Radiologists' responses to inadequate referrals

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Lysdahl, Kristin Bakke [Oslo University College, Faculty of Health Sciences, Oslo (Norway); University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Hofmann, Bjoern Morten [University of Oslo, Section for Medical Ethics, Faculty of Medicine, P.O. Box 1130, Blindern, Oslo (Norway); Gjoevik University College, Faculty of Health Care and Nursing, Gjoevik (Norway); Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway)

2010-05-15

To investigate radiologists' responses to inadequate imaging referrals. A survey was mailed to Norwegian radiologists; 69% responded. They graded the frequencies of actions related to referrals with ambiguous indications or inappropriate examination choices and the contribution of factors preventing and not preventing an examination of doubtful usefulness from being performed as requested. Ninety-five percent (344/361) reported daily or weekly actions related to inadequate referrals. Actions differed among subspecialties. The most frequent were contacting the referrer to clarify the clinical problem and checking test results/information in the medical records. Both actions were more frequent among registrars than specialists and among hospital radiologists than institute radiologists. Institute radiologists were more likely to ask the patient for additional information and to examine the patient clinically. Factors rated as contributing most to prevent doubtful examinations were high risk of serious complications/side effects, high radiation dose and low patient age. Factors facilitating doubtful examinations included respect for the referrer's judgment, patient/next-of-kin wants the examination, patient has arrived, unreachable referrer, and time pressure. In summary, radiologists facing inadequate referrals considered patient safety and sought more information. Vetting referrals on arrival, easier access to referring clinicians, and time for radiologists to handle inadequate referrals may contribute to improved use of imaging. (orig.)

Violence against radiologists. II: Psychosocial factors.

Science.gov (United States)

Magnavita, N; Fileni, A

2012-09-01

Violence against radiologists is a growing problem. This study evaluated the psychosocial factors associated with this phenomenon. A questionnaire was administered to 992 Italian radiologists. Physical violence experienced in the previous 12-month period was associated with the radiologist's poor mental health [odds ratio (OR) 1.11] and overcommitment to work (OR 1.06), whereas radiologists in good physical health (OR 0.64), with job satisfaction (OR 0.96) and with overall happiness (OR 0.67) were less exposed. Nonphysical abuse was equally associated with the radiologist's poor mental health (OR 1.10) and overcommitment (OR 1.14) and negatively associated with physical health (OR 0.54), job satisfaction (OR 0.96), happiness (OR 0.81), organisational justice (OR 0.94) and social support (OR 0.80). Preventive intervention against violence in the workplace should improve workplace organisation and relationships between workers.

The radiologist as defendant

International Nuclear Information System (INIS)

Bundy, A.L.; James, A.E. Jr.

1988-01-01

As the diagnostic radiologist has evolved through medical history, his role has changed from one of a technical expert to that of a respected part of the medical team, possessing extraordinary knowledge and skills in use of the most expensive and complex instrumentation in the health care delivery system. The rapid advances in radiological technology and instrumentation have enabled radiologists to assume a more primary role in medical care. Subspecialties such as ultrasound, computed tomography, digital radiography, and magnetic resonance imaging have emerged over the past decade as invaluable resources in medical diagnosis, and the radiologist, as the expert in these fields, has moved into view. As he assumes his rapidly evolving role, so too must he be prepared to bear the legal pressures that will most likely increase in proportion to the technical advances, as well as his changing role

Social media for radiologists: an introduction.

Science.gov (United States)

Ranschaert, Erik R; van Ooijen, P M A; Lee, Simon; Ratib, Osman; Parizel, P M

2015-12-01

Social media, which can be defined as dynamic and interactive online communication forums, are becoming increasingly popular, not only for the general public but also for radiologists. In addition to assisting radiologists in finding useful profession-related information and interactive educational material in all kinds of formats, they can also contribute towards improving communication with peers, clinicians, and patients. The growing use of social networking in healthcare also has an impact on the visibility and engagement of radiologists in the online virtual community. Although many radiologists are already using social media, a large number of our colleagues are still unaware of the wide spectrum of useful information and interaction available via social media and of the added value these platforms can bring to daily practice. For many, the risk of mixing professional and private data by using social media creates a feeling of insecurity, which still keeps radiologists from using them. In this overview we aim to provide information on the potential benefits, challenges, and inherent risks of social media for radiologists. We will provide a summary of the different types of social media that can be of value for radiologists, including useful tips on how to use them safely and efficiently. • Online social networking enhances communication and collaboration between peers • Social media facilitate access to educational and scientific information • Recommendations and guidelines from policymakers and professional organisations are needed • Applications are desired for efficient and secure exchange of medical images in social media.

Job satisfaction of radiologists in Germany. Status quo; Berufszufriedenheit von Radiologen in Deutschland. Aktueller Stand

Energy Technology Data Exchange (ETDEWEB)

Beitzel, K.I.; Grosse, C.; Reiser, M.; Ertl-Wagner, B. [Klinikum der Univ. Muenchen LMU, Grosshadern (Germany). Inst. fuer Kliniksche Radiologie; Ertl, L. [Klinikum der Univ. Muenchen LMU, Grosshadern (Germany). Inst. fuer Neuroradiologie

2011-08-15

Purpose: The aim of this study was to identify and evaluate the work-related satisfaction of radiologists and its influencing factors in Germany. Materials and Methods: For this purpose an invitational letter for an online opinion survey was sent to all member physicians of the Deutsche Roentgengesellschaft in 2008. 1200 questionnaires were completed (response rate 21 %) and evaluated statistically. Results: 81.7 % of radiologists declared themselves as being 'very' or 'rather satisfied'. The level of satisfaction was largely independent of age, gender, status, salary or family status. It increased over the last 5 years for 37.5 % of participants and decreased for 24.8 %. Nevertheless, 72 % of respondents indicated that they would not choose to specialize in radiology again. The main reason given was the workload. 65.6 % deemed it to be 'considerably' or 'rather too high'. Concomitantly, more than 70 % of respondents indicated that the workload had increased 'a lot' or 'rather'. Further reasons for not wanting to select the radiological profession again were 'unfavorable working hours' and 'unsatisfactory career perspectives'. Conclusion: The job satisfaction of radiologists in Germany is generally very high in spite of the perception of an extensive and frequently increasing workload. The high workload was the dominant factor against a renewed selection of the field of radiology. These data have to be interpreted in light of the current lack of residents and trained radiologists in Germany to counteract the trend toward emigration. (orig.)

Job stress and satisfaction among clinical radiologists

International Nuclear Information System (INIS)

Graham, J.; Ramirez, A.J.; Field, S.; Richards, M.A.

2000-01-01

AIMS: Consultant radiologists appear to be at greater risk of burnout than consultants working in other specialties. The aim of this study was to examine sources of stress and satisfaction at work for radiologists and hospital consultants in other specialties in order to try to understand this difference. MATERIALS AND METHODS: A postal questionnaire survey of psychiatric morbidity (12-item General Health Questionnaire), burnout (Maslach Burnout Inventory) and sources of job stress and satisfaction (study-specific questionnaires) was carried out among a random sample of 882 hospital consultants working in radiology and three other specialties (surgery, gastroenterology and oncology). RESULTS: The most stressful aspect of work for radiologists was work overload. Inadequacies in current staffing and facilities and concerns about funding were also major sources of stress, as were impositions made on radiologists by other clinicians. The most important sources of satisfaction for radiologists were their relationships with patients and being perceived to do their job well by colleagues. Importantly, radiologists reported less satisfaction than the other specialists from many of the aspects of work measured. A greater proportion of radiologists than other specialists felt insufficiently trained in communication skills [80% (n = 168) vs 47% (n = 310);P < 0.001] and management skills [84% (n = 179) vs 76% (n = 506);P < 0.05]. CONCLUSION: These data highlight aspects of radiologists' work which need to be tackled in order to reduce their stress and increase their satisfaction, and thereby their risk of burnout. Graham, J. (2000)

Management of patients taking antiplatelet or anticoagulant medication requiring invasive breast procedures: United Kingdom survey of radiologists' and surgeons' current practice

International Nuclear Information System (INIS)

Pritchard, M.G.; Townend, J.N.; Lester, W.A.; England, D.W.; Kearins, O.; Bradley, S.A.

2008-01-01

Aim: To determine the current practice in the UK National Health Service Breast Screening Programme for invasive diagnostic procedures and surgery in patients taking anticoagulant and antiplatelet medication. Materials and methods: Lead radiologists and surgeons at each breast screening service were surveyed to determine current practice. One hundred and five respondents provided information regarding their services, protocols, and willingness to proceed with combinations of procedures and anti-haemostatic medications. Results: Between units there was wide variation in practice. Within 21 services providing more than one response, 10 (48%) disagreed on whether protocols existed. Decisions to perform biopsies were unrelated to professional group. The taking of a drug history was variable. Surgeons reported more adverse effects than radiologists [21 (48%) versus 12 (26%)], but no difference in self-assessment of knowledge. Conclusion: Both radiologists and surgeons have expressed uncertainty about their understanding of anticoagulant and antiplatelet treatment. This is reflected in a wide range of practice. Guidance regarding the management of these patients is suggested

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

Science.gov (United States)

Lowes, S; Bydder, M; Sinnatamby, R

2017-11-01

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

Effect of voice recognition on radiologist reporting time

International Nuclear Information System (INIS)

Bhan, S.N.; Coblentz, C.L.; Norman, G.R.; Ali, S.H.

2008-01-01

To study the effect that voice recognition (VR) has on radiologist reporting efficiency in a clinical setting and to identify variables associated with faster reporting time. Five radiologists were observed during the routine reporting of 402 plain radiograph studies using either VR (n 217) or conventional dictation (CD) (n = 185). Two radiologists were observed reporting 66 computed tomography (CT) studies using either VR (n - 39) or CD (n - 27). The time spent per reporting cycle, defined as the radiologist's time spent on a study from report finalization to the subsequent report finalization, was compared. As well, characteristics about the radiologist and their reporting style were collected and correlated against reporting time. For plain radiographs, radiologists took 134% (P = 0.048) more time to produce reports using VR, but there was significant variability between radiologists. Significant association with faster reporting times using VR included: English as a first language (r-0.24), use of a template (r -0.34), use of a headset microphone (r -0.46), and increased experience with VR (r -0.43). Experience as a staff radiologist and having previous study for comparison did not correlate with reporting time. For CT, there was no significant difference in reporting time identified between VR and CD (P 0.61). Overall, VR slightly decreases the reporting efficiency of radiologists. However, efficiency may be improved if English is a first language, a headset microphone, and macros and templates are use. (author)

Work stress in radiologists. A pilot study.

Science.gov (United States)

Magnavita, N; Fileni, A; Magnavita, G; Mammi, F; Mirk, P; Roccia, K; Bergamaschi, A

2008-04-01

We studied occupational stress and its psychosocial effects in a sample of Italian radiologists and radiotherapists: Radiologists and radiotherapists attending two medical conferences were invited to complete a questionnaire comprising four sections investigating the risk of occupational stress (organisational discomfort, Karasek's Job Content Questionnaire, Siegrist's Effort-Reward Imbalance, Warr's Job Satisfaction) and four sections investigating the health effects of such stress (Goldberg's Anxiety and Depression Scales, General Health Questionnaire, Lifestyles Questionnaire). Radiologists and radiotherapists generally expressed high levels of control, reward and satisfaction. However, 38.5% complained of severe organisational discomfort, 24% reported job strain, 28% reported effort/reward imbalance and 25% were dissatisfied. Female radiologists and radiotherapists showed higher levels of organisational discomfort than their male colleagues. Younger and less experienced radiologists and radiotherapists had higher strain scores than their older and more experienced colleagues. A significant correlation was observed between stress predictors and the effects of stress on health, including depression and anxiety, psychological distress and unhealthy lifestyles. Radiologists and radiotherapists are exposed to major occupational stress factors, and a significant percentage of them suffer from workplace stress. A special effort is required to prevent this condition.

Improving UK client-contractor relations

International Nuclear Information System (INIS)

Brant, A.W.

1996-01-01

The client's aim in any decommissioning project is that the originally intended end point is achieved, within budget and on time. The contractor's aim is to have a satisfied client, so that both are happy to work together again, and to have a reasonable return for his efforts. How can these - not incompatible - aims best be achieved? (UK)

Physician rating websites: do radiologists have an online presence?

Science.gov (United States)

Gilbert, Kirven; Hawkins, C Matthew; Hughes, Danny R; Patel, Kishen; Gogia, Navdeep; Sekhar, Aarti; Duszak, Richard

2015-08-01

Given that patient satisfaction and provider transparency intersect on online physician-rating websites, we aimed to assess radiologist representation on these increasingly popular sites. From a directory of all Medicare participating physicians, we randomly selected 1,000 self-designated diagnostic radiologists and manually extracted their rating information from five popular online physician-review websites (HealthGrades, Healthcare Reviews, RateMDs, Kudzu, and Yelp). Using automated web "data-scraping" techniques, we separately extracted all radiologist and nonradiologist rating information from a single amenable site (Healthcare Reviews). Rating characteristics were analyzed. Of 1,000 sampled self-designated diagnostic radiologists representing all 50 states, only 197 (19.7%) were profiled on any of the five online physician-review websites. Only 24 (2.4%) were rated on two of the sites, and none was profiled on ≥3 sites. Of all 6,775 physicians listed on a single electronically interrogated site, only 30 (0.4%) were radiologists. With 28,555 (5.2%) of all 547,849 Medicare-participating physicians identified as diagnostic radiologists, radiologists were thus significantly underrepresented online (P < .0001). Although reviewed radiologists and nonradiologists were rated online by similar numbers of patients (1.13 ± 0.43 versus 1.03 ± 0.22, P = .22), radiologists were rated (on a low to high score of 1 to 10) significantly higher than nonradiologists (median 8.5 versus 5, P = .04). Most diagnostic radiologists are not profiled on common online physician-rating websites, and they are significantly underrepresented compared with nonradiologists. Reviewed radiologists, however, scored favorably. Given the potential for patient satisfaction scores and public domain information to affect referrals and future value-based payments, initiatives to enhance radiologists' online presence are advised. Copyright © 2015 American College of Radiology. Published by

Safety of working patterns among UK neuroradiologists: what can we learn from the aviation industry and cognitive science?

Science.gov (United States)

Reicher, John; Currie, Stuart; Birchall, Daniel

2018-04-01

As the volume and complexity of imaging in the UK continues to rise, there is pressure on radiologists to spend increasing lengths of time reporting to cope with the growing workload. However, there is limited guidance for radiologists about structuring the working day to strike the necessary balance between achieving satisfactory reporting volume and maintaining quality and safety. We surveyed 86 neuroradiologists (receiving 59 responses), regarding time spent reporting, frequency and duration of work breaks, and break activities. Our results demonstrate that some neuroradiologists report for up to 12 h a day and for 4 h before taking a break. Mean duration of breaks is less than 15 min and these often consist of computer screen-based or cognitively demanding tasks. Many areas of medicine have looked to the aviation industry to develop improvements in safety through regulated, standardised practices. There are parallels between the work of air traffic controllers (ATCs) and radiologists. We review the legislation that controls the working hours of UK ATCs to minimise fatigue-related errors, and its scientific basis. We also consider the vigilance decrement, a concept in cognitive science which describes the reduction in performance with increasing time-on-task. We conclude that, in comparison with ATCs, work patterns among radiologists are poorly standardised and potentially dangerous. Evidence suggests that placing limits on reporting time and minimum break duration, as well as ensuring appropriate break activities, can benefit reporting quality. It is imperative that radiologists and managers heed these lessons, to improve standards and protect patients from error.

Nuisance levels of noise effects radiologists' performance

Science.gov (United States)

McEntee, Mark F.; Coffey, Amina; Ryan, John; O'Beirne, Aaron; Toomey, Rachel; Evanoff, Micheal; Manning, David; Brennan, Patrick C.

2010-02-01

This study aimed to measure the sound levels in Irish x-ray departments. The study then established whether these levels of noise have an impact on radiologists performance Noise levels were recorded 10 times within each of 14 environments in 4 hospitals, 11 of which were locations where radiologic images are judged. Thirty chest images were then presented to 26 senior radiologists, who were asked to detect up to three nodular lesions within 30 posteroanterior chest x-ray images in the absence and presence of noise at amplitude demonstrated in the clinical environment. The results demonstrated that noise amplitudes rarely exceeded that encountered with normal conversation with the maximum mean value for an image-viewing environment being 56.1 dB. This level of noise had no impact on the ability of radiologists to identify chest lesions with figure of merits of 0.68, 0.69, and 0.68 with noise and 0.65, 0.68, and 0.67 without noise for chest radiologists, non-chest radiologists, and all radiologists, respectively. the difference in their performance using the DBM MRMC method was significantly better with noise than in the absence of noise at the 90% confidence interval (p=0.077). Further studies are required to establish whether other aspects of diagnosis are impaired such as recall and attention and the effects of more unexpected noise on performance.

Prevalence of burnout among musculoskeletal radiologists

Energy Technology Data Exchange (ETDEWEB)

Chew, Felix S.; Porrino, Jack A.; Mulcahy, Hyojeong; Relyea-Chew, Annemarie [University of Washington, Department of Radiology, Seattle, WA (United States); Mulcahy, Michael J. [Central Washington University, Department of Sociology, Ellensburg, WA (United States)

2017-04-15

Burnout is a job-related psychological syndrome with three aspects: emotional exhaustion, depersonalization, and perceived lack of personal accomplishment. Burnout is associated with deleterious effects on both workers and their work. When burnout affects physicians, their well-being, longevity, and care of patients are at risk. Recent studies concerning physician burnout treat specialists such as radiologists as one group. We studied burnout in musculoskeletal (MSK) subspecialist radiologists. An institutional review board exemption was obtained. Society of Skeletal Radiology members received invitations to an anonymous survey that included questions from the Maslach Burnout Inventory trademark (MBI) measuring all three aspects of burnout. The response rate was 36.4% (433/1190). The prevalence of emotional exhaustion was 61.7% (255/413), of depersonalization 53.3% (219/411), and of perceived lack of personal accomplishment 39.6% (161/407). Only 19.5% (79/405) of MSK radiologists reported no burnout, while 80.5% (326/405) reported burnout along one or more dimensions. For all three dimensions, the prevalence was higher and the mean severity was worse for private practice compared with academic practice. The prevalence of burnout was affected more by practice setting than by gender. Burnout prevalence and severity also varied systematically with years since completion of training. Among MSK radiologists, we found a much higher prevalence and greater severity of burnout than has been previously reported for radiologists and other physicians. There were differences in prevalence and severity of burnout among practice settings, genders, and longevity cohorts. (orig.)

Prevalence of burnout among musculoskeletal radiologists

International Nuclear Information System (INIS)

Chew, Felix S.; Porrino, Jack A.; Mulcahy, Hyojeong; Relyea-Chew, Annemarie; Mulcahy, Michael J.

2017-01-01

Burnout is a job-related psychological syndrome with three aspects: emotional exhaustion, depersonalization, and perceived lack of personal accomplishment. Burnout is associated with deleterious effects on both workers and their work. When burnout affects physicians, their well-being, longevity, and care of patients are at risk. Recent studies concerning physician burnout treat specialists such as radiologists as one group. We studied burnout in musculoskeletal (MSK) subspecialist radiologists. An institutional review board exemption was obtained. Society of Skeletal Radiology members received invitations to an anonymous survey that included questions from the Maslach Burnout Inventory trademark (MBI) measuring all three aspects of burnout. The response rate was 36.4% (433/1190). The prevalence of emotional exhaustion was 61.7% (255/413), of depersonalization 53.3% (219/411), and of perceived lack of personal accomplishment 39.6% (161/407). Only 19.5% (79/405) of MSK radiologists reported no burnout, while 80.5% (326/405) reported burnout along one or more dimensions. For all three dimensions, the prevalence was higher and the mean severity was worse for private practice compared with academic practice. The prevalence of burnout was affected more by practice setting than by gender. Burnout prevalence and severity also varied systematically with years since completion of training. Among MSK radiologists, we found a much higher prevalence and greater severity of burnout than has been previously reported for radiologists and other physicians. There were differences in prevalence and severity of burnout among practice settings, genders, and longevity cohorts. (orig.)

Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists

International Nuclear Information System (INIS)

Torres-Mejía, Gabriela; Smith, Robert A.; Carranza-Flores, María de la Luz; Bogart, Andy; Martínez-Matsushita, Louis; Miglioretti, Diana L.; Kerlikowske, Karla; Ortega-Olvera, Carolina; Montemayor-Varela, Ernesto; Angeles-Llerenas, Angélica; Bautista-Arredondo, Sergio; Sánchez-González, Gilberto; Martínez-Montañez, Olga G.; Uscanga-Sánchez, Santos R.; Lazcano-Ponce, Eduardo; Hernández-Ávila, Mauricio

2015-01-01

An alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries. We evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed. Radiographer’s sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7–86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7–57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6–0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms. Given the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists

Radiologists' Training, Experience, and Attitudes About Elder Abuse Detection.

Science.gov (United States)

Rosen, Tony; Bloemen, Elizabeth M; Harpe, Jasmin; Sanchez, Allen M; Mennitt, Kevin W; McCarthy, Thomas J; Nicola, Refky; Murphy, Kieran; LoFaso, Veronica M; Flomenbaum, Neal; Lachs, Mark S

2016-12-01

Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists. We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes. Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism. Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.

Improving the radiologist-CAD interaction : designing for appropriate trust

NARCIS (Netherlands)

Jorritsma, W.; Cnossen, F.; van Ooijen, P. M. A.

Computer-aided diagnosis (CAD) has great potential to improve radiologists' diagnostic performance. However, the reported performance of the radiologist-CAD team is lower than what might be expected based on the performance of the radiologist and the CAD system in isolation. This indicates that the

Changes needed to medicine in the UK before senior UK-trained doctors, working outside the UK, will return: questionnaire surveys undertaken between 2004 and 2015.

Science.gov (United States)

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2017-12-01

To report the changes to UK medicine which doctors who have emigrated tell us would increase their likelihood of returning to a career in UK medicine. Questionnaire survey. UK-trained medical graduates. Questionnaires were sent 11 years after graduation to 7158 doctors who qualified in 1993 and 1996 in the UK: 4763 questionnaires were returned. Questionnaires were sent 17 and 19 years after graduation to the same cohorts: 4554 questionnaires were returned. Comments from doctors working abroad about changes needed to UK medicine before they would return. Eleven years after graduation, 290 (6%) of respondents were working in medicine abroad; 277 (6%) were doing so 17/19 years after graduation. Eleven years after graduation, 53% of doctors working abroad indicated that they did not intend to return, and 71% did so 17/19 years after graduation. These respondents reported a number of changes which would need to be made to UK medicine in order to increase the likelihood of them returning. The most frequently mentioned changes cited concerned 'politics/management/funding', 'pay/pension', 'posts/security/opportunities', 'working conditions/hours', and 'factors outside medicine'. Policy attention to factors including funding, pay, management and particularly the clinical-political interface, working hours, and work-life balance may pay dividends for all, both in terms of persuading some established doctors to return and, perhaps more importantly, encouraging other, younger doctors to believe that the UK and the National Health Service can offer them a satisfying and rewarding career.

Effect of radiologists' diagnostic work-up volume on interpretive performance.

Science.gov (United States)

Buist, Diana S M; Anderson, Melissa L; Smith, Robert A; Carney, Patricia A; Miglioretti, Diana L; Monsees, Barbara S; Sickles, Edward A; Taplin, Stephen H; Geller, Berta M; Yankaskas, Bonnie C; Onega, Tracy L

2014-11-01

To examine radiologists' screening performance in relation to the number of diagnostic work-ups performed after abnormal findings are discovered at screening mammography by the same radiologist or by different radiologists. In an institutional review board-approved HIPAA-compliant study, the authors linked 651 671 screening mammograms interpreted from 2002 to 2006 by 96 radiologists in the Breast Cancer Surveillance Consortium to cancer registries (standard of reference) to evaluate the performance of screening mammography (sensitivity, false-positive rate [ FPR false-positive rate ], and cancer detection rate [ CDR cancer detection rate ]). Logistic regression was used to assess the association between the volume of recalled screening mammograms ("own" mammograms, where the radiologist who interpreted the diagnostic image was the same radiologist who had interpreted the screening image, and "any" mammograms, where the radiologist who interpreted the diagnostic image may or may not have been the radiologist who interpreted the screening image) and screening performance and whether the association between total annual volume and performance differed according to the volume of diagnostic work-up. Annually, 38% of radiologists performed the diagnostic work-up for 25 or fewer of their own recalled screening mammograms, 24% performed the work-up for 0-50, and 39% performed the work-up for more than 50. For the work-up of recalled screening mammograms from any radiologist, 24% of radiologists performed the work-up for 0-50 mammograms, 32% performed the work-up for 51-125, and 44% performed the work-up for more than 125. With increasing numbers of radiologist work-ups for their own recalled mammograms, the sensitivity (P = .039), FPR false-positive rate (P = .004), and CDR cancer detection rate (P women recalled per cancer detected from 17.4 for 25 or fewer mammograms to 24.6 for more than 50 mammograms. Increases in work-ups for any radiologist yielded significant

The development of Radiation Protection Training courses in the UK

International Nuclear Information System (INIS)

Paynter, R. A.

2003-01-01

This paper considers use of modern training materials and aids in radiation protection training activities. The development in the UK of training courses to satisfy the training requirements for Radiation Protection Advisers is also discussed. (Author)

Does radiation exposure produce a protective effect among radiologists

International Nuclear Information System (INIS)

Matanoski, G.M.; Sternberg, A.; Elliott, E.A.

1987-01-01

The mortality experience of radiologists compared to that of other physician specialists demonstrates an increased risk of cancer deaths as well as deaths from all causes among physicians practicing in the early years of this century. However, for the radiologists who joined specialty societies after 1940, the age pattern of deaths has changed. Whereas among early entrants, young radiologists had higher mortality rates than those of other specialists; among later entrants, the young radiologists have lower mortality. However, as these later-entrant radiologists age, their rates appear to exceed those of other specialists. Although the level of radiation exposure is unknown, physicians in more recent years usually have lower cumulative doses. Lower radiation exposure may be one of a number of possible explanatory factors for the cross-over from protected to higher risk status as these physicians age

Observer agreement in the reporting of knee and lumbar spine magnetic resonance (MR) imaging examinations: Selectively trained MR radiographers and consultant radiologists compared with an index radiologist

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Brealey, S., E-mail: stephen.brealey@york.ac.uk [Department of Health Sciences, University of York, York YO10 5DD (United Kingdom); Piper, K., E-mail: keith.piper@canterbury.ac.uk [Department of Allied Health Professions, Canterbury Christ Church University, Canterbury, Kent CT1 1QU (United Kingdom); King, D., E-mail: david.g.king@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Bland, M., E-mail: martin.bland@york.ac.uk [Department of Health Sciences, University of York, York YO10 5DD (United Kingdom); Caddick, J., E-mail: Julie.Caddick@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Campbell, P., E-mail: peter.campbell@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Gibbon, A., E-mail: anthony.j.gibbon@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Highland, A., E-mail: Adrian.Highland@sth.nhs.uk [Sheffield Teaching Hospitals, Herries Road, Sheffield S5 7AU (United Kingdom); Jenkins, N., E-mail: neil.jenkins@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Petty, D., E-mail: daniel.petty@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom); Warren, D., E-mail: david.warren@york.nhs.uk [York Hospital, Wigginton Road, York YO31 8HE (United Kingdom)

2013-10-01

Purpose: To assess agreement between trained radiographers and consultant radiologists compared with an index radiologist when reporting on magnetic resonance imaging (MRI) examinations of the knee and lumbar spine and to examine the subsequent effect of discordant reports on patient management and outcome. Methods: At York Hospital two MR radiographers, two consultant radiologists and an index radiologist reported on a prospective, random sample of 326 MRI examinations. The radiographers reported in clinical practice conditions and the radiologists during clinical practice. An independent consultant radiologist compared these reports with the index radiologist report for agreement. Orthopaedic surgeons then assessed whether the discordance between reports was clinically important. Results: Overall observer agreement with the index radiologist was comparable between observers and ranged from 54% to 58%; for the knee it was 46–57% and for the lumbar spine was 56–66%. There was a very small observed difference of 0.6% (95% CI −11.9 to 13.0) in mean agreement between the radiographers and radiologists (P = 0.860). For the knee, lumbar spine and overall, radiographers’ discordant reports, when compared with the index radiologist, were less likely to have a clinically important effect on patient outcome than the radiologists’ discordant reports. Less than 10% of observer's reports were sufficiently discordant with the index radiologist's reports to be clinically important. Conclusion: Carefully selected MR radiographers with postgraduate education and training reported in clinical practice conditions on specific MRI examinations of the knee and lumbar spine to a level of agreement comparable with non-musculoskeletal consultant radiologists.

Observer agreement in the reporting of knee and lumbar spine magnetic resonance (MR) imaging examinations: Selectively trained MR radiographers and consultant radiologists compared with an index radiologist

International Nuclear Information System (INIS)

Brealey, S.; Piper, K.; King, D.; Bland, M.; Caddick, J.; Campbell, P.; Gibbon, A.; Highland, A.; Jenkins, N.; Petty, D.; Warren, D.

2013-01-01

Purpose: To assess agreement between trained radiographers and consultant radiologists compared with an index radiologist when reporting on magnetic resonance imaging (MRI) examinations of the knee and lumbar spine and to examine the subsequent effect of discordant reports on patient management and outcome. Methods: At York Hospital two MR radiographers, two consultant radiologists and an index radiologist reported on a prospective, random sample of 326 MRI examinations. The radiographers reported in clinical practice conditions and the radiologists during clinical practice. An independent consultant radiologist compared these reports with the index radiologist report for agreement. Orthopaedic surgeons then assessed whether the discordance between reports was clinically important. Results: Overall observer agreement with the index radiologist was comparable between observers and ranged from 54% to 58%; for the knee it was 46–57% and for the lumbar spine was 56–66%. There was a very small observed difference of 0.6% (95% CI −11.9 to 13.0) in mean agreement between the radiographers and radiologists (P = 0.860). For the knee, lumbar spine and overall, radiographers’ discordant reports, when compared with the index radiologist, were less likely to have a clinically important effect on patient outcome than the radiologists’ discordant reports. Less than 10% of observer's reports were sufficiently discordant with the index radiologist's reports to be clinically important. Conclusion: Carefully selected MR radiographers with postgraduate education and training reported in clinical practice conditions on specific MRI examinations of the knee and lumbar spine to a level of agreement comparable with non-musculoskeletal consultant radiologists

Logistics of Three-dimensional Printing: Primer for Radiologists.

Science.gov (United States)

Hodgdon, Taryn; Danrad, Raman; Patel, Midhir J; Smith, Stacy E; Richardson, Michael L; Ballard, David H; Ali, Sayed; Trace, Anthony Paul; DeBenedectis, Carolynn M; Zygmont, Matthew E; Lenchik, Leon; Decker, Summer J

2018-01-01

The Association of University Radiologists Radiology Research Alliance Task Force on three-dimensional (3D) printing presents a review of the logistic considerations for establishing a clinical service using this new technology, specifically focused on implications for radiology. Specific topics include printer selection for 3D printing, software selection, creating a 3D model for printing, providing a 3D printing service, research directions, and opportunities for radiologists to be involved in 3D printing. A thorough understanding of the technology and its capabilities is necessary as the field of 3D printing continues to grow. Radiologists are in the unique position to guide this emerging technology and its use in the clinical arena. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Investigating links between emotional intelligence and observer performance by radiologists in mammography

Science.gov (United States)

Lewis, Sarah J.; Brennan, Patrick C.; Cumming, Steven; MacKay, Stuart J.; McEntee, Mark F.; Keane, Kevin; Mello-Thoms, Claudia R.

2014-03-01

A novel direction of radiology research is better understanding the links between cognitive and personality factors and radiologists' accuracy and performance. This study examines relationships between Emotional Intelligence (EI) scores and observer performance by radiologists in breast cancer detection. Three separate samples were collected with Australian and US breast imaging radiologists. The radiologists were asked to undertake a mammographic interpretation task to identify malignant breast lesions and localise them, in addition to use a confidence rating scale to report confidence in the decision. Following this activity, the radiologists were administered the EI Trait (TEIQue-SF) questionnaire. The Trait EI test gives a Global EI score and 4 sub-scores in Well-being, Self-Control, Emotionality and Sociability. Sample 1 (Sydney 2012) radiologists were divided into 2 experience bands; radiologists practicing emotionality" and "sociability" to Location Sensitivity and JAFROC. Our preliminary results indicate EI is correlated to observer performance in lesser experienced radiologists. It is suggested that tasks perceived as more difficult by less experienced radiologists may evoke more emotion (uncertainty, frustration, pressure). As experience increases, radiologists may develop an ability to control their emotions or emotional intelligence becomes less important in decision making.

Electronic Health Record-Driven Workflow for Diagnostic Radiologists.

Science.gov (United States)

Geeslin, Matthew G; Gaskin, Cree M

2016-01-01

In most settings, radiologists maintain a high-throughput practice in which efficiency is crucial. The conversion from film-based to digital study interpretation and data storage launched the era of PACS-driven workflow, leading to significant gains in speed. The advent of electronic health records improved radiologists' access to patient data; however, many still find this aspect of workflow to be relatively cumbersome. Nevertheless, the ability to guide a diagnostic interpretation with clinical information, beyond that provided in the examination indication, can add significantly to the specificity of a radiologist's interpretation. Responsibilities of the radiologist include, but are not limited to, protocoling examinations, interpreting studies, chart review, peer review, writing notes, placing orders, and communicating with referring providers. Most of the aforementioned activities are not PACS-centric and require a login to one or more additional applications. Consolidation of these tasks for completion through a single interface can simplify workflow, save time, and potentially reduce the incidence of errors. Here, the authors describe diagnostic radiology workflow that leverages the electronic health record to significantly add to a radiologist's ability to be part of the health care team, provide relevant interpretations, and improve efficiency and quality. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Image quality preferences among radiographers and radiologists. A conjoint analysis

International Nuclear Information System (INIS)

Ween, Borgny; Kristoffersen, Doris Tove; Hamilton, Glenys A.; Olsen, Dag Rune

2005-01-01

Purpose: The aim of this study was to investigate the image quality preferences among radiographers and radiologists. The radiographers' preferences are mainly related to technical parameters, whereas radiologists assess image quality based on diagnostic value. Methods: A conjoint analysis was undertaken to survey image quality preferences; the study included 37 respondents: 19 radiographers and 18 radiologists. Digital urograms were post-processed into 8 images with different properties of image quality for 3 different patients. The respondents were asked to rank the images according to their personally perceived subjective image quality. Results: Nearly half of the radiographers and radiologists were consistent in their ranking of the image characterised as 'very best image quality'. The analysis showed, moreover, that chosen filtration level and image intensity were responsible for 72% and 28% of the preferences, respectively. The corresponding figures for each of the two professions were 76% and 24% for the radiographers, and 68% and 32% for the radiologists. In addition, there were larger variations in image preferences among the radiologists, as compared to the radiographers. Conclusions: Radiographers revealed a more consistent preference than the radiologists with respect to image quality. There is a potential for image quality improvement by developing sets of image property criteria

Relationships between radiologists and clinicians: Results from three surveys

International Nuclear Information System (INIS)

Dalla Palma, L.; Stacul, F.; Meduri, S.; Geitung, J. Te.

2000-01-01

AIM: To analyse reasons for and the nature of clinico-radiological contacts and their clinical impact. MATERIALS AND METHODS: Three different surveys were performed. (1) Data concerning contacts between staff radiologists (n = 20) and clinicians during 10 consecutive working days were collected; (2) staff clinicians (n = 174) filled in a questionnaire asking for their opinions about relationships with radiologists; (3) staff radiologists collected data about contacts with clinicians related to more urgent/complicated cases. Radiologists assessed the clinical impact of the radiological procedure and of the consultation. RESULTS: (1) During 220 working days 20 radiologists had a mean of 3.95 contacts per day (48.2% personal contacts, 51.8% telephone contacts), amounting to a personal total of 21.65 min per day. These contacts amounted to a total of 7.08 h per day, roughly one whole-time equivalent radiologist. (2) These consultations helped to refine the diagnostic strategy often (12.6%) or sometimes (71.4%) and to alter therapeutic decisions often (10.4%) or sometimes (56.6%). (3) The initial clinical diagnosis was changed in 50% of cases and the therapy was substantially changed on the basis of further radiological investigations and clinical-radiological discussion in 60% of cases. CONCLUSION: Clinical-radiological consultations are time consuming but have a beneficial diagnostic and therapeutic impact. Dalla Palma, L. (2000)

Radiation protection knowledge among radiologists in northwest Spain.

Science.gov (United States)

Macía-Suárez, D; Sánchez-Rodríguez, E

2018-05-16

To estimate radiologistś level of knowledge of and their implication in radioprotection. An anonymous and supervised survey was conducted during a work meeting. Of the 65 questionnaires handed out, 63 were returned. In general, the radiologists surveyed considered their level of knowledge to be low, and it was statistically demonstrated (P = 0.018) that the level of knowledge they believed they had was related to the number of correct answers. The level of knowledge that radiologists believed they had was also related (p knowledge about radiation protection. Copyright © 2018 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Association between Radiologists' Experience and Accuracy in Interpreting Screening Mammograms

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Maristany Maria-Teresa

2008-04-01

Full Text Available Abstract Background Radiologists have been observed to differ, sometimes substantially, both in their interpretations of mammograms and in their recommendations for follow-up. The aim of this study was to determine how factors related to radiologists' experience affect the accuracy of mammogram readings. Methods We selected a random sample of screening mammograms from a population-based breast cancer screening program. The sample was composed of 30 women with histopathologically-confirmed breast cancer and 170 women without breast cancer after a 2-year follow-up (the proportion of cancers was oversampled. These 200 mammograms were read by 21 radiologists routinely interpreting mammograms, with different amount of experience, and by seven readers who did not routinely interpret mammograms. All readers were blinded to the results of the screening. A positive assessment was considered when a BI-RADS III, 0, IV, V was reported (additional evaluation required. Diagnostic accuracy was calculated through sensitivity and specificity. Results Average specificity was higher in radiologists routinely interpreting mammograms with regard to radiologists who did not (66% vs 56%; p Conclusion Among radiologists who read routinely, volume is not associated with better performance when interpreting screening mammograms, although specificity decreased in radiologists not routinely reading mammograms. Follow-up of cases for which further workup is recommended might reduce variability in mammogram readings and improve the quality of breast cancer screening programs.

What is the relation between number of sessions worked and productivity of radiologists-a pilot study?

Science.gov (United States)

Khan, Shah H M; Hedges, William P

2016-04-01

Increasing workloads and the current austerity measures are putting UK radiology departments under considerable stress. We need to look at the most efficient ways to manage radiology departments in order to cope with increasing demand. Consequently, a system is needed that can compare productivity between radiologists with different jobs. We measured workload in a UK radiology department and compared the productivities of consultants working different numbers of sessions, which are called programmed activities (PAs), to identify the optimal job plan structure for reporting productivity. Reporting data was gathered from electronic records for 14 consultants working different numbers of PA during the period April 2010-March 2011. These were converted into relative value unit (RVU) scores using a modified RCSI RVU system. Crude and net workloads were calculated for each consultant by dividing their total RVU score by the number of PAs they were contracted for and how many they spent reporting. The consultants reported 118,001 imaging studies. There was statistically significant variation in productivity between consultants working different numbers of PAs on χ (2) analysis (p working 12 PAs were more productive than consultants working 11 PAs, with net workloads of 7636 RVU/PA/year versus net 6146 RVU/PA/year, p working 12 PAs per week are more productive than their colleagues, the reasons why are unclear. We have identified a method that can be developed further to identify efficient working practices in UK radiology departments. However, a UK-specific RVU system would make this productivity analysis more accurate.

Radiologists' preferences for just-in-time learning.

Science.gov (United States)

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

2006-09-01

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

Business of radiology: financial fundamentals for radiologists.

Science.gov (United States)

Medverd, Jonathan R; Prabhu, Somnath J; Lam, Diana L

2013-11-01

The purposes of this article are to provide a primer on financial statements and to review several financial concepts that are at the foundation of the business of medicine. For radiologists to effectively contribute to the leadership and management of their practices, it is imperative that they understand the business aspects of radiology. Radiologists' understanding and participation in practice management may also facilitate job satisfaction and assist the provision of optimal patient care.

Investigating the Link Between Radiologists Gaze, Diagnostic Decision, and Image Content

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Tourassi, Georgia [ORNL; Voisin, Sophie [ORNL; Paquit, Vincent C [ORNL; Krupinski, Elizabeth [University of Arizona

2013-01-01

Objective: To investigate machine learning for linking image content, human perception, cognition, and error in the diagnostic interpretation of mammograms. Methods: Gaze data and diagnostic decisions were collected from six radiologists who reviewed 20 screening mammograms while wearing a head-mounted eye-tracker. Texture analysis was performed in mammographic regions that attracted radiologists attention and in all abnormal regions. Machine learning algorithms were investigated to develop predictive models that link: (i) image content with gaze, (ii) image content and gaze with cognition, and (iii) image content, gaze, and cognition with diagnostic error. Both group-based and individualized models were explored. Results: By pooling the data from all radiologists machine learning produced highly accurate predictive models linking image content, gaze, cognition, and error. Merging radiologists gaze metrics and cognitive opinions with computer-extracted image features identified 59% of the radiologists diagnostic errors while confirming 96.2% of their correct diagnoses. The radiologists individual errors could be adequately predicted by modeling the behavior of their peers. However, personalized tuning appears to be beneficial in many cases to capture more accurately individual behavior. Conclusions: Machine learning algorithms combining image features with radiologists gaze data and diagnostic decisions can be effectively developed to recognize cognitive and perceptual errors associated with the diagnostic interpretation of mammograms.

Your Radiologist Explains Nuclear Medicine

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Full Text Available ... Disorders Video: The Basketball Game: An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org Hello! I’m Dr. Ramji ...

Your Radiologist Explains Nuclear Medicine

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Full Text Available ... by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org Hello! ... d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify disease ...

Your Radiologist Explains Nuclear Medicine

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Full Text Available ... An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript ... by a special camera and computer to create images of the inside of your body. If you’ ...

Your Radiologist Explains Nuclear Medicine

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Full Text Available ... Sponsored by Image/Video Gallery Your Radiologist Explains Nuclear Medicine Transcript Welcome to Radiology Info dot org ... I’d like to talk to you about nuclear medicine. Nuclear medicine offers the potential to identify ...

