology procedures in pediatrics, there has been a corresponding increase in demand for procedural sedation to facilitate them. The purpose of our study was to compare the frequency of adverse effects, sedation level, patient recovery characteristics in pediatric patients receiving intravenous propofol fentanyl combination with or without ketamine for interventional radiology procedures. Our main hypothesis was that the addition of ketamine would decrease propofol/fentanyl associated desaturation. Sixty consenting American Society of Anesthesia physical status I-III pediatric patients undergoing interventional radiology procedures under sedation were studied according to a randomized, double-blinded, institutional review board approved protocol. Group 1 received propofol 0.5 + fentanyl 1 + ketamine 0.5, and group 2 received propofol 0.5 + fentanyl 1 + same volume of %0.9 NaCl intravenously. While apnea was not observed in any of the groups, there were three cases (10%) in group 1, and nine cases (30%) in group 2 with oxygen desaturation (P = 0.052). In group 1, 12 (40%) patients and, in group 2, 21 (70%) patients required supplemental propofol during the procedure (P = 0.021). There was no evidence for difference between groups in terms of other side effects except nystagmus. In conclusion, addition of low dose ketamine to propofol-fentanyl combination decreased the risk of desaturation and it also decreased the need for supplemental propofol dosage in pediatric patients at interventional radiology procedures.

  9. The effects of expanding outpatient and inpatient evaluation and management services in a pediatric interventional radiology practice.

    Edalat, Faramarz; Lindquester, Will S; Gill, Anne E; Simoneaux, Stephen F; Gaines, Jennifer; Hawkins, C Matthew


    Despite a continuing emphasis on evaluation and management clinical services in adult interventional radiology (IR) practice, the peer-reviewed literature addressing these services - and their potential economic benefits - is lacking in pediatric IR practice. To measure the effects of expanding evaluation and management (E&M) services through the establishment of a dedicated pediatric interventional radiology outpatient clinic and inpatient E&M reporting system. We collected and analyzed E&M current procedural terminology (CPT) codes from all patients seen in a pediatric interventional radiology outpatient clinic between November 2014 and August 2015. We also calculated the number of new patients seen in the clinic who had a subsequent procedure (procedural conversion rate). For comparison, we used historical data comprising pediatric patients seen in a general interventional radiology (IR) clinic for the 2 years immediately prior. An inpatient E&M reporting system was implemented and all inpatient E&M (and subsequent procedural) services between July 2015 and September 2015 were collected and analyzed. We estimated revenue for both outpatient and inpatient services using the Medicare Physician Fee Schedule global non-facility price as a surrogate. Following inception of a pediatric IR clinic, the number of new outpatients (5.5/month; +112%), procedural conversion rate (74.5%; +19%), estimated E&M revenue (+158%), and estimated procedural revenue from new outpatients (+228%) all increased. Following implementation of an inpatient clinic reporting system, there were 8.3 consults and 7.3 subsequent hospital encounters per month, with a procedural conversion rate of 88%. Growth was observed in all meaningful metrics following expansion of outpatient and inpatient pediatric IR E&M services.

  10. Medical intervention in radiological emergencies, formation and training; Intervencion medica en emergencias radiologicas, formacion y adiestramiento

    Cardenas H, J. [CPHR, Calle 20 No. 4113, e/41 y 47 Playa, CP 11300, La Habana (Cuba)]. e-mail:


    The work exposes the national experience in the development of training programs in medical aspects of the radiological emergencies. Implemented after valuing the existent situation, identified the necessities and the reach of the training, additionally it was elaborated the content of the training program whose purpose is guided to the invigoration of the medical answer capacity in radiological emergencies The content of the modular program it approaches theoretical- practical aspects on preparation and medical answer in radiological emergencies. The program includes an exercise that simulates a radiological accident, to evaluate during the same one, the answer capacity before this situation. The training concludes with the design of a strategy for the preparation and answer in radiological emergencies in correspondence with the potential accidental scenarios that the participants can face. (Author)

  11. Professional development for radiographers and post graduate nurses in radiological interventions: Building teamwork and collaboration through drama.

    Lundén, M; Lundgren, S M; Morrison-Helme, M; Lepp, M


    The rapid development within Interventional Radiology presents new challenges. Hybrid operating rooms consist of interventional radiology, open surgery, computed tomography, magnetic resonance imaging and other techniques. This means that several disciplines and professionals need to work in new constellations creating a multidisciplinary team around the patient. In accordance with this development, higher professional education must provide new pedagogic strategies to successfully address the knowledge expected in today's complex working life. To explore the use of Applied Drama as a learning medium, focusing on the use of Forum Theatre, to foster team work and collaboration in the field of radiography and learning. A qualitative approach, closely related to Ethnography, was utilized. The Drama Workshop utilising Forum Theatre created a dynamic learning environment and enabled the participants from three professions to understand each other's priorities better. The use of drama within health care education allows the students to take different roles in order to find the best way to co-operate. Forum Theatre is a useful learning medium in order to promote teamwork and collaboration in the radiological intervention field. By choosing a personal working experience, Forum Theatre seem to engage the participants at a deeper level and to experience various communication strategies and how the outcome changed depending on the approach. This can lead to improved teamwork and collaboration. Copyright © 2017 The College of Radiographers. All rights reserved.

  12. Current radiology. Volume 5

    Wilson, G.H.; Hanafee, W.N.


    This book contains 10 selections. They are: Nuclear Magnetic Resonance Imaging, Interventional Vascular Radiology, Genitourinary Radiology, Skeletal Radiology, Digital Subtraction Angiography, Neuroradiology, Computed Tomographic Evaluation of Degenerative Diseases of the Lumbar Spine, The Lung, Otolaringology and Opthalmology, and Pediatric Radiology: Cranial, Facial, Cervical, Vertebral, and Appendicular.

  13. Identifying the Learning Curve for Uterine Artery Embolisation in an Interventional Radiological Training Unit

    Das, Raj, E-mail:, E-mail:; Lucatelli, Pierleone, E-mail:; Wang, Haofan, E-mail:; Belli, Anna-Maria, E-mail: [St George’s Hospital, Department of Radiology (United Kingdom)


    AimA clear understanding of operator experience is important in improving technical success whilst minimising patient risk undergoing endovascular procedures, and there is the need to ensure that trainees have the appropriate skills as primary operators. The aim of the study is to retrospectively analyse uterine artery embolisation (UAE) procedures performed by interventional radiology (IR) trainees at an IR training unit analysing fluoroscopy times and radiation dose as surrogate markers of technical skill.MethodsTen IR fellows were primary operator in 200 UAE procedures over a 5-year period. We compared fluoroscopy times, radiation dose and complications, after having them categorised according to three groups: Group 1, initial five, Group 2, >5 procedures and Group 3, penultimate five UAE procedures. We documented factors that may affect screening time (number of vials employed and use of microcatheters).ResultsMean fluoroscopy time was 18.4 (±8.1), 17.3 (±9.0), 16.3 (±8.4) min in Groups 1, 2 and 3, respectively. There was no statistically significant difference between these groups (p > 0.05) with respect to fluoroscopy time or radiation dose. Analysis after correction for confounding factors showed no statistical significance (p > 0.05). All procedures were technically successful, and total complication rate was 4 %.ConclusionUAE was chosen as a highly standardised procedure followed by IR practitioners. Although there is a non-significant trend for shorter screening times with experience, technical success and safety were not compromised with appropriate Consultant supervision, which illustrates a safe construct for IR training. This is important and reassuring information for patients undergoing a procedure in a training unit.

  14. British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry

    Uberoi, Raman, E-mail:; Tapping, Charles Ross [Oxford University Hospitals, John Radcliffe Hospital, Department of Radiology (United Kingdom); Chalmers, Nicholas [Manchester Royal Infirmary, Department of Radiology (United Kingdom); Allgar, Victoria [University of York, Hull and York Medical School (United Kingdom)


    Purpose: The British Society of Interventional Radiology (BSIR) Inferior Vena Cava (IVC) Filter Registry was produced to provide an audit of current United Kingdom (UK) practice regarding placement and retrieval of IVC filters to address concerns regarding their safety. Methods: The IVC filter registry is a web-based registry, launched by the BSIR on behalf of its membership in October 2007. This report is based on prospectively collected data from October 2007 to March 2011. This report contains analysis of data on 1,434 IVC filter placements and 400 attempted retrievals performed at 68 UK centers. Data collected included patient demographics, insertion and retrieval data, and patient follow-up. Results: IVC filter use in the majority of patients in the UK follows accepted CIRSE guidelines. Filter placement is usually a low-risk procedure, with a low major complication rate (<0.5 %). Cook Gunther Tulip (560 filters: 39 %) and Celect (359 filters: 25 %) filters constituted the majority of IVC filters inserted, with Bard G2, Recovery filters, Cordis Trapease, and OptEase constituting most of the remainder (445 filters: 31 %). More than 96 % of IVC filters deployed as intended. Operator inexperience (<25 procedure) was significantly associated with complications (p < 0.001). Of the IVC filters initially intended for temporary placement, retrieval was attempted in 78 %. Of these retrieval was technically successful in 83 %. Successful retrieval was significantly reduced for implants left in situ for >9 weeks versus those with a shorter dwell time. New lower limb deep vein thrombosis (DVT) and/or IVC thrombosis was reported in 88 patients following filter placement, there was no significant difference of incidence between filter types. Conclusions: This registry report provides interventional radiologists and clinicians with an improved understanding of the technical aspects of IVC filter placement to help improve practice, and the potential consequences of IVC filter

  15. Cardiovascular and Interventional Radiological Society of Europe commentary on the treatment of chronic cerebrospinal venous insufficiency.

    Reekers, J A


    , who are directly approached by MS patients, contact the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) for advice. Worldwide, several centres are actively promoting and performing balloon dilatation, with or without stenting, for CCSVI. Thus far, no trial data are available, and there is currently no randomized controlled trial (RCT) in progress Therefore, the basis for this new treatment rests on anecdotal evidence and successful testimonies by patients on the Internet. CIRSE believes that this is not a sound basis on which to offer a new treatment, which could have possible procedure-related complications, to an often desperate patient population.

  16. Red emission phosphor for real-time skin dosimeter for fluoroscopy and interventional radiology

    Nakamura, Masaaki, E-mail:; Chida, Koichi; Zuguchi, Masayuki [Department of Radiological Technology, Faculty of Medicine, School of Health Sciences, Tohoku University, 2-1 Seiryou-machi, Aoba-ku, Sendai 980-8575 (Japan)


    Purpose: There are no effective real-time direct skin dosimeters for interventional radiology. Such a scintillation dosimeter would be available if there was a suitable red emission phosphor in the medical x-ray range, since the silicon photodiode is a highly efficient device for red light. However, it is unknown whether there is a suitable red emission phosphor. The purpose of this study is to find a suitable red emission phosphor that can be used in x-ray dosimeters. Methods: Five kinds of phosphors which emit red light when irradiated with electron beams or ultraviolet rays in practical devices were chosen. For the brightness measurement, phosphor was put into transparent plastic cells or coated onto plastic sheets. The phosphors were irradiated with medical range x-rays [60–120 kV(peak), maximum dose rate of 160 mGy min{sup −1}], and the emission was measured by a luminance meter. Several characteristics, such as brightness, dose rate dependence, tube voltage dependence, and brightness stability, were investigated. Results: The luminescence of Y V O{sub 4}:Eu, (Y,Gd,Eu) BO{sub 3}, and Y{sub 2}O{sub 3}:Eu significantly deteriorated by 5%–10% when irradiated with continuous 2 Gy x-rays. The 0.5MgF{sub 2}⋅3.5MgO⋅GeO{sub 2}:Mn phosphor did not emit enough. Only the Y{sub 2}O{sub 2}S:Eu,Sm phosphor had hardly any brightness deterioration, and it had a linear relationship so that the x-ray dose rate could be determined from the brightness with sufficient accuracy. For the tube voltage dependence of the Y{sub 2}O{sub 2}S:Eu,Sm phosphor, the brightness per unit dose rate with 120 kV(peak) x-rays was 30% higher than that with 60 kV(peak) x-rays. Conclusions: Five kinds of phosphors were chosen as an x-ray scintillator for a real-time direct skin dosimeter. The Y V O{sub 4}:Eu, (Y,Gd,Eu)BO{sub 3}, and Y{sub 2}O{sub 3}:Eu phosphors had brightness deterioration caused by the x-rays. Only the Y{sub 2}O{sub 2}S:Eu,Sm phosphor had hardly any brightness deterioration

  17. Economic evaluation of angiographic interventions including a whole-radiology in- and outpatient care; Wirtschaftliche Evaluation angiographischer Interventionen einschliesslich einer radiologischen stationaeren und ambulanten Patientenbetreuung

    Nolte-Ernsting, C.; Abel, K.; Krupski, G.; Lorenzen, J.; Adam, G. [Klinik und Poliklinik fuer Diagnostische und Interventionelle Radiologie, Universitaetsklinikum Hamburg-Eppendorf (Germany)


    Purpose: To determine the economic efficiency of a whole-radiology in- and outpatient treatment with angiographic interventions performed as the main or sole therapy. Materials and Methods: The calculations represent the data of a university radiology department, including the following angiographic interventions (neuroradiology not considered): Vascular intervention (PTA, stent implantation) of kidneys and extremities, recanalization of hemodialysis access, chemoembolization, diagnostic arterioportal liver CT, port implantation, varicocele embolization, PTCD, percutaneous implantation of biliary stent. First, the different angiographic interventions are categorized with reference to the German DRG system 2005. Considering the example of a university hospital, the individual cost of each intervention is calculated and correlated with reimbursements by G-DRG2005 and so-called ''ambulant operation'' (EBM200plus). With these data, profits and losses are calculated for both in- and outpatient care. Results: Radiologic interventions of inpatients yield a profit in the majority of cases. With a base rate of 2900 Euro, the profits in our university hospital range between -872 Euro and +3411 Euro (mean: +1348 Euro). On the other hand, those angiographic interventions suitable for ''ambulant operation'' generate average profits of +372 Euro, if only direct costs are considered. The data of outpatient radiological interventions average between 381 Euro up to 1612 Euro lower than compared with profits obtained from in patient care. (orig.)

  18. Evaluation of an intervention to improve skills in diagnostic radiology of rural physicians over one year in four rural hospitals.

    Tienan Feng

    Full Text Available BACKGROUND: Primary health care and patient triage are two basic functions of rural hospitals. As a routine test, the diagnostic radiology is still unavailable in some rural hospitals in China. Therefore, high-level hospitals are often the first choice of rural residents when they feel unwell. It brings serious social problems. This study was designed to propose an on-the-job drilling schema with integration of practical medical recordings and experienced radiological doctors as tutors to improve skills in diagnostic radiology of rural physicians. METHODS: The information technology was used to help the contact between rural doctors and tutors. In a longitudinal pre/post-test control study design, a cohort of 20 young physicians, each of whom was working in a rural hospital and had a work experience less than two years, were established as the trial group over one year. Another 20 similar counterparts were established as the control group. Participants' performances were evaluated in four categories at five-time point (TP. RESULTS: The trial group significantly outscored the control group on the style of writing at the second TP (d = 2.28; on the accuracy of the image description at final TP (d = 1.11; on the accuracy of the diagnosis at the fourth TP (d = 3.62; and on the correct treatment selection at the third TP (d = 6.45. The aspects with the most improvement were the accuracies of the diagnosis and the treatment selection. CONCLUSION: This study provided the detailed evidences that applying the on-the-job drilling schema has a significant effect on the skills improvement in diagnostic radiology of rural physicians. It was also concluded that the educational intervention based on practical cases was better than that only based on didactic slides presentation.

  19. Patients and personnel radiation protection in interventional radiology and in surgery;La radioprotection des patients et des travailleurs en radiologie interventionnelle et au bloc operatoire

    Menechal, P. [Centre de Recherches en Psychopathologie et Psychologie Clinique - CRPPC, 69 - Lyon (France); Valero, M.; Godet, J.L. [Lyon-3 Univ. Jean Moulin, 69 (France)


    The development of the interventional radiology and acts realised under radiological guiding is a real benefit for patients. The doses delivered can however, generate important detriments (determinist effects). the patients and the personnel are exposed to important doses, heterogeneous and very different doses according the operator, the patient morphology and the treated pathology. This theme is considered by the the nuclear safety Authority as a priority in the medical medium. (N.C.)

  20. A study of inventiveness among Society of Interventional Radiology members and the impact of their social networks.

    Murphy, Kieran J; Elias, Gavin; Jaffer, Hussein; Mandani, Rashesh


    To investigate the nature of inventiveness among members of the Society of Interventional Radiology (SIR) and learn what influenced the inventors and assisted their creativity. The membership directory of the SIR was cross-referenced with filings at the United States Patent and Trademark Organization (USPTO) and the Patent Cooperation Treaty (PCT). The inventors were queried with an online survey to illuminate their institutions of training and practice as well as enabling or inhibiting factors to their inventiveness. Responses were analyzed through the construction of social network maps and thematic and graphical analysis. It was found that 457 members of the SIR held 2,492 patents or patent filings. After 1986, there was a marked and sustained increase in patent filings. The online survey was completed by 73 inventors holding 470 patents and patent filings. The social network maps show the key role of large academic interventional radiology departments and individual inventors in the formation of interconnectivity among inventors and the creation of the intellectual property (IP). Key inhibitors of the inventive process include lack of mentorship, of industry contacts, and of legal advice. Key enablers include mentorship, motivation, and industry contacts. Creativity and inventiveness in SIR members stem from institutions that are hubs of innovation and networks of key innovators; inventors are facilitated by personal motivation, mentorship, and strong industry contacts. Copyright © 2013 SIR. Published by Elsevier Inc. All rights reserved.

  1. Developing low-dose C-arm CT imaging for temporomandibular joint (TMJ) disorder in interventional radiology

    Zhu, Xiaowei; Cahill, Anne Marie [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Felice, Marc [University of Pennsylvania, Environmental Health and Radiation Safety, Philadelphia, PA (United States); Johnson, Laura [Computed Tomography Division, Siemens Healthcare Sector, Shanghai (China); Sarmiento, Marily [Siemens Medical Solutions, Angiography and X-ray Division, Hoffman Estates, IL (United States)


    Manufacturers have provided C-arm CT imaging technologies for applications in interventional radiology in recent years. However, clinical imaging protocols and radiation doses have not been well studied or reported. The purpose of this study is to develop low-dose settings for clinically acceptable CT imaging of temporomandibular joint in interventional radiology suites, using a C-arm imaging angiography system. CT scans were performed with a flat-panel digital C-arm angiographic system on a 5-year-old anthropomorphic phantom. The CTDI was determined for various rotation times, dose settings and Cu filter selections. The CTDI values were compared with those of conventional low-dose CT for the same phantom. The effectiveness of using Cu filters to reduce dose was also investigated. Images were reviewed by a senior radiologist for clinical acceptance. The manufacturer's default setting gave an equivalent CTDI of 4.8 mGy. Optimizing the dose settings and adding copper filtration reduced the radiation dose by 94%. This represents a 50% reduction from conventional CT. Use of Cu filters and low-dose settings significantly reduced radiation dose from that of standard settings. This phantom study process successfully guided the clinical implementation of low-dose studies for all ages at our institution. (orig.)

  2. C-arm flat detector computed tomography: the technique and its applications in interventional neuro-radiology

    Kamran, Mudassar [John Radcliffe Hospital, Oxford Neurovascular and Neuroradiology Research Unit, Level 6, West Wing, Oxford (United Kingdom); Nagaraja, Sanjoy; Byrne, James V. [John Radcliffe Hospital, Department of Neuroradiology, West Wing, Oxford (United Kingdom)


    Flat detector computed tomography (FDCT) is an imaging tool that generates three-dimensional (3-D) volumes from data obtained during C-arm rotation using CT-like reconstruction algorithms. The technique is relatively new and, at current levels of performance, lags behind conventional CT in terms of image quality. However, the advantage of its availability in the interventional room has prompted neuro-radiologists to identify clinical settings where its role is uniquely beneficial. We performed a search of the online literature databases to identify studies reporting experience with FDCT in interventional neuro-radiology. The studies were systematically reviewed and their findings grouped according to specific clinical situation addressed. FDCT images allow detection of procedural complications, evaluation of low-radiopacity stents and assessment of endosaccular coil packing in intra-cranial aneurysms. Additional roles are 3-D angiography that provides an accurate depiction of vessel morphology with low concentrations of radiographic contrast media and a potential for perfusion imaging due to its dynamic scanning capability. A single scan combining soft tissue and angiographic examinations reduces radiation dose and examination time. Ongoing developments in flat detector technology and reconstruction algorithms are expected to further enhance its performance and increase this range of applications. FDCT images provide useful information in neuro-interventional setting. If current research confirms its potential for assessing cerebral haemodynamics by perfusion scanning, the combination would redefine it as an invaluable tool for interventional neuro-radiology procedures. This facility and its existing capabilities of parenchymal and angiographic imaging would also extend its use to the triage of acute stroke patients. (orig.)

  3. Study of radiation exposure profiles in interventional radiology professionals; Estudo dos perfis de exposicao a radiacao em profissionais de radiologia intervencionista

    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Alvarez, Matheus; Rosa, Maria E.D.; Miranda, Jose R.A.; Freitas, Carlos C.M. de; Moura, Regina; Pina, Diana R. de, E-mail: [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil)


    Interventional Radiology is the radiology area that provides the highest dose values to the medical staff. Recent surveys show that personal dosimeters may underestimate the radiation dose values in interventional physicians, especially in the extremities and crystalline. The objective of this work was to study the exposure levels to radiation from medical staff in different interventional radiology procedures. Therefore, thermoluminescent dosimeters type LiF: Mg, Ti (TLD-100) were used positioned in the main interventional physician and an assistant in the following locations: some inches below the crystalline, thyroid, chest, gonads, hand and foot. By comparing the values obtained with the annual reference dose levels in workers, maximum numbers of annual procedures were found. Altogether, there were 23 procedures evaluated: 10 diagnostics, 9 angioplasties and 4 stents. The maximum number of annual procedures were estimated by discounting the percentages of attenuation of radiological protection. For procedures of the type diagnosis, angioplasty and stent for the main interventionist, the maximum number of annual procedures were 641, 445 and 113 respectively, while for the interventionists assistants were 930, 1202 and 215 respectively. As each interventionist body region is subject to different levels of exposure, detailed studies of exposure in each region provide better conclusions about what actions are necessary to ensure radiological protection professionals.

  4. Dose evaluation in medical staff during diagnostics procedures in interventional radiology; Avaliacao da dose na equipe medica durante procedimentos diagnoticos de radiologia intervencionista

    Bacchim Neto, Fernando A.; Alves, Allan F.F.; Rosa, Maria E.D.; Miranda, Jose R.A. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencias. Departamento de Fisica e Biofisica; Moura, Regina [Faculdade de Medicina de Botucatu, SP (Brazil). Departamento de Cirurgia e Ortopedia; Pina, Diana R., E-mail: [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Doencas Tropicais e Diagnostico por Imagem


    Studies show that personal dosimeters may underestimate the dose values in interventional physicians, especially in extremities and crystalline. The objective of this work was to study the radiation exposure levels of medical staff in diagnostic interventional radiology procedures. For this purpose LiF:Mg,Ti (TLD-100) dosimeters were placed in different regions of the physician body. When comparing with reference dose levels, the maximum numbers of annual procedures were found. This information is essential to ensure the radiological protection of those professionals. (author)

  5. Transition in occupational radiation exposure monitoring methods in diagnostic and interventional radiology.

    Lönnroth, Nadja; Hirvonen-Kari, Mirja; Timonen, Marjut; Savolainen, Sauli; Kortesniemi, Mika


    Radiation exposure monitoring is a traditional keystone of occupational radiation safety measures in medical imaging. The aim of this study was to review the data on occupational exposures in a large central university hospital radiology organisation and propose changes in the radiation worker categories and methods of exposure monitoring. An additional objective was to evaluate the development of electronic personal dosimeters and their potential in the digitised radiology environment. The personal equivalent dose of 267 radiation workers (116 radiologists and 151 radiographers) was monitored using personal dosimeters during the years 2006-2010. Accumulated exposure monitoring results exceeding the registration threshold were observed in the personal dosimeters of 73 workers (59 radiologists' doses ranged from 0.1 to 45.1 mSv; 14 radiographers' doses ranged from 0.1 to 1.3 mSv). The accumulated personal equivalent doses are generally very small, only a few angiography radiologists have doses >10 mSv per 5 y. The typical effective doses are dosimeters. An active real-time dosimetry system is warranted to support radiation protection strategy where optimisation aspects, including improving working methods, are essential.

  6. Extremity and eye lens doses in interventional radiology and cardiology procedures: first results of the ORAMED project.

    Domienik, J; Brodecki, M; Carinou, E; Donadille, L; Jankowski, J; Koukorava, C; Krim, S; Nikodemova, D; Ruiz-Lopez, N; Sans-Mercé, M; Struelens, L; Vanhavere, F


    The main objective of WP1 of the ORAMED (Optimization of RAdiation protection for MEDical staff) project is to obtain a set of standardised data on extremity and eye lens doses for staff in interventional radiology (IR) and cardiology (IC) and to optimise staff protection. A coordinated measurement program in different hospitals in Europe will help towards this direction. This study aims at analysing the first results of the measurement campaign performed in IR and IC procedures in 34 European hospitals. The highest doses were found for pacemakers, renal angioplasties and embolisations. Left finger and wrist seem to receive the highest extremity doses, while the highest eye lens doses are measured during embolisations. Finally, it was concluded that it is difficult to find a general correlation between kerma area product and extremity or eye lens doses.

  7. Preliminary characterization of dose in personnel of interventional radiology; Caracterizacao preliminar da dose em profissionais de radiologia intervencionista

    Godolfim, Laura Larre; Anes, Mauricio; Bacelar, Alexandre; Lykawka, Rochelle [Hospital de Clinicas de Porto Alegre (HCPA), Porto Alegre, RS (Brazil)


    Exposure to X-rays of Interventional Radiology professionals (IR) impacts in the high dose rate received by these individuals, and there are reports of biological effects of this professional activity. Therefore, it is fomented greater control over the doses received by these workers. This research intends to characterize the doses received by the professionals during IR procedures. We evaluated the doses of radiologists, anesthesiologists and nursing staff of the Hospital de Clinicas de Porto Alegre, through measures with dosimeters of the OSL type, distributed in up to six regions of the body of these professionals. Until now were accompanied 33 cholangiography procedures and 29 embolization procedures. As a preliminary result, it was possible to identify a wide variation between doses of the professionals of the same function in each procedure. In overview, the dose of the professionals presented in descending order as a radiologist 1> radiologist 2 > anesthetist > nursing. (author)

  8. Reducing Blood-borne Exposure in Interventional Radiology: What the IR Should Know

    Tso, David K. [University of British Columbia, Department of Radiology (Canada); Athreya, Sriharsha, E-mail: [St. Joseph' s Healthcare Hamilton, Department of Diagnostic Imaging (Canada)


    Interventional radiologists are at risk of exposure to blood-borne pathogens in their day-to-day practice. Percutaneous exposure from unsafe sharps handling, mucocutaneous exposure from body fluid splashes, and glove perforation from excessive wear can expose the radiologist to potentially infectious material. The increasing prevalence of blood-borne pathogens, including hepatitis B and C, and human immunodeficiency virus, puts nurses, residents, fellows, and interventional radiologists at risk for occupational exposure. This review outlines suggestions to establish a culture of safety in the interventional suite.

  9. A comparison of the quality of the information available on the internet on interventional radiology, vascular surgery, and cardiology

    A Alsafi


    Full Text Available Context and Aims: Internet use is rapidly expanding and increasingly plays a substantial role in patient education. We sought to evaluate and compare the quality of information available to patients online on three closely linked specialties: Interventional radiology (IR, cardiology, and vascular surgery. Materials and Methods: We searched the leading three search engines for the terms: "Interventional Radiology", "cardiology," and "vascular surgery," collating the top 50 hits from each search. After excluding duplicates and irrelevant sites, 43, 25, and 36 sites remained, respectively. Sites were analyzed using the LIDA instrument (an online tool for assessing health-related websites and Fleisch Reading Ease Scores (FRES were compared across the different search terms and correlated with the country of origin and certification by the Health on the Net (HON Foundation. Results: There was no significant difference ( P>0.05 in the total LIDA, accessibility, usability or reliability scores between the three specialties. HONCode certification was associated with higher LIDA (83.1±1.6 vs. 71.53±0.8 ( P<0.0001, reliability (75.7±3.6 vs. 49.0±1.6 ( P<0.0001 and FRES (37.4±4.0 vs. 29.7±1.4 ( P=0.0441. Conclusion: Websites are generally well designed and easy to use; the majority however, lacks currency and reliability. Despite similarity in quality of online information, there is a disparity in knowledge of IR; this may be due to low web-traffic figures of IR sites. Wikipedia′s user-generated content, ranks highly in major search engines, as such; this could serve as means of disseminating reliable health information to patients.

  10. MOrtality and infectious complications of therapeutic EndoVAscular interventional radiology: a systematic and meta-analysis protocol.

    Mellouk Aid, Kaoutar; Tchala Vignon Zomahoun, Hervé; Soulaymani, Abdelmajid; Lebascle, Karin; Silvera, Stephane; Astagneau, Pascal; Misset, Benoit


    Endovascular interventional radiology (EIR) is an increasingly popular, mini invasive treatment option for patient with symptomatic vascular disease. The EIR practiced by qualified hands is an effective, well-tolerated procedure that offers relief of patient's symptoms with a low risk of complications. During acute post procedural period, immediate complications may relate to vascular access, restenosis, thromboembolic events, uterine ischemia, infection, necrosis, sepsis, ICU stay, surgical recovery, pain management, treatment failure, and death. Moreover, additional non-life-threatening complications exist, but they are not well described and represent disparate information. A range of databases will be screened consulted to identify the relevant studies: PubMed, EMBASE, The Cochrane Library, NosoBase, and Google Scholar (to identify articles not yet indexed). Scientist librarian used Medical Subject Headings (MeSH) and free terms to construct the search strategy in PubMed. This search strategy will be adapted in other databases. Two coauthors will independently select the relevant studies, extract the relevant data, and assess the risk of bias in the included studies. Any disagreements between the two authors will be solved by a third author. This systematic review will provide a synthesis of EIR complications. The spotlighted results will be analyzed in order to provide a state-of-knowledge synopsis of the current evidence base in relation to the epidemiology of the infectious complications after EIR. In the event of conclusive results, our findings will serve as a reference background to assess guidelines on reality of the problem of the infections linked to endovascular interventional radiology and to formulate of assumptions and propose preventive measures, based on the results of our investigations. These propositions will aim to reduce the risk and/or the severity of these complications in the concerned population in favor a positive medical economics

  11. Optimization approach within an interventional radiology department; Demarche d'optimisation au sein d'un service de radiologie interventionnelle

    Mozziconacci, J.G.; Brot, A.M. [Centre Hospitalier de Bourges, PCR, 18 (France); Jarrige, V. [Centre Hospitalier de Bourges, PSRPM, 18 (France)


    The authors present an approach aimed at optimizing working conditions and radioprotection for the different actors in interventional radiology. This approach comprises a monitoring of personnel dosimetry, a workstation analysis with risk assessment, and the taking into account of patient dosimetry. For each of these aspects, the authors discuss procedures and available devices (dosemeters and other detection or dose measurement equipment)

  12. Monte Carlo simulations of scattered radiation fields in interventional radiology; Simulacion Monte Carlo de campos de radiacion dispersa en radiologia intervencionista

    Duch, M. A.; Zaragoza, F. J.; Sempau, J.; Ginjaume, M.; Vano, E.; Sanchez, R.; Fernandez, J. M.


    The study shows that the MC simulation is a useful tool to facilitate the assessment of the spatial distribution of the dose due to the radiation scattered in interventional radiology procedures, as well as to determine the influence of various operational parameters in the same , avoiding experimental measures that require much time of use the Cath Labs. (Author)

  13. Near infrared spectroscopy for frontal lobe oxygenation during non-vascular abdominal surgery

    Sørensen, Henrik; Grocott, Hilary P; Secher, Niels H


    PURPOSE: Cerebral deoxygenation, as determined by near infrared spectroscopy (NIRS), seems to predict postoperative complications following cardiac surgery. We identify the type of non-vascular abdominal surgery associated with cerebral deoxygenation and/or hyperoxygenation, how such deviations...

  14. Role of Interventional Radiology in the Emergent Management of Acute Upper Gastrointestinal Bleeding

    Navuluri, Rakesh; Patel, Jay; Kang, Lisa


    Approximately 100,000 cases of upper gastrointestinal bleeding (UGIB) require inpatient admission annually in the United States. When medical management and endoscopic therapy are inadequate, endovascular intervention can be lifesaving. These emergent situations highlight the importance of immediate competence of the interventional radiologist in the preangiographic evaluation as well as the endovascular treatment of UGIB. We describe a case of UGIB managed with endovascular embolization and detail the angiographic techniques used. The case description is followed by a detailed discussion of the treatment approach to UGIB, with attention to both nonvariceal and variceal algorithms. PMID:23997408

  15. Periprocedural Prophylactic Antithrombotic Strategies in Interventional Radiology: Current Practice in the Netherlands and Comparison with the United Kingdom

    Wiersema, Arno M., E-mail: [Westfriesgasthuis, Hoorn, Department of Surgery (Netherlands); Vos, Jan-Albert, E-mail: [St Antonius Hospital, Nieuwegein, Department of Radiology, Division of Interventional Radiology (Netherlands); Bruijninckx, Cornelis M. A., E-mail: [Equipe Zorg Bedrijven, Rotterdam, Department of Surgery (Netherlands); Delden, Otto M. van, E-mail: [Academic Medical Centre, University of Amsterdam, Department of Radiology, Division of Interventional Radiology (Netherlands); Reijnen, Michel M. P. J., E-mail: [Rijnstate Hospital, Arnhem, Department of Surgery (Netherlands); Vahl, Anco, E-mail: [Onze Lieve Vrouwe Gasthuis, Amsterdam, Department of Surgery (Netherlands); Zeebregts, Clark J., E-mail: [University of Groningen, Department of Surgery, Division of Vascular Surgery, University Medical Centre Groningen (Netherlands); Moll, Frans L., E-mail: [University of Utrecht, Department of Surgery, Division of Vascular Surgery, University Medical Centre Utrecht (Netherlands)


    Purpose: The use of prophylactic antithrombotic drugs to prevent arterial thrombosis during the periprocedural period during (percutaneous) peripheral arterial interventions (PAIs) is still a matter of dispute, and clear evidence-based guidelines are lacking. To create those guidelines, a study group was formed in the Netherlands in cooperation with the Dutch Society of Vascular Surgery and the Society of Interventional Radiology. The study group is called 'Consensus on Arterial PeriProcedural Anticoagulation (CAPPA).' Materials and Methods: The CAPPA study group devised and distributed a comprehensive questionnaire amongst Dutch interventional radiologists (IRs). Results: One hundred forty-two IRs responded (68 %) to the questionnaire. Almost no IR stopped acetyl salicylic acid before interventions, and 40 % stopped clopidogrel before PAI but not before carotid artery stenting (CAS). A flushing solution on the sideport of the sheath was used routinely by 30 % of IRs in PAI and by 50 % of IRs during CAS. A minority of IRs used a heparinised flushing solution (28 %). Unfractionated heparin was used by 95 % of IRs as bolus; 5000 IU was the most used dosage. Timing of administration varied widely. A majority of IRs (75 %) repeated heparin administration after 1 h. Conclusion: A substantial variety exists amongst IRs in the Netherlands regarding the use of prophylactic periprocedural antithrombotic drugs to prevent arterial thrombosis during PAI. When compared with varying results regarding the use of heparin in the United Kingdom, the variety in the Netherlands showed a different pattern. The proven variety in these countries, and also between these countries, emphasises the need for authoritative studies to develop evidence-based practical guidelines.

  16. EU-CIS joint study project 2. Intervention criteria in CIS, risk assessments and non-radiological factors in decision-making

    Hedemann Jensen, P. [Risoe National Lab., Roskilde (Denmark); Demin, V.F. [Russian Reserch Centre `Kurchatov Inst.`, Moscow (Russian Federation); Konstantinov, Y.O. [Research Inst. of Radiation Hygiene, St. Petersburg (Russian Federation); Likhtarev, I.A. [Ukrainian Scientific Centre for Radiation Medicine, Kiev (Ukraine); Rolevich, I.V. [Chernobyl State Commiettee, Minsk (Belarus); Schneider, T. [Centre d`etudes sur l`Evaluation de la Protection dans le domaine Nucleaire, CEPN, Paris (France)


    An extensive radiation risk estimation methodology has recently been developed in Russia and used for estimates of risk in exposed populations in the republics of Russia, Belarus and Ukraine. Results based on demographic data for the three republics are presented and compared with risk estimates from the EU risk model ASQRAD. The intervention criteria in the CIS republics have been evolving since the Chernobyl accident. The development of criteria in each of the three republics has been analysed and the CIS-Criteria have been compared to international guidance on intervention. After a nuclear or radiological emergency both radiological and non-radiological protection factors will influence the level of protective actions being introduced. The role of non-radiological protection factors in the overall optimization of health protection is addressed. It is argued that optimization of the overall health protection is not a question of developing radiation radiation protection philosophy to fully include socio-psychological factors. It is rather a question of including these factors - in parallel with the radiological protection factors - in cooperation between radiation protection experts and psychological specialists under the responsibility of the decision maker. (au) 19 tabs., 10 ills., 45 refs.

  17. Effective dose estimates for cone beam computed tomography in interventional radiology

    Kwok, Y.M.; Irani, F.G.; Tay, K.H.; Yang, C.C.; Padre, C.G.; Tan, B.S. [Singapore General Hospital, Department of Diagnostic Radiology, Singapore (Singapore)


    To compare radiation doses in cone beam computed tomography (CBCT) with those of multi-detector computed tomography (MDCT) using manufacturers' standard protocols. Dose-levels in head and abdominal imaging were evaluated using a dosimetric phantom. Effective dose estimates were performed by placing thermoluminescent dosimeters in the phantom. Selected protocols for two CBCT systems and comparable protocols for one MDCT system were evaluated. Organ doses were measured and effective doses derived by applying the International Commission on Radiological Protection 2007 tissue weighting factors. Effective doses estimated for the head protocol were 4.4 and 5.4 mSv for the two CBCT systems respectively and 4.3 mSv for MDCT. Eye doses for one CBCT system and MDCT were comparable (173.6 and 148.4 mGy respectively) but significantly higher compared with the second CBCT (44.6 mGy). Two abdominal protocols were evaluated for each system; the effective doses estimated were 15.0 and 18.6 mSv, 25.4 and 37.0 mSv, and 9.8 and 13.5 mSv, respectively, for each of the CBCT and MDCT systems. The study demonstrated comparable dose-levels for CBCT and MDCT systems in head studies, but higher dose levels for CBCT in abdominal studies. There was a significant difference in eye doses observed between the CBCT systems. (orig.)

  18. The role of interventional radiology in the management of deep venous thrombosis: advanced therapy.

    O'Sullivan, Gerard J


    Deep vein thrombosis (DVT) is often managed with a health care pathway that funnels patients to anticoagulation therapy alone. This "usual treatment" is designed to stop propagation and embolisation of venous thrombus but not remove it. Surgical thrombectomy was once the only option in severe cases in which limbs were threatened, but thrombus removal is no longer restricted to emergency cases. Interventional radiologists are now using advanced endovascular techniques to achieve thrombus removal in a minimally invasive manner in a very short treatment time, thereby quickly restoring patency, relieving acute symptoms, and potentially limiting the subsequent development of postthrombotic syndrome when followed with anticoagulation and compression regimens. This article provides an overview of the interventions available for treating DVT. One of the newer "single-session" techniques is isolated pharmacomechanical thrombolysis, which is described here in detail with supporting cases.

  19. Clinical application on CT guiding interventional radiology technology%CT导引介人技术的临床应用

    何建华; 彭述文; 米霞


    Objective The Computer Tomography (CT) guiding interventional radiology technology already became an extremely adequate technology in the large-scale general hospital, which was brought in since 2008-2009 in our hospital, and it has carried out dozens of cases, we improved it into a new kind of technology suitable for our hospital after summing up and studying it. This technology should be extended for popular use among the primary hospitals. Methods TOSHIBA Activion 16 screw CT scanner was used with the puncture needle Cook19G.After skin lung puncture biopsy 12 cases, after skin kidney puncture 25 cases, after skin liver puncture 7 cases. Results Among 12 cases of lung puncture biopsy, 9 cases are periphery the lung cancer, 2 cases are the pulmonary tuberculoses, 1 cases is pneumonia change in sexuality. 32 cases livers, the kidney puncture biopsy is a cyst, after extracts the pouch fluid to involve the hardened treatment, biggest cyst 11 cm, smallest cyst approximately 6cm, the short-term reexamination cyst obviously reduces approximately, after half year of reexaminations, the cyst disappeared basically or completely. No serious complication occurred. Conclusion The CT guiding interventional radiology technology belongs to the interventional radiology technology category, its application scope is broad, involving the whole body various systems, becoming one of the important methods of clinical diagnosis and treatment domain with characteristics of high security, minimally invasive surgery and less complication, etc. It' s worth to be extended popularly in primary hospitals.%目的 归纳、总结并不断改进我院CT导引介入技术,形成适应本院的一种新技术.方法 使用TOSHIBA Activion 16螺旋CT扫描机.穿刺针为Cook19G.经皮肺穿刺活检12例,经皮肾穿刺25例,经皮肝穿刺7例.结果 12例肺穿刺活检,9例为周围型肺癌,2例为肺结核,1例为肺炎性变.32例肝、肾穿刺活检为囊肿,抽取囊液后介入

  20. Calculation of conversion factors for effective dose for various interventional radiology procedures

    Compagnone, Gaetano; Giampalma, Emanuela; Domenichelli, Sara; Renzulli, Matteo; Golfieri, Rita [Medical Physics Department, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna (Italy); Radiology Department, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna (Italy); Medical Physics Department, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna (Italy); Radiology Department, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna (Italy)


    Purpose: To provide dose-area-product (DAP) to effective dose (E) conversion factors for complete interventional procedures, based on in-the-field clinical measurements of DAP values and using tabulated E/DAP conversion factors for single projections available from the literature. Methods: Nine types of interventional procedures were performed on 84 patients with two angiographic systems. Different calibration curves (with and without patient table attenuation) were calculated for each DAP meter. Clinical and dosimetric parameters were recorded in-the-field for each projection and for all patients, and a conversion factor linking DAP and effective doses was derived for each complete procedure making use of published, Monte Carlo calculated conversion factors for single static projections. Results: Fluoroscopy time and DAP values for the lowest-dose procedure (biliary drainage) were approximately 3-fold and 13-fold lower, respectively, than those for the highest-dose examination (transjugular intrahepatic portosystemic shunt, TIPS). Median E/DAP conversion factors from 0.12 (abdominal percutaneous transluminal angioplasty) to 0.25 (Nephrostomy) mSvGy{sup -1} cm{sup -2} were obtained and good correlations between E and DAP were found for all procedures, with R{sup 2} coefficients ranging from 0.80 (abdominal angiography) to 0.99 (biliary stent insertion, Nephrostomy and TIPS). The DAP values obtained in this study showed general consistency with the values provided in the literature and median E values ranged from 4.0 mSv (biliary drainage) to 49.6 mSv (TIPS). Conclusions: Values of E/DAP conversion factors were derived for each procedure from a comprehensive analysis of projection and dosimetric data: they could provide a good evaluation for the stochastic effects. These results can be obtained by means of a close cooperation between different interventional professionals involved in patient care and dose optimization.