Importance of training on clinical thinking and clinical competence to interventional radiologists

International Nuclear Information System (INIS)

Xu Ke; Zhong Hongshan

2010-01-01

Although the history of Interventional Radiology is no longer than 50 years, interventional techniques have been dramatically developed. Interventional radiologists have been responsible for much of the medical innovations and development of the minimally invasive procedures that are commonplace today to treat many complicated diseases as physicians. But the education backgrounds of interventional radiologist in China are different. Therefore, we should be aware that the job of an interventional radiologist is totally different from that of a diagnostic radiologist. It is very important to train interventional radiologists for improving their clinical thinking and clinical competence. Herein, we propose our suggestions on how to improve the clinical thinking and clinical competence of interventional radiologists. In this paper we also systemically introduce the accurate and proper treatment procedures which should be strictly followed in clinical work and,meanwhile, the perioperative patients care is emphasized. (authors)

A radiologist's guide to small bowel and multivisceral transplantation

International Nuclear Information System (INIS)

Godfrey, E.M.; Upponi, S.S.; See, T.C.; Cheow, H.K.; Sivaprakasam, R.; Butler, A.J.; Whitley, S.

2013-01-01

This review will describe the indications for the various small bowel containing transplants. The importance of early referral will be highlighted. Radiologists play a central role in assessing these complex patients prior to transplantation. Furthermore, in the postoperative period, radiologists play an important part in diagnosing and treating complications

Critical analysis of radiologist-patient interaction.

Science.gov (United States)

Morris, K J; Tarico, V S; Smith, W L; Altmaier, E M; Franken, E A

1987-05-01

A critical incident interview technique was used to identify features of radiologist-patient interactions considered effective and ineffective by patients. During structured interviews with 35 radiology patients and five patients' parents, three general categories of physician behavior were described: attention to patient comfort, explanation of procedure and results, and interpersonal sensitivity. The findings indicated that patients are sensitive to physicians' interpersonal styles and that they want physicians to explain procedures and results in an understandable manner and to monitor their well-being during procedures. The sample size of the study is small; thus further confirmation is needed. However, the implications for training residents and practicing radiologists in these behaviors are important in the current competitive medical milieu.

Social networks and expertise development for Australian breast radiologists.

Science.gov (United States)

Taba, Seyedamir Tavakoli; Hossain, Liaquat; Willis, Karen; Lewis, Sarah

2017-02-11

In this study, we explore the nexus between social networks and expertise development of Australian breast radiologists. Background literature has shown that a lack of appropriate social networks and interaction among certain professional group(s) may be an obstacle for knowledge acquisition, information flow and expertise sharing. To date there have not been any systematic studies investigating how social networks and expertise development are interconnected and whether this leads to improved performance for breast radiologists. This study explores the value of social networks in building expertise alongside with other constructs of performance for the Australian radiology workforce using semi-structured in-depth interviews with 17 breast radiologists. The findings from this study emphasise the influences of knowledge transfer and learning through social networks and interactions as well as knowledge acquisition and development through experience and feedback. The results also show that accessibility to learning resources and a variety of timely feedback on performance through the information and communication technologies (ICT) is likely to facilitate improved performance and build social support. We argue that radiologists' and, in particular, breast radiologists' work performance, needs to be explored not only through individual numerical characteristics but also by analysing the social context and peer support networks in which they operate and we identify multidisciplinary care as a core entity of social learning.

Digital platform for improving non-radiologists' and radiologists' interpretation of chest radiographs for suspected tuberculosis - a method for supporting task-shifting in developing countries

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Semakula-Katende, Namakula S.; Lucas, Susan [University of the Witwatersrand, Department of Radiology, Faculty of Health Sciences, Witwatersrand (South Africa); Andronikou, Savvas [University of Bristol, Department of Radiology/CRIC Bristol, Bristol (United Kingdom); Bristol Royal Hospital for Children, Department of Radiology, Bristol (United Kingdom)

2016-09-15

Shifting X-ray interpretation to non-radiologists can help to address radiologist shortages in developing countries. To determine the change in accuracy of non-radiologists and radiologists for the radiographic diagnosis of paediatric tuberculosis after a short skill-development course. Participants interpreted 15 paediatric chest radiographs before and after a 30-minute course using three possible responses: (1) diagnostic for tuberculosis, (2) abnormal but inconclusive for diagnosis of tuberculosis and (3) normal. We compared proportions of correct diagnoses, sensitivity, and specificity, before and after the course. We included 256 participants comprising 229 non-radiologists (134 radiographers, 32 paediatricians, 39 Medecins Sans Frontieres clinicians and 24 physicians including paediatricians) and 27 radiologists. Mean change proportions of correct diagnosis ranged from -27% to 53% for individuals and 9% to 20% for groups. All groups showed a statistically significant improvement. Mean change in diagnostic sensitivity ranged from -38% to 100% for individuals and from 16% to 41% for groups. All groups showed a statistically significant improvement. Mean change in specificity ranged from -57% to 57% for individuals and from -15% to -4% for groups. The decrease was statistically significant for physicians, paediatricians and radiographers. The course resulted in increased correct diagnoses and improved sensitivity at the expense of specificity. (orig.)

Introduction to mathematics of satisfiability

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Marek, Victor W

2009-01-01

Although this area has a history of over 80 years, it was not until the creation of efficient SAT solvers in the mid-1990s that it became practically important, finding applications in electronic design automation, hardware and software verification, combinatorial optimization, and more. Exploring the theoretical and practical aspects of satisfiability, Introduction to Mathematics of Satisfiability focuses on the satisfiability of theories consisting of propositional logic formulas. It describes how SAT solvers and techniques are applied to problems in mathematics and computer science as well

Fractal Analysis of Radiologists Visual Scanning Pattern in Screening Mammography

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Alamudun, Folami T [ORNL; Yoon, Hong-Jun [ORNL; Hudson, Kathy [University of Tennessee, Knoxville (UTK); Morin-Ducote, Garnetta [University of Tennessee, Knoxville (UTK); Tourassi, Georgia [ORNL

2015-01-01

Several investigators have investigated radiologists visual scanning patterns with respect to features such as total time examining a case, time to initially hit true lesions, number of hits, etc. The purpose of this study was to examine the complexity of the radiologists visual scanning pattern when viewing 4-view mammographic cases, as they typically do in clinical practice. Gaze data were collected from 10 readers (3 breast imaging experts and 7 radiology residents) while reviewing 100 screening mammograms (24 normal, 26 benign, 50 malignant). The radiologists scanpaths across the 4 mammographic views were mapped to a single 2-D image plane. Then, fractal analysis was applied on the derived scanpaths using the box counting method. For each case, the complexity of each radiologist s scanpath was estimated using fractal dimension. The association between gaze complexity, case pathology, case density, and radiologist experience was evaluated using 3 factor fixed effects ANOVA. ANOVA showed that case pathology, breast density, and experience level are all independent predictors of the visual scanning pattern complexity. Visual scanning patterns are significantly different for benign and malignant cases than for normal cases as well as when breast parenchyma density changes.

Prevalence of cancer risk factors among women radiologists and radiology assistants in Lithuania

International Nuclear Information System (INIS)

Samerdokiene, V.; Kurtinaitis, J.; Atkocius, V. and others

2005-01-01

The aim of the work was to study potential cancer risk factors among radiologists and non-radiologists in Lithuania. Cancer risk factors were investigated among female medical staff at the departments of ionizing (243, 33.33%) and non-ionizing environment (486, 66.67%). The questionnaire covered the diet, lifestyle, reproductive factors as well as the demographic and physical characteristics. Univariate analysis was done separately for physicians and nurses. Each of risk factors was evaluated in stratified analysis for unequal ORs using Mantel-Haenszel estimate control for age and occupation. Evaluation of features of risk factors among radiologists vs. non-radiologists has shown that smoking was most the prevalent risk factor among radiologists and radiology assistants. Despite the relatively low prevalence, the questionnaire data showed the higher frequency of smoking among radiologists (OR = 2.78, 95% CI 1.12-6.87) and radiology assistants (OR = 2.25, 95% 1.38-3.66) compared to non-radiologists. The prevalence of non-users and occasional users was 74% to 66%, respectively. Alcohol use by smoking among radiologists was influenced insignificantly. The cohort of radiologists in Lithuania offer an opportunity for obtaining direct observational evidence on health effects associated with chronic low-dose radiation exposure. The data on possible cancer risk factors can be helpful for validation of the risks in future. (author)

Radiologists' knowledge and perceptions of the impact of contrast-induced nephropathy and its risk factors when performing computed tomography examinations: A survey of European radiologists

International Nuclear Information System (INIS)

Reddan, Donal; Fishman, Elliot K.

2008-01-01

Background: The past decade has seen a proliferation in the number of CT procedures. As increasing numbers of elderly patients with multiple comorbidities undergo contrast media (CM)-enhanced procedures, more patients are at risk for contrast-induced nephropathy (CIN). Objectives: To understand whether radiologists are sufficiently aware of the incidence, impact and risk factors of CIN, and whether they are taking sufficient measures to prevent CIN among patients undergoing CT. Materials and methods: A telephone or online survey was conducted in 2005 with 509 radiologists from 10 European countries. Participants had a minimum of 3 years' experience and performed at least 50 CT scans per week. Results: Most (88%) radiologists believed that CIN is an important issue. While 45% identify that a patient is experiencing CIN when the serum creatinine level increases >25% (0.5 mg/dL) from baseline within 48 h, the remainder used criteria that might lead to significant under-diagnosis. Most (72%) radiologists believed that CIN is associated with increased morbidity; 56% did not believe that it is associated with increased mortality. Most respondents agreed that pre-existing renal impairment (97%), dehydration (90%) and diabetes (89%) were risk factors for CIN; however, 26%, 30% and 46%, respectively, did not identify advanced age, CM dose or congestive cardiac failure as risk factors. Only 7% of radiologists thought they were always made aware of CIN associated with their cases and 28% never consulted a nephrologist to discuss patients at risk of CIN or who had developed CIN. Conclusion: There is highly variable awareness of the definition, impact and risk factors for CIN among European radiologists. Data regarding the importance of CIN in CT are limited. Improved efforts are required to better educate radiologists and referring physicians and to institute appropriate protocols to identify at-risk patients and prevent CIN

Systematic Layout Planning of a Radiology Reporting Area to Optimize Radiologists' Performance.

Science.gov (United States)

Benitez, Guilherme Brittes; Fogliatto, Flavio Sanson; Cardoso, Ricardo Bertoglio; Torres, Felipe Soares; Faccin, Carlo Sasso; Dora, José Miguel

2018-04-01

Optimizing radiologists' performance is a major priority for managers of health services/systems, since the radiologists' reporting activity imposes a severe constraint on radiology productivity. Despite that, methods to optimize radiologists' reporting workplace layout are scarce in the literature. This study was performed in the Radiology Division (RD) of an 850-bed University-based general hospital. The analysis of the reporting workplace layout was carried out using the systematic layout planning (SLP) method, in association with cluster analysis as a complementary tool in early stages of SLP. Radiologists, architects, and hospital managers were the stakeholders consulted for the completion of different stages of the layout planning process. A step-by-step description of the proposed methodology to plan an RD reporting layout is presented. Clusters of radiologists were defined using types of exams reported and their frequency of occurrence as clustering variables. Sectors with high degree of interaction were placed in proximity in the new RD layout, with separation of noisy and quiet areas. Four reporting cells were positioned in the quiet area, grouping radiologists by subspecialty, as follows: cluster 1-abdomen; cluster 2-musculoskeletal; cluster 3-neurological, vascular and head & neck; cluster 4-thoracic and cardiac. The creation of reporting cells has the potential to limit unplanned interruptions and enhance the exchange of knowledge and information within cells, joining radiologists with the same expertise. That should lead to improvements in productivity, allowing managers to more easily monitor radiologists' performance.

Nonresearch Industry Payments to Radiologists: Characteristics and Associations With Regional Medical Imaging Utilization.

Science.gov (United States)

Kokabi, Nima; Junn, Jacqueline C; Xing, Minzhi; Hemingway, Jennifer; Hughes, Danny R; Duszak, Richard

2017-03-01

To evaluate characteristics of nonresearch industry payments to radiologists and associations with regional diagnostic imaging utilization. Using 2014 CMS Open Payment data, all disclosed nonresearch-related industry payments to radiologists were identified. Health Resources and Services Administration Area Health Resources Files were used to identify actual and population-weighted numbers of radiologists by state. Utilizing the 5% random beneficiary sample CMS Research Identifiable Files from 2014, average Medicare imaging spending per beneficiary in each state was calculated. Average frequency and dollar amounts of nonresearch nonroyalty payments to radiologists were calculated at the state level. Using the Pearson correlation coefficient, the relationship between frequency and amounts of nonresearch payments to radiologists versus per-beneficiary Medicare imaging spending was evaluated at the state level. Overall, 2,008 radiologists (1,670 diagnostic, 338 interventional) received nonresearch nonroyalty payments from industry, representing 5.2% of all 38,857 radiologists nationwide. A total of 4,975 individual transfers translated to 2.5 ± 1.3 discrete payments per receiving radiologist with a mean of $432 ± $1,976 (median $26; range $1-$34,050). Food and beverage expenses constituted the vast majority of disclosed transfers (4,111; 83%), followed by travel and lodging (444; 9%), consulting fees (279; 6%), and educational expenses (51; 1%). Considerable geographic variation in payments was observed, ranging from 0% of radiologists in Vermont to 12.9% in the District of Columbia. No correlation was identified between average per-beneficiary Medicare imaging spending and the proportion of nonresearch-funded radiologists in each state (r = 0.06). Similarly, no correlation was identified between average per-beneficiary Medicare imaging spending and the average nonresearch transfer amount to radiologists in each state (r = -0.08). In 2014, only a small minority of

Admission Privileges and Clinical Responsibilities for Interventional Radiologists

Energy Technology Data Exchange (ETDEWEB)

Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [The American University of Beirut Medical Center, IR Division, The Department of Diagnostic Radiology (Lebanon)

2015-04-15

Although clinical involvement by interventional radiologists in the care of their patients was advocated at the inception of the specialty, the change into the clinical paradigm has been slow and patchy for reasons related to pattern of practice, financial remuneration or absence of training. The case for the value of clinical responsibilities has been made in a number of publications and the consequences of not doing so have been manifest in the erosion of the role of the interventional radiologists particularly in the fields of peripheral vascular and neuro intervention. With the recent recognition of interventional radiology (IR) as a primary specialty in the USA and the formation of IR division in the Union of European Medical Specialists and subsequent recognition of the subspecialty in many European countries, it is appropriate to relook at the issue and emphasize the need for measures to promote the clinical role of the interventional radiologist.

Admission Privileges and Clinical Responsibilities for Interventional Radiologists

International Nuclear Information System (INIS)

Al-Kutoubi, Aghiad

2015-01-01

Although clinical involvement by interventional radiologists in the care of their patients was advocated at the inception of the specialty, the change into the clinical paradigm has been slow and patchy for reasons related to pattern of practice, financial remuneration or absence of training. The case for the value of clinical responsibilities has been made in a number of publications and the consequences of not doing so have been manifest in the erosion of the role of the interventional radiologists particularly in the fields of peripheral vascular and neuro intervention. With the recent recognition of interventional radiology (IR) as a primary specialty in the USA and the formation of IR division in the Union of European Medical Specialists and subsequent recognition of the subspecialty in many European countries, it is appropriate to relook at the issue and emphasize the need for measures to promote the clinical role of the interventional radiologist

Sex Differences in Radiologist Salary in U.S. Public Medical Schools.

Science.gov (United States)

Kapoor, Neena; Blumenthal, Daniel M; Smith, Stacy E; Ip, Ivan K; Khorasani, Ramin

2017-11-01

The purpose of this study was to evaluate salary differences between male and female academic radiologists at U.S. medical schools. Laws in several U.S. states mandate public release of government records, including salary information of state employees. From online salary data published by 12 states, we extracted the salaries of all academic radiologists at 24 public medical schools during 2011-2013 (n = 573 radiologists). In this institutional review board-approved cross-sectional study, we linked these data to a physician database with information on physician sex, age, faculty rank, years since residency, clinical trial involvement, National Institutes of Health (NIH) funding, scientific publications, and clinical volume measured by 2013 Medicare payments. Sex difference in salary, the primary outcome, was estimated using a multilevel logistic regression adjusting for these factors. Among 573 academic radiologists, 171 (29.8%) were women. Female radiologists were younger (48.5 vs 51.6 years, p = 0.001) and more likely to be assistant professors (50.9% [87/171] vs 40.8% [164/402], p = 0.026). Salaries between men and women were similar in unadjusted analyses ($290,660 vs $289,797; absolute difference, $863; 95% CI, -$18,363 to $20,090), and remained so after adjusting for age, faculty rank, years since residency, clinical trial involvement, publications, total Medicare payments, NIH funding, and graduation from a highly ranked medical school. Among academic radiologists employed at 24 U.S. public medical schools, male and female radiologists had similar annual salaries both before and after adjusting for several variables known to influence salary among academic physicians.

Impact of Breast Reader Assessment Strategy on mammographic radiologists' test reading performance.

Science.gov (United States)

Suleiman, Wasfi I; Rawashdeh, Mohammad A; Lewis, Sarah J; McEntee, Mark F; Lee, Warwick; Tapia, Kriscia; Brennan, Patrick C

2016-06-01

The detection of breast cancer is somewhat limited by human factors, and thus there is a need to improve reader performance. This study assesses whether radiologists who regularly undertake the education in the form of the Breast Reader Assessment Strategy (BREAST) demonstrate any changes in mammography interpretation performance over time. In 2011, 2012 and 2013, 14 radiologists independently assessed a year-specific BREAST mammographic test-set. Radiologists read a different single test-set once each year, with each comprising 60 digital mammogram cases. Radiologists marked the location of suspected lesions without computer-aided diagnosis (CAD) and assigned a confidence rating of 2 for benign and 3-5 for malignant lesions. The mean sensitivity, specificity, location sensitivity, JAFROC FOM and ROC AUC were calculated. A Kruskal-Wallis test was used to compare the readings for the 14 radiologists across the 3 years. Wilcoxon signed rank test was used to assess comparison between pairs of years. Relationships between changes in performance and radiologist characteristics were examined using a Spearman's test. Significant increases were noted in mean sensitivity (P = 0.01), specificity (P = 0.01), location sensitivity (P = 0.001) and JAFROC FOM (P = 0.001) between 2011 and 2012. Between 2012 and 2013, significant improvements were noted in mean sensitivity (P = 0.003), specificity (P = 0.002), location sensitivity (P = 0.02), JAFROC FOM (P = 0.005) and ROC AUC (P = 0.008). No statistically significant correlations were shown between the levels of improvement and radiologists' characteristics. Radiologists' who undertake the BREAST programme demonstrate significant improvements in test-set performance during a 3-year period, highlighting the value of ongoing education through the use of test-set. © 2016 The Royal Australian and New Zealand College of Radiologists.

Breast Density Legislation in New England: A Survey Study of Practicing Radiologists.

Science.gov (United States)

Lourenco, Ana P; DiFlorio-Alexander, Roberta M; Slanetz, Priscilla J

2017-10-01

This study aimed to assess radiologists' knowledge about breast density legislation as well as perceived practice changes resulting from the enactment of breast density legislation. This is an institutional review board-exempt anonymous email survey of 523 members of the New England Roentgen Ray Society. In addition to radiologist demographics, survey questions addressed radiologist knowledge of breast density legislation, knowledge of breast density as a risk factor for breast cancer, recommendations for supplemental screening, and perceived practice changes resulting from density notification legislation. Of the 523 members, 96 responded, yielding an 18% response rate. Seventy-three percent of respondents practiced in a state with breast density legislation. Sixty-nine percent felt that breast density notification increased patient anxiety about breast cancer, but also increased patient (74%) and provider (66%) understanding of the effect of breast density on mammographic sensitivity. Radiologist knowledge of the relative risk of breast cancer when comparing breasts of different density was variable. Considerable confusion and controversy regarding breast density persists, even among practicing radiologists. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Radiologists' Usage of Social Media: Results of the RANSOM Survey.

Science.gov (United States)

Ranschaert, Erik R; Van Ooijen, Peter M A; McGinty, Geraldine B; Parizel, Paul M

2016-08-01

The growing use of social media is transforming the way health care professionals (HCPs) are communicating. In this changing environment, it could be useful to outline the usage of social media by radiologists in all its facets and on an international level. The main objective of the RANSOM survey was to investigate how radiologists are using social media and what is their attitude towards them. The second goal was to discern differences in tendencies among American and European radiologists. An international survey was launched on SurveyMonkey ( https://www.surveymonkey.com ) asking questions about the platforms they prefer, about the advantages, disadvantages, and risks, and about the main incentives and barriers to use social media. A total of 477 radiologists participated in the survey, of which 277 from Europe and 127 from North America. The results show that 85 % of all survey participants are using social media, mostly for a mixture of private and professional reasons. Facebook is the most popular platform for general purposes, whereas LinkedIn and Twitter are more popular for professional usage. The most important reason for not using social media is an unwillingness to mix private and professional matters. Eighty-two percent of all participants are aware of the educational opportunities offered by social media. The survey results underline the need to increase radiologists' skills in using social media efficiently and safely. There is also a need to create clear guidelines regarding the online and social media presence of radiologists to maximize the potential benefits of engaging with social media.

Radiologist perceptions of radiographer role development in Scotland

Energy Technology Data Exchange (ETDEWEB)

Forsyth, Lesley J. [School of Health Sciences, Robert Gordon University, Faculty of Health and Social Care, Garthdee Road, Garthdee, Aberdeen AB10 7QG (United Kingdom)]. E-mail: l.forsyth@rgu.ac.uk; Robertson, Elizabeth M. [Department of Radiology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN (United Kingdom)]. E-mail: e.m.robertson@arh.grampian.scot.nhs.uk

2007-02-15

Aim: To survey the perceptions of the Scottish radiology community in relation to radiographer role development. Methods: A postal questionnaire was sent to all consultant radiologists recorded on the NHS Scotland database of consultants. Results: Response rate was 63%. (i) Respondents considered increased professional standing of radiographers, best use of manpower resources, reduced pressure on the service and improved recruitment and retention, as positive advantages of radiographer development. (ii) The potential impact on radiology specialist registrar training, lack of clear medico-legal responsibilities and radiographers recognising the limitations of their abilities were identified as the main areas of radiologist anxiety. (iii) Fifty-seven percent did not consider current post-registration radiography education and training resources adequate to underpin the requirement of developed roles. (iv) Barriers to radiographer development were identified as lack of radiography and radiology staff, suitable education, financial constraints, traditional views and resistance to change. (v) Eighty-two percent reported support for radiographer role development and willingness to participate actively in developments. Conclusion: Despite reservations Scottish radiologists are supportive of the development of radiography colleagues, however, guidance is required on the medico-legal and accountability aspects of radiographers assuming new roles. Radiologist involvement in education and training for new roles may increase their confidence and trust in radiographers to work within the limitations of their competency and training.

Radiologist perceptions of radiographer role development in Scotland

International Nuclear Information System (INIS)

Forsyth, Lesley J.; Robertson, Elizabeth M.

2007-01-01

Aim: To survey the perceptions of the Scottish radiology community in relation to radiographer role development. Methods: A postal questionnaire was sent to all consultant radiologists recorded on the NHS Scotland database of consultants. Results: Response rate was 63%. (i) Respondents considered increased professional standing of radiographers, best use of manpower resources, reduced pressure on the service and improved recruitment and retention, as positive advantages of radiographer development. (ii) The potential impact on radiology specialist registrar training, lack of clear medico-legal responsibilities and radiographers recognising the limitations of their abilities were identified as the main areas of radiologist anxiety. (iii) Fifty-seven percent did not consider current post-registration radiography education and training resources adequate to underpin the requirement of developed roles. (iv) Barriers to radiographer development were identified as lack of radiography and radiology staff, suitable education, financial constraints, traditional views and resistance to change. (v) Eighty-two percent reported support for radiographer role development and willingness to participate actively in developments. Conclusion: Despite reservations Scottish radiologists are supportive of the development of radiography colleagues, however, guidance is required on the medico-legal and accountability aspects of radiographers assuming new roles. Radiologist involvement in education and training for new roles may increase their confidence and trust in radiographers to work within the limitations of their competency and training

Bounded Satisfiability for PCTL

OpenAIRE

Bertrand, Nathalie; Fearnley, John; Schewe, Sven

2012-01-01

While model checking PCTL for Markov chains is decidable in polynomial-time, the decidability of PCTL satisfiability, as well as its finite model property, are long standing open problems. While general satisfiability is an intriguing challenge from a purely theoretical point of view, we argue that general solutions would not be of interest to practitioners: such solutions could be too big to be implementable or even infinite. Inspired by bounded synthesis techniques, we turn to the more appl...

Artificial Intelligence: Threat or Boon to Radiologists?

Science.gov (United States)

Recht, Michael; Bryan, R Nick

2017-11-01

The development and integration of machine learning/artificial intelligence into routine clinical practice will significantly alter the current practice of radiology. Changes in reimbursement and practice patterns will also continue to affect radiology. But rather than being a significant threat to radiologists, we believe these changes, particularly machine learning/artificial intelligence, will be a boon to radiologists by increasing their value, efficiency, accuracy, and personal satisfaction. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Occupational radiation risk to radiologists

International Nuclear Information System (INIS)

Schuettmann, W.

1981-01-01

A review is given of the most important publications dealing with attempts to estimate the occupational radiation risk to radiologists by comparing data on their mortality from leukemia and other forms of cancer with respective data for other physicians who were not occupationally exposed to ionizing radiation. (author)

Radiologists' knowledge and perceptions of the impact of contrast-induced nephropathy and its risk factors when performing computed tomography examinations: A survey of European radiologists

Energy Technology Data Exchange (ETDEWEB)

Reddan, Donal [University College Galway Hospitals, Unit 7, Merlin Park Hospital, Galway (Ireland)], E-mail: donal.reddan@mailn.hse.ie; Fishman, Elliot K. [Johns Hopkins Hospital, Baltimore, MD (United States)

2008-05-15

Background: The past decade has seen a proliferation in the number of CT procedures. As increasing numbers of elderly patients with multiple comorbidities undergo contrast media (CM)-enhanced procedures, more patients are at risk for contrast-induced nephropathy (CIN). Objectives: To understand whether radiologists are sufficiently aware of the incidence, impact and risk factors of CIN, and whether they are taking sufficient measures to prevent CIN among patients undergoing CT. Materials and methods: A telephone or online survey was conducted in 2005 with 509 radiologists from 10 European countries. Participants had a minimum of 3 years' experience and performed at least 50 CT scans per week. Results: Most (88%) radiologists believed that CIN is an important issue. While 45% identify that a patient is experiencing CIN when the serum creatinine level increases >25% (0.5 mg/dL) from baseline within 48 h, the remainder used criteria that might lead to significant under-diagnosis. Most (72%) radiologists believed that CIN is associated with increased morbidity; 56% did not believe that it is associated with increased mortality. Most respondents agreed that pre-existing renal impairment (97%), dehydration (90%) and diabetes (89%) were risk factors for CIN; however, 26%, 30% and 46%, respectively, did not identify advanced age, CM dose or congestive cardiac failure as risk factors. Only 7% of radiologists thought they were always made aware of CIN associated with their cases and 28% never consulted a nephrologist to discuss patients at risk of CIN or who had developed CIN. Conclusion: There is highly variable awareness of the definition, impact and risk factors for CIN among European radiologists. Data regarding the importance of CIN in CT are limited. Improved efforts are required to better educate radiologists and referring physicians and to institute appropriate protocols to identify at-risk patients and prevent CIN.

[Acceptance of medical apps and e‑books among German radiologists].

Science.gov (United States)

Schleder, S; Dendl, L M; Niessen, C; Stroszczynski, C; Schreyer, A G

2017-09-01

Smartphones, tablet PCs, mobile applications (apps) and electronic book files (e-books) affect our lives in private and job-related settings. The aim of this study was to analyze the behavior of radiologists on smartphones, tablet PCs and e‑books and to investigate its effect on their daily work. An online survey containing of 23 questions was conducted using Survey Monkey© ( www.surveymonkey.com ). The invitation to the survey was done using the newsletter of the German Radiological Society (DRG). The acquired data was automatically stored by the software and then analyzed using descriptive statistics. In total, 104 radiologists (29% female) participated in the online survey. Of these, 93% and 96.5% owned a smartphone or a tablet PC, respectively, and 72% and 67% used medical apps and e‑books, respectively. Through their use, 31% found moderate and 41% found enormous improvement in their daily work. A majority of participating radiologists would be willing to pay an increased user fee for optimized apps or e‑books. With currently only moderate individual benefit of mobile medical apps and e‑books, there is a widespread need for optimally configured apps and e‑books with a correspondingly high market potential. (1) Radiologists use smartphones (93%) or tablet PCs (96.5%); (2) 72% of radiologists use a smartphone or tablet PC for medical material; (3) 53% of radiologists report significant assistance from or a high value of the mobile medical applications used; (4) There is a willingness to pay a license fee for optimized mobile applications or e‑books.

Age determination of subdural hematomas: survey among radiologists.

Science.gov (United States)

Postema, F A M; Sieswerda-Hoogendoorn, Tessa; Majoie, C B L M; van Rijn, R R

2014-08-01

Abusive head trauma is a severe form of child abuse. One important diagnostic finding is the presence of a subdural hematoma. Age determination of subdural hematomas is important to relate radiological findings to the clinical history presented by the caregivers. In court this topic is relevant as dating subdural hematomas can lead to identification of a suspect. The aim of our study is to describe the current practice among radiologists in the Netherlands regarding the age determination of subdural hematomas in children. This is a cross-sectional study, describing the results of an online questionnaire regarding dating subdural hematomas among pediatric and neuro-radiologists in the Netherlands. The questionnaire consisted of sociodemographic questions, theoretical questions and eight pediatric cases in which the participants were asked to date subdural hematomas based on imaging findings. Fifty-one out of 172 radiologists (30 %) filled out the questionnaire. The percentage of participants that reported it was possible to date the subdural hematoma varied between 58 and 90 % for the eight different cases. In four of eight cases (50 %), the age of the subdural hematoma as known from clinical history fell within the range reported by the participants. None of the participants was "very certain" of their age determination. The results demonstrate that there is a considerable practice variation among Dutch radiologists regarding the age determination of subdural hematomas. This implicates that dating of subdural hematomas is not suitable to use in court, as no uniformity among experts exists.

Public Health England survey of eye lens doses in the UK medical sector

International Nuclear Information System (INIS)

Ainsbury, E A; Bouffler, S; Gilvin, P; Peters, S; Slack, K; Cocker, M; Holt, E; Williamson, A

2014-01-01

The ICRP has recently recommended that the occupational exposure limit for the lens of the eye be reduced to 20 mSv in a year, averaged over defined periods of 5 years, with no single year exceeding 50 mSv. There has been concern amongst some groups of individuals, particularly interventional cardiologists and radiologists as well as relevant professional bodies, that implementation of these recommendations into UK law will adversely affect working patterns. However, despite a number of informative European studies, there is currently little UK dosimetry data available upon which judgements can effectively be based. In order to address this knowledge gap, Public Health England has carried out a small, targeted survey of UK lens doses to medical staff undertaking procedures likely to involve the highest levels of radiation exposure. Two out of a total of 61 individuals surveyed had projected annual doses which could be close to 20 mSv, measured outside lead glasses. Use of protective equipment was generally good; however, lead glasses were only used by 9 participants. The results of this survey suggest that compliance with the ICRP recommendations is likely to be possible for most individuals in the UK medical sector. (paper)

Measuring and managing radiologist workload: measuring radiologist reporting times using data from a Radiology Information System

International Nuclear Information System (INIS)

Cowan, Ian A.; MacDonald, Sharon L.S.; Floyd, Richard A.

2013-01-01

Historically, there has been no objective method of measuring the time required for radiologists to produce reports during normal work. We have created a technique for semi-automated measurement of radiologist reporting time, and through it produced a robust set of absolute time requirements and relative value units for consultant reporting of diagnostic examinations in our hospital. A large sample of reporting times, recorded automatically by the Radiology Information System (COMRAD, Software Innovations, Christchurch, New Zealand) along with the description of each examination being reported, was placed in a database. Analysis was confined to diagnostic reporting by consultant radiologists. A spreadsheet was produced, listing the total number and the frequency of reporting times of each distinct examination. Outliers with exceptionally long report times (more than 10min for plain radiography, 30min for ultrasound, or 60min for CT or MRI with some exceptions) were culled; this removed 9.5% of the total. Complex CTs requiring separate workstation time were assigned times by consensus. The median time for the remainder of each sample was the assigned absolute reporting time in minutes and seconds. Relative value units were calculated using the reporting time for a single view department chest X-ray of 1min 38s including verifying a report made using speech recognition software. A schedule of absolute and relative values, based on over 179,000 reports, forms Table 2 of this paper. The technique provides a schedule of reporting times with reduced subjective input, which is more robust than existing systems for measuring reporting time.

Personal Branding: A Primer for Radiology Trainees and Radiologists.

Science.gov (United States)

Kalia, Vivek; Patel, Amy K; Moriarity, Andrew K; Canon, Cheri L

2017-07-01

A radiologist's personal brand is a composite of many parts in one's professional life. In an age where work quality and digital footprints are tracked and measured more than ever before, it behooves radiologists to develop and curate their own individual brands in effective ways. Personal branding consists of the decisions we make, both consciously and unconsciously, which affect our reputation and the likelihood of seeking our services in the future for both patients and referring providers. As hospital systems are increasingly adjusting their systems to cater to better patient experiences, it is imperative that radiologists similarly adjust our practice patterns to accommodate the needs of the new paradigm of value-based care. It is no longer sufficient to only practice excellent clinical radiology; one's service experience to clinical providers, report quality, and digital presence must all be robust and compelling. Defining your brand and promoting your vision and quality standards have become as important to radiologists' future as keeping up with advancements in radiologic technology. One must select the proper platforms and types of interactions in which to engage from available social media options. Developing a consistent brand and presence in the work setting, on social media accounts, and in professional organizations at the local, national, and international levels is the ultimate goal. At present, very little, if any, formal training is provided on personal branding skills such as these in current residency curricula, and it is critical for radiologists to fill their gaps in knowledge through additional means. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Who collects professional fees for neuroradiology interpretation, radiologists or nonradiologists?

Science.gov (United States)

Babiarz, Lukasz S; Yousem, David M; Parker, Laurence; Rao, Vijay

2012-07-01

An increasing portion of imaging studies are performed by nonradiologists, especially for modalities with the highest relative value units. The aim of this study was to examine the trends in neuroradiologic interpretation among radiologists, neurologists, neurosurgeons, and other specialists within the Medicare population. The number of neuroradiologic studies interpreted by radiologists, neurologists, neurosurgeons, and other specialists in the inpatient, hospital outpatient, and private office settings was determined from the CMS Physician/Supplier Procedure Summary Master Files for 1996 to 2010. Studies billed through professional and global charges were aggregated. Utilization rates and utilization rate compound annual growth rates were computed by specialty and by imaging study. In 1996, radiologists interpreted 4,802,490 (93.7%) CMS neuroradiologic procedures, neurologists 77,312 (1.5%), neurosurgeons 9,825 (0.19%), and other specialists 234,423 (4.6%). In 2010, radiologists interpreted 11,476,376 (93.5%) procedures, neurologists 101,172 (0.8%), neurosurgeons 20,697 (0.17%), and other specialists 680,786 (5.5%). Neurology and neurosurgery lost market share at all sites. Radiology's share increased in the inpatient (from 94.8% to 98.7%) and hospital outpatient (from 95% to 98.7%) settings but decreased in the private office setting (from 88.2% to 73.1%). Lost market share was captured by the other CMS specialty categories, including independent diagnostic testing facilities and multidisciplinary groups, many of which included radiologists. There was marked growth (140%) in neuroradiologic studies between 1996 and 2010 in the Medicare patient population. Radiologists' share of the total neuroradiologic interpretations remained unchanged and constituted 93.5% in 2010. Radiology's market share has shown growth in the inpatient and hospital outpatient sectors but not the private office sector, where independent diagnostic testing facilities, multidisciplinary

Preliminary investigation of the interaction between radiologists and digital radiologic work stations

International Nuclear Information System (INIS)

Fajardo, L.L.; McNeill, K.M.; Maloney, K.; Mockbee, B.

1987-01-01

Using a work station built in the authors' department, they conducted an investigation into the interaction between radiologist and a digital radiologic work station. A survey provided information regarding the experience of 18 radiologists with digital technology and their expectations of its benefits. They ranked the potential attributes of digital work stations, with spatial resolution first, followed by contrast resolution, ease of use, speed, ease of learning, and cost. Observation of the radiologists' interaction with the work station has provided recommendations for implementation of functions. The authors conclude that radiologic work station user interfaces must be intuitive and support the radiologist's task without increasing the time or effort required for the task

Practical Approaches to Quality Improvement for Radiologists.

Science.gov (United States)

Kelly, Aine Marie; Cronin, Paul

2015-10-01

Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. © RSNA, 2015.

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

Science.gov (United States)

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

2017-03-01

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

Radiologists and Social Media: Do Not Forget About Facebook.

Science.gov (United States)

Seidel, Rebecca L; Jalilvand, Aryan; Kunjummen, Jean; Gilliland, Lea; Duszak, Richard

2018-01-01

Facebook (Facebook, Inc, Menlo Park, California, USA) is the most popular social networking platform worldwide. Facebook groups are virtual communities of people who share a common interest. Breast Imaging Radiologists is a Facebook group for radiologists with an interest in breast imaging. The purpose of this study was to analyze the membership and activity of the Breast Imaging Radiologists Facebook group (BIRFG) for 2 years since its inception. Using both the Grytics (www.grytics.com) and Sociograph (www.sociograph.io) analytic engines, the activity of the BIRFG was analyzed retrospectively from its inception on February 11, 2015, through February 12, 2017. Activity data were exported for further qualitative and quantitative analysis using Excel (Microsoft, Redmond, Washington, USA). Member demographic data were obtained by querying public Facebook profiles, US News Doctor Finder (US News & World Report, Washington, DC, USA), Doximity (Doximity, San Francisco, California, USA), and Google (Google Inc, Mountain View, California, USA). Membership grew from 1 to 774 over the study period, and 84% of the members were female. There were 493 posts, 3,253 comments, and 1,732 reactions; 92% of posts received either comments or reactions. Each post received an average of 6.6 comments, and 55% of members were active over the study period. There was an increase in all measures of activity from year 1 to year 2. Our findings indicate that radiologists find value in using Facebook groups as a forum to network and exchange information about breast imaging. This may be generalizable to other radiology subspecialties. Given the popularity and accessibility of Facebook for personal use, it may prove a more comfortable social medium for radiologists to interact professionally. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Quality and Efficiency Improvement Tools for Every Radiologist.

Science.gov (United States)

Kudla, Alexei U; Brook, Olga R

2018-03-20

In an era of value-based medicine, data-driven quality improvement is more important than ever to ensure safe and efficient imaging services. Familiarity with high-value tools enables all radiologists to successfully engage in quality and efficiency improvement. In this article, we review the model for improvement, strategies for measurement, and common practical tools with real-life examples that include Run chart, Control chart (Shewhart chart), Fishbone (Cause-and-Effect or Ishikawa) diagram, Pareto chart, 5 Whys, and Root Cause Analysis. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Radiographers and radiologists reporting plain radiograph requests from accident and emergency and general practice

International Nuclear Information System (INIS)

Brealey, S.D.; King, D.G.; Hahn, S.; Crowe, M.; Williams, P.; Rutter, P.; Crane, S.

2005-01-01

AIM: To assess selectively trained radiographers and consultant radiologists reporting plain radiographs for the Accident and Emergency Department (A and E) and general practitioners (GPs) within a typical hospital setting. METHODS: Two radiographers, a group of eight consultant radiologists, and a reference standard radiologist independently reported under controlled conditions a retrospectively selected, random, stratified sample of 400 A and E and 400 GP plain radiographs. An independent consultant radiologist judged whether the radiographer and radiologist reports agreed with the reference standard report. Clinicians then assessed whether radiographer and radiologist incorrect reports affected confidence in their diagnosis and treatment plans, and patient outcome. RESULTS: For A and E and GP plain radiographs, respectively, there was a 1% (95% confidence interval (CI) -2 to 5) and 4% (95% CI -1 to 8) difference in reporting accuracy between the two professional groups. For both A and E and GP cases there was an 8% difference in the clinicians' confidence in their diagnosis based on radiographer or radiologist incorrect reports. For A and E and GP cases, respectively, there was a 2% and 8% difference in the clinicians' confidence in their management plans based on radiographer or radiologist incorrect reports. For A and E and GP cases, respectively, there was a 1% and 11% difference in effect on patient outcome of radiographer or radiologist incorrect reports. CONCLUSION: There is the potential to extend the reporting role of selectively trained radiographers to include plain radiographs for all A and E and GP patients. Further research conducted during clinical practice at a number of sites is recommended

On occupational-appointment demands on radiation hygiene for medical radiologists

International Nuclear Information System (INIS)

Usol'tsev, V.I.; Kuzin, V.I.; Tselikov, N.V.

1988-01-01

The aim of the work was to determine occupational requirements on radiation hygiene for medical radiologists. To solve the problem using questionnaire, personal conversations with doctors, analysis of basis control and examinations volume and character of work on radiation hygiene were studied in 510 medical radiologists. Occupational requirements for these specialists were worked out on the basis the obtained data. 4 refs

Radiographers and trainee radiologists reporting accident radiographs

DEFF Research Database (Denmark)

Buskov, L; Abild, A; Christensen, A

2013-01-01

To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital....

The Quality of Curative-intent Radiotherapy for Non-small Cell Lung Cancer in the UK.

Science.gov (United States)

McAleese, J; Baluch, S; Drinkwater, K

2015-09-01

Lung cancer is the leading cause of cancer-related death in the UK. The quality of curative-intent radiotherapy is associated with better outcomes. National quality standards from the National Institute for Health and Care Excellence (NICE) on patient work-up and treatment selection were used, with guidance from the Royal College of Radiologists on the technical delivery of radiotherapy, to assess the quality of curative-intent non-small cell lung cancer radiotherapy and to describe current UK practice. Radiotherapy departments completed one questionnaire for each patient started on curative-intent radiotherapy for 8 weeks in 2013. Eighty-two per cent of centres returned a total of 317 proformas. Patient selection with positron emission tomography/computed tomography, performance status and Forced Expiratory Volume in 1 second (FEV1) was usually undertaken. Fifty-six per cent had pathological confirmation of mediastinal lymph nodes and 22% staging brain scans; 20% were treated with concurrent chemoradiation, 12% with Stereotactic Ablative Radiotherapy (SABR) and 8% with Continuous Hyperfractionated Accelerated Radiotherapy (CHART). Sixty-three per cent of patients received 55 Gy/20 fractions. Although respiratory compensation was routinely undertaken, only 33% used four-dimensional computed tomography. Seventy per cent of patients were verified with cone beam computed tomography. There was consistency of practice in dosimetric constraints for organs at risk and follow-up. This audit has described current UK practice. The latest recommendations for patient selection with pathological confirmation of mediastinal lymph nodes, brain staging and respiratory function testing are not universally followed. Although there is evidence of increasing use of newer techniques such as four-dimensional computed tomography and cone beam image-guided radiotherapy, there is still variability in access. Efforts should be made to improve access to modern technologies and quality

The UK's diverted profits tax:an admission of defeat or a pre-emptive strike?

OpenAIRE

Picciotto, Sol

2015-01-01

The author explains the draft legislation for the U.K.’s proposed diverted profits tax and analyzes the relationship of the provisions to the reforms under negotiation through the BEPS process of the G-20 and OECD. Although the official U.K. position is that the proposals are not out of line, they clearly go beyond what has been proposed so far in the BEPS project. Hence, they seem to be either an admission that international agreement will not be reached that would satisfy U.K. concerns or a...

On selfadjoint functors satisfying polynomial relations

DEFF Research Database (Denmark)

Agerholm, Troels; Mazorchuk, Volodomyr

2011-01-01

We study selfadjoint functors acting on categories of finite dimen- sional modules over finite dimensional algebras with an emphasis on functors satisfying some polynomial relations. Selfadjoint func- tors satisfying several easy relations, in particular, idempotents and square roots of a sum...

Research by pediatric radiologists - past accomplishments and future opportunities

International Nuclear Information System (INIS)

Effmann, E.L.

1987-01-01

Pediatric radiologists have made numerous and important contributions to the body of medical knowledge. This essay reviews aspects of biomedical and radiological research, analyses the state of scholarship in pediatric radiology today, and examines future research opportunities. The author's research interest in cardiopulmonary malformations and in the use of murine models of human disease serve to illustrate of but one of many investigative areas open to academic pediatric radiologists. Finally, the application process for NIH funding is briefly discussed. (orig.)

Reading a radiologist's mind: monitoring rising and falling interest levels while scanning chest x-rays

Science.gov (United States)

Alzubaidi, Mohammad; Patel, Ameet; Panchanathan, Sethuraman; Black, John A., Jr.

2010-02-01

Radiological images constitute a special class of images that are captured (or computed) specifically for the purpose of diagnosing patients. However, because these are not "natural" images, radiologists must be trained to interpret them through a process called "perceptual learning". However, because perceptual learning is implicit, experienced radiologists may sometimes find it difficult to explicitly (i.e. verbally) train less experienced colleagues. As a result, current methods of training can take years before a new radiologist is fully competent to independently interpret medical images. We hypothesize that eye tracking technology (coupled with multimedia technology) can be used to accelerate the process of perceptual training, through a Hebbian learning process. This would be accomplished by providing a radiologist-in-training with real-time feedback as he/she is fixating on important regions of an image. Of course this requires that the training system have information about what regions of an image are important - information that could presumably be solicited from experienced radiologists. However, our previous work has suggested that experienced radiologists are not always aware of those regions of an image that attract their attention, but are not clinically significant - information that is very important to a radiologist in training. This paper discusses a study in which local entropy computations were done on scan path data, and were found to provide a quantitative measure of the moment-by-moment interest level of radiologists as they scanned chest x-rays. The results also showed a striking contrast between the moment-by-moment deployment of attention between experienced radiologists and radiologists in training.

Mergers and acquisitions for the radiologist.

Science.gov (United States)

Fleishon, Howard B

2008-05-01

In 2006 and the first half of 2007, the rapid pace of global activity contributed to the popularity of mergers and acquisitions (M&A). In fact, the medical imaging industry has a significant history in M&A as well. Along with the expectation of continued growth in medical imaging utilization and other industry trends, radiologists may become more involved in M&A transactions. There is little in the radiology literature dealing with the logistics and pitfalls of M&A. This article is an introduction for radiologists who might consider buying or selling their practices or merging with strategic partners. Although there are significant differences in the approaches of buy or sell situations compared with mergers, they do share several concepts that are outlined. One key to success in M&A transactions is the "process" or approach, which is described with some practical guidelines. Some basic terms and suggestions are also presented for reference.

Follow up on a workloaded interventional radiologist's occupational radiation doses - a study case

International Nuclear Information System (INIS)

Ketner, D.; Ofer, A.; Engel, A.

2004-01-01

During many interventional procedures, patients' radiation doses are high, affecting radiologist's radiation doses. We checked occupational doses of a workloaded interventional radiologist during seven years

Mortality of British radiologists. A lecture Note+

International Nuclear Information System (INIS)

Doll, R.

2005-01-01

The precautions introduced after the first 23 years experience of the use of x-rays for medical diagnosis proved adequate to eliminate the acute hazards of exposure, but it was much longer before it was realized that small doses that did not produce any acute effect could increase the risk of cancer. British radiologists who took up the specialty at different periods have, therefore, been studied to see if the risk has now been adequately controlled. Four groups have been studied starting respectively before 1921, in 1921-34, 1935-54, and 1955-77, corresponding approximately to periods when different limits of exposure were applied. Altogether 2698 male radiologists have been identified and all but 27 followed successfully to emigration, death, or survival to January 1 st 1997. Of the 1198 who had died, 228 are known to have died of cancer. Two problems arise in evaluating the carcinogenic hazard to which they were exposed: the assessment of the doses received and the selection of an appropriate control group with which to compare their mortality. The most appropriate comparison group would seem to be medical practitioners in general. In comparison with them, radiologists entering in the first 3 periods had increased risks of death from cancer though appreciably less than would have been predicted from the expected effect of the radiation they had received. Those who joined in the latest period had a relatively reduced risk, irrespective of any effect of the small dose of radiation they are likely to have received. Independent evidence suggests, however, that since 1951 radiologists have smoked less than other doctors and the lower than predicted risk in the groups exposed since 1920 is limited to smoking related cancers, the mortality from other cancers being higher than in doctors generally. In assessing the risk of occupational exposure to radiation, life-style has to be taken into consideration, as well as dose of radiation. (author)

Is direct radiologist supervision of abdominal computed tomography (CT) scans necessary?

Energy Technology Data Exchange (ETDEWEB)

Goh, V. [Department of Clinical Radiology, Northwick Park and St Mark' s Hospitals, Harrow (United Kingdom); Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood (United Kingdom); Halligan, S. [Department of Clinical Radiology, Northwick Park and St Mark' s Hospitals, Harrow (United Kingdom)]. E-mail: s.halligan@imperial.ac.uk; Anderson, J.M. [Department of Clinical Radiology, Northwick Park and St Mark' s Hospitals, Harrow (United Kingdom); Hugill, J. [Department of Clinical Radiology, Northwick Park and St Mark' s Hospitals, Harrow (United Kingdom); Leonard, A. [Department of Clinical Radiology, Northwick Park and St Mark' s Hospitals, Harrow (United Kingdom)

2005-07-01

AIM: To determine the effect of direct radiological supervision of patients attending for abdominal CT by assessing the frequency of protocol alteration subsequent to radiologist review of the images obtained. MATERIALS AND METHODS: A prospective questionnaire-based observational study was performed of 187 consecutive patients undergoing abdominal CT. The CT protocol was determined by a radiologist in advance, with reference to the request form. Any subsequent change in the prescribed study that was contingent on radiologist review of the images obtained was documented on the questionnaire. Comparison was made with a second (control) group of 100 patients undergoing cranial CT. RESULTS: A protocol change was undertaken following radiologist review of the CT images of 17 (9%) of the group undergoing abdominal CT, compared with 14 (14%) of the group undergoing cranial CT. In the abdominal CT group, further scanning was performed for lesion characterization, to guide a subsequent interventional procedure, because of inadequate anatomical coverage or to evaluate an unexpected lung tumour. There was no significant difference in proportions between the two groups (p=0.23). CONCLUSION: When abdominal and cranial CT studies were compared, there was no significant difference in the proportion of studies requiring a change in the prescribed protocol following radiologist review of the images obtained. There was no evidence to suggest that abdominal CT was any less suited to protocol.

HOW DO RADIOLOGISTS USE THE HUMAN SEARCH ENGINE?

Science.gov (United States)

Wolfe, Jeremy M.; Evans, Karla K.; Drew, Trafton; Aizenman, Avigael; Josephs, Emilie

2016-01-01

Radiologists perform many ‘visual search tasks’ in which they look for one or more instances of one or more types of target item in a medical image (e.g. cancer screening). To understand and improve how radiologists do such tasks, it must be understood how the human ‘search engine’ works. This article briefly reviews some of the relevant work into this aspect of medical image perception. Questions include how attention and the eyes are guided in radiologic search? How is global (image-wide) information used in search? How might properties of human vision and human cognition lead to errors in radiologic search? PMID:26656078

How do radiologists use the human search engine?

International Nuclear Information System (INIS)

Wolfe, Jeremy M.; Evans, Karla K.; Drew, Trafton; Aizenman, Avigael; Josephs, Emilie

2016-01-01

Radiologists perform many 'visual search tasks' in which they look for one or more instances of one or more types of target item in a medical image (e.g. cancer screening). To understand and improve how radiologists do such tasks, it must be understood how the human 'search engine' works. This article briefly reviews some of the relevant work into this aspect of medical image perception. Questions include how attention and the eyes are guided in radiologic search? How is global (image-wide) information used in search? How might properties of human vision and human cognition lead to errors in radiologic search? (authors)

Views of senior UK doctors about working in medicine: questionnaire survey.

Science.gov (United States)

Lambert, Trevor W; Smith, Fay; Goldacre, Michael J

2014-11-01

We surveyed the UK medical qualifiers of 1993. We asked closed questions about their careers; and invited them to give us comments, if they wished, about any aspect of their work. Our aim in this paper is to report on the topics that this senior cohort of UK-trained doctors who work in UK medicine raised with us. Questionnaire survey. 3479 contactable UK-trained medical graduates of 1993. UK. Comments made by doctors about their work, and their views about medical careers and training in the UK. Postal and email questionnaires. Response rate was 72% (2507); 2252 were working in UK medicine, 816 (36%) of whom provided comments. Positive comments outweighed negative in the areas of their own job satisfaction and satisfaction with their training. However, 23% of doctors who commented expressed dissatisfaction with aspects of junior doctors' training, the impact of working time regulations, and with the requirement for doctors to make earlier career decisions than in the past about their choice of specialty. Some doctors were concerned about government health service policy; others were dissatisfied with the availability of family-friendly/part-time work, and we are concerned about attitudes to gender and work-life balance. Though satisfied with their own training and their current position, many senior doctors felt that changes to working hours and postgraduate training had reduced the level of experience gained by newer graduates. They were also concerned about government policy interventions.

The radiologist's responsibilities for the radiation protection of patients

International Nuclear Information System (INIS)

Etard, C.

2010-01-01

The obligations of the radiologist for the radiation protection of patients include a review of the appropriateness of the examination and optimization of the protocol. Both internal and external quality assurance programs are mandatory. The specific tasks and their frequency are defined by the AFSSAPS. The radiology report of procedures performed over radiosensitive regions must include the delivered dose. The imaging technique must be optimized based on published guidelines or law for the most frequent examinations. All radiologists should be familiar with radiation protection. Incidents should be reported to the Nuclear Safety Authority. (author)

Role of the radiologist in the management of pain

International Nuclear Information System (INIS)

Quinn, S.F.; Murtagh, F.R.; Chatfield, R.; Kori, S.; Kavanagh, J.; Clark, R.A.

1987-01-01

Radiologists are taking an expanding role in the management of pain. The procedures most commonly used at our institution are facet blocks, peripheral nerve blocks, peripheral nerve ablations, ganglion ablations, chemoinfusions, chemoembolizations, and embolizations alone. CT is used for the facet, ganglion, and peripheral nerve procedures. The techniques for these procedures will be stressed, as meticulous technique is imperative. The radiologist must work closely with the attending clinician to determine both the neurologic level and to monitor therapy. The University of South Florida pain team flow sheet and pain evaluation method is presented

Spatially Explicit Analysis of Water Footprints in the UK

Directory of Open Access Journals (Sweden)

John Barrett

2010-12-01

Full Text Available The Water Footprint, as an indicator of water consumption has become increasingly popular for analyzing environmental issues associated with the use of water resources in the global supply chain of consumer goods. This is particularly relevant for countries like the UK, which increasingly rely on products produced elsewhere in the world and thus impose pressures on foreign water resources. Existing studies calculating water footprints are mostly based on process analysis, and results are mainly available at the national level. The current paper assesses the domestic and foreign water requirements for UK final consumption by applying an environmentally extended multi-regional input-output model in combination with geo-demographic consumer segmentation data. This approach allows us to calculate water footprints (both direct and indirect for different products as well as different geographies within the UK. We distinguished between production and consumption footprints where the former is the total water consumed from the UK domestic water resources by the production activities in the UK and the latter is the total water consumed from both domestic and global water resources to satisfy the UK domestic final consumption. The results show that the production water footprint is 439 m3/cap/year, 85% of which is for the final consumption in the UK itself. The average consumption water footprint of the UK is more than three times bigger than the UK production water footprint in 2006. About half of the UK consumption water footprints were associated with imports from Non-OECD countries (many of which are water-scarce, while around 19% were from EU-OECD countries, and only 3% from Non-EU-OECD countries. We find that the water footprint differs considerably across sub-national geographies in the UK, and the differences are as big as 273 m3/cap/year for the internal water footprint and 802 m3/cap/year for the external water footprint. Our results suggest

Your Radiologist Explains Magnetic Resonance Angiography (MRA)

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Full Text Available ... to Radiology Info dot org Hello, I’m Dr. Elliot Fishman, a radiologist at Johns Hopkins Hospital ... of your body and to identify abnormalities and disease. If you’re scheduled for an MRA scan, ...

Your Radiologist Explains Magnetic Resonance Angiography (MRA)

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Full Text Available ... Angiography (MRA) Transcript Welcome to Radiology Info dot org Hello, I’m Dr. Elliot Fishman, a radiologist ... question you might have, visit Radiology Info dot org. Thank you for your time and for your ...

Your Radiologist Explains Magnetic Resonance Angiography (MRA)

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Full Text Available ... An MRI Story Radiology and You Sponsored by Image/Video Gallery Your Radiologist Explains Magnetic Resonance Angiography ( ... posted: How to Obtain and Share Your Medical Images Movement Disorders Video: The Basketball Game: An MRI ...

Reading screening mammograms – Attitudes among radiologists and radiographers about skill mix

International Nuclear Information System (INIS)

Johansen, Lena Westphal; Brodersen, John

2011-01-01

Introduction: Because of shortage of personnel for the Danish mammography screening programme, the aim of this study was to investigate the attitudes of radiologists and radiographers towards a future implementation of radiographers reading screening mammograms. Materials and methods: Seven combined phenomenological and hermeneutical interviews with radiographers and radiologists were performed. Stratified selection was used for sampling of informants. The interviews were analysed against theory about quality, organization and profession. Results: Quality related possibilities: radiographers do routinely measure the performance quality, radiographers obtain sufficient reading qualifications, and skill mix improves quality. Quality related obstacles: radiologists do not routinely measure performance quality. Organization related possibilities: shortage of radiologists, positive attitudes of managers, and improved working relations. Organization related obstacles: shortage of radiographers and negative attitudes of managers. Professional related possibilities: positive experience with skill mix. Professional related obstacles: worries about negative consequences for the training of radiologists, and resistance against handing over tasks to another profession. Conclusion: Attitudes towards radiographers reading screening mammograms are attached to either quality-, organisational or professional perspectives. Radiographers are capable of learning to read mammograms at sufficient performance level but routine measurement of performance quality is essential. Resistance against skill mix may be caused by an emotionally conditioned fear of losing demarcations. The main motive for skill mix is improvement of the utilization of resources. No evidence was found regarding the organisational and financial consequences of skill mix. Despite of this all radiologists and radiographers experienced with skill mix were strong advocates for reading radiographers.

A survey on visual information search behavior and requirements of radiologists.

Science.gov (United States)

Markonis, D; Holzer, M; Dungs, S; Vargas, A; Langs, G; Kriewel, S; Müller, H

2012-01-01

The main objective of this study is to learn more on the image use and search requirements of radiologists. These requirements will then be taken into account to develop a new search system for images and associated meta data search in the Khresmoi project. Observations of the radiology workflow, case discussions and a literature review were performed to construct a survey form that was given online and in paper form to radiologists. Eye tracking was performed on a radiology viewing station to analyze typical tasks and to complement the survey. In total 34 radiologists answered the survey online or on paper. Image search was mentioned as a frequent and common task, particularly for finding cases of interest for differential diagnosis. Sources of information besides the Internet are books and discussions with colleagues. Search for images is unsuccessful in around 25% of the cases, stopping the search after around 10 minutes. The most common reason for failure is that target images are considered rare. Important additions for search requested in the survey are filtering by pathology and modality, as well as search for visually similar images and cases. Few radiologists are familiar with visual retrieval but they desire the option to upload images for searching similar ones. Image search is common in radiology but few radiologists are fully aware of visual information retrieval. Taking into account the many unsuccessful searches and time spent for this, a good image search could improve the situation and help in clinical practice.

Experiences with a self-test for Dutch breast screening radiologists: lessons learnt

NARCIS (Netherlands)

Timmers, J. M. H.; Verbeek, A. L. M.; Pijnappel, R. M.; Broeders, M. J. M.; den Heeten, G. J.

2014-01-01

To evaluate a self-test for Dutch breast screening radiologists introduced as part of the national quality assurance programme. A total of 144 radiologists were invited to complete a test-set of 60 screening mammograms (20 malignancies). Participants assigned findings such as location, lesion type

Preliminary report of an intervention to improve mammography skills of radiologists

International Nuclear Information System (INIS)

D'Orsi, C.J.; Karellas, A.; Costanza, M.E.; Gaw, V.P.

1989-01-01

This paper presents a preliminary report of an intervention to improve mammography skills of radiologists. Although implementation of the screening guidelines has not occurred as readily as had been anticipated, use of mammograms is increasing. As the demand for this relatively new technology increases, both the availability of the test and the quality of the test done are valid concerns. Until recently, few radiology training programs provided trainees with opportunities to develop these skills. As a result, few radiologists who have been in practice more than five years have had formal training in the interpretation of mammograms. Thus providing practicing radiologists with the opportunities to develop skills in mammographic interpretation will serve to increase both availability and quality of mammographic exams

Your Radiologist Explains Magnetic Resonance Angiography (MRA)

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Full Text Available ... Sponsored by Image/Video Gallery Your Radiologist Explains Magnetic Resonance Angiography (MRA) Transcript Welcome to Radiology Info dot ... I’d like to talk with you about magnetic resonance angiography, or as it’s commonly known, MRA. MRA ...

Overseas trained nurses' perception of UK nurses' caring attitudes: a qualitative study.

Science.gov (United States)

Alexis, Obrey

2009-08-01

The aim of this study was to explore overseas nurses' perception of their nursing colleagues' caring attitudes in the National Health Service (NHS) in the UK. A qualitative phenomenological approach using semi-structured interviews was used to obtain data from 12 overseas nurses. The interview transcripts were transcribed verbatim and analysed using van Manen thematic approach. Although many themes emerged following thematic analysis, this study will report the findings of three themes such as empathy, understanding and caring perspectives, emotional impact and lack of teamwork. In conclusion, this study provides an insight and it increases our understanding of overseas nurses' perceptions of their nursing colleagues' caring attitudes in the NHS in the UK. This paper concludes by indicating that teamwork, being empathetic, understanding and reducing emotional labour for overseas nurses could lead to a more satisfied working environment for overseas nurses in the NHS in the UK.

MRI of the prostate in Germany. Online survey among radiologists

Energy Technology Data Exchange (ETDEWEB)

Mueller-Lisse, U.G.; Reiser, M. [Univ. Munich (Germany). Dept. of Radiology; Lewerich, B. [Deutsche Roentgengesellschaft, Geschaeftsstelle, Berlin (Germany); Mueller-Lisse, U.L. [Interdisziplinaeres Onkologisches Zentrum Muenchen (IOZ) (Germany). Dept. of Urology; Scherr, M.K. [Berufsgenossenschaftliche Unfallklinik, Dept. of Radiology, Murnau (Germany)

2015-08-15

To assess structural, technical, and communicative aspects of dedicated MR examinations of the prostate (MRP) offered by radiologists in Germany. We conducted an eight-item online survey among members of the German Radiology Society (DRG). Radiological institutions were asked about their structure, i. e., either hospital department (HD) or private practice (PP), number of board-certified radiologists, postal regions, number of MRPs in 2011, MR technology and MR sequences applied, ways to communicate results, and feedback from referring physicians on results of subsequent tests and procedures. Submissions were cleared of redundancies and anonymized. Differences in the number of positive replies to each item were statistically significant at p < 0.05 for two-tailed testing in 2 x 2 tables. The survey represented board-certified radiologists in 128 institutions (63 HDs and 65 PPs) in 67/95 German postal regions (71 %). Almost two-thirds of institutions performed 11 to 50 MRPs in 2011, more often at 1.5 T (116/128, 91 %) than at 3.0 T (36/128, 28 %), and most frequently with surface coils (1.5 T, 88/116, 76 %; 3.0 T, 34/36, 94 %; chi-square, 1.9736, 0.1 < p < 0.25). About two-thirds of 1.5 T users and 90 % of 3.0 T users applied at least one functional MR modality (diffusion-weighted imaging, dynamic contrast-enhanced imaging, or MR spectroscopy) for MRP. Reports including graphic representations of the prostate were applied by 21/128 institutions (16 %). Clinical feedback after MRP to radiologists other than upon their own request was infrequent (HDs, 32 - 45 %, PPs, 18 - 32 %). MRP was a widely available, small-volume examination among radiologists in Germany in 2011. The technology mainstay was a 1.5 T surface coil examination including at least one functional MR modality. Dedicated reporting and feedback mechanisms for quality control were underdeveloped.

MRI of the prostate in Germany. Online survey among radiologists

International Nuclear Information System (INIS)

Mueller-Lisse, U.G.; Reiser, M.; Mueller-Lisse, U.L.

2015-01-01

To assess structural, technical, and communicative aspects of dedicated MR examinations of the prostate (MRP) offered by radiologists in Germany. We conducted an eight-item online survey among members of the German Radiology Society (DRG). Radiological institutions were asked about their structure, i. e., either hospital department (HD) or private practice (PP), number of board-certified radiologists, postal regions, number of MRPs in 2011, MR technology and MR sequences applied, ways to communicate results, and feedback from referring physicians on results of subsequent tests and procedures. Submissions were cleared of redundancies and anonymized. Differences in the number of positive replies to each item were statistically significant at p < 0.05 for two-tailed testing in 2 x 2 tables. The survey represented board-certified radiologists in 128 institutions (63 HDs and 65 PPs) in 67/95 German postal regions (71 %). Almost two-thirds of institutions performed 11 to 50 MRPs in 2011, more often at 1.5 T (116/128, 91 %) than at 3.0 T (36/128, 28 %), and most frequently with surface coils (1.5 T, 88/116, 76 %; 3.0 T, 34/36, 94 %; chi-square, 1.9736, 0.1 < p < 0.25). About two-thirds of 1.5 T users and 90 % of 3.0 T users applied at least one functional MR modality (diffusion-weighted imaging, dynamic contrast-enhanced imaging, or MR spectroscopy) for MRP. Reports including graphic representations of the prostate were applied by 21/128 institutions (16 %). Clinical feedback after MRP to radiologists other than upon their own request was infrequent (HDs, 32 - 45 %, PPs, 18 - 32 %). MRP was a widely available, small-volume examination among radiologists in Germany in 2011. The technology mainstay was a 1.5 T surface coil examination including at least one functional MR modality. Dedicated reporting and feedback mechanisms for quality control were underdeveloped.

WE-G-19A-01: Radiologists and Medical Physicists: Working Together to Achieve Common Goals

International Nuclear Information System (INIS)

Jones, A; Ma, J; Steele, J; Choi, H

2014-01-01

It is vitally important that medical physicists understand the clinical questions that radiologists are trying to answer with patient images. Knowledge of the types of information the radiologist needs helps medical physicists configure imaging protocols that appropriately balance radiation dose, time, and image quality. The ability to communicate with radiologists and understand medical terminology, anatomy, and physiology is key to creating such imaging protocols. In this session, radiologists will present clinical cases and describe the information they are seeking in the clinical images. Medical physicists will then discuss how imaging protocols are configured. Learning Objectives: Understand the types of information that radiologists seek in medical images. Apply this understanding in configuring the imaging equipment to deliver this information. Develop strategies for working with physician colleagues

WE-G-19A-01: Radiologists and Medical Physicists: Working Together to Achieve Common Goals

Energy Technology Data Exchange (ETDEWEB)

Jones, A; Ma, J; Steele, J; Choi, H [UT MD Anderson Cancer Center, Houston, TX (United States)

2014-06-15

It is vitally important that medical physicists understand the clinical questions that radiologists are trying to answer with patient images. Knowledge of the types of information the radiologist needs helps medical physicists configure imaging protocols that appropriately balance radiation dose, time, and image quality. The ability to communicate with radiologists and understand medical terminology, anatomy, and physiology is key to creating such imaging protocols. In this session, radiologists will present clinical cases and describe the information they are seeking in the clinical images. Medical physicists will then discuss how imaging protocols are configured. Learning Objectives: Understand the types of information that radiologists seek in medical images. Apply this understanding in configuring the imaging equipment to deliver this information. Develop strategies for working with physician colleagues.

Radiographers and trainee radiologists reporting accident radiographs: A comparative plain film-reading performance study

International Nuclear Information System (INIS)

Buskov, L.; Abild, A.; Christensen, A.; Holm, O.; Hansen, C.; Christensen, H.

2013-01-01

Aim: To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital. Materials and methods: Plain radiographs of the appendicular skeleton from 1000 consecutive emergency room patients were included in the study: 500 primarily reported by radiographers and 500 by trainee radiologists. The final reporting was subsequently undertaken by a consultant radiologist in consensus with an orthopaedic surgeon. Two observers classified reports as either true positive/negative or false positive/negative based on the final report, which was considered the reference standard. To evaluate the severity of incorrect primary reports, errors were graded into three categories concerning clinical impact and erroneous reports graded as the most severe category were subsequently analysed. Mann–Whitney and Chi-squared tests were used to compare differences and associations between radiographers versus trainee radiologists regarding film reporting. Results: The sensitivity for correct diagnosis was 99% for reporting radiographers and 94% for trainee radiologists. The specificity was found to be 97% for reporting radiographers and 99% for trainee radiologists. Radiographers missed significantly fewer fractures (n = 2) than trainee radiologists (n = 14; p = 0.006) but had a higher, but not significant, degree of overcalling. No significant difference was found between groups regarding clinical impact of incorrect reporting. Conclusion: Trained radiographers report accident radiographs of the extremities with high accuracy and constitute a qualified resource to help meet increasing workload and demands in quality standards.

Form follows function: the architecture of operational requirements. [Winstow Mine of UK

Energy Technology Data Exchange (ETDEWEB)

Crawford, C W

1984-07-01

Wistow Mine, in the Selby Coalfield (UK) has recently received a Festival of Architecture Award. The success of the visual appearance of the site is the result of careful consideration of the NCB's operational requirements, by a special design team, and the subsequent development of designs for all the buildings on the site and the layout of the site itself, which satisfy those requirements.

Questions of an otorhinolaryngologist to a radiologist

International Nuclear Information System (INIS)

Theopold, H.M.

1982-01-01

The otorhinolaryngologist expects the radiologist to answer very quickly in emergencies such as complications of inflammatory processes of the paranasal accessory sinuses, diseases, tumours, and skull traumatology. Aspects of conventional X-ray diagnosis, X-ray tomography, and computerized tomography are discussed. (APR) [de

The U.S. Radiologist Workforce: An Analysis of Temporal and Geographic Variation by Using Large National Datasets.

Science.gov (United States)

Rosenkrantz, Andrew B; Hughes, Danny R; Duszak, Richard

2016-04-01

To determine recent trends related to temporal as well as national and statewide geographic variation in the U.S. radiologist and radiology resident workforce. This retrospective HIPAA-compliant study was exempted from the internal review board. Federal Area Health Resources Files and Medicare 5% research identifiable files were used to compute parameters related to the radiologist workforce. Geographic variation and annual temporal trends were analyzed. Pearson and Spearman correlations were assessed. Nationally, the number of radiology trainees increased 84.2% from a nadir in 1997 (3080 trainees) to 2011 (5674 trainees) and showed high state-to-state variation (range, 0-678 trainees in 2011). However, total radiologists nationally increased 39.2% from 1995 (27 906 radiologists) to 2011 (38 875 radiologists), and radiologists per 100 000 population nationally increased by 7.5% from 1995 (10.62%) to 2011 (11.42%), while showing high state-to-state variation (highest-to-lowest state ratio of 4.3). Radiologists' share of the overall physician workforce declined nationally by 8.8% from 1995 (4.0%) to 2011 (3.7%), with moderate state-to-state variation (highest-to-lowest state ratio of 1.7). Radiology trainee numbers exhibited weak-to-moderate positive state-by-state correlation with radiologists per 100 000 population (r = 0.292-0.532), but moderate-to-strong inverse correlation with the percentage of radiologists in rural practice (r = -0.464 to -0.635). Although the number of radiology trainees dramatically increased, radiologists per 100 000 population increased only slightly, and radiologists' share of the overall physician workforce declined. State-to-state variations in radiologist and radiology resident workforces are high, which suggests a potential role for geographic redistribution rather than changes in the overall workforce size.

HOW DO RADIOLOGISTS USE THE HUMAN SEARCH ENGINE?

Science.gov (United States)

Wolfe, Jeremy M; Evans, Karla K; Drew, Trafton; Aizenman, Avigael; Josephs, Emilie

2016-06-01

Radiologists perform many 'visual search tasks' in which they look for one or more instances of one or more types of target item in a medical image (e.g. cancer screening). To understand and improve how radiologists do such tasks, it must be understood how the human 'search engine' works. This article briefly reviews some of the relevant work into this aspect of medical image perception. Questions include how attention and the eyes are guided in radiologic search? How is global (image-wide) information used in search? How might properties of human vision and human cognition lead to errors in radiologic search? © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Performance in the FRCR (UK) Part 2B examination: Analysis of factors associated with success

International Nuclear Information System (INIS)

Hawtin, K.E.; Williams, H.R.T.; McKnight, L.; Booth, T.C.

2014-01-01

Aim: To assess factors that influence pass rates and examination scores in the Fellowship of the Royal College of Radiologists (FRCR) 2B examination. Materials and methods: 2238 attempts at the FRCR 2B examination were evaluated between Spring 2006 and Spring 2010. Pass rates and examination scores were analysed by gender and ethnicity, and the influence of factors such as radiology training (UK versus non-UK), sitting (Spring versus Autumn), and the presence of an undergraduate or postgraduate degree were examined. Results: 1571 candidates made 2238 examination attempts, with an overall pass rate of 59.4% (63.1% at first attempt). 66.2% entrants were male; 48.8% attempts were by candidates from a UK radiology training scheme. UK candidates were significantly more likely to pass than non-UK candidates (p < 0.0001). White candidates were more likely to pass at first or second attempt than non-white candidates (p < 0.0001), but when restricted to UK entrants ethnicity did not influence success at first attempt. Overall, females were more successful than males (p < 0.001). Presence of an undergraduate (p = 0.19) or postgraduate (p = 0.80) degree did not affect pass rate at first attempt for UK candidates. However, logistic regression demonstrated that the only significant factor influencing pass rates at first attempt was whether radiology training was undertaken in the UK (p < 0.0001). A trend towards increased pass rates in autumn sittings was seen (p = 0.06), but ethnicity (p = 0.99) and gender (p = 0.41) were not significant factors. Conclusion: The FRCR 2B examination is non-discriminatory for UK candidates with respect to gender and ethnicity. Poorer performance of non-UK trained candidates is a consistent outcome in the literature. - Highlights: • Factors influencing pass rates and scores in FRCR 2B examination were assessed. • UK candidates are more likely to pass than non-UK candidates. • There is no effect of gender or ethnicity on UK

Book Review: Radiology where there are no radiologists ...

African Journals Online (AJOL)

Abstract. "Radiology Where There Are no Radiologists" "Manual of Radiographic interpretation for General Practitioners" Palmer, ps., Cockshott, WP., Hegedus v., Samuel, E.: WHO Basic Radiological System WHO, Geneva, 1985 (SFr. 23) ...

Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?

International Nuclear Information System (INIS)

Schellhammer, F.

2003-01-01

Purpose: Prompt and effective cardiopulmonary resuscitation (CPR) decreases morbidity and mortality following cardiopulmonary arrest. Radiologists are frequently confronted with severely ill patients, who may deteriorate at any time. Furthermore, they have to be aware of life-threatening reactions towards contrast media. This study was designed to assess experience and self-estimation of German-speaking radiologists in CPR and cardiac defibrillation (CD). Material and Methods: 650 German-speaking radiologists were audited by a specially designed questionnaire, which was sent via e-mail. The answers were expected to be re-mailed within a 2-month period. Results: The response rate was 12.6%. 72.8% of the responders had performed at least 1 CPR (range 9.5 ± 13.1) and 37% at least 1 CD. 67.9% had had opportunities to attend training courses, which had been utilized by 41.8% of them. The last training of the responders was more than 2 years ago in 69.2% and more than 5 years ago in 37%. Of all responders 75.6% expressed the need for further education. Conclusion: The small response rate indicates the small importance of CPR in the subpopulation surveyed. The vast majority of the responders, however, showed interest in basic and advanced life support and advocated regular updates. It seems reasonable that radiological Dept. themselves should organize courses in order to cope with their specific situations

Do Radiologists Want/Need Training in Cardiopulmonary Resuscitation?

Energy Technology Data Exchange (ETDEWEB)

Schellhammer, F. [St. Katharinen Hospital, Frechen (Germany). Dept. of Radiology

2003-03-01

Purpose: Prompt and effective cardiopulmonary resuscitation (CPR) decreases morbidity and mortality following cardiopulmonary arrest. Radiologists are frequently confronted with severely ill patients, who may deteriorate at any time. Furthermore, they have to be aware of life-threatening reactions towards contrast media. This study was designed to assess experience and self-estimation of German-speaking radiologists in CPR and cardiac defibrillation (CD). Material and Methods: 650 German-speaking radiologists were audited by a specially designed questionnaire, which was sent via e-mail. The answers were expected to be re-mailed within a 2-month period. Results: The response rate was 12.6%. 72.8% of the responders had performed at least 1 CPR (range 9.5 {+-} 13.1) and 37% at least 1 CD. 67.9% had had opportunities to attend training courses, which had been utilized by 41.8% of them. The last training of the responders was more than 2 years ago in 69.2% and more than 5 years ago in 37%. Of all responders 75.6% expressed the need for further education. Conclusion: The small response rate indicates the small importance of CPR in the subpopulation surveyed. The vast majority of the responders, however, showed interest in basic and advanced life support and advocated regular updates. It seems reasonable that radiological Dept. themselves should organize courses in order to cope with their specific situations.

Diagnostic performance of radiographers as compared to radiologists in magnetic resonance colonography

International Nuclear Information System (INIS)

Zijta, F.M.; Florie, J.; Jensch, S.; Bipat, S.; Nievelstein, R.A.J.; Poulus, M.; Thomassen-de Graaf, M.A.; Montauban van Swijndregt, A.D.; Stoker, J.

2010-01-01

Purpose: To evaluate the diagnostic performance of radiographers compared to radiologists in the detection of colorectal lesions in MR colonography. Material and methods: 159 patients at increased risk of colorectal cancer were included. Four different experienced observers, one MR radiologist, one radiologist in training and two radiographers evaluated all MR colonography examinations. The protocol included T1-weighted and T2-weighted sequences in prone and supine position. Colonoscopy was used as reference standard. Mean sensitivity rates with 95% confidence intervals (CIs) were determined on a per-patient and per-polyp basis, segmented by size (≥6 mm and ≥10 mm). Specificity was calculated on a per-patient basis. The McNemar and chi-square (χ 2 ) test was used to determine significant differences. Results: At colonoscopy 74 patients (47%) had normal findings; 23 patients had 40 polyps with a size ≥6 mm. In 10 patients at least 1 polyp ≥10 mm was found (20 polyps in total). Similar sensitivities for patients with lesions ≥10 mm were found for radiologists and radiographers (65% (95%CI: 44-86%) vs. 50% (95%CI: 28-72%)) (p = n.s.). For lesions ≥10 mm combined per-patient specificity for radiologists and radiographers was 96% (95%CI: 94-98%) and 73% (95%CI: 68-79%) (p < 0.0001). Combined per-patient sensitivity for lesions ≥6 mm differed significantly between both groups of observers (57% (95%CI: 42-71%) vs. 33% (95%CI: 19-46%)) (p = 0.03). Conclusion: Radiographers have comparable sensitivity but lower specificity relative to radiologists in the detection of colorectal lesions ≥10 mm at MR colonography. Adequate training in evaluating MR colonography is necessary, especially for readers with no prior experience with colonography.

Computer-aided detection (CAD) in mammography: Does it help the junior or the senior radiologist?

International Nuclear Information System (INIS)

Balleyguier, Corinne; Kinkel, Karen; Fermanian, Jacques; Malan, Sebastien; Djen, Germaine; Taourel, Patrice; Helenon, Olivier

2005-01-01

Objectives: To evaluate the impact of a computer-aided detection (CAD) system on the ability of a junior and senior radiologist to detect breast cancers on mammograms, and to determine the potential of CAD as a teaching tool in mammography. Methods: Hundred biopsy-proven cancers and 100 normal mammograms were randomly analyzed by a CAD system. The sensitivity (Se) and specificity (Sp) of the CAD system were calculated. In the second phase, to simulate daily practice, 110 mammograms (97 normal or with benign lesions, and 13 cancers) were examined independently by a junior and a senior radiologist, with and without CAD. Interpretations were standardized according to BI-RADS classification. Sensitivity, Specificity, positive and negative predictive values (PPV, NPV) were calculated for each session. Results: For the senior radiologist, Se slightly improved from 76.9 to 84.6% after CAD analysis (NS) (one case of clustered microcalcifications case overlooked by the senior radiologist was detected by CAD). Sp, PPV and PNV did not change significantly. For the junior radiologist, Se improved from 61.9 to 84.6% (significant change). Three cancers overlooked by the junior radiologist were detected by CAD. Sp was unchanged. Conclusion: CAD mammography proved more useful for the junior than for the senior radiologist, improving sensitivity. The CAD system may represent a useful educational tool for mammography

Cochlear implant: what the radiologist should know

Directory of Open Access Journals (Sweden)

Natalia Delage Gomes

2013-06-01

Full Text Available Cochlear implant is the method of choice in the treatment of deep sensorineural hypoacusis, particularly in patients where conventional amplification devices do not imply noticeable clinical improvement. Imaging findings are crucial in the indication or contraindication for such surgical procedure. In the assessment of the temporal bone, radiologists should be familiar with relative or absolute contraindication factors, as well as with factors that might significantly complicate the implantation. Some criteria such as cochlear nerve aplasia, labyrinthine and/or cochlear aplasia are still considered as absolute contraindications, in spite of studies bringing such criteria into question. Cochlear dysplasias constitute relative contraindications, among them labyrinthitis ossificans is highlighted. Other alterations may be mentioned as complicating agents in the temporal bone assessment, namely, hypoplasia of the mastoid process, aberrant facial nerve, otomastoiditis, otosclerosis, dehiscent jugular bulb, enlarged endolymphatic duct and sac. The experienced radiologist assumes an important role in the evaluation of this condition.

Cochlear implant: what the radiologist should know

International Nuclear Information System (INIS)

Gomes, Natalia Delage; Couto, Caroline Laurita Batista; Gaiotti, Juliana Oggioni; Costa, Ana Maria Doffemond; Ribeiro, Marcelo Almeida; Diniz, Renata Lopes Furletti Caldeira

2013-01-01

Cochlear implant is the method of choice in the treatment of deep sensorineural hypoacusis, particularly in patients where conventional amplification devices do not imply noticeable clinical improvement. Imaging findings are crucial in the indication or contraindication for such surgical procedure. In the assessment of the temporal bone, radiologists should be familiar with relative or absolute contraindication factors, as well as with factors that might significantly complicate the implantation. Some criteria such as cochlear nerve aplasia, labyrinthine and/or cochlear aplasia are still considered as absolute contraindications, in spite of studies bringing such criteria into question. Cochlear dysplasias constitute relative contraindications, among them labyrinthitis ossificans is highlighted. Other alterations may be mentioned as complicating agents in the temporal bone assessment, namely, hypoplasia of the mastoid process, aberrant facial nerve, otomastoiditis, otosclerosis, dehiscent jugular bulb, enlarged endolymphatic duct and sac. The experienced radiologist assumes an important role in the evaluation of this condition. (author)

Radiologist and angiographic procedures. Absorbed radiation dose

International Nuclear Information System (INIS)

Tryhus, M.; Mettler, F.A. Jr.; Kelsey, C.