  1. Pictorial essay: Interventional radiology in the management of hemodialysis vascular access - A single-center experience

    Suraj Mammen


    Full Text Available Chronic kidney disease (CKD is a worldwide public health problem and is associated with high morbidity and mortality. The majority of patients with CKD stage 5 (CKD-5, who cannot undergo renal transplant, depend on maintenance hemodialysis by surgically created access sites. Native fistulae are preferred over grafts due to their longevity. More than half of these vital portals for dialysis access will fail over time. Screening procedures to select high-risk patients before thrombosis or stenosis appears have resulted in aggressive management. These patients are referred for angiographic evaluation and/or therapy. We present the patterns of dialysis-related interventions done in our institution.

  2. Management of patient and staff radiation dose in interventional radiology: current concepts.

    Bartal, Gabriel; Vano, Eliseo; Paulo, Graciano; Miller, Donald L


    The increasing complexity and numbers of interventional fluoroscopy procedures have led to increasing patient doses of radiation and to increasing concern over staff doses. Hybrid rooms incorporate multiple imaging modalities and are used by multidisciplinary teams in interventional fluoroscopy suites and operating theaters. These rooms present additional radiation protection challenges. The new low annual exposure limit for the lens of the eye also requires specific measures to prevent cataracts in operators. The traditional attitude of radiation protection must be changed to one of proactive management of radiation dose and image quality. Incorporation of a comprehensive dose management program into the departmental quality assurance program is now essential. Physicians, radiographers, and medical physicists play an essential role in the safe use of fluoroscopy in medical practice. Efficient use of all imaging modalities (e.g., fluoroscopy, digital subtraction angiography, cone-beam CT) requires knowledge of the effects of different equipment settings on patient and staff doses as well as the skill and competence to optimize these settings for each procedure and patient. Updates and recommendations on radiation protection and dose management programs, including aspects of education and training, are presented.

  3. 介入放射线诊疗设备应用及不良事件检测%Interventional radiological equipment application and adverse event detection

    芦静; 尹今扬; 胡良运


    目的:介绍介入放射学的设备、材料及其在临床中的应用,更好地掌握介入放射治疗的方法,减少介入放射治疗在临床应用中不良事件的发生。方法:介绍各种影像设备DSA、CT、MRI等的性能及使用方法以及介入放射线设备防护知识,分析产生介入治疗不良事件的原因,给出避免介入治疗不良事件的方案。结果:介入放射医生在介入放射线诊疗中增强了放射线设备防护意识,减少了不良事件的发生。结论:介入放射治疗应用中存在不良事件发生的潜在因素,会损害医生与患者的身体健康以及导致临床诊断事故,为此应做好防犯工作,使介入放射治疗工作得以顺利开展。%Objective:Application of interventional radiology equipment, through the introduction and materials in clinic,to better grasp the method of interventional radiotherapy and interventional radiology treatment,reduce adverse events in clinical application. Methods: Various imaging devices such as DSA, CT, MRI etc, imaging within the body structure, the size of the lesion and its relationship with the surrounding tissue by these devices can be very good;and the development of medical devices that need not operation, can accurately reach the lesion site for treatment. Results:At present, the interventional radiology doctors has to catheters or devices"interventional"vascular branches, the digestive tract and other specific parts, used in the treatment of disease. Conclusion:Interventional radiology is an emerging treatment method as the development of modern science and technology. Interventional also has some adverse events radiotherapy applications, will damage the doctor and the patient's health and the impact of clinical diagnosis and other accidents, so do the crime prevention work is very important, so as to carry out the interventional radiology treatment.

  4. WE-EF-BRD-04: MR in the OR: The Growth and Applications of MRI for Interventional Radiology and Surgery

    Fahrig, R. [Stanford University (United States)


    MRI-guided treatment is a growing area of medicine, particularly in radiotherapy and surgery. The exquisite soft tissue anatomic contrast offered by MRI, along with functional imaging, makes the use of MRI during therapeutic procedures very attractive. Challenging the utility of MRI in the therapy room are many issues including the physics of MRI and the impact on the environment and therapeutic instruments, the impact of the room and instruments on the MRI; safety, space, design and cost. In this session, the applications and challenges of MRI-guided treatment will be described. The session format is: Past, present and future: MRI-guided radiotherapy from 2005 to 2025: Jan Lagendijk Battling Maxwell’s equations: Physics challenges and solutions for hybrid MRI systems: Paul Keall I want it now!: Advances in MRI acquisition, reconstruction and the use of priors to enable fast anatomic and physiologic imaging to inform guidance and adaptation decisions: Yanle Hu MR in the OR: The growth and applications of MRI for interventional radiology and surgery: Rebecca Fahrig Learning Objectives: To understand the history and trajectory of MRI-guided radiotherapy To understand the challenges of integrating MR imaging systems with linear accelerators To understand the latest in fast MRI methods to enable the visualisation of anatomy and physiology on radiotherapy treatment timescales To understand the growing role and challenges of MRI for image-guided surgical procedures My disclosures are publicly available and updated at:

  5. Hospital organization and importance of an interventional radiology inpatient admitting service: Italian single-center 3-year experience.

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel; Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore


    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of 1,009,095.35 euros. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

  6. Changes in Occupational Radiation Exposures after Incorporation of a Real-time Dosimetry System in the Interventional Radiology Suite.

    Poudel, Sashi; Weir, Lori; Dowling, Dawn; Medich, David C


    A statistical pilot study was retrospectively performed to analyze potential changes in occupational radiation exposures to Interventional Radiology (IR) staff at Lawrence General Hospital after implementation of the i2 Active Radiation Dosimetry System (Unfors RaySafe Inc, 6045 Cochran Road Cleveland, OH 44139-3302). In this study, the monthly OSL dosimetry records obtained during the eight-month period prior to i2 implementation were normalized to the number of procedures performed during each month and statistically compared to the normalized dosimetry records obtained for the 8-mo period after i2 implementation. The resulting statistics included calculation of the mean and standard deviation of the dose equivalences per procedure and included appropriate hypothesis tests to assess for statistically valid differences between the pre and post i2 study periods. Hypothesis testing was performed on three groups of staff present during an IR procedure: The first group included all members of the IR staff, the second group consisted of the IR radiologists, and the third group consisted of the IR technician staff. After implementing the i2 active dosimetry system, participating members of the Lawrence General IR staff had a reduction in the average dose equivalence per procedure of 43.1% ± 16.7% (p = 0.04). Similarly, Lawrence General IR radiologists had a 65.8% ± 33.6% (p=0.01) reduction while the technologists had a 45.0% ± 14.4% (p=0.03) reduction.

  7. Cardiovascular and Interventional Radiological Society of Europe Guidelines on Endovascular Treatment in Aortoiliac Arterial Disease

    Rossi, Michele, E-mail: [Sant’Andrea University Hospital, Interventional Radiology Unit (Italy); Iezzi, Roberto, E-mail: [“Sacro Cuore” Catholic University, Radiology Department (Italy)


    PurposeThese guidelines are intended for use in assessing the standard for technical success and safety in aorto-iliac percutaneous endovascular interventions.MethodsAny recommendation contained in the text comes from the highest level and extension of literature review available to date.ResultsThe success of endovascular procedures is strictly related to an accurate planning based mainly on CT- or MR-angiography. TASC II A through C lesions have an endovascular-first option Pre-procedure ASA antiplatelet therapy is advisable in all cases. The application of stents improves the immediate hemodynamic and most likely long-term clinical results. Cumulative mean complication rate is 7.51 % according to the most relevant literature. Most of the complications can be managed by means of percutaneous techniques.ConclusionThe design and quality of devices, as well as the easy and accuracy of performing these procedures, have improved over the last decades, leading to the preferential treatment of aorto-iliac steno-obstructive disease via endovascular means, often as first-line therapy, with high technical success rate and low morbidity. This is mirrored by the decreasing number of patients undergoing surgical grafts over the last years with patency, limb salvage, and survival rates equivalent to open reconstruction.

  8. High potential for weathering and climate effects of non-vascular vegetation in the Late Ordovician

    Porada, P.; Lenton, T. M.; Pohl, A.; Weber, B.; Mander, L.; Donnadieu, Y.; Beer, C.; Pöschl, U.; Kleidon, A.


    It has been hypothesized that predecessors of today's bryophytes significantly increased global chemical weathering in the Late Ordovician, thus reducing atmospheric CO2 concentration and contributing to climate cooling and an interval of glaciations. Studies that try to quantify the enhancement of weathering by non-vascular vegetation, however, are usually limited to small areas and low numbers of species, which hampers extrapolating to the global scale and to past climatic conditions. Here we present a spatially explicit modelling approach to simulate global weathering by non-vascular vegetation in the Late Ordovician. We estimate a potential global weathering flux of 2.8 (km3 rock) yr-1, defined here as volume of primary minerals affected by chemical transformation. This is around three times larger than today's global chemical weathering flux. Moreover, we find that simulated weathering is highly sensitive to atmospheric CO2 concentration. This implies a strong negative feedback between weathering by non-vascular vegetation and Ordovician climate.

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

    Wadhwa, Vibhor, E-mail: [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States); Leeper, William R., E-mail: [Johns Hopkins University School of Medicine, Department of Surgery (United States); Tamrazi, Anobel, E-mail: [Johns Hopkins University School of Medicine, Division of Vascular & Interventional Radiology (United States)


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

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

    Klinken, Sven; Humphries, Charlotte; Ferguson, John


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

  11. Pilot study of the dose in crystalline lens in the interventional radiology practice; Estudio piloto de la dosis en cristalino en la practica de radiologia intervencionista

    Castro, A.; Martinez, A.; Fernandez, A.; Molina, D. [Centro de Proteccion e Higiene de las Radiaciones, Carretera de la Cantera, Victoria II, Km. 21.5 Guanabacoa, La Habana (Cuba); Sanchez, L.; Diaz, A., E-mail: [Hospital Clinico Quirurgico Hermanos Ameijeiras, San Lazaro 701, Centro Habana, La Habana (Cuba)


    The interventional radiology involves considerable exposure levels for the occupationally exposed personnel (OEP). The doses can encompass a wide range of values in dependence of the function that develops the personnel and the complexity of each procedure. In organs like the crystalline lens and skin values can be reached that imply the appearance of deterministic effects if is not fulfilled the appropriate measures of radiological protection. This has been demonstrated through multiple studies, among those that the retrospective study of damages in the crystalline lens and dose has been one of those most commented, known as RELID. The objective of that study was to examine the opacity prevalence in the crystalline lens in workers linked to the interventional cardiology and to correlate it with the occupational exposition. The obtained results contributed to that the ICRP recommend a new limit value of equivalent dose for crystalline lens of 20 mSv in one year. With the objective of analyzing the operational implications, in the radiological surveillance programs that they could originate with the new recommendations was developed a pilot study to evaluate the dose in crystalline lens in the OEP linked to the interventional radiology in a Cuban hospital. For this, an anthropomorphic mannequin RANDO-ALDERSON was used on which thermoluminescent dosimeters were placed below and above of the leaded apron and in different positions at level of the crystalline lens: above, below and to the sides of the leaded lenses that the personnel uses routinely. The mannequin was located on the same positions that occupy the main specialist that execute the procedure, as well as of the nurse to assist him. The measurements were made simulating the more representative procedures about complexity, duration time and exposure rate. The used dosimeters were RADOS model for whole body composed of two thermoluminescent detectors Gr-200 (LiF: Mg, Cu, P) to evaluate personal equivalent dose

  12. Radiological-guided liver-port implantation: evaluation, technical approach, interventional procedure and follow up; Radiologisch-interventionelle Leberportanlage: Evaluierung, Zugangswege, Intervention und Nachkontrolle

    Puls, R.; Stroszczynski, C. [Campus Virchow-Klinikum, Berlin (Germany). Klinik fuer Strahlenheilkunde; Abt. Roentgendiag., Robert-Roessle-Klinik, Campus Berlin-Buch (Germany); Hildebrandt, B.; Riess, H. [Med. Klinik Haematologie/Onkologie, Campus Virchow-Klinikum (Germany); Amthauer, H.; Podrabsky, P.; Hidajat, N. [Campus Virchow-Klinikum, Berlin (Germany). Klinik fuer Strahlenheilkunde; Schlag, P. [Klinik fuer Chirurgie/Onkologische Chirurgie, Robert-Roessle-Klinik, Campus Berlin-Buch (Germany); Humboldt-Universitaet, Berlin (Germany). Universitaetsklinikum Charite; Hosten, N. [Inst. fuer Diagnostische Radiologie und Neuroradiologie, Ernst-Moritz-Arndt-Univ. Greifswald (Germany)


    Purpose: Description of evaluation, technical approach, interventional procedure and follow up of radiological-guided liver-port implantation. Method: Percutaneous implantation of a liver-port system was performed in twelve patients through a transfemoral approach and in one patient via the superficial epigastric artery after surgical exploration. In four patients we used port systems which are accessible via ventral puncture. Strecker-port systems were implanted in the remaining nine patients. Results: The liver-port implantation was technically successful in all cases. No dislocation of the distal catheter tip, no thrombosis of the hepatic or splenic artery, no leakage near connections of the catheters or connections of catheter and port system and no thrombosis of the femoral arteries were observed. Correction of a kink in the catheter was performed in one patient. Another patient showed prolonged healing of the subcutaneous pocket. Conclusions: Interventional liver-port implantation is a safe procedure and leads to good clinical results. From the view of the radiologist the Strecker-system shows a good performance. The approach via the superficial epigastric artery demands excellent interdisciplinary cooperation. (orig.) [German] Zielstellung: Beschreibung der Evaluierung, Zugangswege, Intervention und Nachkontrolle bei der radiologisch-interventionellen Leberportanlage. Methode: Fuer die perkutane Implantation des Leberports wurden bei zwoelf Patienten die A. femoralis communis und bei einem Patienten die A. epigastrica superficialis nach chirurgischer Exploration als Zugangsweg gewaehlt. Bei vier Patienten wurde ein ventral zu punktierendes herkoemmliches Portkammersystem verwendet. Die uebrigen neun Patienten erhielten ein Strecker-Portsystem. Ergebnisse: Die Portanlage konnte bei allen Patienten technisch erfolgreich durchgefuehrt werden. Waehrend der Nachkontrollen wurden keine Dislokation der distalen Katheterspitze oder Thrombosierung der A. hepatica

  13. Radiological protection in the interventional techniques: experience in the Pain Clinic of the CIMEQ; Proteccion radiologica en las tecnicas intervencionistas: experiencia en la Clinica del Dolor del CIMEQ

    Guerrero C, M. C.; Benitez N, P. P.; Gonzalez G, Y. [Centro de Investigaciones Medico Quirurgicas, Av. 216 Esq. 11B, Playa Siboney, 6096 La Habana (Cuba); Martinez G, A.; Gonzalez R, N. [Centro de Proteccion e Higiene de las Radiaciones, Carretera de la Cantera, Victoria II, Km. 21.5 Guanabacoa, La Habana (Cuba); Sanchez Z, L. R., E-mail: [Hospital C. Q. Hermanos Ameijeiras, San Lazaro 701, Centro Habana, La Habana (Cuba)


    The Pain Clinic of the CIMEQ offers treatment to patients with different pathologies, using interventional techniques as the radiology like visual guide to reach the target structure and to apply the election technique. The personnel that carry out these procedures are inserted in the program of radiological surveillance of the institution, reason for which a radiological event could be detected where the main physician responsible of the service was implied. In this work the results of an investigation are presented realized with the objective of to know the causes of the event and to determine the necessary measures to avoid that this repeats again. The investigation was oriented to three fundamental aspects: medical exam of the affected worker; evaluation of the operational procedures from the radiological protection view point; and dosimetric measurements simulating the real conditions of work for which were used ionization chamber, radiometer and PMMA mannequin. As a result of the medical exam was detected that the main physician of the service did not use during the execution of all the procedures the extremities dosimetry and that he presented a radio induced erythema in the right hand, reason for which he was separated of the activity with ionizing radiations, until the conclusion of the investigation. With relationship to the evaluation of the operational procedures from the radiological protection view point, was verified that the medical physician not carried out any collimation of the beam and he was located in the positions where the dose rate reached the maximum values, frequently introducing the hands in the direct beam; that which implied an overexposure of the superior extremities and a not optimized exposure for whole body. This result was proven with the realized experimental measurements, which gave dose estimated values in extremities of the order of the deterministic effects. The investigation facilitated to introduce modifications in the

  14. Radiologic quality and safety: mapping value into radiology.

    Swensen, Stephen J; Johnson, C Daniel


    The authors have created a radiology quality map to help understand the opportunities for improvement in the radiologic safety, reliability, quality, and appropriateness of examinations and interventions. It entails 9 steps with dozens of specific opportunities for improving care to patients. The radiology profession has an obligation to robustly document and improve quality and safety in its practice.

  15. The ORAMED European project: optimization of the use of operational dosimeters in interventional radiology; Projet europeen oramed: optimisation de l'utilisation des dosimetres operationnels en radiologie interventionnelle

    Clairand, I.; Debroas, J.; Donadille, L.; Itie, C. [Institut de Radioprotection et de Surete Nucleaire, 92 - Fontenay aux Roses (France); Bordy, J.M.; Daures, J.; Denoziere, M. [CEA Saclay, LIST, Laboratoire National Henri Becquerel (LNE-LNHB), 91 - Gif-sur-Yvette (France); Ginjaume, M. [Institute of Energy Technology, Universitat Politecnica de Catalunya (UPC) (Spain); Koukorava, C. [Greek Atomic Energy Commission (GAEC) (Greece); Krim, S.; Lebacq, A.L.; Struelens, L.; Vanhavere, F. [Belgian Nuclear Research Centre (SCK.CEN) (Belgium); Martin, P. [MGP Intruments (MGPi) (France); Sans-Merce, M.; Tosic, M. [Institut Universitaire de Radiophysique Appliquee (IRA) (Switzerland)


    Within the frame of the ORAMED European project which concerns personnel radioprotection in the medical sector, the authors, members of a work group within this project, briefly report the study of the behaviour of some operational dosemeters which have been selected for their potential usability in interventional radiology. They indicate the required performance, evoke the performed tests, and discuss the results which revealed the limits of these dosimeters when used in interventional radiology

  16. Paediatric interventional radiology


    Jun 29, 2016 ... that most appropriately addresses their clinical needs.2. Biopsy ... occasionally required, such as in cases of rapidly involuting ... FIGURE 1: A 17-year-old male status post–bone marrow transplant requiring central intravenous ...

  17. Percutaneous arteriovenous shunting in patients with severe COPD. A new interventional radiological treatment; Perkutane arteriovenoese Shuntanlage bei Patienten mit schwerer COPD. Eine neue interventionelle radiologische Technik

    Schlosser, Thomas; Forsting, M. [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Burbelko, M. [Marburg Univ. (Germany). Klinik fuer Strahlendiagnostik; Ulrich, M. [Parkkrankenhaus Leipzig (Germany). Klinik fuer Innere Medizin/Angiologie/Kardiologie; Ludwig, F.; Reutiman, T. [ROX Medical, San Clemente, CA (United States); Antoch, G. [Universitaetsklinikum Duesseldorf (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Adamus, R. [Klinikum Nuernberg Nord (Germany). Inst. fuer Radiologie


    Purpose: The aim of this study was to evaluate the technical feasibility and safety of a new interventional radiological technique to create a shunt percutanously between the external iliac vein and artery in patients with severe COPD. Materials and Methods: 40 patients were included in this multicenter trial. In 38 patients the artery was punctured from the vein using a novel crossing needle. A special delivery system was used to implant a novel nitinol device (ACS, ROX Medical) between the artery and the vein to maintain a 4 mm calibrated and structured fistula between the two vessels. Results: Shunt implantation was successful in 38 patients. The perfused arteriovenous shunts could be well documented in DSA and the diameter was measured between 3 and 4 mm in all cases. Peri-interventional non-flow-limiting dissection of the iliac artery occurred in one patient. Post-interventional venous bleeding in two patients was treated successfully by local compression. In one patient a peripheral artery thrombembolism was successfully treated by thrombolysis. Conclusion: The new interventional radiological technique to create an arteriovenous shunt in the iliac vessels presented in this study has proven to be feasible and safe. (orig.)

  18. High potential for weathering and climate effects of non-vascular vegetation in the Late Ordovician

    Porada, Philipp; Lenton, Tim; Pohl, Alexandre; Weber, Bettina; Mander, Luke; Donnadieu, Yannick; Beer, Christian; Pöschl, Ulrich; Kleidon, Axel


    Early non-vascular vegetation in the Late Ordovician may have strongly increased chemical weathering rates of surface rocks at the global scale. This could have led to a drawdown of atmospheric CO2 and, consequently, a decrease in global temperature and an interval of glaciations. Under current climatic conditions, usually field or laboratory experiments are used to quantify enhancement of chemical weathering rates by non-vascular vegetation. However, these experiments are constrained to a small spatial scale and a limited number of species. This complicates the extrapolation to the global scale, even more so for the geological past, where physiological properties of non-vascular vegetation may have differed from current species. Here we present a spatially explicit modelling approach to simulate large-scale chemical weathering by non-vascular vegetation in the Late Ordovician. For this purpose, we use a process-based model of lichens and bryophytes, since these organisms are probably the closest living analogue to Late Ordovician vegetation. The model explicitly represents multiple physiological strategies, which enables the simulated vegetation to adapt to Ordovician climatic conditions. We estimate productivity of Ordovician vegetation with the model, and relate it to chemical weathering by assuming that the organisms dissolve rocks to extract phosphorus for the production of new biomass. Thereby we account for limits on weathering due to reduced supply of unweathered rock material in shallow regions, as well as decreased transport capacity of runoff for dissolved weathered material in dry areas. We simulate a potential global weathering flux of 2.8 km3 (rock) per year, which we define as volume of primary minerals affected by chemical transformation. Our estimate is around 3 times larger than today's global chemical weathering flux. Furthermore, chemical weathering rates simulated by our model are highly sensitive to atmospheric CO2 concentration, which implies

  19. The development of Operational Intervention Levels (OILs) for Soils - A decision support tool in nuclear and radiological emergency response

    Lee Zhi Yi, Amelia; Dercon, Gerd; Blackburn, Carl; Kheng, Heng Lee


    In the event of a large-scale nuclear accident, the swift implementation of response actions is imperative. For food and agriculture, it is important to restrict contaminated food from being produced or gathered, and to put in place systems to prevent contaminated produce from entering the food chain. Emergency tools and response protocols exist to assist food control and health authorities but they tend to focus on radioactivity concentrations in food products as a means of restricting the distribution and sale of contaminated produce. Few, if any, emergency tools or protocols focus on the food production environment, for example radioactivity concentrations in soils. Here we present the Operational Intervention Levels for Soils (OIL for Soils) concept, an optimization tool developed at the IAEA to facilitate agricultural decision making and to improve nuclear emergency preparedness and response capabilities. Effective intervention relies on the prompt availability of radioactivity concentration data and the ability to implement countermeasures. Sampling in food and agriculture can be demanding because it may involve large areas and many sample types. In addition, there are finite resources available in terms of manpower and laboratory support. Consequently, there is a risk that timely decision making will be hindered and food safety compromised due to time taken to sample and analyse produce. However, the OILs for Soils concept developed based on experience in Japan can help in this situation and greatly assist authorities responsible for agricultural production. OILs for Soils - pre-determined reference levels of air dose rates linked to radionuclide concentrations in soils - can be used to trigger response actions particularly important for agricultural and food protection. Key considerations in the development of the OILs for Soils are: (1) establishing a pragmatic sampling approach to prioritize and optimize available resources and data requirements for

  20. Analysis of dose to crystalline in Interventional radiology: a purpose of one case; Analisis de dosis a cristalino en Radiologia intervencionista: a proposito de un caso

    Carrera M, F.; Moreno R, F.; Velazquez M, F.; Manzano M, F.J.; Moreno S, T. [Hospital `Juan Ramon Jimenez` Ronda Norte s/n 21005. Huelva, Espana (Spain)


    The present work shows the dose values to crystalline for the personnel which works in interventional radiology procedures. It was took data of 436 studies with a total of 2,133.4 minutes in fluoroscopy and 19,563 images. It was showed dose values to crystalline in three situations: without blinding, with blinding of 0.25 and 0.50 mm Pb and by type of study: fluoroscopy, graphie and total. The dose means and ranges to patient for each of these studies also are detailed. (Author)

  1. M{sup 2}IRAGE: Management of measurements during radiological interventions geographically assisted in the environment; M{sup 2}IRAGE management des mesures dans le cadre d'interventions radiologiques assistees geographiquement dans l'environnement

    Gerphagnon, O. [SDIS, Service NRBC, 91 - Evry (France); Roche, H.; Lelache, H.; Guelin, M.; Fauquant, J.M. [CEA Saclay, Service de Protection contre les Rayonnements - SPR, 91 - Gif-sur-Yvette (France); Kacenelen, Y. [SDIS, Service C and IG, 91 (France); Armand, Y. [SDIS, SPV Expert Risques Technologiques, 91 (France)


    This report presents the M{sup 2}IRAGE software, a data processing tool designed to share radioactivity measurements and to give a schematised view of a radiological situation and of its evolution, while respecting different legal frameworks, notably the obligation to produce a radiological measurement programme. After a simplified recall of the crisis management organisation, the authors describe the M{sup 2}IRAGE software and hardware architecture, the functions of its main modules (presentation of radioprotection information during field intervention, field mission management, data browsing, and data transmission to field teams). While giving some display examples, the authors describe how an event is managed and processed by this tool: event creation, measurement acquisition, aid to decision, team management. They report and discuss the results of a national exercise which took place in September 2009 in Saclay with a prototype version of M{sup 2}IRAGE

  2. S3 Guideline. Diagnosis and treatment of colorectal carcinoma. Relevance for radiologic imaging and interventions; Aktualisierte S3-Leitlinie zur Diagnostik und Therapie des kolorektalen Karzinoms. Bedeutung fuer die radiologische Diagnostik und Intervention

    Vogl, T.J.; Fischer, S. [Universitaetsklinikum Frankfurt (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Schmiegel, W.; Pox, C. [Bochum Univ. (Germany). Medizinische Universitaetsklinik; Pereira, P.L. [SLK Kliniken, Heilbronn (Germany). Klinik fuer Radiologie, Minimal-Invasive Therapien und Nuklearmedizin; Brambs, H.J. [Universitaetsklinikum Ulm (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Lux, P. [Universitaetsklinikum Erlangen (Germany). Chirurgische Klinik


    The new German S3 guideline 'Colorectal Carcinoma' was created as part of the German Guideline Program in Oncology of the Association of the Scientific Medical Societies in Germany, the German Cancer Society and the German Cancer Aid under the auspices of the German Society for Digestive and Metabolic Diseases and replaces the guideline from 2008. With its evidence-based treatment recommendations, the guideline contains numerous updates and detailed definitions regarding the diagnosis and treatment of colon and rectal cancer. In particular, consensus-based recommendations regarding early detection, preoperative diagnostic method selection, and the use of interventional radiological treatment methods are detailed. The guideline also includes quality indicators so that standardized quality assurance methods can be used to optimize patient-related processes. The present article discusses the significance of the current recommendations for radiological diagnosis and treatment and is intended to enhance the quality of patient information and care by increasing distribution. (orig.)

  3. A feasibility inquiry on the radiodermatitis secondary to an interventional radiology act;Une enquete de faisabilite sur les radiodermites secondaires a un geste de radiologie interventionnelle

    Roudier, C.; Pirard, Ph.; Donadieu, J. [Institut de veille sanitaire, Saint-Maurice (France)


    The radiodermatitis is a burning of skin tissue and subcutaneous tissue in relation with ionizing radiation. In the medical practice, outside radiotherapy excluded of our study, it is observed only with acts of interventional radiology. The consequences of a radiodermatitis can be aesthetic, with appearance of a scar or a definitive alopecia, functional with loss of substance needing sometimes a remedial surgical act and finally oncologic with a risk of localised skin cancer. A radiodermatitis can appear with a radiation dose of 2 grays and its intensity worsens with the dose. Since the late 1970's about 200 cases of radiodermatitis have been reported. the most of cases have been reported between 1993 and 2000 and less than ten cases have been reported since 2000, suggesting a possible reduction of incidence explainable by a concomitant improvement of technological quality of the equipment. In order to confirm this eventual trend az feasibility study has been organised and is reported in this article. Given the results, this complication is still existing. In spite of the small number of observed cases, it is to notice that every procedures of interventional radiology are concerned. The preliminary character of this study encourages the institute of Health surveillance to work on the elaboration of a program of radiodermatitis surveillance. It could be associated to actions of improvement of the prevention and follow-up of patients, of feedback, and making easy an optimization of the practices. (N.C.)

  4. [Controlling instruments in radiology].

    Maurer, M


    Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.

  5. Radiological English

    Ribes, R. [Hospital Reina Sofia, Cordoba (Spain). Servicio de Radiologia; Ros, P.R. [Harvard Medical School, Boston, MA (United States). Div. of Radiology


    The book is an introductory book to radiological English on the basis that there are a lot of radiologists, radiology residents, radiology nurses, radiology students, and radiographers worldwide whose English level is indeterminate because their reading skills are much higher than their fluency. It is intended to help those health care professionals who need English for their work but do not speak English on a day-to-day basis. (orig.)

  6. Development of a Method for Evaluating the Existing Patient Radiation Protection Protocols in Interventional Radiology Unit of University-Affiliated Hospitals in Isfahan

    Parvaneh Shokrani


    Full Text Available Since the late 1960s, the use of interventional procedures utilizing radiology in medicine has increased significantly and continues to grow. There are also possible longer-term effects for surviving patients-mainly induction of cancers. The International Commission on Radiological Protection considers that there is no dose below which there is zero risk and therefore, minimizing the risk by confining the irradiation field and constraining the dose is highly desirable. There are a lot of national and international organs that work regarding radiation protection. These organs suggest a lot of code for patient radiation protection based on research and evidence. Per-sonnel dose monitoring is performed by the radiation safety officer but radiation protection of the patient is the responsibility of the physician and medical physicist. The aim of this research was the evaluation of patient radiation protection protocols in university hospitals in the city of Isfahan with respect to international protocols."nThis investigation was done in two interventional radiology units of Isfahan university-affiliated hospitals. The following international protocols related to patient protection were used as the standard protocols AAPM Report NO. 70, ICRP Publication 85, and IAEA SAFETY GUIDE No. RS-G-1.5. The recommendations of these protocols were ranked and classified into 3 questionnaires. These questionnaires included recommendations about factors that affect the dose to patients, factors that affect staff doses, and procurement. These questionnaires were used to evaluate the patient radiation protection protocols currently used in Isfahan university hospitals against the above international protocols. In this investigation, we used letter 'A' and 'B' for description of the two hospitals. "nFor interventional radiology units the following agreements and disagreements were observed when the local protocols were compared to the international

  7. Relative frequencies of interventional radiology procedures. Type of procedure, modality, dose, patient's gender and age. Final report; Erfassung der relativen Haeufigkeiten verschiedener Massnahmen in der interventionellen Radiologie. Art der Untersuchung, Modalitaet, Dosis, Geschlecht und Alter der Patienten fuer den stationaeren und ambulanten Bereich. Abschlussbericht

    Heuser, Lothar; Bode-Schnurbus, Lucas [Bochum Univ. Klinikum (Germany). Inst. fuer Diagnostische Radiologie, Interventionelle Radiologie, Neuroradiologie und Nuklearmedizin


    The assessment of the relative frequencies of interventional radiology procedures in Germany includes the following chapters: (1) Introduction and scope. (2) Radiological interventions: diagnostics, pain therapy, liver and kidneys, vascular re-opening and extending measures, devascularization, special neuroradiologic therapies. (3) History of AGIR (workgroup vascular diseases and interventional radiology). (4) Software development. (5) Data pool. (6) Categorization of institutes. (7) Statistics: patients data; radiation protection relevant data; CT guided intervention, MR-guided interventions; ultrasound-guided interventions; process quality; retrospective analysis (2000-2003).

  8. Radiology fundamentals

    Singh, Harjit


    ""Radiology Fundamentals"" is a concise introduction to the dynamic field of radiology for medical students, non-radiology house staff, physician assistants, nurse practitioners, radiology assistants, and other allied health professionals. The goal of the book is to provide readers with general examples and brief discussions of basic radiographic principles and to serve as a curriculum guide, supplementing a radiology education and providing a solid foundation for further learning. Introductory chapters provide readers with the fundamental scientific concepts underlying the medical use of imag

  9. Occupational exposure to the whole body, extremities and to the eye lens in interventional radiology in Poland, as based on personnel dosimetry records at IFJ PAN

    Szumska, Agnieszka; Budzanowski, M.; Kopeć, R.


    We report results of measurements of Hp(10) from whole body dosimeters (about 53 thousand readouts), of Hp(0.07) from finger ring dosimeters (23 thousand readouts) and of Hp(3) from eye lens dosimeters (100 readouts), issued in the years 2010-12 to over 150 medical departments in Poland which apply X-rays in radiology, interventional radiology (haemodynamic, angiology, cardiac surgery), urology, orthopaedics, electrophysiology or electro-cardiology. In all measurements thermoluminescence detectors (TLD) were used: the well-known standard MTS-N (LiF:Mg, Ti) for whole body and extremity dosimetry, and the high-sensitivity MCP-N (LiF:Mg, Cu, P) for eye lens dosimetry and environmental monitoring. We analysed the data base of the accredited Laboratory of Individual and Environmental Dosimetry (LADIS) at the Institute of Nuclear Physics PAN which offers its dosimetry service to these departments on a regular basis. We found that in the population of radiation workers that studied over the years 2010-2012 in 84%, 87%, and 34% of Hp(10), Hp(0.07) and Hp(3) measurements, respectively, the level of 0.1 mSv/quarter did not exceed, indicating lack of their occupational exposure. In the remaining 16%, 13% and 66% of individual cases, the 0.1 mSv/quarter exceeded, occasionally reaching several hundreds of mSv/quarter.

  10. Radiology illustrated. Pediatric radiology

    Kim, In-One (ed.) [Seoul National Univ. College of Medicine (Korea, Republic of). Dept. of Radiology


    Depicts characteristic imaging findings of common and uncommon diseases in the pediatric age group. Will serve as an ideal diagnostic reference in daily practice. Offers an excellent teaching aid, with numerous high-quality illustrations. This case-based atlas presents images depicting the findings typically observed when imaging a variety of common and uncommon diseases in the pediatric age group. The cases are organized according to anatomic region, covering disorders of the brain, spinal cord, head and neck, chest, cardiovascular system, gastrointestinal system, genitourinary system, and musculoskeletal system. Cases are presented in a form resembling teaching files, and the images are accompanied by concise informative text. The goal is to provide a diagnostic reference suitable for use in daily routine by both practicing radiologists and radiology residents or fellows. The atlas will also serve as a teaching aide and a study resource, and will offer pediatricians and surgeons guidance on the clinical applications of pediatric imaging.

  11. Proposed method to calculate FRMAC intervention levels for the assessment of radiologically contaminated food and comparison of the proposed method to the U.S. FDA's method to calculate derived intervention levels

    Kraus, Terrence D.; Hunt, Brian D.


    This report reviews the method recommended by the U.S. Food and Drug Administration for calculating Derived Intervention Levels (DILs) and identifies potential improvements to the DIL calculation method to support more accurate ingestion pathway analyses and protective action decisions. Further, this report proposes an alternate method for use by the Federal Emergency Radiological Assessment Center (FRMAC) to calculate FRMAC Intervention Levels (FILs). The default approach of the FRMAC during an emergency response is to use the FDA recommended methods. However, FRMAC recommends implementing the FIL method because we believe it to be more technically accurate. FRMAC will only implement the FIL method when approved by the FDA representative on the Federal Advisory Team for Environment, Food, and Health.

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

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


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

  13. Imaging recommendations for acute stroke and transient ischemic attack patients: a joint statement by the American Society of Neuroradiology, the American College of Radiology and the Society of NeuroInterventional Surgery.

    Wintermark, Max; Sanelli, Pina C; Albers, Gregory W; Bello, Jacqueline A; Derdeyn, Colin P; Hetts, Steven W; Johnson, Michele H; Kidwell, Chelsea S; Lev, Michael H; Liebeskind, David S; Rowley, Howard A; Schaefer, Pamela W; Sunshine, Jeffrey L; Zaharchuk, Greg; Meltzer, Carolyn C


    In the article entitled "Imaging Recommendations for Acute Stroke and Transient Ischemic Attack Patients: A Joint Statement by the American Society of Neuroradiology, the American College of Radiology and the Society of NeuroInterventional Surgery", we are proposing a simple, pragmatic approach that will allow the reader to develop an optimal imaging algorithm for stroke patients at their institution.

  14. Role of Interventional Radiology in the Management of Chylothorax: A Review of the Current Management of High Output Chylothorax

    Lyon, Stuart, E-mail:; Mott, Nigel, E-mail:; Koukounaras, Jim; Shoobridge, Jen [Alfred Hospital, Department of Radiology (Australia); Hudson, Patricio Vargas [Clinica Alemana, Department of Radiology (Chile)


    Chylothorax is an uncommon type of pleural effusion whose etiology may be classified as traumatic or nontraumatic. Low-output chylothoraces usually respond well to conservative management, whereas high-output chylothoraces are more likely to require surgical or interventional treatment. Conservative management focuses on alleviation of symptoms, replacement of fluid and nutrient losses, and reduction of chyle output to facilitate spontaneous healing. Surgical management can be technically difficult due to the high incidence of variant anatomy and the high-risk patient population. Percutaneous treatments have rapidly developed and evolved during the past 14 years to represent a minimally invasive treatment compared with the more invasive nature of surgery. Percutaneous therapies provide a range of treatment options despite difficult or variant anatomy, with a reported high success rate coupled with low morbidity and mortality. This article is a review of etiology, diagnosis, and treatment of chylothorax, with a focus on interventional management techniques.

  15. ERRAPRI Project: estimation of radiation risk to patients in interventional radiology, initial results and proposed levels of complexity; Proyecto ERRAPRI: estimacion del riesgo radiologico a los pacientes en radiologia intervencionista. Primeros resultados y propuestas de indices de complejidad

    Ruiz Cruces, R.; Vano, E.; Hernandez-Armas, J.; Carrera, F.; Diaz, F.; Gallego Beuther, J. F.; Ruiz Munoz-Canela, J. P.; Sanchez Casanueva, R.; Perez Martinez, M.; Fernandez Soto, J. M.; Munoz, V.; Moreno, F.; Moreno, C.; Martin-Palanca, A.


    The project ERRAPRI (2009 - 2012) will assess the most relevant aspects of the radiological risk associated with interventional radiology techniques (IR) guided by fluoroscopy in a sample of Spanish hospitals of three autonomous regions. Specific objectives include: assessing procedural protocols, especially the parameters related to radiation dose and diagnostic information obtained to establish balances cost (radiation risk) benefit to the procedures evaluated, and propose an index of complex procedures on several levels, based on the difficulty of making the same, assessing its relationship with the radiation dose values.