1987-01-01

The radiation dose absorbed by the angiographer during angiographic procedures is of vital importance to the radiologist. Nevertheless, most articles on the subject are incomplete, and few measure gonadal dose. In this study, three TLDs were used for each of the following sites: radiologist's eyes, thyroid, gonads with and without shielding apron, and hands. The average dose during carotid angiograms was 2.6, 4.1, 0.4, 4.7, and 7.1 mrads to the eyes, thyroid, gonads with and without .5 mm of lead shielding, and hands, respectively. Average dose during abdominal and peripheral vascular angiographic procedures was 5.2, 7.5, 1.2, 8.5, and 39.9 mrads to the eyes, thyroid, gonads with and without shielding, and hands, respectively. A literature review demonstrates a significant reduction in radiation dose to the angiographer after the advent of automated injectors. Our measured doses for carotid angiography are compatible with contemporary reported values. There was poor correlation with fluoroscopy time and measured dose to the angiographer

The relationship between back pain and lead apron use in radiologists

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Moore, B.; vanSonnenberg, E.; Casola, G.; Novelline, R.A. (Department of Radiology, University of California, San Diego (Unites States))

1992-01-01

Anecdotal experience has suggested that back pain in radiologists may result from extensive wearing of lead aprons. To investigate this possibility, the authors sent questionnaires to 688 radiologists in various subspecialties whose use of lead aprons varied from none to moderate to extensive. The questionnaire included both objective items that quantitated apron use and back pain and subjective items that asked, for example, if the respondent believed that lead aprons were responsible for his or her back pain. They received 236 responses (34% response rate). Objective data from those radiologists who had experienced no back pain before wearing a lead apron (179 radiologists, 26% of those surveyed) were tabulated; respondents were grouped according to age, time spent wearing a lead apron, and degree of back pain. Odds ratios were calculated. Answers to subjective questions for all respondents were tabulated. Back pain was reported by 52% of those who estimated their lead apron use at greater than or equal to 10 hr per week, the mean response, as opposed to 46% of those who wore lead aprons fewer than 10 hr a week. These and related results were not statistically significant. Our study does not prove that wearing a lead apron is a significant risk factor for the development of back pain.

The relationship between back pain and lead apron use in radiologists

International Nuclear Information System (INIS)

Moore, B.; vanSonnenberg, E.; Casola, G.; Novelline, R.A.

1992-01-01

Anecdotal experience has suggested that back pain in radiologists may result from extensive wearing of lead aprons. To investigate this possibility, the authors sent questionnaires to 688 radiologists in various subspecialties whose use of lead aprons varied from none to moderate to extensive. The questionnaire included both objective items that quantitated apron use and back pain and subjective items that asked, for example, if the respondent believed that lead aprons were responsible for his or her back pain. They received 236 responses (34% response rate). Objective data from those radiologists who had experienced no back pain before wearing a lead apron (179 radiologists, 26% of those surveyed) were tabulated; respondents were grouped according to age, time spent wearing a lead apron, and degree of back pain. Odds ratios were calculated. Answers to subjective questions for all respondents were tabulated. Back pain was reported by 52% of those who estimated their lead apron use at greater than or equal to 10 hr per week, the mean response, as opposed to 46% of those who wore lead aprons fewer than 10 hr a week. These and related results were not statistically significant. Our study does not prove that wearing a lead apron is a significant risk factor for the development of back pain

Expanding the use of Microsoft PowerPoint. An overview for radiologists

International Nuclear Information System (INIS)

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

2006-01-01

Most radiologists need to give a lecture, present research or speak at a scientific meeting at some stage in their career. In our technologically advanced world, electronic presentations have become the norm and are almost universally expected. Microsoft PowerPoint is by far and away the most commonly used computer-based presentation package. As a result most radiologists have developed at least a modicum of PowerPoint expertise but many lack the time or inclination to develop these skills further. The purpose of this article is to explain how to expand the use of PowerPoint with freely available resources from the internet, to highlight websites where useful information on advanced PowerPoint techniques can be found, and to discuss extended functions of PowerPoint likely to be of interest to radiologists such as poster design

The 'Battered-Child-Syndrome': The view of the pediatric radiologist

International Nuclear Information System (INIS)

Greinacher, I.; Troeger, J.

1982-01-01

The diagnosis of the Battered-Child-Syndrome (BSC) is made by the pediatrician and the radiologist. The recognition of this entity by the radiologist is possible because of the high frequency of the typical skeletal lesions. This skeletal changes are illustrated by X-ray pictures and bone scans. Not only skeletal trauma can be discovered but also visceral injuries may be combined and diagnosed in the BCS. For the detection of all changes in the BCS nowadays all possible imaging procedures should be used. Some forensic problems in this field are added. (orig.)

The relationship between oncologists and peripheral hospital radiologists in the north-west of England

International Nuclear Information System (INIS)

Bungay, Peter M.; Carrington, Bernadette M.; Corgie, Delphine; Eardley, Anne

2002-01-01

AIM: To audit the relationship between Cancer Centre oncologists visiting peripheral hospitals and peripheral hospital radiologists by assessing (i) oncologists' knowledge of local radiological services; (ii) oncologists' perceptions of peripheral radiological services; (iii) peripheral radiologist's perceptions of oncologists; (iv) barriers to communication. MATERIALS AND METHODS: A postal questionnaire was sent to all radiology departments visited by an oncologist, and to all medical and clinical oncologists from two regional oncology centres. RESULTS: The response rate was 100% (21 peripheral hospital radiology departments and all 35 oncologists). (i) Oncologists' knowledge of peripheral hospital imaging modalities was limited (especially MRI and intervention). (ii) 72% of oncologists rated the peripheral hospital radiology service as excellent or good, 46% rated the radiology report quality excellent to good. Deficiencies in oncological reports were identified. (iii) 44% of radiologists thought the oncologist did not relate well with the local radiology department. 50% of radiologists did not know the visiting oncologist's specialist interest. (iv) 69% of oncologists did not regularly attend peripheral hospital clinico-radiological meetings. Lack of written and oral information was hampering both specialities. CONCLUSION: Communication between oncologists and the local radiology department should include: (1) information about local radiology services for visiting oncologists (including trainees) and on the oncology team for radiologists; (2) standardized report content; (3) improved clinical information for radiologists; (4) regular clinico-radiological meetings. Bungay, P.M. et al. (2002)

A national UK survey of radiology trainees special interest choices: what and why?

Science.gov (United States)

Parvizi, Nassim; Bhuva, Shaheel

2017-11-01

A national survey was designed to better understand factors influencing special interest choices, future aspirations of UK radiology trainees and perceptions of breast radiology. A SurveyMonkey questionnaire was developed and distributed to all radiology trainees in the UK through the British Institute of Radiology, RCR Junior Radiologists Forum and by directly contacting UK training schemes as well as by social media between December 2015 and January 2016. From 21 training schemes across the UK, 232 responses were received. Over half entered radiology after foundation training and 62% were ST1-3; one-fifth of trainees intended to leave the NHS. The most popular special interests were musculoskeletal (18%), abdominal imaging (16%) and neuroradiology (13%). Gynaecological and oncological imaging proved to be the least popular. Strong personal interest, a successful rotation during training, a mix of imaging modalities, direct impact on patient care and job prospects were the most popular factors influencing career choice. Research and potential for private income were the least influential factors. Respondents detailed their perceptions of breast radiology, selecting an awareness of career prospects (41%) and a better trainee experience (36%) as factors that would increase their interest in pursuing it as a career. Understanding the factors that influence special interest choice is essential to addressing the alarming staffing shortfalls that will befall certain radiology special interests. Addressing trainee's preconceptions and improving the trainee experience are key to attracting trainees to breast radiology. Advances in knowledge: This is the first survey of its kind in the UK literature designed to evaluate special interest career choices and the factors that influence those among radiology trainees.

MACRA, MIPS, and the New Medicare Quality Payment Program: An Update for Radiologists.

Science.gov (United States)

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

2017-03-01

The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 advances the goal of tying Medicare payments to quality and value. In April 2016, CMS published an initial proposed rule for MACRA, renaming it the Quality Payment Program (QPP). Under QPP, clinicians receive payments through either advanced alternative payment models or the Merit-Based Incentive Payment System (MIPS), a consolidation of existing federal performance programs that applies positive or negative adjustments to fee-for-service payments. Most physicians will participate in MIPS. This review highlights implications of the QPP and MIPS for radiologists. Although MIPS incorporates radiology-specific quality measures, radiologists will also be required to participate in other practice improvement activities, including patient engagement. Recognizing physicians' unique practice patterns, MIPS will provide special considerations in performance evaluation for physicians with limited face-to-face patient interaction. Although such considerations will affect radiologists' likelihood of success under QPP, many practitioners will be ineligible for the considerations under currently proposed criteria. Reporting using qualified clinical data registries will benefit radiologists' performance by allowing expanded arrays of MIPS and non-MIPS specialty-specific measures. A group practice reporting option will substantially reduce administrative burden but introduce new challenges by requiring uniform determination of patient-facing status and performance measurement for all of the group's physicians (diagnostic radiologists, interventional radiologists, and nonradiologists) under the same taxpayer identification number. Given that the initial MIPS performance period begins in 2017, radiologists must begin preparing for QPP and taking actions to ensure their future success under this new quality-based payment system. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights

Inborn errors of metabolism for the diagnostic radiologist

Energy Technology Data Exchange (ETDEWEB)

Hendriksz, Chris J. [Birmingham Children' s Hospital NHS Foundation Trust, Department of Clinical Inherited Metabolic Disorders, Birmingham (United Kingdom)

2009-03-15

Inherited metabolic disorders are becoming more important with the increasing availability of diagnostic methods and therapies for these conditions. The radiologist has become an important link in making the diagnosis or collaborating with the specialist centre to diagnose these disorders and monitor effects of therapy. The modes of presentation, disease-specific groups, classic radiological features and investigations are explored in this article to try and give the general radiologist some crucial background knowledge. The following presentations are covered: acute intoxication, hypoglycaemia, developmental delay and storage features. Specific groups of disorders covered are the abnormalities of intermediary metabolism, disorders of fatty acid oxidation and ketogenesis, mitochondrial disorders, lysosomal storage disorders, and, briefly, other groups such as peroxisomal disorders, disorders of glycosylation, and creatine synthesis disorders. New advances and the demands for monitoring are also briefly explored. (orig.)

Inborn errors of metabolism for the diagnostic radiologist

International Nuclear Information System (INIS)

Hendriksz, Chris J.

2009-01-01

Inherited metabolic disorders are becoming more important with the increasing availability of diagnostic methods and therapies for these conditions. The radiologist has become an important link in making the diagnosis or collaborating with the specialist centre to diagnose these disorders and monitor effects of therapy. The modes of presentation, disease-specific groups, classic radiological features and investigations are explored in this article to try and give the general radiologist some crucial background knowledge. The following presentations are covered: acute intoxication, hypoglycaemia, developmental delay and storage features. Specific groups of disorders covered are the abnormalities of intermediary metabolism, disorders of fatty acid oxidation and ketogenesis, mitochondrial disorders, lysosomal storage disorders, and, briefly, other groups such as peroxisomal disorders, disorders of glycosylation, and creatine synthesis disorders. New advances and the demands for monitoring are also briefly explored. (orig.)

Career choices for radiology: national surveys of graduates of 1974-2002 from UK medical schools

International Nuclear Information System (INIS)

Turner, G.; Lambert, T.W.; Goldacre, M.J.

2006-01-01

Aim: To report on trends in career choices for radiology among UK medical graduates. Materials and methods: One and 3 years after graduation, and at longer time intervals thereafter, postal questionnaire surveys were sent to all doctors who graduated from UK medical schools in 1974, 1977, 1980, 1983, 1993, 1996, 1999, 2000 and 2002. Doctors were asked to specify their choice of long-term career and to identify factors influencing their choice. Employment details were also collected. Results were analysed using χ 2 statistics and binary logistic regression. Results: Seventy-four percent (24,621/33,412) and 73% (20,720/28,459) of doctors responded 1 and 3 years after graduation. Choices for radiology in year 1 increased significantly over time (1.7% of 1974 graduates to 3.2% of 2002 graduates; χ 2 test for trend = 15.3, p < 0.001). In particular, there has been a steady increase from the cohorts of 1993 onwards. Thirty-eight percent of those who chose radiology in year 1, and 80% who chose radiology in year 3, were still working in radiology 10 years after graduation. Hours and working conditions influenced long-term career choices more for radiology than for other careers. Conclusions: The proportion of UK trained junior doctors who want to become radiologists has increased in recent years. However, although medical school intake and the numbers making an early choice for radiology have risen, it is unclear whether sufficient UK graduates will be attracted to radiology to fulfil future service requirements from UK trained graduates alone

Inferior Vena Cava Filter Placement and Retrieval Rates among Radiologists and Nonradiologists.

Science.gov (United States)

Guez, David; Hansberry, David R; Eschelman, David J; Gonsalves, Carin F; Parker, Laurence; Rao, Vijay M; Levin, David C

2018-04-01

To evaluate inferior vena cava (IVC) filter placement and retrieval rates among radiologists, vascular surgeons, cardiologists, other surgeons, and all other health care providers for Medicare fee-for-service beneficiaries in the years 2012-2015. The nationwide Medicare Physician/Supplier Procedure Summary Master Files were used to determine the volume and utilization rate of IVC filter placement, IVC filter repositioning, and IVC filter retrieval, which correspond to procedure codes 37191, 37192, and 37193, respectively. Procedural code 37193 was not available before 2012, so data were reviewed for the years 2012-2015. The total volume of Medicare IVC filter placement decreased from 57,785 in 2012 to 44,378 in 2015, with radiologists responsible for 60% of all filter placements. Volume of IVC filter placement declined across all specialties, including radiologists, who placed 33,744 in 2012 and 27,957 in 2015. In contrast, total retrieval of IVC filters increased from 4,060 removals in 2012 to 6,166 in 2015. Retrieval rate per 100,000 Medicare beneficiaries increased from 11 in 2012 to 16 in 2015. Radiologists removed the bulk of the filters: 64% in both 2012 and 2015. Vascular surgeons, cardiologists, and other surgeons retrieved, respectively, 20%, 10%, and 5% of all IVC filters in 2012 and 22%, 9%, and 5% in 2015. From 2012 to 2015, IVC filter placement steadily decreased across all specialties. Retrieval rate of IVC filters continued to rise over the same period. Radiologists were responsible for the majority of IVC filter placements and retrievals. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Why radiologists lose their hospital contracts: is your contract secure?

Science.gov (United States)

Muroff, Lawrence R

2010-03-01

Previously, a hospital contract meant tenure for the incumbent group of radiologists; however, those days are long gone. Exclusive contracts have morphed into exclusive contracts with carve-outs. Turf erosion has become a fact of life for radiology practices. Now radiologists are losing their hospital contracts in record numbers. Group size, though helpful for a variety of reasons, does not ensure that a practice will be secure in its hospital setting. The reasons that groups lose their hospital contracts are varied, and in this paper, the author discusses the most common ones. Suggestions to help practices avoid this unfortunate fate are presented.

Malpractice suits in chest radiology: an evaluation of the histories of 8265 radiologists.

Science.gov (United States)

Baker, Stephen R; Patel, Ronak H; Yang, Lily; Lelkes, Valdis M; Castro, Alejandro

2013-11-01

The aim of this study was to present rates of claims, causes of error, percentage of cases resulting in a judgment, and average payments made by radiologists in chest-related malpractice cases in a survey of 8265 radiologists. The malpractice histories of 8265 radiologists were evaluated from the credentialing files of One-Call Medical Inc., a preferred provider organization for computed tomography/magnetic resonance imaging in workers' compensation cases. Of the 8265 radiologists, 2680 (32.4%) had at least 1 malpractice suit. Of those who were sued, the rate of claims was 55.1 per 1000 person years. The rate of thorax-related suits was 6.6 claims per 1000 radiology practice years (95% confidence interval, 6.0-7.2). There were 496 suits encompassing 48 different causes. Errors in diagnosis comprised 78.0% of the causes. Failure to diagnose lung cancer was by far the most frequent diagnostic error, representing 211 cases or 42.5%. Of the 496 cases, an outcome was known in 417. Sixty-one percent of these were settled in favor of the plaintiff, with a mean payment of $277,230 (95% confidence interval, 226,967-338,614). Errors in diagnosis, and among them failure to diagnose lung cancer, were by far the most common reasons for initiating a malpractice suit against radiologists related to the thorax and its contents.

Imaging Findings in Elder Abuse: A Role for Radiologists in Detection.

Science.gov (United States)

Wong, Natalie Z; Rosen, Tony; Sanchez, Allen M; Bloemen, Elizabeth M; Mennitt, Kevin W; Hentel, Keith; Nicola, Refky; Murphy, Kieran J; LoFaso, Veronica M; Flomenbaum, Neal E; Lachs, Mark S

2017-02-01

Emergency department assessment represents a critical but often missed opportunity to identify elder abuse, which is common and has serious consequences. Among emergency care providers, diagnostic radiologists are optimally positioned to raise suspicion for mistreatment when reviewing imaging of geriatric injury victims. However, little literature exists describing relevant injury patterns, and most radiologists currently receive neither formal nor informal training in elder abuse identification. We present 2 cases to begin characterisation of the radiographic findings in elder abuse. Findings from these cases demonstrate similarities to suspicious findings in child abuse including high-energy fractures that are inconsistent with reported mechanisms and the coexistence of acute and chronic injuries. Specific injuries uncommon to accidental injury are also noted, including a distal ulnar diaphyseal fracture. We hope to raise awareness of elder abuse among diagnostic radiologists to encourage future large-scale research, increased focus on chronic osseous findings, and the addition of elder abuse to differential diagnoses. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Deep Learning: A Primer for Radiologists.

Science.gov (United States)

Chartrand, Gabriel; Cheng, Phillip M; Vorontsov, Eugene; Drozdzal, Michal; Turcotte, Simon; Pal, Christopher J; Kadoury, Samuel; Tang, An

2017-01-01

Deep learning is a class of machine learning methods that are gaining success and attracting interest in many domains, including computer vision, speech recognition, natural language processing, and playing games. Deep learning methods produce a mapping from raw inputs to desired outputs (eg, image classes). Unlike traditional machine learning methods, which require hand-engineered feature extraction from inputs, deep learning methods learn these features directly from data. With the advent of large datasets and increased computing power, these methods can produce models with exceptional performance. These models are multilayer artificial neural networks, loosely inspired by biologic neural systems. Weighted connections between nodes (neurons) in the network are iteratively adjusted based on example pairs of inputs and target outputs by back-propagating a corrective error signal through the network. For computer vision tasks, convolutional neural networks (CNNs) have proven to be effective. Recently, several clinical applications of CNNs have been proposed and studied in radiology for classification, detection, and segmentation tasks. This article reviews the key concepts of deep learning for clinical radiologists, discusses technical requirements, describes emerging applications in clinical radiology, and outlines limitations and future directions in this field. Radiologists should become familiar with the principles and potential applications of deep learning in medical imaging. © RSNA, 2017.

Evaluation of the Occupational Doses of Interventional Radiologists

International Nuclear Information System (INIS)

Kuipers, Gerritjan; Velders, Xandra L.; Winter, Robbert J. de; Reekers, Jim A.; Piek, Jan J.

2008-01-01

The aim of the present study was to determine whether there is a linear relation between the doses measured above and those measured under the lead apron of the radiologists performing interventional procedures. To monitor radiation exposure the International Commission of Radiological Protection (ICRP) recommends the use of a single dosimeter under the protective apron. To determine the exposure more accurately an additional dosimeter is recommended above the protective apron. The exposure of eight radiologists was monitored with two personal dosimeters during 3 consecutive years. To measure the doses uniformly the two dosimeters were worn in a special holder attached to the lead apron. The two personal dosimeters were replaced every 4 weeks on the same day. The doses above and under the protective aprons of seven radiologists did not differ significantly. A significant lower dose above and under the protective apron was measured for one of the radiologists. During a 4-week period the average dose measured above the lead apron was 3.44 mSv (median, 3.05 mSv), while that under the 0.25-mm lead apron was 0.12 mSv (median, 0.1 mSv). The coefficients of the regression line result in the equation Y = 0.036X - 0.004, with Y as the dose under the lead apron and X as the dose above the lead apron. The statistical analysis of the data established a linear relation between the doses above and those under the lead apron (R 2 = 0.59). Before the special holder was introduced it was not possible to derive a relation between the doses above and those under the lead apron, as the doses were measured at varying places above and under the lead apron. There is no evidence that the effective dose can be estimated more accurately when an additional dosimeter is used. The present study revealed a threshold before doses under the lead apron were measured. Due to the threshold it can be concluded that the doses under the lead apron will not be underestimated easily when doses above the

Frequency of recommendations for additional imaging in diagnostic ultrasound examinations: Evaluation of radiologist, technologist, and other examination-related factors.

Science.gov (United States)

Margolis, Nathaniel E; Rosenkrantz, Andrew B; Babb, James S; Macari, Michael

2015-10-01

Our aim in this study was to evaluate the effect of the radiologist, technologist, and other examination-related factors on the frequency of recommendations for additional imaging (RAI) during sonographic (US) interpretation. We retrospectively reviewed 719 US reports from a single academic medical center for the presence of RAI. All studies had been interpreted by one of three abdominal radiologists. Examinations were performed at an outpatient radiology facility with no onsite radiologist (n = 299) or at an inpatient emergency department or hospital-based outpatient setting that had an onsite radiologist (n = 420). Possible associations between the frequency of RAI and the presence of an onsite radiologist, location of the examination, body part or region imaged, patient age, technologist performing the exam, and radiologist reading the exam were evaluated. There were significant differences between each pair of radiologists in terms of overall frequency of RAI (p technologists (13.6%-40.0%, p = 0.03). However, other factors such as patient age, patient sex, US unit, patient location, and radiologist location were not associated with the frequency of RAI (p = 0.15-0.93). The individual radiologist and technologist influenced the frequency of RAI for US examinations, whereas other examination-related factors did not. The observed substantial variability in RAI between radiologists and technologists warrants further study, with consideration of strategies to optimize RAI within US reports. © 2015 Wiley Periodicals, Inc.

Recent advances in neonatology - new tasks for the radiologist

International Nuclear Information System (INIS)

Klebermass, K.; Birnbacher, R.; Weninger, M.; Pollak, A.

2000-01-01

Modern neonatology comprises care for a growing number of infants with congenital abnormalities and an increasing number of premature born infants. The survival rates of premature infants have increased dramatically during the past decade. This increase in survival rates can be attributed to improved prenatal and obstetric management and to advances in neonatal intensive care medicine. Radiological support: Neonatology has become a pediatric subspeciality of its own resulting in the demand for an equally specialised radiological support. Therefore, the availability of a children's radiologist for radiological and sonographic examinations is mandatory (24 hours a day) for optimal patient care on a neonatal intensive care unit. A good cooperation between radiologist and neonatologist in neonatal intensive care medicine is therefore warranted. (orig.) [de

Evaluation of the occupational doses of interventional radiologists

NARCIS (Netherlands)

Kuipers, Gerritjan; Velders, Xandra L.; de Winter, Robbert J.; Reekers, Jim A.; Piek, Jan J.

2008-01-01

The aim of the present study was to determine whether there is a linear relation between the doses measured above and those measured under the lead apron of the radiologists performing interventional procedures. To monitor radiation exposure the International Commission of Radiological Protection

Defining the abdominal radiologist based on the current U.S. job market.

Science.gov (United States)

Hoffman, David H; Rosenkrantz, Andrew B

2018-03-24

The purpose of the study is to characterize current practice patterns of abdominal radiologists based on work descriptions within job postings on numerous national radiology specialty websites. Job postings for either "abdominal" or "body" radiologists were searched weekly on five society websites (SAR, SCBT-MR, ARRS, ACR, RSNA) over a 1-year period. Postings were reviewed for various characteristics. Nine hundred and sixteen total ads for 341 unique abdominal radiologist positions were reviewed (34.6% academic, 64.2% private practice, 1.2% other). Postings occurred most commonly in March (12.3%) and least commonly in November (4.8%). States with most positions were Florida (27), California (26), and New York (24). Of postings delineating expectations of specific abdominal modalities, 67.4% mentioned MRI, 58.5% ultrasound, 41.1% fluoroscopy, 14.3% PET, and 54.0% interventions. Additional non-abdominal expectations included general radiology (28.7%), breast imaging (21.1%), and general nuclear medicine (9.7%). Additional skills included prostate MRI (7.0%), OBGYN ultrasound (5.0%), and CT colonoscopy (2.6%). 79.2% required an abdominal imaging fellowship (specifically a body MRI fellowship in 4.1%). By using job postings for abdominal radiologists, we have taken a practical approach to characterizing the current status of this subspecialty, reflecting recent job expectations and requirements. The large majority of positions required a body fellowship, and the positions commonly entailed a variety of skills beyond non-invasive diagnostic abdominal imaging. Of note, expectations of considerable minorities of positions included abdominal interventions, general radiology, and breast imaging. These insights may guide the development of abdominal radiology fellowships and mini-fellowships, as well as assist radiologists entering or returning to the job market.

A dedicated BI-RADS training programme: Effect on the inter-observer variation among screening radiologists

International Nuclear Information System (INIS)

Timmers, J.M.H.; Doorne-Nagtegaal, H.J. van; Verbeek, A.L.M.; Heeten, G.J. den; Broeders, M.J.M.

2012-01-01

Introduction: The Breast Imaging Reporting and Data System (BI-RADS) was introduced in the Dutch breast cancer screening programme to improve communication between medical specialists. Following introduction, a substantial variation in the use of the BI-RADS lexicon for final assessment categories was noted among screening radiologists. We set up a dedicated training programme to reduce this variation. This study evaluates whether this programme was effective. Materials and methods: Two comparable test sets were read before and after completion of the training programme. Each set contained 30 screening mammograms of referred women selected from screening practice. The sets were read by 25 experienced and 30 new screening radiologists. Cohen's kappa (κ) was used to calculate the inter-observer agreement. The BI-RADS 2003 version was implemented in the screening programme as the BI-RADS 2008 version requires the availability of diagnostic work-up, and this is unavailable. Results: The inter-observer agreement of all participating radiologists (n = 55) with the expert panel increased from a pre-training κ-value of 0.44 to a post-training κ-value of 0.48 (p = 0.14). The inter-observer agreement of the new screening radiologists (n = 30) with the expert panel increased from κ = 0.41 to κ = 0.50 (p = 0.01), whereas there was no difference in agreement among the 25 experienced radiologists (from κ = 0.48 to κ = 0.46, p = 0.60). Conclusion: Our training programme in the BI-RADS lexicon resulted in a significant improvement of agreement among new screening radiologists. Overall, the agreement among radiologists was moderate (guidelines Landis and Koch). This is in line with results found in the literature

Radiologists' preferences for digital mammographic display. The International Digital Mammography Development Group.

Science.gov (United States)

Pisano, E D; Cole, E B; Major, S; Zong, S; Hemminger, B M; Muller, K E; Johnston, R E; Walsh, R; Conant, E; Fajardo, L L; Feig, S A; Nishikawa, R M; Yaffe, M J; Williams, M B; Aylward, S R

2000-09-01

To determine the preferences of radiologists among eight different image processing algorithms applied to digital mammograms obtained for screening and diagnostic imaging tasks. Twenty-eight images representing histologically proved masses or calcifications were obtained by using three clinically available digital mammographic units. Images were processed and printed on film by using manual intensity windowing, histogram-based intensity windowing, mixture model intensity windowing, peripheral equalization, multiscale image contrast amplification (MUSICA), contrast-limited adaptive histogram equalization, Trex processing, and unsharp masking. Twelve radiologists compared the processed digital images with screen-film mammograms obtained in the same patient for breast cancer screening and breast lesion diagnosis. For the screening task, screen-film mammograms were preferred to all digital presentations, but the acceptability of images processed with Trex and MUSICA algorithms were not significantly different. All printed digital images were preferred to screen-film radiographs in the diagnosis of masses; mammograms processed with unsharp masking were significantly preferred. For the diagnosis of calcifications, no processed digital mammogram was preferred to screen-film mammograms. When digital mammograms were preferred to screen-film mammograms, radiologists selected different digital processing algorithms for each of three mammographic reading tasks and for different lesion types. Soft-copy display will eventually allow radiologists to select among these options more easily.

Standalone computer-aided detection compared to radiologists' performance for the detection of mammographic masses

International Nuclear Information System (INIS)

Hupse, Rianne; Samulski, Maurice; Imhof-Tas, Mechli W.; Karssemeijer, Nico; Lobbes, Marc; Boetes, Carla; Heeten, Ard den; Beijerinck, David; Pijnappel, Ruud

2013-01-01

We developed a computer-aided detection (CAD) system aimed at decision support for detection of malignant masses and architectural distortions in mammograms. The effect of this system on radiologists' performance depends strongly on its standalone performance. The purpose of this study was to compare the standalone performance of this CAD system to that of radiologists. In a retrospective study, nine certified screening radiologists and three residents read 200 digital screening mammograms without the use of CAD. Performances of the individual readers and of CAD were computed as the true-positive fraction (TPF) at a false-positive fraction of 0.05 and 0.2. Differences were analysed using an independent one-sample t-test. At a false-positive fraction of 0.05, the performance of CAD (TPF = 0.487) was similar to that of the certified screening radiologists (TPF = 0.518, P = 0.17). At a false-positive fraction of 0.2, CAD performance (TPF = 0.620) was significantly lower than the radiologist performance (TPF = 0.736, P <0.001). Compared to the residents, CAD performance was similar for all false-positive fractions. The sensitivity of CAD at a high specificity was comparable to that of human readers. These results show potential for CAD to be used as an independent reader in breast cancer screening. (orig.)

Diagnostic Performance on Low Dose Computed Tomography For Acute Appendicitis Among Attending and Resident Radiologists

International Nuclear Information System (INIS)

Chang, Chih-Chen; Wong, Yon-Cheong; Wu, Cheng-Hsien; Chen, Huan-Wu; Wang, Li-Jen; Lee, Yu-Hsien; Wu, Patricia Wanping; Irama, Wiwan; Chen, Wei Yuan; Chang, Chee-Jen

2016-01-01

Low-dose computed tomography (LDCT) techniques can reduce exposure to radiation. Several previous studies have shown that radiation dose reduction in LDCT does not decrease the diagnostic performance for appendicitis among attending radiologists. But, the LDCT diagnostic performance for acute appendicitis in radiology residents with variable training levels has not been well discussed. To compare inter-observer and intra-observer differences of diagnostic performance on non-enhanced LDCT (NE-LDCT) and contrast-enhanced standard dose CT (CE-SDCT) for acute appendicitis among attending and resident radiologists. This retrospective study included 101 patients with suspected acute appendicitis who underwent NE-LDCT and CE-SDCT. The CT examinations were interpreted and recorded on a five-point scale independently by three attending radiologists and three residents with 4, 1 and 1 years of training. Diagnostic performance for acute appendicitis of all readers on both examinations was represented by area under receiver operating characteristic (ROC) curves. Inter-observer and intra-observer AUC values were compared using Jackknife FROC software on both modalities. The diagnostic accuracy of each reader on NE-LDCT was compared with body mass index (BMI) subgroups and noise using independent T test. Diagnostic performances for acute appendicitis were not statistically different for attending radiologists at both examinations. Better performance was noted on the CE-SDCT with a borderline significant difference (P = 0.05) for senior radiology resident. No statistical difference of AUC values was observed between attending radiologists and fourth year resident on both examinations. Statistically signifi@@cant differences of AUC values were observed between attending radiologists and first year residents (P = 0.001 ~ 0.018) on NE-LDCT. Diagnostic accuracies of acute appendicitis on NE-LDCT for each reader were not significantly related to BMI or noise. Attending radiologists

Pressure injectors for radiologists: A review and what is new

International Nuclear Information System (INIS)

Indrajit, Inna K; Sivasankar, Rajeev; D’Souza, John; Pant, Rochan; Negi, Raj S; Sahu, Samresh; Hashim, PI

2015-01-01

Pressure Injectors are used routinely in diagnostic and interventional radiology. Advances in medical science and technology have made it is imperative for both diagnostic as well as interventional radiologists to have a thorough understanding of the various aspects of pressure injectors. Further, as many radiologists may not be fully conversant with injections into ports, central lines and PICCs, it is important to familiarize oneself with the same. It is also important to follow stringent operating protocols during the use of pressure injectors to prevent complications such as contrast extravastion, sepsis and air embolism. This article aims to update existing knowledge base in this respect

Barriers to and drivers for UK bioenergy development

Energy Technology Data Exchange (ETDEWEB)

Adams, P.W.; Mezzullo, W.G. [Department of Mechanical Engineering, Faculty of Engineering and Design, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Hammond, G.P.; McManus, M.C. [Department of Mechanical Engineering, Faculty of Engineering and Design, University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom); Institute for Sustainable Energy and Environment (I.SEE), University of Bath, Claverton Down, Bath BA2 7AY (United Kingdom)

2011-02-15

Barriers to UK bioenergy development arise from a number of technical, financial, social and other constraints. Likewise, the drivers for using bioenergy are numerous and diverse. A range of these barriers and drivers have been identified through a comprehensive literature and case study review, and then assessed through an online questionnaire, completed by stakeholders from across the UK bioenergy industry: farmers/suppliers, developers/owners of bioenergy projects, primary end-users, and government/policy stakeholders. The results are presented in the form of 'spider web' diagrams. The most critical barriers and drivers relate to economic factors of bioenergy projects. Farmers/suppliers and developers are influenced by production costs and benefits, whilst primary end-users of bioenergy are concerned mainly with the cost of purchasing energy resources. Common drivers for all stakeholders were found to be reducing carbon emissions and the dependency on fossil fuels. In order to satisfy the needs of stakeholders schemes must be both economically attractive and environmentally sustainable for projects to be successful. (author)

Diffusion Processes Satisfying a Conservation Law Constraint

Directory of Open Access Journals (Sweden)

J. Bakosi

2014-01-01

Full Text Available We investigate coupled stochastic differential equations governing N nonnegative continuous random variables that satisfy a conservation principle. In various fields a conservation law requires a set of fluctuating variables to be nonnegative and (if appropriately normalized sum to one. As a result, any stochastic differential equation model to be realizable must not produce events outside of the allowed sample space. We develop a set of constraints on the drift and diffusion terms of such stochastic models to ensure that both the nonnegativity and the unit-sum conservation law constraints are satisfied as the variables evolve in time. We investigate the consequences of the developed constraints on the Fokker-Planck equation, the associated system of stochastic differential equations, and the evolution equations of the first four moments of the probability density function. We show that random variables, satisfying a conservation law constraint, represented by stochastic diffusion processes, must have diffusion terms that are coupled and nonlinear. The set of constraints developed enables the development of statistical representations of fluctuating variables satisfying a conservation law. We exemplify the results with the bivariate beta process and the multivariate Wright-Fisher, Dirichlet, and Lochner’s generalized Dirichlet processes.

Developing satisfied and talented consultants

International Nuclear Information System (INIS)

Greenwood, Sarah; Higgs, Helen

2007-01-01

It has been well documented that the ageing, male dominated profile of the workforce in the UK nuclear industry will not support the forecasted nuclear renaissance. Based upon the aspects of age, gender and level of education, there is an existing shortfall in available knowledgeable resource to undertake and manage the extensive new build, operational and decommissioning programmes. The 2005 Nuclear Employers Survey advised the industry to recruit and train more: - young and qualified people. - experienced and qualified people from outside the industry. The future for the UK nuclear industry lies with people in their 20's and 30's. It is essential that not just technical talent but also managerial talent be identified early and that they are nourished and allowed to flourish. (authors)

Radiographer and radiologist perception error in reporting double contrast barium enemas: A pilot study

International Nuclear Information System (INIS)

Booth, Alison M.; Mannion, Richard A.J.

2005-01-01

Purpose: The practice of radiographers performing double contrast barium enemas (DCBE) is now widespread and in many centres the radiographer's opinion is, at least, contributing to a dual reporting system [Bewell J, Chapman AH. Radiographer performed barium enemas - results of a survey to assess progress. Radiography 1996;2:199-205; Leslie A, Virjee JP. Detection of colorectal carcinoma on double contrast barium enema when double reporting is routinely performed: an audit of current practice. Clin Radiol 2001;57:184-7; Culpan DG, Mitchell AJ, Hughes S, Nutman M, Chapman AH. Double contrast barium enema sensitivity: a comparison of studies by radiographers and radiologists. Clin Radiol 2002;57:604-7]. To ensure this change in practice does not lead to an increase in reporting errors, this study aimed to compare the perception abilities of radiographers with those of radiologists. Methods: Three gastro-intestinal (GI) radiographers and three consultant radiologists independently reported on a selection of 50 DCBE examinations, including the level of certainty in their comments for each examination. A blinded comparison of the results with an independent 'standard report' was recorded. Results: The results demonstrate there was no significant difference in perception error for any of the levels of certainty, for single reporting, for double reading by a radiographer/radiologist or by two radiologists. Conclusions: The study shows that radiographers can perceive abnormalities on DCBE at similar sensitivities and specificities as radiologists. While the participants in the study may be typical of a district general hospital, the nature of the study gives it limited external validity. As a pilot, the results demonstrate that, with slight modification, the methodology could be used for a larger study

The role of a consultant radiologist - are patients still in the dark?

Energy Technology Data Exchange (ETDEWEB)

Grant, L.; Griffin, N.; McDonald, S.; Vargas, H.; Hampson, F.; Sinnatamby, R. [Cambridge University Teaching Hospitals, NHS Foundation Trust, Department of Radiology, Cambridge (United Kingdom); Vasconcelos, J.C. [University of Cambridge, Centre for Applied Medical Statistics, Department of Public Health and Primary Care, Cambridge (United Kingdom)

2009-10-15

Little is known regarding public awareness of the roles and responsibilities of a consultant radiologist. Between 1 April and 20 May 2008, 916 outpatients attending our radiology department completed a questionnaire addressing this issue. We found public perception variable. Thirty-six percent of respondents thought we were responsible for choosing appropriate imaging; only 65% perceived that we reported studies. Another 38% felt that we did not play an important role in their treatment, and 38% considered that we were not part of their medical team. Thirty-two percent of respondents preferred their hospital consultant to give them their imaging results, with 17% preferring this to come from the radiologist. There is significant under-appreciation of the roles and responsibilities of a consultant radiologist. It is important that we educate the public to ensure that future health policy reflects the increasingly central role imaging plays in health-care delivery. (orig.)

Interdisciplinary shock-room care: tasks for the radiologist from the viewpoint of the trauma surgeon

International Nuclear Information System (INIS)

Mutschler, W.; Kanz, K.G.

2002-01-01

Efficient resuscitation of major trauma requests an interdisciplinary communication between trauma surgeons, anaesthesiologists and radiologists. Trauma outcome is significantly influenced by horizontal trauma team organisation and coherence to clinical algorithms, which allow fast diagnosis and intervention. A radiologist present on patients arrival in the trauma room provides a major impact on trauma care. Nevertheless optimal integration in the trauma team implies profound knowledge of the priorities of advanced trauma life support and trauma algorithms. His or her involvement is not limited to patient care only, also active participation in trauma room design, interdisciplinary algorithm development and trauma research are essential tasks for radiologists devoted to emergency radiology. Based on the pathophysiology of polytrauma and the structure of German trauma system, current concepts and proven clinical algorithms with special regard to the radiologist and his duties and tasks will are presented. (orig.) [de

Preliminary reports in the emergency department: is a subspecialist radiologist more accurate than a radiology resident?

Science.gov (United States)

Branstetter, Barton F; Morgan, Matthew B; Nesbit, Chadd E; Phillips, Jinnah A; Lionetti, David M; Chang, Paul J; Towers, Jeffrey D

2007-02-01

To determine whether emergency department (ED) preliminary reports rendered by subspecialist attending radiologists who are reading outside their field of expertise are more accurate than reports rendered by radiology residents, and to compare error rates between radiologists and nonradiologists in the ED setting. The study was performed at a large academic medical center with a busy ED. An electronic preliminary report generator was used in the ED to capture preliminary interpretations rendered in a clinical setting by radiology residents, junior attendings (within 2 years of taking their oral boards), senior attendings, and ED clinicians between August 1999 and November 2004. Each preliminary report was later reviewed by a final interpreting radiologist, and the preliminary interpretation was adjudicated for the presence of substantial discordances, defined as a difference in interpretation that might immediately impact the care of the patient. Of the 612,890 preliminary reports in the database, 65,780 (11%) met inclusion criteria for this study. A log-linear analysis was used to assess the effects of modality and type of author on preliminary report error rates. ED clinicians had significantly higher error rates when compared with any type of radiologist, regardless of modality. Within the radiologists, residents and junior attendings had lower error rates than did senior attendings, but the differences were not statistically significant. Subspecialized attending radiologists who interpret ED examinations outside their area of expertise have error rates similar to those of radiology residents. Nonradiologists have significantly higher error rates than radiologists and radiology residents when interpreting examinations in the ED.

Assessing Doses to Interventional Radiologists Using a Personal Dosimeter Worn Over a Protective Apron

Energy Technology Data Exchange (ETDEWEB)

Stranden, E.; Widmark, A.; Sekse, T. (Buskerud Univ. College, Drammen (Norway))

2008-05-15

Background: Interventional radiologists receive significant radiation doses, and it is important to have simple methods for routine monitoring of their exposure. Purpose: To evaluate the usefulness of a dosimeter worn outside the protective apron for assessments of dose to interventional radiologists. Material and Methods: Assessments of effective dose versus dose to dosimeters worn outside the protective apron were achieved by phantom measurements. Doses outside and under the apron were assessed by phantom measurements and measurements on eight radiologists wearing two routine dosimeters for a 2-month period during ordinary working conditions. Finger doses for the same radiologists were recorded using thermoluminescent dosimeters (TLD; DXT-RAD Extremity dosimeters). Results: Typical values for the ratio between effective dose and dosimeter dose were found to be about 0.02 when the radiologist used a thyroid shield and about 0.03 without. The ratio between the dose to the dosimeter under and outside a protective apron was found to be less than 0.04. There was very good correlation between finger dose and dosimeter dose. Conclusion: A personal dosimeter worn outside a protective apron is a good screening device for dose to the eyes and fingers as well as for effective dose, even though the effective dose is grossly overestimated. Relatively high dose to the fingers and eyes remains undetected by a dosimeter worn under the apron

Assessing Doses to Interventional Radiologists Using a Personal Dosimeter Worn Over a Protective Apron

International Nuclear Information System (INIS)

Stranden, E.; Widmark, A.; Sekse, T.

2008-01-01

Background: Interventional radiologists receive significant radiation doses, and it is important to have simple methods for routine monitoring of their exposure. Purpose: To evaluate the usefulness of a dosimeter worn outside the protective apron for assessments of dose to interventional radiologists. Material and Methods: Assessments of effective dose versus dose to dosimeters worn outside the protective apron were achieved by phantom measurements. Doses outside and under the apron were assessed by phantom measurements and measurements on eight radiologists wearing two routine dosimeters for a 2-month period during ordinary working conditions. Finger doses for the same radiologists were recorded using thermoluminescent dosimeters (TLD; DXT-RAD Extremity dosimeters). Results: Typical values for the ratio between effective dose and dosimeter dose were found to be about 0.02 when the radiologist used a thyroid shield and about 0.03 without. The ratio between the dose to the dosimeter under and outside a protective apron was found to be less than 0.04. There was very good correlation between finger dose and dosimeter dose. Conclusion: A personal dosimeter worn outside a protective apron is a good screening device for dose to the eyes and fingers as well as for effective dose, even though the effective dose is grossly overestimated. Relatively high dose to the fingers and eyes remains undetected by a dosimeter worn under the apron

'Whatever happened to the class of 2000?' An outcome survey of potential interventional radiologists

International Nuclear Information System (INIS)

Nicholson, A.A.; Adam, A.

2006-01-01

Objectives: To find out what final career choices were made by trainee doctors who had indicated a strong interest in pursuing a career in interventional radiology and to establish the reasons behind their final career choice. Methods: Eighty-eight doctors who attended a meeting in 2000 designed to promote interventional radiology as a career were questioned as to whether the meeting influenced their potential career choices and then further surveyed via postal questionnaire 5 years later to find out their eventual career choices. Of the 88 doctors who attended, 56 were radiology trainees and 32 were training in either medical or surgical specialties. There were 25 women and 63 men. Results: Five years after the meeting, six are now interventional radiologists (6.8%) though four of these are still in a 6th year interventional radiology fellowship. A further 12 (13.6%) are systems based, predominantly diagnostic radiologists with an interest in intervention. Thirty-two (43.2%) are diagnostic radiologists who undertake little or no therapeutic intervention. Of the 32 non-radiologists who attended the meeting only three entered radiology and are still in training. Conclusions: Interventional radiology is a popular initial career choice amongst trainee doctors. However, only a small number eventually pursue the specialty. If the manpower shortage of interventional radiologists is to be addressed, there needs to be improvements in training, accreditation, career opportunities and working conditions

Medical 3D Printing for the Radiologist

Science.gov (United States)

Mitsouras, Dimitris; Liacouras, Peter; Imanzadeh, Amir; Giannopoulos, Andreas A.; Cai, Tianrun; Kumamaru, Kanako K.; George, Elizabeth; Wake, Nicole; Caterson, Edward J.; Pomahac, Bohdan; Ho, Vincent B.; Grant, Gerald T.

2015-01-01

While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article. ©RSNA, 2015 PMID:26562233

Medical 3D Printing for the Radiologist.

Science.gov (United States)

Mitsouras, Dimitris; Liacouras, Peter; Imanzadeh, Amir; Giannopoulos, Andreas A; Cai, Tianrun; Kumamaru, Kanako K; George, Elizabeth; Wake, Nicole; Caterson, Edward J; Pomahac, Bohdan; Ho, Vincent B; Grant, Gerald T; Rybicki, Frank J

2015-01-01

While use of advanced visualization in radiology is instrumental in diagnosis and communication with referring clinicians, there is an unmet need to render Digital Imaging and Communications in Medicine (DICOM) images as three-dimensional (3D) printed models capable of providing both tactile feedback and tangible depth information about anatomic and pathologic states. Three-dimensional printed models, already entrenched in the nonmedical sciences, are rapidly being embraced in medicine as well as in the lay community. Incorporating 3D printing from images generated and interpreted by radiologists presents particular challenges, including training, materials and equipment, and guidelines. The overall costs of a 3D printing laboratory must be balanced by the clinical benefits. It is expected that the number of 3D-printed models generated from DICOM images for planning interventions and fabricating implants will grow exponentially. Radiologists should at a minimum be familiar with 3D printing as it relates to their field, including types of 3D printing technologies and materials used to create 3D-printed anatomic models, published applications of models to date, and clinical benefits in radiology. Online supplemental material is available for this article. (©)RSNA, 2015.

Post optimization paradigm in maximum 3-satisfiability logic programming

Science.gov (United States)

Mansor, Mohd. Asyraf; Sathasivam, Saratha; Kasihmuddin, Mohd Shareduwan Mohd

2017-08-01

Maximum 3-Satisfiability (MAX-3SAT) is a counterpart of the Boolean satisfiability problem that can be treated as a constraint optimization problem. It deals with a conundrum of searching the maximum number of satisfied clauses in a particular 3-SAT formula. This paper presents the implementation of enhanced Hopfield network in hastening the Maximum 3-Satisfiability (MAX-3SAT) logic programming. Four post optimization techniques are investigated, including the Elliot symmetric activation function, Gaussian activation function, Wavelet activation function and Hyperbolic tangent activation function. The performances of these post optimization techniques in accelerating MAX-3SAT logic programming will be discussed in terms of the ratio of maximum satisfied clauses, Hamming distance and the computation time. Dev-C++ was used as the platform for training, testing and validating our proposed techniques. The results depict the Hyperbolic tangent activation function and Elliot symmetric activation function can be used in doing MAX-3SAT logic programming.

Toward Augmented Radiologists: Changes in Radiology Education in the Era of Machine Learning and Artificial Intelligence.

Science.gov (United States)

Tajmir, Shahein H; Alkasab, Tarik K

2018-06-01

Radiology practice will be altered by the coming of artificial intelligence, and the process of learning in radiology will be similarly affected. In the short term, radiologists will need to understand the first wave of artificially intelligent tools, how they can help them improve their practice, and be able to effectively supervise their use. Radiology training programs will need to develop curricula to help trainees acquire the knowledge to carry out this new supervisory duty of radiologists. In the longer term, artificially intelligent software assistants could have a transformative effect on the training of residents and fellows, and offer new opportunities to bring learning into the ongoing practice of attending radiologists. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Reading screening mammograms - Attitudes among radiologists and radiographers about skill mix

DEFF Research Database (Denmark)

Johansen, Lena Westphal; Brodersen, John

2011-01-01

INTRODUCTION: Because of shortage of personnel for the Danish mammography screening programme, the aim of this study was to investigate the attitudes of radiologists and radiographers towards a future implementation of radiographers reading screening mammograms. MATERIALS AND METHODS: Seven...... of managers, and improved working relations. Organization related obstacles: shortage of radiographers and negative attitudes of managers. Professional related possibilities: positive experience with skill mix. Professional related obstacles: worries about negative consequences for the training...... and financial consequences of skill mix. Despite of this all radiologists and radiographers experienced with skill mix were strong advocates for reading radiographers....

SpecSatisfiabilityTool: A tool for testing the satisfiability of specifications on XML documents

Directory of Open Access Journals (Sweden)

Javier Albors

2015-01-01

Full Text Available We present a prototype that implements a set of logical rules to prove the satisfiability for a class of specifications on XML documents. Specifications are given by means of constrains built on Boolean XPath patterns. The main goal of this tool is to test whether a given specification is satisfiable or not, and justify the decision showing the execution history. It can also be used to test whether a given document is a model of a given specification and, as a by-product, it permits to look for all the relations (monomorphisms between two patterns and to combine patterns in different ways. The results of these operations are visually shown and therefore the tool makes these operations more understandable. The implementation of the algorithm has been written in Prolog but the prototype has a Java interface for an easy and friendly use. In this paper we show how to use this interface in order to test all the desired properties.

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

Science.gov (United States)

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

1998-07-01

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

Personal and Network Dynamics in Performance of Knowledge Workers: A Study of Australian Breast Radiologists.

Directory of Open Access Journals (Sweden)

Seyedamir Tavakoli Taba

Full Text Available In this paper, we propose a theoretical model based upon previous studies about personal and social network dynamics of job performance. We provide empirical support for this model using real-world data within the context of the Australian radiology profession. An examination of radiologists' professional network topology through structural-positional and relational dimensions and radiologists' personal characteristics in terms of knowledge, experience and self-esteem is provided. Thirty one breast imaging radiologists completed a purpose designed questionnaire regarding their network characteristics and personal attributes. These radiologists also independently read a test set of 60 mammographic cases: 20 cases with cancer and 40 normal cases. A Jackknife free response operating characteristic (JAFROC method was used to measure the performance of the radiologists' in detecting breast cancers.Correlational analyses showed that reader performance was positively correlated with the social network variables of degree centrality and effective size, but negatively correlated with constraint and hierarchy. For personal characteristics, the number of mammograms read per year and self-esteem (self-evaluation positively correlated with reader performance. Hierarchical multiple regression analysis indicated that the combination of number of mammograms read per year and network's effective size, hierarchy and tie strength was the best fitting model, explaining 63.4% of the variance in reader performance. The results from this study indicate the positive relationship between reading high volumes of cases by radiologists and expertise development, but also strongly emphasise the association between effective social/professional interactions and informal knowledge sharing with high performance.

Dental panoramic tomography: an approach for the general radiologist

International Nuclear Information System (INIS)

Boeddinghaus, R.; Whyte, A.

2006-01-01

Dental panoramic tomography is commonly presented to radiologists with no dental training for interpretation. An overview of the technique, basic anatomy and nomenclature and common pathology is presented with examples to show the anatomy and nomenclature, the artefacts and common pathology

Geographic Distribution of Radiologists and Utilization of Teleradiology in Japan: A Longitudinal Analysis Based on National Census Data.

Science.gov (United States)

Matsumoto, Masatoshi; Koike, Soichi; Kashima, Saori; Awai, Kazuo

2015-01-01

Japan has the most CT and MRI scanners per unit population in the world, and as these technologies spread, their geographic distribution is becoming equalized. In contrast, the number of radiologists per unit population in Japan is the lowest among OECD countries and their geographic distribution is unknown. Likewise, little is known about the use of teleradiology, which can compensate for the uneven distribution of radiologists. Based on the Survey of Physicians, Dentists and Pharmacists and the Static Survey of Medical Institutions by the Ministry of Health, Labour and Welfare, a dataset of radiologists and CT and MRI utilizations in each of Japan's 1811 municipalities was created. The inter-municipality equity of the number of radiologists was evaluated using Gini coefficient. Logistic regression analysis, based on Static Survey data, was performed to evaluate the association between hospital location and teleradiology use. Between 2006 and 2012 the number of radiologists increased by 21.7%, but the Gini coefficient remained unchanged. The number of radiologists per 1,000 CT (MRI) utilizations decreased by 17.9% (1.0%); the number was highest in metropolis and lowest in town/village and the disparity has widened from 1.9 to 2.2 (1.6 to 2.0) times. The number of hospitals and clinics using teleradiology has increased (by 69.6% and 18.1%, respectively). Hospitals located in towns/villages (odds ratio 1.61; 95% confidence interval 1.26-2.07) were more likely to use teleradiology than those in metropolises. Contrary to the CT and MRI distributions, radiologist distribution has not been evened out by the increase in their number; in other words, the distribution of radiologists was not affected by market-derived spatial competition force. As a consequence, the gap of the radiologist shortage between urban and rural areas is increasing. Teleradiology, which is one way to ameliorate this gap, should be encouraged.

Satisfying pedagogical practices using ICT

NARCIS (Netherlands)

Voogt, Joke; Law, N.; Pelgrum, W.J.; Plomp, T.

2008-01-01

This chapter describes the results of the international option that was included in SITES 2006. The international option, which was part of the teacher questionnaire, solicited responses from teachers on satisfying experiences in their pedagogical use of ICT. Twenty-one of the participating

Evaluation and management of patients with peripheral artery disease by interventional radiologists: current practices.

Science.gov (United States)

Prince, Ethan A; Murphy, Timothy P; Dhangana, Raj; Soares, Gregory M; Ahn, Sun H; Dubel, Gregory J

2008-05-01

Traditionally, surgeons have served as primary consultants for patients with peripheral vascular disease for whom revascularization is considered. An important component of care for patients with peripheral artery disease (PAD) is risk factor management. The present study was undertaken to determine current management practices of interventional radiologists for patients with PAD and compare them to published data for vascular surgeons. If PAD patient management practices are similar, this would support direct referral of PAD patients who are considered for revascularization from primary care doctors to interventional radiologists. An online survey was administered to full members of the Society of Interventional Radiology with e-mail addresses on file. Filtering was done to examine and compare interactions among several responses. The margin of error for the survey was +/-2%, based on 95% CIs for the entire surveyed population (N=2,371). Seventy-five percent of respondents see PAD patients in ambulatory office settings. Only eight percent see themselves as the physician responsible for risk factor management, similar to reported results of vascular surgeons (10%). Other variables examined, such as frequency of inquiring about Framingham risk factors, indicate similar practices to those previously reported for vascular surgeons. For interventional radiologists who accept direct referrals for medical management of patients with PAD, disease management by interventional radiologists is similar to that previously reported for vascular surgeons. This supports the role of interventional radiologists who accept direct referrals of patients with PAD as primary consultants to primary care doctors.

Role of young child formulae and supplements to ensure nutritional adequacy in U.K. young children

DEFF Research Database (Denmark)

Vieux, Florent; Brouzes, Chloé M C; Maillot, Matthieu

2016-01-01

The European Food Safety Authority (EFSA) states that young child formulae (YCFs) “cannot be considered as a necessity to satisfy the nutritional requirements” of children aged 12–36 months. This study quantifies the dietary changes needed to ensure nutritional adequacy in U.K. young children who...... consume YCFs and/or supplements and in those who do not. Dietary data from 1147 young children (aged 12–18 months) were used to identify, using linear programming models, the minimum changes needed to ensure nutritional adequacy: (i) by changing the quantities of foods initially consumed by each child....../day, respectively). Increasing YCF and supplement consumption was the shortest way to cover the EFSA nutrient requirements of U.K. children....

Regional variation in Medicare payments for medical imaging: radiologists versus nonradiologists.

Science.gov (United States)

Rosman, David A; Nsiah, Eugene; Hughes, Danny R; Duszak, Richard

2015-05-01

The purpose of this article was to study regional variation in Medicare Physician Fee Schedule (MPFS) payments for medical imaging to radiologists compared with nonradiologists. Using a 5% random sample of all Medicare enrollees, which covered approximately 2.5 million Part B beneficiaries in 2011, total professional-only, technical-only, and global MPFS spending was calculated on a state-by-state and United States Census Bureau regional basis for all Medicare Berenson-Eggers Type of Service-defined medical imaging services. Payments to radiologists versus nonradiologists were identified and variation was analyzed. Nationally, mean MPFS medical imaging spending per Medicare beneficiary was $207.17 ($95.71 [46.2%] to radiologists vs $111.46 [53.8%] to nonradiologists). Of professional-only (typically interpretation) payments, 20.6% went to nonradiologists. Of technical-only (typically owned equipment) payments, 84.9% went to nonradiologists. Of global (both professional and technical) payments, 70.1% went to nonradiologists. The percentage of MPFS medical imaging spending on nonradiologists ranged from 32% (Minnesota) to 69.5% (South Carolina). The percentage of MPFS payments for medical imaging to nonradiologists exceeded those to radiologists in 58.8% of states. The relative percentage of MPFS payments to nonradiologists was highest in the South (58.5%) and lowest in the Northeast (48.0%). Nationally, 53.8% of MPFS payments for medical imaging services are made to nonradiologists, who claim a majority of MPFS payments in most states dominated by noninterpretive payments. This majority spending on nonradiologists may have implications in bundled and capitated payment models for radiology services. Medical imaging payment policy initiatives must consider the roles of all provider groups and associated regional variation.

Teleradiology in Southeast Iran: Evaluating the Views of Senior Executives and Radiologists.

Science.gov (United States)

Sadoughi, Farahnaz; Erfannia, Leila; Sancholi, Mahboobe; Salmani, Fatemeh; Sarsarshahi, Aida

Teleradiology is considered as one of the important forms of telemedicine. Positive views of the users and providers of these services play an important role in its successful implementations. The aim of this study was to investigate the views of radiologists used in the radiology departments of teaching hospitals in the Zahedan University of Medical Sciences through teleradiology, as well as evaluate the executive possibility of teleradiology in these hospitals by the views of chief executive officer and comparison between these two views. The current cross-sectional research was performed in 2014 at Zahedan teaching hospitals. The views of 13 chief executive officers on the possibility of the execution of teleradiology and 26 radiologists on the teleradiology process were evaluated by means of two valid and reliable questionnaires. The results of the research revealed that most of the radiologists had knowledge of and positive opinions about teleradiology. Conversely, the view by chief executive officers was that implementation of these processes was not possible in the studied hospitals. Dealing with some issues including data security, controlling or restricting access to clinical information of patients during the process of teleradiology, the possibility of legal protection for the participating radiologists, constitution of executive teams in the organization along with the financial supports, and, subsequently, invitation of the supports from the chief executive officers as the main sponsors of teleradiology implementation in the teaching hospitals are all guidelines for improvement of the successful implementation of teleradiology.

Satisfiability of ATL with strategy contexts

Directory of Open Access Journals (Sweden)

François Laroussinie

2013-07-01

Full Text Available Various extensions of the temporal logic ATL have recently been introduced to express rich properties of multi-agent systems. Among these, ATLsc extends ATL with strategy contexts, while Strategy Logic has first-order quantification over strategies. There is a price to pay for the rich expressiveness of these logics: model-checking is non-elementary, and satisfiability is undecidable. We prove in this paper that satisfiability is decidable in several special cases. The most important one is when restricting to turn-based games. We prove that decidability also holds for concurrent games if the number of moves available to the agents is bounded. Finally, we prove that restricting strategy quantification to memoryless strategies brings back undecidability.

Can Radiologists Learn From Airport Baggage Screening?: A Survey About Using Fictional Patients for Quality Assurance.

Science.gov (United States)

Phelps, Andrew; Callen, Andrew L; Marcovici, Peter; Naeger, David M; Mongan, John; Webb, Emily M

2018-02-01

For both airport baggage screeners and radiologists, low target prevalence is associated with low detection rate, a phenomenon known as "prevalence effect." In airport baggage screening, the target prevalence is artificially increased with fictional weapons that are digitally superimposed on real baggage. This strategy improves the detection rate of real weapons and also allows airport supervisors to monitor screener performance. A similar strategy using fictional patients could be applied in radiology. The purpose of this study was twofold: (1) to review the psychophysics literature regarding low target prevalence and (2) to survey radiologists' attitudes toward using fictional patients as a quality assurance tool. We reviewed the psychophysics literature on low target prevalence and airport x-ray baggage screeners. An online survey was e-mailed to all members of the Association of University Radiologists to determine their attitudes toward using fictional patients in radiology. Of the 1503 Association of University Radiologists member recipients, there were 153 respondents (10% response rate). When asked whether the use of fictional patients was a good idea, the responses were as follows: disagree (44%), neutral (25%), and agree (31%). The most frequent concern was the time taken away from doing clinical work (89% of the respondents). The psychophysics literature supports the use of fictional targets to mitigate the prevalence effect. However, the use of fictional patients is not a popular idea among academic radiologists. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The impact of European research ethics legislation on UK radiology research activity: a bibliometric analysis

International Nuclear Information System (INIS)

Johnson, C.A.; Toms, A.P.

2009-01-01

Aim: To determine whether there is evidence of a reduction in radiology research activity in the UK following the implementation of the European research ethics legislation, which came in to force in 2001 and has been widely criticised as an impediment to research. Materials and methods: A bibliometric analysis was performed by searching PubMed for all first-author publications from UK departments of 'radiology' or 'medical imaging' between 1995 and 2007. Results were subcategorized into those papers published in the highest cited general radiology journals and by publication type: original research, reviews, and case reports. Results: From 1995 to 2007 the total number of publications rose by 6.5% from 137 to 146 with the increase occurring in non-general radiology journals. Original articles fell from 18 in 1995 to 12 in 2003, but then rose to 24 by 2007 (33% rise). This dip was paralleled by a fall and then recovery in case report publications. The most dramatic change has been in the number of review articles, which has increased more than eightfold from seven in 1995 to 65 in 2007 to become the most common form of publication. Conclusion: The overall number of original scientific articles, published by first-author UK radiologists, has increased slightly over the last 12 years despite a temporary fall associated with the introduction of new research ethics legislation.

Term Satisfiability in FLew-Algebras

Czech Academy of Sciences Publication Activity Database

Haniková, Zuzana; Savický, Petr

2016-01-01

Roč. 631, 6 June (2016), s. 1-15 ISSN 0304-3975 R&D Projects: GA ČR GBP202/12/G061 Institutional support: RVO:67985807 Keywords : substructural logic * FLew-algebra * MV-algebra * satisfiability * computational complexity Subject RIV: BA - General Mathematics Impact factor: 0.698, year: 2016

Integrated surgical academic training in the UK: a cross-sectional survey.

Science.gov (United States)

Blencowe, Natalie S; Glasbey, James C; McElnay, Philip J; Bhangu, Aneel; Gokani, Vimal J; Harries, Rhiannon L

2017-10-01

This study aimed to explore variations in the provision of integrated academic surgical training across the UK. This is an online cross-sectional survey (consisting of 44 items with a range of free-text, binomial and 5-point Likert scale responses) developed by the Association of Surgeons in Training. A self-reported survey instrument was distributed to academic surgical trainees across the UK (n=276). 143 (51.9%) responses were received (81% male, median age: 34 years), spanning all UK regions and surgical specialties. Of the 143 trainees, 29 were core trainees (20.3%), 99 were specialty trainees (69.2%) and 15 (10.5%) described themselves as research fellows. The structure of academic training varied considerably, with under a third of trainees receiving guaranteed protected time for research. Despite this, however, 53.1% of the respondents reported to be satisfied with how their academic training was organised. Covering clinical duties during academic time occurred commonly (72.7%). Although most trainees (n=88, 61.5%) met with their academic supervisor at least once a month, six (4.2%) never had an academic supervisory meeting. Most trainees (n=90, 62.9%) occupied a full-time rota slot and only 9.1% (n=13) described their role as 'supernumerary'. Although 58.7% (n=84) of the trainees were satisfied with their clinical competence, 37.8% (n=54) felt that clinical time focused more on service provision than the acquisition of technical skills. 58 (40.6%) had experienced some form of negative sentiment relating to their status as an academic trainee. Integrated academic training presents unique challenges and opportunities within surgery. This survey has identified variation in the quality of current programmes, meaning that the future provision of integrated surgical academic training should be carefully considered. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

Double contrast barium enema sensitivity: A comparison of studies by radiographers and radiologists

International Nuclear Information System (INIS)

Culpan, D.G.; Mitchell, A.J.; Hughes, S.; Nutman, M.; Chapman, A.H.

2002-01-01

PURPOSE: A retrospective study of histologically proven cases of colorectal cancer (CRC) was performed to assess whether the sensitivity of the radiographer-performed double contrast barium enema (DCBE) differed from that of the radiologist-performed study. MATERIALS AND METHODS: Histologically proven cases of CRC were reviewed over a 3-year period to ascertain whether: the diagnosis had been made by DCBE in the 3 years before histological diagnosis; the lesion had been correctly diagnosed; the examination had been performed by a radiologist or radiographer. RESULTS: In the 3-year period there were 478 cases with histologically proven CRC. Of these, 239 (50%) had undergone DCBE as the initial radiological investigation of the colon. Sixty-four examinations had been performed by radiographers. A correct diagnosis was made in 58 cases (90.6%), the report was equivocal in one case (1.6%), there were four false-negatives (6.25%), and one case was abandoned (1.6%). One hundred and seventy-five examinations were performed by radiologists. A correct diagnosis was made in 157 cases (89.7%), the report was equivocal in one case (0.6%), there were 16 false-negatives (9.1%), and one case was abandoned (0.6%). CONCLUSION: A sensitivity of 90.6% for radiographer-performed studies compared favourably with 89.7% for radiologist-performed studies and supports the practice of radiographers undertaking barium enemas. Culpan, D.G. et al. (2002)

Indices of agreement between neurosurgeons and a radiologist in interpreting tomography scans in an emergency department.

Science.gov (United States)

Dourado, Jules Carlos; Pereira, Júlio Leonardo Barbosa; Albuquerque, Lucas Alverne Freitas de; Carvalho, Gervásio Teles Cardos de; Dias, Patrícia; Dias, Laura; Bicalho, Marcos; Magalhães, Pollyana; Dellaretti, Marcos

2015-08-01

The power of interpretation in the analysis of cranial computed tomography (CCT) among neurosurgeons and radiologists has rarely been studied. This study aimed to assess the rate of agreement in the interpretation of CCTs between neurosurgeons and a radiologist in an emergency department. 227 CCT were independently analyzed by two neurosurgeons (NS1 and NS2) and a radiologist (RAD). The level of agreement in interpreting the examination was studied. The Kappa values obtained between NS1 and NS2 and RAD were considered nearly perfect and substantial agreement. The highest levels of agreement when evaluating abnormalities were observed in the identification of tumors, hydrocephalus and intracranial hematomas. The worst levels of agreement were observed for leukoaraiosis and reduced brain volume. For diseases in which the emergency room procedure must be determined, agreement in the interpretation of CCTs between the radiologist and neurosurgeons was satisfactory.

Chemotherapy Agents: A Primer for the Interventional Radiologist

OpenAIRE

Mihlon, Frank; Ray, Charles E.; Messersmith, Wells

2010-01-01

In this article, the authors review the basic principles of cancer chemotherapy and provide an overview of each of the general classes of chemotherapeutic agents with a target audience of interventional radiologists in mind. Special attention is paid to agents used in regional chemotherapy as well as agents commonly included in systemic chemotherapeutic regimens for patients who also require regional chemotherapy.

Acute abdominal emergencies: What radiologist have to know

International Nuclear Information System (INIS)

Nedevska, M.

2015-01-01

Full text: Acute abdominal pathology is an important cause of emergency admissions, generally putting pressure to obtain a quick and correct diagnosis. This may lead to the simultaneous use of concurrent imaging techniques, where the diagnostic accuracy may be operator dependent. It is important to the radiologist to understand how, when and why medical imaging should be used for each clinical context under appreciation. Imaging protocols should be optimally set in order not to miss the most important, bur subtle diagnostic signs. Radiologist should be conversant in all aspects of this emergency situation including the ability to provide minimally invasive treatment option, such as access drainage or vascular embolization. Although multidetector computed tomography is considered the workhorse in the diagnostic management, imaging alternatives must be kept in mind, especially tailored to the available equipment and the experience of the investigator team. Learning objectives: to describe the advantages and shortcomings of the different imaging techniques; to understand the value of the diagnostic information and the way this can change patient management; to describe and propose an effective diagnostic imaging strategy for the assessment of acute abdominal pain

Single reading with computer-aided detection performed by selected radiologists in a breast cancer screening program

Energy Technology Data Exchange (ETDEWEB)

Bargalló, Xavier, E-mail: xbarga@clinic.cat [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Santamaría, Gorane; Amo, Montse del; Arguis, Pedro [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Ríos, José [Biostatistics and Data Management Core Facility, IDIBAPS, (Hospital Clinic) C/ Mallorca, 183. Floor -1. Office #60. 08036 Barcelona (Spain); Grau, Jaume [Preventive Medicine and Epidemiology Unit, Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain); Burrel, Marta; Cores, Enrique; Velasco, Martín [Department of Radiology (CDIC), Hospital Clínic de Barcelona, C/ Villarroel, 170, 08036 Barcelona (Spain)

2014-11-15

Highlights: • 1-The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD. • 2-The cancer detection rate improved at the cost of increasing recall rate. • 3-CAD, used by breast radiologists, did not help to detect more cancers. - Abstract: Objectives: To assess the impact of shifting from a standard double reading plus arbitration protocol to a single reading by experienced radiologists assisted by computer-aided detection (CAD) in a breast cancer screening program. Methods: This was a prospective study approved by the ethics committee. Data from 21,321 consecutive screening mammograms in incident rounds (2010–2012) were read following a single reading plus CAD protocol and compared with data from 47,462 consecutive screening mammograms in incident rounds (2004–2010) that were interpreted following a double reading plus arbitration protocol. For the single reading, radiologists were selected on the basis of the appraisement of their previous performance. Results: Period 2010–2012 vs. period 2004–2010: Cancer detection rate (CDR): 6.1‰ (95% confidence interval: 5.1–7.2) vs. 5.25‰; Recall rate (RR): 7.02% (95% confidence interval: 6.7–7.4) vs. 7.24% (selected readers before arbitration) and vs. 3.94 (all readers after arbitration); Predictive positive value of recall: 8.69% vs. 13.32%. Average size of invasive cancers: 14.6 ± 9.5 mm vs. 14.3 ± 9.5 mm. Stage: 0 (22.3/26.1%); I (59.2/50.8%); II (19.2/17.1%); III (3.1/3.3%); IV (0/1.9%). Specialized breast radiologists performed better than general radiologists. Conclusions: The cancer detection rate of the screening program improved using a single reading protocol by experienced radiologists assisted by CAD, at the cost of a moderate increase of the recall rate mainly related to the lack of arbitration.

Hypervascular mediastinal masses: Action points for radiologists

International Nuclear Information System (INIS)

Cabral, Fernanda C.; Trotman-Dickenson, Beatrice; Madan, Rachna

2015-01-01

Highlights: •An algorithm combining clinical data and radiology features of hypervascular mediastinal masses is proposed to determine further evaluation and subsequently guide treatment. •Characteristic features and known association with syndromes and genetic mutations assists in achieving a diagnosis. •MRI and functional imaging can be very helpful in the evaluation of hypervascular mediastinal masses. •Identification of hypervascularity within mediastinal masses should alert the radiologist and clinician and an attempt should be made to preferably avoid percutaneous CT guided biopsies and attempt tissue sampling surgically with better control of post procedure hemorrhage. -- Abstract: Hypervascular mediastinal masses are a distinct group of rare diseases that include a subset of benign and malignant entities. Characteristic features and known association with syndromes and genetic mutations assist in achieving a diagnosis. Imaging allows an understanding of the vascularity of the lesion and should alert the radiologist and clinician to potential hemorrhagic complications and avoid percutaneous CT guided biopsies. In such cases, pre-procedure embolization and surgical biopsy maybe considered for better control of post procedure hemorrhage. The purpose of this article is to describe and illustrate the clinical features and radiologic spectrum of hypervascular mediastinal masses, and discuss the associated clinical and genetic syndromes. We will present an imaging algorithm to determine further evaluation and subsequently guide treatment

Hypervascular mediastinal masses: Action points for radiologists

Energy Technology Data Exchange (ETDEWEB)

Cabral, Fernanda C.; Trotman-Dickenson, Beatrice; Madan, Rachna, E-mail: rmadan@partners.org

2015-03-15

Highlights: •An algorithm combining clinical data and radiology features of hypervascular mediastinal masses is proposed to determine further evaluation and subsequently guide treatment. •Characteristic features and known association with syndromes and genetic mutations assists in achieving a diagnosis. •MRI and functional imaging can be very helpful in the evaluation of hypervascular mediastinal masses. •Identification of hypervascularity within mediastinal masses should alert the radiologist and clinician and an attempt should be made to preferably avoid percutaneous CT guided biopsies and attempt tissue sampling surgically with better control of post procedure hemorrhage. -- Abstract: Hypervascular mediastinal masses are a distinct group of rare diseases that include a subset of benign and malignant entities. Characteristic features and known association with syndromes and genetic mutations assist in achieving a diagnosis. Imaging allows an understanding of the vascularity of the lesion and should alert the radiologist and clinician to potential hemorrhagic complications and avoid percutaneous CT guided biopsies. In such cases, pre-procedure embolization and surgical biopsy maybe considered for better control of post procedure hemorrhage. The purpose of this article is to describe and illustrate the clinical features and radiologic spectrum of hypervascular mediastinal masses, and discuss the associated clinical and genetic syndromes. We will present an imaging algorithm to determine further evaluation and subsequently guide treatment.

A guide to radiological research. The Research Sub-Committee of the Board of the Faculty of Clinical Radiology, the Royal College of Radiologists

International Nuclear Information System (INIS)

1997-11-01

There are broad categories of radiological research. Basic science research undertaken in universities or in manufacturing companies may lead to new techniques or even new products like MRI, CT or contrast media. MRI is a product of university based research, while CT developed within a manufacturing company. Basic science type research is vital for the continuing development of our speciality, but requires considerable resources, teamwork, and research/management expertise. The best place for an interested radiologist to learn such skills is within university departments, typically in the context of an MD, Ph.D. or similar degree course. Clinical radiological research is of equal importance and, in the UK, underpins our international reputation for radiological excellence. Clinical research may be defined as research requiring patients. It can therefore only be carried out in hospitals and clinics. New technologies, drugs, indications, procedures etc., all require clinical research to validate them. The role of the clinical radiologist is pivotal to the proper conduct of clinical imaging research and technology assessment. This is not confined to university and teaching centres, but is of equal importance in district general hospitals. Results from clinical research carried out 'in the field' are the true test of our specialty. This research guide is sponsored by the RCR. Its target is radiologists and others carrying out clinical research within departments of radiology. If it stimulates Fellows and Members of the RCR to conduct more and better research then it will have succeeded in its basic objective. Research is always planned. It is based on observation, measurement and the testing of ideas or hypotheses. It is presented to peers for criticism and then published to be available to all for review. Research is always hard work and requires discipline. Like many things the ability to conduct research improves with practice. Many radiologists have not had much

Assessment of Volumetric versus Manual Measurement in Disseminated Testicular Cancer; No Difference in Assessment between Non-Radiologists and Genitourinary Radiologist.

Directory of Open Access Journals (Sweden)

Çiğdem Öztürk

Full Text Available The aim of this study was to assess the feasibility and reproducibility of semi-automatic volumetric measurement of retroperitoneal lymph node metastases in testicular cancer (TC patients treated with chemotherapy versus the standardized manual measurements based on RECIST criteria.21 TC patients with retroperitoneal lymph node metastases of testicular cancer were studied with a CT scan of chest and abdomen before and after cisplatin based chemotherapy. Three readers, a surgical resident, a radiological technician and a radiologist, assessed tumor response independently using computerized volumetric analysis with Vitrea software® and manual measurement according to RECIST criteria (version 1.1. Intra- and inter-rater variability were evaluated with intra class correlations and Bland-Altman analysis.Assessment of intra observer and inter observer variance proved non-significant in both measurement modalities. In particularly all intraclass correlation (ICC values for the volumetric analysis were > .99 per observer and between observers. There was minimal bias in agreement for manual as well as volumetric analysis.In this study volumetric measurement using Vitrea software® appears to be a reliable, reproducible method to measure initial tumor volume of retroperitoneal lymph node metastases of testicular cancer after chemotherapy. Both measurement methods can be performed by experienced non-radiologists as well.

Computer-aided detection of pulmonary embolism: Influence on radiologists' detection performance with respect to vessel segments

International Nuclear Information System (INIS)

Das, Marco; Muehlenbruch, Georg; Helm, Anita; Guenther, Rolf W.; Wildberger, Joachim E.; Bakai, Annemarie; Salganicoff, Marcos; Liang, Jianming; Wolf, Matthias; Stanzel, Sven

2008-01-01

The purpose was to assess the sensitivity of a CAD software prototype for the detection of pulmonary embolism in MDCT chest examinations with regard to vessel level and to assess the influence on radiologists' detection performance. Forty-three patients with suspected PE were included in this retrospective study. MDCT chest examinations with a standard PE protocol were acquired at a 16-slice MDCT. All patient data were read by three radiologists (R1, R2, R3), and all thrombi were marked. A CAD prototype software was applied to all datasets, and each finding of the software was analyzed with regard to vessel level. The standard of reference was assessed in a consensus read. Sensitivity for the radiologists and CAD software was assessed. Thirty-three patients were positive for PE, with a total of 215 thrombi. The mean overall sensitivity for the CAD software alone was 83% (specificity, 80%). Radiologist sensitivity was 77% = R3, 82% = R2, and R1 = 87%. With the aid of the CAD software, sensitivities increased to 98% (R1), 93% (R2), and 92% (R3) (p<0.0001). CAD performance at the lobar level was 87%, at the segmental 90% and at the subsegmental 77%. With the use of CAD for PE, the detection performance of radiologists can be improved. (orig.)

Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs

International Nuclear Information System (INIS)

Zubizarreta Alberdi, Raquel; Llanes, Ana B.F.; Ortega, Raquel Almazan; Exposito, Ruben Roman; Collado, Jose M.V.; Oliveres, Xavier Castells; Queiro Verdes, Teresa; Natal Ramos, Carmen; Sanz, Maria Ederra; Salas Trejo, Dolores

2011-01-01

To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p 14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening. (orig.)

Who should be performing routine abdominal ultrasound? A prospective double-blind study comparing the accuracy of radiologist and radiographer

International Nuclear Information System (INIS)

Leslie, A.; Lockyer, H.; Virjee, J.P.

2000-01-01

AIM: To compare the accuracy of radiographers and radiologists in routine abdominal ultrasound. MATERIALS AND METHODS: One hundred consecutive patients attending for routine abdominal ultrasound were included. Each patient was examined by both a radiographer and radiologist. Both operators noted their findings and wrote a concluding report without conferring. Reports were compared. Where there was disagreement the patient was either re-examined by another radiologist or had further investigation. RESULTS: Of 100 patients, 52 were men and 48 were women. The age range was 19-88 years (median 52 years). Thirty-seven patients had renal tract ultrasound, one had an aortic ultrasound and 62 had general upper abdominal ultrasound. In 44 cases both operators reported the examination as normal. In 49 cases both operators reported the examinations as abnormal and there was complete agreement between the operators. In seven cases there was not complete agreement between operators. Three of these disagreements were considered minor and four major. In three of the seven cases the radiographer was correct, and in four the radiologist was correct. CONCLUSION: Experienced radiographers and radiologists are highly accurate in performing and interpreting routine abdominal sonography. Both operators missed a small minority of abnormalities. There was no statistically significant difference in the accuracy of radiographers and radiologist. Leslie, A. (2000)

Do the terms 'proximal' and 'distal' cause confusion amongst radiologists and other clinicians?

International Nuclear Information System (INIS)

Skillicorn, C.J.

2009-01-01

Aim: To investigate the use of the terms 'proximal' and 'distal', and what respondents think the terms mean, when applied to certain structures within the trunk, notably the veins and the biliary tract. Materials and Methods: Fifty-three respondents were interviewed using simplified anatomical diagrams. Respondents were asked what terms they would use to describe sites at opposite ends of the superior vena cava (SVC), internal jugular vein (IJV), common bile duct (CBD), and pancreatic duct. They were also asked which end of each of these structures they would think was being referred to if they read a radiological report that used these terms. Results: The terms 'proximal' and 'distal' were used by at least 50% of all respondents, and, specifically, at least 60% of radiologists at all four anatomical sites. Eighty-five percent (n = 45) of all respondents and 100% (n = 24) of radiologists agreed that the term 'proximal' CBD referred to its superior end. However, at the other sites there was marked disagreement, 67% (n = 16) of radiologists thought the superior SVC and superior IJV were 'proximal', 33% (n = 8) thought they were 'distal'. There was a 54% (n = 13) to 46% (n = 11) split amongst radiologists as to which end of the pancreatic duct was 'proximal'. Conclusion: The terms 'proximal' and 'distal' are the most frequently used terms to describe positions in veins and the biliary system, but there is widespread confusion about their meaning, which could lead to medical error and ultimately patient harm. The use of alternative terms is advised

Do the terms "proximal" and "distal" cause confusion amongst radiologists and other clinicians?

Science.gov (United States)

Skillicorn, C J

2009-04-01

To investigate the use of the terms "proximal" and "distal", and what respondents think the terms mean, when applied to certain structures within the trunk, notably the veins and the biliary tract. Fifty-three respondents were interviewed using simplified anatomical diagrams. Respondents were asked what terms they would use to describe sites at opposite ends of the superior vena cava (SVC), internal jugular vein (IJV), common bile duct (CBD), and pancreatic duct. They were also asked which end of each of these structures they would think was being referred to if they read a radiological report that used these terms. The terms "proximal" and "distal" were used by at least 50% of all respondents, and, specifically, at least 60% of radiologists at all four anatomical sites. Eighty-five percent (n=45) of all respondents and 100% (n=24) of radiologists agreed that the term "proximal" CBD referred to its superior end. However, at the other sites there was marked disagreement, 67% (n=16) of radiologists thought the superior SVC and superior IJV were "proximal", 33% (n=8) thought they were "distal". There was a 54% (n=13) to 46% (n=11) split amongst radiologists as to which end of the pancreatic duct was "proximal". The terms "proximal" and "distal" are the most frequently used terms to describe positions in veins and the biliary system, but there is widespread confusion about their meaning, which could lead to medical error and ultimately patient harm. The use of alternative terms is advised.

Radiologist involvement is associated with reduced use of MRI in the acute period of low back pain in a non-elderly population

International Nuclear Information System (INIS)

Kumamaru, Kanako K.; Sano, Yukiko; Hori, Masaaki; Takamura, Tomohiro; Irie, Ryusuke; Suzuki, Michimasa; Hagiwara, Akifumi; Kamagata, Koji; Nakanishi, Atsushi; Aoki, Shigeki; Kumamaru, Hiraku

2018-01-01

To test the hypothesis that ''acute-period'' lumbar MRI in non-elderly patients with low back pain is less frequently performed at clinics/hospitals with greater involvement of full-time radiologists in the imaging workflow. In a national-level claims database, we identified 14,819 non-elderly patients (mean age: 38.7±8.0 years) who visited clinics/hospitals for low back pain in 2013-2015. We classified the clinics/hospitals into four groups based on the level of full-time radiologist involvement and MRI ownership, and compared the frequency of acute-period lumbar MRI using hierarchical logistic regression analysis. Patients visiting facilities without a full-time radiologist (n=2105) were significantly (p<0.001) more likely to undergo acute-period MRI than those visiting facilities with ≥1 radiologist partially managing imaging workflow (level-1, n=491) or ≥1 radiologist intensively involved in imaging workflow (level-2, n=1190) (15.7% vs. 6.9% and 7.3%; adjusted odds ratio of no-radiologist versus level-2: 2.93, p=0.018). No difference was observed between level-1 and level-2 involvement. Facilities with no full-time radiologist were more likely to perform acute-period MRI to assess for low back pain, while no difference was seen between facilities with varying levels of radiologist involvement in the imaging workflow. Radiologist involvement may contribute to optimal utilisation of medical imaging. (orig.)

Occupational burnout among radiographers, sonographers and radiologists in Australia and New Zealand: Findings from a national survey.