  16. Status of radiation protection in interventional radiology. Assessment of inspections in 2009 by the ASN; Etat de la radioprotection en radiologie interventionnelle. Bilan des inspections 2009 par l'ASN



    This report first describes the organization of inspections performed in health institutions, indicates the inspected establishments, the types of fixed installations in interventional radiology, the use of imagery in the operating theatre, and discusses the regulatory arrangements applicable to interventional radiology (in the Public Health Code, in the Labour Code). Then, the report discusses the results of inspections regarding radiation protection in interventional radiology: application of public health code arrangements (justification, patient training in radiation protection, radiological procedures and protocols, patient dosimetry monitoring), application of Labour Code arrangements (designation of the person with expertise in radiation protection, risk assessment and delimitation of monitored and controlled areas, workstation analysis, workers' training in radiation protection, individual protection equipment, workers' dosimetric monitoring, workers' medical monitoring, radiation protection technical controls), significant events, radiation protection in operating theatre. Propositions are stated regarding the differences noticed within or between the health establishments, the methodological and organisational difficulties faced by persons with expertise in radiation protection (PCR), the need of an interdisciplinary team

  17. The role of interventional radiology in the management of kidney transplant complications; Ruolo della radiologia interventistica nel trattamento delle complicanze del trapianto renale

    Carrafiello, Gianpaolo; Lagana, Domenico; Mangini, Monica; Cafaro, Tamara; Recaldini, Chiara; Genovese, Eugenio; Fugazzola, Carlo [Insubria Univ., Varese (Italy). Cattedra di radiologia; Cuffari, Salvatore [Ospedale di circolo, Varese (Italy). Servizio di anestesia e rianimazione


    Purpose. To evaluate the role and the effectiveness of interventional radiology in the treatment of renal transplant complications. Materials and methods. From 1996 to 2004 a total of 288 kidney transplants from cadavers were performed in our Institute. The kidney was always collocated in iliac fossa by creating a vascular anastomosis with the external iliac artery and vein; in all cases the ureter was implanted into the recipient bladder. During the follow-up, 34 complications were observed. Twenty-seven complications in 25 patients (20 males and 5 females; age 35-65 years) were treated by a radiologic procedure: 9 renal artery stenosis and 1 native external iliac artery stenosis (by PTA), 5 ureteral obstructions (by nephrostomy and ureteral stenting), 8 ureteral leaks (by nephrostomy, in 2 cases associated to ureteral stenting) and 4 limphoceles (by percutaneous ultrasound-guided catheter drainage). Results. Primary technical success was obtained in 20/27 cases (74%). Success was obtained with a second interventional procedure in 3/27 cases, 2 limphoceles and 1 ureteral fistula (secondary technical success: 85.2%), with a clinical final success in 23/27 cases (85.2%). We observed a peri-procedural complication rate of 3.7% (1 renal artery post-PTA dissection during a restenosis treatment). Four cases (1 renal arterial post-PTA dissection, 1 ureteral obstructions, 1 ureteral leak and llimphocele) needed a surgical correction (14.8%). Conclusions. Interventional radiology is the first therapeutic approach to treat renal transplant complications. It shows good technical and clinical results and a low complication rate. Surgery had to be considered only if minimally invasive procedures are infeasible or ineffective. [Italian] Scopo. Valutare l'efficacia delle procedure di radiologia interventistica nel trattamento delle complicanze del trapianto renale. Materiale e metodi. Dal 1996 al 2004 sono stati eseguiti, presso il nostro centro 288 trapianti renali da

  18. Radiation protection of patients in diagnostic and interventional radiology in Asian countries: Impact of an IAEA project

    Rehani, Madan M., E-mail: [International Atomic Energy Agency (IAEA), Vienna International Centre, P.O. Box 100, Vienna (Austria); Ciraj-Bjelac, Olivera, E-mail: [University of Belgrade, Vinca Institute of Nuclear Sciences, Radiation Protection Department, Mike Petrovica Alasa 12-14, P.O. Box 522, 11001 Belgrade (Serbia); Al-Naemi, Huda M., E-mail: [Hamad Medical Corp, Occupational Health and Safety, P.O. Box 1725, Doha (Qatar); Al-Suwaidi, Jamila Salem, E-mail: [Dubai Hospital, Dubai (United Arab Emirates); El-Nachef, Leila, E-mail: [Lebanon Atomic Energy Commission (Lebanon); Khosravi, Hamid Reza, E-mail: [National Radiation Protection Department, Iranian Nuclear Regulatory Authority, Tehran (Iran, Islamic Republic of); Kharita, Mohammad Hassan, E-mail: [Atomic Energy Commission of Syria, Damascus (Syrian Arab Republic); Muthuvelu, Pirunthavany, E-mail: [Ministry of Health Malaysia, Putrajaya Wilayah Persekutuan (Malaysia); Pallewatte, Aruna S., E-mail: [Lady Ridgeway Hospital for Children, Dr Danister de Silva Mawatha, Colombo (Sri Lanka); Juan, Bayani Cruz San, E-mail: [Center for Device Regulation, Radiation Health, and Research Department of Health, Manila (Philippines); Shaaban, Mohamed, E-mail: [Al-Sabah Hospital (Kuwait); Zaman, Areesha, E-mail: [Institute of Nuclear Medicine and Oncology, PAEC, Lahore (Pakistan)


    Recognizing the lack of information on image quality and patient doses in most countries in Asia, the International Atomic Energy Agency (IAEA) initiated a project to assess the status of imaging technology, practice in conventional radiography, mammography, computed tomography (CT) and interventional procedures, and to implement optimisation actions. A total of 20 countries participated. Obsolete practices of use of fluoroscopy for positioning, photofluorography, chest fluoroscopy and conventional tomography were reported by 4 out of 7 countries that provided this information. Low-kV technique for chest radiography is in use in participating countries for 20–85% of cases, and manual processing is in 5–85% of facilities in 5 countries. Instances of the use of adult CT protocol for children in three participating countries were observed in 10–40% of hospitals surveyed. After implementation of a Quality Control programme, the image quality in conventional radiography improved by zero to 13 percentage points in certain countries and dose reduction was from 10% to 85%. In mammography, poor quality, ranging from 10 to 29% of images in different countries was observed. The project increased attention to dose quantities and dose levels in computed tomography, although doses in most cases were not higher than reference levels. In this study 16–19% of patients in interventional cardiology received doses that have potential for either stochastic risk or tissue reaction. This multi-national study is the first of its kind in the Asia, and it provided insight into the situation and opportunities for improvement.

  19. 介入神经放射技术规范化刍议%Stardard recommendation for neurological intervention radiology



    @@ 介入神经放射学(interventional neuroradiology)技术在广东省开展已有10多年了.改革开放给我省带来了繁荣进步,也给介入神经放射学带来了蓬勃发展的春天.由于先进医疗设备的大量引进,高素质人材的涌入,以及人民生活水平的提高,对高新技术的渴求和较强的支付能力,都使我省这一新学科新技术的发展在国内占据了先进地位,为国内同道们所瞩目!

  20. Impact on Patient Safety and Satisfaction of Implementation of an Outpatient Clinic in Interventional Radiology (IPSIPOLI-Study): A Quasi-Experimental Prospective Study

    Lutjeboer, Jacob, E-mail:; Burgmans, Mark Christiaan, E-mail:, E-mail:; Chung, Kaman, E-mail:; Erkel, Arian Robert van, E-mail: [Leiden University Medical Center, Department of Radiology (Netherlands)


    PurposeInterventional radiology (IR) procedures are associated with high rates of preparation and planning errors. In many centers, pre-procedural consultation and screening of patients is performed by referring physicians. Interventional radiologists have better knowledge about procedure details and risks, but often only get acquainted with the patient in the procedure room. We hypothesized that patient safety (PS) and patient satisfaction (PSAT) in elective IR procedures would improve by implementation of a pre-procedural visit to an outpatient IR clinic.Material and MethodsIRB approval was obtained and informed consent was waived. PS and PSAT were measured in patients undergoing elective IR procedures before (control group; n = 110) and after (experimental group; n = 110) implementation of an outpatient IR clinic. PS was measured as the number of process deviations. PSAT was assessed using a questionnaire measuring Likert scores of three dimensions: interpersonal care aspects, information/communication, and patient participation. Differences in PS and PSAT between the two groups were compared using an independent t test.ResultsThe average number of process deviations per patient was 0.39 in the control group compared to 0.06 in the experimental group (p < 0.001). In 9.1 % patients in the control group, no legal informed consent was obtained compared to 0 % in the experimental group. The mean overall Likert score was significantly higher in the experimental group compared to the control group: 2.68 (SD 0.314) versus 2.48 (SD 0.381) (p < 0.001).ConclusionPS and PSAT improve significantly if patients receive consultation and screening in an IR outpatient clinic prior to elective IR procedures.

  1. The Future of Radiology

    Alexander R. Margulis


    Full Text Available It has been my good fortune to live and practice radiology during a long period of momentous change – to see the transformation of the discipline from a supportive service into a mainstream, essential branch of clinical medicine. I remember wearing red goggles to adapt my vision before performing fluoroscopy; observing the horrible, now thankfully obsolete, practice of ventriculography, which was considered advanced neuroradiology; and performing other, now rarely prescribed procedures, such as double-contrast barium enemas and intravenous pyelography. Witnessing the beginnings of interventional radiology, I suggested its name in an editorial. I also had the good fortune to see the introduction of computed tomography (CT and a technology first known as nuclear magnetic resonance imaging. Together with fellow members of a committee of the American College of Radiology and editors of prestigious radiological journals, I took part in changing the name of the latter modality to MRI, freeing it from threatening implications. Looking back on these experiences, one lesson stands out above all: Innovation and transformation never cease. Looking forward, it is clear that radiology, along with the rest of medicine, is now undergoing further momentous changes that will affect the future of all those already practicing as well as those yet to start their careers.

  2. Web-based platform for patient dose surveys in diagnostic and interventional radiology in Bulgaria: Functionality testing and optimisation.

    Simeonov, F; Palov, N; Ivanova, D; Kostova-Lefterova, D; Georgiev, E; Zagorska, A; Madzharova, R; Vassileva, J


    In the period 2013-2016 the National Centre of Radiobiology and Radiation Protection (NCRRP) at the Ministry of Health of Bulgaria has developed a web based platform for performing national patient dose surveys and establishing Diagnostic Reference Levels (DRLs). It is accessible via internet browser, allowing the users to submit data remotely. Electronic questionnaires, specific for radiography, fluoroscopy, image guided interventional procedures, mammography and CT, were provided. Short and clear manuals were added to guide users and minimise human errors. The web-based data collection platform is functional and is currently being used for performing the third national dose survey in Bulgaria, launched in 2016. Data analysis is facilitated due to the standardisation of collected data and their storing. Using the platform, the participating facilities can establish their typical dose levels based on the median value, and compare them to DRLs. A disadvantage of the platform is the need to enter data manually, but it is opened for future upgrades for automatic data harvesting and analysis. Various practical approaches were used to overcome the lack of qualified human resources and insufficient understanding of the DRL and dose tracking concept and to motivate facilities to submit data. Copyright © 2017. Published by Elsevier Ltd.

  3. Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System.

    Cazzato, Roberto Luigi; Garnon, Julien; Ramamurthy, Nitin; Tsoumakidou, Georgia; Caudrelier, Jean; Thénint, Marie-Aude; Rao, Pramod; Koch, Guillaume; Gangi, Afshin


    To describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures. Between May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioning a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications. Mean FB size was 23 mm (range 8-74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications. Percutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.

  4. Availability of on-site acute vascular interventional radiology techniques performed by trained acute care specialists: A single–emergency center experience

    Tsurukiri, Junya; Ohta, Shoichi; Mishima, Shiro; Homma, Hiroshi; Okumura, Eitaro; Akamine, Itsuro; Ueno, Masahito; Oda, Jun; Yukioka, Tetsuo


    INTRODUCTION Comprehensive treatment of a patient in acute medicine and surgery requires the use of both surgical techniques and other treatment methods. Recently, acute vascular interventional radiology techniques (AVIRTs) have become increasingly popular, enabling adequately trained in-house experts to improve the quality of on-site care. METHODS After obtaining approval from our institutional ethics committee, we conducted a retrospective study of AVIRT procedures performed by acute care specialists trained in acute medicine and surgery over a 1-year period, including those conducted out of hours. Trained acute care specialists were required to be certified by the Japanese Association of Acute Medicine and to have completed at least 1 year of training as a member of the endovascular team in the radiology department of another university hospital. The study was designed to ensure that at least one of the physicians was available to perform AVIRT within 1 h of a request at any time. Femoral sheath insertion was usually performed by the resident physicians under the guidance of trained acute care specialists. RESULTS The study sample comprised 77 endovascular procedures for therapeutic AVIRT (trauma, n = 29, and nontrauma, n = 48) among 62 patients (mean age, 64 years; range, 9–88 years), of which 55% were male. Of the procedures, 47% were performed out of hours (trauma, 52%; and nontrauma, 44%). Three patients underwent resuscitative endovascular balloon occlusion of the aorta in the emergency room. No major device-related complications were encountered, and the overall mortality rate within 60 days was 8%. The recorded causes of death included exsanguination (n = 2), pneumonia (n = 2), sepsis (n = 1), and brain death (n = 1). CONCLUSION When performed by trained acute care specialists, AVIRT seems to be advantageous for acute on-site care and provides good technical success. Therefore, a standard training program should be established for acute care specialists

  5. Determination of radiation dose to patient by biological dosimetry in interventional radiological procedures; Estimacion de la dosis de radiacion a paciente mediante dosimetria biologica en exploraciones complejas de radiodiagnostico

    Serna Berna, A.; Alcaraz, M.; Armero, D.; Navarro, J. L.; Morant, J. J.; Canteras, M.


    Interventional radiology is substituting complex surgical procedures. The requirements of high quality images and long fluoroscopy exposure times gives rise to high levels of radiation doses to patients. This topic is increasingly becoming of high concern. The purpose of this work was to evaluate the micronucleus assay (MN) in lymphocytes for the determination of the dose delivered to 15 patients who underwent interventional radiological procedures. The determination of a dose to patients supposing uniform irradiation was done with a dose-effect calibration curve previously determined for 120 keV X-rays. due to the low level of MN rate compared with background we used a bayesian approach to obtain the net MN counting rate, resulting and average counting rate of 3,2{+-}2,5 MN/500 bi nucleated cell. The group of coronariography patients resulted in higher MN rate 5,1 MN/500 BC vs 2,6 for the rest of patients. Average equivalent uniform dose for the total group of patients was 6,5{+-}2,6 cGy, while for the coronariography group was 8,8 {+-} 4,6 cGy. In conclusion, interventional radiology procedures deliver significant doses to patients and the MN assay as biological dosimeter is a good too to evaluate this range to doses. (Author)

  6. Management of postoperative arterial hemorrhage after pancreato-biliary surgery according to the site of bleeding: re-laparotomy or interventional radiology.

    Miura, Fumihiko; Asano, Takehide; Amano, Hodaka; Yoshida, Masahiro; Toyota, Naoyuki; Wada, Keita; Kato, Kenichiro; Yamazaki, Eriko; Kadowaki, Susumu; Shibuya, Makoto; Maeno, Sawako; Furui, Shigeru; Takeshita, Koji; Kotake, Yutaka; Takada, Tadahiro


    Intra-abdominal arterial hemorrhage is still one of the most serious complications after pancreato-biliary surgery. We retrospectively analyzed our experiences with 15 patients in order to establish a therapeutic strategy for postoperative arterial hemorrhage following pancreato-biliary surgery. Between August 1981 and November 2007, 15 patients developed massive intra-abdominal arterial bleeding after pancreato-biliary surgery. The initial surgery of these 15 patients were pylorus-preserving pancreatoduodenectomy (PPPD) (7 patients), hemihepatectomy and caudate lobectomy with extrahepatic bile duct resection or PPPD (4 patients), Whipple's pancreatoduodenectomy (PD) (3 patients), and total pancreatectomy (1 patient). Twelve patients were managed by transcatheter arterial embolization and three patients underwent re-laparotomy. Patients were divided into two groups according to the site of bleeding: SMA group, superior mesenteric artery (4 patients); HA group, stump of gastroduodenal artery, right hepatic artery, common hepatic artery, or proper hepatic artery (11 patients). In the SMA group, re-laparotomy and coil embolization for pseudoaneurysm were performed in three and one patients, respectively, but none of the patients survived. In the HA group, all 11 patients were managed by transcatheter arterial embolization. None of four patients who had major hepatectomy with extrahepatic bile duct resection survived. Six of seven patients (85.7%) who had pancreatectomy survived, although hepatic infarction occurred in four. Management of postoperative arterial hemorrhage after pancreato-biliary surgery should be done according to the site of bleeding and the initial operative procedure. Careful consideration is required for indication of interventional radiology for bleeding from SMA after pancreatectomy and hepatic artery after major hepatectomy with bilioenteric anastomosis.

  7. Applying 'Technology Assessment' and 'Evidence Based Medicine' theory to interventional radiology. Part 1: Suggestions for the phased evaluation of new procedures

    Malone, Dermot E.; Maceneaney, Peter M


    AIM: To compare and contrast interventional radiology (IR) clinical and research practices with the technology assessment and evidence-based medicine (EBM) paradigms and make suggestions for the phased evaluation of new IR procedures. MATERIALS AND METHODS: Course literature of the Association of University Radiologists' 'Basic Technology Assessment for Radiologists' course and the McMaster University Health Information Research Unit's 'How to Teach Evidence-Based Medicine 1999' course were used to identify major publications in each discipline. A computer search was performed to seek other relevant literature. A model of traditional development of IR procedures was developed. Suggestions for the phased evaluation of IR procedures were derived. RESULTS: As in diagnostic radiology, several levels of progressively stronger IR study design can be described and related to EBM 'levels of evidence'. These range from case reports and case series through case-control and cohort studies to randomized controlled trials (RCTs). The major weakness in the existing IR literature is the predominance of small, uncontrolled, case series. Randomized controlled trials are likely to provide the best possible evidence of effectiveness. They are expensive and randomization is sometimes unethical or impractical. Case-control and cohort studies have been under-utilized. Evidence-based medicine indices of benefit and harm have not yet been applied in IR and may have clinical advantages over traditional statistical methods. A literature search (10 years) using MeSH terms 'radiology, interventional' and 'efficacy' yielded 30 papers. Combining 'radiology, interventional' and 'evidence-based medicine' yielded no papers. Comparative searches substituting the term 'diagnostic imaging' for 'radiology, interventional' yielded 4883 and 62 papers, respectively. CONCLUSION: Principles of technology

  8. Diagnostic and interventional radiology in the post-operative period and follow-up of patients after rectal resection with coloanal anastomosis

    Severini, A.; Civelli, E.M.; Uslenghi, E.; Cozzi, G.; Salvetti, M.; Milella, M. [Department of Radiology, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy); Gallino, G.; Bonfanti, G.; Belli, F.; Leo, E. [Department of Surgery, National Cancer Institute of Milan, via Venezian 1, I-23100 Milan (Italy)


    Surgical treatment of carcinoma of the distal third of the rectum with anal sphincter preservation is increasingly used in accredited cancer centers. This study aimed to evaluate the diagnostic usefulness of radiological investigations in the management of patients who had undergone resection with coloanal anastomosis for carcinoma of the rectum, in the immediate post-operative period, during closure of the protective colostomy and in the follow-up of symptomatic recanalized patients. A total of 175 patients who had undergone total rectal resection with end-to-side anastomosis for carcinoma of the distal third of the rectal ampulla, most of whom had received postoperative radiotherapy, were evaluated radiologically. In the postoperative period radiological investigation was ordered only for symptomatic patients to detect pathology of the anastomosis and the pouch sutures and was used direct film abdominal radiography and contrast-enhanced radiography of the rectal stump with a water-soluble radio-opaque agent. Before closure of the colostomy, 2 months after rectal excision or approximately 4 months after if postoperative radiotherapy was given, the anastomosis and pouch of all patients, even asymptomatic ones, were studied with water-soluble contrast enema to check for normal canalization. In the follow-up after recanalization radiological examinations were done to complete the study of the large intestine if the endoscopist was not able to examine it up to the cecum. Of the 175 patients examined radiologically during the postoperative period and/or subsequent follow-up, 95 showed no pathological findings. Seventy-nine patients had fistulas of the coloanal anastomosis or the pouch, 23 of which supplied a presacral collection. In the absence of severe sepsis, the only therapeutic measures were systemic antibiotics and washing of the surgical catheters to maintain efficient operation. In 2 patients in whom transanal drainage was performed radiologically the fistula

  9. Risk management in radiology departments

    Craciun, Horea; Mankad, Kshitij; Lynch, Jeremy


    Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as a result of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients. PMID:26120383

  10. Risk management in radiology departments

    Horea; Craciun; Kshitij; Mankad; Jeremy; Lynch


    Medical imaging and interventional radiology sustained prompt changes in the last few years, mainly as aresult of technology breakthroughs, rise in workload, deficit in workforce and globalization. Risk is considered to be the chance or possibility of incurring loss or of a negative event happening that may cause injury to patients or medical practitioners. There are various causes of risks leading to harm and injury in radiology departments, and it is one of the objectives of this paper to scrutinize some of the causes. This will drive to consideration of some of the approaches that are used in managing risks in radiology. This paper aims at investigating risk management in radiology, and this will be achieved through a thorough assessment of the risk control measures that are used in the radiology department. It has been observed that the major focus of risk management in such medical setting is to reduce and eliminate harm and injury to patients through integration of various medical precautions. The field of Radiology is rapidly evolving due to technology advances and the globalization of healthcare. This ongoing development will have a great impact on the level of quality of care and service delivery. Thus, risk management in radiology is essential in protecting the patients, radiologists, and the medical organization in terms of capital and widening of the reputation of the medical organization with the patients.

  11. Radiology today. Volume 4

    Heuck, F.H.W.; Donner, M.W.


    The book discusses the following contents: Advances in Cardiovascular Imaging: Digital Arteriography: Ongoing Developments. Magnetic Resonance Imaging of the Cardiovascular System. Comparison of Vascular CT and MRI. Characterization of Vascular Lesions by Ultrasound - Progress in Vascular Interventions: Laser Angioplasty: A Review. Fibrinolytic Therapy Combined with Clot Extraction. Drugs Useful in Angioplasty. Developments in Cardiovascular Imaging: Blood Flow Measurements with Digital Arteriography. Selection of Imaging Techniques for Venous Thromboembolic Disease. Clinical Usefulness of High-Verus Low-Osmolality Contrast Agents. Developments in Angiographic and Interventional Instrumentation. Progress in Cardiovascular Interventions. Inferior Vena Cava Filters: Types, Placement, and Efficiency. Transluminal Vascular Stenting and Grafting. Venography and Sclerotherapy of Varioceles in Children and Adolescents. A New Catheter System - Important Hip Problems: Radiologic and Pathologic Correlation and Hip Disease. Comparison of Imaging Modalities in Femoral Head Necrosis. Osteoartrosis and Arthritis (Synovitis) of the Hip. Hip Anthrography.

  12. Radiochromic film calibration EBT2 Gafchromic-R for the evaluation of skin dose in interventional radiology; Calibracion de la pelicula radiocromica Gafchromic EBT2 para la evaluacion de la dosis en piel en radiologia intevencionista

    Manano Herrera, J. A.; Roldan Arjona, J. M.; Martinez-Luna, R. J.; Soler Cantos, M. M.


    The estimate of the dose in the entrance surface (DSE) in interventional radiology procedures is of interest to identify those which by their nature may lead to skin lesions. The purpose of this paper is to analyze the possibility of use of radiochromic film GAFCHROMICrEBT2 in the estimation of the DSE in these procedures. This is a calibration curve obtained in the dose range of this type of scans proving its validity in relation to the dose given in Perspex phantom exposed to similar values ??of fluoroscopy time and number of acquisitions of employees in the above proceedings.

  13. Pulsed X-rays for interventional radiology: tests on active personal dosemeters (APD) (European project FP7 ORAMED WP3); Rayons X pulses pour la radiologie interventionnelle: tests sur dosimetres personnel actifs

    Denoziere, M.; Bordy, J.M.; Daures, J.; Lecerf, N


    this report presents the results of the tests performed on Active Personal dosemeters (A.P.D.) to check their responses in pulsed X-ray beam used in interventional X-ray radiology. this work is one of the goal of O.R.A.M.E.D W.P.3. (Optimization of radiation protection for medical staff)The response of seven A.P.D.s types was measured in terms of dose equivalent Hp (10) for different pulsed X-ray width and dose rate. (author)

  14. Functionalized Non-vascular Nitinol Stent via Electropolymerized Polydopamine Thin Film Coating Loaded with Bortezomib Adjunct to Hyperthermia Therapy

    Aguilar, Ludwig Erik; Tumurbaatar, Batgerel; GhavamiNejad, Amin; Park, Chan Hee; Kim, Cheol Sang


    Gastrointestinal malignancies have been a tremendous problem in the medical field and cover a wide variety of parts of the system, (i.e. esophagus, duodenum, intestines, and rectum). Usually, these malignancies are treated with palliation with the use of non-vascular nitinol stents. However, stenting is not a perfect solution for these problems. While it can enhance the quality of life of the patient, in time the device will encounter problems such as re-occlusion due to the rapid growth of t...

  15. Reinventing radiology reimbursement.

    Marshall, John; Adema, Denise


    Lee Memorial Health System (LMHS), located in southwest Florida, consists of 5 hospitals, a home health agency, a skilled nursing facility, multiple outpatient centers, walk-in medical centers, and primary care physician offices. LMHS annually performs more than 300,000 imaging procedures with gross imaging revenues exceeding dollar 350 million. In fall 2002, LMHS received the results of an independent audit of its IR coding. The overall IR coding error rate was determined to be 84.5%. The projected net financial impact of these errors was an annual reimbursement loss of dollar 182,000. To address the issues of coding errors and reimbursement loss, LMHS implemented its clinical reimbursementspecialist (CRS) system in October 2003, as an extension of financial services' reimbursement division. LMHS began with CRSs in 3 service lines: emergency department, cardiac catheterization, and radiology. These 3 CRSs coordinate all facets of their respective areas' chargemaster, patient charges, coding, and reimbursement functions while serving as a resident coding expert within their clinical areas. The radiology reimbursement specialist (RRS) combines an experienced radiologic technologist, interventional technologist, medical records coder, financial auditor, reimbursement specialist, and biller into a single position. The RRS's radiology experience and technologist knowledge are key assets to resolving coding conflicts and handling complex interventional coding. In addition, performing a daily charge audit and an active code review are essential if an organization is to eliminate coding errors. One of the inherent effects of eliminating coding errors is the capturing of additional RVUs and units of service. During its first year, based on account level detail, the RRS system increased radiology productivity through the additional capture of just more than 3,000 RVUs and 1,000 additional units of service. In addition, the physicians appreciate having someone who "keeps up

  16. How to promote the optimization of radioprotection in interventional radiology: the ASN's point of view; Comment favoriser l'optimisation de la radioprotection en radiologie interventionnelle: le point de vue de l'ASN

    Menechal, Ph. [Autorite de Surete Nucleaire, Division de Bordeaux, 75 - Paris (France); Valero, M.; Godet, J.L [Autorite de Surete Nucleaire, Direction des rayonnements ionisants et de la sante, 75 - Paris (France)


    Within a context of development of interventional imagery practices, radioprotection in interventional radiology and in operating theatre suite where ionizing radiation are used has become a matter of concern. Before the publication of a work group created at the initiative of the ASN (the French nuclear safety authority) with a professional group (the GPMED, the permanent group of radioprotection experts for medical and forensics applications of ionizing radiations), the authors, members of the ASN, based on declared events and radioprotection inspection reports, give an overview of the faced challenges and problems and of progresses to be made in terms of radioprotection, dosimetry, procedures, and personnel qualification. They make a distinction between the patient radioprotection issue and the worker radioprotection issue

  17. Treatment of large bone defects with a novel biological transport disc in non-vascular transport distraction osteogenesis.

    Zeng, J J; Guo, P; Zhou, N; Xie, Q T; Liao, F C


    The aim of this study was to investigate a potential novel biological transport disc that avoids secondary injury to the body and facilitates bone healing. Twenty-seven dogs were divided randomly into three groups: group A were treated with human bone morphogenetic protein 2 (BMP-2) modified bone mesenchymal stem cell (BMSC) sheets combined with freeze-dried bone allograft as biological transport disc; group B were treated with BMSC sheets combined with freeze-dried bone allograft as transport disc (control); and group C were treated with direct extension only (blank). There were nine dogs in each group. Non-vascular transport distraction osteogenesis was performed in groups A and B to repair the mandibular bone defects, and in group C only mandibular truncation surgery was performed. The regeneration of bone was evaluated through X-ray, haematoxylin and eosin assay, and immunohistochemistry. After 2, 4, and 8 weeks of distraction, new bone density values in group A were 49.00±1.16, 66.63±2.62, and 72.78±2.67, respectively, and these were significantly different to values in groups B (P=0.0005, P=0.0004, P=0.0012) and C (Ptransport disc represents an effective non-secondary injury method to enhance new bone formation in non-vascular transport distraction osteogenesis.

  18. Consequences of non-vascular trans-femoral amputation: a survey of quality of life, prosthetic use and problems.

    Hagberg, K; Brånemark, R


    Individuals with unilateral trans-femoral amputations due to non-vascular causes were studied in a mailed survey designed to investigate health-related quality of life (HRQL), prosthetic use and problems. The Swedish SF-36 Health Survey and a structured questionnaire designed for trans-femoral amputees were used. The series consisted of 97 subjects (60 men, 37 women), aged 20 to 69 years with a mean of 22 years since the amputation. Trauma was the cause of amputation in 55%, tumour in 35% and other causes in 10%. Ninety-two (92) subjects (95%) had a prosthesis and 80 (82%) used it daily. General HRQL was significantly lower than Swedish age- and gender-matched norms in all dimensions as measured by SF-36. Most frequently reported problems that had led to reduction in quality of life were heat/sweating in the prosthetic socket (72%), sores/skin irritation from the socket (62%), inability to walk in woods and fields (61%) and inability to walk quickly (59%). Close to half were troubled by stump pain (51%), phantom limb pain (48%), back pain (47%) and pain in the other leg (46%). One fourth considered themselves to have a poor or extremely poor overall situation. Transfemoral amputation, due to non-vascular causes, has an evident impact on quality of life and there are considerable problems related to the amputation and the prosthesis. Efforts to improve the physical and the psychological well-being for this group, with a long life expectancy, are needed.

  19. Numerical investigations of the mechanical properties of a braided non-vascular stent design using finite element method.

    Ni, Xiao-Yu; Pan, Chang-Wang; Gangadhara Prusty, B


    This paper discusses various issues relating to the mechanical properties of a braided non-vascular stent made of a Ni-Ti alloy. The design of the stent is a major factor which determines its reliability after implantation into a stenosed non-vascular cavity. This paper presents the effect of the main structural parameters on the mechanical properties of braided stents. A parametric analysis of a commercial stent model is developed using the commercial finite element code ANSYS. As a consequence of the analytical results that the pitch of wire has a greater effect than other structural parameters, a new design of a variable pitch stent is presented to improve mechanical properties of these braided stents. The effect of structural parameters on mechanical properties is compared for both stent models: constant and variable pitches. When the pitches of the left and right quarters of the stent are 50% larger and 100% larger than that of the central portion, respectively, the radial stiffness in the central portion increases by 10% and 38.8%, while the radial stiffness at the end portions decreases by 128% and 164.7%, the axial elongation by 25.6% and 56.6% and the bending deflection by 3.96% and 10.15%. It has been demonstrated by finite element analysis that the variable pitch stent can better meet the clinical requirements.

  20. ICRP PUBLICATION 120: Radiological protection in cardiology.

    Cousins, C; Miller, D L; Bernardi, G; Rehani, M M; Schofield, P; Vañó, E; Einstein, A J; Geiger, B; Heintz, P; Padovani, R; Sim, K-H


    Cardiac nuclear medicine, cardiac computed tomography (CT), interventional cardiology procedures, and electrophysiology procedures are increasing in number and account for an important share of patient radiation exposure in medicine. Complex percutaneous coronary interventions and cardiac electrophysiology procedures are associated with high radiation doses. These procedures can result in patient skin doses that are high enough to cause radiation injury and an increased risk of cancer. Treatment of congenital heart disease in children is of particular concern. Additionally, staff(1) in cardiac catheterisation laboratories may receive high doses of radiation if radiological protection tools are not used properly. The Commission provided recommendations for radiological protection during fluoroscopically guided interventions in Publication 85, for radiological protection in CT in Publications 87 and 102, and for training in radiological protection in Publication 113 (ICRP, 2000b,c, 2007a, 2009). This report is focused specifically on cardiology, and brings together information relevant to cardiology from the Commission's published documents. There is emphasis on those imaging procedures and interventions specific to cardiology. The material and recommendations in the current document have been updated to reflect the most recent recommendations of the Commission. This report provides guidance to assist the cardiologist with justification procedures and optimisation of protection in cardiac CT studies, cardiac nuclear medicine studies, and fluoroscopically guided cardiac interventions. It includes discussions of the biological effects of radiation, principles of radiological protection, protection of staff during fluoroscopically guided interventions, radiological protection training, and establishment of a quality assurance programme for cardiac imaging and intervention. As tissue injury, principally skin injury, is a risk for fluoroscopically guided interventions

  1. Radiological Control Manual


    This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records.

  2. Protection of the unborn child in diagnostic and interventional radiological procedures; Schutz des ungeborenen Lebens bei diagnostischen und interventionellen radiologischen Verfahren

    Hojreh, A.; Prosch, H.; Karanikas, G.; Trattnig, S. [Medizinische Universitaet Wien, Universitaetsklinik fuer Radiologie und Nuklearmedizin, Wien (Austria); Homolka, P. [Medizinische Universitaet Wien, Zentrum fuer medizinische Physik und biomedizinische Technik, Wien (Austria)


    The radiation exposure of an unborn child should be principally avoided, whenever it is medically reasonably possible; therefore, the identification of pregnant patients is the first and the most important step in radiation protection of the unborn child. However, in cases of emergency saving the life of the patient has a higher priority than the radiation protection of the unborn child. In this review article, we present a longitudinal section through the national and international literature and guidelines as a basis for radiological management of a (possibly) pregnant patient. We also list some radiological procedures recommended in the literature for a series of maternal indications considering the contraindications of each method during pregnancy and radiation protection of the unborn child. (orig.) [German] Die Strahlenexposition eines ungeborenen Kindes ist prinzipiell, wann immer dieses medizinisch sinnvoll moeglich ist, zu vermeiden. Daher ist die Identifizierung der schwangeren Patientinnen der erste und wichtigste Schritt zum Strahlenschutz des ungeborenen Kindes. In einer Notfallsituation hat allerdings das Leben der Patientin hoechste Prioritaet. In dieser Uebersichtsarbeit praesentieren wir einen Laengsschnitt durch die nationale und internationale Literatur und Leitlinien, die als Grundlage fuer das radiologische Management einer (moeglicherweise) schwangeren Patientin angewendet werden kann. Wir stellen auch einige in der Literatur empfohlene radiologische Verfahren fuer eine Reihe von Indikationen in der Schwangerschaft vor. Dabei werden sowohl die Kontraindikationen der jeweiligen Methode waehrend der Schwangerschaft als auch der Strahlenschutz des ungeborenen Kindes beruecksichtigt. (orig.)

  3. An approach to patient dose optimisation in interventional radiology at the Clermont-Ferrand Hospital Centre; Demarche d'optimisation de la dosimetrie des patients en radiologie interventionnelle au CHU de Clermont-Ferrand

    Guersen, Joel; Chabrot, Pascal; Cassagnes, Lucie; Gabrillargues, Jean; Boyer [Centre Hospitalier Universitaire - CHU, Clermont-Ferrand (France)


    In late October 2009, a serious event occurred in the imaging unit of the Clermont- Ferrand university hospital, corresponding to localised pruritic erythematous cutaneous lesions which resemble radiation-induced damage, following a double pelvic arterial embolization, which saved the life of a young female patient. The imaging unit and the General Management of the University Hospital notified ASN of the event and an on-site dosimetric appraisal carried out by IRSN confirmed that there was a very strong probability that the cutaneous symptoms were attributable to radiation. An internal inquiry concluded that there was a problem with optimisation of the machine parameters in the angiography facility concerned. The imaging unit then initiated a Patient dosimetry optimisation process for the 3 vascular radiology and vascular neuro-radiology facilities in the establishment, divided into 3 main phases dealing with: - image acquisition rates; - the high-voltage settings of the facility concerned, following notification of the event to AFSSAPS, implicating the manufacturer; - the radioscopy and radiography image acquisition parameters, following intervention by the IRSN experts at the request of the imaging unit. On the facility concerned, the reduction in the X-ray dose delivered to the patients was initially 30%, then 35% and finally 25%, representing a total reduction by a factor of three. (authors)

  4. Clinical evaluation of serum alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels in patients with hepatocellular carcinoma following interventional radiology.

    Minakuchi, K; Murata, K; Kaminoh, T; Takada, K; Takashima, S; Nakamura, K; Onoyama, Y


    Fourteen patients with unrespectable HCC were treated with various interventional radiology (IVR) procedures. The initial therapeutic response was determined using computed tomography (CT) findings, and determinations of serum alpha-fetoprotein (AFP) and protein induced by Vitamin K absence or antagonist-II (PIVKA-II) levels. When CT studies of the initial response to IVR were compared with changes in the serum AFP and PIVKA-II levels, the AFP level was found to correlate more closely than the PIVKA-II levels. The PIVKA-II level correlated more closely than the AFP level in cases with poor response to IVR. Both of these tumor markers should be measured in combination with the diagnostic imagings for follow-up studies of IVR.

  5. American diagnostic radiology residency and fellowship programmes.

    Rumack, Carol Masters


    American Diagnostic Radiology Residency and Fellowship programmes are Graduate Medical Education programmes in the United States (US) equivalent to the Postgraduate Medical Education programmes in Singapore. Accreditation Council for Graduate Medical Education (ACGME) accredited diagnostic radiology residency programmes require 5 years total with Post Graduate Year (PGY) 1 year internship in a clinical specialty, e.g. Internal Medicine following medical school. PGY Years 2 to 5 are the core years which must include Radiology Physics, Radiation Biology and rotations in 9 required subspecialty rotations: Abdominal, Breast, Cardiothoracic, Musculoskeletal, Neuroradiology, Nuclear and Paediatric Radiology, Obstetric & Vascular Ultrasound and Vascular Interventional Radiology. A core curriculum of lectures must be organised by the required 9 core subspecialty faculty. All residents (PGY 2 to 4) take a yearly American College of Radiology Diagnostic In-Training Examination based on national benchmarks of medical knowledge in each subspecialty. Because the American Board of Radiology (ABR) examinations are changing, until 2012, residents have to take 3 ABR examinations: (i) ABR physics examination in the PGY 2 to 3 years, (ii) a written examination at the start of the PGY 5 year and (iii) an oral exam at the end of the PGY 5 year. Beginning in 2013, there will be only 2 examinations: (i) the physics and written examinations after PGY 4 will become a combined core radiology examination. Beginning in 2015, the final certifying examination will be given 15 months after the completion of residency. After residency, ACGME fellowships in PGY 6 are all one-year optional programmes which focus on only one subspecialty discipline. There are 4 ACGME accredited fellowships which have a Board Certifi cation Examination: Neuroradiology, Nuclear, Paediatric and Vascular Interventional Radiology. Some ACGME fellowships do not have a certifying examination: Abdominal, Endovascular

  6. Educational treasures in Radiology: The Radiology Olympics - striving for gold in Radiology education

    Talanow, Roland


    This article focuses on Radiology Olympics ( - a collaboration with the international Radiology community for Radiology education, Radiolopolis ( The Radiology Olympics honour the movers and shakers in Radiology education and offer an easy to use platform for educating medical professionals based on Radiology cases.

  7. Educational treasures in Radiology: The Radiology Olympics - striving for gold in Radiology education

    Talanow, Roland


    This article focuses on Radiology Olympics ( - a collaboration with the international Radiology community for Radiology education, Radiolopolis ( The Radiology Olympics honour the movers and shakers in Radiology education and offer an easy to use platform for educating medical professionals based on Radiology cases.

  8. Early experience with X-ray magnetic resonance fusion for low-flow vascular malformations in the pediatric interventional radiology suite

    Hwang, Tiffany J. [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Keck School of Medicine of the University of Southern California, Los Angeles, CA (United States); Girard, Erin [Siemens Corporation, Corporate Technology, Princeton, NJ (United States); Shellikeri, Sphoorti; Vossough, Arastoo; Ho-Fung, Victor; Cahill, Anne Marie [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Setser, Randolph [Siemens Medical Solutions USA, Inc., Hoffman Estates, IL (United States)


    This technical innovation describes our experience using an X-ray magnetic resonance fusion (XMRF) software program to overlay 3-D MR images on real-time fluoroscopic images during sclerotherapy procedures for vascular malformations at a large pediatric institution. Five cases have been selected to illustrate the application and various clinical utilities of XMRF during sclerotherapy procedures as well as the technical limitations of this technique. The cases demonstrate how to use XMRF in the interventional suite to derive additional information to improve therapeutic confidence with regards to the extent of lesion filling and to guide clinical management in terms of intraprocedural interventional measures. (orig.)

  9. Laenderyggens degeneration og radiologi

    Jacobsen, Steffen; Gosvig, Kasper Kjaerulf; Sonne-Holm, Stig


    and significant relationships between radiological findings and subjective symptoms have both been notoriously difficult to identify. The lack of consensus on clinical criteria and radiological definitions has hampered the undertaking of properly executed epidemiological studies. The natural history of LBP...

  10. Radioprotection of patients and workers in interventional and operating block radiology; La radioprotection des patients et des travailleurs en radiologie interventionnelle et au bloc operatoire

    Menechal, P. [Autorite de Surete Nucleaire, Div. de Bordeaux, 33 (France); Valero, M.; Megnigbeto, C.; Marchal, C.; Godet, J.L. [Autorite de surete nucleaire, Dir. des rayonnements ionisants et de la sante, 75 - Paris (France)


    Over the last ten years or so, extensive development in radiological and implantable equipment has generated significant growth in radio-guided procedures. The real benefit of these practices to patients explains their development. These procedures can be undertaken using not only dedicated, specific fixed installations and computed tomography scanners, but also mobile installations in facilities not designed for radiography, such as operating blocks. The complexity of these procedures and the times spent implementing the required radiation can lead to major detrimental effects on personnel and patients, if they are not fully controlled. Many specialist medical disciplines now perform invasive procedures guided by images. Optimisation of patient doses mainly depends on the training level of medical teams, the intrinsic performance characteristics of the equipment used, adjustment of the technical parameters and the presence or absence of qualified personnel. Optimisation of professional personnel exposure is complex and depends on the performance conditions of procedures, which can expose workers extensively and non-uniformly. Designation of personnel competent in radioprotection, assessment of risks and definition of controlled areas, analysis of workstations and dosimetric monitoring of operators (especially of body extremities) are difficult to implement. Use of collective and personal protective equipment must be improved. The general manager of the French nuclear safety authority (ASN) has referred the matter to the permanent group of radioprotection experts (GPMED) to ensure that recommendations are drawn up in the short term. (authors)

  11. Evaluation of radiation exposure in interventional radiology (IR) using active personal dosimeters (APD); Evaluierung der Strahlenexposition in der Interventionellen Radiologie (IR) mit Hilfe von Aktiv-Personen-Dosimetern (APD)

    Neugschwandtner, K. [KH Hietzing mit NZ Rosenhuegel, Wien (Austria). Inst. fuer Krankenhausphysik; TU Wien (Austria). Atominstitut; Freund, R. [KH Hietzing mit NZ Rosenhuegel, Wien (Austria). Inst. fuer Krankenhausphysik; Mertikian, G. [KH Hietzing mit NZ Rosenhuegel, Wien (Austria). Inst. fuer Radiologie; Poljanc, K. [TU Wien (Austria). Atominstitut; Ibi, B. [KA Rudolfstiftung, Wien (Austria). Stabstelle Medizinphysik


    Increased awareness of high personal dose exposure of medical staff in interventional radiology (IR) demands an assessment of radiation protection procedures. Mandatory dose monitoring systems do not allow to relate dose to specific actions of the staff as they just accumulate a total dose per month. Doses of head and limbs are expected to be high as those body parts which are not protected by the lead apron. We decided to use a measuring system by Unfors, RaySafe i2 which is built for real- time- dosimetry of scattered radiation in pulsed X-ray fields. An increased dose of the body side closer to the X-ray source (left body side) was detected. This is due to the position and the posture of the radiologist during intervention. Separating the phases of digital subtraction angiography (DSA) from those of fluoroscopy allowed not only to list the separate accumulated doses, but showed as well a big difference in dose rate. The measurements revealed the need of an improvement of common radiation protection, especially while DSA.

  12. Functionalized Non-vascular Nitinol Stent via Electropolymerized Polydopamine Thin Film Coating Loaded with Bortezomib Adjunct to Hyperthermia Therapy.