Science.gov (United States)

Singh, Nabita; Knight, Kellie; Wright, Caroline; Baird, Marilyn; Akroyd, Duane; Adams, Robert D; Schneider, Michal E

2017-06-01

Evidence demonstrates that health care professionals are more prone to burnout than other professionals due to the emotionally taxing interactions they have with their patients on a daily basis. The aims of this study were to measure occupational burnout levels among sonographers, radiographers and radiologists and to examine predictors of burnout according to demographic characteristics. A cross-sectional online survey was administered in 2010 to radiographers, sonographers and radiologists who were members of the following professional bodies: Australian Institute of Radiography, Australian Sonographers Association and The Royal Australian and New Zealand College of Radiologists. The Maslach Burnout Inventory was used to measure burnout levels for each profession. Data were analysed using SPSS Ver 20 (IBM, Chicago, IL, USA) statistical software. A total of 613 radiographers, 121 sonographers and 35 radiologists participated in the survey. Radiographers, sonographers and radiologists had a high mean (±SD) burnout score for emotional exhaustion (39.9 ± 8.5, 42.2 ± 8.5 and 44.9 ± 7.1 respectively) and depersonalization (18.9 ± 5.5, 20.3 ± 5.8 and 20.6 ± 5.6) compared to MBI norms. Radiographers also had low personal achievement (30.8 ± 5.5) compared to MBI norms. Radiographers and sonographers who were male, worked >10 hours overtime and spent <10% of their time training students per week had significantly higher depersonalization scores (p < 0.05). Burnout levels among radiographers, sonographers and radiologists are high and likely to vary according to some demographic and work-related factors. Further research is needed to examine ways to alleviate burnout in these professions so that loss of experienced staff due to burnout can be minimized and quality of patient care can be maintained. © 2016 The Royal Australian and New Zealand College of Radiologists.

How well do we prepare pediatric radiologists regarding child abuse? Results of a survey of recently trained fellows

International Nuclear Information System (INIS)

Pennington, Debra J.; Lonergan, Gael J.; Mendelson, Kenneth L.

2004-01-01

Pediatric radiologists serve an important role in the radiologic diagnosis, investigation, and in legal proceedings in cases of child abuse. The Society for Pediatric Radiology should evaluate and insure the adequacy of training of pediatric radiologists for this important role. The Society for Pediatric Radiology Committee on Child Abuse, 2002, conducted a 24-question survey to evaluate the scope and perceived adequacy of training received by pediatric radiology fellows regarding the radiologic diagnosis of child abuse and the associated legal process. Eighty-four surveys were mailed to radiologists who had completed a year in pediatric radiology fellowship training during the years 1999 and 2000. There were 33 surveys returned for an overall response of 39%. Respondents' perception of adequacy of training was best for the radiologic diagnosis of child abuse. The majority perceived they were not well trained in the investigative and legal processes regarding child abuse. The majority would welcome standardized training. Current pediatric radiology training programs do not sufficiently prepare pediatric radiologists for their role in the legal system regarding child abuse. A standardized program to train pediatric radiologists about the imaging diagnosis of child abuse and their role in the legal system is recommended. (orig.)

35 Years of Experience From the American Association for Women Radiologists: Increasing the Visibility of Women in Radiology.

Science.gov (United States)

Spalluto, Lucy B; Arleo, Elizabeth K; Macura, Katarzyna J; Rumack, Carol M

2017-03-01

Women radiologists remain in minority, unchanged for the past several decades. In 1981, the American Association for Women Radiologists (AAWR) was founded to address the problems that women radiologists were experiencing in being subordinate to male radiologists in the workplace and at the national level in organizations with respect to political power and financial compensation, as well as additional issues unique to women in radiology. The AAWR defined goals to meet the needs of women in radiology: improve the visibility of women radiologists, advance the professional and academic standing of women in radiology, and identify and address issues faced by women in radiology. AAWR efforts have included providing opportunities for career development and award recognition, hosting educational programs at national meetings, and publishing numerous manuscripts on issues faced by women in radiology. The AAWR recognizes that although there has been significant progress in the standing of women in radiology over the past 35 years, there is much room for improvement. The AAWR will continue to advocate for the needs of women in radiology. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

How well do we prepare pediatric radiologists regarding child abuse? Results of a survey of recently trained fellows

Energy Technology Data Exchange (ETDEWEB)

Pennington, Debra J.; Lonergan, Gael J. [Austin Radiological Association, 6101 West Courtyard Drive, Bldg. 5, TX 78730, Austin (United States); Mendelson, Kenneth L. [South Shore Hospital, Weymouth, Massachusetts (United States)

2004-01-01

Pediatric radiologists serve an important role in the radiologic diagnosis, investigation, and in legal proceedings in cases of child abuse. The Society for Pediatric Radiology should evaluate and insure the adequacy of training of pediatric radiologists for this important role. The Society for Pediatric Radiology Committee on Child Abuse, 2002, conducted a 24-question survey to evaluate the scope and perceived adequacy of training received by pediatric radiology fellows regarding the radiologic diagnosis of child abuse and the associated legal process. Eighty-four surveys were mailed to radiologists who had completed a year in pediatric radiology fellowship training during the years 1999 and 2000. There were 33 surveys returned for an overall response of 39%. Respondents' perception of adequacy of training was best for the radiologic diagnosis of child abuse. The majority perceived they were not well trained in the investigative and legal processes regarding child abuse. The majority would welcome standardized training. Current pediatric radiology training programs do not sufficiently prepare pediatric radiologists for their role in the legal system regarding child abuse. A standardized program to train pediatric radiologists about the imaging diagnosis of child abuse and their role in the legal system is recommended. (orig.)

Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists

Energy Technology Data Exchange (ETDEWEB)

Abujudeh, Hani H.; Boland, Giles W.; Kaewlai, Rathachai; Rabiner, Pavel; Thrall, James H. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Halpern, Elkarn F.; Gazelle, G.S. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Massachusetts General Hospital and Harvard Medical School, Institute for Technology Assessment, Boston, MA (United States)

2010-08-15

To assess the discrepancy rate for the interpretation of abdominal and pelvic computed tomography (CT) examinations among experienced radiologists. Ninety abdominal and pelvic CT examinations reported by three experienced radiologists who specialize in abdominal imaging were randomly selected from the radiological database. The same radiologists, blinded to previous interpretation, were asked to re-interpret 60 examinations: 30 of their previous interpretations and 30 interpreted by others. All reports were assessed for the degree of discrepancy between initial and repeat interpretations according to a three-level scoring system: no discrepancy, minor, or major discrepancy. Inter- and intrareader discrepancy rates and causes were evaluated. CT examinations included in the investigation were performed on 90 patients (43 men, mean age 59 years, SD 14, range 19-88) for the following indications: follow-up/evaluation of malignancy (69/90, 77%), pancreatitis (5/90, 6%), urinary tract stone (4/90, 4%) or other (12/90, 13%). Interobserver and intraobserver major discrepancy rates were 26 and 32%, respectively. Major discrepancies were due to missed findings, different opinions regarding interval change of clinically significant findings, and the presence of recommendation. Major discrepancy of between 26 and 32% was observed in the interpretation of abdominal and pelvic CT examinations. (orig.)

Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists

International Nuclear Information System (INIS)

Abujudeh, Hani H.; Boland, Giles W.; Kaewlai, Rathachai; Rabiner, Pavel; Thrall, James H.; Halpern, Elkarn F.; Gazelle, G.S.

2010-01-01

To assess the discrepancy rate for the interpretation of abdominal and pelvic computed tomography (CT) examinations among experienced radiologists. Ninety abdominal and pelvic CT examinations reported by three experienced radiologists who specialize in abdominal imaging were randomly selected from the radiological database. The same radiologists, blinded to previous interpretation, were asked to re-interpret 60 examinations: 30 of their previous interpretations and 30 interpreted by others. All reports were assessed for the degree of discrepancy between initial and repeat interpretations according to a three-level scoring system: no discrepancy, minor, or major discrepancy. Inter- and intrareader discrepancy rates and causes were evaluated. CT examinations included in the investigation were performed on 90 patients (43 men, mean age 59 years, SD 14, range 19-88) for the following indications: follow-up/evaluation of malignancy (69/90, 77%), pancreatitis (5/90, 6%), urinary tract stone (4/90, 4%) or other (12/90, 13%). Interobserver and intraobserver major discrepancy rates were 26 and 32%, respectively. Major discrepancies were due to missed findings, different opinions regarding interval change of clinically significant findings, and the presence of recommendation. Major discrepancy of between 26 and 32% was observed in the interpretation of abdominal and pelvic CT examinations. (orig.)

The causes of medical malpractice suits against radiologists in the United States.

Science.gov (United States)

Whang, Jeremy S; Baker, Stephen R; Patel, Ronak; Luk, Lyndon; Castro, Alejandro

2013-02-01

To determine the most frequent causes of malpractice suits as derived from credentialing data of 8401 radiologists. This study was approved by the Institutional Review Board of New Jersey Medical School. A total of 8401 radiologists in 47 states participating in the network of One-Call Medical, a broker for computed tomographic/magnetic resonance studies in workers' compensation cases, were required to provide their malpractice history as part of their credentialing application. Of these, 2624 (31%) radiologists had at least one claim in their career. In each enrollee's credentialing file, if there was a claim against the enrollee there was a narrative regarding each malpractice case from which, in most instances, a primary allegation could be discerned. Among the 4793 cases, an alleged cause could be derived from the narrative in 4043 (84%). Statistical analysis was performed with Stata 12 (2011; Stata, College Station, Tex) software. The most common general cause was error in diagnosis (14.83 claims per 1000 person-years [95% confidence interval {CI}: 14.19, 15.51]). In this category, breast cancer was the most frequently missed diagnosis (3.57 claims per 1000 person-years [95% CI: 3.26, 3.91]), followed by nonspinal fractures (2.49 claims per 1000 person-years [95% CI: 2.28, 2.72]), spinal fractures (1.32 claims per 1000 person-years [95% CI: 1.16, 1.49]), lung cancer (1.26 claims per 1000 person-years [95% CI: 1.11, 1.42]), and vascular disease (1.08 claims per 1000 person-years [95% CI: 0.93, 1.24]). The category next in frequency was procedural complications (1.76 claims per 1000 person-years [95% CI: 1.58, 1.96]), followed by inadequate communication with either patient (0.40 claim per 1000 person-years [95% CI: 0.32, 0.50]) or referrer (0.71 claim per 1000 person-years [95% CI: 0.60, 0.84]). Radiologists had only a peripheral role in 0.92 claim per 1000 person-years (95% CI: 0.77, 1.10). Failure to recommend additional testing was a rare cause (0.41 claim

Radiologists' Usage of Social Media : Results of the RANSOM Survey

NARCIS (Netherlands)

Ranschaert, Erik R.; Van Ooijen, Peter M. A.; McGinty, Geraldine B.; Parizel, Paul M.

The growing use of social media is transforming the way health care professionals (HCPs) are communicating. In this changing environment, it could be useful to outline the usage of social media by radiologists in all its facets and on an international level. The main objective of the RANSOM survey

Computer hardware for radiologists: Part 2

International Nuclear Information System (INIS)

Indrajit, IK; Alam, A

2010-01-01

Computers are an integral part of modern radiology equipment. In the first half of this two-part article, we dwelt upon some fundamental concepts regarding computer hardware, covering components like motherboard, central processing unit (CPU), chipset, random access memory (RAM), and memory modules. In this article, we describe the remaining computer hardware components that are of relevance to radiology. “Storage drive” is a term describing a “memory” hardware used to store data for later retrieval. Commonly used storage drives are hard drives, floppy drives, optical drives, flash drives, and network drives. The capacity of a hard drive is dependent on many factors, including the number of disk sides, number of tracks per side, number of sectors on each track, and the amount of data that can be stored in each sector. “Drive interfaces” connect hard drives and optical drives to a computer. The connections of such drives require both a power cable and a data cable. The four most popular “input/output devices” used commonly with computers are the printer, monitor, mouse, and keyboard. The “bus” is a built-in electronic signal pathway in the motherboard to permit efficient and uninterrupted data transfer. A motherboard can have several buses, including the system bus, the PCI express bus, the PCI bus, the AGP bus, and the (outdated) ISA bus. “Ports” are the location at which external devices are connected to a computer motherboard. All commonly used peripheral devices, such as printers, scanners, and portable drives, need ports. A working knowledge of computers is necessary for the radiologist if the workflow is to realize its full potential and, besides, this knowledge will prepare the radiologist for the coming innovations in the ‘ever increasing’ digital future

Computer hardware for radiologists: Part 2

Directory of Open Access Journals (Sweden)

Indrajit I

2010-01-01

Full Text Available Computers are an integral part of modern radiology equipment. In the first half of this two-part article, we dwelt upon some fundamental concepts regarding computer hardware, covering components like motherboard, central processing unit (CPU, chipset, random access memory (RAM, and memory modules. In this article, we describe the remaining computer hardware components that are of relevance to radiology. "Storage drive" is a term describing a "memory" hardware used to store data for later retrieval. Commonly used storage drives are hard drives, floppy drives, optical drives, flash drives, and network drives. The capacity of a hard drive is dependent on many factors, including the number of disk sides, number of tracks per side, number of sectors on each track, and the amount of data that can be stored in each sector. "Drive interfaces" connect hard drives and optical drives to a computer. The connections of such drives require both a power cable and a data cable. The four most popular "input/output devices" used commonly with computers are the printer, monitor, mouse, and keyboard. The "bus" is a built-in electronic signal pathway in the motherboard to permit efficient and uninterrupted data transfer. A motherboard can have several buses, including the system bus, the PCI express bus, the PCI bus, the AGP bus, and the (outdated ISA bus. "Ports" are the location at which external devices are connected to a computer motherboard. All commonly used peripheral devices, such as printers, scanners, and portable drives, need ports. A working knowledge of computers is necessary for the radiologist if the workflow is to realize its full potential and, besides, this knowledge will prepare the radiologist for the coming innovations in the ′ever increasing′ digital future.

Cliques, coloring, and satisfiability

CERN Document Server

Johnson, David S

1996-01-01

The purpose of a DIMACS Challenge is to encourage and coordinate research in the experimental analysis of algorithms. The First DIMACS Challenge encouraged experimental work in the area of network flow and matchings. The Second DIMACS Challenge, on which this volume is based, took place in conjunction with the DIMACS Special Year on Combinatorial Optimization. Addressed here are three difficult combinatorial optimization problems: finding cliques in a graph, coloring the vertices of a graph, and solving instances of the satisfiability problem. These problems were chosen both for their practical interest and because of their theoretical intractability.

Testing of the assisting software for radiologists analysing head CT images: lessons learned.

Science.gov (United States)

Martynov, Petr; Mitropolskii, Nikolai; Kukkola, Katri; Gretsch, Monika; Koivisto, Vesa-Matti; Lindgren, Ilkka; Saunavaara, Jani; Reponen, Jarmo; Mäkynen, Anssi

2017-12-11

Assessing a plan for user testing and evaluation of the assisting software developed for radiologists. Test plan was assessed in experimental testing, where users performed reporting on head computed tomography studies with the aid of the software developed. The user testing included usability tests, questionnaires, and interviews. In addition, search relevance was assessed on the basis of user opinions. The testing demonstrated weaknesses in the initial plan and enabled improvements. Results showed that the software has acceptable usability level but some minor fixes are needed before larger-scale pilot testing. The research also proved that it is possible even for radiologists with under a year's experience to perform reporting of non-obvious cases when assisted by the software developed. Due to the small number of test users, it was impossible to assess effects on diagnosis quality. The results of the tests performed showed that the test plan designed is useful, and answers to the key research questions should be forthcoming after testing with more radiologists. The preliminary testing revealed opportunities to improve test plan and flow, thereby illustrating that arranging preliminary test sessions prior to any complex scenarios is beneficial.

Breast Density Estimation with Fully Automated Volumetric Method: Comparison to Radiologists' Assessment by BI-RADS Categories.

Science.gov (United States)

Singh, Tulika; Sharma, Madhurima; Singla, Veenu; Khandelwal, Niranjan

2016-01-01

The objective of our study was to calculate mammographic breast density with a fully automated volumetric breast density measurement method and to compare it to breast imaging reporting and data system (BI-RADS) breast density categories assigned by two radiologists. A total of 476 full-field digital mammography examinations with standard mediolateral oblique and craniocaudal views were evaluated by two blinded radiologists and BI-RADS density categories were assigned. Using a fully automated software, mean fibroglandular tissue volume, mean breast volume, and mean volumetric breast density were calculated. Based on percentage volumetric breast density, a volumetric density grade was assigned from 1 to 4. The weighted overall kappa was 0.895 (almost perfect agreement) for the two radiologists' BI-RADS density estimates. A statistically significant difference was seen in mean volumetric breast density among the BI-RADS density categories. With increased BI-RADS density category, increase in mean volumetric breast density was also seen (P BI-RADS categories and volumetric density grading by fully automated software (ρ = 0.728, P BI-RADS density category by two observers showed fair agreement (κ = 0.398 and 0.388, respectively). In our study, a good correlation was seen between density grading using fully automated volumetric method and density grading using BI-RADS density categories assigned by the two radiologists. Thus, the fully automated volumetric method may be used to quantify breast density on routine mammography. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Radiation exposure of radiologists during angiography: Dose measurements outside the lead apron

International Nuclear Information System (INIS)

Fischer, H.; Przetak, C.; Teubert, G.; Ewen, K.; Moedder, U.

1995-01-01

The aim of this study was to provide practical information to angiographers concerning radiation exposure to body parts not covered by lead aprons. Individual doses to the neck and hands of radiologists measured in micro-Sieverts were obtained during the course of 80 angiographies of various types. The number of diagnostic and interventional procedures, which might lead to exceeding permissible doses, have been calculated. Possibilities of estimating doses during angiography by means of parameters such as screening times were examined statistically. Especially with regard to the hands, estimations of the doses are insufficient (correlation r=0.21). Radiologists who undertake much angiographic and particularly interventional work may reach exposure levels requiring protective measures in addition to lead aprons. (orig.) [de

Carbon and environmental footprinting of low carbon UK electricity futures to 2050

International Nuclear Information System (INIS)

Alderson, Helen; Cranston, Gemma R.; Hammond, Geoffrey P.

2012-01-01

Electricity generation contributes a large proportion of the total greenhouse gas emissions in the United Kingdom (UK), due to the predominant use of fossil fuel (coal and natural gas) combustion for this purpose. A range of future UK energy scenarios has been employed to determine their resulting environmental and carbon footprints. Methodologies have been established to calculate these footprints for the UK electricity supply industry on both a historic timescale and in accordance with the three selected scenarios. The latter scenarios, developed by the UK SUPERGEN Consortium on ‘Highly Distributed Power Systems’ (HDPS), were characterised as ‘Business As Usual’ (BAU), ‘Low Carbon’ (LC) and ‘Deep Green’ (DG) futures, and yielded possible electricity demands out to 2050. It was found that the environmental footprint of the current power network is 41 million (M) global hectares (gha). If future trends follow a ‘Business As Usual’ scenario, then this footprint is observed to fall to about 25 Mgha in 2050. The LC scenario implies an extensive penetration of micro-generators in the home to satisfy heat and power demands. However, these energy requirements are minimised by way of improved insulation of the building fabric and other demand reduction measures. In contrast, the DG scenario presupposes a network where centralised renewable energy technologies – mainly large-scale onshore and offshore wind turbines - have an important role in the power generation. However, both the LC and DG scenarios were found to lead to footprints of less than 4 Mgha by 2050. These latter two scenarios were found to give rise to quite similar trajectories over the period 2010–2050. They are therefore more likely to reflect an effective transition pathway in terms of meeting the 2050 UK CO 2 reduction targets associated with decarbonisation of its power network. However, this appears unlikely to be achieved by 2030–2040 as advocated by the UK Government

Does Direct Radiologist-Patient Verbal Communication Affect Follow-Up Compliance of Probably Benign Assessments?

Science.gov (United States)

Bosma, Melissa S; Neal, Colleen H; Klein, Katherine A; Noroozian, Mitra; Patterson, Stephanie K; Helvie, Mark A

2016-03-01

The aim of this study was to determine whether direct verbal communication of results by a radiologist affected follow-up compliance rates for probably benign breast imaging findings. This study was institutional review board approved and HIPAA compliant. A retrospective search identified all patients from January 1, 2010 to December 31, 2010 who had breast findings newly assessed as probably benign (BI-RADS category 3). Patients were categorized by whether the radiologist or the technologist verbally communicated the result and follow-up recommendation. Patient adherence to 6-, 12-, and 24-month follow-up imaging recommendations was recorded. Compliance data were available for 770 of 819 patients in the study. Overall compliance was 83.0% (639 of 770) for 6-month examinations, 68.1% (524 of 770) for 6- and 12-month examinations, and 57.4% (442 of 770) for 6-, 12-, and 24-month examinations. For patients who initially underwent diagnostic mammography alone, there was no significant difference in compliance between those who had and those who did not have radiologist-patient communication (6 months, 81.9% vs 80.8% [P = .83]; 6 and 12 months, 70.8% vs 67.3% [P = .58]; 6, 12, and 24 months, 54.2% vs 58.4% [P = .53]). For patients who initially underwent diagnostic mammography alone versus ultrasound with or without diagnostic mammography, there was no significant difference in compliance (6 months, 81.1% vs 84.3% [P = .24]; 6 and 12 months, 68.1% vs 68.0% [P = .96]; 6, 12, and 24 months, 57.4% vs 57.4% [P = .00]). High initial compliance was achieved by radiologist or technologist verbal communication of findings and recommendations. Direct communication by the radiologist did not increase compliance compared with communication by a technologist. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Digital Breast Tomosynthesis Practice Patterns Following 2011 FDA Approval: A Survey of Breast Imaging Radiologists.

Science.gov (United States)

Gao, Yiming; Babb, James S; Toth, Hildegard K; Moy, Linda; Heller, Samantha L

2017-08-01

To evaluate uptake, patterns of use, and perception of digital breast tomosynthesis (DBT) among practicing breast radiologists. Institutional Review Board exemption was obtained for this Health Insurance Portability and Accountability Act-compliant electronic survey, sent to 7023 breast radiologists identified via the Radiological Society of North America database. Respondents were asked of their geographic location and practice type. DBT users reported length of use, selection criteria, interpretive sequences, recall rate, and reading time. Radiologist satisfaction with DBT as a diagnostic tool was assessed (1-5 scale). There were 1156 (16.5%) responders, 65.8% from the United States and 34.2% from abroad. Of these, 749 (68.6%) use DBT; 22.6% in academia, 56.5% private, and 21% other. Participants are equally likely to report use of DBT if they worked in academics versus in private practice (78.2% [169 of 216] vs 71% [423 of 596]) (odds ratio, 1.10; 95% confidence interval: 0.87-1.40; P = 1.000). Of nonusers, 43% (147 of 343) plan to adopt DBT. No US regional differences in uptake were observed (P = 1.000). Although 59.3% (416 of 702) of DBT users include synthetic 2D (s2D) for interpretation, only 24.2% (170 of 702) use s2D alone. Majority (66%; 441 of 672) do not perform DBT-guided procedures. Radiologist (76.6%) (544 of 710) satisfaction with DBT as a diagnostic tool is high (score ≥ 4/5). DBT is being adopted worldwide across all practice types, yet variations in examination indication, patient selection, utilization of s2D images, and access to DBT-guided procedures persist, highlighting the need for consensus and standardization. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Variations in management of mild prenatal hydronephrosis among maternal-fetal medicine obstetricians, and pediatric urologists and radiologists.

Science.gov (United States)

Zanetta, Vitor C; Rosman, Brian M; Bromley, Bryan; Shipp, Thomas D; Chow, Jeanne S; Campbell, Jeffrey B; Herndon, C D Anthony; Passerotti, Carlo C; Cendron, Marc; Retik, Alan B; Nguyen, Hiep T

2012-11-01

There are no current guidelines for diagnosing and managing mild prenatal hydronephrosis. Variations in physician approach make it difficult to analyze outcomes and establish optimal management. We determined the variability of diagnostic approach and management regarding prenatal hydronephrosis among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists. Online surveys were sent to mailing lists for national societies for each specialty. Participants were surveyed regarding criteria for diagnosing mild prenatal hydronephrosis and recommendations for postnatal management, including use of antibiotic prophylaxis, followup scheduling and type of followup imaging. A total of 308 maternal-fetal medicine obstetricians, 126 pediatric urologists and 112 pediatric radiologists responded. Pediatric urologists and radiologists were divided between Society for Fetal Urology criteria and use of anteroposterior pelvic diameter for diagnosis, while maternal-fetal medicine obstetricians preferred using the latter. For postnatal evaluation radiologists preferred using personal criteria, while urologists preferred using anteroposterior pelvic diameter or Society for Fetal Urology grading system. There was wide variation in the use of antibiotic prophylaxis among pediatric urologists. Regarding the use of voiding cystourethrography/radionuclide cystography in patients with prenatal hydronephrosis, neither urologists nor radiologists were consistent in their recommendations. Finally, there was no agreement on length of followup for mild prenatal hydronephrosis. We observed a lack of uniformity regarding grading criteria in diagnosing hydronephrosis prenatally and postnatally among maternal-fetal medicine obstetricians, pediatric urologists and pediatric radiologists. There was also a lack of agreement on the management of mild intermittent prenatal hydronephrosis, resulting in these cases being managed inconsistently. A unified set of guidelines for

Radiologists' leading position in image-guided therapy.

Science.gov (United States)

Helmberger, Thomas; Martí-Bonmatí, Luis; Pereira, Philippe; Gillams, Alice; Martínez, Jose; Lammer, Johannes; Malagari, Katarina; Gangi, Afshin; de Baere, Thierry; Adam, E Jane; Rasch, Coen; Budach, Volker; Reekers, Jim A

2013-02-01

Image-guided diagnostic and therapeutic procedures are related to, or performed under, some kind of imaging. Such imaging may be direct inspection (as in open surgery) or indirect inspection as in endoscopy or laparoscopy. Common to all these techniques is the transformation of optical and visible information to a monitor or the eye of the operator. Image-guided therapy (IGT) differs by using processed imaging data acquired before, during and after a wide range of different imaging techniques. This means that the planning, performing and monitoring, as well as the control of the therapeutic procedure, are based and dependent on the "virtual reality" provided by imaging investigations. Since most of such imaging involves radiology in the broadest sense, there is a need to characterise IGT in more detail. In this paper, the technical, medico-legal and medico-political issues will be discussed. The focus will be put on state-of-the-art imaging, technical developments, methodological and legal requisites concerning radiation protection and licensing, speciality-specific limitations and crossing specialty borders, definition of technical and quality standards, and finally to the issue of awareness of IGT within the medical and public community. The specialty-specific knowledge should confer radiologists with a significant role in the overall responsibility for the imaging-related processes in various non-radiological specialties. These processes may encompass purchase, servicing, quality management, radiation protection and documentation, also taking responsibility for the definition and compliance with the legal requirements regarding all radiological imaging performed by non-radiologists.

Software Aids for radiologists: Part 1, Useful Photoshop skills.

Science.gov (United States)

Gross, Joel A; Thapa, Mahesh M

2012-12-01

The purpose of this review is to describe the use of several essential techniques and tools in Adobe Photoshop image-editing software. The techniques shown expand on those previously described in the radiologic literature. Radiologists, especially those with minimal experience with image-editing software, can quickly apply a few essential Photoshop tools to minimize the frustration that can result from attempting to navigate a complex user interface.

SmArT solving : Tools and techniques for satisfiability solvers

NARCIS (Netherlands)

Heule, M.J.H.

2008-01-01

The satisfiability problem (Sat) lies at the core of the complexity theory. This is a decision problem: Not the solution itself, but whether or not a solution exists given a specified set of requirements is the central question. Over the years, the satisfiability problem has taken center stage as a

Breast cancer staging: the role of the radiologist

International Nuclear Information System (INIS)

Trop, I.; David, J.; Lalonde, L.

2005-01-01

The role of the breast radiologist has evolved over the past years, with an increasing involvement in patient care. Improvements in diagnostic technology and surgical techniques allow for better preoperative staging and surgeries with decreased morbidity. This article reviews the elements of investigation that are important to the surgeon and oncologist in optimizing care for the newly diagnosed breast cancer patient, with the 6th edition of the TNM classification of the American Joint Committee on Cancer used as a reference. (author)

Current opinion on clip placement after breast biopsy: A survey of practising radiologists in France and Quebec

International Nuclear Information System (INIS)

Thomassin-Naggara, I.; Jalaguier-Coudray, A.; Chopier, J.; Tardivon, A.; Trop, I.

2013-01-01

Aim: To investigate current practice regarding clip placement after breast biopsy. Materials and methods: In June 2011, an online survey instrument was designed using an Internet-based survey site ( (www.surveymonkey.com)) to assess practices and opinions of breast radiologists regarding clip placement after breast biopsy. Radiologists were asked to give personal practice data, describe their current practice regarding clip deployment under stereotactic, ultrasonographic, and magnetic resonance imaging (MRI) guidance, and describe what steps are taken to ensure quality control with regards to clip deployment. Results: The response rate was 29.9% in France (131 respondents) and 46.7% in Quebec (50 respondents). The great majority of respondents used breast markers in their practice (92.1% in France and 96% in Quebec). In both countries, most reported deploying a clip after percutaneous biopsy under stereotactic or MRI guidance. Regarding clip deployment under ultrasonography, 38% of Quebec radiologists systematically placed a marker after each biopsy, whereas 30% of French radiologists never placed a marker in this situation, mainly due to its cost. Finally, 56.4% of radiologists in France and 54% in Quebec considered that their practice regarding clip deployment after breast percutaneous biopsy had changed in the last 5 years. Conclusion: There continues to be variations in the use of biopsy clips after imaging-guided biopsies, particularly with regards to sonographic techniques. These variations are likely to decrease over time, with the standardization of relatively new investigation protocols

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

Science.gov (United States)

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

2018-05-01

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

The impact of radiologists' expertise on screen results decisions in a CT lung cancer screening trial

International Nuclear Information System (INIS)

Heuvelmans, Marjolein A.; Vliegenthart, Rozemarijn; Oudkerk, Matthijs; Jong, Pim A. de; Mali, Willem P.; Groen, Harry J.M.

2015-01-01

To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial. In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule's volume. The protocol allowed radiologists to manually adjust screen results in cases of high suspicion of benign or malignant nodule nature. Participants whose baseline CT result was based on a solid or part-solid nodule were included in this study. Adjustments by radiologists at baseline were evaluated. Histology was the reference for diagnosis or to confirm benignity and stability on subsequent CT examinations. A total of 3,318 participants (2,796 male, median age 58.0 years) were included. In 195 participants (5.9 %) the initial baseline screen result was adjusted by the radiologist. Adjustment was downwards from positive or indeterminate to negative in two and 119 participants, respectively, and from positive to indeterminate in 65 participants. None of these nodules turned out to be malignant. In 9/195 participants (4.6 %) the screen result was adjusted upwards from negative to indeterminate or indeterminate to positive; two nodules were malignant. In one in 20 cases of baseline lung cancer screening, nodules were reclassified by the radiologist, leading to a reduction of false-positive screen results. (orig.)

Health issues and the practicing radiologist: defining concepts and developing recommendations for leave options and policies.

Science.gov (United States)

Heilbrun, Marta E; Bender, Claire E; Truong, Hang B; Bluth, Edward I

2013-09-01

Radiologists today are faced with the challenges of maintaining and balancing individual and family health needs and the demands of the workplace. To provide the highest quality and safest care of our patients, a corresponding ethos of support for a healthy workforce is required. There is a paucity of targeted information describing protections for and maintenance of the health of the practicing radiologist, in both private and academic settings. However, a review of existing family and medical leave policies may be helpful to practice leaders and practicing radiologists as a platform for the development of strategic workforce plans. This writing, by members of the ACR Commission on Human Resources, addresses the following areas: (1) medical leave, (2) maternity and/or paternity leave, and (3) disability. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Li, Feng

2015-07-01

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

Is the application of CAD useful for radiologists for passing the official tests required for outpatient breast imaging?

International Nuclear Information System (INIS)

Malich, A.; Beier, A.; Gorna, R.; Bank, P.

2007-01-01

Purpose: to analyze whether currently available CAD systems meet the diagnostic requirements for passing screening tests (first reader CAD) and to analyze whether the additional usage of CAD systems provides significant support for the diagnosing radiologist on the basis of official screening test cases (second reading by CAD). Material and methods: 200 images of 100 mammographies of 50 patients of an official screening test case collection were analyzed double-blind with and without CAD printouts (iCAD, U.S.A.) by three radiologists: one experienced in breast analysis and CAD application, one experienced in mammography analysis but inexperienced in CAD usage, one with minimal experience with breast analysis and CAD application. All radiologists measured the largest diameter of any malignant mass. The mean value of these calculations was correlated to the largest diameter given by CAD prompts. Results: the mean sensitivity and specificity increased slightly as a result of the additional usage of CAD (1 and 0.6%, resp.). Both values are not statistically significant. The highest effect was measured for the radiologist with CAD experience, while no effect was measured for the inexperienced radiologist. CAD met the sensitivity requirements but not the specificity criteria (96 and 20.3%, resp.). The sizes given by CAD prompts corresponded significantly with the real sizes (r = 0.45, p < 0.05). (orig.)

The Response of Corporate Dividend Policy to The Abolition of Tax Credit in the United Kingdom (U.K.

Directory of Open Access Journals (Sweden)

Hardo Basuki

2007-06-01

This study also investigates whether individual U.K. companies respond to the 1997 abolition of tax-credit. The test results show that the majority of companies in the sample do not change their dividend policies after the abolition of tax credit. It is possible that companies are reluctant to cut their dividend payment since the existing dividend payout could be sustained in the long-run. They also avoid sending negative signals to the market. Thus, companies typically chose to keep a dividend level relatively stable following the tax change in 1997. Only the minority of the U.K. companies experience a decline in their dividend payment. This evidence supports the hypothesis that the abolition of tax credit on dividends results in a decrease in aggregate dividend payment in order to satisfy a tax clientele.

Shielding effect of lead glasses on radiologists' eye lens exposure in interventional procedures

International Nuclear Information System (INIS)

Hu, Panpan; Kong, Yan; Chen, Bo; Liu, Qianqian; Zhuo, Weihai; Liu, Haikuan

2017-01-01

To study the shielding effect of radiologists' eye lens with lead glasses of different equivalent thicknesses and sizes in interventional radiology procedures. Using the human voxel phantom with a more accurate model of the eye and MCNPX software, eye lens doses of the radiologists who wearing different kinds of lead glasses were simulated, different beam projections were taken into consideration during the simulation. Measurements were also performed with the physical model to verify simulation results. Simulation results showed that the eye lens doses were reduced by a factor from 3 to 9 when wearing a 20 cm"2-sized lead glasses with the equivalent thickness ranging from 0.1 to 1.0 mm Pb. The increase of dose reduction factor (DRF) was not significant whenever increase the lead equivalent of glasses of which larger than 0.35 mm. Furthermore, the DRF was proportional to the size of glass lens from 6 to 30 cm"2 with the same lead equivalent. The simulation results were in well agreements with the measured ones. For more reasonable and effective protection of the eye lens of interventional radiologists, a pair of glasses with a lead equivalent of 0.5 mm Pb and large-sized (at least 27 cm"2 per glass) lens are recommended (authors)

Magnetic resonance imaging and magnetic resonance arthrography of the shoulder: dependence on the level of training of the performing radiologist for diagnostic accuracy

Energy Technology Data Exchange (ETDEWEB)

Theodoropoulos, John S. [University of Toronto, Division of Orthopaedics, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); Andreisek, Gustav [University of Toronto, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto, ON (Canada); University Hospital Zuerich, Institute for Diagnostic Radiology, Zuerich (Switzerland); Harvey, Edward J. [McGill University, Division of Orthopaedics, MUHC - Montreal General Hospital, Montreal, Quebec (Canada); Wolin, Preston [Center for Athletic Medicine, Chicago, IL (United States)

2010-07-15

Discrepancies were identified between magnetic resonance (MR) imaging and clinical findings in patients who had MR imaging examinations evaluated by community-based general radiologists. The purpose of this study was to evaluate the diagnostic performance of MR imaging examinations of the shoulder with regard to the training level of the performing radiologist. A review of patient charts identified 238 patients (male/female, 175/63; mean age, 40.4 years) in whom 250 arthroscopies were performed and who underwent MR imaging or direct MR arthrography in either a community-based or hospital-based institution prior to surgery. All MR imaging and surgical reports were reviewed and the diagnostic performance for the detection of labral, rotator cuff, biceps, and Hill-Sachs lesions was determined. Kappa and Student's t test analyses were performed in a subset of cases in which initial community-based MR images were re-evaluated by hospital-based musculoskeletal radiologists, to determine the interobserver agreement and any differences in image interpretation. The diagnostic performance of community-based general radiologists was lower than that of hospital-based sub-specialized musculoskeletal radiologists. A sub-analysis of re-evaluated cases showed that musculoskeletal radiologists performed better. {kappa} values were 0.208, 0.396, 0.376, and 0.788 for labral, rotator cuff, biceps, and Hill-Sachs lesions (t test statistics: p =<0.001, 0.004, 0.019, and 0.235). Our results indicate that the diagnostic performance of MR imaging and MR arthrography of the shoulder depends on the training level of the performing radiologist, with sub-specialized musculoskeletal radiologists having a better diagnostic performance than general radiologists. (orig.)

A survey of radiology reporting practices in veterinary teaching hospitals

International Nuclear Information System (INIS)

Adams, W.M.

1998-01-01

Radiologists from 28 veterinary schools and one private teaching hospital responded to a survey questionnaire focused on diagnostic image reporting. Radiologists at 26 hospitals generated a hard copy report on essentially all imaging studies performed. At 25 hospitals, radiologists dictated and transcriptionists typed all or most reports; radiologists at two institutions typed all or some of their reports. At five hospitals, preliminary and/or final handwritten reports were generated. The range of reports generated per day was <10 to 40 per radiologist on duty. Seven respondents generated reports as films came from the processor and another 12 routinely generated reports the day the studies were completed. Clinician access to a processed report averaged 2 to 4 days after study was completed (reported range: several hours to 7 or more days). Fifteen responding radiologists personally mounted films from storage jackets for a majority of their reporting. Fourteen respondents generated reports from films mounted on motorized or stationary viewers. Nineteen respondents generated reports in a busy viewing area where they were frequently interrupted. Radiologists' impression of clinician and resident satisfaction regarding availability of radiology reports was that they were satisfied or very satisfied at 15 of the 29 hospitals. Five respondents reported that clinicians and residents were not concerned about availability of processed radiology reports. Thirteen radiologists were planning to change their reporting method within the next 2 years. The change most frequently sought (12 respondents) was to decrease turn-around time of reports. Ten radiologists indicated an interest in trying a voice recognition dictation system. The most common reasons given for not planning any changes in radiology reporting in the next 2 years were: limited number of radiologists (8) and 1 ''satisfied as is'' (7). Turn-around of radiology reports at these veterinary institutions averaged 2

Dose reduction - the radiologist's view

International Nuclear Information System (INIS)

Russell, J.G.B.

1984-01-01

The magnitude of the exposure to ionising radiation dominates radiological practice in only three fields, i.e. foetal radiography, mammography and computed tomography. The balance between risk and benefit are briefly examined. The types of hazard considered are carcinogenesis, genetic injury and organogenesis. Ways of achieving a reduction of the dose to the patient are also briefly discussed. (U.K.)

Value-Based Assessment of Radiology Reporting Using Radiologist-Referring Physician Two-Way Feedback System-a Design Thinking-Based Approach.

Science.gov (United States)

Shaikh, Faiq; Hendrata, Kenneth; Kolowitz, Brian; Awan, Omer; Shrestha, Rasu; Deible, Christopher

2017-06-01

In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study. These new dimensions of value measurement will directly impact the cascade of further medical management. We share our continued experience with this project that had two components: RESP (Referrer Evaluation System Pilot) and FRACI (Feedback from Radiologist Addressing Confounding Issues), which were introduced to the clinical radiology workflow in order to capture referrer-based and radiologist-based feedback on radiology reporting. We also share our insight into the principles of design thinking as applied in its planning and execution.

Inter-radiologist agreement for CT scoring of pediatric splenic injuries and effect on an established clinical practice guideline.

Science.gov (United States)

Leschied, Jessica R; Mazza, Michael B; Davenport, Matthew; Chong, Suzanne T; Smith, Ethan A; Hoff, Carrie N; Ladino-Torres, Maria F; Khalatbari, Shokoufeh; Ehrlich, Peter F; Dillman, Jonathan R

2016-02-01

The American Pediatric Surgical Association (APSA) advocates for the use of a clinical practice guideline to direct management of hemodynamically stable pediatric spleen injuries. The clinical practice guideline is based on the CT score of the spleen injury according to the American Association for the Surgery of Trauma (AAST) CT scoring system. To determine the potential effect of radiologist agreement for CT scoring of pediatric spleen injuries on an established APSA clinical practice guideline. We retrospectively analyzed blunt splenic injuries occurring in children from January 2007 to January 2012 at a single level 1 trauma center (n = 90). Abdominal CT exams performed at clinical presentation were reviewed by four radiologists who documented the following: (1) splenic injury grade (AAST system), (2) arterial extravasation and (3) pseudoaneurysm. Inter-rater agreement for AAST injury grade was assessed using the multi-rater Fleiss kappa and Kendall coefficient of concordance. Inter-rater agreement was assessed using weighted (AAST injury grade) or prevalence-adjusted bias-adjusted (binary measures) kappa statistics; 95% confidence intervals were calculated. We evaluated the hypothetical effect of radiologist disagreement on an established APSA clinical practice guideline. Inter-rater agreement was good for absolute AAST injury grade (kappa: 0.64 [0.59–0.69]) and excellent for relative AAST injury grade (Kendall w: 0.90). All radiologists agreed on the AAST grade in 52% of cases. Based on an established clinical practice guideline, radiologist disagreement could have changed the decision for intensive care management in 11% (10/90) of children, changed the length of hospital stay in 44% (40/90), and changed the time to return to normal activity in 44% (40/90). Radiologist agreement when assigning splenic AAST injury grades is less than perfect, and disagreements have the potential to change management in a substantial number of pediatric patients.

Inter-radiologist agreement for CT scoring of pediatric splenic injuries and effect on an established clinical practice guideline

International Nuclear Information System (INIS)

Leschied, Jessica R.; Smith, Ethan A.; Ladino-Torres, Maria F.; Dillman, Jonathan R.; Mazza, Michael B.; Chong, Suzanne T.; Hoff, Carrie N.; Davenport, Matthew S.; Khalatbari, Shokoufeh; Ehrlich, Peter F.