    Aguilar, Ludwig Erik; Tumurbaatar, Batgerel; Ghavaminejad, Amin; Park, Chan Hee; Kim, Cheol Sang


    Gastrointestinal malignancies have been a tremendous problem in the medical field and cover a wide variety of parts of the system, (i.e. esophagus, duodenum, intestines, and rectum). Usually, these malignancies are treated with palliation with the use of non-vascular nitinol stents. However, stenting is not a perfect solution for these problems. While it can enhance the quality of life of the patient, in time the device will encounter problems such as re-occlusion due to the rapid growth of the tumor. In this study, we propose a functionalization technique using electropolymerization of polydopamine directly onto the nitinol stent struts for the combined application of hyperthermia and chemotherapy. The coating was characterized using FESEM, XPS, and FT-IR. Drug release studies show that facile release of the anticancer drug BTZ from the surface of the polydopamine-coated stent could be achieved by the dissociation between catechol groups of polydopamine and the boronic acid functionality of BTZ in a pH-dependent manner. The anti-cancer property was also evaluated, and cytotoxicity on ESO26 and SNU-5 cancer cell lines were observed. Our results suggest that the introduced approach can be considered as a potential method for therapeutic stent application.

  13. Imaging of implants on chest radiographs: a radiological perspective

    Burney, K. [Department of Clinical Radiology, Bristol Royal Infirmary (United Kingdom)]. E-mail:; Thayur, N. [Department of Clinical Radiology, Bristol Royal Infirmary (United Kingdom); Husain, S.A. [Department of Respiratory Medicine, Bristol Royal Infirmary (United Kingdom); Martin, R.P. [Department of Cardiology, Bristol Royal Hospital for Children, Bristol (United Kingdom); Wilde, P. [Department of Clinical Radiology, Bristol Royal Infirmary (United Kingdom)


    Endovascular and percutaneous techniques have emerged as alternatives to surgical management in the treatment for a wide range of congenital and acquired cardiac, non-vascular and vascular conditions. Consequently, there has been an increasing use of implants such as closure devices, vascular stents (coronary, aortic, pulmonary and superior vena cava) and non-vascular stents like oesophageal and tracheo-bronchial stents. A large number of percutaneously sited implants are used for treating congenital cardiac anomalies such as atrial septal defects (ASD), ventricular septal defects (VSD), and patent ductus arteriosus (PDA). These implants take many shapes and forms. The aim of this review is to demonstrate the radiographic appearances of the various types of cardiovascular, bronchial and oesophageal implants that are visible on plain films. A brief outline of the aims and indications of various implant procedures, the general appearance of the commonest types of implants, and the radiological procedures are discussed. All radiologists are likely to come across implanted devices in plain film reporting. Imaging can be useful in identifying the device, assessing the position, integrity, and for the identification of complications related directly to the implant.

  14. Radiology Resident Supply and Demand: A Regional Perspective.

    Pfeifer, Cory M


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

  15. Hepatobiliary Intervention in Children

    Franchi-Abella, Stéphanie [Le Centre Hospitalier Universitaire du Kremlin-Bicêtre (France); Cahill, Anne Marie; Barnacle, Alex M. [Great Ormond Street Hospital, Department of Radiology (United Kingdom); Pariente, Danièle [Le Centre Hospitalier Universitaire du Kremlin-Bicêtre (France); Roebuck, Derek J., E-mail: [Great Ormond Street Hospital, Department of Radiology (United Kingdom)


    Various vascular and nonvascular hepatobiliary interventional radiology techniques are now commonly performed in children’s hospitals. Although the procedures are broadly similar to interventional practice in adults, there are important differences in indications and technical aspects. This review describes the indications, techniques, and results of liver biopsy, hepatic and portal venous interventions and biliary interventions in children.

  16. C臂CT在介入诊疗中的应用%Application of C-arm computed tomography in interventional radiology

    肖运平; 肖恩华


    Recently, C-arm computed tomography (CT), as a new technology of flat detector digital subtraction angiography (DSA) system, has been applied in both vascular and no-vascular interventional procedures. This imaging unit provides the functions of radiography, fluoroscopy, DSA and volumetric CT imaging in a single patient setup, within the interventional suite. This article aims to describe its potentiality ,limitation and prospect in clinical practice. (J Intervent Radiol, 2011 , 20 : 249-252)%C臂CT是平板探测器数字减影血管造影系统的一种新技术,在介入室同一工作床上能提供透视、摄影、DSA及容积CT成像,已在血管性及非血管介入诊疗中开始发挥其独特作用,本文介绍C臂CT在介入诊疗应用中的潜力、限度与前景.

  17. Development of an auxiliary system for the execution of vascular catheter interventions with a reduced radiological risk; system description and first experimental results.

    Placidi, Giuseppe; Franchi, Danilo; Marsili, Luca; Gallo, Pasquale


    Vascular catheterization is a common procedure in clinical medicine. It is normally performed by a specialist using an X-ray fluoroscopic guide and contrast-media. In the present paper, an image-guided navigation system which indicates a path providing guidance to the desired target inside the vascular tree is described with the aim of reducing the exposure of personnel and patients to X-rays during the catheterization procedure. A 3D model of the patient vascular tree, reconstructed with data collected by an angiography before starting the intervention, is used as a guide map instead of fluoroscopic scans. An accurate spatial correspondence between the body of the patient and the 3D reconstructed vascular model is established and, by means of a position indicator installed over the catheter tip, the real-time position/orientation of the tip is indicated correctly. This paper describes the system and the operational procedures necessary to use the proposed method efficiently during a catheter intervention. Preliminary experimental results on a phantom are also reported.

  18. Radiation Protection in Interventional Radiology. Training objectives for the medical specialists; Proteccion radiologia en radiologia intervencionista. Objectivos de formacion para especialistas medicos

    Ruiz-Cruces, R.; Vano, E.; Hernandez Armas, J.; Carrera, F.


    The Directive 97/43 Euratom on medical exposures and the report RP 116 published by the European Commission on Education and Training in radiation protection for medical exposures, established that interventional radiologists should have a more skilled training for handling X-Ray equipment and a better knowledge about the ways of protecting patients and staff against ionising radiation. To analyse the objectives for training in radiation protection recommended in the European Guideline and to show the most important points and modifications for a better practical application of this guide. An inquiry has been performed into the specific objectives recommended by the European Guideline RP 116 about training on Radiation Protection. Twenty interventional radiologists were requested to fill in the test, pointing out the importance of each objective (0-no necessary, 1-medium importance, 2-very important), and they were encouraged to suggest other more interesting for them not included in the European Guideline. The average scores for each of the objectives included in the European Guideline are shown, and an additional relation of suggested topics has been added to the current list. The scoring system show the priority and importance of the objectives that could be taken into account during the next training courses to be held in Spain and it could be used as a base of discussion in some European meeting in order to improve the European Guideline in the future. (Author) 13 refs.

  19. Medical liability and patient law in Germany. Main features with particular focus on treatments in the field of interventional radiology; Arzthaftung und Patientenrechtegesetz in Deutschland. Die Grundzuege unter besonderer Beruecksichtigung von Behandlungen auf dem Gebiet der Interventionellen Radiologie

    Sommer, S.A.; Geissler, R. [Kapp and Geissler Lawyers, Stuttgart (Germany); Stampfl, U.; Radeleff, B.A.; Kauczor, H.U.; Sommer, Christof M. [Univ. Hospital Heidelberg (Germany). Clinic for Diagnostic and Interventional Radiology; Wolf, M.B. [German Cancer Research Center (DKFZ), Heidelberg (Germany). Radiology (E010); Richter, G.M. [Klinikum Stuttgart (Germany). Clinic for Diagnostic and Interventional Radiology; Pereira, P.L. [SLK Kliniken, Heilbronn (Germany). Radiology, Minimally-invasive Therapies and Nuclearmedicine


    On February 26th, 2013 the patient law became effective in Germany. Goal of the lawmakers was a most authoritative case law for liability of malpractice and to improve enforcement of the rights of the patients. The following article contains several examples detailing legal situation. By no means should these discourage those persons who treat patients. Rather should they be sensitized to to various aspects of this increasingly important field of law. To identify relevant sources according to judicial standard research was conducted including first- and second selection. Goal was the identification of jurisdiction, literature and other various analyses that all deal with liability of malpractice and patient law within the field of Interventional Radiology - with particular focus on transarterial chemoembolization of the liver and related procedures. In summary, 89 different sources were included and analyzed. The individual who treats a patient is liable for an error in treatment if it causes injury to life, the body or the patient's health. Independent of the error in treatment the individual providing medical care is liable for mistakes made in the context of obtaining informed consent. Prerequisite is the presence of an error made when obtaining informed consent and its causality for the patient's consent for the treatment. Without an effective consent the treatment is considered illegal whether it was free of treatment error or not. The new patient law does not cause material change of the German liability of malpractice law.

  20. Essentials of skeletal radiology

    Yochum, T.R.; Rowe, L.J.


    This book discusses the following topics of skeletal radiology: Positioning of patients for diagnostic radiology and normal anatomy; congenital malformations of skeleton; measurements in radiology; spondylolisthesis; metabolic and endocrine diseases of bone and their diagnostic aspects; image processing of vertebrae, skeleton, bone fractures evaluations and epidemiological and social aspects of some bone diseases. Various modalities as CT scanning, NMR imaging, ultrasonography and biomedical radiography are briefly discussed in relation to bone pathology.

  1. Machine Learning and Radiology

    Wang, Shijun; Summers, Ronald M.


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

  2. Radiological Emergency Response Data

    U.S. Environmental Protection Agency — Quality Data Asset includes all current and historical emergency radiological response event and incident of national significance data and surveillance, monitoring,...

  3. Quality management systems in radiology

    Geoffrey K. Korir


    Full Text Available Background: The use of X-ray imaging is ever increasing in proportion to the need for radiological services and technological capabilities. Quality management that includes patient radiation dose monitoring is fundamental to safety and quality improvement of radiological services.Objective: To assess the level of quality management systems in X-ray medical facilities in Kenya.Methods: Quality management inspection, quality control performance tests and patient radiation exposure were assessed in 54 representative X-ray medical facilities. Additionally, a survey of X-ray examination frequency was conducted in 140 hospitals across the country.Results: The overall findings placed the country’s X-ray imaging quality management systems at 61±3% out of a possible 100%. The most and the least quality assurance performance indicators were general radiography X-ray equipment quality control tests at 88±4%, and the interventional cardiology adult examinations below diagnostic reference level at 25±1%, respectively.Conclusions: The study used a systematic evidence-based approach for the assessment of national quality management systems in radiological practice in clinical application, technical conduct of the procedure, image quality criteria, and patient characteristics as part of the quality management programme.

  4. Radiological chest manifestations in diffuse infiltrative lymphocytosis syndrome (DILS

    F Ismail


    Full Text Available This report focuses on the radiological manifestations of diffuse interstitial lymphocytosis syndrome (DILS in the chest. Awareness of this entity and early diagnosis by radiologists will enable timeous intervention by clinicians.

  5. A framework for organ dose estimation in x-ray angiography and interventional radiology based on dose-related data in DICOM structured reports

    Omar, Artur; Bujila, Robert; Fransson, Annette; Andreo, Pedro; Poludniowski, Gavin


    Although interventional x-ray angiography (XA) procedures involve relatively high radiation doses that can lead to deterministic tissue reactions in addition to stochastic effects, convenient and accurate estimation of absorbed organ doses has traditionally been out of reach. This has mainly been due to the absence of practical means to access dose-related data that describe the physical context of the numerous exposures during an XA procedure. The present work provides a comprehensive and general framework for the determination of absorbed organ dose, based on non-proprietary access to dose-related data by utilizing widely available DICOM radiation dose structured reports. The framework comprises a straightforward calculation workflow to determine the incident kerma and reconstruction of the geometrical relation between the projected x-ray beam and the patient’s anatomy. The latter is difficult in practice, as the position of the patient on the table top is unknown. A novel patient-specific approach for reconstruction of the patient position on the table is presented. The proposed approach was evaluated for 150 patients by comparing the estimated position of the primary irradiated organs (the target organs) with their position in clinical DICOM images. The approach is shown to locate the target organ position with a mean (max) deviation of 1.3 (4.3), 1.8 (3.6) and 1.4 (2.9) cm for neurovascular, adult and paediatric cardiovascular procedures, respectively. To illustrate the utility of the framework for systematic and automated organ dose estimation in routine clinical practice, a prototype implementation of the framework with Monte Carlo simulations is included.

  6. SU-E-I-57: Estimating the Occupational Eye Lens Dose in Interventional Radiology Using Active Personal Dosimeters Worn On the Chest

    Omar, A; Marteinsdottir, M; Kadesjo, N; Fransson, A [Dept. of Medical Physics, Karolinska University Hospital, Stockholm (Sweden)


    Purpose: To provide a general formalism for determination of occupational eye lens dose based on the response of an active personal dosimeter (APD) worn at chest level above the radiation protection apron. Methods: The formalism consists of three factors: (1) APD conversion factor converting the reading at chest level (APDchest) to the corresponding personal dose equivalent at eye level, (2) Dose conversion factor transferring the measured dose quantity, Hp(10), into a dose quantity relevant for the eye lens dose, (3) Correction factor accounting for differences in exposure of the eye(s) compared to the exposure at chest level (e.g., due to protective lead glasses).The different factors were investigated and evaluated based on phantom and clinical measurements performed in an x-ray angiography suite for interventional cardiology. Results: The eye lens dose can be conservatively estimated by assigning an appropriate numerical value to each factor entering the formalism that in most circumstances overestimates the dose. Doing so, the eye lens dose to the primary operator and assisting staff was estimated in this work as D-eye,primary = 2.0 APDchest and D-eye,assisting = 1.0 APDchest, respectively.The annual eye lens dose to three nurses and one cardiologist was estimated to be 2, 2, 2, and 13 mSv (Hp(0.07)), respectively, using a TLD dosimeter worn at eye level. In comparison, using the formalism and APDchest measurements, the respective doses were 2, 2, 2, and 16 mSv (Hp(3)). Conclusion: The formalism outlined in this work can be used to estimate the occupational eye lens dose from the response of an APD worn on the chest. The formalism is general and could be applied also to other types of dosimeters. However, the numerical value of the different factors may differ from those obtained with the APD’s used in this work due to differences in dosimeter properties.

  7. [Shared web-based data center for multi-institutional clinical trials: evaluation of UMIN-INDICE (university hospital medical information network-internet data and information center for medical research)in clinical trials of JIVROSG (Japan interventional radiology in oncology study group)].

    Sone, Miyuki; Arai, Yasuaki; Kiuchi, Takahiro; Ishikawa, Hirono; Aoki, Noriaki; Inaba, Yoshitaka; Yoshioka, Tetsuya; Aramaki, Takeshi; Kobayashi, Takeshi; Matsuoka, Toshiyuki; Anai, Hiroshi; Tanigawa, Noboru; Osuga, Keigo; Takeuchi, Yoshito; Okusaka, Takushi; Kanazawa, Susumu; Matsui, Osamu; Endo, Keigo


    A patient registration system is mandatory for establishing the scientific credibility of the multi-center clinical trials. The Japan Interventional Radiology in Oncology Study Group (JIVROSG) was organized in 2002 to establish evidence supporting the procedures used in interventional radiology. The Internet Data and Information Center for Medical Research (INDICE), provided by the University Hospital Medical Information Network(UMIN), has been utilized for patient registration in the clinical trials of JIVROSG. In this study, the safety and efficacy of UMIN-INDICE were evaluated. From 2002 to 2010, 18 clinical trials, including one international trial, were conducted. A total of 736 patients were enrolled from 51 institutions. No significant trouble was encountered during this period. A questionnaire survey demonstrated that 90% of participating researchers could use this system without difficulties. UMIN-INDICE may contribute to promoting clinical trials as an infrastructure of multicenter studies.

  8. Comparison of in vivo immune responses following transplantation of vascularized and non-vascularized human dermo-epidermal skin substitutes.

    Klar, Agnes S; Biedermann, Thomas; Simmen-Meuli, Claudia; Reichmann, Ernst; Meuli, Martin


    Autologous bio-engineered dermo-epidermal skin substitutes (DESS) represent an alternative therapeutic option for a definitive treatment of skin defects in human patients. Largely, the interaction of host immune cells with transplanted DESS is considered to be essential for the granulation tissue formation, graft take, and its functionality. The aim of this study was to compare the spatiotemporal distribution and density of host-derived monocytes/macrophages and granulocytes in vascularized (vascDESS) versus non-vascularized DESS (non-vascDESS) in a rat model. Keratinocytes and the stromal vascular fraction (SVF) were derived from human skin or human adipose tissue, respectively. Human SVF containing both endothelial and mesenchymal/stromal progenitors was used to develop a vascularized collagen type I-based dermal component in vitro. The donor-matched, monolayer-expanded adipose stromal cells lacking endothelial cells were used as a negative control. Subsequently, human keratinocytes were seeded on top of hydrogels to build dermo-epidermal skin grafts. After transplantation onto full-thickness skin wounds on the back of immuno-incompetent rats, grafts were excised and analyzed after 1 and 3 weeks. The expression of distinct inflammatory cell markers specific for host-derived monocytes/macrophages (CD11b, CD68) or granulocytes (HIS48) was analyzed by immunofluorescence microscopy. All skin grafts were infiltrated by host-derived monocytes/macrophages (CD11b(+), CD68(+)) and granulocytes (HIS48(+)) between 1-3 week post-transplantation. When compared to non-vascDESS, the vascDESS showed an increased granulocyte infiltration at all time points analyzed with the majority of cells scattered throughout the whole dermal part. Whereas a moderate number of rat monocytes/macrophages (CD11b(+), CD68(+)) were found in vascDESS at 1 week, only a few cells were detected in non-vascDESS. We observed a time-dependent decrease of monocytes/macrophages in all transplants at 3

  9. American College of Radiology

    American College of Radiology Login About Us Media Center Contact Us Follow us Shopping Cart (0) ACR Catalog Donate My ACR Join ACR ... ACR Catalog Education Center eLearning Exams & Assessments AIRP™ Radiology Leadership Institute ® Quality & Safety Accreditation Appropriateness Criteria ® Practice ...

  10. Physics of Radiology

    Johns, Harold Elford


    Authority, comprehensivity and a consummate manner of presentation have been hallmarks of The Physics of Radiology since it first saw publication some three decades past. This Fourth Edition adheres to that tradition but again updates the context. It thoroughly integrates ideas recently advanced and practices lately effected. Students and professionals alike will continue to view it, in essence, as the bible of radiological physics.

  11. Radiologic Imaging in Meckel Diverticulum Complications

    Erin Leslee Dames


    Full Text Available In 1809, Johann Friedrich Meckel the Younger described the most common congenital small bowel anomaly, which was named after him; however, the radiologic manifestations and interventional guidelines related to this entity are still limited to a few large-scale case series as well as proposed therapeutic protocols for the general population. Despite the fact that this entity is more commonly found within the first decade of life, imaging and management protocols remain controversial in the pediatric population, particularly within the asymptomatic group. We present an article depicting the radiologic and histologic findings in a series of Meckel's diverticulum within the pediatric population seen within our institution. We present this series to underscore the importance of high clinical suspicion in the early diagnosis and management of Meckel's diverticulum and to examine further the radiologic and therapeutic protocols within the pediatric population based on our local experience.

  12. Laenderyggens degeneration og radiologi

    Jacobsen, Steffen; Gosvig, Kasper Kjaerulf; Sonne-Holm, Stig


    Low back pain (LBP) is one of the most common conditions, and at the same time one of the most complex nosological entities. The lifetime prevalence is approximately 80%, and radiological features of lumbar degeneration are almost universal in adults. The individual risk factors for LBP and signi......Low back pain (LBP) is one of the most common conditions, and at the same time one of the most complex nosological entities. The lifetime prevalence is approximately 80%, and radiological features of lumbar degeneration are almost universal in adults. The individual risk factors for LBP...... and significant relationships between radiological findings and subjective symptoms have both been notoriously difficult to identify. The lack of consensus on clinical criteria and radiological definitions has hampered the undertaking of properly executed epidemiological studies. The natural history of LBP...

  13. Radiologic Technology Program Standards.

    Georgia Univ., Athens. Dept. of Vocational Education.

    This publication contains statewide standards for the radiologic technology program in Georgia. The standards are divided into 12 categories; Foundations (philosophy, purpose, goals, program objectives, availability, evaluation); Admissions (admission requirements, provisional admission requirements, recruitment, evaluation and planning); Program…

  14. Malignant biliary obstruction: treatment with interventional radiology

    翟仁友; 钱晓军; 戴定可; 于平


    Objective To evaluate the method of palliative drainage by means of metallic indwelling stents or plastic tubes for patients with malignant biliary obstruction. Methods From January 1995 to Febuary 2001, 243 consecutive patients (161 men and 82 women; aged 26-91 years, mean of 61.3 years) with malignant biliary obstruction were treated with transhepatic placement of metallic stents and/or plastic tubes. Among them, 47 patients had pancreatic carcinoma, 98 cholangiocarcinoma, 28 metastatic carcinoma and 60 hepatic carcinoma. 169 stents of nine types were used in this series. After stenting, 47 patients were treated for local tumors. Procedure- and device-related complications were recorded. Patient survival and stent patency rates were calculated with Kaplan-Meier survival analysis.Results One hundred and three patients underwent successfully stent placement for the first time. Others had their stents installed 1-2 weeks after catheterization. Stents were used in 132 patients. Ninety-five patients were treated with a single stent. Seventeen patients had two stents installed for bilateral drainage,20 patients had two stents installed from top to bottom to create stenting of adequate ength, and 12 patients had stents placed across the ampulla. The 2-month mortality rate was 8.64% (21/243). Major complications occurred in two patients (0.8%, 2/243). Minor complications included self-limited bleeding into the drainage tubes and fever. The average patency of the initial stent was 7.5 months and average survival was 9 months. Thirteen patients received brachytherapy in their stents, 15 extra radiation therapy, and 19 intra-arterial infusion chemotherapy. The 47 patients treated for local tumors had an average survival of 11.3 months (log rank 32.8,P<0.001) with an average patency of 9.7 months(log rank 4.7,P<0.05).Conclusion Percutaneous transhepatic bile drainage as a palliative procedure is well tolerated by patients. After stenting, treatment for local tumor may prolong the duration of stent patency and the survival of patients.

  15. Hygiene in radiology

    Kapp-Schwoerer, A.; Daschner, F.


    A survey is given of the hygienic management in radiological departments with special regard to the handling of injections and infusions. It includes prevention of bacterial as well as viral infections. In radiological departments disinfection of X-ray tables is necessary only in exceptional cases. A special proposal for disinfection is added. A safe method of sterilisation of flexible catheders is included, which proved to prevent bacterial infection.

  16. Radiologic science for technologists

    Bushong, S.C.


    This book provides in-depth coverage of physics, biology and protection for the radiologic technology student. It presents a significant portion of all of the science required of radiologic technology students under one cover. Chapter content reflects a readable and practical organization with outlines listed on the first page of each chapter and sample problems at the end. New to this edition are: new and expanded sections on radiation techniques, digital imaging, and magnetic resonance imaging and ultrasound.

  17. Troponin elevations after non-cardiac, non-vascular surgery are predictive of major adverse cardiac events and mortality

    Ekeloef, S; Alamili, M; Devereaux, P J


    -analysis was conducted in January 2016 according to the Meta-analysis Of Observational Studies in Epidemiology guidelines. Both interventional and observational studies measuring troponin within the first 4 days after surgery were eligible. A systematic search was performed in PubMed, EMBASE, Scopus, and the Cochrane...


    Rade R. Babić


    Full Text Available The development of information systems in health care is approaching the process of integration of various systems used in a single computer so that we witness today the omnipresent idea of merging the functions of the clinical-hospital (CHIS and radiology (RIS information system. Radiological Information System (RIS is a technology solution to complete computerization and modernization of the work of the radiology center, and transition from film to paper and ful electronic management and digital recordings. RIS creates the digital radiology center where information is always available at the right place and at the right time. Within the realisation of RIS, it is necessary to follow the standards and systems relating to the specific RIS, which are: DICOM (Digital Imaging and Communications in Medicine, PACS (Picture Archiving and Communication System, HL7 (Health Level Seven. The relevant links of modern RIS are teleradiology and mobile radiology. The authors conclude that the introduction of RIS, HIS and other information systems are reflected in the automation, reduction of possible errors, increase in diagnostic and therapeutic quality, lower costs for materials, the increase in efficiency, saving time and others.

  19. Radiological protection; Proteccion radiologica

    Azorin N, J. [Universidad Autonoma Metropolitana, Unidad Iztapalapa, Division de Ciencias Basicas e Ingenieria, Av. San Rafael Atlixco 186, Col. Vicentina, 09340 Mexico, D. F. (Mexico); Azorin V, J. C. [Universidad de Guanajuato, Campus Leon, Division de Ciencias e Ingenieria, Loma del Bosque 103, Lomas del Campestre, 37150 Leon de los Aldama, Guanajuato (Mexico)


    This work is directed to all those people related with the exercise of the radiological protection and has the purpose of providing them a base of knowledge in this discipline so that they can make decisions documented on technical and scientist factors for the protection of the personnel occupationally exposed, the people in general and the environment during the work with ionizing radiations. Before de lack of a text on this matter, this work seeks to cover the specific necessities of our country, providing a solid presentation of the radiological protection, included the bases of the radiations physics, the detection and radiation dosimetry, the radiobiology, the normative and operational procedures associates, the radioactive wastes, the emergencies and the transport of the radioactive material through the medical and industrial applications of the radiations, making emphasis in the relative particular aspects to the radiological protection in Mexico. The book have 16 chapters and with the purpose of supplementing the given information, are included at the end four appendixes: 1) the radioactive waste management in Mexico, 2-3) the Mexican official standards related with the radiological protection, 4) a terms glossary used in radiological protection. We hope this book will be of utility for those people that work in the investigation and the applications of the ionizing radiations. (Author)

  20. Radiology illustrated. Uroradiology. 2. ed.

    Kim, Seung Hyup (ed.) [Seoul National University Hospital, Seoul (Korea, Republic of). Dept. of Radiology


    Uroradiology is an up-to-date, image-oriented reference in the style of a teaching file that has been designed specifically to be of value in clinical practice. All aspects of the imaging of urologic diseases are covered, and case studies illustrate the findings obtained with the relevant imaging modalities in both common and uncommon conditions. Most chapters focus on a particular clinical problem, but normal findings, congenital anomalies, and interventions are also discussed and illustrated. In this second edition, the range and quality of the illustrations have been enhanced, and many schematic drawings have been added to help readers memorize characteristic imaging findings through pattern recognition. The accompanying text is concise and informative. Besides serving as an outstanding aid to differential diagnosis, this book will provide a user-friendly review tool for certification or recertification in radiology. (orig.)

  1. The Development of Radiology among Slovenes

    Zvonka Zupanič Slavec


    1993. The Clinical Radiology Institute, Ljubljana University Medical Centre, performs ambulatory and hospital radiological management at the secondary and tertiary levels for patients from the region of Ljubljana and from the rest of the country. A sophisticated radiology is also at the University Medical Centre Maribor. In the first decade of the 21st century radiology developed particularly quickly, bringing recent developments in international radiology to Slovenia, especially in the field of interventional radiology.

  2. Organizational decentralization in radiology.

    Aas, I H Monrad


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

  3. Radiology illustrated. Hepatobiliary and pancreatic radiology

    Choi, Byung Ihn (ed.) [Seoul National Univ. Hospital (Korea, Republic of). Dept. of Radiology


    Clear, practical guide to the diagnostic imaging of diseases of the liver, biliary tree, gallbladder, pancreas, and spleen. A wealth of carefully selected and categorized illustrations. Highlighted key points to facilitate rapid review. Aid to differential diagnosis. Radiology Illustrated: Hepatobiliary and Pancreatic Radiology is the first of two volumes that will serve as a clear, practical guide to the diagnostic imaging of abdominal diseases. This volume, devoted to diseases of the liver, biliary tree, gallbladder, pancreas, and spleen, covers congenital disorders, vascular diseases, benign and malignant tumors, and infectious conditions. Liver transplantation, evaluation of the therapeutic response of hepatocellular carcinoma, trauma, and post-treatment complications are also addressed. The book presents approximately 560 cases with more than 2100 carefully selected and categorized illustrations, along with key text messages and tables, that will allow the reader easily to recall the relevant images as an aid to differential diagnosis. At the end of each text message, key points are summarized to facilitate rapid review and learning. In addition, brief descriptions of each clinical problem are provided, followed by both common and uncommon case studies that illustrate the role of different imaging modalities, such as ultrasound, radiography, CT, and MRI.

  4. Radiology's value chain.

    Enzmann, Dieter R


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

  5. Radiological worker training



    This Handbook describes an implementation process for core training as recommended in Implementation Guide G441.12, Radiation Safety Training, and as outlined in the DOE Radiological Control Standard (RCS). The Handbook is meant to assist those individuals within the Department of Energy, Managing and Operating contractors, and Managing and Integrating contractors identified as having responsibility for implementing core training recommended by the RCS. This training is intended for radiological workers to assist in meeting their job-specific training requirements of 10 CFR 835. While this Handbook addresses many requirements of 10 CFR 835 Subpart J, it must be supplemented with facility-specific information to achieve full compliance.

  6. Westinghouse radiological containment guide

    Aitken, S.B. [Idaho National Engineering Lab., Idaho Falls, ID (United States); Brown, R.L. [Westinghouse Hanford Co., Richland, WA (United States); Cantrell, J.R. [Westinghouse Savannah River Co., Aiken, SC (United States); Wilcox, D.P. [West Valley Nuclear Services Co., Inc., West Valley, NY (United States)


    This document provides uniform guidance for Westinghouse contractors on the implementation of radiological containments. This document reflects standard industry practices and is provided as a guide. The guidance presented herein is consistent with the requirements of the DOE Radiological Control Manual (DOE N 5480.6). This guidance should further serve to enable and encourage the use of containments for contamination control and to accomplish the following: Minimize personnel contamination; Prevent the spread of contamination; Minimize the required use of protective clothing and personal protective equipment; Minimize the generation of waste.

  7. Radiological sciences dictionary

    Dowsett, David


    The Radiological Sciences Dictionary is a rapid reference guide for all hospital staff employed in diagnostic imaging, providing definitions of over 3000 keywords as applied to the technology of diagnostic radiology.Written in a concise and easy to digest form, the dictionary covers a wide variety of subject matter, including:· radiation legislation and measurement · computing and digital imaging terminology· nuclear medicine radionuclides and radiopharmaceuticals· radiographic contrast agents (x-ray, MRI and ultrasound)· definitions used in ultrasound and MRI technology· statistical exp

  8. Design of a realistic radiation field for the calibration of dosimeters used in interventional radiology cardiology (medical personnel dosimetry); Conception d'un champ de rayonnements realiste pour l'etalonnage des dosimetres utilises en radiologie cardiologie interventionnelle (dosimetrie du personnel medical)

    Bordy, J.M.; Daures, J.; Denoziere, M.; Gouriou, J. [CEA Saclay, LIST, Laboratoire National Henri Becquerel, 91 - Gif-sur-Yvette (France); Itie, Ch.; Donadile, L. [Institut de Radioprotection et de Surete Nucleaire (IRSN), 92263 Fontenay-aux-Roses (France); Struelens, L. [Belgian Nuclear Research Centre (SCK.CEN) (Belgium); Schultz, F. [Delft University of Technology, Applied Physics-RRR-RIH, Pays Bas (Netherlands)


    The authors present the principle to determine the reference value in terms of individual dose equivalent for a calibration installation specifically designed to emulate a radiation field faced at a workstation during interventional cardiology or radiology. They present the workstation configuration which includes the patient and the surgeon. They report the study of the calibration installation where the patient and surgeon are replaced by 'phantoms', and indicate the various fluence spectra obtained at different locations corresponding to different parts of the human body. They compare the simulated and measured spectra

  9. Radiological Approach to Forefoot Pain

    Sai Chung Ho


    Full Text Available Forefoot pain is a common clinical complaint in orthopaedic practice. In this article, we discuss the anatomy of the forefoot, clinical and radiological approaches to forefoot pain, and common painful forefoot disorders and their associated radiological features.

  10. 324 Building Baseline Radiological Characterization

    R.J. Reeder, J.C. Cooper


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

  11. Radiological Safety Handbook.

    Army Ordnance Center and School, Aberdeen Proving Ground, MD.

    Written to be used concurrently with the U.S. Army's Radiological Safety Course, this publication discusses the causes, sources, and detection of nuclear radiation. In addition, the transportation and disposal of radioactive materials are covered. The report also deals with the safety precautions to be observed when working with lasers, microwave…

  12. Radiology of spinal curvature

    De Smet, A.A.


    This book offers the only comprehensive, concise summary of both the clinical and radiologic features of thoracic and lumbar spine deformity. Emphasis is placed on idiopathic scoliosis, which represents 85% of all patients with scoliosis, but less common areas of secondary scoliosis, kyphosis and lordosis are also covered.

  13. Radiologic Technology Program Guide.

    Georgia Univ., Athens. Dept. of Vocational Education.

    This guide presents the standard curriculum for technical institutes in Georgia. The curriculum addresses the minimum competencies for a radiologic technology program. The guide contains four major sections. The General Information section contains an introduction giving an overview and defining purpose and objectives; a program description,…

  14. Radiologic manifestations in alcaptonuria

    Justesen, P.; Andersen, P.E.


    Alcaptonuria is a rare, hereditary disorder of amino acid metabolism, secondary to lack of homogentisic acid oxydase. As a consequence, there is an accumulation of homogenitisic acid, which is excreted in the urine and deposited in the connective tissues. This deposition results in ochronotic pigmentation and arthropathy, of which some characteristic radiological findings are demonstrated.

  15. Pituitary adenylate cyclase activating polypeptide induces vascular relaxation and inhibits non-vascular smooth muscle activity in the rabbit female genital tract

    Steenstrup, B R; Ottesen, B; Jørgensen, M


    a significant dose-related relaxation on the NA-precontracted vessels. However, pre-incubation of the vessels with 10(-7) M PACAP-38, PACAP-27 and vaso active intestinal polypeptide (VIP) did not induce a general rightward shift of the NA concentration-response curves, although a tendency to inhibition......In vitro effects of two bioactive forms of pituitary adenylate cyclase activating polypeptide (PACAP): PACAP-38 and PACAP-27 were studied on rabbit vascular and non-vascular smooth muscle. Segments of the ovarian artery and muscle strips from the fallopian tube were used. Two series of experiments...... in the low-dose interval was observed. The peptides caused a significant, dose-dependent inhibition of both frequency and amplitude on the fallopian tube smooth muscle activity. The effects of the three peptides on longitudinally as well as transversally cut specimens were alike....

  16. Ethical problems in radiology: radiological consumerism.

    Magnavita, N; Bergamaschi, A


    One of the causes of the increasing request for radiological examinations occurring in all economically developed countries is the active role played by the patient-consumer. Consumerism places the radiologist in an ethical dilemma, between the principle of autonomy on the one hand and the ethical principles of beneficence, nonmaleficence and justice on the other. The choice made by radiologists in moral dilemmas is inspired by an adherence to moral principles, which in Italy and elsewhere refer to the Judaeo-Christian tradition or to neo-Darwinian relativism. Whatever the choice, the radiologist is bound to adhere to that choice and to provide the patient with all the relevant information regarding his or her state of health.

  17. Computer assisted radiology and surgery. CARS 2010



    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  18. Science and Values in Radiological Protection

    Lochard, J. [Centre d' Etude sur l' Evaluation de la Protection dans le Domaine Nucleaire (CEPN), 92 - Fontenay-aux-Roses (France); Eggermont, G. [Belgian Association of Radiation Protection (Belgium); Britt-Marie, Drottz Sjoberg [Norwegian University of Science and Technology (Norway); Tirmarche, M. [Institut de radioprotection et de surete nucleaire (IRSN), 92 - Fontenay-aux-Roses (France); Geard, Ch.R. [Center for Radiological Research of Columbia University (United States); Atkinson, M. [Institute of Radiation Biology, Helmholtz Zentrum Munich (Germany); Murith, Ch. [Federal Office of Public Health (Switzerland); Grant, K.G. [RESOLVE (United States); Luccioni, C. [Conservatoire National des Arts et Metiers (CNAM), 75 - Paris (France); Mays, C. [NEA, 75 - Paris (France); Sisko, Salomaa [Finnish Centre for Radiation and Nuclear Safety (STUK), Helsinki (Finland); Kelly, N.G.; Oughton, D. [Norwegian University of Life Sciences (Norway); Shannoun, F. [WHO, Geneva (Switzerland); Grant, K.G. [RESOLVE (United States); Cooper, J. [Health Protection Agency (United Kingdom); Mays, C. [NEA, 75 - Paris (France); Weiss, V. [Bundesamt fur Strahlenschutz (Germany); Oughton, D. [Norwegian University of Life Sciences (Norway); Kazuo, Sakai [National Institute of Radiological Science (Japan); Carroll, S. [Swedish Biodiversity Centre, University of Agricultural Sciences and Uppsala University (Sweden)


    protection professionals can better identify and respond to civil society concerns. Session 1: Setting the scene: Holistic presentations of science, values, regulation and public health policy, NGO viewpoints.. An informed view of 'where we stand' on each case topic following the Helsinki workshop. Presentations: Radon as a public health issue (Margot Tirmarche); The continuing story of CT scan risks (Charles R. Geard). Break-out sessions 1. part - Issues surrounding current approaches. This session deepens the discussion and widens the process begun at Helsinki, regarding the new data, phenomena and observations that stimulate us to ask whether current public health and regulatory approaches in each topical area are still adequate, or whether they may need revision. The focus of this session is thus on scientific aspects which may induce a need for paradigm change. Presentation: Radon as a public health issue (Christophe Murith). Evening session 1: Stakeholder platform opportunity (Ola Holmberg). One of the workshop objectives is to foster dialogue between radiological protection professionals, researchers, regulators, and other stakeholders from interested publics in order to deepen discussion on points of interest. In order to maximize stakeholders' benefit in attending the workshop, a platform for communicating and discussing relevant stakeholder views and concerns is offered in this evening context. The on-topic interventions are intended to cover relevant subjects that may not be directly addressed during the rest of the workshop (e.g., risk communication, etc.). This evening session focusses on aspects of dose regulations in radiodiagnostic and radiotherapeutic fields, ALARA in medicine and other issues related to medical exposures. Discussion is intended to be linked to introductory talk in Session 1 on Public Health Perspective in Radiological Protection in Challenging Topical Areas. Presentation: Paediatric CT examinations in nineteenth developing

  19. ISSLS PRIZE IN BIOENGINEERING SCIENCE 2017: Automation of reading of radiological features from magnetic resonance images (MRIs) of the lumbar spine without human intervention is comparable with an expert radiologist.

    Jamaludin, Amir; Lootus, Meelis; Kadir, Timor; Zisserman, Andrew; Urban, Jill; Battié, Michele C; Fairbank, Jeremy; McCall, Iain


    Investigation of the automation of radiological features from magnetic resonance images (MRIs) of the lumbar spine. To automate the process of grading lumbar intervertebral discs and vertebral bodies from MRIs. MR imaging is the most common imaging technique used in investigating low back pain (LBP). Various features of degradation, based on MRIs, are commonly recorded and graded, e.g., Modic change and Pfirrmann grading of intervertebral discs. Consistent scoring and grading is important for developing robust clinical systems and research. Automation facilitates this consistency and reduces the time of radiological analysis considerably and hence the expense. 12,018 intervertebral discs, from 2009 patients, were graded by a radiologist and were then used to train: (1) a system to detect and label vertebrae and discs in a given scan, and (2) a convolutional neural network (CNN) model that predicts several radiological gradings. The performance of the model, in terms of class average accuracy, was compared with the intra-observer class average accuracy of the radiologist. The detection system achieved 95.6% accuracy in terms of disc detection and labeling. The model is able to produce predictions of multiple pathological gradings that consistently matched those of the radiologist. The model identifies 'Evidence Hotspots' that are the voxels that most contribute to the degradation scores. Automation of radiological grading is now on par with human performance. The system can be beneficial in aiding clinical diagnoses in terms of objectivity of gradings and the speed of analysis. It can also draw the attention of a radiologist to regions of degradation. This objectivity and speed is an important stepping stone in the investigation of the relationship between MRIs and clinical diagnoses of back pain in large cohorts. Level 3.

  20. Radiological analysis of osteoporosis

    Lemaire, C


    This paper is intended to provide medical radiation technologists with an overview of how radiology can play a role in the detection of osteoporosis. Osteoporosis is defined as disease where there is a generalized or localized deficiency of bone matrix. This deficiency causes bones to become weak resulting in an increased risk of fracture. Current methods to detect bone deficiency involve the use of bone densitometry. Over the years both radioactivity and ionizing radiation have been used to measure bone density. Currently the preferred method of choice for bone densitometry is a dual energy x-ray absorptiometry unit. This unit has the greatest reliability and precision with a low absorbed dose to the patient. With early detection of the disease, treatment can begin and further bone loss prevented. In the future, radiology will continue to be a valuable asset in the diagnosis and management of osteoporosis. (author)

  1. Radiologic aspects of lunatomalacia

    Rasmussen, F.; Schantz, K.


    A radiological classification of lunatomalacia, based upon the chronological radiologic manifestations in 93 patients is presented. Compression fractures were not seen as the initial event. Fifty-seven per cent of the patients had a short ulna (ulna minus variant). The presence of ulna minus variant was expecially observed in the younger patients. In 16 patients suffering from a lunate fracture and in 20 patients with lunate or perilunate luxations, lunatomalacia did not develop. Immobilization as treatment of the disorder resulted in a progressive course in all patients, but one, an 8-year-old girl. The lesion of the lunate was arrested and tended to heal following radial osteotomy in all patients. (orig.)

  2. Data mining in radiology.

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


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

  3. Radiology and Ethics Education.

    Camargo, Aline; Liu, Li; Yousem, David M


    The purpose of this study is to assess medical ethics knowledge among trainees and practicing radiologists through an online survey that included questions about the American College of Radiology Code of Ethics and the American Medical Association Code of Medical Ethics. Most survey respondents reported that they had never read the American Medical Association Code of Medical Ethics or the American College of Radiology Code of Ethics (77.2% and 67.4% of respondents, respectively). With regard to ethics education during medical school and residency, 57.3% and 70.0% of respondents, respectively, found such education to be insufficient. Medical ethics training should be highlighted during residency, at specialty society meetings, and in journals and online resources for radiologists.

  4. Data mining in radiology

    Amit T Kharat


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

  5. Data mining in radiology

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


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

  6. Disabling Radiological Dispersal Terror

    Hart, M


    Terror resulting from the use of a radiological dispersal device (RDD) relies upon an individual's lack of knowledge and understanding regarding its significance. Disabling this terror will depend upon realistic reviews of the current conservative radiation protection regulatory standards. It will also depend upon individuals being able to make their own informed decisions merging perceived risks with reality. Preparation in these areas will reduce the effectiveness of the RDD and may even reduce the possibility of its use.

  7. Microcephaly: a radiological review

    Tarrant, Ailbhe; Garel, Catherine; Germanaud, David; Lenoir, Marion; Pointe, Hubert Ducou le [Universite Paris VI Pierre et Marie Curie, Radiology Department, Hopital d' Enfants Armand-Trousseau, Paris (France); Villemeur, Thierry Billette de; Mignot, Cyril [Universite Paris V Rene Descartes, CNRS (UMR 8104), Inserm, U567, Institut Cochin, Paris (France); Universite Paris VI Pierre et Marie Curie, Paediatric Neurology Department, Hopital d' Enfants Armand-Trousseau, Paris (France)


    Microcephaly results from inadequate brain growth during development. It may develop in utero, and therefore be present at birth, or may develop later as a result of perinatal events or postnatal conditions. The aetiology of microcephaly may be congenital (secondary to cerebral malformations or metabolic abnormalities) or acquired, most frequently following an ischaemic insult. This distinct radiological and pathological entity is reviewed with a specific focus on aetiology. (orig.)

  8. Radiological safety and control

    Chang, Sea Young; Yoo, Y. S.; Lee, J. C.; Lee, T. Y.; Lee, J. L.; Kim, B. W.; Lee, B. J.; Chung, K. K.; Chung, R. I.; Kim, J. S.; Lee, H. S.; Han, Y. D.; Lee, J. I.; Lee, K. C.; Yoon, J. H.; Sul, C. W.; Kim, C. K.; Yoon, K. S.; Seo, K. W.; Yoon, Y. C. [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)


    This report describes the annual results of radiological safety and control program of 1995. This program consists of working area monitoring including HANARO, personnel radiation monitoring, education for radiation protection. As a result, the objectives of radiation protection have been achieved satisfactorily through the activities mentioned above. Also, the calibration services were provided to insure accurate radiation measurement in the radiation working places. 21 figs., 39 tabs., 5 refs. (Author) .new.

  9. Pitfalls in diagnostic radiology

    Peh, Wilfred C.G. (ed.) [Khoo Teck Puat Hospital (Singapore). Dept. of Diagnostic Radiology


    Only textbook to focus primarily on the topic of pitfalls in diagnostic radiology. Highlights the pitfalls in a comprehensive and systematic manner. Written by experts in different imaging modalities and subspecialties from reputable centers across the world. The practice of diagnostic radiology has become increasingly complex, with the use of numerous imaging modalities and division into many subspecialty areas. It is becoming ever more difficult for subspecialist radiologists, general radiologists, and residents to keep up with the advances that are occurring year on year, and this is particularly true for less familiar topics. Failure to appreciate imaging pitfalls often leads to diagnostic error and misinterpretation, and potential medicolegal problems. Diagnostic errors may be due to various factors such as inadequate imaging technique, imaging artifacts, failure to recognize normal structures or variants, lack of correlation with clinical and other imaging findings, and poor training or inexperience. Many, if not most, of these factors are potentially recognizable, preventable, or correctable. This textbook, written by experts from reputable centers across the world, systematically and comprehensively highlights the pitfalls that may occur in diagnostic radiology. Both pitfalls specific to different modalities and techniques and those specific to particular organ systems are described with the help of numerous high-quality illustrations. Recognition of these pitfalls is crucial in helping the practicing radiologist to achieve a more accurate diagnosis.

  10. Progress in diagnosis of breast cancer: Advances in radiology technology

    J Mari Beth Linder


    Full Text Available Breast cancer is the leading cause of cancer in females between the ages of 15 and 54, and the second leading cause of cancer death in women in the United States. Diagnosis begins with detection by breast examination (clinical breast exam or breast self-exam or by radiologic studies, like mammography. Many advances in the diagnosis of breast cancer have taken place in recent years. This article will review the history of radiologic advances in the diagnosis of breast cancer. Use of technological advancements in digital breast tomosynthesis, magnetic resonance imaging, and ultrasound in breast cancer diagnosis will be presented. Advantages and disadvantages of these diagnostic interventions when compared to older, traditional X-ray films will be discussed. It is important for all nurses, including radiology and oncology nurses, to be well informed about these varied diagnostic modalities, and appreciate the fact that advances in radiologic imaging technologies can yield improved outcomes for breast cancer patients.

  11. French days of radiology (J.F.R.) 2005; Journees francaises de radiologie (JFR) 2005



    Five parts are presented, the nuclear safety authority informs the radiologists on the evolution of the regulation in radiation protection and its practical application; statements of medical and dental radiodiagnosis equipments; licensing for use of radiodiagnosis installation; to use the diagnosis reference levels in radiology to optimize the practices; radiation protection in interventional radiology. (N.C.)

  12. French days of radiology (J.F.R.) 2005; Journees francaises de radiologie (JFR) 2005



    Five parts are presented, the nuclear safety authority informs the radiologists on the evolution of the regulation in radiation protection and its practical application; statements of medical and dental radiodiagnosis equipments; licensing for use of radiodiagnosis installation; to use the diagnosis reference levels in radiology to optimize the practices; radiation protection in interventional radiology. (N.C.)

  13. Renewal of radiological equipment.


    In this century, medical imaging is at the heart of medical practice. Besides providing fast and accurate diagnosis, advances in radiology equipment offer new and previously non-existing options for treatment guidance with quite low morbidity, resulting in the improvement of health outcomes and quality of life for the patients. Although rapid technological development created new medical imaging modalities and methods, the same progress speed resulted in accelerated technical and functional obsolescence of the same medical imaging equipment, consequently creating a need for renewal. Older equipment has a high risk of failures and breakdowns, which might cause delays in diagnosis and treatment of the patient, and safety problems both for the patient and the medical staff. The European Society of Radiology is promoting the use of up-to-date equipment, especially in the context of the EuroSafe Imaging Campaign, as the use of up-to-date equipment will improve quality and safety in medical imaging. Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or renewal. This plan should look forward a minimum of 5 years, with annual updates. Teaching points • Radiological equipment has a definite life cycle span, resulting in unavoidable breakdown and decrease or loss of image quality which renders equipment useless after a certain time period.• Equipment older than 10 years is no longer state-of-the art equipment and replacement is essential. Operating costs of older equipment will be high when compared with new equipment, and sometimes maintenance will be impossible if no spare parts are available.• Older equipment has a high risk of failure and breakdown, causing delays in diagnosis and treatment of the patient and safety problems both for the patient and the medical staff.• Every healthcare institution or authority should have a plan for medical imaging equipment upgrade or replacement. This plan should look forward a

  14. Radiological aspects of Gaucher disease

    Katz, Robert; Booth, Tom; Hargunani, Rikin; Wylie, Peter; Holloway, Brian [Royal Free Hospital, Radiology Department, London (United Kingdom)


    Advances in imaging and the development of commercially available enzyme therapy have significantly altered the traditional radiology of Gaucher disease. The cost of treatment and need for monitoring response to therapy have magnified the importance of imaging. There are no recent comprehensive reviews of the radiology of this relatively common lysosomal storage disease. This article describes the modern imaging, techniques and radiological manifestations of Gaucher disease. (orig.)

  15. Radiological safety and control

    Seo, Kyeong Won; You, Young Soo; Chang, Sea Young; Yoon, Yeo Chang; Yoon, Suk Chul; Kim, Jang Yeol; Lee, Tae Young; Lee, Bong Jae; Kim, Bong Hwan; Lee, Jong Il; Jeong, Juk Yeon; Lee, Sang Yeol; Jeong, Kyung Ki; Jeong, Rae Ik; Kim, Jong Su; Han, Young Dae; Lee, Hyung Sub; Kim, Chang Kyung [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)


    This report describes the annual results of radiological safety and control program. This program includes working area monitoring (WAM), personnel radiation monitoring (PRM), education for radiation protection (ERP), preparing for KMRR operation and developing QA program on personal dose evaluation. As a result, the objectives of radiation protection have been achieved satisfactorily through the WAM, PRM and ERP. The QA program on personal dose evaluation has been approved by the MOST according to the Ministerial Ordinance (No. 1992-15). KAERI has also been authorized as a specialized processor for personal dose evaluation. 32 tabs., 20 figs. (Author) .new.

  16. Radiological evaluation of chondroblastoma

    Hudson, T.M.; Hawkins, I.F. Jr.


    Eleven new and six recurrent chondroblastomas were studied with multiple radiological imaging methods (plain radiography, conventional tomography, computed tomography, radionuclide bone scanning, and angiography). When the plain radiographic appearance was typical, conventional tomography or computed tomography (CT) was helpful, but other studies were not. Periosteal reaction and angiographic hypervascularity were common and did not indicate cortical breakthrough. For large, aggressive, or atypical lesions, conventional tomography and CT were helpful in delineating anatomic extent, and angiography was of value in demonstrating major vessel displacement. Radionuclide bone scanning was not useful.

  17. Radiological Calibration and Standards Facility

    Federal Laboratory Consortium — PNNL maintains a state-of-the-art Radiological Calibration and Standards Laboratory on the Hanford Site at Richland, Washington. Laboratory staff provide expertise...

  18. Radiology illustrated. Spine

    Kang, Heung Sik; Lee, Joon Woo [Seoul National Univ. Bundang Hospital, Seongnam, Kyonggi-do (Korea, Republic of). Dept. of Radiology; Kwon, Jong Won [Samsung Medical Center, Seoul (Korea, Republic of). Dept. of Radiology


    Offers a practical approach to image interpretation for spinal disorders. Includes numerous high-quality radiographic images and schematic illustrations. Will serve as a self-learning book covering daily routine cases from the basic to the advanced. Radiology Illustrated: Spine is an up-to-date, superbly illustrated reference in the style of a teaching file that has been designed specifically to be of value in clinical practice. Common, critical, and rare but distinctive spinal disorders are described succinctly with the aid of images highlighting important features and informative schematic illustrations. The first part of the book, on common spinal disorders, is for radiology residents and other clinicians who are embarking on the interpretation of spinal images. A range of key disorders are then presented, including infectious spondylitis, cervical trauma, spinal cord disorders, spinal tumors, congenital disorders, uncommon degenerative disorders, inflammatory arthritides, and vascular malformations. The third part is devoted to rare but clinically significant spinal disorders with characteristic imaging features, and the book closes by presenting practical tips that will assist in the interpretation of confusing cases.

  19. Sexual Harassment in Radiology.

    Camargo, Aline; Liu, Li; Yousem, David M


    To gauge the prevalence of sexual harassment (SH) and to understand the issues regarding its disclosure among radiologists. A questionnaire on ethics and SH was sent by e-mail to 1,569 radiologists and radiology trainees in an institutional database maintained for continuing medical education purposes on three separate occasions between September 17 and October 31, 2016. The link to the survey was also posted on social media sites via the authors' divisional and institutional accounts on Facebook, Twitter, Instagram, and Aunt Minnie, as well as on ACR and RSNA web blogs. Overall, 9.75% (39 of 400) respondents stated they had suffered SH, with more female (22 of 90 = 24.4%) than male victims (11 of 249 = 4.4%) (P victims said they would likely report SH (P witnessed SH. By percentage responding, female radiologists are more frequently victims and witnesses of sexual harassment but are less likely to report such cases. Steps need to be taken to eliminate a culture that leads radiologists to tolerate SH without addressing it. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. Radiology – Changing Role in Healthcare

    Md Khalilur Rahman


    also as a major contributor to treatment and recovery. Working in tandem with other disciplines, radiology has had a major impact on achievements in such significant areas as early cancer detection, speedy trauma analysis, precise stroke localization and many others.7 Interventional radiology, one of the subspecialty areas of radiology, uses the imaging modalities of diagnostic radiology to guide minimally invasive surgical procedures, such as that in laparoscopic gallstone surgery. The number of interventional radiology examinations has shown a huge rise, increasing by over 50% since 2007. Therapeutic radiology, better known as radiation oncology uses radiation to treat diseases such as cancer using a form of treatment called radiation therapy.5,8 The last few decades have witnessed dramatic innovations and improvisations in imaging technology. In all sense radiological advances have revolutionized the practice of modern medicine. Imaging now uses a wide range of modalities that vary in their mode of image acquisition. In order to request the correct imaging technique and thereby improve patient management, it is useful for the practicing clinician to be conversant with all imaging techniques available, their advantages as well as limitations, indications and contraindications of each modality.

  1. White Paper: Radiological Curriculum for Undergraduate Medical Education in Germany.

    Ertl-Wagner, B; Barkhausen, J; Mahnken, A H; Mentzel, H J; Uder, M; Weidemann, J; Stumpp, P


    Purpose: Radiology represents a highly relevant part of undergraduate medical education from preclinical studies to subinternship training. It is therefore important to establish a content base for teaching radiology in German Medical Faculties. Materials and Methods: The German Society of Radiology (DRG) developed a model curriculum for radiological teaching at German medical universities, which is presented in this article. There is also a European model curriculum for undergraduate teaching (U-level curriculum of the European Society of Radiology). In a modular concept, the students shall learn important radiological core principles in the realms of knowledge, skills and competences as well as core scientific competences in the imaging sciences. Results: The curriculum is divided into two modules. Module 1 includes principles of radiation biology, radiation protection and imaging technology, imaging anatomy as well as the risks and side effects of radiological methods, procedures and contrast media. This module is modality-oriented. Module 2 comprises radiological diagnostic decision-making and imaging-based interventional techniques for various disease entities. This module is organ system-oriented. Conclusion: The curriculum is meant as a living document to be amended and revised at regular intervals. The curriculum can be used as a basis for individual curricular development at German Medical Faculties. It can be integrated into traditional or reformed medical teaching curricula. Key Points: • Radiology is an integral and important part of medical education.• The German Society of Radiology (DRG) developed a model curriculum for teaching radiology at German Medical Faculties to help students develop the ability to make medical decisions based on scientific knowledge and act accordingly.• This curriculum can be used for individual curricular development at medical departments. It is divided into two modules with several chapters. Citation Format

  2. Outcome of radiologically placed tunneled haemodialysis catheters.

    Sayani, Raza; Anwar, Muhammad; Tanveer-ul-Haq; Al-Qamari, Nauman; Bilal, Muhammad Asif


    To study the outcome of radiologically placed double lumen tunneled haemodialysis catheters for the management of renal failure. Case series. Interventional Suite of Radiology Department at the Aga Khan University Hospital, Karachi, from April 2010 to June 2011. All consecutive patients who were referred to the department of radiology by the nephrologists for double lumen tunneled haemodialysis catheter (Permacath) placement during the study period were included. Patients with septicemia, those for whom follow-up was not available, those coming for catheter exchange or who died due to a noncatheter related condition were excluded. A radio-opaque, soft silicone double lumen catheter was inserted through a subcutaneous tunnel created over the anterior chest wall. The catheter tip was placed in the right atrium via the internal jugular vein. Ultrasound guidance was used for initial venous puncture. The rest of the procedure was carried out under fluoroscopic guidance. Technical success, catheter related bacteremia rates, adequacy of dialysis, patency, and adverse events were analyzed. Overall 88 tunneled haemodialysis catheters were placed in 87 patients. Patients were followed-up for duration of 1 - 307 days with mean follow-up period of 4 months. Immediate technical success was 100%. The procedural complication rate was 5.6% (5 catheters). Eight patients died during the study period, seven from causes unrelated to the procedure. One patient died due to septicemia secondary to catheter related infection. Of the remaining 69 patients, 50 (72.4%) predominantly had uneventful course during the study period. Twelve patients developed infection (17.3%); two were successfully treated conservatively while in 10 patients catheter had to be removed. Seven catheters (10.1%) failed due to mechanical problems. In 3 patients the internal jugular veins got partially thrombosed. One catheter was accidentally damaged in the ward and had to be removed. Radiological guided tunneled

  3. Common Data Elements in Radiology.

    Rubin, Daniel L; Kahn, Charles E


    Diagnostic radiologists generally produce unstructured information in the form of images and narrative text reports. Although designed for human consumption, radiologic reports contain a wealth of information that could be valuable for clinical care, research, and quality improvement if that information could be extracted by automated systems. Unfortunately, the lack of structure in radiologic reports limits the ability of information systems to share information easily with other systems. A common data element (CDE)-a unit of information used in a shared, predefined fashion-can improve the ability to exchange information seamlessly among information systems. In this article, a model and a repository of radiologic CDEs is described, and three important applications are highlighted. CDEs can help advance radiologic practice, research, and performance improvement, and thus, it is crucial that CDEs be adopted widely in radiologic information systems. (©) RSNA, 2016.

  4. Radiological Work Planning and Procedures

    Kurtz, J E


    Each facility is tasked with maintaining personnel radiation exposure as low as reasonably achievable (ALARA). A continued effort is required to meet this goal by developing and implementing improvements to technical work documents (TWDs) and work performance. A review of selected TWDs from most facilities shows there is a need to incorporate more radiological control requirements into the TWD. The Radioactive Work Permit (RWP) provides a mechanism to place some of the requirements but does not provide all the information needed by the worker as he/she is accomplishing the steps of the TWD. Requiring the engineers, planners and procedure writers to put the radiological control requirements in the work steps would be very easy if all personnel had a strong background in radiological work planning and radiological controls. Unfortunately, many of these personnel do not have the background necessary to include these requirements without assistance by the Radiological Control organization at each facility. In add...

  5. Radiological changes of adult sprue

    Neutard, E.; Kluge, F.


    Radiological findings of 10 adult patients with sprue were compared with histology. Patients suffering from subtotal villous atrophy were showing distinct radiological changes. The most important finding of sprue is the dilatation of the small intestine. Further typical changes are segmentations and fragmentations as well as mucous hypertrophy and the sign of moulage. In a 57-year-old female patient who was suffering from sprue for 35 years, a carcinoma of the small bowl was found and was resected during laparatomy. Sprue is a premalignant disease; therefore radiological investigations are of special importance. Therapy by a diet without gluten can reduce the radiological changes to normal very bad changes rarely can be reduced totally. Radiological changes are not significant, but the diagnosis can be made in most cases by investigation with barium.

  6. Radiology illustrated. Gastrointestinal tract

    Choi, Byung Ihn (ed.) [Seoul National University Hospital (Korea, Republic of). Dept. of Radiology


    Radiology Illustrated: Gastrointestinal Tract is the second of two volumes designed to provide clear and practical guidance on the diagnostic imaging of abdominal diseases. The book presents approximately 300 cases with 1500 carefully selected and categorized illustrations of gastrointestinal tract diseases, along with key text messages and tables that will help the reader easily to recall the relevant images as an aid to differential diagnosis., Essential points are summarized at the end of each text message to facilitate rapid review and learning. Additionally, brief descriptions of each clinical problem are provided, followed by case studies of both common and uncommon pathologies that illustrate the roles of the different imaging modalities, including ultrasound, radiography, computed tomography, and magnetic resonance imaging.

  7. Abdominal hernias: Radiological features

    Lassandro, Francesco; Iasiello, Francesca; Pizza, Nunzia Luisa; Valente, Tullio; Stefano, Maria Luisa Mangoni di Santo; Grassi, Roberto; Muto, Roberto


    Abdominal wall hernias are common diseases of the abdomen with a global incidence approximately 4%-5%. They are distinguished in external, diaphragmatic and internal hernias on the basis of their localisation. Groin hernias are the most common with a prevalence of 75%, followed by femoral (15%) and umbilical (8%). There is a higher prevalence in males (M:F, 8:1). Diagnosis is usually made on physical examination. However, clinical diagnosis may be difficult, especially in patients with obesity, pain or abdominal wall scarring. In these cases, abdominal imaging may be the first clue to the correct diagnosis and to confirm suspected complications. Different imaging modalities are used: conventional radiographs or barium studies, ultrasonography and Computed Tomography. Imaging modalities can aid in the differential diagnosis of palpable abdominal wall masses and can help to define hernial contents such as fatty tissue, bowel, other organs or fluid. This work focuses on the main radiological findings of abdominal herniations. PMID:21860678

  8. Radiologic findings in neurofibromatosis

    Kim, Dai Young; Jeon, Seok Chol; Lee, Kwan Se; Yeon, Kyung Mo; Choo, Dong Woon [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Neurofibromatosis is an uncommon but certainly not a rare hereditary disorder, probably of neuralcrest origin, involving not only neuroectoderm and mesoderm but also endoderm and characterized by cafe au lait spots and cutaneous and subcutaneous tumors, with secondary mesodermal defects responsible for protean osseous abnormalities and various manifestations in other systems. This paper is a study of confirmed 143 cases of neurofibromatosis collected for past 8 years. In this analysis, special attention was given to the selected 37 cases which showed abnormal findings on radiological examinations. Overall male to female ratio was 1 : 1.3. The most frequent kind of abnormalities was vertebral kyphoscoliosis in 12 cases. Among the more pathognomonic but uncommon abnormalities to neurofibromatosis, we experienced each 2 cases of lambdoid defect, pseudoarthrosis and renovascular hypertension, and 1 cases of sphenoid bone absence.

  9. "Patient care in radiology"

    Bro Brask, Kirsten; Birkelund, Regner


    and semistructured interviews and analyzed according to the guidelines for meaning condensation by Giorgi. The imaging staff found that care is expressed in an administrative, an instrumental, and a compassionate sense. The imaging staff perceived care in a way that clearly differs from the traditional perception...... of care understood as the close relations between people. In their self-understanding, the staff found that care not only comprised the relational aspect but also that it was already delivered during the preparatory phases before the actual meeting with the patient and up until the image...... was electronically forwarded. And, care expressed in between was perceived as care in the traditional sense and termed as “patient care in radiology.”...

  10. Optimal Radiologic Report

    Esmaeel Shokrollahi


    Full Text Available The radiological report is the medical document that qualifies the radiologist as a clinician and as a specialist, because through it radiologists expresse their professionalism."nThere is nothing more debatable than the report and how it should be written. It is conditioned by many variables that derive from the wide variety of sensitivities and personal or local cultures. In addition, there has never been a specific school in which these rules are taught."nIn the assessment of each written material, two things are explained:"n1. Methodology of the writing process itself as an act"n2. Characters of the written material "nIn assessing the method of writing a radiological report, two dimensions are discussed: "n1. Hardware: including data gathering, their processing and preparing them to be seen, the me-thod of reporting, conditions of workspace, instru-ments and all the physical parts of the work."n2. Software: how someone watches the images, me-thodology of thought and logical reasoning, and ultimately, how pictures are transferred to understandable, meaningful and useful written material."nIn assessing the characters of the written material itself, we should note:"n1. The configuration includes the structure of the words and grammar, style of writing, order of things to come after each other. This is the carrier of the content. "n2. The content is the main reason of the writing which contains the whole meaning and all parts of what one wants his or her audience to get from the note.

  11. Radiology of bacterial pneumonia

    Vilar, Jose E-mail:; Domingo, Maria Luisa; Soto, Cristina; Cogollos, Jonathan


    Bacterial pneumonia is commonly encountered in clinical practice. Radiology plays a prominent role in the evaluation of pneumonia. Chest radiography is the most commonly used imaging tool in pneumonias due to its availability and excellent cost benefit ratio. CT should be used in unresolved cases or when complications of pneumonia are suspected. The main applications of radiology in pneumonia are oriented to detection, characterisation and follow-up, especially regarding complications. The classical classification of pneumonias into lobar and bronchial pneumonia has been abandoned for a more clinical classification. Thus, bacterial pneumonias are typified into three main groups: Community acquired pneumonia (CAD), Aspiration pneumonia and Nosocomial pneumonia (NP).The usual pattern of CAD is that of the previously called lobar pneumonia; an air-space consolidation limited to one lobe or segment. Nevertheless, the radiographic patterns of CAD may be variable and are often related to the causative agent. Aspiration pneumonia generally involves the lower lobes with bilateral multicentric opacities. Nosocomial Pneumonia (NP) occurs in hospitalised patients. The importance of NP is related to its high mortality and, thus, the need to obtain a prompt diagnosis. The role of imaging in NP is limited but decisive. The most valuable information is when the chest radiographs are negative and rule out pneumonia. The radiographic patterns of NP are very variable, most commonly showing diffuse multifocal involvement and pleural effusion. Imaging plays also an important role in the detection and evaluation of complications of bacterial pneumonias. In many of these cases, especially in hospitalised patients, chest CT must be obtained in order to better depict these associate findings.

  12. Radiological anatomy - evaluation of integrative education in radiology.

    Dettmer, S; Schmiedl, A; Meyer, S; Giesemann, A; Pabst, R; Weidemann, J; Wacker, F K; Kirchhoff, T


    Evaluation and analysis of the integrative course "Radiological Anatomy" established since 2007 at the Medical School Hannover (MHH) in comparison with conventional education. Anatomy and radiology are usually taught separately with a considerable time lag. Interdisciplinary teaching of these associated subjects seems logical for several reasons. Therefore, the integrative course "Radiological Anatomy" was established in the second year of medical education, combining these two closely related subjects. This interdisciplinary course was retrospectively evaluated by consideration of a student questionnaire and staff observations. The advantages and disadvantages of integrative teaching in medical education are discussed. The course ratings were excellent (median 1; mean 1.3 on a scale of 1 to 6). This is significantly (p radiology increased during the course (88 %). According to the students' suggestions the course was enhanced by a visitation in the Department of Radiology and the additional topic central nervous system. Integrative teaching of anatomy and radiology was well received by the students. Both, anatomical and radiological comprehension and the motivation to learn were improved. However, it should be considered, that the amount of work and time required by the teaching staff is considerably increased compared to traditional teaching. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Status of radiological services in Addis Ababa public hospitals.

    Shimelis, Dagmawit; Tsige, Mesfin; Atnafu, Asfaw


    believe this finding can be used as an indirect indicator of the possible worse scenario in the regional and peripheral hospitals. Therefore a nation- wide survey & plannedgovernment intervention is recommended to improve the radiological service.

  14. [Nursing care in patients undergoing radiological surgery. A case report].

    Armero-Barranco, David; Ruiz-Mateos, María; Alcaraz-Baños, Miguel; Bernal-Páez, Fernando Luis


    We report the case of a 73-year-old man with medical diagnoses of long-standing diabetes mellitus, chronic ischemia of the lower limbs and intermittent claudication, for which the patient had been treated with minimally invasive radiological surgery. On arrival at the radiology unit, the patient had nursing diagnoses of anxiety and fear. Intraoperatively, the client had nursing diagnoses of pain, urine retention and infection risk. At discharge, a collaboration problem was detected and hemorrhagic risk. The patient received individualized nursing care. Interventions were planned following the nursing intervention classification (NIC) and the expected results for these interventions followed the Nursing Outcomes Classification (NOC) taxonomy. The application of an appropriate nursing care plan contributes to making the patient's hospital stay easier, more comfortable and less traumatic.

  15. Crystalline dose of interventional radiologists; Dosis en cristalino de radiologicos intervencionistas

    Hernandez Concepcion, E.; Diaz Romero, F.; Catalan Acosta, A.; Hernandez Armas, J.


    The measured dose area product in radiology equipment used in angio radiology during different diagnostic and therapeutic can be used to estimate the value of the dose in the lens of doctors or medical personnel carrying out such interventions. (Author)

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

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


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

  17. Radiological aspects of rheumatoid arthritis

    Schacherl, M.


    An introductory summary of the imaging-diagnosis will be given. The necessity of acquiring a catalogue of application to particular imaging methods is emphasized. Discussion of step by step diagnosis regarding rheumatologic questions is given on example of the hand. Technically insufficient radiographs and bad habits during diagnostic analysis are pointed out. Radiologic problems in differentiating arthritis/osteoarthrosis will be mentioned. The discussion of these points is followed by outlining the radiology of rheumatoid arthritis and the complexity of this disease. Introduction of a new stage classification. Finally twelve basic radiologic types of rheumatoid arthritis will be presented.

  18. Radiology system evolution in the new millennium.

    Nauert, R C


    For many decades the practice of radiology grew slowly in America and was largely a secondary function under the control of hospitals. In more recent times it has vastly expanded its array of diagnostic, interventional, and therapeutic abilities. There is increasing consumer logic for direct access. Motivations have grown to create large independent entities with broadly diverse capabilities in order to succeed in the new millennium. Most regional markets are evolving rapidly in terms of managed care penetration, health system formation, physician practice consolidation and aggressive purchaser behavior by employers and consumers. To understand the enormity of healthcare evolution, it is useful to look at the industry's paradigm shifts in recent decades. Virtually every aspect of organizational infrastructure, delivery approaches, and the business environment has evolved markedly during the past fifty years. These changes will accelerate. To succeed financially, radiology groups must strengthen their market positions, technical capabilities, continuums of care and geographic dominance. Equally important is the wisdom of diversifying incomes into related services and businesses that provide additional related revenues. Key factors for successful development include facility market growth, full coverage of managed care contracts, high efficiency and aggressive diversification. A fully evolved system generates significant revenues and profitability by protecting and strengthening its financial position in this environment. That is accomplished through the development of strategically located radiology groups, aggressive alliances with medical practices in allied disciplines, and managed radiology departments and facilities for partner health systems. Organizational success ultimately depends on the ability to accept capitated payments under risk-bearing arrangements. The strategic business plan should be organized with the appropriate levels of detail needed to

  19. Cardiac radiology: centenary review.

    de Roos, Albert; Higgins, Charles B


    During the past century, cardiac imaging technologies have revolutionized the diagnosis and treatment of acquired and congenital heart disease. Many important contributions to the field of cardiac imaging were initially reported in Radiology. The field developed from the early stages of cardiac imaging, including the use of coronary x-ray angiography and roentgen kymography, to nowadays the widely used echocardiographic, nuclear medicine, cardiac computed tomographic (CT), and magnetic resonance (MR) applications. It is surprising how many of these techniques were not recognized for their potential during their early inception. Some techniques were described in the literature but required many years to enter the clinical arena and presently continue to expand in terms of clinical application. The application of various CT and MR contrast agents for the diagnosis of myocardial ischemia is a case in point, as the utility of contrast agents continues to expand the noninvasive characterization of myocardium. The history of cardiac imaging has included a continuous process of advances in our understanding of the anatomy and physiology of the cardiovascular system, along with advances in imaging technology that continue to the present day.

  20. Granulomatous mastitis: radiological findings

    Ozturk, M.; Mavili, E.; Kahriman, G.; Akcan, A.C.; Ozturk, F. [Depts. of Radiology, Surgery, and Pathology, Erciyes Univ. Medical Faculty, Kayseri (Turkey)


    Purpose: To evaluate the radiological, ultrasonographic, and magnetic resonance imaging (MRI) findings of idiopathic granulomatous mastitis. Material and Methods: Between April 2002 and June 2005, the mammography, ultrasound, color Doppler ultrasound, non enhanced MR, and dynamic MR findings of nine patients with the preliminary clinical diagnosis of malignancy and the final diagnosis of granulomatous mastitis were evaluated. Results: On mammography, asymmetrical focal densities with no distinct margins, ill-defined masses with spiculated contours, and bilateral multiple ill-defined nodules were seen. On ultrasound, in four patients a discrete, heterogenous hypoechoic mass, in two patients multiple abscesses, in one patient bilateral multiple central hypo peripheral hyperechoic lesions, in two patients heterogeneous hypo- and hyperechoic areas together with parenchymal distortion, and in one patient irregular hypoechoic masses with tubular extensions and abscess cavities were seen. Five of the lesions were vascular on color Doppler ultrasound. On MR mammography, the most frequent finding was focal or diffuse asymmetrical signal intensity changes that were hypointense on T1W images and hyperintense on T2W images, without significant mass effect. Nodular lesions were also seen. On dynamic contrast-enhanced mammography, mass-like enhancement, ring-like enhancement, and nodular enhancement were seen. The time-intensity curves differed from patient to patient and from lesion to lesion. Conclusion: The imaging findings of idiopathic granulomatous mastitis have a wide spectrum, and they are inconclusive for differentiating malignant and benign lesions.

  1. [Controlling in outpatient radiology].

    Baum, T


    Radiology is among the medical disciplines which require the highest investment costs in the healthcare system. The need to design efficient workflows to ensure maximum utilization of the equipment has long been known. In order to be able to establish a sound financial plan prior to a project or equipment purchase, the costs of an examination have to be broken down by modality and compared with the reimbursement rates. Obviously, the same holds true for operative decisions when scarce human resources have to be allocated. It is the task of controlling to review the economic viability of the different modalities and ideally, the results are incorporated into the management decision-making processes. The main section of this article looks at the recognition and allocation of direct and indirect costs in a medical center (Medizinisches Versorgungszentrum - MVZ) in the German North Rhine region. The profit contribution of each examination is determined by deducting the costs from the income generated by the treatment of patients with either private or statutory health insurance.

  2. Radiological Assistance Program (RAP) Regions

    Department of Homeland Security — The U.S. Department of Energy (DOE) created the Radiological Assistance Program (RAP) in the 1950s to make DOE resources and expertise available to organizations...

  3. National Radiological Fixed Lab Data

    U.S. Environmental Protection Agency — The National Radiological Fixed Laboratory Data Asset includes data produced in support of various clients such as other EPA offices, EPA Regional programs, DOE,...

  4. Development of Mobile Radiological Monitor


    <正>Mobile radiological monitor is used to detect gamma rays and neutron for personal and vehicle. It can be installed on a microbus as a mobile monitoring system. One large plastic scintillation detector is

  5. The Radiological Research Accelerator Facility

    Hall, E.J.


    The Radiological Research Accelerator Facility (RARAF) is based on a 4-MV Van de Graaff accelerator, which is used to generate a variety of well-characterized radiation beams for research in radiobiology, radiological physics, and radiation chemistry. It is part of the Center for Radiological Research (CRR) -- formerly the Radiological Research Laboratory (RRL) -- of Columbia University, and its operation is supported as a National Facility by the US Department of Energy (DOE). As such, RARAF is available to all potential users on an equal basis, and scientists outside the CRR are encouraged to submit proposals for experiments at RARAF. The operation of the Van de Graaff is supported by the DOE, but the research projects themselves must be supported separately. Experiments performed from May 1991--April 1992 are described.

  6. The Radiological Research Accelerator Facility

    Hall, E.J.; Marino, S.A.


    The Radiological Research Accelerator Facility (RARAF) is based on a 4-MV Van de Graaff accelerator, which is used to generate a variety of well-characterized radiation beams for research in radiobiology, radiological physics, and radiation chemistry. It is part of the Center for Radiological Research (CRR) - formerly the Radiological Research Laboratory of Columbia University, and its operation is supported as a National Facility by the US Department of Energy (DOE). As such, RARAF is available to all potential users on an equal basis and scientists outside the CRR are encouraged to submit proposals for experiments at RARAF. The operation of the Van de Graaff is supported by the DOE, but the research projects themselves must be supported separately. This report provides a listing and brief description of experiments performed at RARAF during the May 1, 1992 through April 30, 1993.

  7. Peer review in cardiothoracic radiology.

    Kanne, Jeffrey P


    A variety of peer review methods can be used as part of quality assurance and quality improvement in cardiothoracic radiology. Traditionally, peer review in radiology is a retrospective process relying primarily on review of previously interpreted studies at the time of follow-up or additional imaging. However, peer review can be enhanced with other methods such as double reads, focused practice review, practice audit, and correlation with operative and pathologic findings. Furthermore, feedback from referring physicians can be extremely useful in improving the quality of a radiology practice. This article discusses peer review in radiology with a focus on cardiothoracic imaging. Types of peer review, advantages and shortcomings, and future challenges are addressed.

  8. Analysis of Radiological Case Presentations and their Impact on Therapy and Treatment Concepts in Internal Medicine.

    Dendl, Lena-Marie; Teufel, Andreas; Schleder, Stephan; Rennert, Janine; Stroszczynski, Christian; Mueller-Schilling, Martina; Schreyer, Andreas G


    Purpose Evaluation of clinical impact regarding diagnostic and therapeutic changes influenced by interdisciplinary radiological case presentations. Materials and Methods Prospective evaluation of radiological-gastrointestinal clinical case conferences over a 1-year period at a tertiary care center. We documented the preparation (phase 1) and clinical case conference (phase 2) regarding their impact on the radiology report and further diagnostic work-up and therapy. Results 1067 examinations were evaluated in 69 clinical case conferences including 487 cases. We calculated a mean time of 35.8 minutes per conference with 5.1 minutes per case for preparation. During phase 1, major changes compared to the previous report were found in 1.2 % of cases, and no change was found in 91.4 % of cases. In phase 2 an additional relevant finding was found in 0.6 % of cases, while there was no major change to the reports in 99 % of cases. We recommended further radiological diagnostic workup in 9 % of cases and interventional radiological examination in 2.7 % of cases, while no change was documented in 83.2 %. Further radiological or surgical therapy was recommended in 7 % and 6.8 % of cases, respectively. There was no change in therapy in 78.5 % of cases. Conclusion The analysis of an interdisciplinary radiological case presentation in internal medicine shows that the case discussion with the radiologist results in a change in patient management in 37.3 % of cases (16.8 % diagnosis, 21.5 % therapy). Overall, interdisciplinary radiological clinical case conferences help to improve the management and quality of patient care. Our data support the broad implementation of radiological clinical case conferences. Key Points · The second opinion obtained during the preparation of a radiological case presentation does not change the written report in most cases.. · "Talking radiology" in radiological case presentations results in a significant change in

  9. 21 CFR 892.1980 - Radiologic table.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiologic table. 892.1980 Section 892.1980 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1980 Radiologic table. (a) Identification. A radiologic...

  10. Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery).

    Magnone, Stefano; Coccolini, Federico; Manfredi, Roberto; Piazzalunga, Dario; Agazzi, Roberto; Arici, Claudio; Barozzi, Marco; Bellanova, Giovanni; Belluati, Alberto; Berlot, Giorgio; Biffl, Walter; Camagni, Stefania; Campanati, Luca; Castelli, Claudio Carlo; Catena, Fausto; Chiara, Osvaldo; Colaianni, Nicola; De Masi, Salvatore; Di Saverio, Salomone; Dodi, Giuseppe; Fabbri, Andrea; Faustinelli, Giovanni; Gambale, Giorgio; Capponi, Michela Giulii; Lotti, Marco; Marchesi, Gianmariano; Massè, Alessandro; Mastropietro, Tiziana; Nardi, Giuseppe; Niola, Raffaella; Nita, Gabriela Elisa; Pisano, Michele; Poiasina, Elia; Poletti, Eugenio; Rampoldi, Antonio; Ribaldi, Sergio; Rispoli, Gennaro; Rizzi, Luigi; Sonzogni, Valter; Tugnoli, Gregorio; Ansaloni, Luca


    Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients

  11. Financial accounting for radiology executives.

    Seidmann, Abraham; Mehta, Tushar


    The authors review the role of financial accounting information from the perspective of a radiology executive. They begin by introducing the role of pro forma statements. They discuss the fundamental concepts of accounting, including the matching principle and accrual accounting. The authors then explore the use of financial accounting information in making investment decisions in diagnostic medical imaging. The paper focuses on critically evaluating the benefits and limitations of financial accounting for decision making in a radiology practice.

  12. Radiological training for tritium facilities



    This program management guide describes a recommended implementation standard for core training as outlined in the DOE Radiological Control Manual (RCM). The standard is to assist those individuals, both within DOE and Managing and Operating contractors, identified as having responsibility for implementing the core training recommended by the RCM. This training may also be given to radiological workers using tritium to assist in meeting their job specific training requirements of 10 CFR 835.

  13. FDH radiological design review guidelines

    Millsap, W.J.


    These guidelines discuss in more detail the radiological design review process used by the Project Hanford Management Contractors as described in HNF-PRO-1622, Radiological Design Review Process. They are intended to supplement the procedure by providing background information on the design review process and providing a ready source of information to design reviewers. The guidelines are not intended to contain all the information in the procedure, but at points, in order to maintain continuity, they contain some of the same information.

  14. Radiological Control Manual. Revision 0, January 1993


    This manual has been prepared by Lawrence Berkeley Laboratory to provide guidance for site-specific additions, supplements, and clarifications to the DOE Radiological Control Manual. The guidance provided in this manual is based on the requirements given in Title 10 Code of Federal Regulations Part 835, Radiation Protection for Occupational Workers, DOE Order 5480.11, Radiation Protection for Occupational Workers, and the DOE Radiological Control Manual. The topics covered are (1) excellence in radiological control, (2) radiological standards, (3) conduct of radiological work, (4) radioactive materials, (5) radiological health support operations, (6) training and qualification, and (7) radiological records.

  15. Radiological protection in pediatric radiodiagnostic; Proteccion Radiologica en Radiodiagnostico Pediatrico

    Espana Lopez, M. L.; Gomez Mardones, G.; Garcia Gastonon; Bermudez Luna, R.; Garcia Esparza, E.; Solis Muniz, I.


    Diagnostic x-ray examinations remains the most frequent use of ionizing radiation in medicine, and represent the most significant source of medical exposure. Justification and optimization process are worthy of special considerations for the pediatric patient, in view of their longer life expectancy and the increased risk for stochastic effects. the aim of the present study is to review the state of the art of the radiation protection in pediatric radiology. Proper equipment, periodic quality control, pediatric protocols, experienced operator, experienced operator, dosimetric estimations, superficial shielding and evaluation of image quality are required to achieve patient doses. As low As Reasonably Achievable in pediatric radiology. Technical advances haves increased the number of possibilities to reduce patient doses, but their optimal use implies a deep knowledge of the different technology. Practical dosimetry, dose indicators and dose reference levels are essential elements of patient protection, and must be reviewed for the pediatric patient, especially in higher radiation doses procedures, such CT and interventional examinations. Although the most effective way to reduce the radiation dose is to eliminate the unnecessary referrals, Radiology Department and Medical Physics and Radiological Protection Department, must be involved in the optimizations procedures in order to achieve ALARA patients dose in pediatric radiology reflects the reality in our country. (Author) 37 refs.