2016-01-01

The American Pediatric Surgical Association (APSA) advocates for the use of a clinical practice guideline to direct management of hemodynamically stable pediatric spleen injuries. The clinical practice guideline is based on the CT score of the spleen injury according to the American Association for the Surgery of Trauma (AAST) CT scoring system. To determine the potential effect of radiologist agreement for CT scoring of pediatric spleen injuries on an established APSA clinical practice guideline. We retrospectively analyzed blunt splenic injuries occurring in children from January 2007 to January 2012 at a single level 1 trauma center (n = 90). Abdominal CT exams performed at clinical presentation were reviewed by four radiologists who documented the following: (1) splenic injury grade (AAST system), (2) arterial extravasation and (3) pseudoaneurysm. Inter-rater agreement for AAST injury grade was assessed using the multi-rater Fleiss kappa and Kendall coefficient of concordance. Inter-rater agreement was assessed using weighted (AAST injury grade) or prevalence-adjusted bias-adjusted (binary measures) kappa statistics; 95% confidence intervals were calculated. We evaluated the hypothetical effect of radiologist disagreement on an established APSA clinical practice guideline. Inter-rater agreement was good for absolute AAST injury grade (kappa: 0.64 [0.59-0.69]) and excellent for relative AAST injury grade (Kendall w: 0.90). All radiologists agreed on the AAST grade in 52% of cases. Based on an established clinical practice guideline, radiologist disagreement could have changed the decision for intensive care management in 11% (10/90) of children, changed the length of hospital stay in 44% (40/90), and changed the time to return to normal activity in 44% (40/90). Radiologist agreement when assigning splenic AAST injury grades is less than perfect, and disagreements have the potential to change management in a substantial number of pediatric patients. (orig.)

Inter-radiologist agreement for CT scoring of pediatric splenic injuries and effect on an established clinical practice guideline

Energy Technology Data Exchange (ETDEWEB)

Leschied, Jessica R.; Smith, Ethan A.; Ladino-Torres, Maria F.; Dillman, Jonathan R. [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Mazza, Michael B.; Chong, Suzanne T.; Hoff, Carrie N. [University of Michigan Health System, Department of Radiology, Division of Emergency Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Davenport, Matthew S. [University of Michigan Health System, Department of Radiology, Division of Abdominal Imaging, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Khalatbari, Shokoufeh [University of Michigan, Michigan Institute for Clinical and Health Research, Ann Arbor, MI (United States); Ehrlich, Peter F. [University of Michigan Health System, Department of Surgery, Section of Pediatric Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States)

2016-02-15

The American Pediatric Surgical Association (APSA) advocates for the use of a clinical practice guideline to direct management of hemodynamically stable pediatric spleen injuries. The clinical practice guideline is based on the CT score of the spleen injury according to the American Association for the Surgery of Trauma (AAST) CT scoring system. To determine the potential effect of radiologist agreement for CT scoring of pediatric spleen injuries on an established APSA clinical practice guideline. We retrospectively analyzed blunt splenic injuries occurring in children from January 2007 to January 2012 at a single level 1 trauma center (n = 90). Abdominal CT exams performed at clinical presentation were reviewed by four radiologists who documented the following: (1) splenic injury grade (AAST system), (2) arterial extravasation and (3) pseudoaneurysm. Inter-rater agreement for AAST injury grade was assessed using the multi-rater Fleiss kappa and Kendall coefficient of concordance. Inter-rater agreement was assessed using weighted (AAST injury grade) or prevalence-adjusted bias-adjusted (binary measures) kappa statistics; 95% confidence intervals were calculated. We evaluated the hypothetical effect of radiologist disagreement on an established APSA clinical practice guideline. Inter-rater agreement was good for absolute AAST injury grade (kappa: 0.64 [0.59-0.69]) and excellent for relative AAST injury grade (Kendall w: 0.90). All radiologists agreed on the AAST grade in 52% of cases. Based on an established clinical practice guideline, radiologist disagreement could have changed the decision for intensive care management in 11% (10/90) of children, changed the length of hospital stay in 44% (40/90), and changed the time to return to normal activity in 44% (40/90). Radiologist agreement when assigning splenic AAST injury grades is less than perfect, and disagreements have the potential to change management in a substantial number of pediatric patients. (orig.)

A Geometric Presentation of Probabilistic Satisfiability

OpenAIRE

Morales-Luna, Guillermo

2010-01-01

By considering probability distributions over the set of assignments the expected truth values assignment to propositional variables are extended through linear operators, and the expected truth values of the clauses at any given conjunctive form are also extended through linear maps. The probabilistic satisfiability problems are discussed in terms of the introduced linear extensions. The case of multiple truth values is also discussed.

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

Science.gov (United States)

G Pitman, Alexander

2017-06-01

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

Physicians, radiologists, and quality control

International Nuclear Information System (INIS)

Payne, W.F.

1973-01-01

Factors involved in quality control in medical x-ray examinations to achieve the least possible exposure to the patient are discussed. It would be hoped that film quality will remain in the position of paramount importance that it must in order to achieve the greatest amount of diagnostic information on each radiographic examination. At the same time, it is hoped that this can be done by further reducing the exposure of the patient to ionizing radiation by the methods that have been discussed; namely, education of the physician, radiologist, and technologist, modern protective equipment and departmental construction, efficient collimation whether automatic or manual, calibration and output measurement of the radiographic and fluoroscopic units, ongoing programs of education within each department of radiographic facility, film badge monitoring, education of and cooperation with the nonradiologic physician, and hopefully, more intensive programs by the National and State Bureaus and Departments of Radiological Health in education and encouragement to the medical community. (U.S.)

Neonatal ischemic brain injury: what every radiologist needs to know

International Nuclear Information System (INIS)

Badve, Chaitra A.; Khanna, Paritosh C.; Ishak, Gisele E.

2012-01-01

We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist's perspective. The concept of perinatal stroke is defined and its distinction from hypoxic-ischemic injury is emphasized. A brief review of recent imaging advances is included and a diagnostic approach to neonatal ischemic brain injury is suggested. (orig.)

Is Value-Driven Health Care an Unfunded Mandate for Radiologists?

Science.gov (United States)

McGinty, Geraldine

2016-02-01

The goals of the 2010 Patient Protection and Affordable Care Act (ACA) can be summed up by the Triple Aim, as defined by the Institute for Healthcare Improvement: Improve population health, optimize the patient experience, and reduce the costs of care. Despite recent reimbursement reductions, radiologists have increasing opportunities to participate in value-based payment programs and should leverage those opportunities.

Neonatal ischemic brain injury: what every radiologist needs to know

Energy Technology Data Exchange (ETDEWEB)

Badve, Chaitra A.; Khanna, Paritosh C.; Ishak, Gisele E. [Seattle Children' s Hospital, University of Washington Medical Center, Department of Radiology, Seattle, WA (United States)

2012-05-15

We present a pictorial review of neonatal ischemic brain injury and look at its pathophysiology, imaging features and differential diagnoses from a radiologist's perspective. The concept of perinatal stroke is defined and its distinction from hypoxic-ischemic injury is emphasized. A brief review of recent imaging advances is included and a diagnostic approach to neonatal ischemic brain injury is suggested. (orig.)

Career destinations, views and future plans of the UK medical qualifiers of 1988.

Science.gov (United States)

Taylor, Kathryn; Lambert, Trevor; Goldacre, Michael

2010-01-01

To report the career destinations, views and future plans of a cohort of senior doctors who qualified in the 1980s. Postal questionnaire survey of all doctors who qualified from all UK medical schools in 1988. The response rate was 69%. We estimated that 81% of the total cohort was working in the NHS, 16 years after qualification; and that at least 94% of graduates who, when students, were from UK homes, were working in medicine. Of NHS doctors, 30% worked part-time. NHS doctors rated their job satisfaction highly (median score 19.9, scale 5-25) but were less satisfied with the amount of leisure time available to them (median score 5.4, scale 1-10). NHS doctors were very positive about their careers, but were less positive about working hours and some other aspects of the NHS. Women were more positive than men about working conditions; general practitioners were more positive than hospital doctors. Twenty-five percent reported unmet needs for further training or career-related advice, particularly about career development. Twenty-nine percent intended to reduce their hours in future, while 6%, mainly part-time women, planned to increase their hours. Overall, 10% of NHS doctors planned to do more service work in future and 24% planned to do less; among part-time women, 18% planned to do more and only 14% less. These NHS doctors, now in their 40s, had a high level of satisfaction with their jobs and their careers but were less satisfied with some other aspects of their working environment. A substantial percentage had expectations about future career development and change.

Interobserver agreement of radiologists assessing the response of rectal cancers to preoperative chemoradiation using the MRI tumour regression grading (mrTRG)

International Nuclear Information System (INIS)

Siddiqui, M.R.S.; Gormly, K.L.; Bhoday, J.; Balyansikova, S.; Battersby, N.J.; Chand, M.; Rao, S.; Tekkis, P.; Abulafi, A.M.; Brown, G.

2016-01-01

Aim: To investigate whether the magnetic resonance imaging (MRI) tumour regression grading (mrTRG) scale can be taught effectively resulting in a clinically reasonable interobserver agreement (>0.4; moderate to near perfect agreement). Materials and methods: This study examines the interobserver agreement of mrTRG, between 35 radiologists and a central reviewer. Two workshops were organised for radiologists to assess regression of rectal cancers on MRI staging scans. A range of mrTRGs on 12 patient scans were used for assessment. Results: Kappa agreement ranged from 0.14–0.82 with a median value of 0.57 (95% CI: 0.37–0.77) indicating good overall agreement. Eight (26%) radiologists had very good/near perfect agreement (κ>0.8). Six (19%) radiologists had good agreement (0.8≥κ>0.6) and a further 12 (39%) had moderate agreement (0.6≥κ>0.4). Five (16%) radiologists had a fair agreement (0.4≥κ>0.2) and two had poor agreement (0.2>κ). There was a tendency towards good agreement (skewness: 0.92). In 65.9% and 90% of cases the radiologists were able to correctly highlight good and poor responders, respectively. Conclusions: The assessment of the response of rectal cancers to chemoradiation therapy may be performed effectively using mrTRG. Radiologists can be taught the mrTRG scale. Even with minimal training, good agreement with the central reviewer along with effective differentiation between good and intermediate/poor responders can be achieved. Focus should be on facilitating the identification of good responders. It is predicted that with more intensive interactive case-based learning a κ>0.8 is likely to be achieved. Testing and retesting is recommended. - Highlights: • Inter-observer agreement of radiologists was assessed using MRI rectal tumour regression scale. • Kappa agreement had a median value of 0.57 (95% CI: 0.37–0.77) indicating an overall good agreement. • In 65.9% and 90% of cases the radiologists were able to correctly highlight

Effect of radiologist experience on the risk of false-positive results in breast cancer screening programs

Energy Technology Data Exchange (ETDEWEB)

Zubizarreta Alberdi, Raquel [Galician Breast Cancer Screening Programme, Public Health and Planning Directorate, Health Office, Galicia (Spain); Edificio Administrativo da Conselleria de Sanidade, Servicio de Programas Poboacionais de Cribado, Direccion Xeral de Saude Publica e Planificacion, Santiago de Compostela, Galicia (Spain); Llanes, Ana B.F.; Ortega, Raquel Almazan [Galician Breast Cancer Screening Programme, Public Health and Planning Directorate, Health Office, Galicia (Spain); Exposito, Ruben Roman; Collado, Jose M.V.; Oliveres, Xavier Castells [Department of Epidemiology and Evaluation, Institut Municipal d' Investigacio Medica-Parc de Salut Mar. CIBERESP, Barcelona (Spain); Queiro Verdes, Teresa [Galician Agency for Health Technology Assessment, Public Health and Planning Directorate, Health Office, Galicia (Spain); Natal Ramos, Carmen [Principality of Asturias Breast Cancer Screening Programme, Principality of Asturias (Spain); Sanz, Maria Ederra [Public Health Institute, Navarra Breast Cancer Screening Programme, Pamplona (Spain); Salas Trejo, Dolores [General Directorate Public Health and Centre for Public Health Research (CSISP), Valencia Breast Cancer Screening Programme, Valencia (Spain)

2011-10-15

To evaluate the effect of radiologist experience on the risk of false-positive results in population-based breast cancer screening programmes. We evaluated 1,440,384 single-read screening mammograms, corresponding to 471,112 women aged 45-69 years participating in four Spanish programmes between 1990 and 2006. The mammograms were interpreted by 72 radiologists. The overall percentage of false-positive results was 5.85% and that for false-positives resulting in an invasive procedure was 0.38%. Both the risk of false-positives overall and of false-positives leading to an invasive procedure significantly decreased (p < 0.001) with greater reading volume in the previous year: OR 0.77 and OR 0.78, respectively, for a reading volume 500-1,999 mammograms and OR 0.59 and OR 0.60 for a reading volume of >14,999 mammograms with respect to the reference category (<500). The risk of both categories of false-positives was also significantly reduced (p < 0.001) as radiologists' years of experience increased: OR 0.96 and OR 0.84, respectively, for 1 year's experience and OR 0.72 and OR 0.73, respectively, for more than 4 years' experience with regard to the category of <1 year's experience. Radiologist experience is a determining factor in the risk of a false-positive result in breast cancer screening. (orig.)

Management of patient dose in radiology in the UK

International Nuclear Information System (INIS)

Martin, C. J.

2011-01-01

Programmes to manage patient dose in radiology are becoming a higher priority as the number of imaging examinations and the proportion of higher dose computed tomography (CT) and complex interventional procedures all continue to rise. Such programmes have a number of components and their implementation in UK hospitals, which have been developing such programmes over two decades, is described. As part of any programme to manage patient doses, elements should be in place for both justification and optimisation. The system for justification needs to be robust in order to minimise the number of unnecessary procedures and requires the provision of training in radiation protection for medical and other staff to ensure that they understand the risks. Optimisation of X-ray techniques requires performance tests on equipment at installation and regularly thereafter, linked to surveys of patient doses. Confirming the performance of the available options on fluoroscopy and CT equipment is essential and the information obtained should be available to radiographers and radiologists, so they can make informed choices in developing imaging protocols. Patient doses should be compared with diagnostic reference levels set in terms of measured dose quantities to allow the identification of equipment that is giving higher doses. Taking the next step of analysing results to determine the reasons for high doses is crucial and requires a link with the equipment performance tests and an understanding of the underlying physics. Medical physics services play an important role at the hub of the dose management programme for carrying out tests, organising surveys, making recommendations on optimisation strategies and training other staff in radiation protection, performance testing and dose reduction. Programmes for management of patient doses in UK hospitals were first set up in the late 1980's by medical physicists and have been developed since that time to keep pace with the developments in

Improved cancer detection in automated breast ultrasound by radiologists using Computer Aided Detection

International Nuclear Information System (INIS)

Zelst, J.C.M. van; Tan, T.; Platel, B.; Jong, M. de; Steenbakkers, A.; Mourits, M.; Grivegnee, A.; Borelli, C.; Karssemeijer, N.; Mann, R.M.

2017-01-01

Objective: To investigate the effect of dedicated Computer Aided Detection (CAD) software for automated breast ultrasound (ABUS) on the performance of radiologists screening for breast cancer. Methods: 90 ABUS views of 90 patients were randomly selected from a multi-institutional archive of cases collected between 2010 and 2013. This dataset included normal cases (n = 40) with >1 year of follow up, benign (n = 30) lesions that were either biopsied or remained stable, and malignant lesions (n = 20). Six readers evaluated all cases with and without CAD in two sessions. CAD-software included conventional CAD-marks and an intelligent minimum intensity projection of the breast tissue. Readers reported using a likelihood-of-malignancy scale from 0 to 100. Alternative free-response ROC analysis was used to measure the performance. Results: Without CAD, the average area-under-the-curve (AUC) of the readers was 0.77 and significantly improved with CAD to 0.84 (p = 0.001). Sensitivity of all readers improved (range 5.2–10.6%) by using CAD but specificity decreased in four out of six readers (range 1.4–5.7%). No significant difference was observed in the AUC between experienced radiologists and residents both with and without CAD. Conclusions: Dedicated CAD-software for ABUS has the potential to improve the cancer detection rates of radiologists screening for breast cancer.

Improved cancer detection in automated breast ultrasound by radiologists using Computer Aided Detection

Energy Technology Data Exchange (ETDEWEB)

Zelst, J.C.M. van, E-mail: Jan.vanZelst@radboudumc.nl [Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Tan, T.; Platel, B. [Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Jong, M. de [Jeroen Bosch Medical Centre, Department of Radiology, ‘s-Hertogenbosch (Netherlands); Steenbakkers, A. [Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands); Mourits, M. [Jeroen Bosch Medical Centre, Department of Radiology, ‘s-Hertogenbosch (Netherlands); Grivegnee, A. [Jules Bordet Institute, Department of Radiology, Brussels (Belgium); Borelli, C. [Catholic University of the Sacred Heart, Department of Radiological Sciences, Rome (Italy); Karssemeijer, N.; Mann, R.M. [Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen (Netherlands)

2017-04-15

Objective: To investigate the effect of dedicated Computer Aided Detection (CAD) software for automated breast ultrasound (ABUS) on the performance of radiologists screening for breast cancer. Methods: 90 ABUS views of 90 patients were randomly selected from a multi-institutional archive of cases collected between 2010 and 2013. This dataset included normal cases (n = 40) with >1 year of follow up, benign (n = 30) lesions that were either biopsied or remained stable, and malignant lesions (n = 20). Six readers evaluated all cases with and without CAD in two sessions. CAD-software included conventional CAD-marks and an intelligent minimum intensity projection of the breast tissue. Readers reported using a likelihood-of-malignancy scale from 0 to 100. Alternative free-response ROC analysis was used to measure the performance. Results: Without CAD, the average area-under-the-curve (AUC) of the readers was 0.77 and significantly improved with CAD to 0.84 (p = 0.001). Sensitivity of all readers improved (range 5.2–10.6%) by using CAD but specificity decreased in four out of six readers (range 1.4–5.7%). No significant difference was observed in the AUC between experienced radiologists and residents both with and without CAD. Conclusions: Dedicated CAD-software for ABUS has the potential to improve the cancer detection rates of radiologists screening for breast cancer.

The impact of radiologists' expertise on screen results decisions in a CT lung cancer screening trial

Energy Technology Data Exchange (ETDEWEB)

Heuvelmans, Marjolein A.; Vliegenthart, Rozemarijn [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Groningen (Netherlands); University of Groningen / University Medical Center Groningen, Department of Radiology, Groningen (Netherlands); Oudkerk, Matthijs [University of Groningen, University Medical Center Groningen, Center for Medical Imaging - North East Netherlands, Groningen (Netherlands); Jong, Pim A. de; Mali, Willem P. [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Groen, Harry J.M. [University of Groningen, University Medical Center Groningen, Department of Pulmonology, Groningen (Netherlands)

2014-11-04

To evaluate the impact of radiological expertise on screen result decisions in a CT lung cancer screening trial. In the NELSON lung cancer screening trial, the baseline CT result was based on the largest lung nodule's volume. The protocol allowed radiologists to manually adjust screen results in cases of high suspicion of benign or malignant nodule nature. Participants whose baseline CT result was based on a solid or part-solid nodule were included in this study. Adjustments by radiologists at baseline were evaluated. Histology was the reference for diagnosis or to confirm benignity and stability on subsequent CT examinations. A total of 3,318 participants (2,796 male, median age 58.0 years) were included. In 195 participants (5.9 %) the initial baseline screen result was adjusted by the radiologist. Adjustment was downwards from positive or indeterminate to negative in two and 119 participants, respectively, and from positive to indeterminate in 65 participants. None of these nodules turned out to be malignant. In 9/195 participants (4.6 %) the screen result was adjusted upwards from negative to indeterminate or indeterminate to positive; two nodules were malignant. In one in 20 cases of baseline lung cancer screening, nodules were reclassified by the radiologist, leading to a reduction of false-positive screen results. (orig.)

The vascular surgery workforce: a survey of consultant vascular surgeons in the UK, 2014.

Science.gov (United States)

Harkin, D W; Beard, J D; Shearman, C P; Wyatt, M G

2015-04-01

The purpose of this study was to describe the demographics, training, and practice characteristics of consultant vascular surgeons across the UK to provide an assessment of current, and inform future prediction of workforce needs. A questionnaire was developed using a modified Delphi process to generate questionnaire items. The questionnaire was emailed to all consultant vascular surgeons (n = 450) in the UK who were members of the Vascular Society of Great Britain & Ireland. 352 consultant vascular surgeons from 95 hospital trusts across the UK completed the survey (78% response rate). The mean age was 50.6 years old, the majority (62%) were mid-career, but 24% were above the age of 55. Currently, 92% are men and only 8% women. 93% work full-time, with 60% working >50 hours, and 21% working >60 hours per week. The average team was 5 to 6 (range 2-10) vascular surgeons, with 23% working in a large team of ≥8. 17% still work in small teams of ≤3. Over 90% of consultant vascular surgeons perform the major index vascular surgery procedures (aneurysm repair, carotid endarterectomy, infra-inguinal bypass, amputation). While 84% perform standard endovascular abdominal aortic aneurysm repair (EVAR), <50% perform more complex endovascular aortic therapy. The majority of vascular surgeons "like their job" (85%) and are "satisfied" (69%) with their job. 34% of consultant vascular surgeons indicated they were "extremely likely" to retire within the next 10 years. This study provides the first detailed analysis of the new specialty of vascular surgery as practiced in the UK. There is a need to plan for a significant expansion in the consultant vascular surgeon workforce in the UK over the next 10 years to maintain the status quo. Copyright © 2014 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

One-Stop Clinic Utilization in Plastic Surgery: Our Local Experience and the Results of a UK-Wide National Survey

Science.gov (United States)

Gorman, Mark; Coelho, James; Gujral, Sameer; McKay, Alastair

2015-01-01

Introduction. “See and treat” one-stop clinics (OSCs) are an advocated NHS initiative to modernise care, reducing cancer treatment waiting times. Little studied in plastic surgery, the existing evidence suggests that though they improve care, they are rarely implemented. We present our experience setting up a plastic surgery OSC for minor skin surgery and survey their use across the UK. Methods. The OSC was evaluated by 18-week wait target compliance, measures of departmental capacity, and patient satisfaction. Data was obtained from 32 of the 47 UK plastic surgery departments to investigate the prevalence of OSCs for minor skin cancer surgery. Results. The OSC improved 18-week waiting times, from a noncompliant mean of 80% to a compliant 95% average. Department capacity increased 15%. 95% of patients were highly satisfied with and preferred the OSC to a conventional service. Only 25% of UK plastic surgery units run OSCs, offering varying reasons for not doing so, 42% having not considered their use. Conclusions. OSCs are underutilised within UK plastic surgery, where a significant proportion of units have not even considered their benefit. This is despite associated improvements in waiting times, department capacity, and levels of high patient satisfaction. We offer our considerations and local experience instituting an OSC service. PMID:26236502

Computed tomography use in minor head injury: attitudes and practices of emergency physicians, neurosurgeons, and radiologists in Turkey.

Science.gov (United States)

Özan, Ebru; Ataç, Gökçe Kaan

2018-03-01

We aimed to determine the attitudes and practices of emergency physicians (EPs), neurosurgeons, and radiologists in Turkey regarding computed tomography (CT) use for adults with minor head injury (MHI). This cross-sectional study was conducted between August 2015 and October 2016 after obtaining the approval of the institutional ethical committee. The purpose of this study was disclosed to the participants prior to beginning the survey. The study was performed conducting a questionnaire via e-mail on three groups of participants including EPs, neurosurgeons, and radiologists. Participants comprised academic staff at university hospitals as well as department chiefs, specialists, and residents working at university, government, and private hospitals, all of whom are in charge of evaluating MHI patients. A total of 607 participants including 201 (33.1%) EPs, 179 (29.5%) neurosurgeons, and 227 (37.4%) radiologists responded to the survey; 31% of the participants reported awareness and 27.3% reported use of head CT rules in MHI. Awareness and use of the rules were most prominent in EPs group, while the lowest rates were observed in radiologists group (pprotection or on patient dose from imaging are the common reasons for this practice pattern.

Radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography

Energy Technology Data Exchange (ETDEWEB)

Brito, Milene Carneiro Barbosa de, E-mail: milenebrito7@gmail.com [Clinica da Imagem do Tocantins, Araguaia, TO (Brazil); Ota, Mauricio Kenji [Fundacao Instituto de Pesquisa e Estudos de Diagnostico por Imagem (FIDI), Sao Paulo, SP (Brazil); Leitao Filho, Fernando Sergio Studart [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Meirelles, Gustavo de Souza Portes [Grupo Fleury, Sao Paulo, SP (Brazil)

2017-01-15

Objective: To evaluate radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography (HRCT). Materials and Methods: The HRCT scans of 43 patients with bronchiectasis were analyzed by two radiologists, who used a scoring system to grade the findings. Kappa (κ) values and overall agreement were calculated. Results: For the measurement and appearance of bronchiectasis, the interobserver agreement was moderate (κ = 0.45 and κ = 0.43, respectively), as was the intraobserver agreement (κ = 0.54 and κ = 0.47, respectively). Agreement on the presence of mucous plugging was fair, for central distribution (overall interobserver agreement of 68.3% and κ = 0.39 for intraobserver agreement) and for peripheral distribution (κ = 0.34 and κ = 0.35 for interobserver and intraobserver agreement, respectively). The agreement was also fair for peri bronchial thickening (κ = 0.21 and κ = 0.30 for interobserver and intraobserver agreement, respectively). There was fair interobserver and intraobserver agreement on the detection of opacities (κ = 0.39 and 71.9%, respectively), ground-glass attenuation (64.3% and κ = 0.24, respectively), and cysts/bullae (κ = 0.47 and κ = 0.44, respectively). Qualitative analysis of the HRCT findings of bronchiectasis and the resulting individual patient scores showed that there was an excellent correlation between the observers (intra class correlation coefficient of 0.85 and 0.81 for interobserver and intraobserver agreement, respectively). Conclusion: In the interpretation of HRCT findings of bronchiectasis, radiologist agreement appears to be fair. In our final analysis of the findings using the proposed score, we observed excellent interobserver and intraobserver agreement. (author)

Radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography

International Nuclear Information System (INIS)

Brito, Milene Carneiro Barbosa de; Ota, Mauricio Kenji; Leitao Filho, Fernando Sergio Studart; Meirelles, Gustavo de Souza Portes

2017-01-01

Objective: To evaluate radiologist agreement on the quantification of bronchiectasis by high-resolution computed tomography (HRCT). Materials and Methods: The HRCT scans of 43 patients with bronchiectasis were analyzed by two radiologists, who used a scoring system to grade the findings. Kappa (κ) values and overall agreement were calculated. Results: For the measurement and appearance of bronchiectasis, the interobserver agreement was moderate (κ = 0.45 and κ = 0.43, respectively), as was the intraobserver agreement (κ = 0.54 and κ = 0.47, respectively). Agreement on the presence of mucous plugging was fair, for central distribution (overall interobserver agreement of 68.3% and κ = 0.39 for intraobserver agreement) and for peripheral distribution (κ = 0.34 and κ = 0.35 for interobserver and intraobserver agreement, respectively). The agreement was also fair for peri bronchial thickening (κ = 0.21 and κ = 0.30 for interobserver and intraobserver agreement, respectively). There was fair interobserver and intraobserver agreement on the detection of opacities (κ = 0.39 and 71.9%, respectively), ground-glass attenuation (64.3% and κ = 0.24, respectively), and cysts/bullae (κ = 0.47 and κ = 0.44, respectively). Qualitative analysis of the HRCT findings of bronchiectasis and the resulting individual patient scores showed that there was an excellent correlation between the observers (intra class correlation coefficient of 0.85 and 0.81 for interobserver and intraobserver agreement, respectively). Conclusion: In the interpretation of HRCT findings of bronchiectasis, radiologist agreement appears to be fair. In our final analysis of the findings using the proposed score, we observed excellent interobserver and intraobserver agreement. (author)

Bladder cancer treatment response assessment with radiomic, clinical, and radiologist semantic features

Science.gov (United States)

Gordon, Marshall N.; Cha, Kenny H.; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Cohan, Richard H.; Caoili, Elaine M.; Paramagul, Chintana; Alva, Ajjai; Weizer, Alon Z.

2018-02-01

We are developing a decision support system for assisting clinicians in assessment of response to neoadjuvant chemotherapy for bladder cancer. Accurate treatment response assessment is crucial for identifying responders and improving quality of life for non-responders. An objective machine learning decision support system may help reduce variability and inaccuracy in treatment response assessment. We developed a predictive model to assess the likelihood that a patient will respond based on image and clinical features. With IRB approval, we retrospectively collected a data set of pre- and post- treatment CT scans along with clinical information from surgical pathology from 98 patients. A linear discriminant analysis (LDA) classifier was used to predict the likelihood that a patient would respond to treatment based on radiomic features extracted from CT urography (CTU), a radiologist's semantic feature, and a clinical feature extracted from surgical and pathology reports. The classification accuracy was evaluated using the area under the ROC curve (AUC) with a leave-one-case-out cross validation. The classification accuracy was compared for the systems based on radiomic features, clinical feature, and radiologist's semantic feature. For the system based on only radiomic features the AUC was 0.75. With the addition of clinical information from examination under anesthesia (EUA) the AUC was improved to 0.78. Our study demonstrated the potential of designing a decision support system to assist in treatment response assessment. The combination of clinical features, radiologist semantic features and CTU radiomic features improved the performance of the classifier and the accuracy of treatment response assessment.

Cardiac drugs used in cross-sectional cardiac imaging: what the radiologist needs to know

International Nuclear Information System (INIS)

McParland, P.; Nicol, E.D.; Harden, S.P.

2010-01-01

The demand for cross-sectional imaging of the heart is increasing dramatically and in many centres these imaging techniques are being performed by radiologists. Although radiologists are familiar with the computed tomography (CT) and magnetic resonance imaging (MRI) techniques to generate high-quality images and with using contrast agents, many are less familiar with administering the drugs necessary to perform CT coronary angiography and cardiac MR reliably. The aim of this article is to give an overview of the indications for and the contraindications to administering cardiac drugs in cross-sectional imaging departments. We also outline the complications that may be encountered and provide advice on how to treat these complications when they occur.

Improvement in Detection of Wrong-Patient Errors When Radiologists Include Patient Photographs in Their Interpretation of Portable Chest Radiographs.

Science.gov (United States)

Tridandapani, Srini; Olsen, Kevin; Bhatti, Pamela

2015-12-01

This study was conducted to determine whether facial photographs obtained simultaneously with radiographs improve radiologists' detection rate of wrong-patient errors, when they are explicitly asked to include the photographs in their evaluation. Radiograph-photograph combinations were obtained from 28 patients at the time of portable chest radiography imaging. From these, pairs of radiographs were generated. Each unique pair consisted of one new and one old (comparison) radiograph. Twelve pairs of mismatched radiographs (i.e., pairs containing radiographs of different patients) were also generated. In phase 1 of the study, 5 blinded radiologist observers were asked to interpret 20 pairs of radiographs without the photographs. In phase 2, each radiologist interpreted another 20 pairs of radiographs with the photographs. Radiologist observers were not instructed about the purpose of the photographs but were asked to include the photographs in their review. The detection rate of mismatched errors was recorded along with the interpretation time for each session for each observer. The two-tailed Fisher exact test was used to evaluate differences in mismatch detection rates between the two phases. A p value of error detection rates without (0/20 = 0%) and with (17/18 = 94.4%) photographs were different (p = 0.0001). The average interpretation times for the set of 20 radiographs were 26.45 (SD 8.69) and 20.55 (SD 3.40) min, for phase 1 and phase 2, respectively (two-tailed Student t test, p = 0.1911). When radiologists include simultaneously obtained photographs in their review of portable chest radiographs, there is a significant improvement in the detection of labeling errors. No statistically significant difference in interpretation time was observed. This may lead to improved patient safety without affecting radiologists' throughput.

Drug smuggling by body packing: what radiologists should know about it.

Science.gov (United States)

Hergan, Klaus; Kofler, Karl; Oser, Wolfgang

2004-04-01

Body packing is a distinct method for smuggling drugs. What radiologists need to know is discussed in this pictorial review. Radiologists are confronted with diagnostic imaging of body packers because of two main reasons: complications of body packing and identifying drug packets within the gastrointestinal tract. The standard examination used is plain X-ray of the abdomen in an upright and a supine position. Computed tomography is occasionally used but nevertheless described as a very accurate diagnostic tool. Ultrasound and MR imaging do not play an important role in that field. Depending on the purity of the drug, three different forms of attenuation have been described: hashish is denser than stool; cocaine appears similar to stool; and heroin has a gaseous transparence. The packets are of a round to oval form, usually of a particular uniformity and rarely confused with scybala if arranged like a pearl chain; therefore, plain X-ray is the method of choice to detect drug-filled packets within the gastrointestinal tract of body packers.

Performance of computer-aided diagnosis for detection of lacunar infarcts on brain MR images: ROC analysis of radiologists' detection

International Nuclear Information System (INIS)

Uchiyama, Y.; Yokoyama, R.; Hara, T.; Fujita, H.; Asano, T.; Kato, H.; Hoshi, H.; Yamakawa, H.; Iwama, T.; Ando, H.; Yamakawa, H.

2007-01-01

The detection and management of asymptomatic lacunar infarcts on magnetic resonance (MR) images are important tasks for radiologists to ensure the prevention of sever cerebral infarctions. However, accurate identification of lacunar infarcts is a difficult. Therefore, we developed a computer-aided diagnosis (CAD) scheme for detection of lacunar infarcts. The purpose of this study was to evaluate radiologists' performance in detection of lacunar infarcts without and with use of CAD scheme. 30 T1- and 30 T2- weighted images obtained from 30 patients were used for an observer study, which were consisted of 15 cases with a single lacunar infarct and 15 cases without any lacunar infarct. Six radiologists participated in the observer study. They interpreted lacunar infarcts first without and then with use of the scheme. For all six observers, average area under the receiver operating characteristic curve value was increased from 0.920 to 0.965 when they used the computer output. This CAD scheme might have the potential to improve the accuracy of radiologists' performance in the detection of lacunar infarcts on MR images. (orig.)

Fighting lung cancer in the developed world - a model of care in a UK hospital

International Nuclear Information System (INIS)

Baig, I.M.; Milroy, R.

2010-01-01

To highlight the initial management approach for Lung Cancer in a UK Hospital with the aim of translating the principles of such methodology to a developing country, such as Pakistan. A descriptive observational study was carried out at Stobhill Hospital , Glasgow, UK. The investigator (IMB) observed the Lung Cancer Service, attending the weekly 'New patients Clinic', 'Results Clinic', and 'Multidisciplinary team (MDT) meetings'. The process observations and the factual data describing the details of the service were recorded on a pre designed proforma. Observations relating to two aspects of this service (Results Clinic and MDT) are included in this report. The methodology of communicating results of lung cancer investigations to patients in a pre-planned and staged manner at a dedicated 'Results Clinic' was identified as a useful approach. A format of communication was consistently followed. The MDT consisted of a Respiratory Physician, Clinical Oncologist, Thoracic Surgeon, Radiologist, Pathologist and Palliative Care Specialist. Each patient's case was discussed on an individual basis and the team developed a consensus regarding diagnosis, staging of the disease, further need for diagnostic procedures and treatment options, bearing in mind the patient's performance status, co-morbidity and their wishes. This approach has improved the initial part of the lung cancer patient journey and components of this approach could easily be transferred to a developing country (JPMA 60:93; 2010). (author)

An observer study comparing spot imaging regions selected by radiologists and a computer for an automated stereo spot mammography technique

International Nuclear Information System (INIS)

Goodsitt, Mitchell M.; Chan, Heang-Ping; Lydick, Justin T.; Gandra, Chaitanya R.; Chen, Nelson G.; Helvie, Mark A.; Bailey, Janet E.; Roubidoux, Marilyn A.; Paramagul, Chintana; Blane, Caroline E.; Sahiner, Berkman; Petrick, Nicholas A.

2004-01-01

We are developing an automated stereo spot mammography technique for improved imaging of suspicious dense regions within digital mammograms. The technique entails the acquisition of a full-field digital mammogram, automated detection of a suspicious dense region within that mammogram by a computer aided detection (CAD) program, and acquisition of a stereo pair of images with automated collimation to the suspicious region. The latter stereo spot image is obtained within seconds of the original full-field mammogram, without releasing the compression paddle. The spot image is viewed on a stereo video display. A critical element of this technique is the automated detection of suspicious regions for spot imaging. We performed an observer study to compare the suspicious regions selected by radiologists with those selected by a CAD program developed at the University of Michigan. True regions of interest (TROIs) were separately determined by one of the radiologists who reviewed the original mammograms, biopsy images, and histology results. We compared the radiologist and computer-selected regions of interest (ROIs) to the TROIs. Both the radiologists and the computer were allowed to select up to 3 regions in each of 200 images (mixture of 100 CC and 100 MLO views). We computed overlap indices (the overlap index is defined as the ratio of the area of intersection to the area of interest) to quantify the agreement between the selected regions in each image. The averages of the largest overlap indices per image for the 5 radiologist-to-computer comparisons were directly related to the average number of regions per image traced by the radiologists (about 50% for 1 region/image, 84% for 2 regions/image and 96% for 3 regions/image). The average of the overlap indices with all of the TROIs was 73% for CAD and 76.8%+/-10.0% for the radiologists. This study indicates that the CAD determined ROIs could potentially be useful for a screening technique that includes stereo spot

Work-Related Injuries of Radiologists and Possible Ergonomic Solutions: Recommendations From the ACR Commission on Human Resources.

Science.gov (United States)

Sze, Gordon; Bluth, Edward I; Bender, Claire E; Parikh, Jay R

2017-10-01

Increasingly, radiologists' workplaces revolve around PACS and digital imaging. Use of these technologies can lead to repetitive strain injuries, many of which can be exacerbated by specific features of a radiology practice environment. Ergonomic approaches, such as proper reading room structure, lighting, temperature, noise, and equipment setup, can help decrease the frequency and severity of repetitive strain injuries and improve radiologist productivity. However, ergonomic approaches are complex, include all aspects of the radiology practice environment, and are best implemented along with proper training of the practicing radiologists. The ergonomic approaches considered most important by members of the ACR Commission on Human Resources are presented in this report, and this information may serve as an aid in departmental planning. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Variations in screening outcome among pairs of screening radiologists at non-blinded double reading of screening mammograms: a population-based study

NARCIS (Netherlands)

Klompenhouwer, E. G.; Duijm, L. E. M.; Voogd, A. C.; den Heeten, G. J.; Nederend, J.; Jansen, F. H.; Broeders, M. J. M.

2014-01-01

Substantial inter-observer variability in screening mammography interpretation has been reported at single reading. However, screening results of pairs of screening radiologists have not yet been published. We determined variations in screening performances among pairs of screening radiologists at

Shielding Effect of Lead Glasses on Radiologists' Eye Lens Exposure in Interventional Procedures.

Science.gov (United States)

Hu, Panpan; Kong, Yan; Chen, Bo; Liu, Qianqian; Zhuo, Weihai; Liu, Haikuan

2017-04-20

To study the shielding effect of radiologists' eye lens with lead glasses of different equivalent thicknesses and sizes in interventional radiology procedures. Using the human voxel phantom with a more accurate model of the eye and MCNPX software, eye lens doses of the radiologists who wearing different kinds of lead glasses were simulated, different beam projections were taken into consideration during the simulation. Measurements were also performed with the physical model to verify simulation results. Simulation results showed that the eye lens doses were reduced by a factor from 3 to 9 when wearing a 20 cm2-sized lead glasses with the equivalent thickness ranging from 0.1 to 1.0 mm Pb. The increase of dose reduction factor (DRF) was not significant whenever increase the lead equivalent of glasses of which larger than 0.35 mm. Furthermore, the DRF was proportional to the size of glass lens from 6 to 30 cm2 with the same lead equivalent. The simulation results were in well agreements with the measured ones. For more reasonable and effective protection of the eye lens of interventional radiologists, a pair of glasses with a lead equivalent of 0.5 mm Pb and large-sized (at least 27 cm2 per glass) lens are recommended. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Digital teaching files – a useful teaching tool for the modern radiologist

African Journals Online (AJOL)

Radiologists have always collected copies of model examples and interesting cases encountered in daily practice to use for teaching purposes.1,2 A collection of teaching files is an important resource for medical education and the dissemination of knowledge in radiology. Furthermore, the presence of a radiological ...

Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

Energy Technology Data Exchange (ETDEWEB)

Leeuwenburgh, Marjolein M.N., E-mail: m.m.leeuwenburgh@amc.uva.nl [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands); Wiarda, Bart M. [Department of Radiology, Alkmaar Medical Center, Alkmaar (Netherlands); Jensch, Sebastiaan [Department of Radiology, Sint Lucas Andreas Hospital, Amsterdam (Netherlands); Wouter van Es, H. [Department of Radiology, Sint Antonius Hospital, Nieuwegein (Netherlands); Stockmann, Hein B.A.C. [Department of Surgery, Kennemer Gasthuis, Haarlem (Netherlands); Gratama, Jan Willem C. [Department of Radiology, Gelre Hospitals, Apeldoorn (Netherlands); Cobben, Lodewijk P.J. [Department of Radiology, Haaglanden Medical Center, Leidschendam (Netherlands); Bossuyt, Patrick M.M. [Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam (Netherlands); Boermeester, Marja A. [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Stoker, Jaap [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands)

2014-01-15

Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher.

Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

International Nuclear Information System (INIS)

Leeuwenburgh, Marjolein M.N.; Wiarda, Bart M.; Jensch, Sebastiaan; Wouter van Es, H.; Stockmann, Hein B.A.C.; Gratama, Jan Willem C.; Cobben, Lodewijk P.J.; Bossuyt, Patrick M.M.; Boermeester, Marja A.; Stoker, Jaap

2014-01-01

Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher

Volumetry of Artificial Pulmonary Nodules in Ex Vivo Porcine Lungs: Comparison of Semi-automated Volumetry and Radiologists' Performance

International Nuclear Information System (INIS)

Jeong, Ju Hyeon; Kim, Jin Hwan; Kim, Song Soo; Jeon, Ho Sang; Lee, Hyun Ju; Park, Noh Hyuck; Cho, Gyu Seong

2010-01-01

With the advent of MSCT, the detection rate of small pulmonary nodules is markedly greater. However, there is no definite diagnostic clue to differentiate between malignant and benign nodules, except for the interval growth in small nodule less than 1 cm in diameter. We evaluated the accuracy of computer aided volumetry (CAV) and compared it with 4 radiologists' measurement. Fifteen artificial nodules that were embedded in the ex vivo porcine lung were scanned by MSCT. The diameters and volumes of nodules were independently measured three times, at 5-day intervals, and by four radiologists as well as by CAV. We evaluated the accuracy of the measurements on the basis of the true diameter and volume of the nodules. Using a paired t-test and a Bland-Altman plot, we evaluated whether there was a statistically significant difference between the radiologists' measurements and the CAV. The accuracy of the manual measurements by radiologists revealed a statistically significant difference from the true diameter and volume of the artificial nodules (p 0.01) The results of this study suggest that CAV is an accurate and useful tool to evaluate the volume of pulmonary nodules and can eventually be used to differentiate malignant and benign nodules as well as evaluate the therapeutic response of lung cancer

Multicentre survey of radiologically inserted gastrostomy feeding tube (RIG) in the UK

International Nuclear Information System (INIS)

Lowe, A.S.; Laasch, H.U.; Stephenson, S.; Butterfield, C.; Goodwin, M.; Kay, C.L.; Glancy, S.; Jackson, S.; Brown, D.; McLean, P.; Keanie, J.; Thrower, A.; Briggs, R.; Punekar, S.; Krishnan, S.; Thomas, B.; Yap, K.; Mullan, D.; Maskell, G.; Hancock, J.