  16. Radiologic analysis of amebiasis

    Kim, S. Y.; Lee, Y. H.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    The amebiasis is a common diseases in Korea as well as worldwide especially frequent in tropical area such as India, Africa and South America. The diagnosis of amebiasis remain difficult and complex, despite of many diagnostic method, for example, direct stool test for ameba, many immunologic studies and biopsy. Authors analyzed radiologically the patient who have had confirmed as a amebiasis from June, 1976 to September, 1979 at Yonsei University, College of Medicine, Severance Hospital. The results as follows: 1. The amebic liver abscess was a most common from of the amebiasis in Korea, which were 40 cases among 56 cases. Plain abdomen showed huge hepatomegaly, compression and displacement in hepatic flexure of colon, and reflex gas distension in almost cases. Chest P-A showed nonspecific right lower lung findings from secondary to right upper abdominal pathology, such as elevated right diaphragm (61.3%), pleural effusion (60.0%), right lower lung consolidation (37.5%) and abscess cavities (5.0%). Liver scan showed large space occupying lesion, most commonly situated in right lobe of liver (68.6%). 2. Among total 15 cases of the amebic colitis, positive findings on barium enema were 80%. Barium enama showed spas and irritability (89.2%), narrowing of lumen and lack of distensibility (71.4%) and deformity of cecum (20.0%). Involved site was cecum, ascending colon, rectosigmoid, transeverse and descending colon in order of frequency. Unusual involvement of terminal ileum was 2 cases. 3. Combined cases of amebic liver abscess and colitis were 4 cases (27.7%)

  17. DOE standard: Radiological control


    The Department of Energy (DOE) has developed this Standard to assist line managers in meeting their responsibilities for implementing occupational radiological control programs. DOE has established regulatory requirements for occupational radiation protection in Title 10 of the Code of Federal Regulations, Part 835 (10 CFR 835), ``Occupational Radiation Protection``. Failure to comply with these requirements may lead to appropriate enforcement actions as authorized under the Price Anderson Act Amendments (PAAA). While this Standard does not establish requirements, it does restate, paraphrase, or cite many (but not all) of the requirements of 10 CFR 835 and related documents (e.g., occupational safety and health, hazardous materials transportation, and environmental protection standards). Because of the wide range of activities undertaken by DOE and the varying requirements affecting these activities, DOE does not believe that it would be practical or useful to identify and reproduce the entire range of health and safety requirements in this Standard and therefore has not done so. In all cases, DOE cautions the user to review any underlying regulatory and contractual requirements and the primary guidance documents in their original context to ensure that the site program is adequate to ensure continuing compliance with the applicable requirements. To assist its operating entities in achieving and maintaining compliance with the requirements of 10 CFR 835, DOE has established its primary regulatory guidance in the DOE G 441.1 series of Guides. This Standard supplements the DOE G 441.1 series of Guides and serves as a secondary source of guidance for achieving compliance with 10 CFR 835.

  18. The HPCSA and radiology

    JP van Niekerk


    Full Text Available There is general agreement that adequate radiation control is essential. But in my opinion there are more important issues that were not in the remit of the committee, namely the proliferation of many diagnostic and therapeutic interventions that are reliant on expensive equipment. Such equipment is often acquired because of its potential revenue generation and that often results in self-referral – a sure way of driving up medical costs through unnecessary procedures.

  19. Pilot Study of a Patient-Centered Radiology Process Model.

    Swan, J Shannon; Furtado, Vanessa F; Keller, Lisa A; Lotti, Judith Borsody; Saltalamacchia, Catherine A; Lennes, Inga T; Salazar, Gloria M


    The Radiology Process Model (RPM) was previously described in terms of its conceptual basis and proposed survey items. The current study describes the first pilot application of the RPM in the field and the results of initial psychometric analysis. We used an Institutional Review Board-approved pilot RPM survey in 100 patients having outpatient interventional radiology procedures. The 24 survey items had 4 or 5 levels of severity. We assessed for missing data, items that patients found confusing, any suggestions by patients for additional items and clarity of items from patient feedback. Factor analysis was performed and internal consistency measured. Construct validity was assessed by correlation of patient responses to the items as a summated scale with a visual analog scale (VAS) they completed indicating their interventional radiology experience. The visual analog scale and the RPM summated scale were strongly correlated (r = 0.7). Factor analysis showed four factors: interactions with facility and doctors/staff, time-sensitive aspects, pain, and anxiety. The items showed high internal consistency (alpha: 0.86) as a group and approximately 0.7 to 0.9 by the factors. Analysis shows that two items could be deleted (cost and communication between radiologist and referrers). Revision of two items and potential addition of others are discussed. The RPM shows initial evidence of psychometric validity and internal consistency reliability. Minor changes are anticipated before wider use. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. CARS 2008: Computer Assisted Radiology and Surgery. Proceedings



    The proceedings contain contributions to the following topics: digital imaging, computed tomography, magnetic resonance, cardiac and vascular imaging, computer assisted radiation therapy, image processing and display, minimal invasive spinal surgery, computer assisted treatment of the prostate, the interventional radiology suite of the future, interventional oncology, computer assisted neurosurgery, computer assisted head and neck and ENT surgery, cardiovascular surgery, computer assisted orthopedic surgery, image processing and visualization, surgical robotics, instrumentation and navigation, surgical modelling, simulation and education, endoscopy and related techniques, workflow and new concepts in surgery, research training group 1126: intelligent surgery, digital operating room, image distribution and integration strategies, regional PACS and telemedicine, PACS - beyond radiology and E-learning, workflow and standardization, breast CAD, thoracic CAD, abdominal CAD, brain CAD, orthodontics, dentofacial orthopedics and airways, imaging and treating temporomandibular joint conditions, maxillofacial cone beam CT, craniomaxillofacial image fusion and CBCT incidental findings, image guided craniomaxillofacial procedures, imaging as a biomarker for therapy response, computer aided diagnosis. The Poster sessions cover the topics computer aided surgery, Euro PACS meeting, computer assisted radiology, computer aided diagnosis and computer assisted radiology and surgery.

  1. Persistent carotid-vertebrobasilar anastomosis: radiologic findings

    Park, Sung Il; Kim, Dong Ik; Jun, Pyoung; Yoon, Pyeong Ho; Hwang, Geum Ju; Cheon, Young Jik; Lim, Joon Seok [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)


    To evaluate the radiologic findings of carotid-vertebrobasilar anastomosis and associated anomalies. Thirteen pateints with fourteen cases of carotid-vertebrobasilar anastomosis collected from January 1992 to December 1997 were reviewed. Clinical diagnosis refered for cerebral angiography were cerebral infarction (n=3D3), intracranial hemorrhage (n=3D2), subarachnoid hemorrhage (n=3D1), brain tumor (n=3D3), arteriovenous malformation (n=3D3) and trigeminal neuralgia (n=3D1). Cerebral angiograms and clinical symptoms were retrospectively analyzed. The fourteen carotid-vertebrobasilar anastomsis consisted of eleven cases of persistent trigeminal artery and three cases of type I proatantal intersegmental artery. Persistent trigeminal arteries were associated with anterior communicating artery aneurysm(n=3D1), posterior fossa arteriovenous malformation(n=3D2) and persistent trigeminal artery variant(n=3D5). Type I proatantal intersegmental arteries were associated with hypoplastic vertebral arteries(n=3D2): only proximal segment in one, and proximal and distal segments in one case. Only one patient had clinical symptom related to the carotid-vertebrobasilar anastomosis which was trigeminal neuralgia. Knowledge of the anatomical and radiologic findings of carotid-vertebrobasilar anastomosis and associated anomalies will aid in the accurate diagnosis of neurovascular disease and prevent possible complications during surgical and interventional procedures.=20.

  2. Radiological impacts of phosphogypsum.

    Al Attar, Lina; Al-Oudat, Mohammad; Kanakri, Salwa; Budeir, Youssef; Khalily, Hussam; Al Hamwi, Ahmad


    This study was carried out to assess the radiological impact of Syrian phosphogypsum (PG) piles in the compartments of the surrounding ecosystem. Estimating the distribution of naturally occurring radionuclides (i.e. (226)Ra, (238)U, (232)Th, (210)Po and (210)Pb) in the raw materials, product and by-product of the Syrian phosphate fertilizer industry was essential. The data revealed that the concentrations of the radionuclides were enhanced in the treated phosphate ore. In PG, (226)Ra content had a mean activity of 318 Bq kg(-1). The uranium content in PG was low, ca. 33 Bq kg(-1), because uranium remained in the phosphoric acid produced. Over 80% of (232)Th, (210)Po and (210)Pb present partitioned in PG. The presence of PG piles did not increase significantly the concentration of (222)Rn or gamma rays exposure dose in the area studied. The annual effective dose was only 0.082 mSv y(-1). The geometric mean of total suspended air particulates (TSP) ca. 85 μg m(-3). The activity concentration of the radionuclides in filtrates and runoff waters were below the detection limits (ca. 0.15 mBq L(-1) for (238)U, 0.1 mBq L(-1) for (232)Th and 0.18 mBq L(-1) for both of (210)Po and (210)Pb); the concentration of the radionuclides in ground water samples and Qattina Lake were less than the permissible limits set for drinking water by the World Health Organisation, WHO, (10, 1 and 0.1 Bq L(-1) for (238)U, (232)Th and both of (210)Po and (210)Pb, respectively). Eastern sites soil samples of PG piles recorded the highest activity concentrations, i.e. 26, 33, 28, 61 and 40 Bq kg(-1) for (226)Ra, (238)U, (232)Th, (210)Po and (210)Pb, respectively, due to the prevailing western and north-western wind in the area, but remained within the natural levels reported in Syrian soil (13-32 Bq kg(-1) for (226)Ra, 24.9-62.2 Bq kg(-1) for (238)U and 10-32 Bq kg(-1) for (232)Th). The impact of PG piles on plants varied upon the plant species. Higher concentrations of the radionuclides were

  3. Radiological findings in NAO syndrome

    Al-Otaibi, Leftan; Hugosson, Claes O. [Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia); Al-Mayouf, Sulalman M.; Majeed, Mahmoud; Al-Eid, Wea' am; Bahabri, Sultan [Department of Paediatrics, King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia)


    Background: Diseases exhibiting osteolysis in children are rare hereditary conditions. Several types have been recognised with different clinical manifestations. One type includes subcutaneous nodules, arthropathy and osteolysis and has been termed NAO syndrome. Previous radiological reports have described the affected bones, usually the carpal and tarsal regions, but a detailed analysis of the radiological findings of both the axial as well as the appendicular skeleton has not been reported. Objectives: To describe the radiological findings in a large group of children with an autosomal recessive disease characterized by nodules, familial arthropathy and osteolysis. Materials and methods: The study comprises 14 patients from 9 families and all patients had the triad of nodulosis, arthropathy and osteolysis (NAO). Results: The most common radiological manifestations were osteopenia, undertubulation of long bones, arthritic changes, sclerotic sutures of the calvaria, osteolysis and muscle contractures. Other common findings were squared vertebrae, broad medial clavicles and brachycephaly. Progress of disease was documented in more than half of the patients. Conclusions: Our study is the first report of the detailed radiological findings of NAO syndrome. In NAO syndrome, both the axial and appendicular skeleton are involved (orig.)

  4. Head-neck-radiology; Kopf-Hals-Radiologie

    Cohnen, Mathias (ed.) [Staedtische Kliniken Neuss Lukaskrankenhaus GmbH (Germany). Institut fuer klinische Radiologie


    The book on head-neck-radiology covers the following issues: (1) Methodic fundamentals: conventional radiography, angiography, sonography, computerized tomography, digital volume tomography, NMR imaging, nuclear medicine. (2) Base of the skull. (3) Petrous bone. (4) Pharynx. (5) Paranasal sinuses. (6) Eye socket. (7) Temporomandibular joint. (8) Salivary gland. (9) Oral cavity. (19) Parynx. (11) Neck soft tissue and lymph nodes. (12) Thyroid and parathyroid. (13) Teeth and jaw. (14) Interventions.

  5. The use of sedation in the radiology department

    Patatas, K. [Radiology Academy, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds (United Kingdom); St James University Hospital, Leeds (United Kingdom)], E-mail:; Koukkoulli, A. [St James University Hospital, Leeds (United Kingdom)


    The use of intravenous sedation and analgesia in patients undergoing interventional diagnostic and therapeutic procedures is increasing. Sedation by non-anaesthetists is considered to be safe, provided that they have received adequate training and have the necessary equipment, facilities, and personnel. This article aims to increase awareness of the safe use of sedative drugs in radiology and provide a practical guideline for minimal and moderate sedation.

  6. Radiological control manual. Revision 1

    Kloepping, R.


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

  7. Implications Of Computer Assisted Radiology

    Lemke, Heinz U.


    Within the field of radiology, assistance with computer and communication systems may be applied to generation, storing, transmission, viewing, analyzing and interpreting of images. As a result, digital image management and communication systems will be applied at various levels in the health care system. Four groups of people are somehow involved or affected by this process. These are, first of all, the patients and the medical personnel, but also the scientific-engineering community and the group of professions involved with financing and/or administering these systems. Each group approaches computer assisted radiology from a particular point of view. The paper outlines some aspects as regards the different perceptions of these groups, which need to be clarified in order to successfully realise computer assisted radiology.

  8. Radiology information management system, TOSRIM

    Tani, Yuichiro; Uchiyama, Akira; Kimura, Hirohito (Toshiba Corp., Kawasaki, Kanagawa (Japan))


    This is a report on a new type of distributed computer system for radiology departments named 'TOSRIM' (Toshiba radiology information management system), which is designed to be installed between medical diagnosis equipment and a host computer system in a hospital. Recently, a new type of host computer system has been developed which enables doctors to order any of the hospital's entire activities using terminals. By connecting 'TOSRIM' to this type of host computer system, many of the activities of a radiology department can be carried out via terminals without the use of examination requirement forms. As well as being connected to medical diagnosis equipment, 'TOSRIM' can also be connected to a medical imaging system which stores and displays medical images. By means of these connections, doctors will be able to diagnose medical images using display terminals without the need for films. (author).

  9. Making decisions using radiology in lower GI hemorrhage.

    Zahid, Assad; Young, Christopher John


    Acute lower gastrointestinal bleeding (LGIB) is a common diagnosis in current practice that may warrant hospitalization and invasive management. There is a shift in the paradigm in the management of this condition away from traditional extensive operative intervention to minimally invasive radiological techniques. These newer modalities offer an opportunity to provide more accurate information on location of bleeding and subsequent management. The increased ease of access to interventional radiology units in major teaching hospitals represents an opportunity to adopt its use in the management of gastrointestinal bleeding. Further, with technological improvements, it is becoming an increasingly favoured option. Traditional endoscopic techniques have been fraught with poor vision in the acute setting, requiring the colon to be purged to aide in better visualization. The use of these newer technologies have been the subject of many reviews which highlight their efficacy in providing a road map to the bleeding site and eventual intervention. We aim to review the literature regarding the use of radiology in the management of LGIB, to provide surgeons with a discourse with regards to the approach in synthesizing the data and applying it when deciding its use.

  10. Evaluation of Stress Scores Throughout Radiological Biopsies



    Full Text Available Background Ultrasound-guided biopsy procedures are the most prominent methods that increase the trauma, stress and anxiety experienced by the patients. Objectives Our goal was to examine the level of stress in patients waiting for radiologic biopsy procedures and determine the stress and anxiety level arising from waiting for a biopsy procedure. Patients and Methods This prospective study included 35 female and 65 male patients who were admitted to the interventional radiology department of Kartal Dr. Lütfi Kirdar training and research hospital, Istanbul between the years 2014 and 2015. They filled out the adult resilience scale consisting of 33 items. Patients who were undergoing invasive radiologic interventions were grouped according to their phenotypic characteristics, education level (low, intermediate, and high, and biopsy features (including biopsy localization: neck, thorax, abdomen, and bone; and the number of procedures performed, 1 or more than 1. Before the biopsy, they were also asked to complete the depression-anxiety-stress scale (DASS 42, state-trait anxiety inventory scale (STAI-I, and continuous anxiety scale STAI-II. A total of 80 patients were biopsied (20 thyroid and parathyroid, 20 thorax, 20 liver and kidney, and 20 bone biopsies. The association between education levels (primary- secondary, high school and postgraduate and the number of biopsies (1 and more than 1 with the level of anxiety and stress were evaluated using the above-mentioned scales. Results Evaluation of sociodemographic and statistical characteristics of the patients showed that patients with biopsy in the neck region were moderately and severely depressed and stressed. In addition, the ratio of severe and extremely severe anxiety scores was significantly high. While the STAI-I and II scores were lined up as neck > bone > thorax > abdomen, STAI-I was higher in neck biopsies compared to thorax and abdomen biopsies. Regarding STAI-I and II scales, patients

  11. Managing Generational Differences in Radiology.

    Eastland, Robin; Clark, Kevin R


    Diversity can take many forms. One type of recent focus is generational differences and intergenerational issues. Much research exists regarding generational differences in the workplace and in healthcare as a whole. Very little has been done on generational differences within the field of radiology. An analysis of current research of generational differences within radiology, nursing, and healthcart in general was performed to identify current trends and establish similarities and discordance in available studies. An emphasis was placed on how generational differences influence education, teamwork, and patient care, along with what challenges and opportunities exist for managers, leaders, and organizations.

  12. 介入技术在完全性前置胎盘和胎盘植入中的临床应用价值%Clinical Value of Interventional Radiologic Technique Combined with Cesarean Delivery in Placenta Previa and Placenta Accrete Patients

    谢娅; 张颖; 彭铮


    Objective:To investigate the clinical value of interventional radiologic technique combined with cesarean delivery. Method:40 consecutive patients in our hospital with complete placenta previa or suspected placenta accrete were prospectively assessed from June 2011 to December 2013. 20 cases were treated by traditional cesarean delivery methods, termination of pregnancy as the control group. 20 patients were treated by obstetric joint intervention carried out new DSA in the operating room for abdominal aortic balloon placed+cesarean delivery+the iliac artery and uterine artery embolization, as the DSA group,the different outcomes of the two groups were compared. Result:There were no statistical significance in the neonatal Apgar scores of the two groups(P>0.05);intraoperative and postpartum blood loss,blood transfusion amount in the DSA group were significantly lower than the control group,the differences had statistical significance(P0.05);DSA组术中及产后失血量、输血量均明显低于对照组,差异均有统计学意义(P<0.05);DSA组子宫切除率显著低于对照组,母乳喂养率显著高于对照组,差异均有统计学意义(P<0.05)。结论:剖宫产术中腹主动脉放置球囊联合术后髂内动脉子宫动脉栓塞技术能够显著降低产时产后出血量、输血量、子宫切除率,并提高母乳喂养率。

  13. Radiology in 2030: A Guide for Strategic Planning

    Sh. Akhlaghpoor


    Full Text Available Imaging science and technology are major contributors to the discovery of new knowledge in diagnosis and treatment of disease. Given such rapid past advances, is it not likely the future rate of progress will be at least as great? As part of the strategic plan is to estimate future change, it is necessary to have a vision for what will happen in radiology in next 20 years. There are several questions that we should find answer for them: 1. Which type of information clinicians will request from radiologists? 2. How will imaging devices of the future differ from those of the present? 3. What appearance might medical images of the future have? Only 30 years ago, radiologists depended heavily on plain radiographs, tomography, and catheter angiography.Presently, very high-resolution crosssectional imaging studies, four-dimensional sonography, and functional imaging techniques (such as brain activation studies and perfusion imaging are common place. Physicians in the future will increasingly seek clinical information that is physiological, and not solely anatomical, in nature.Functional and molecular imaging will be the area of great development in future. Broadly, multidisciplinary, molecular imaging incorporates methods and concepts from molecular and cell biology, imaging sciences, chemistry, highthroughput"nbiology (eg, genomics, proteomics, nanotechnology, pharmacology, and bioinformatics. It is through molecular imaging that radiology is expected"nto play a critical role in advancing molecular medicine and potentially revolutionize patient care and biomedical research. Other promising options will be minimally invasive image-guided therapy and interventional radiology The convergence of molecular imaging and interventional radiology benefits both fields. This lecture is an effort to explain a roadmap for future in the field of Radiology.

  14. [Radiological media and modern supporting tools in radiology].

    Sachs, A; Pokieser, P


    Radiology is a field with a high demand on information. Nowadays, a huge variety of electronic media and tools exists in addition to the classical media. Asynchronous and synchronous e-learning are constantly growing and support radiology with case collections, webinars and online textbooks. Various internet resources, social media and online courses have been established. Dynamic websites show a variety of interactive elements and it is easier and faster to access large amounts of data. Social media have an exponentially growing number of users and enable an efficient collaboration as well as forming professional networks. Massive open online courses (MOOCs) complete the offer of education and increase the opportunity to take part in educational activities. Apart from the existing variety of resources it is essential to focus on a critical selection for using these radiological media. It is reasonable to combine classical and electronic media instead of a one-sided use. As dynamic as the progress in the field of radiological media and its tools may be, the personal contact remains and should be maintained.

  15. Analysis of reconstruction using non-vascularized iliac bone graft for patients with mandibular defects%非血管化髂骨移植重建下颌骨缺损的临床分析

    谢富强; 孙健


    Objective To make a clinical retrospective analysis of reconstruction using autogenous non-vascularized iliac bone graft for patients with mandibular defects, and then to evaluate the treatment effectiveness and operation announcements of this method. Methods 34 patients who were suffered from discontinued mandibule because of tumor or trauma, were treated with autogenous non-vascularized iliac bone graft. The surgery technique, postoperative outcomes and complications were analyzed. Results In 34 patients adopted non-vascularized iliac bone graft, 31 patients adopted rigid internal fixation with titanium mini plate, 3 patients with bridging titanium plate. 27 bone grafts survived completely, the overall success rate was 79.41%. 3(8.82%) of the bone grafts healed after infection, 4(11.76%) bone grafts lost because of infection. Conclusion The autogenous non-vascularized iliac bone graft is one of the most important way for the reconstruction of mandibular defects. The methods of internal fixation includes titanium mini pate and bridging titanium plate.%目的 对非血管化髂骨移植重建下颌骨缺损的病例进行临床回顾性分析,探讨其治疗效果及手术注意事项.方法 选择因肿瘤和外伤致下颌骨缺损后行自体非血管化髂骨同期移植重建术修复的34例患者为研究对象,分析其手术方法、术后效果及并发症的发生情况.结果 采用游离非血管化髂骨同期移植重建下颌骨缺损的34例患者中,小钛板双排内固定31例,重建板内固定3例.34例患者中,成功病例27例(79.41%),良好病例3例(8.82%),失败病例4例(11.76%).失败原因均为感染而取出植入骨.结论 自体非血管化髂骨移植重建术是下颌骨缺损重建的重要方法之一,内固定的方式有小钛板和重建板.

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

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


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

  17. How to Read Your Radiology Report

    ... Site Index A-Z How to Read Your Radiology Report Imaging studies such as magnetic resonance imaging ( ... this article. top of page Sections of the Radiology Report Type of exam The type of exam ...

  18. International Data on Radiological Sources

    Martha Finck; Margaret Goldberg


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

  19. Radiologic Technology Occupations. Curriculum Guide.

    Reneau, Fred; And Others

    This guide delineates the tasks and performance standards for radiologic technology occupations. It includes job seeking skills, work attitudes, energy conservation practices, and safety. The guide is centered around the three domains of learning: psychomotor, cognitive, and affective. For each duty, the following are provided: task, standard of…

  20. [A review of current concepts in evidence-based radiology].

    Roldán-Valadez, Ernesto; Lee, Angel; Jiménez-Corona, Aída; Vega-González, Iván; Martínez-López, Manuel; Vázquez-LaMadrid, Jorge


    It has been noted that "Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough. " Evidence-based medicine (EBM) is defined as the process of systematically finding, critically appraising, and using contemporary research published in the medical literature as a basis to make decisions regarding individual patient care and health care policy. In radiology, including its diagnostic and interventional aspects, the principles and practice of EBM have not been thoroughly studied. In this brief review article, we describe key aspects of evidence-based radiology (EBR), concepts and steps followed in EBM and meta-analysis. The skills required to practice EBR are identified, and the roles of EBR in radiologic practice, education, and research are discussed. The application of EBM principles to diagnostic imaging facilitates the interpretation of imaging studies and produces a sound and comprehensive radiologic evaluation. This review could be useful for radiologists and clinicians at any stage of their training or career. It encourages the practice of EBM and EBR especially in developing countries.

  1. 10 CFR 835.501 - Radiological areas.


    ... 10 Energy 4 2010-01-01 2010-01-01 false Radiological areas. 835.501 Section 835.501 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Entry Control Program § 835.501 Radiological areas. (a) Personnel entry control shall be maintained for each radiological area. (b) The degree of control shall...

  2. Women in Radiology: Exploring the Gender Disparity.

    Zener, Rebecca; Lee, Stefanie Y; Visscher, Kari L; Ricketts, Michelle; Speer, Stacey; Wiseman, Daniele


    In 2015, only 1.5% of female Canadian medical students pursued radiology as a specialty, versus 5.6% of men. The aim of this study was to determine what factors attract and deter Canadian medical students from pursuing a career in radiology, and why fewer women than men pursue radiology as a specialty. An anonymous online survey was e-mailed to English-speaking Canadian medical schools, and 12 of 14 schools participated. Subgroup analyses for gender and radiology interest were performed using the Fisher exact test (P Physics deterred more women (47%) than it did men (21%), despite similar educational backgrounds for the two gender groups in physical sciences (P < .0001). More women who were considering radiology as a specialty rated intellectual stimulation as being important to their career choice (93%), compared with women who were not (80%; P = .002). Fewer women who were not interested in radiology had done preclinical observerships in radiology (20%), compared with men who were not interested in radiology (28%; P = .04). A perceived lack of direct patient contact dissuades medical students from pursuing radiology as a career. Women have less preclinical radiology exposure than do men. Programs that increase preclinical exposure to radiology subspecialties that have greater patient contact should be initiated, and an effort to actively recruit women to such programs should be made. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

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


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

  4. Pediatric radiology for medical-technical radiology assistants/radiologists; Paediatrische Radiologie fuer MTRA/RT

    Oppelt, Birgit


    The book on pediatric radiology includes the following chapter: differences between adults and children; psycho-social aspects concerning the patient child in radiology; relevant radiation doses in radiology; help for self-help: simple phantoms for image quality estimation in pediatric radiology; general information; immobilization of the patient; pediatric features for radiological settings; traumatology; contrast agents; biomedical radiography; computerized tomography; NMR imaging; diagnostic ultrasonography; handling of stress practical recommendations; medical displays.

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

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


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

  6. Importance of establishing radiation protection culture in Radiology Department

    Agapi Ploussi; Efstathios P Efstathopoulos


    The increased use of ionization radiation for diagnostic and therapeutic purposes, the rapid advances in computed tomography as well as the high radiation doses delivered by interventional procedures have raised serious safety and health concerns for both patients and medical staff and have necessitated the establishment of a radiation protection culture(RPC) in every Radiology Department. RPC is a newly introduced concept. The term culture describes the combination of attitudes, beliefs, practices and rules among the professionals, staff and patients regarding to radiation protection. Most of the time, the challenge is to improve rather than to build a RPC. The establishment of a RPC requires continuing education of the staff and professional, effective communication among stakeholders of all levels and implementation of quality assurance programs. The RPC creation is being driven from the highest level. Leadership, professionals and associate societies are recognized to play a vital role in the embedding and promotion of RPC in a Medical Unit. The establishment of a RPC enables the reduction of the radiation dose, enhances radiation risk awareness, minimizes unsafe practices, and improves the quality of a radiation protection program. The purpose of this review paper is to describe the role and highlight the importance of establishing a strong RPC in Radiology Departments with an emphasis on promoting RPC in the Interventional Radiology environment.

  7. High sensitive radiation detector for radiology dosimetry

    Valente, M.; Malano, F. [Instituto de Fisica Enrique Gaviola, Oficina 102 FaMAF - UNC, Av. Luis Medina Allende, Ciudad Universitaria, 5000 Cordoba (Argentina); Molina, W.; Vedelago, J., E-mail: [Laboratorio de Investigaciones e Instrumentacion en Fisica Aplicada a la Medicina e Imagenes por Rayos X, Laboratorio 448 FaMAF - UNC, Ciudad Universitaria, 5000 Cordoba (Argentina)


    Fricke solution has a wide range of applications as radiation detector and dosimetry. It is particularly appreciated in terms of relevant comparative advantages, like tissue equivalence when prepared in aqueous media like gel matrix, continuous mapping capability, dose rate recorded and incident direction independence as well as linear dose response. This work presents the development and characterization of a novel Fricke gel system, based on modified chemical compositions making possible its application in clinical radiology. Properties of standard Fricke gel dosimeter for high dose levels are used as starting point and suitable chemical modifications are introduced and carefully investigated in order to attain high resolution for low dose ranges, like those corresponding to radiology interventions. The developed Fricke gel radiation dosimeter system achieves the expected typical dose dependency, actually showing linear response in the dose range from 20 up to 4000 mGy. Systematic investigations including several chemical compositions are carried out in order to obtain a good enough dosimeter response for low dose levels. A suitable composition among those studied is selected as a good candidate for low dose level radiation dosimetry consisting on a modified Fricke solution fixed to a gel matrix containing benzoic acid along with sulfuric acid, ferrous sulfate, xylenol orange and ultra-pure reactive grade water. Dosimeter samples are prepared in standard vials for its in phantom irradiation and further characterization by spectrophotometry measuring visible light transmission and absorbance before and after irradiation. Samples are irradiated by typical kV X-ray tubes and calibrated Farmer type ionization chamber is used as reference to measure dose rates inside phantoms in at vials locations. Once sensitive material composition is already optimized, dose-response curves show significant improvement regarding overall sensitivity for low dose levels. According to

  8. Radiology education: a glimpse into the future

    Scarsbrook, A.F. [Department of Radiology, John Radcliffe Hospital, Headley Way, Headington, Oxford (United Kingdom)]. E-mail:; Graham, R.N.J. [Department of Radiology, John Radcliffe Hospital, Headley Way, Headington, Oxford (United Kingdom); Perriss, R.W. [Department of Radiology, John Radcliffe Hospital, Headley Way, Headington, Oxford (United Kingdom)


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

  9. 放射介入联合内镜在上消化道动脉性出血诊疗的应用%Application of the Treantment in Arterial Hemorrhage of Upper Digestive Tract Combining with Interventional Radiology and Endoscopy



    目的回顾分析27例上消化道动脉性出血患者的诊疗情况,探讨内镜及放射介入联合诊疗的临床实用价值。方法收集我院2011年7月~2013年12月临床诊断急性上消化道出血,内科保守治疗无效的患者。常规行内镜检查排除食管胃底静脉曲张破裂出血,并查找可能出血的病灶部位,行DSA检查的27例上消化道出血病例,其中诊断有阳性发现的11例,阴性16例,造影阳性的病例超选择性插管明胶海绵栓塞,造影阴性的病例依据病灶位置栓塞相应动脉。结果11例阳性病例中,栓塞术后即停止出血;16例阴性病例中栓塞后11例停止出血,3例出血量减少,2例止血无效,转外科手术探查。结论合理联合内镜及放射介入诊疗上消化道动脉性出血,可明显提高治疗有效率,降低死亡率,对血管造影阴性的病例有较大的临床应用价值,值得在临床上广泛推广应用。%Objective Review and analysis 27cases of upper gastrointestinal arterial hemorrhage in diagnosis and treatment, to explore the clinical practical value of endoscopy and interventional radiology clinic. Methods Col ecting the patients that who with the clinical diagnosis of acute upper gastrointestinal hemorrhage failed in conservative treatment in our hospital during the period from July 2011 to December 2013. Adopting conventional endoscopic examination to exclude the esophageal gastric variceal hemorrhage, and find the possible bleeding lesion location. The 27 cases of upper gastrointestinal hemorrhage patients by DSA examination,which 11 cases were diagnosed positive, negative in 16 cases. The radiography positive cases used super-selective catheterization gelatin sponge embolization, the radiography negative cases embolized relevant artery according to lesion location.Results The 11 positive cases bleeding stopped after embolization, however, in the 16 negative cases, 11 cases bleeding stopped after embolization, 3 cases reduced

  10. A hypermedia radiological reporting system.

    De Simone, M; Drudi, F M; Lalle, C; Poggi, R; Ricci, F L


    Report is the main phase of a diagnostic process by images. The product of the process is the diagnostic report. We are proposing an hypermedia structure of diagnostic report in radiology, in order to facilitate exchange between radiologist and clinician (specialist in internal medicine or surgeon) on a clinical case, without anymore charge on the side of the radiologist but with an 'off-line' consultation. An hypermedia radiological report software will produce further advantages in many aspects: radiologist and clinician could access patient's data directly from DB on patients; radiologist could check DB on exemplary cases real-time; clinician could read preliminary and final reports available in network and make requests online. The proposed hyper-report system is modular. Starting from the 'report text' writing, edited by the radiologist on the basis of most significative images, it is possible to insert comments in text, drawing and 'external' images form.

  11. Radiologic findings of neonatal sepsis

    Kim, Sam Soo; Han, Dae Hee; Choi, Guk Myeong; Jung, Hye Won [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Yoon, Hye Kyung; Han, Bokyung Kim; Lee, Nam Yong [Sansung Medical Center, Seoul (Korea, Republic of)


    To review the simple radiographic and sonographic findings in infants with neonatal sepsis. We retrospectively analyzed simple chest and abdominal radiographs, and brain sonograms in 36 newborn infants (preterm : term=23 :13). With neonatal sepsis diagnosed by blood culture and clinical manifestations. Pulmonary parenchymal infiltrate excluding respiratory distress syndrome and pulmonary edema or atelectasis was found in 22 infants (61%). Paralytic ileus, hepatosplenomegaly, and necrotizing enterocolitis were present in 18(50%), 9(25%), and 1(3%) infants, respectively, while skeletal changes suggesting osteomyelitis were found in three. Brain sonography was performed in 29 infants and in four, abnormalities were seen ; these comprised three germinal matrix hemorrhages and one intraparenchymal hemorrhage. In six patients(17%) radiologic examinations revealed no abnormality. In patients with neonatal sepsis, pulmonary infiltrates and paralytic ileus were common abnormalities. Although these were nonspecific, radiologic findings may be used to supplement clinical and laboratory findings in diagnosing neonatal sepsis and planning its treatment.

  12. Radiology applications of financial accounting.

    Leibenhaut, Mark H


    A basic knowledge of financial accounting can help radiologists analyze business opportunities and examine the potential impacts of new technology or predict the adverse consequences of new competitors entering their service area. The income statement, balance sheet, and cash flow statement are the three basic financial statements that document the current financial position of the radiology practice and allow managers to monitor the ongoing financial operations of the enterprise. Pro forma, or hypothetical, financial statements can be generated to predict the financial impact of specific business decisions or investments on the profitability of the practice. Sensitivity analysis, or what-if scenarios, can be performed to determine the potential impact of changing key revenue, investment, operating cost or financial assumptions. By viewing radiology as both a profession and a business, radiologists can optimize their use of scarce economic resources and maximize the return on their financial investments.

  13. Thalamic Lesions: A Radiological Review

    Dimitri Renard


    Full Text Available Background. Thalamic lesions are seen in a multitude of disorders including vascular diseases, metabolic disorders, inflammatory diseases, trauma, tumours, and infections. In some diseases, thalamic involvement is typical and sometimes isolated, while in other diseases thalamic lesions are observed only occasionally (often in the presence of other typical extrathalamic lesions. Summary. In this review, we will mainly discuss the MRI characteristics of thalamic lesions. Identification of the origin of the thalamic lesion depends on the exact localisation inside the thalamus, the presence of extrathalamic lesions, the signal changes on different MRI sequences, the evolution of the radiological abnormalities over time, the history and clinical state of the patient, and other radiological and nonradiological examinations.

  14. Radiology of the resurfaced hip

    Rahman, Luthfur [The London Hip Unit, London (United Kingdom); Hall-Craggs, Margaret [University College London Hospital, London (United Kingdom); Muirhead-Allwood, Sarah K. [The London Hip Unit, London (United Kingdom); The Royal National Orthopaedic Hospital, Middlesex (United Kingdom)


    Hip resurfacing arthroplasty is an increasingly common procedure for osteoarthritis. Conventional radiographs are used routinely for follow-up assessment, however they only provide limited information on the radiological outcome. Various complications have been reported in the scientific literature although not all are fully understood. In an effort to investigate problematic or failing hip resurfacings, various radiological methods have been utilized. These methods can be used to help make a diagnosis and guide management. This paper aims to review and illustrate the radiographic findings in the form of radiography, computerized tomography (CT), magnetic resonance imaging (MRI), and ultrasound of both normal and abnormal findings in hip resurfacing arthroplasty. However, imaging around a metal prosthesis with CT and MRI is particularly challenging and therefore the potential techniques used to overcome this are discussed. (orig.)

  15. Increasing diversity in radiologic technology.

    Carwile, Laura


    Diversity is increasingly important in the radiologic technology workplace. For significant changes to occur in work force diversity, educators must first recruit and retain students from a wide variety of backgrounds. This article examines personality, race and gender as factors affecting career choice and how educators can use these factors to increase diversity in their programs. An overview of the ASRT's efforts to improve diversity within the profession is presented, along with suggestions for developing effective recruitment and retention plans to increase diversity.

  16. Otologic radiology with clinical correlations

    Ruenes, R.; De la Cruz, A.


    This manual covers developments in the radiologic diagnosis of otologic problems. To demonstrate the appearance of each disorder comprehensively, a large number of radiographs are included, many of them annotated to highlight both diagnostic signs and the subtle aspects of normal pathologic anatomy. Contents: X-ray and Imaging Techniques and Anatomy. Congenital Malformations. Middle and External Ear Infections. Otosclerosis and Otospongiosis. Temporal Bone Fractures. The Facial Nerve. Tumors of the Temporal Bone and Skull Base. Tumors of the Cerebellopontine Angle. Cochlear Implants.

  17. Radiological diagnosis of aggressive fibromatosis

    Wiesmann, W.; Galanski, M.; Peters, P.E.; Timm, C.


    Aggressive fibromatosis (desmoid, desmoid tumour) resembles, in its infiltrating and destructive growth, a fibrosarcoma, but does not metastasise. Because of its high recurrence rate, the tumour remains a surgical problem. Various imaging methods were evaluated retrospectively in 23 patients with histologically confirmed aggressive fibromatosis. Conventional radiological procedures are poor at demonstrating the extent and type of tumour. Modern tomographic methods are more able to determine the size of the lesion and a combination of angiography and CT can frequently provide a definite diagnosis.

  18. Frontiers in European radiology 9

    Baert, A.L. (ed.) (Leuven Univ. (Belgium)); Heuck, F.H.W. (ed.) (Katharinenhospital, Stuttgart (Germany))


    The twelve chapters of the book - which were not prepared for separate retrieval from the database - deal with recent enhancements in equipment or technique, or novel applications, of existing diagnostic medical radiology methods such as magnetic resonance angiography, magnetic resonance spectroscopy, magnetic resonance imaging, Doppler sonography, digital subtraction angiography, and non-invasive thermometry. Possible side effects of the methods covered are also discussed, as e.g. nephropathy induced by contrast media, or artifacts involved in MRI. (UWA). 182 figs., 26 tabs.

  19. Benign chondroblastoma - malignant radiological appearances

    Schulze, K.; Treugut, H.; Mueller, G.E.


    The very rare benign chondroblastoma occasionally invades soft tissues and may grow beyond the epiphysis into the metaphysis. In the present case such a tumour did not show the typical radiological appearances, but presented malignant features both on plain films and on the angiogram. The importance of biopsy of tumours which cannot be identified with certainty must be stressed before radical surgery is carried out.

  20. ACR appropriateness criteria radiologic management of infected fluid collections.

    Lorenz, Jonathan M; Al-Refaie, Waddah B; Cash, Brooks D; Gaba, Ron C; Gervais, Debra A; Gipson, Matthew G; Kolbeck, Kenneth J; Kouri, Brian E; Marshalleck, Francis E; Nair, Ajit V; Ray, Charles E; Hohenwalter, Eric J


    The best management of infected fluid collections depends on a careful assessment of clinical and anatomic factors as well as an up-to-date review of the published literature, to be able to select from a host of multidisciplinary treatment options. This article reviews conservative, radiologic, endoscopic, and surgical options and their best application to infected fluid collections as determined by the ACR Appropriateness Criteria Expert Panel on Interventional Radiology. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals, and the application, by the panel, of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  1. The radiological management of the thrombosed arteriovenous dialysis fistula

    Bent, C.L., E-mail: [Royal Bournemouth and Christchurch Hospitals, Bournemouth (United Kingdom); Sahni, V.A. [Division of Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women' s Hospital, Harvard Medical School, Boston (United States); Matson, M.B. [Barts and The London NHS Trust, London (United Kingdom)


    Patent vascular access is a prerequisite for adequate haemodialysis, and is a major determinant of quality of life and long-term survival of patients with end-stage renal disease. Autogenous haemodialysis fistulas (AVFs) have demonstrated superior clinical outcome when compared to synthetic grafts, but both types of access remain susceptible to venous stenoses, and consequent thrombotic occlusion. Recent publications have reported primary patency rates of up to 100% following percutaneous de-clotting of AVFs incorporating techniques such as pharmacological thrombolysis, mechanical thrombectomy, and thrombo-aspiration. Endovascular management also provides information regarding the underlying cause of access thrombosis, with option to treat. Consequently, there has been a paradigm shift in the management of fistula thrombosis, with interventional radiology assuming a lead role in initial salvage procedures. This article will attempt to provide the reader with an insight into the multiple radiological techniques that can be employed to salvage a thrombosed AVF based on current published literature.

  2. Number of radiological examinations in Finland in 2000

    Hakanen, A


    STUK (Radiation and Nuclear Safety Authority) collected the number of radiological examinations in Finland in 2000. The work was based on a decree of the ministry of social affairs and health on the medical use of radiation. The work was done in cooperation with the Finnish work group of nomenclature of radiological examinations and procedures and professor Seppo Soimakallio. In 2000, ca. 4.1 million x-ray examinations were made in Finland. In 1984 and in 1995, the numbers were ca. 4.6 million and 4.2 million, respectively, indicating that the total number of x-ray examinations has remained nearly unaltered. The proportions of conventional x-ray examinations, computed tomography examinations, angiographic and interventional procedures were ca. 93.5 %, 5.0 %, 0.9 % and 0.6 %, respectively. The reported number of ultrasound examinations was ca. 0.5 million. The reported number of MRI examinations was ca. 0.1 million.

  3. Understanding Mechanisms of Radiological Contamination

    Rick Demmer; John Drake; Ryan James, PhD


    Over the last 50 years, the study of radiological contamination and decontamination has expanded significantly. This paper addresses the mechanisms of radiological contamination that have been reported and then discusses which methods have recently been used during performance testing of several different decontamination technologies. About twenty years ago the Idaho Nuclear Technology Engineering Center (INTEC) at the INL began a search for decontamination processes which could minimize secondary waste. In order to test the effectiveness of these decontamination technologies, a new simulated contamination, termed SIMCON, was developed. SIMCON was designed to replicate the types of contamination found on stainless steel, spent fuel processing equipment. Ten years later, the INL began research into methods for simulating urban contamination resulting from a radiological dispersal device (RDD). This work was sponsored by the Defense Advanced Research Projects Agency (DARPA) and included the initial development an aqueous application of contaminant to substrate. Since 2007, research sponsored by the US Environmental Protection Agency (EPA) has advanced that effort and led to the development of a contamination method that simulates particulate fallout from an Improvised Nuclear Device (IND). The IND method diverges from previous efforts to create tenacious contamination by simulating a reproducible “loose” contamination. Examining these different types of contamination (and subsequent decontamination processes), which have included several different radionuclides and substrates, sheds light on contamination processes that occur throughout the nuclear industry and in the urban environment.

  4. Radiologic evaluation of os odontoideum

    Lee, Eun Ju; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Kim, Yong Soo; Park, Hyoung Chun; Oh, Soung Hoon [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    We took an analysis on the clinical and radiologic findings of os odontoideum, which had been regarded as relatively uncommon disease, on 5 patients whom we have recently experienced. Our results were as follows: 1. Os odontoideums were incidentally discovered during the radiologic evaluation of traumatised 4 cases, who had been well being. Another one case of os odontoideum was associated with multiple epiphyseal dysplasia. 2. General radiologic findings of os odontoideum were a round or oval and hypoplastic ossicle separated from the base of odontoid process by wise gap. 3. Alanto-Axial instability was developed in 5 cases of os odontoideum by flexion and extension stress view of lateral cervical spine. 4. Flexion views of lateral cervical spine showed narrowing of anteroposterior diameter of spinal canal which were available at atlantoaxial level on 5 cases of os odontoidum. 5. CT myelogram and cervical myelogram showed anteriorly compressed dural sac and deformed spinal cord by body of axis at the atlanto-axial level.

  5. Telemetry of Aerial Radiological Measurements

    H. W. Clark, Jr.


    Telemetry has been added to National Nuclear Security Administration's (NNSA's) Aerial Measuring System (AMS) Incident Response aircraft to accelerate availability of aerial radiological mapping data. Rapid aerial radiological mapping is promptly performed by AMS Incident Response aircraft in the event of a major radiological dispersal. The AMS airplane flies the entire potentially affected area, plus a generous margin, to provide a quick look at the extent and severity of the event. The primary result of the AMS Incident Response over flight is a map of estimated exposure rate on the ground along the flight path. Formerly, it was necessary to wait for the airplane to land before the map could be seen. Now, while the flight is still in progress, data are relayed via satellite directly from the aircraft to an operations center, where they are displayed and disseminated. This permits more timely utilization of results by decision makers and redirection of the mission to optimize its value. The current telemetry capability can cover all of North America. Extension to a global capability is under consideration.

  6. Research and development in radiological protection; Investigacion y desarrollo en proteccion radiologica

    Butragueno, J. L.; Villota, C.; Gutierrez, C.; Rodriguez, A.


    The objective of Radiological Protection is to gurantee that neither people, be they workers or members of the public, or the environment are exposed to radiological risks considered by society to be unacceptable. Among the various resources available to meet this objective is Research and Development (R and D), which is carried out in three areas: I. Radiological protection of persons: (a) knowledge of the biological effects of radiations, in order to determine the relationship that exists between radiation exposure dose and its effects on health; (b) the development of new personal dosimetry techniques in order to adapt to new situations, instrumental techniques and information managmenet technologies allowing for better assessment of exposure dose; and (c) development of the principle of radiological protection optimisation (ALARA), which has been set up internationally as the fundamental principle on which radiological protection interventions are based. II. Assessment of environmental radiological impact, the objective of which is to assess the nature and magnitude of situations of exposure to ionising radiations as a result of the controlled or uncontrolled release of radioactive material to the environment, and III.Reduction of the radiological impact of radioactive wastes, the objective of which is to develop radioactive material and waste management techniques suitable for each situation, in order to reduce the risks assocaited with their definitive managmenet or thier release to the environment. Briefly desribed below are the strategic lines of R and D of the CSN, the Electricity Industry, Ciemat and Enresa in the aforementioned areas. (Author)

  7. Driving Innovation in Radiology: A Summary of the 2015 Intersociety Committee Summer Conference.

    Dodd, Gerald D; Restauri, Nicole L; Kondo, Kimi L; Lewis, Petra J


    The membership of the Intersociety Committee convened to consider how best to continue to stimulate, nurture, and support innovation in radiologic research and education in the face of ever increasing clinical demands and financial constraints. The topic was chosen in recognition that the growth and success of radiology over the past 50-plus years have been driven by spectacular technological developments in imaging and intervention and that the future relevance of the specialty will hinge on how the specialty continues to evolve. To keep radiology a dynamic and vital component of the health care enterprise will require continued innovation in technology and the requisite education that goes with it. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. Radiology of non-spinal pain procedures. A guide for the interventionalist

    Syed, Mubin I. [Dayton Interventional Radiology, Dayton, OH (United States); Shaikh, Azin


    Most interventionalists are not radiologists and most radiologists do not understand interventional pain procedures. Nevertheless, interventionalists order extensive diagnostic imaging in the workup prior to any intervention. Against this background, this handy, well-illustrated manual has been designed to meet the major need of interventional pain physicians to understand the radiologic imaging involved in the performance of non-spinal pain procedures. It provides information on such topics as radiologic anatomy, the radiologic manifestations of indications and contraindications to interventional procedures, and the radiologic appearance of complications that may arise from these procedures. In addition, it will be useful for the diagnostic radiologist, who may be unaware of many of the interventional pain procedures. The chosen format will ensure that the reader is quickly able to reference any given procedure. Sections are devoted to the head and neck, thorax, abdomen, pelvis, and the upper and lower extremities. As this is a guidebook, it does not encompass every single pathologic entity that may be encountered; however, the commonly performed non-spinal pain procedures are included. This text will prove essential for any interventionalist who does not have easy access to a radiologist and vice versa. (orig.)

  9. Nucleating emergency radiology specialization in India.

    Agrawal, Anjali; Khandelwal, Niranjan


    Emergency radiology is being recognized as an important and distinct specialty of radiology which merits utmost attention of educators, radiology program curricula committees, and radiology practices in India. Providing an accurate but timely diagnosis requires a skilled judgement and a strong process framework, particularly in acute trauma setting or a life-threatening acute illness. However, due to a shortage of radiologists in India and lack of awareness and suitable opportunities, there has been no concerted movement towards emergency radiology subspecialty training or dedicated emergency radiology positions. It was with these gaps in mind that the Society for Emergency Radiology was envisioned in 2012 and formulated in 2013. The proposed role of the Society for Emergency Radiology is to identify deficiencies in the field, namely, lack of adequate exposure, lack of mentorship by experienced emergency radiologists, lack of suitable opportunities for emergency radiologists; establish standards of practice; and promote education and implementation research to bridge the gaps. Through collaboration with other societies and partnership with the journal Emergency Radiology, the Society for Emergency Radiology hopes to promote a free exchange of ideas, protocols, and multi-institutional trials across continents.

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

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


    Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time. We sought to investigate the impact of systems engineering science targeting ED radiology transport delays and determine the most effective techniques. This prospective, before-and-after analysis of radiology process flow improvements in an academic hospital ED was exempt from institutional review board review as a quality improvement initiative. We hypothesized that reorganization of radiology transport would improve radiology cycle time and reduce waste. The intervention included systems engineering science-based reorganization of ED radiology transport processes, largely using Lean methodologies, and adding no resources. The primary outcome was average transport time between study order and complete time. All patients presenting between 8/2013-3/2016 and requiring plain film imaging were included. We analyzed electronic medical record data using Microsoft Excel and SAS version 9.4, and we used a two-sample t-test to compare data from the pre- and post-intervention periods. Following the intervention, average transport time decreased significantly and sustainably. Average radiology transport time was 28.7 ± 4.2 minutes during the three months pre-intervention. It was reduced by 15% in the first three months (4.4 minutes [95% confidence interval [CI] 1.5-7.3]; to 24.3 ± 3.3 min, P=0.021), 19% in the following six months (5.4 minutes, 95% CI [2.7-8.2]; to 23.3 ± 3.5 min, P=0.003), and 26% one year

  11. Post-endoscopic biliary sphincterotomy bleeding: an interventional radiology approach.

    Dunne, Ruth


    Endoscopic sphincterotomy is an integral component of endoscopic retrograde cholangiopancreatography. Post-sphincterotomy hemorrhage is a recognized complication. First line treatment involves a variety of endoscopic techniques performed at the time of sphincterotomy. If these are not successful, transcatheter arterial embolization or open surgical vessel ligation are therapeutic considerations.

  12. Venous malformations: classification, development, diagnosis, and interventional radiologic management.

    Legiehn, Gerald M; Heran, Manraj K S


    Venous malformations are categorized as low-flow vascular malformations within the domain of vascular anomalies and are the most common vascular malformation encountered clinically. Venous malformations are by definition present at birth, undergo pari passu growth, and present clinically because of symptoms related to mass effect or stasis. Although diagnosis can usually be made by clinical history and examination, differentiation from other vascular and nonvascular entities often requires an imaging work-up that includes ultrasound, CT, MR imaging, and diagnostic phlebography. All decisions regarding imaging work-up and decision to treat must be coordinated though referral and discussions with a multidisciplinary team and be based on clearly defined clinical indications. Percutaneous image-guided sclerotherapy has become the mainstay of treatment for venous malformations and involves the introduction of any one of a number of endothelial-cidal sclerosants into the vascular spaces of the lesion, with each sclerosant possessing its own unique spectrum of advantages and disadvantages.

  13. Current Status of Interventional Radiology Treatment of Infrapopliteal Arterial Disease

    Rand, T., E-mail: [General Hospital Hietzing, Department of Radiology (Austria); Uberoi, R. [John Radcliffe Hospital, Department of Radiology (United Kingdom)


    Treatment of infrapopliteal arteries has developed to a standard technique during the past two decades. With the introduction of innovative devices, a variety of techniques has been created and is still under investigation. Treatment options range from plain balloon angioplasty (POBA), all sorts of stent applications, such as bare metal, balloon expanding, self-expanding, coated and drug-eluting stents, and bio-absorbable stents, to latest developments, such as drug-eluting balloons. Regarding the scientific background, several prospective, randomized studies with relevant numbers of patients have been (or will be) published that are Level I evidence. In contrast to older studies, which primarily were based mostly on numeric parameters, such as diameters or residual stenoses, more recent study concepts focus increasingly on clinical features, such as amputation rate improvement or changes of clinical stages and quality of life standards. Although it is still not decided, which of the individual techniques might be the best one, we can definitely conclude that whatever treatment of infrapopliteal arteries will be used it is of substantial benefit for the patient. Therefore, the goal of this review is to give an overview about the current developments and techniques for the treatment of infrapopliteal arteries, to present clinical and technical results, to weigh individual techniques, and to discuss the recent developments.

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

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


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

  15. [European curriculum for further education in radiology].

    Ertl-Wagner, B


    The European training curriculum for radiology of the European Society of Radiology (ESR) aims to harmonize training in radiology in Europe. Levels I and II constitute the centerpiece of the curriculum. The ESR recommends a 5-year training period in radiology with 3 years of level I and 2 years of level II training. The undergraduate (U) level curriculum is conceived as a basis for teaching radiology in medical schools and consists of a modality-oriented U1 level and an organ-based U2 level. Level III curricula provide contents for subspecialty and fellowship training after board certification in radiology. The curricular contents of all parts of the European Training Curriculum are divided into the sections knowledge, skills as well as competences and attitudes. The European training curriculum is meant to be a recommendation and a basis for the development of national curricula, but is not meant to replace existing national regulations.

  16. Radiology.

    Patel, Ketan; Wallace, Roxanne; Busconi, Brian D


    Hip and groin pain are a common complaint among athletes of all ages, and may result from an acute injury or from chronic, repetitive trauma. Hip injuries can be intraarticular, extraarticular, or both. Labral abnormalities may occur in asymptomatic patients as well as in those with incapacitating symptoms and signs. Athletic hip injury leading to disabling intraarticular hip pain most commonly involves labral tear. The extraarticular causes are usually the result of overuse activity, leading to inflammation, tendonitis, or bursitis. In clinical practice, the term athletic pubalgia is used to describe exertional pubic or groin pain.

  17. Technical support and preparations for the response to radiological emergencies; Soporte tecnico y preparativos para la respuesta a emergencias radiologicas

    Cardenas H, J.; Ramos V, E.O.; Fernandez G, I.M.; Capote F, E.; Zerquera J, T.; Garcia L, O.; Lopez B, G.; Molina P, D.; Lamdrid B, A.I.; Benitez N, J.C.; Salgado M, M. [CPHR, Calle 20 No. 4113, e/41 y 47 Playa, CP 11300, La Habana (Cuba); Lopez F, Y.; Jerez V, P. [CNSN, Calle 28 e/5ta y 7ta, Playa, La Habana (Cuba)]. e-mail:


    The work picks up the efforts directed to elevate the technical capacity of the answer in front of the radiological emergencies. Expressing them by means of the actions carried out as for teaching, research and development and intervention before accidental radiological events. The same one reflects the leading role of the participant institutions in those marks of the answer system to radiological emergencies that for its technical level it satisfies the national and international demands in the matter. In execution of the mentioned goals research projects guided to endow to the national system of methodologies and procedures for the administration of radiological emergencies have been executed that favor the improvement of its technical and organizational capacities. As well as the postulates of the National Plan of Measures for Case of Catastrophes in the corresponding to radiological accidents. (Author)

  18. Radiological findings of pulmonary aspergillosis

    Song, Kounn Sik; Im, Chung Kie [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    The pulmonary aspergillosis is a group of three separate disease, comprising invasive aspergillosis, aspergilloma, and allergic bronchopulmonary aspergillosis, or a disease process in which one of three entities overlap with another process such as mucoid impaction, pulmonary infiltration with eosinophilia, bronchocentric granulomatosis, microgranulomatous hypersensitivity, or asthma. The radiological findings of 24 cases of pulmonary aspergillosis diagnosed and treated at Seoul National University Hospital during the past 7 years were analyzed retrospectively. The results were as follows: 1. Final diagnosis of 24 cases of pulmonary aspergillosis was aspergilloma in 16 cases, invasive aspergillosis in 2 cases, variant form of allergic bronchopulmonary aspergillosis in 3 cases, and endobronchial aspergillosis in 3 cases. 2. The underlying causes of the aspergilloma were healed tuberculous cavity in 6 cases, bronchiectasis in 8 cases, and no underlying cause were found in 2 cases. All the 16 cases of aspergilloma were correctly diagnosed without difficultly by demonstrating the intracavitary mass or air meniscus. 3. Radiological findings of the invasive aspergillosis in kidney transplant patients were multiple round nodules with early cavitation and formation of aspergilloma which shows slowly progressive cavitation over 13 months in one case, and diffusely scattered miliary nodules with occasional cavitation in the other case. 4. Classic allergic bronchopulmonary aspergillosis were not found in our series but variant form of ABPA was found in 3 young female patients. All the three patients shows some degree of central bronchiectasis and combined aspergilloma was found in 2 cases. 5. Three patients diagnosed as endobronchial aspergillosis-saprophytic infection of aspergillus in the bronchial tree-by bronchoscopic biopsy shows nonspecific radiological findings.

  19. Ebola virus disease: radiology preparedness.

    Bluemke, David A; Meltzer, Carolyn C


    At present, there is a major emphasis on Ebola virus disease (EVD) preparedness training at medical facilities throughout the United States. Failure to have proper EVD procedures in place was cited as a major reason for infection of medical personnel in the United States. Medical imaging does not provide diagnosis of EVD, but patient assessment in the emergency department and treatment isolation care unit is likely to require imaging services. The purpose of this article is to present an overview of relevant aspects of EVD disease and preparedness relevant to the radiologic community. © RSNA, 2014.

  20. Nuclear and radiological Security: Introduction.

    Miller, James Christopher [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    Nuclear security includes the prevention and detection of, and response to, theft, sabotage, unauthorized access, illegal transfer, or other malicious acts involving nuclear or other radioactive substances or their associated facilities. The presentation begins by discussing the concept and its importance, then moves on to consider threats--insider threat, sabotage, diversion of materials--with considerable emphasis on the former. The intrusion at Pelindaba, South Africa, is described as a case study. The distinction between nuclear security and security of radiological and portable sources is clarified, and the international legal framework is touched upon. The paper concludes by discussing the responsibilities of the various entities involved in nuclear security.

  1. Computational radiology in skeletal radiography

    Peloschek, Ph.; Nemec, S. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Widhalm, P. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Pattern Recognition and Image Processing Group, Department of Computer Aided Automation, Vienna University of Technology, Wiedner Hauptstrasse 8-10/020, A-1040 Vienna (Austria); Donner, R. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Pattern Recognition and Image Processing Group, Department of Computer Aided Automation, Vienna University of Technology, Wiedner Hauptstrasse 8-10/020, A-1040 Vienna (Austria); Institute for Computer Graphics and Vision, Graz University of Technology, Inffeldgasse 16, A-8010 Graz (Austria); Birngruber, E. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Thodberg, H.H. [Visiana Aps, Sollerodvej 57C, DK-2840 Holte (Denmark); Kainberger, F. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Langs, G. [Computational Image Analysis and Radiology Lab (CIR), Department of Radiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)], E-mail:


    Recent years have brought rapid developments in computational image analysis in musculo-skeletal radiology. Meanwhile the algorithms have reached a maturity that makes initial clinical use feasible. Applications range from joint space measurement to erosion quantification, and from fracture detection to the assessment of alignment angles. Current results of computational image analysis in radiography are very promising, but some fundamental issues remain to be clarified, among which the definition of the optimal trade off between automatization and operator-dependency, the integration of these tools into clinical work flow and last not least the proof of incremental clinical benefit of these methods.

  2. Schneckenbecken dysplasia, radiology, and histology

    Nikkels, P.G. [Rijksuniversiteit Utrecht (Netherlands). Dept. of Pathology; Stigter, R.H. [Div. of Neonatology and Obstetrics, University Medical Centre Utrecht (Netherlands); Knol, I.E. [Div. of Medical Genetics, University Medical Centre Utrecht (Netherlands); Harten, H.J. van der [Dept. of Pathology, Free University Amsterdam (Netherlands)


    To our knowledge this is the first report of Schneckenbecken dysplasia with the development of hydrops early in the second trimester. The radiological findings showed the typical hypoplastic iliac bones with medial extension and very flattened, on lateral view, oval-shaped vertebral bodies and short long bones. The histology showed hypercellular and hypervascular cartilage with chondrocytes with centrally located nucleus. The absence of the lacunar space as described before was also observed in some chondrocytes in our case. This male fetus was the product of consanguineous parents of Mediterranean origin compatible with autosomal recessive inheritance. (orig.)

  3. Radiology of total hip replacement

    Griffiths, H.J.; Lovelock, J.E.; McCollister Evarts, C.; Geyer, D.


    The radiology of total hip replacement (THR) and its complications is reviewed in conjunction with a long-term follow-up study on 402 patients with 501 prostheses. The indications, contraindications, biomechanics, and operative management of these patients is discussed. Clinical complications such as deep vein thrombosis, pulmonary embolism, and hemorrhage are mentioned. Postoperative infections including granulomatous pseudotumors, dislocations and fractures, true loosening of the prosthesis, and heterotopic bone formation (HBF) are discussed and illustrated. The importance of differentiating the lucent line from true loosening is stressed. Mechanical and other clinical complications which are largely ignored by radiologists are also discussed. The uses of arthrography and bone scanning are included.

  4. Online social networking for radiology.

    Auffermann, William F; Chetlen, Alison L; Colucci, Andrew T; DeQuesada, Ivan M; Grajo, Joseph R; Heller, Matthew T; Nowitzki, Kristina M; Sherry, Steven J; Tillack, Allison A


    Online social networking services have changed the way we interact as a society and offer many opportunities to improve the way we practice radiology and medicine in general. This article begins with an introduction to social networking. Next, the latest advances in online social networking are reviewed, and areas where radiologists and clinicians may benefit from these new tools are discussed. This article concludes with several steps that the interested reader can take to become more involved in online social networking. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  5. Retracted Publications Within Radiology Journals.

    Rosenkrantz, Andrew B


    The purpose of this study was to characterize trends related to retracted publications within radiology journals. PubMed was queried to identify all articles with the publication type "retracted publication" or "notification of retraction." Articles published within radiology journals were identified using Journal Citation Reports' journal categories. Available versions of original articles and publication notices were accessed from journal websites. Citations to retracted publications were identified using Web of Science. Overall trends were assessed. Forty-eight retracted original research articles were identified within radiology journals since 1983, which included 1.1% of all PubMed "retracted publication" entries. Distinct PubMed entries were available for the retracted publication and retraction notification in 39 of 48 articles. The original PDF was available for 37 articles, although the articles were not watermarked as retracted in 23 cases. In six cases with a watermarked PDF, further searches identified nonwatermarked versions. Original HTML versions were available for 13 articles but 11 were not watermarked. The mean (± SD) delay between publication and retraction was 2.7 ± 2.8 years (range, 0-16 years). The mean number of citations to retracted articles was 10.9 ± 17.1 (range, 0-94 citations). Reasons for retraction included problematic or incorrect methods or results (although it typically was unclear whether these represented honest errors or misconduct) in 33.3% of cases, complete or partial duplicate publication in 33.3% of cases, plagiarism in 14.6% of cases, a permission issue in 8.3% of cases, the publisher's error in 6.3% of cases, and no identified reason in 6.3% of cases. One or no retractions occurred annually from 1986 to 2001, although two or more retractions occurred annually in nine of the 12 years from 2002 through 2013. Retraction represents an uncommon, yet potentially increasing, issue within radiology journals that publishers

  6. Radiological diagnosis of Brodie's abscess.

    Kowalewski, Michał; Swiatkowski, Jan; Michałowska, Ilona; Swiecicka, Dorota


    Background. Brodie's abscess is a kind of rare subacute or chronic osteitis. It is probably caused by mistreated or non-treated osteitis, or by bacteria of low virulence. Material and methods. In the Orthopedic and Traumatology Clinic of our medical school 5 patients were diagnosed with Brodie's obsecess between 1999 and 2002. all the patients had conventional x-rays, while one also had CT and MRI. Results and conclusions. The typical x-ray image shows an osteolytic lesion with sclerotic margin in the diametophysis. Each of the 5 patients had surgery. In 4 cases the histopatological results confirmed the radiological diagnosis. In one case fibrous dysplasia was found.

  7. Emergency department musculoskeletal radiological requests abuse and patients attitude toward radiological exposure in Saudi Arabia

    T. Montaser*


    Conclusion: People in Saudi Arabia expose to huge amount of radiological hazardous with a common believe that radiology is essential for diagnosis all musculoskeletal injuries. Wealthy medical system does not always lead to competent practice.

  8. The role of radiology in Campylobacter enterocolitis

    Demaerel, P.; Ponette, E.; Baert, A.L. (Leuven Univ. (Belgium). Dept. of Radiology); Lacquet, F.; Verbist, L. (Leuven Univ. (Belgium). Dept. of Microbiology); Rutgeerts, A.L. (Leuven Univ. (Belgium). Dept. of Internal Medicine)


    A series of 18 patients with diarrhoea and positive stool cultures for Campylobacter jejuni is presented. The most important radiological features were thickening of ileal mucosal folds, of interhaustral indentations and of the ileocaecal valve, lymphoid hyperplasia and microulcerations. Radiology, as well as endoscopy, are both non-specific in Campylobacter jejuni enterocolitis. The importance of radiology is to exclude more typical features of other causes of inflammatory bowel diseases. Moreover, before the result of the stool culture is available, the radiological features should suggest the suspicion of an acute infectious enterocolitis by Campylobacter jejuni as possible diagnosis. (orig.).

  9. Radiological Features and Postoperative Histopathologic Diagnosis ...

    Radiological Features and Postoperative Histopathologic Diagnosis of Intracranial Masses at Tikur Anbessa ... East and Central African Journal of Surgery ... features and postoperative histopathology diagnosis of intracranial mass lesions.

  10. Implementation of a Radiological Safety Coach program

    Konzen, K.K. [Safe Sites of Colorado, Golden, CO (United States). Rocky Flats Environmental Technology Site; Langsted, J.M. [M.H. Chew and Associates, Golden, CO (United States)


    The Safe Sites of Colorado Radiological Safety program has implemented a Safety Coach position, responsible for mentoring workers and line management by providing effective on-the-job radiological skills training and explanation of the rational for radiological safety requirements. This position is significantly different from a traditional classroom instructor or a facility health physicist, and provides workers with a level of radiological safety guidance not routinely provided by typical training programs. Implementation of this position presents a challenge in providing effective instruction, requiring rapport with the radiological worker not typically developed in the routine radiological training environment. The value of this unique training is discussed in perspective with cost-savings through better radiological control. Measures of success were developed to quantify program performance and providing a realistic picture of the benefits of providing one-on-one or small group training. This paper provides a description of the unique features of the program, measures of success for the program, a formula for implementing this program at other facilities, and a strong argument for the success (or failure) of the program in a time of increased radiological safety emphasis and reduced radiological safety budgets.

  11. Postpartum hemorrhage: Clinical and radiologic aspects

    Lee, Nam Kyung [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, 1-10, Ami-Dong, Seo-Gu, Busan 602-739 (Korea, Republic of); Kim, Suk [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, 1-10, Ami-Dong, Seo-Gu, Busan 602-739 (Korea, Republic of)], E-mail:; Lee, Jun Woo; Sol, Yu Li; Kim, Chang Won [Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, 1-10, Ami-Dong, Seo-Gu, Busan 602-739 (Korea, Republic of); Hyun Sung, Kim [Department of Surgery, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of); Jang, Ho Jin; Suh, Dong Soo [Department of Obstetrics and Gynecology, Pusan National University Hospital, Pusan National University School of Medicine and Medical Research Institute, Pusan National University, Busan 602-739 (Korea, Republic of)


    Postpartum hemorrhage (PPH) is a potentially life threatening condition, and it remains the leading cause of maternal morbidity. Uterine atony, lower genital tract lacerations, uterine rupture or inversion, retained products of conception and underlying coagulopathy are some of the common causes of PPH. Most conditions can be diagnosed based on clinical and laboratory evaluation supplemented by ultrasound information. Computed tomography (CT) or magnetic resonance (MR) imaging can provide information for the detection, localization and characterization of PPH in some difficult cases. CT can accurately demonstrate the anatomic location of significant arterial hemorrhage as sites of intravenous contrast material extravasation, which can be as a guide for angiographic intervention. The presence of focal or diffuse intravenous contrast extravasation or a hematoma within the enlarged postpartum uterine cavity on CT can help the diagnosis of uterine atony when the clinical diagnosis of uterine atony is unclear. CT can also provide the information of other alternative conditions such as a puerperal genital hematoma, uterine rupture and concealed hematoma in other sites. MR imaging may be considered as a valuable complement to ultrasound where the ultrasound findings are inconclusive in the diagnosis and differential diagnosis of retained products of conception. Knowledge of the various radiologic appearances of PPH and the correlation with clinical information can ensure correct diagnosis and appropriate and prompt treatment planning in the patients with PPH.

  12. [Decision analysis in radiology using Markov models].

    Golder, W


    Markov models (Multistate transition models) are mathematical tools to simulate a cohort of individuals followed over time to assess the prognosis resulting from different strategies. They are applied on the assumption that persons are in one of a finite number of states of health (Markov states). Each condition is given a transition probability as well as an incremental value. Probabilities may be chosen constant or varying over time due to predefined rules. Time horizon is divided into equal increments (Markov cycles). The model calculates quality-adjusted life expectancy employing real-life units and values and summing up the length of time spent in each health state adjusted for objective outcomes and subjective appraisal. This sort of modeling prognosis for a given patient is analogous to utility in common decision trees. Markov models can be evaluated by matrix algebra, probabilistic cohort simulation and Monte Carlo simulation. They have been applied to assess the relative benefits and risks of a limited number of diagnostic and therapeutic procedures in radiology. More interventions should be submitted to Markov analyses in order to elucidate their cost-effectiveness.

  13. Radiological aspects of SIRT; Radiologisches Vorgehen bei der Durchfuehrung einer SIRT

    Heusner, T.A.; Blondin, D.; Antoch, G. [Duesseldorf Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie


    This article focuses on the radiologist's perspective within an interdisciplinary approach when performing selective internal radiation therapy (SIRT). The following topics are addressed: 1. Goals of pre-interventional cross-sectional imaging, 2. preparing angiography, 3. SIRT procedure, 4. special features of radiological follow-up after SIRT. (orig.)

  14. Intraabdominal foreign bodies: radiological aspects; Corpos estranhos intra-abdominais: aspectos radiologicos

    Baena, Marcos Eduardo da Silva; Domenicis Junior, Osvaldo de; Costacurta, Marcos Antonio; Cerri, Giovanni Guido [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Servico de Diagnostico por Imagem


    The intraabdominal foreign bodies secondary to previous surgical interventions are relatively rare nowadays. In spite of this, it still remains a problem that a diagnostic imaging department have sometimes to face. In this article the authors report the evolution of five intraabdominal foreign bodies with clinical, radiological and preventive aspects. The medical literature is also reviewed. (author) 7 refs., 11 figs.

  15. The location and tracking of swallowed dental appliances: the role of radiology.

    Absi, E G; Buckley, J G


    Two cases of swallowing mishaps, one involving a spoon-denture and the other an orthodontic partial arch wire, are reported. The former was recovered following interventional radiology, the latter by proctoscopy. The role of radiographic investigation and possible measures to prevent such potential life-threatening emergencies are discussed.

  16. [Process management and controlling in diagnostic radiology in the hospital].

    Gocke, P; Debatin, J F; Dürselen, L F J


    Systematic process management and efficient quality control is rapidly gaining importance in our healthcare system. What does this mean for diagnostic radiology departments? To improve efficiency, quality and productivity the workflow within the department of diagnostic and interventional radiology at the University Hospital of Essen were restructured over the last two years. Furthermore, a controlling system was established. One of the pursued aims was to create a quality management system as a basis for the subsequent certification according to the ISO EN 9001:2000 norm. Central to the success of the workflow reorganisation was the training of selected members of the department's staff in process and quality management theory. Thereafter, a dedicated working group was created to prepare the reorganisation and the subsequent ISO certification with the support of a consulting partner. To assure a smooth implementation of the restructured workflow and create acceptance for the required ISO-9001 documentation, the entire staff was familiarized with the basic ideas of process- and quality-management in several training sessions. This manuscript summarizes the basic concepts of process and quality management as they were taught to our staff. A direct relationship towards diagnostic radiology is maintained throughout the text.

  17. Bony sequestrum: A radiologic review

    Jennin, Felicie; Bousson, Valerie; Parlier, Caroline; Jomaah, Nabil; Khanine, Vanessa; Laredo, Jean-Denis [Lariboisiere Hospital, Department of Radiology, Paris (France)


    According to a pathological definition, a bony sequestrum is defined as a piece of devitalized bone that has been separated from the surrounding bone during the process of necrosis. However, the radiological definition of a sequestrum is different and refers to an image of calcification visible within a lucent lesion, completely separated from the surrounding bone, without referring to the vascular status and histological nature of the calcified tissue. The term ''button sequestrum'' has been used in calvarial lesions. The prototype conditions that may present with a bony sequestrum are osteomyelitis and skeletal tuberculosis. Other conditions such as radiation necrosis, eosinophilic granuloma, metastatic carcinoma, primary lymphoma of bone, aggressive fibrous tumors may also manifest as osteolytic lesions containing a sequestrum. In addition, some primary bone tumors produce a matrix that may mineralize and sometimes simulate a bone sequestrum. These include osteoid tumors (osteoid osteoma, osteoblastoma), cartilaginous tumors (chondroma and chondroblastoma), lipomatous tumors (lipoma), and benign fibrous tumors (fibromyxoma, myxoma, and desmoplastic fibroma). Therefore, various conditions may present at imaging as a small area of osteolysis containing central calcifications. However, a careful analysis of the sequestrum as well as the associated clinical and radiological findings often enables to point toward a limited number of conditions. (orig.)

  18. 2015 RAD-AID Conference on International Radiology for Developing Countries: The Evolving Global Radiology Landscape.

    Kesselman, Andrew; Soroosh, Garshasb; Mollura, Daniel J


    Radiology in low- and middle-income (developing) countries continues to make progress. Research and international outreach projects presented at the 2015 annual RAD-AID conference emphasize important global themes, including (1) recent slowing of emerging market growth that threatens to constrain the advance of radiology, (2) increasing global noncommunicable diseases (such as cancer and cardiovascular disease) needing radiology for detection and management, (3) strategic prioritization for pediatric radiology in global public health initiatives, (4) continuous expansion of global health curricula at radiology residencies and the RAD-AID Chapter Network's participating institutions, and (5) technologic innovation for recently accelerated implementation of PACS in low-resource countries. Published by Elsevier Inc.

  19. Curricular Guidelines for Dental Auxiliary Radiology.

    Journal of Dental Education, 1981


    AADS curricular guidelines suggest objectives for these areas of dental auxiliary radiology: physical principles of X-radiation in dentistry, related radiobiological concepts, principles of radiologic health, radiographic technique, x-ray films and intensifying screens, factors contributing to film quality, darkroom, and normal variations in…

  20. Radiology Aide. Instructor Key [and] Student Manual.

    Hartwein, Jon; Dunham, John

    This manual can be used independently by students in secondary health occupations programs or by persons receiving on-the-job training in a radiology department. The manual includes an instructor's key that provides answers to the activity sheets and unit evaluations. The manual consists of the following five units: (1) orientation to radiology;…

  1. Curricular Guidelines for Dental Auxiliary Radiology.

    Journal of Dental Education, 1981


    AADS curricular guidelines suggest objectives for these areas of dental auxiliary radiology: physical principles of X-radiation in dentistry, related radiobiological concepts, principles of radiologic health, radiographic technique, x-ray films and intensifying screens, factors contributing to film quality, darkroom, and normal variations in…

  2. Radiology Aide. Instructor Key [and] Student Manual.

    Hartwein, Jon; Dunham, John

    This manual can be used independently by students in secondary health occupations programs or by persons receiving on-the-job training in a radiology department. The manual includes an instructor's key that provides answers to the activity sheets and unit evaluations. The manual consists of the following five units: (1) orientation to radiology;…

  3. Nevada Test Site Radiological Control Manual

    Radiological Control Managers' Council - Nevada Test Site


    This document supersedes DOE/NV/11718--079, “NV/YMP Radiological Control Manual,” Revision 5 issued in November 2004. Brief Description of Revision: A complete revision to reflect the recent changes in compliance requirements with 10 CFR 835, and for use as a reference document for Tenant Organization Radiological Protection Programs.

  4. Mucocele of the appendix. Radiological findings

    Inoue, Shingo; Satani, Kenichiro; Ozuki, Taizo [Tokyo Medical Coll. (Japan); Shindou, Hiroaki; Saguchi, Toru; Koizumi, Kiyoshi; Katsumata, Kenji [Tokyo Medical Coll. (Japan). Hachioji Medical Center; Kotake, Fumio [Tokyo Medical Coll., Ami, Ibaraki (Japan). Kasumigaura Hospital


    Radiological findings of CT and MRI were evaluated in 11 cases of mucocele of the appendix. Mucocele is a rare disease entity and preoperative diagnosis is very important. The radiological findings were a well defined cystic mass with a wall of variable thickness. Nodular lesion in the wall of the mucocele may be a suggestive finding of malignant case of mucocele. (author)

  5. New trends in radiology workstation design

    Moise, Adrian; Atkins, M. Stella


    In the radiology workstation design, the race for adding more features is now morphing into an iterative user centric design with the focus on ergonomics and usability. The extent of the list of features for the radiology workstation used to be one of the most significant factors for a Picture Archiving and Communication System (PACS) vendor's ability to sell the radiology workstation. Not anymore is now very much the same between the major players in the PACS market. How these features work together distinguishes different radiology workstations. Integration (with the PACS/Radiology Information System (RIS) systems, with the 3D tool, Reporting Tool etc.), usability (user specific preferences, advanced display protocols, smart activation of tools etc.) and efficiency (what is the output a radiologist can generate with the workstation) are now core factors for selecting a workstation. This paper discusses these new trends in radiology workstation design. We demonstrate the importance of the interaction between the PACS vendor (software engineers) and the customer (radiologists) during the radiology workstation design. We focus on iterative aspects of the workstation development, such as the presentation of early prototypes to as many representative users as possible during the software development cycle and present the results of a survey of 8 radiologists on designing a radiology workstation.

  6. Radiological health aspects of uranium milling

    Fisher, D.R.; Stoetzel, G.A.


    This report describes the operation of conventional and unconventional uranium milling processes, the potential for occupational exposure to ionizing radiation at the mill, methods for radiological safety, methods of evaluating occupational radiation exposures, and current government regulations for protecting workers and ensuring that standards for radiation protection are adhered to. In addition, a survey of current radiological health practices is summarized.

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

    Bethapudi, Sarath [County Durham Darlington Foundation NHS Trust, Durham (United Kingdom); Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom); Ritchie, David [Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom); Greater Glasgow and Clyde Hospitals NHS Trust, Western Infirmary, Glasgow (United Kingdom); Bongale, Santosh [Glasgow 2014 Commonwealth Games, Immediate Care Department, Glasgow (United Kingdom); NHS Greater Glasgow and Clyde, Royal Alexandra Hospital, Paisley (United Kingdom); Gordon, Jonny [Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom); NHS Greater Glasgow and Clyde, Glasgow (United Kingdom); MacLean, John [Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom); National Stadium Sports Medicine Centre, Glasgow (United Kingdom); Mendl, Liz [Glasgow 2014 Commonwealth Games, Glasgow (United Kingdom)


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

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

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


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

  9. Applying industrial engineering practices to radiology.

    Rosen, Len


    Seven hospitals in Oregon and Washington have successfully adopted the Toyota Production System (TPS). Developed by Taiichi Ohno, TPS focuses on finding efficiencies and cost savings in manufacturing processes. A similar effort has occurred in Canada, where Toronto's Hospital for Sick Children has developed a database for its diagnostic imaging department built on the principles of TPS applied to patient encounters. Developed over the last 5 years, the database currently manages all interventional patient procedures for quality assurance, inventory, equipment, and labor. By applying industrial engineering methodology to manufacturing processes, it is possible to manage these constraints, eliminate the obstacles to achieving streamlined processes, and keep the cost of delivering products and services under control. Industrial engineering methodology has encouraged all stakeholders in manufacturing plants to become participants in dealing with constraints. It has empowered those on the shop floor as well as management to become partners in the change process. Using a manufacturing process model to organize patient procedures enables imaging department and imaging centers to generate reports that can help them understand utilization of labor, materials, equipment, and rooms. Administrators can determine the cost of individual procedures as well as the total and average cost of specific procedure types. When Toronto's Hospital for Sick Children first implemented industrial engineering methodology to medical imaging interventional radiology patient encounters, it focused on materials management. Early in the process, the return on investment became apparent as the department improved its management of more than 500,000 dollars of inventory. The calculated accumulated savings over 4 years for 10,000 interventional procedures alone amounted to more than 140,000 dollars. The medical imaging department in this hospital is only now beginning to apply what it has learned to

  10. Bridging radiology and public health: the emerging field of radiologic public health informatics.

    Mollura, Daniel J; Carrino, John A; Matuszak, Diane L; Mnatsakanyan, Zaruhi R; Eng, John; Cutchis, Protagoras; Babin, Steven M; Sniegoski, Carol; Lombardo, Joseph S


    Radiology and public health have an emerging opportunity to collaborate, in which radiology's vast supply of imaging data can be integrated into public health information systems for epidemiologic assessments and responses to population health problems. Fueling the linkage of radiology and public health include (i) the transition from analog film to digital formats, enabling flexible use of radiologic data; (ii) radiology's role in imaging across nearly all medical and surgical subspecialties, which establishes a foundation for a consolidated and uniform database of images and reports for public health use; and (iii) the use of radiologic data to characterize disease patterns in a population occupying a geographic area at one time and to characterize disease progression over time via follow-up examinations. The backbone for this integration is through informatics projects such as Systematized Nomenclature of Medicine Clinical Terms and RadLex constructing terminology libraries and ontologies, as well as algorithms integrating data from the electronic health record and Digital Imaging and Communications in Medicine Structured Reporting. Radiology's role in public health is being tested in disease surveillance systems for outbreak detection and bioterrorism, such as the Electronic Surveillance System for the Early Notification of Community-based Epidemics. Challenges for radiologic public health informatics include refining the systems and user interfaces, adhering to privacy regulations, and strengthening collaborative relations among stakeholders, including radiologists and public health officials. Linking radiology with public health, radiologic public health informatics is a promising avenue through which radiology can contribute to public health decision making and health policy.

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

    Marshall, Nina L


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

  12. Radiological protection in veterinary practice

    Konishi, Emiko; Tabara, Takashi (Tokyo Univ. (Japan). Research Center for Nuclear Engineering and Technology); Kusama, Tomoko


    To propose measures for radiological protection of veterinary workers in Japan, X-ray exposure of workers in typical conditions in veterinary clinics was assessed. Dose rates of useful beam and scattered radiation, worker exposure doses at different stations, and effectiveness of protective clothing were determined using TLD and ion chambers. As precausions against radiation, the following practices are important: (1) use of suitable and properly maintained X-ray equipment, (2) proper selection of safe working stations, (3) use of protective clothing. Regulations are necessary to restrict the use of X-rays in the veterinary field. Because the use of X-rays in the veterinary field is not currently controlled by law, the above precautions are essential for minimizing exposure of veterinary staff. (author).

  13. Radiological aspects of psoriatic osteoarthropathia

    Ellegast, H.H.; Haydl, H.; Petershofer, H.; Prohaska, E.


    Psoriatic osteoarthropathia is a disease of the joints, spine, and bones. It belongs to the category of ''seronegative spondarthritis'', the prototype of which is ankylosing spondylitis. Contrary to earlier assumptions, morphological changes in the X-ray picture are frequent if the joints (psoriatic arthritis) or axial skeleton (psoriatic spondylitis) are affected. Radiographic signs are listed and scintigraphic findings discussed. The morphological changes in the X-ray picture are characteristic, even without psoriatic lesions of the skin. Sacro-iliac changes in the axial skeleton are frequent. In other parts of the skeleton, typical parasyndesmophytes are slightly less frequent, and changes as in ankylosing spondylitis may occur. The diagnosis is easier with whole-body scintiscanning as this technique is able to detect early changes which are not noticeable clinically or radiologically.

  14. Radiologic Imaging of Diaphragmatic Pathologies

    Hatice Öztürkmen Akay


    Full Text Available We researched the images methods in the evaluation of diaphragmaticpathologies. The study was done with 30 patients (21 males, 9 females. Themedian age of the patients was 36.1 years (Range 1-74 years. Firstly,lateraly and posteroanterior chest X-Ray were done in all patients the otherradiological images were the Barium examination, ultrasonography,computerized tomography and magnetic rezonans imaging. We determineddiaphragmatic pseudotumour in 4 patients, congenital diaphragmatichernia in 6 patients, diaphragmatic paralysis in 2 patients, diaphragmaticelevation in 8 patients, hiatal hernia in 5 patients, and diaphragmaticrupture in 5 patients.Although radiological images were developed all, we believe that thediaphragmatic pathologies should be evaluated with both clinically andradiologically in all patients.

  15. Radiology of gestational trophoblastic neoplasia

    Allen, S.D. [Department of Radiology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom); Lim, A.K. [Department of Radiology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom); Seckl, M.J. [Department of Medical Oncology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom); Blunt, D.M. [Department of Radiology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom); Mitchell, A.W. [Department of Radiology, Charing Cross Hospital, Hammersmith Hospitals NHS Trust, London (United Kingdom)]. E-mail:


    Gestational trophoblastic neoplasia (GTN) encompasses a broad spectrum of placental lesions from the pre-malignant hydatidiform mole (complete and partial) through to the malignant invasive mole, choriocarcinoma and rare placental site trophoblastic tumour (PSTT). Ultrasound remains the radiological investigation of choice for initial diagnosis, and it can also predict invasive and recurrent disease. Magnetic resonance imaging is of invaluable use in assessing extra-uterine tumour spread, tumour vascularity, and overall staging. Positron emission tomography and computed tomography undoubtedly have a role in recurrent and metastatic disease, while angiography has a place in disease and complication management. This review will describe the relevant pathophysiology and natural history of GTN, and the use of imaging techniques in the diagnosis and management of these conditions.


    Rade R. Babic


    Full Text Available Renal papylar necrosis is rare disease. It is diagnosed by intravenous urography. Radio-logical presentation is patognomonical: necrotis focus of the papila, on the urogram is visualised as a punctiformne, blot spot of the iodine contrast, or the depots of the iodine contrast are spread from the edge of fornix to the renal medulla as a ribbon-like or needle-shaped formations, apear-ing in a late phase of illness like a crebs legs or feeler, sometimes convergning in the oreol or in ring-shaped formation, while necrotic sequestar is resorbed formating the cavity filled by iodine contrast, which has trigonal shape with the lateral basis, or necrotican sequestar can be removed with the channel system obstruction, presenting with the picture of ureterohydronephrosis, caused by the organic concrement. In the late stadium of the desease necrotic cavity can present with calcified wall and it can be diagnoses also at the native radiogram of the urotract.

  17. Radiological maps for Trabzon, Turkey

    Kurnaz, A., E-mail: [Karadeniz Technical University, Department of Physics, 61080 Trabzon (Turkey); Kucukomeroglu, B. [Karadeniz Technical University, Department of Physics, 61080 Trabzon (Turkey); Damla, N. [Batman University, Department of Physics, 72060 Batman (Turkey); Cevik, U. [Karadeniz Technical University, Department of Physics, 61080 Trabzon (Turkey)


    The activity concentrations and absorbed gamma dose rates due to primordial radionuclides and {sup 137}Cs have been ascertained in 222 soil samples in 18 counties of the Trabzon province of Turkey using a HPGe detector. The mean activity concentrations of {sup 238}U, {sup 232}Th, {sup 40}K and {sup 137}Cs in soil samples were 41, 35, 437 and 21 Bq kg{sup -1}, respectively. Based on the measured concentrations of these radionuclides, the mean absorbed gamma dose in air was calculated as 59 nGy h{sup -1} and hence, the mean annual effective dose due to terrestrial gamma radiation was calculated as 72 {mu}Sv y{sup -1}. In addition, outdoor in situ gamma dose rate (D) measurements were performed in the same 222 locations using a portable NaI detector and the annual effective dose was calculated to be 66 {mu}Sv y{sup -1} from these results. The results presented in this study are compared with other parts of Turkey. Radiological maps of the Trabzon province were composed using the results obtained from the study. - Highlights: {yields} {yields}The study highlights activity concentrations of {sup 238}U, {sup 232}Th, {sup 40}K and {sup 137}Cs in soil. {yields} The absorbed gamma dose in air and the mean annual effective dose were calculated. {yields} The calculated results compared with outdoor in situ gamma dose measurements. {yields} Radiological maps of the Trabzon province were created using ArcGIS applications. {yields} The results will be valuable data for future estimations of radioactive pollution.

  18. Bacteriological Monitoring of Radiology Room Apparatus in the Department of Radiological Technology and Contamination on Hands of Radiological Technologists

    Kim, Seon Chil [Dept. of Radiologic Technology, Daegu Health College, Daegu (Korea, Republic of)


    Distribution of microorganisms were examined for the bucky tables in the radiology rooms of the department of radiological technology, the aprons, handles of various apparatus, handles of mobile radiological apparatus, and hands of the radiological technologists. As a result, relatively larger amounts of bacteria were found on the handles of the mobile radiological apparatus and the aprons. Among the isolated bacteria, Acinetobacter baumanni (7.3%), Klebsiella pneumoniae (6.7%), Staphylococcus aureus (3.9%), Serratia liquefaciens (1.7%), Enterobacter cloaceae (0.6%), Providenica rettgeri (0.6%) are known as the cause of nosocomial infection (hospital acquired infection). In addition, similar colonies were also found on the hands of the radiological technologists such as microorganisms of Klebsiella pneumoniae (8.4%), Staphylococcus aureus (6.6%), Yersinia enterocolotica (5.4%), Acinetobacter baumanni (4.2%), Enterobacter cloaceae (2.4%), Serratia liquefaciens (1.8%), Yersinia pseuotuberculosis (18%), Enterobacter sakazakii (1.2%), and Escherichia coli (0.6%). In particular, this result indicates clinical significance since Staphylococcus aureus and Escherichia coli show strong pathogenicity. Therefore, a continuous education is essential for the radiological technologists to prevent the nosocomial infection.

  19. Assessment of Safety Parameters for Radiological Explosion Based on Gaussian Dispersion Model

    Pandey, Alok [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Yu, Hyungjoon; Kim, Hong Suk [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)


    These sources if used with explosive (called RDD - radiological dispersion device), can cause dispersion of radioactive material resulting in public exposure and contamination of the environment. Radiological explosion devices are not weapons for the mass destruction like atom bombs, but can cause the death of few persons and contamination of large areas. The reduction of the threat of radiological weapon attack by terrorist groups causing dispersion of radioactive material is one of the priority tasks of the IAEA Nuclear Safety and Security Program.Emergency preparedness is an essential part for reducing and mitigating radiological weapon threat. Preliminary assessment of dispersion study followed by radiological explosion and its quantitative effect will be helpful for the emergency preparedness team for an early response. The effect of the radiological dispersion depends on various factors like radioisotope, its activity, physical form, amount of explosive used and meteorological factors at the time of an explosion. This study aim to determine the area affected by the radiological explosion as pre assessment to provide feedback to emergency management teams for handling and mitigation the situation after an explosion. Most practical scenarios of radiological explosion are considered with conservative approach for the assessment of the area under a threat for emergency handling and management purpose. Radioisotopes under weak security controls can be used for a radiological explosion to create terror and socioeconomic threat for the public. Prior assessment of radiological threats is helpful for emergency management teams to take prompt decision about evacuation of the affected area and other emergency handling actions. Comparable activities of Co-60 source used in radiotherapy and Sr-90 source of disused and orphaned RTGs with two different quantities of TNT were used for the scenario development of radiological explosion. In the Basic Safety Standard (BSS

  20. Estimating radiological background using imaging spectroscopy

    Bernacki, Bruce E.; Schweppe, John E.; Stave, Sean C.; Jordan, David V.; Kulisek, Jonathan A.; Stewart, Trevor N.; Seifert, Carolyn E.


    Optical imaging spectroscopy is investigated as a method to estimate radiological background by spectral identification of soils, sediments, rocks, minerals and building materials derived from natural materials and assigning tabulated radiological emission values to these materials. Radiological airborne surveys are undertaken by local, state and federal agencies to identify the presence of radiological materials out of regulatory compliance. Detection performance in such surveys is determined by (among other factors) the uncertainty in the radiation background; increased knowledge of the expected radiation background will improve the ability to detect low-activity radiological materials. Radiological background due to naturally occurring radiological materials (NORM) can be estimated by reference to previous survey results, use of global 40K, 238U, and 232Th (KUT) values, reference to existing USGS radiation background maps, or by a moving average of the data as it is acquired. Each of these methods has its drawbacks: previous survey results may not include recent changes, the global average provides only a zero-order estimate, the USGS background radiation map resolutions are coarse and are accurate only to 1 km – 25 km sampling intervals depending on locale, and a moving average may essentially low pass filter the data to obscure small changes in radiation counts. Imaging spectroscopy from airborne or spaceborne platforms can offer higher resolution identification of materials and background, as well as provide imaging context information. AVIRIS hyperspectral image data is analyzed using commercial exploitation software to determine the usefulness of imaging spectroscopy to identify qualitative radiological background emissions when compared to airborne radiological survey data.

  1. Role of noninvasive testing in the clinical evaluation of women with suspected coronary artery disease: Consensus statement from the Cardiac Imaging Committee, Council on Clinical Cardiology, and the Cardiovascular Imaging and Intervention Committee, Council on Cardiovascular Radiology and Intervention, American Heart Association.

    Mieres, Jennifer H; Shaw, Leslee J; Arai, Andrew; Budoff, Matthew J; Flamm, Scott D; Hundley, W Gregory; Marwick, Thomas H; Mosca, Lori; Patel, Ayan R; Quinones, Miguel A; Redberg, Rita F; Taubert, Kathryn A; Taylor, Allen J; Thomas, Gregory S; Wenger, Nanette K


    Cardiovascular disease is the leading cause of mortality for women in the United States. Coronary heart disease, which includes coronary atherosclerotic disease, myocardial infarction, acute coronary syndromes, and angina, is the largest subset of this mortality, with >240,000 women dying annually from the disease. Atherosclerotic coronary artery disease (CAD) is the focus of this consensus statement. Research continues to report underrecognition and underdiagnosis of CAD as contributory to high mortality rates in women. Timely and accurate diagnosis can significantly reduce CAD mortality for women; indeed, once the diagnosis is made, it does appear that current treatments are equally effective at reducing risk in both women and men. As such, noninvasive diagnostic and prognostic testing offers the potential to identify women at increased CAD risk as the basis for instituting preventive and therapeutic interventions. Nevertheless, the recent evidence-based practice program report from the Agency for Healthcare Research and Quality noted the paucity of women enrolled in diagnostic research studies. Consequently, much of the evidence supporting contemporary recommendations for noninvasive diagnostic studies in women is extrapolated from studies conducted predominantly in cohorts of middle-aged men. The majority of diagnostic and prognostic evidence in cardiac imaging in women and men has been derived from observational registries and referral populations that are affected by selection and other biases. Thus, a better understanding of the potential impact of sex differences on noninvasive cardiac testing in women may greatly improve clinical decision making. This consensus statement provides a synopsis of available evidence on the role of the exercise ECG and cardiac imaging modalities, both those in common use as well as developing technologies that may add clinical value to the diagnosis and risk assessment of the symptomatic and asymptomatic woman with suspected

  2. Radiologic diagnosis of a newborn with cloaca.

    Kraus, Steven J


    When a female is born and has only a single perineal orifice on the newborn clinical examination, a diagnosis of cloaca type of anorectal malformation is made. Along with associated malformations which may initiate the ordering of radiologic imaging, there are a finite number of radiologic tests that are performed to help in the immediate management of the patient with cloaca. The following discussion will outline the most important radiologic tests and demonstrate examples of images from newborn females with cloaca. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Justification and radiology: some ethical considerations.

    Sia, Santiago


    This paper, which seeks to address the issue of justification in radiology, intends firstly to comment on the current discussion of the ethical foundation of radiological practice that focuses on the move from utilitarianism to the rights-centred criterion. Secondly, and this constitutes the bulk of the paper, it aims to offer a philosophical perspective, which is hoped will lead to a consideration of certain specific areas in ethical decision-making in the attempts here to deal with the main issue of justification in radiology.

  4. Evidence-Based Radiology (EBR

    Mansoor Fatehi


    Full Text Available   "nRecent increase in scientific advancements has led to inability to cover many scientific data and remain “up-to-date”. Nowadays doubling time of scientific data production is remarkably reduced, so that there is no adequate time to find this information and it seems inevitable to use resources which periodically assess most published papers or web-based data in that particular field to finally provide evidence-based knowledge, namely “Evidence-Based Medicine (EBM” in medical sciences. EBM is the systematic, scientific and explicit use of current best evidence in making decisions about the care of individual patients. Medical practice is largely based on clinical anecdotes, uncontrolled investigations and expert opinion. In radiology, the situation is especially problematic. "nRadiologists require to be able to evaluate studies in the literature, i.e., how reliable is this information and does it apply to patients in the radiologist’s practice? "nWe may find that our textbooks are out of date, guidelines are non-specific and there are conflicting "nor unreliable reports in the literature. Expert opinions vary from centre to centre. "nWhen we go to the literature ourselves, the first problem we encounter is the volume of literature being published and the next (at least for most of us is lack of training in how to separate good studies from weak ones. Evidence-based radiology (EBR can be a solution. "nThere are 5 steps in applying an approach as a solution: "n1. Ask - Information needs relevant to individual patients are converted into ‘answerable’ or ‘focused’ questions. "n2. Search - A comprehensive literature search is performed to find the best evidence to help answer these questions. "n3. Appraise - The evidence must then be critically appraised, in an explicit and structured manner, in order to establish its validity, reliability and usefulness in practice. "n4. Apply - The results of this critical appraisal are then

  5. Radiologic findings of thoracic trauma

    Akgul Ozmen C


    Full Text Available Cihan Akgul Ozmen,1 Serdar Onat,2 Delal Aycicek3 1Department of Radiology, 2Department of Chest Surgery, Dicle University School of Medicine, Diyarbakir, 3Radiology Unit, Siirt State Hospital, Siirt, Turkey Introduction: Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department. Methods: A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included. Most of the patients were male (83.3% and victims of a blunt chest trauma. The images were analyzed with respect to the presence of fractures of bony structures, hemothorax, pneumothorax, mediastinal organ injury, and pulmonary and vascular injuries. Results: MDCT images of the 240 patients yielded a prevalence of 41.7% rib fractures, 11.2% scapular fractures, and 7.5% clavicle fractures. The prevalence of thoracic vertebral fracture was 13.8% and that of sternal fracture was 3.8%. The prevalence of hemothorax, pneumothorax, pneumomediastinum, and subcutaneous emphysema was 34.6%, 62.1%, 9.6%, and 35.4%, respectively. The prevalence of rib, clavicle, and thoracic vertebral fractures and pulmonary contusion was higher in the blunt trauma group, whereas the prevalence of hemothorax, subcutaneous emphysema, diaphragmatic injury, and other vascular lacerations was significantly higher in the penetrating trauma group than in the blunt trauma group (p<0.05. Conclusion: MDCT images may yield a high prevalence of fracture of bony structures, soft tissue lacerations, and vascular lesions, which should be well understood by

  6. Definition of Local Diagnostic Reference Levels in a Radiology Department Using a Dose Tracking Software.

    Ghetti, C; Ortenzia, O; Palleri, F; Sireus, M


    Dose optimization in radiological examinations is a mandatory issue: in this study local Diagnostic Reference Levels (lDRLs) for Clinical Mammography (MG), Computed Tomography (CT) and Interventional Cardiac Procedures (ICP) performed in our Radiology Department were established. Using a dose tracking software, we have collected Average Glandular Dose (AGD) for two clinical mammographic units; CTDIvol, Size-Specific Dose Estimate (SSDE), Dose Length Product (DLP) and total DLP (DLPtot) for five CT scanners; Fluoro Time, Fluoro Dose Area Product (DAP) and total DAP (DAPtot) for two angiographic systems. Data have been compared with Italian Regulation and with the recent literature. The 75th percentiles of the different dosimetric indices have been calculated. Automated methods of radiation dose data collection allow a fast and detailed analysis of a great amount of data and an easy determination of lDRLs for different radiological procedures.

  7. Diagnostic errors in pediatric radiology

    Taylor, George A.; Voss, Stephan D. [Children' s Hospital Boston, Department of Radiology, Harvard Medical School, Boston, MA (United States); Melvin, Patrice R. [Children' s Hospital Boston, The Program for Patient Safety and Quality, Boston, MA (United States); Graham, Dionne A. [Children' s Hospital Boston, The Program for Patient Safety and Quality, Boston, MA (United States); Harvard Medical School, The Department of Pediatrics, Boston, MA (United States)


    Little information is known about the frequency, types and causes of diagnostic errors in imaging children. Our goals were to describe the patterns and potential etiologies of diagnostic error in our subspecialty. We reviewed 265 cases with clinically significant diagnostic errors identified during a 10-year period. Errors were defined as a diagnosis that was delayed, wrong or missed; they were classified as perceptual, cognitive, system-related or unavoidable; and they were evaluated by imaging modality and level of training of the physician involved. We identified 484 specific errors in the 265 cases reviewed (mean:1.8 errors/case). Most discrepancies involved staff (45.5%). Two hundred fifty-eight individual cognitive errors were identified in 151 cases (mean = 1.7 errors/case). Of these, 83 cases (55%) had additional perceptual or system-related errors. One hundred sixty-five perceptual errors were identified in 165 cases. Of these, 68 cases (41%) also had cognitive or system-related errors. Fifty-four system-related errors were identified in 46 cases (mean = 1.2 errors/case) of which all were multi-factorial. Seven cases were unavoidable. Our study defines a taxonomy of diagnostic errors in a large academic pediatric radiology practice and suggests that most are multi-factorial in etiology. Further study is needed to define effective strategies for improvement. (orig.)

  8. Radiologic features of granulomatous mastitis.

    Al-Khawari, Hanaa A T; Al-Manfouhi, Huda A; Madda, John P; Kovacs, Agnes; Sheikh, Mehraj; Roberts, Omolara


    Granulomatous mastitis (GM) is a recognized, but an uncommon cause of breast mass. Awareness of this condition is important, because it can clinically as well as radiologically mimic breast carcinoma. In this study, we present the imaging features of a series of 10 cases with proved diagnosis of granulomatous mastitis with emphasis on magnetic resonance (MR) findings. All those patients who were histologically proven to have GM of the breast were analyzed. Their files were reviewed and data recorded for demographic, clinical presentation and imaging appearances. The imaging features of the lesions by mammography, ultrasound, and magnetic resonance imaging were analyzed. Of the 305 patients who were surgically treated, 10 (3%) cases proved to have GM. All the patients were females with age ranging from 27 to 53 years (average 38 years and median age 36 years). Guided core biopsy was performed in all cases for confirmation of diagnosis followed by either excision biopsy (in five cases) or lumpectomy (in five cases). The final histopathologic results were chronic granulomatous inflammation consistent with tuberculosis in four cases and GM with acute inflammation, but unknown etiology in four cases and GM due to duct ectasia in two cases. GM, a rare breast condition, should be considered in the differential diagnosis of patients with a breast mass associated with inflammatory change. Routine breast imaging with US, MG, or MRI, the condition from malignant lesions and biopsy, still remains the only method of definite diagnosis. © 2011 Wiley Periodicals, Inc.

  9. Radiologic findings of granulomatous mastitis

    Kim, Tae Gyu; Kim, Ji Young; Jeong, Myeong Ja; Kim, Jae Hyung; Kim, Soung Hee; Kim, Soo Hyun; Jun, Woo Sun; Park, Kyeong Mee; Han, Se Hwan [Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)


    The describe the radiologic findings of granulomatous mastitis of the breast. This study included 19 patients (age range: 22 to 56 years; mean 37 years) with 22 lesions that were pathologically confirmed as having granulomatous mastitis. All the patients underwent a breast ultrasonography and 13 patients underwent a mammography. The results of the mammography revealed focal asymmetry (n = 9), multiple ill-defined isodense nodules (n 2), ill-defined nodular density on craniocaudal view (n = 1), and unremarkable finding (n = 1). The sonographic findings included continuous or discontinuous multiple tubular and nodular low echoic lesions (n = 7), ill-defined heterogeneously low echoic lesion (n = 5), irregular-shaped, ill-defined low echoic mass (n = 4), fluid collection with internal floating materials suggesting the presence of an abscess (n = 4), ill-defined heterogeneously low echoic lesion and abscess (n = 1), and multiple ill-defined nodules (n = 1). In the case of granulomatous mastitis, the mammography results indicate a lack of specificity between normal findings and focal asymmetry. The sonographic findings indicate that ill-defined heterogeneously low echoic lesions or irregular shaped, ill-defined low echoic masses are difficult to differentiate from breast cancer. The sonographic findings of abscesses indicate a difficulty in differentiating them from cases of pyogenic mastitis. However, multiple tubular and nodular low echoic lesions, especially with a continuous appearance, should point to granulomatous mastitis, and is helpful in its differential diagnosis and treatment.

  10. Patient dosimetry in diagnostic radiology

    Ciraj-Bjelac Olivera F.


    Full Text Available The objective of this work is to assess patient organ doses, effective doses and entrance surface doses in conventional diagnostic radiology procedures for standard adult patient. The survey consists of measurements of doses delivered to 239 patients in nine types of X-ray examinations. Three types of data were collected: X-ray machine data, patient data, and output measurements. Entrance surface dose was assessed based on the survey data and subsequently, using conversion coefficients, the organ doses and effective doses were calculated. Values of the entrance surface dose and the effective dose were estimated to be 0.4 to 5.8 mGy and 0.03 to 3.00 mSv for different examinations. Derived doses were compared with recommended general diagnostic reference levels. The impact of examination parameters on dose values was discussed. Except for posterior-anterior chest examination, all estimated doses are lower than stated reference levels. Survey data are aimed at helping development of national quality control and radiation protection programmed for medical exposures.

  11. Multilingual retrieval of radiology images.

    Kahn, Charles E


    The multilingual search engine ARRS GoldMiner Global was created to facilitate broad international access to a richly indexed collection of more than 200,000 radiologic images. Images are indexed according to key-words and medical concepts that appear in the unstructured text of their English-language image captions. GoldMiner Global exploits the Unicode standard, which allows the accurate representation of characters and ideographs from virtually any language and which supports both left-to-right and right-to-left text directions. The user interface supports queries in Arabic, Chinese, French, German, Italian, Japanese, Korean, Portuguese, Russian, or Spanish. GoldMiner Global incorporates an interface to the United States National Library of Medicine that translates queries into English-language Medical Subject Headings (MeSH) terms. The translated MeSH terms are then used to search the image index and retrieve relevant images. Explanatory text, pull-down menu choices, and navigational guides are displayed in the selected language; search results are displayed in English. GoldMiner Global is freely available on the World Wide Web.

  12. Complications of pneumoconiosis: Radiologic overview

    Jun, Jae Sup [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Jung, Jung Im, E-mail: [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Kim, Hyo Rim [Department of Radiology, Yeouido St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Ahn, Myeong Im; Han, Dae Hee [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Ko, Jeong Min [Department of Radiology, St. Vincent Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Park, Seog Hee; Lee, Hae Giu [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea (Korea, Republic of); Arakawa, Hiroaki [Department of Radiology, Dokkyo University School of Medicine (Japan); Koo, Jung-Wan [Department of Occupational and Environmental Medicine, Seoul St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of)


    A wide spectrum of pulmonary complications occurs in patients with pneumoconiosis. Those complications include chronic obstructive pulmonary disease, hemoptysis, pneumothorax, pleural disease, tuberculosis, autoimmune disease, anthracofibrosis, chronic interstitial pneumonia, and malignancy. Generally, imaging workup starts with plain chest radiography. However, sometimes, plain radiography has limited role in the diagnosis of pulmonary complications of pneumoconiosis because of overlapping pneumoconiotic infiltration. Computed tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI) are potentially helpful for the detection of pulmonary complications in patients with pneumoconiosis. CT, with its excellent contrast resolution, is more sensitive and specific method than plain radiograph in the evaluation of pulmonary abnormalities. CT is useful in detecting lung parenchymal abnormalities caused by infection, anthracofibrosis, and chronic interstitial pneumonia. Also, CT is valuable in distinguishing localized pneumothorax from bullae and aiding the identification of multiloculated effusions. US can be used in detection of complicated pleural effusions and guidance of the thoracentesis procedure. MRI is useful for differentiating between progressive massive fibrosis and lung cancer. Radiologists need to be familiar with the radiologic and clinical manifestations of, as well as diagnostic approaches to, complications associated with pneumoconiosis. Knowledge of the various imaging features of pulmonary complications of pneumoconiosis can enhance early diagnosis and improve the chance to cure.

  13. Evaluation of use of e-Learning in undergraduate radiology education: A review

    Zafar, Saad, E-mail: [Riphah International University, Islamabad (Pakistan); Safdar, Saima, E-mail: [Riphah International University, Islamabad (Pakistan); Zafar, Aasma N., E-mail: [Radiology Department, Senior Registrar Shifa College of Medicine and Assistant Consultant Shifa International Hospital, Islamabad (Pakistan)


    Highlights: • We have systematically reviewed the literature on use of e-Learning in Radiology at the undergraduate level. • Kirkpatrick's Learning Model is used to evaluate the learning outcomes of the reported studies. • There is an increase in positive response for learning management systems used in blended learning environments. • There are wide range of technologies being used for e-Learning including use of audio response system and customized PAC solutions. • There is a clear trend toward highly interactive, self directed learning environment to support the concept of life long independent learners. - Abstract: Purpose: The aim of this review is to investigate the evaluative outcomes present in the literature according to Kirkpatrick's learning model and to examine the nature and characteristics of the e-Learning interventions in radiology education at undergraduate level. Materials and methods: Four databases (PubMed, MEDLINE, Embase, Eric) are searched for publications related to the application of e-Learning in undergraduate radiology education. The search strategy is a combination of e-Learning and Mesh and non Mesh radiology and undergraduate related terms. These search strategies are established in relation to experts of respective domains. The full text of thirty pertinent articles is reviewed. Author's country and study location data is extracted to identify the most active regions and year's are extracted to know the existing trend. Data regarding radiology subfields and undergraduate year of radiology education is extracted along with e-Learning technologies to identify the most prevalent or suitable technologies or tools with respect to radiology contents. Kirkpatricks learning evaluation model is used to categorize the evaluative outcomes reported in the identified studies. Results: The results of this analysis reveal emergence of highly interactive games, audience response systems and designing of wide range of

  14. Workshop Sciences and values in radiological protection; Atelier 'Sciences and values in radiological protection

    Lebaron-Jacobs, L. [CEA Cadarache (DSV/DIR/CARMIN), 13 - Saint-Paul-lez-Durance (France); Gaillard-Lecanu, E. [CEA Cadarache (DSV/DIR/CARMIN), 92 - Fontenay-aux-Roses (France)


    The Nea (Nuclear Energy Agency) organized a workshop entitled 'Sciences and values in radiological protection' in order to identify the possible ways of integration of results, coming from scientific research on the biological and health effects of ionizing radiation, in radiological protection. Three current topics were addressed: non-targeted effects, individual radiosensitivity and cardiovascular diseases. At the end of this workshop, recommendations towards scientists, radiological protection practitioners and stakeholders were expressed. (authors)

  15. Advancing radiology through informed leadership: summary of the proceedings of the Seventh Biannual Symposium of the International Society for Strategic Studies in Radiology (IS{sup 3}R), 23-25 August 2007

    Muellner, Ada; Hricak, Hedvig [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Glazer, Gary M. [Stanford University School of Medicine, Department of Radiology, Palo Alto, CA (United States); Reiser, Maximilian F. [Ludwig Maximilian University, Department of Clinical Radiology, Munich (Germany); Bradley, William G. [UCSD Medical Center, Department of Radiology, San Diego, CA (United States); Krestin, Gabriel P. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Thrall, James H. [Massachusetts General Hospital, Boston, MA (United States)


    The International Society for Strategic Studies in Radiology (IS{sup 3}R) brings together thought leaders from academia and industry from around the world to share ideas, points of view and new knowledge. This article summarizes the main concepts presented at the 2007 IS{sup 3}R symposium, providing a window onto trends shaping the future of radiology. Topics addressed include new opportunities and challenges in the field of interventional radiology; emerging techniques for evaluating and improving quality and safety in radiology; and factors impeding progress in molecular imaging and nanotechnology and possible ways to overcome them. Regulatory hurdles to technical innovation and drug development are also discussed more broadly, along with proposals for addressing regulators' concerns and streamlining the regulatory process. (orig.)

  16. Radiological changes and complications associated with nasal ...

    Radiological changes and complications associated with nasal polyposis. *A.().A. Ogunleye and ... polyposis patients seen at the department of Otorhin0- llaryngology of .... Long-standing nasasl polyps can enlarge to such a degree that they ...

  17. Radiological dose assessment for vault storage concepts

    Richard, R.F.


    This radiological dose assessment presents neutron and photon dose rates in support of project W-460. Dose rates are provided for a single 3013 container, the ``infloor`` storage vault concept, and the ``cubicle`` storage vault concept.

  18. Diagnostic radiology in paediatric palliative care

    Patel, Preena; Koh, Michelle; Carr, Lucinda; McHugh, Kieran [Great Ormond Street Hospital, Radiology Department, London (United Kingdom)


    Palliative care is an expanding specialty within paediatrics, which has attracted little attention in the paediatric radiological literature. Paediatric patients under a palliative care team will have numerous radiological tests which we traditionally categorise under organ systems rather than under the umbrella of palliative medicine. The prevalence of children with life-limiting illness is significant. It has been estimated to be one per thousand, and this may be an underestimate. In this review, we will focus on our experience at one institution, where radiology has proven to be an invaluable partner to palliative care. We will discuss examples of conditions commonly referred to our palliative care team and delineate the crucial role of diagnostic radiology in determining treatment options. (orig.)

  19. Role of Radiology in Forensic Dentistry

    T Chandrasekhar


    Full Text Available Forensic radiology is a specialized area of medical imaging utilizing radiological techniques to assist physicians and pathologists in matter pertaining to the law. Postmortem dental radiographs are the most consistent part of the antemortem records that can be transmitted during the forensic examination procedures. Pathologists regularly use radiographic images during the course of autopsy to assist them in identification of foreign bodies or determination of death. Forensic radiology can be used in suspicious death or murder, in analysis of adverse medical events, solving legal matters, to detect child abuse, drug trafficking, body identification and disease identification. Using the possibilities of radiology, special characteristics of the internal structures of the dentomaxillofacial region can be revealed. We can also detect endodontic treatments, healing extraction sockets, implants or even tooth colored restoration. Therefore, we can give answers to problems dealing with identification procedures, mass disaster and dental age estimation.

  20. ORIGINAL ARTICLE Quality management systems in radiology

    performance and financial circumstances of radiology departments in the healthcare ... institution, requesting them to participate and also to complete a QA questionnaire. ..... risks and benefits, all in a consistent database format. According to.

  1. Radiological emergency: Malaysian preparedness and response.

    Yusof, Mohd Abd Wahab; Ali, Hamrah Mohd


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

  2. How to Read Your Radiology Report

    ... pelvis. Impression In the impression section, the radiologist combines the findings, patient clinical history and indication for ... radiology report. View full size with caption Related Articles and Media What does a radiologist do? Sponsored ...


    Laszlo, A.; Elpeleg, On; Horvath, K.; Jakobs, C.; Kobor, J.; Gal, A.; Barsi, P.; Kelemen, A.; Saracz, J.; Svekus, A.; Tegzes, A.; Voeroes, E.


    The authors summarize the pathomechanism of the myelination process, the clinical, radiological and the genetical aspects of the leukodystrophies, as in 18q deletion syndrome, adrenoleukodysrtophy, metachromatic leukodystrophy, Pelizaeus-Merzbacher leukodystrophy, Alexander disease and olivo-ponto-c

  4. Corporate social responsibility of future radiology professionals.

    Collins, Sandra K; Collins, Kevin S


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

  5. Radiological safety training for uranium facilities



    This handbook contains recommended training materials consistent with DOE standardized core radiological training material. These materials consist of a program management guide, instructor`s guide, student guide, and overhead transparencies.

  6. 42 CFR 482.26 - Condition of participation: Radiologic services.


    ... radiologic services, particularly ionizing radiology procedures, must be free from hazards for patients and... qualified full-time, part-time, or consulting radiologist must supervise the ionizing radiology services and... osteopathy who is qualified by education and experience in radiology. (2) Only personnel designated...

  7. VIA-RAD: a blackboard-based system for diagnostic radiology. Visual Interaction Assistant for Radiology.

    Rogers, E


    The work described in this article presents an approach to the integration of computer-displayed radiological images with cooperative computerized assistance for decision-making. The VIA-RAD system (Visual Interaction Assistant for Radiology) is a blackboard-based architecture, founded on extensive data collection and analysis in the domain of diagnostic radiology, together with cognitive modeling of the interaction between perception and problem-solving. The details of this system are presented in terms of domain knowledge representation and domain knowledge mapping. A small prototype of the system has been implemented and tested with radiology subjects, and the results of this study are also described.

  8. Review of Radioisotopes as Radiological Weapons


    Device (RED)  The simplest radiological threat would be the placement of unshielded radio- active material in a heavily trafficked area as an RED...10 U.S. Department of Health and Human Services, “Radiological Dispersal Device Playbook: Introduc- tion,” last updated July 2, 2015, http...contaminated and will not require decontamination. 12 U.S. Department of Health and Human Services

  9. Current status of radiology in China

    Meng Su Zeng; Kang Rong Zhou; Zhi Yong Zhang; Wei Jun Peng; Fu Hua Yang; Jiang Lin; Jun Yang; Xin Ye Han


    @@INTRODUCTION Radiology has been greatly advanced in China since its founding in 1949 and has been developed faster and further more since China adopted the policy of socioeconomic reform in 1978. It plays an increasingly important role in the medical health care and treatment in the country and has reached the world′s advanced level in certain fields. We now briefly review the history of China′s radiology so as to give a clear picture of its development.

  10. Radiologic Professionalism in Modern Health Care.

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


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

  11. A digital library of radiology images.

    Kahn, Charles E


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

  12. A NATO exercise on radiological sampling.

    Haslip, Dean S; Mercier, J R


    The North Atlantic Treaty Organization (NATO) has held its first-ever large-scale radiological exercise employing unsealed radioactive sources. The objective of the exercise was to validate NATO protocols on radiological sampling and surveying. However, the exercise also proved to be a valuable training opportunity and was highly instructive to all involved. This paper highlights the lessons learned from this exercise, particularly in the areas of radiation survey equipment and techniques, sampling techniques, and field measurements.

  13. Objective structured clinical examination in radiology

    Agarwal Anurag


    Full Text Available There is a growing need for introducing objective structured clinical examination (OSCE as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed "key-list" that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as "manned" or "unmanned" stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations.

  14. Objective structured clinical examination in radiology.

    Agarwal, Anurag; Batra, Bipin; Sood, Ak; Ramakantan, Ravi; Bhargava, Satish K; Chidambaranathan, N; Indrajit, Ik


    There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed "key-list" that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as "manned" or "unmanned" stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations.

  15. Objective structured clinical examination in radiology

    Agarwal, Anurag; Batra, Bipin; Sood, AK; Ramakantan, Ravi; Bhargava, Satish K; Chidambaranathan, N; Indrajit, IK


    There is a growing need for introducing objective structured clinical examination (OSCE) as a part of radiology practical examinations in India. OSCE is an established, reliable, and effective multistation test for the assessment of practical professional skills in an objective and a transparent manner. In India, it has been successfully initiated and implemented in specialties like pediatrics, ophthalmology, and otolaryngology. Each OSCE station needs to have a pre-agreed “key-list” that contains a list of objective steps prepared for uniformly assessing the tasks given to students. Broadly, OSCE stations are classified as “manned” or “unmanned” stations. These stations may include procedure or pictorial or theory stations with clinical oriented contents. This article is one of a series of measures to initiate OSCE in radiology; it analyzes the attributes of OSCE stations and outlines the steps for implementing OSCE. Furthermore, important issues like the advantages of OSCE, its limitations, a strengths, weaknesses, opportunities, and threats (SWOT) analysis, and the timing of introduction of OSCE in radiology are also covered. The OSCE format in radiology and its stations needs to be validated, certified, and finalized before its use in examinations. This will need active participation and contribution from the academic radiology fraternity and inputs from faculty members of leading teaching institutions. Many workshops/meetings need to be conducted. Indeed, these collaborative measures will effectively sensitize universities, examiners, organizers, faculty, and students across India to OSCE and help successfully usher in this new format in radiology practical examinations. PMID:20607015

  16. Radiological Worker II Training, Course 20301 (Live), Course 12909 (Test)

    Harris, Jimmy D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)


    Radiological worker training is the basic building block for any additional radiological training you may receive. Upon completing radiological worker training, you will have the basic knowledge needed to work safely, using proper radiological practices, in areas where radiological hazards exist. You will also have a better understanding of the hazards and responsibilities associated with radiological work to help prevent the carelessness that can occur when working continually with or around radioactive material. This course does not qualify you for any specific radiological work. You may be required to take additional training at individual facilities to address facility- and job-specific hazards and procedures.

  17. European obesity and the radiology department. What can we do to help?

    Buckley, O.; Ward, E.; Colin, Walsh; Snow, A. [Adelaide and Meath Hospital, Department of Radiology, Dublin (Ireland); Ryan, A. [Waterford Regional Hospital Co, Department of Radiology, Waterford (Ireland); Torreggiani, W.C. [Adelaide and Meath Hospital, Department of Radiology, Dublin (Ireland)]|[AMNCH, Dublin 24 (Ireland)


    Obesity is a chronic disease that is now a global epidemic. The numbers of obese people are exponentially rising in Europe, and it is projected that in Europe by 2010 there will be 150 million obese people. The obesity-related health crisis does not only affect adults, with one in four European children now overweight. Radiologists, both adult and paediatric, need to be aware of the magnitude of the problem, and obese patients cannot be denied radiologic evaluation due to their size. Missed diagnosis, appointment cancellation and embarrassing situations for patients when they are referred for a radiological examination for which they are not suitable are all issues that can be avoided if careful provision is made to accommodate the needs of the obese patient requiring radiologic evaluation. This paper will discuss the epidemiology of obesity and the role of radiology in the assessment of obesity and disorders of fat metabolism. The limitations obesity poses to current radiological equipment and how the radiologist can optimise imaging in the obese patient will be described. Dose reference levels and dose control are discussed. Examples of how obesity both hinders and helps the radiologist will be illustrated. Techniques and pre-procedural preparation to help the obese patient in the interventional suite are discussed. (orig.)

  18. Invasive radiologic management of hemodialysis fistulas: measuring flow with an endovascular catheter.

    García-Medina, J


    To analyze the values of flow obtained with an endovascular catheter, and to determine whether they are more reliable than angiographic and clinical findings for planning and for determining the outcome of invasive radiologic treatment of hemodialysis fistulas, as well as to determine the safety of this technique during interventional radiology procedures. We used endovascular catheters to measure flow in 341 vascular accesses for hemodialysis (162 [47.6%] distal fistulas, 132 [38.4%] humeral fistulas, and 47 [14%] arteriovenous grafts) in 598 procedures (a total of 3,051 flow measurements). Dysfunction was most commonly due to high pressures and flow deficits. The catheter was used to measure the results of radiologic treatment in 419 (70%) cases and only to measure the control of flow in the hemodialysis access in 179 (30%) cases. In the cases where lesions of the access had been treated radiologically, the flow improved by a mean of 1,232ml/min. In 2 (0.35%) cases, the tip of the catheter perforated the wall of the vein; this complication was resolved by inflating a low pressure balloon. Endovascular catheters are useful for measuring flow in invasive vascular radiology procedures for hemodialysis. In assessing the hemodynamic status of a vascular access, they are most helpful in determining whether stenosis is present. Copyright © 2013 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  19. European obesity and the radiology department. What can we do to help?

    Buckley, O


    Obesity is a chronic disease that is now a global epidemic. The numbers of obese people are exponentially rising in Europe, and it is projected that in Europe by 2010 there will be 150 million obese people. The obesity-related health crisis does not only affect adults, with one in four European children now overweight. Radiologists, both adult and paediatric, need to be aware of the magnitude of the problem, and obese patients cannot be denied radiologic evaluation due to their size. Missed diagnosis, appointment cancellation and embarrassing situations for patients when they are referred for a radiological examination for which they are not suitable are all issues that can be avoided if careful provision is made to accommodate the needs of the obese patient requiring radiologic evaluation. This paper will discuss the epidemiology of obesity and the role of radiology in the assessment of obesity and disorders of fat metabolism. The limitations obesity poses to current radiological equipment and how the radiologist can optimise imaging in the obese patient will be described. Dose reference levels and dose control are discussed. Examples of how obesity both hinders and helps the radiologist will be illustrated. Techniques and pre-procedural preparation to help the obese patient in the interventional suite are discussed.

  20. A critical synopsis of the diagnostic and screening radiology outcomes literature.

    Blackmore, C C; Black, W C; Jarvik, J G; Langlotz, C P


    In summary, the radiology outcomes research literature is both extensive and broad. The methodologic quality, however, is quite variable. Overall, this quality could be improved by intervention in two areas: methodologic dissemination and development. The number of researchers investigating radiology-related outcomes is high, and presently there are over 20 journals devoted exclusively to radiology research. Even with a relatively narrow definition of "outcomes," we identified over 200 radiology outcomes studies, most from the past few years. However, the methodologic quality of most of these articles was relatively low, with important design flaws and biases. Nonetheless, a substantial number of radiology publications do employ state-of-the-art research methods and innovative approaches to methodologic challenges. The quality of radiology outcomes research overall would benefit tremendously from dissemination of such research methods. Instruction in outcomes research methods is accessible to radiologists. For example, there have been several recent articles and series of articles on outcomes research methods in JAMA, including guidelines for the performance and reporting of cost-effectiveness analyses (38-40) and for developing clinical prediction rules (57). Within radiology, several recent articles have appeared on, among other things, cost-effectiveness analysis (34,59,60), assessing quality of life (43), screening for disease (53), and defining the study population (61). The research compendium compiled for the GERRAF (General Electric-Association of University Radiologists Radiology Research Academic Fellowships) program remains a comprehensive methodologic source for many of the issues in radiology outcomes research, and outcomes research methods courses are offered every year at the Society for Health Services Research in Radiology and Society for Medical Decision Making meetings, as well as at the meeting of the Radiological Society of North America. Even