2012-01-01

Aims: To evaluate the variance in current UK clinical practice and clinical outcomes for direct percutaneous radiologically inserted gastrostomy (RIG). Materials and methods: A prospective UK multicentre survey of RIG performed between October 2008 and August 2010 was performed through the British Society of Gastrointestinal and Abdominal Radiology (BSGAR). Results: Data from 684 patients were provided by 45 radiologists working at 17 UK centres. Two hundred and sixty-three cases (40%) were performed with loop-retained catheters, and 346 (53%) with balloon-retained devices. Sixty percent of all patients experienced pain in the first 24 h, but settled in the majority thereafter. Early complications, defined as occurring in the first 24 h, included minor bleeding (1%), wound infection (3%), peritonism (2%), and tube misplacement (1%). Late complications, defined as occurring between day 2 and day 30 post-procedure, included mild pain (30%), persisting peritonism (2%), and 30 day mortality of 1% (5/665). Pre-procedural antibiotics or anti-methicillin-resistant Staphylococcus aureus (MRSA) prophylaxis did not affect the rate of wound infection, peritonitis, post-procedural pain, or mortality. Ninety-three percent of cases were performed using gastropexy. Gastropexy decreased post-procedural pain (p < 0.001), but gastropexy-related complications occurred in 5% of patients. However, post-procedure pain increased with the number of gastropexy sutures used (p < 0.001). The use of gastropexy did not affect the overall complication rate or mortality. Post-procedure pain increased significantly as tube size increased (p < 0.001). The use of balloon-retention feeding tubes was associated with more pain than the deployment of loop-retention devices (p < 0.001). Conclusion: RIG is a relatively safe procedure with a mortality of 1%, with or without gastropexy. Pain is the commonest complication. The use of gastropexy, fixation dressing or skin sutures, smaller tube sizes, and

What keeps Melbourne GPs satisfied in their jobs?

Science.gov (United States)

Walker, Kate Anne; Pirotta, Marie

2007-10-01

Workforce shortages make it important to promote job satisfaction and career longevity in general practitioners. We aimed to investigate strategies that maintain and improve Melbourne (Victoria) GP job satisfaction. A postal survey of a random selection of The Royal Australian College of General Practitioners vocationally recognised GPs (N=860). Open ended answers were coded according to themes and compared between genders. Thirty-eight percent of surveyed GPs responded. The mean satisfaction score was 50 out of 70 (SD 9). Women GPs were more satisfied than men with life-work balance (pwork and intellectual stimulation. Strategies to improve GP satisfaction were increased pay, reduced paperwork, and improved administrative systems. General practitioners were satisfied with their jobs due to the intrinsic qualities of their work and workplace. Decreasing the administrative burden, increasing remuneration and improving practice supports may improve metropolitan GP job satisfaction.

PLAB and UK graduates’ performance on MRCP(UK) and MRCGP examinations: data linkage study

Science.gov (United States)

Wakeford, Richard

2014-01-01

Objectives To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Design Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Setting Doctors in training for internal medicine or general practice in the United Kingdom. Participants 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18 532, 14 094, and 14 376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14 235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Main outcome measures Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. Results PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all PIELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two

PLAB and UK graduates' performance on MRCP(UK) and MRCGP examinations: data linkage study.

Science.gov (United States)

McManus, I C; Wakeford, Richard

2014-04-17

To assess whether international medical graduates passing the two examinations set by the Professional and Linguistic Assessments Board (PLAB1 and PLAB2) of the General Medical Council (GMC) are equivalent to UK graduates at the end of the first foundation year of medical training (F1), as the GMC requires, and if not, to assess what changes in the PLAB pass marks might produce equivalence. Data linkage of GMC PLAB performance data with data from the Royal Colleges of Physicians and the Royal College of General Practitioners on performance of PLAB graduates and UK graduates at the MRCP(UK) and MRCGP examinations. Doctors in training for internal medicine or general practice in the United Kingdom. 7829, 5135, and 4387 PLAB graduates on their first attempt at MRCP(UK) Part 1, Part 2, and PACES assessments from 2001 to 2012 compared with 18,532, 14,094, and 14,376 UK graduates taking the same assessments; 3160 PLAB1 graduates making their first attempt at the MRCGP AKT during 2007-12 compared with 14,235 UK graduates; and 1411 PLAB2 graduates making their first attempt at the MRCGP CSA during 2010-12 compared with 6935 UK graduates. Performance at MRCP(UK) Part 1, Part 2, and PACES assessments, and MRCGP AKT and CSA assessments in relation to performance on PLAB1 and PLAB2 assessments, as well as to International English Language Testing System (IELTS) scores. MRCP(UK), MRCGP, and PLAB results were analysed as marks relative to the pass mark at the first attempt. PLAB1 marks were a valid predictor of MRCP(UK) Part 1, MRCP(UK) Part 2, and MRCGP AKT (r=0.521, 0.390, and 0.490; all PIELTS scores correlated significantly with later performance, multiple regression showing that the effect of PLAB1 (β=0.496) was much stronger than the effect of IELTS (β=0.086). Changes to PLAB pass marks that would result in international medical graduate and UK medical graduate equivalence were assessed in two ways. Method 1 adjusted PLAB pass marks to equate median performance of PLAB

Partially satisfied to fully satisfied transitions in co-evolving inverse voter model and possible scaling behavior

International Nuclear Information System (INIS)

Choi, C.W.; Xu, C.; Hui, P.M.

2015-01-01

Understanding co-evolving networks characterized by the mutual influence of agents' actions and network structure remains a challenge. We study a co-evolving inverse voter model in which agents adapt to achieve a preferred environment with more opposite-opinion neighbors by rewiring their connections and switching opinion. Numerical studies reveal a transition from a dynamic partially satisfied phase to a frozen fully satisfied phase as the rewiring probability is varied. A simple mean field theory is shown to capture the behavior only qualitatively. An improved mean field theory carrying a longer spatial correlation gives better results. Motivated by numerical results in networks of different degrees and mean field results, we propose a scaling variable that combines the rewiring probability and mean degree in a special form. The scaling variable is shown to work well in analyzing data corresponding to different networks and different rewiring probabilities. An application is to predict the results for networks of different degrees based solely on results obtained from networks of one degree. Studying scaling behavior provides an alternative path for understanding co-evolving agent-based dynamical systems, especially in light of the trade-off between complexity of a theory and its accuracy. - Highlights: • Identified key features and phase transitions in coevolving inverse voter model. • Constructed a better theory incorporating longer spatial correlation. • Proposed scaling variable and illustrated possible scaling behavior. • Used scaling behavior to predict results of IVM in a different network.

Added value of coronal reformations for duty radiologists and for referring physicians or surgeons in the CT diagnosis of acute appendicitis

International Nuclear Information System (INIS)

Lee, Kyoung Ho; Kim, Young Hoon; Hahn, Seo Kyung; Lee, Kyung Won; Lee, Hak Jong; Kim, Tae Jung; Kang, Sung Bum; Shin, Joong Ho; Park, Byung Joo

2006-01-01

To assess the added value of coronal reformation for radiologists and for referring physicians or surgeons in the CT diagnosis of acute appendicitis. Contrast-enhanced CT was performed using 16-detector-row scanners in 110 patients, 46 of whom had appendicitis. Transverse (5-mm thickness, 4-mm increment), coronal (5-mm thickness, 4-mm increment), and combined transverse and coronal sections were interpreted by four radiologists, two surgeons and two emergency physicians. The area under the receiver operating characteristic curve (Az value), sensitivity, specificity, (McNemar test), diagnostic confidence and appendiceal visualization (Wilcoxon signed rank test) were compared. For radiologists, the additional coronal sections tended to increase the Az value (0.972 vs 0.986, ρ=0.076) and pooled sensitivity (92% [95% CI: 88,96] vs. 96% [93,99]), and enhanced appendiceal visualization in true-positive cases (ρ= 0.031). For non-radiologists, no such enhancement was observed, and the confidence for excluding acute appendicitis declined (ρ=0.013). Coronal sections alone were inferior to transverse sections for diagnostic confidence as well as appendiceal visualization for each reader group studied (ρ<0.05). The added value of coronal reformation is more apparent for radiologists compared to referring physicians or surgeons in the CT diagnosis of acute appendicitis

Constraint programming for modelling and solving modal satisfiability

NARCIS (Netherlands)

Brand, S.; Gennari, R.; de Rijke, M.

2003-01-01

We explore to what extent and how efficiently constraint programmingcan be used in the context of automated reasoning for modal logics. We encode modal satisfiability problems as constraint satisfactionproblems with non-boolean domains, together with suitable constraints.Experiments show that the

The co-evolutionary relationship between Energy Service Companies and the UK energy system: Implications for a low-carbon transition

International Nuclear Information System (INIS)

Hannon, Matthew J.; Foxon, Timothy J.; Gale, William F.

2013-01-01

The Energy Service Company (ESCo) business model is designed to reward businesses by satisfying consumers’ energy needs at less cost and with fewer carbon emissions via energy demand management and/or sustainable supply measures. In contrast, the revenue of the incumbent Energy Utility Company (EUCo) model is coupled with the sale of units of energy, which are predominantly sourced from fossil fuels. The latter is currently dominant in the UK. This paper addresses two questions. First, why has the ESCo model traditionally been confined to niche applications? Second, what role is the ESCo model likely to play in the transition to a low-carbon UK energy system? To answer these, the paper examines the core characteristics of the ESCo model, relative to the EUCo model. The paper then examines how ESCos have co-evolved with the various dimensions of the energy system (i.e. ecosystems, institutions, user practices, technologies and business models) to provide insight into how ESCos might help to shape the future UK energy system. We suggest that institutional and technological changes within the UK energy system could result in a more favourable selection environment for ESCos, consequently enabling the ESCo model to proliferate at the expense of the EUCo model. - Highlights: • Comparison of Energy Utility and Energy Service Company (ESCo) business models • Limited uptake of ESCos in UK energy system, which is dominated by Energy Utilities • The ESCo model has a poor fit with the existing selection environment • System changes are improving ESCo model's fitness within its selection environment • ESCo population will coevolve with UK energy system

UK-trained junior doctors' intentions to work in UK medicine: questionnaire surveys, three years after graduation.

Science.gov (United States)

Surman, Geraldine; Goldacre, Michael J; Lambert, Trevor W

2017-12-01

Objective To report on the career intentions, three years after qualification, of 12 national cohorts of UK-trained doctors who qualified between 1974 and 2012, and, specifically, to compare recent UK medical graduates' intentions to work in medicine in the UK with earlier graduates. Design Questionnaire surveys of cohorts of UK medical graduates defined by year of graduation. Setting UK. Participants 30,272 UK medical graduates. Main outcome measures Stated level of intention to pursue a long-term career in medicine in the UK. Results The response rate was 62% (30,272/48,927). We examined responses to the question ' Apart from temporary visits abroad, do you intend to practise medicine in the United Kingdom for the foreseeable future?' Of doctors from UK homes, 90% had specified that they would 'definitely or probably' practise medicine in the UK in the surveys of 1977-1986, 81% in 1996-2011 and 64% in 2015. Those who said that they would probably or definitely not practise medicine in the UK comprised 5% in 1977-1986, 8% in 1996-2011 and 15% in 2015. Most who were not definite about a future career in UK medicine indicated that they would wish to practise medicine outside the UK rather than to leave medicine. Conclusions The wish to remain in UK medical practice in the 2015 survey was unprecedentedly low in this unique series of 40 years of surveys.

Branding and Positioning to Satisfy the Customer's Appetite: An Educational Case Study

Science.gov (United States)

Ham, Tim

2010-01-01

Rebranding and positioning a school district has become critical to satisfy the "customer's" appetite, enhance public relations, and advance consumer perceptions. A service design model provides a district with the framework to advance its position by identifying attributes and prompts to satisfy customer needs and increase student…

The Image Quality of a Digital Chest X-Ray Radiography System: Comparison of Quantitative Image Quality Analysis and Radiologists' Visual Scoring

Energy Technology Data Exchange (ETDEWEB)

Nam, Ji Ho [Dept. of Radiology Oncology, Yongsan Hospital, Pusan National University College of Medicine, Yongsan (Korea, Republic of); Chung, Myung Jin [Dept. of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Park, Darl; Kim, Won Taek; Kim, Yong Ho; Ki, Yong Kan; Kim, DFong Hyun; Lee, Ju Hee; Kim, Dong Won [Dept. of Radiology Oncology, Yongsan Hospital, Pusan National University College of Medicine, Yongsan (Korea, Republic of); Jeon, Ho Sang [Reserach Institue for Convergence of Biomedical Science and Technology, Yongsan Hospital, Pusan National University College of Medicine, Yongsan (Korea, Republic of)

2011-11-15

To evaluate the performance of imaging devices, which should be periodically monitored to maintain high quality images to the radiologists. Additionally, this evaluation may prevent patients from radiation over-exposure. The most suitable engineering standard for imaging performance evaluation of digital X-ray thoracic images was determined. IEC 62220-1 standards were used to evaluate the performance of the images. In succession, the visibilities of overall image, pneumothorax, and humerus head in anthropomorphic thoracic phantom images were used to evaluate the image qualities by radiologists. The rank correlation coefficient (p) of visual scoring by radiologists with system spatial resolution is not meaningful (p-value, p = 0.295), but is significant with image noise (p-value, p -0.9267). Finally, the noise equivalent quanta (NEQ) presents a high rank correlation for visual scoring of radiologists (p-value, p = 0.9320). Image quality evaluation of radiologists were mainly affected by imaging noise. Hence, the engineered standard for evaluating image noise is the most important index to effectively monitor the performance of X-ray images. Additionally, the NEQ can be used to evaluate the performance of radiographic systems, because it theoretically corresponds to the synthetic image quality of systems.

Explaining sex differences in managerial career satisfier preferences: the role of gender self-schema.

Science.gov (United States)

Eddleston, Kimberly A; Veiga, John F; Powell, Gary N

2006-03-01

Using survey data from 400 managers, the authors examined whether gender self-schema would explain sex differences in preferences for status-based and socioemotional career satisfiers. Female gender self-schema, represented by femininity and family role salience, completely mediated the relationship between managers' sex and preferences for socioemotional career satisfiers. However, male gender self-schema, represented by masculinity and career role salience, did not mediate the relationship between managers' sex and preferences for status-based career satisfiers. As expected, male managers regarded status-based career satisfiers as more important and socioemotional career satisfiers as less important than female managers did. The proposed conceptualization of male and female gender self-schemas, which was supported by the data, enhances understanding of adult self-schema and work-related attitudes and behavior.

Performance of computer-aided diagnosis for detection of lacunar infarcts on brain MR images: ROC analysis of radiologists' detection

Energy Technology Data Exchange (ETDEWEB)

Uchiyama, Y.; Yokoyama, R.; Hara, T.; Fujita, H. [Dept. of Intelligent Image Information, Graduate Scholl of Medicine, Gifu Univ. (Japan); Asano, T.; Kato, H.; Hoshi, H. [Dept. of Radiology, Graduate Scholl of Medicine, Gifu Univ. (Japan); Yamakawa, H.; Iwama, T. [Dept. of Neurosurgery, Graduate Scholl of Medicine, Gifu Univ. (Japan); Ando, H. [Dept. of Neurosurgery, Gifu Municipal Hospital (Japan); Yamakawa, H. [Dept. of Emergency and Critical Care Medicine, Chuno-Kousei Hospital (Japan)

2007-06-15

The detection and management of asymptomatic lacunar infarcts on magnetic resonance (MR) images are important tasks for radiologists to ensure the prevention of sever cerebral infarctions. However, accurate identification of lacunar infarcts is a difficult. Therefore, we developed a computer-aided diagnosis (CAD) scheme for detection of lacunar infarcts. The purpose of this study was to evaluate radiologists' performance in detection of lacunar infarcts without and with use of CAD scheme. 30 T1- and 30 T2- weighted images obtained from 30 patients were used for an observer study, which were consisted of 15 cases with a single lacunar infarct and 15 cases without any lacunar infarct. Six radiologists participated in the observer study. They interpreted lacunar infarcts first without and then with use of the scheme. For all six observers, average area under the receiver operating characteristic curve value was increased from 0.920 to 0.965 when they used the computer output. This CAD scheme might have the potential to improve the accuracy of radiologists' performance in the detection of lacunar infarcts on MR images. (orig.)

The impact of an early-morning radiologist work shift on the timeliness of communicating urgent imaging findings on portable chest radiography.

Science.gov (United States)

Kaewlai, Rathachai; Greene, Reginald E; Asrani, Ashwin V; Abujudeh, Hani H

2010-09-01

The aim of this study was to assess the potential impact of staggered radiologist work shifts on the timeliness of communicating urgent imaging findings that are detected on portable overnight chest radiography of hospitalized patients. The authors conducted a retrospective study that compared the interval between the acquisition and communication of urgent findings on portable overnight critical care chest radiography detected by an early-morning shift for radiologists (3 am to 11 am) with historical experience with a standard daytime shift (8 am to 5 pm) in the detection and communication of urgent findings in a similar patient population a year earlier. During a 4-month period, 6,448 portable chest radiographic studies were interpreted on the early-morning radiologist shift. Urgent findings requiring immediate communication were detected in 308 (4.8%) studies. The early-morning shift of radiologists, on average, communicated these findings 2 hours earlier compared with the historical control group (P chest radiography of hospitalized patients. Published by Elsevier Inc.

Satisfying the demand for financial information in public traded companies

DEFF Research Database (Denmark)

Holm, Claus

A public traded company which wishes to comply with IAS standards and stock exchange requirements for full public disclosure of relevant information faces a major communication task. The Investor Relation policy of such a company has to satisfy a demand for financial information which seems...... line focus to the disclosure of cash flow surrogates like EBITA and EBITDA. Overall, the findings suggest a communication strategy intended to satisfy the demand from the professional analysts. However, the shear number of different key figures and financial ratios identified in the study suggest...

How changes in a radiologist's technique can reduce patient dose in barium enema studies

International Nuclear Information System (INIS)

Corbett, R.H.

2001-01-01

Changes in a radiologist's technique, especially utilising digital technology, can lead to substantial dose savings in barium enema examinations. Data will be provided showing a 20% saving with only minimal change in technique. (author)

Anatomy of Alternating Quantifier Satisfiability (Work in progress)

DEFF Research Database (Denmark)

Dung, Phan Anh; Bjørner, Nikolaj; Monniaux, David

We report on work in progress to generalize an algorithm recently introduced in [10] for checking satisfiability of formulas with quantifier alternation. The algorithm uses two auxiliary procedures: a procedure for producing a candidate formula for quantifier elimination and a procedure for elimi...

The inter-observer variability of breast density scoring between mammography technologists and breast radiologists and its effect on the rate of adjuvant ultrasound.

Science.gov (United States)

Mazor, Roei D; Savir, Avital; Gheorghiu, David; Weinstein, Yuliana; Abadi-Korek, Ifat; Shabshin, Nogah

2016-05-01

This study assesses the inter-observer variability of mammographic breast density scoring (BDS) between technologists and radiologists and evaluates the effect of technologist patient referral on the load of adjuvant ultrasounds. In this IRB approved study, a retrospective analysis of 503 prospectively acquired, random mammograms was performed between January and March 2014. Each mammogram was evaluated for BDS independently and blindly by both the performing technologist and the interpreting radiologist. Statistical calculation of the Spearman correlation coefficient and weighted kappa were obtained to evaluate the inter-observer variability between technologists and radiologists and to examine whether it relates to the technologist's seniority or women's age. The effect on the load of adjuvant ultrasounds was evaluated. 10 mammography technologists and 7 breast radiologists participated in this study. BDS agreement levels between technologists and radiologists were in the fair to moderate range (kappa values: 0.3-0.45, Spearman coefficient values: 0.59-0.65). The technologists markedly over-graded the density compared to the radiologists in all the subsets evaluated. Comparison between low and high-density groups demonstrated a similar trend of over-grading by technologists, who graded 51% of the women as having dense breasts (scores 3-4) compared to 27% of the women graded as such by the radiologists. This trend of over grading breast density by technologists was unrelated to the women's age or to the technologists' seniority. Mammography technologists over-grade breast density. Technologists' referral to an adjuvant ultrasound leads to redundant ultrasound studies, unnecessary breast biopsies, costs and increased patient anxiety. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Shoulder, hip, and knee arthrography needle placement using fluoroscopic guidance: practice patterns of musculoskeletal radiologists in North America

International Nuclear Information System (INIS)

Shortt, Conor P.; Morrison, William B.; Deely, Diane M.; Gopez, Angela G.; Zoga, Adam C.; Roberts, Catherine C.

2009-01-01

The aim of this study was to evaluate the range of techniques used by radiologists performing shoulder, hip, and knee arthrography using fluoroscopic guidance. Questionnaires on shoulder, hip, and knee arthrography were distributed to radiologists at a national radiology meeting. We enquired regarding years of experience, preferred approaches, needle gauge, gadolinium dilution, and volume injected. For each approach, the radiologist was asked their starting and end needle position based on a numbered and lettered grid superimposed on a radiograph. Sixty-eight questionnaires were returned. Sixty-eight radiologists performed shoulder and hip arthrography, and 65 performed knee arthrograms. Mean experience was 13.5 and 12.8 years, respectively. For magnetic resonance arthrography, a gadolinium dilution of 1/200 was used by 69-71%. For shoulder arthrography, an anterior approach was preferred by 65/68 (96%). The most common site of needle end position, for anterior and posterior approaches, was immediately lateral to the humeral cortex. A 22-gauge needle was used by 46/66 (70%). Mean injected volume was 12.7 ml (5-30). For hip arthrography, an anterior approach was preferred by 51/68 (75%). The most common site of needle end position, for anterior and lateral approaches, was along the lateral femoral head/neck junction. A 22-gauge needle was used by 53/68 (78%). Mean injected volume was 11.5 ml (5-20). For knee arthrography, a lateral approach was preferred by 41/64 (64%). The most common site of needle end position, for lateral and medial approaches, was mid-patellofemoral joint level. A 22-gauge needle was used by 36/65 (56%). Mean injected volume was 28.2 ml (5-60). Arthrographic approaches for the shoulder, hip, and knee vary among radiologists over a wide range of experience levels. (orig.)

Shoulder, hip, and knee arthrography needle placement using fluoroscopic guidance: practice patterns of musculoskeletal radiologists in North America

Energy Technology Data Exchange (ETDEWEB)

Shortt, Conor P. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Morrison, William B.; Deely, Diane M.; Gopez, Angela G.; Zoga, Adam C. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Roberts, Catherine C. [Mayo Clinic College of Medicine, Department of Radiology, Phoenix, AZ (United States)

2009-04-15

The aim of this study was to evaluate the range of techniques used by radiologists performing shoulder, hip, and knee arthrography using fluoroscopic guidance. Questionnaires on shoulder, hip, and knee arthrography were distributed to radiologists at a national radiology meeting. We enquired regarding years of experience, preferred approaches, needle gauge, gadolinium dilution, and volume injected. For each approach, the radiologist was asked their starting and end needle position based on a numbered and lettered grid superimposed on a radiograph. Sixty-eight questionnaires were returned. Sixty-eight radiologists performed shoulder and hip arthrography, and 65 performed knee arthrograms. Mean experience was 13.5 and 12.8 years, respectively. For magnetic resonance arthrography, a gadolinium dilution of 1/200 was used by 69-71%. For shoulder arthrography, an anterior approach was preferred by 65/68 (96%). The most common site of needle end position, for anterior and posterior approaches, was immediately lateral to the humeral cortex. A 22-gauge needle was used by 46/66 (70%). Mean injected volume was 12.7 ml (5-30). For hip arthrography, an anterior approach was preferred by 51/68 (75%). The most common site of needle end position, for anterior and lateral approaches, was along the lateral femoral head/neck junction. A 22-gauge needle was used by 53/68 (78%). Mean injected volume was 11.5 ml (5-20). For knee arthrography, a lateral approach was preferred by 41/64 (64%). The most common site of needle end position, for lateral and medial approaches, was mid-patellofemoral joint level. A 22-gauge needle was used by 36/65 (56%). Mean injected volume was 28.2 ml (5-60). Arthrographic approaches for the shoulder, hip, and knee vary among radiologists over a wide range of experience levels. (orig.)

PACS administrators' and radiologists' perspective on the importance of features for PACS selection.

Science.gov (United States)

Joshi, Vivek; Narra, Vamsi R; Joshi, Kailash; Lee, Kyootai; Melson, David

2014-08-01

Picture archiving and communication systems (PACS) play a critical role in radiology. This paper presents the criteria important to PACS administrators for selecting a PACS. A set of criteria are identified and organized into an integrative hierarchical framework. Survey responses from 48 administrators are used to identify the relative weights of these criteria through an analytical hierarchy process. The five main dimensions for PACS selection in order of importance are system continuity and functionality, system performance and architecture, user interface for workflow management, user interface for image manipulation, and display quality. Among the subdimensions, the highest weights were assessed for security, backup, and continuity; tools for continuous performance monitoring; support for multispecialty images; and voice recognition/transcription. PACS administrators' preferences were generally in line with that of previously reported results for radiologists. Both groups assigned the highest priority to ensuring business continuity and preventing loss of data through features such as security, backup, downtime prevention, and tools for continuous PACS performance monitoring. PACS administrators' next high priorities were support for multispecialty images, image retrieval speeds from short-term and long-term storage, real-time monitoring, and architectural issues of compatibility and integration with other products. Thus, next to ensuring business continuity, administrators' focus was on issues that impact their ability to deliver services and support. On the other hand, radiologists gave high priorities to voice recognition, transcription, and reporting; structured reporting; and convenience and responsiveness in manipulation of images. Thus, radiologists' focus appears to be on issues that may impact their productivity, effort, and accuracy.

Exploring the Usability of Mobile Apps Supporting Radiologists' Training in Diagnostic Decision Making.

Science.gov (United States)

Kim, Min Soon; Aro, Michael R; Lage, Kraig J; Ingalls, Kevin L; Sindhwani, Vivek; Markey, Mia K

2016-03-01

The objective of this study was to conduct a usability evaluation of mobile apps for supporting education and training in radiologic diagnostic decision-making processes. Of 381 mobile apps available at two major stores (Google Play and iTunes), eight iOS apps were selected for laboratory-based usability tests. Six staff radiologists completed eight app-specific task sets, using a think-aloud strategy. The triangular methods approach included quantitative performance measures, System Usability Scale (SUS), and qualitative thematic analysis using heuristic usability principles of usability issues. Overall, radiologists achieved higher than 70% success, with favorable SUS scores, in completing the tasks for seven of the eight apps. However, task success rate and SUS score had a weak relation (r = 0.23), indicating that the perceived usability may not reflect the holistic usability of the app. Task analysis and self-report revealed 108 usability issues, which were condensed to 55 unique issues and categorized by nine usability themes and mapped to ten usability heuristics. Nonintuitive functionality (eg, nonintuitive or misleading labels) was the most frequent theme observed, leading to inefficient navigation. These usability findings were consistent with the 13 improvements the radiologists suggested. This study demonstrates the feasibility of usability evaluation of radiology mobile apps and suggests potential improvements in the development of radiology mobile apps. This study also suggests that proficiency with mobile devices may not be equivalent to being an expert user, proficient in using the apps. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Burnout of Radiologists: Frequency, Risk Factors, and Remedies: A Report of the ACR Commission on Human Resources.

Science.gov (United States)

Harolds, Jay A; Parikh, Jay R; Bluth, Edward I; Dutton, Sharon C; Recht, Michael P

2016-04-01

Burnout is a concern for radiologists. The burnout rate is greater among diagnostic radiologists than the mean for all physicians, while radiation oncologists have a slightly lower burnout rate. Burnout can result in unprofessional behavior, thoughts of suicide, premature retirement, and errors in patient care. Strategies to reduce burnout include addressing the sources of job dissatisfaction, instilling lifestyle balance, finding reasons to work other than money, improving money management, developing a support group, and seeking help when needed. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Nonaccidental trauma: clinical aspects and epidemiology of child abuse

Energy Technology Data Exchange (ETDEWEB)

Hobbs, Christopher J. [St James' s University Hospital, Department of Community Paediatrics, Leeds (United Kingdom); Bilo, Robert A.C. [Netherlands Forensic Institute, Department of Forensic Pathology, The Hague (Netherlands)

2009-05-15

Radiologists play a key role in the recognition of child abuse. In the last century, radiologists pioneered the identification of nonaccidental injuries, including fractures and brain injury, and together with colleagues in paediatrics advocated the protection of children from abuse. Prevalence studies in many countries have revealed the widespread and hidden nature of child maltreatment. New and complex forms of abuse, e.g. fabricated or induced illness, have been recognized. Physical abuse affects 7-9% of children in the UK, although fewer suffer the severe or life-threatening injuries seen by radiologists. A high index of suspicion of nonaccidental trauma is required where known patterns of injury or inconsistencies of presentation and history are detected. In many cases the diagnosis is readily made, although some cases remain contentious or controversial and consume much clinical time and energy. Differences of view between doctors are tested in the courts. Adverse publicity has made this work unpopular in the UK. Knowledge of the differential diagnosis of unexplained or apparent injury is essential for accurate diagnosis, vital where errors in either direction can be disastrous. New UK radiological guidelines will assist radiologists in achieving best evidence-based practice. (orig.)

Nonaccidental trauma: clinical aspects and epidemiology of child abuse

International Nuclear Information System (INIS)

Hobbs, Christopher J.; Bilo, Robert A.C.

2009-01-01

Radiologists play a key role in the recognition of child abuse. In the last century, radiologists pioneered the identification of nonaccidental injuries, including fractures and brain injury, and together with colleagues in paediatrics advocated the protection of children from abuse. Prevalence studies in many countries have revealed the widespread and hidden nature of child maltreatment. New and complex forms of abuse, e.g. fabricated or induced illness, have been recognized. Physical abuse affects 7-9% of children in the UK, although fewer suffer the severe or life-threatening injuries seen by radiologists. A high index of suspicion of nonaccidental trauma is required where known patterns of injury or inconsistencies of presentation and history are detected. In many cases the diagnosis is readily made, although some cases remain contentious or controversial and consume much clinical time and energy. Differences of view between doctors are tested in the courts. Adverse publicity has made this work unpopular in the UK. Knowledge of the differential diagnosis of unexplained or apparent injury is essential for accurate diagnosis, vital where errors in either direction can be disastrous. New UK radiological guidelines will assist radiologists in achieving best evidence-based practice. (orig.)

Time Spent by Breast Imaging Radiologists to Perform Value-Added Activities at an Academic Cancer Center.

Science.gov (United States)

Collado-Mesa, Fernando; Klevos, Geetika; Arheart, Kristopher; Banks, James; Yepes, Monica; Net, Jose

2017-04-01

Health care reform in the United States has generated a paradigm shift in the practice of radiology aimed at increasing the degree of patient-centered care. We conducted a study to quantify the amount of time breast imaging radiologists spend on value-added activities at an academic comprehensive cancer center located in Miami, Florida, and accredited by the American College of Radiology as a Breast Imaging Center of Excellence. A prospective, observational study was conducted during a period of 20 consecutive workdays. Three participating breast imaging radiologists maintained a real-time log of each activity performed. A generalized linear model was used to perform a 1-way analysis of variance. An alpha level of .05 was used to determine statistical significance. The average daily time dedicated to these activities was 92.1 minutes (range, 56.4-132.2). The amount of time significantly differed among breast imaging radiologists and correlated with their assigned daily role (P value-added activities to help improve patients' experience across the continuity of their care. We propose that similar studies be conducted at other institutions to better assess the magnitude of this finding across different breast imaging care settings.

Fractional Stochastic Differential Equations Satisfying Fluctuation-Dissipation Theorem

Science.gov (United States)

Li, Lei; Liu, Jian-Guo; Lu, Jianfeng

2017-10-01

We propose in this work a fractional stochastic differential equation (FSDE) model consistent with the over-damped limit of the generalized Langevin equation model. As a result of the `fluctuation-dissipation theorem', the differential equations driven by fractional Brownian noise to model memory effects should be paired with Caputo derivatives, and this FSDE model should be understood in an integral form. We establish the existence of strong solutions for such equations and discuss the ergodicity and convergence to Gibbs measure. In the linear forcing regime, we show rigorously the algebraic convergence to Gibbs measure when the `fluctuation-dissipation theorem' is satisfied, and this verifies that satisfying `fluctuation-dissipation theorem' indeed leads to the correct physical behavior. We further discuss possible approaches to analyze the ergodicity and convergence to Gibbs measure in the nonlinear forcing regime, while leave the rigorous analysis for future works. The FSDE model proposed is suitable for systems in contact with heat bath with power-law kernel and subdiffusion behaviors.

Satisfaction with inpatient treatment for first-episode psychosis among different ethnic groups: A report from the UK AeSOP study.

LENUS (Irish Health Repository)

Boydell, Jane

2010-09-17

BACKGROUND: There is concern about the level of satisfaction with mental healthcare among minority ethnic patients in the UK, particularly as black patients have more compulsory admissions to hospital. AIMS: To determine and compare levels of satisfaction with mental healthcare between patients from different ethnic groups in a three-centre study of first-onset psychosis. METHOD: Data were collected from 216 patients with first-episode psychosis and 101 caregivers from South London, Nottingham and Bristol, using the Acute Services Study Questionnaire (Patient and Relative Version) and measures of sociodemographic variables and insight. RESULTS: No differences were found between ethnic groups in most domains of satisfaction tested individually, including items relating to treatment by ward staff and number of domains rated as satisfactory. However, logistic regression modelling (adjusting for age, gender, social class, diagnostic category and compulsion) showed that black Caribbean patients did not believe that they were receiving the right treatment and were less satisfied with medication than white patients. Black African patients were less satisfied with non-pharmacological treatments than white patients. These findings were not explained by lack of insight or compulsory treatment. CONCLUSIONS: The study found that black patients were less satisfied with specific aspects of treatment, particularly medication, but were equally satisfied with nursing and social care. Understanding the reasons behind this may improve the acceptability of psychiatric care to black minority ethnic groups.

Satisfaction with inpatient treatment for first-episode psychosis among different ethnic groups: a report from the UK AeSOP study.

Science.gov (United States)

Boydell, Jane; Morgan, Craig; Dutta, Rina; Jones, Barry; Alemseged, Fana; Dazzan, Paola; Morgan, Kevin; Doody, Gillian; Harrison, Glynn; Leff, Julian; Jones, Peter; Murray, Robin; Fearon, Paul

2012-01-01

There is concern about the level of satisfaction with mental healthcare among minority ethnic patients in the UK, particularly as black patients have more compulsory admissions to hospital. To determine and compare levels of satisfaction with mental healthcare between patients from different ethnic groups in a three-centre study of first-onset psychosis. Data were collected from 216 patients with first-episode psychosis and 101 caregivers from South London, Nottingham and Bristol, using the Acute Services Study Questionnaire (Patient and Relative Version) and measures of sociodemographic variables and insight. No differences were found between ethnic groups in most domains of satisfaction tested individually, including items relating to treatment by ward staff and number of domains rated as satisfactory. However, logistic regression modelling (adjusting for age, gender, social class, diagnostic category and compulsion) showed that black Caribbean patients did not believe that they were receiving the right treatment and were less satisfied with medication than white patients. Black African patients were less satisfied with non-pharmacological treatments than white patients. These findings were not explained by lack of insight or compulsory treatment. The study found that black patients were less satisfied with specific aspects of treatment, particularly medication, but were equally satisfied with nursing and social care. Understanding the reasons behind this may improve the acceptability of psychiatric care to black minority ethnic groups.

Diagnosis of IPA in HIV: The role of the chest X-ray and radiologist

International Nuclear Information System (INIS)

Zaspel, Uta; Denning, David W.; Lemke, Arne J.; Roettgen, Rainer; Bittner, Roland; Oestmann, Joerg W.; Greene, Reginald; Schuermann, Dirk; Maschmeyer, Georg; Ruhnke, Markus; Herbrecht, Raoul; Ribaud, Patricia; Lortholary, Olivier; Zonderland, Harmien; Rabe, Klaus F.; Neumann, Klaus

2004-01-01

The role of clinical information and chest film for the discrimination between invasive pulmonary aspergillosis (IPA) and its differential diagnoses in human immunodeficiency virus (HIV) infection was studied. The diagnostic performance of clinical information and chest film alone and in combination was studied for eight internists and eight radiologists with regular exposure to IPA patients. The multicenter case sample consisted of 25 patients with proven IPA and 25 with other pulmonary diseases typical for HIV. The cases were presented on a CD-ROM. Receiver operating characteristics (ROC) methodology was employed. With clinical information alone, internists achieved the highest diagnostic performance (area under curve/AUC=0.84). Viewing the chest films did not contribute to their performance (AUC=0.80, P=0.26). The radiologist's performance on the basis of viewing the chest film (AUC=0.75) increased significantly (P=0.012) when clinical information (AUC=0.83) was supplied. IPA cases with characteristic radiological appearance were correctly identified in 90% with chest film. For radiologists with regular exposure to HIV patients, chest films hold relevant information and contribute to the determination in cases with characteristic radiological appearance. Overall and especially in cases with less characteristic radiological appearance, they have significant profit from full access to the clinical data. For internists with regular exposure to HIV patients, chest films do not provide information essential for the verification or differentiation of potential IPA. (orig.)

Referring Physicians' Tendency to Collaborate With Radiologists in Managing Contrast Media-Related Risk Factors.

Science.gov (United States)

İmamoğlu, Hakan; Doğan, Serap; Erdoğan, Nuri

2018-02-01

The aim of this study was to investigate the tendency of referring physicians to collaborate with radiologists in managing contrast media (CM)-related risk factors. The study was conducted at a single academic hospital. Among 150 referring physicians from various specialties, 51 referring physicians (34%) responded to the invitation letter asking for an interview with a radiologist. During the interview, a modified form of the Control Preferences Scale was administered, in which there were five preferences (each displayed on a separate card) that ranged from the fully active to fully passive involvement of referring physicians in managing CM-related risk factors. A descriptive analysis was performed through categorization of the results depending on the respondents' two most preferred roles. Thirty-six referring physicians (70.5%) preferred a collaborative role, and 15 (29.4%) preferred a noncollaborative role (i.e., remained on either the fully active or fully passive side). Among the referring physicians who preferred a collaborative role, the most common response (n = 15 [29.4%]) was collaborative-active. Referring physicians at the authors' institution have basic cognitive and motivational-affective tone toward collaboration in future teamwork aimed at the management of CM-related risk factors. A modified form of the Control Preferences Scale, as in this study, can be used to investigate the tendency of referring physicians to collaborate with radiologists. The results are discussed from ethical and legal perspectives. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Clinical application of S-Detect to breast masses on ultrasonography: A study evaluating the diagnostic performance and agreement with a dedicated breast radiologist

International Nuclear Information System (INIS)

Kim, Ki Wook; Kim, Eun Kyung; Yoon, Jung Hyun; Song, Mi Kyung

2017-01-01

The purpose of this study was to evaluate the diagnostic performance of S-Detect when applied to breast ultrasonography (US), and the agreement with an experienced radiologist specializing in breast imaging. From June to August 2015, 192 breast masses in 175 women were included. US features of the breast masses were retrospectively analyzed by a radiologist who specializes in breast imaging and S-Detect, according to the fourth edition of the American College of Radiology Breast Imaging Reporting and Data System lexicon and final assessment categories. Final assessments from S-Detect were in dichotomized form: possibly benign and possibly malignant. Kappa statistics were used to analyze the agreement between the radiologist and S-Detect. Diagnostic performance of the radiologist and S-Detect was calculated, including sensitivity, specificity, positive predictive value (PPV), negative predictive value, accuracy, and area under the receiving operator characteristics curve. Of the 192 breast masses, 72 (37.5%) were malignant, and 120 (62.5%) were benign. Benign masses among category 4a had higher rates of possibly benign assessment on S-Detect for the radiologist, 63.5% to 36.5%, respectively (P=0.797). When the cutoff was set at category 4a, the specificity, PPV, and accuracy was significantly higher in S-Detect compared to the radiologist (all P<0.05), with a higher area under the receiver operator characteristics curve of 0.725 compared to 0.653 (P=0.038). Moderate agreement (k=0.58) was seen in the final assessment between the radiologist and S-Detect. S-Detect may be used as an additional diagnostic tool to improve the specificity of breast US in clinical practice, and guide in decision making for breast masses detected on US

How “consistent” is “consistent”? A clinician-based assessment of the reliability of expressions used by radiologists to communicate diagnostic confidence

International Nuclear Information System (INIS)

Rosenkrantz, A.B.; Kiritsy, M.; Kim, S.

2014-01-01

Aim: To evaluate the degree of variability in clinicians' interpretation of expressions used by radiologists to communicate their level of diagnostic confidence within radiological reports. Materials and methods: Clinicians were solicited to complete a prospective survey asking them to select the approximate perceived level of certainty, expressed as a percentage, associated with 20 expressions used by radiologists to communicate their level of diagnostic confidence within radiological reports. The median and inter-decile range (IDR) were computed for each expression, with a smaller IDR indicating greater reproducibility. Clinicians were also asked questions regarding their attitudes about radiologists' communication of diagnostic confidence. Results: Forty-nine surveys were completed. Median confidence associated with the expressions ranged from 10–90%. Reproducibility of the expressions was variable, as IDR ranged from 15–53%, although a median IDR of 40% indicated overall poor reproducibility. Expressions with relatively higher reproducibility included “most likely”, “likely”, and “unlikely” (IDR 15–20%), whereas expressions with relatively lower reproducibility included “compatible with”, “suspicious for”, “possibly,” and “can be seen in the setting of” (IDR ≥45%). Only 20% of clinicians agreed or strongly agreed that radiologists consistently use such expressions within their reports. Fifty-five percent of clinicians preferred that diagnostic confidence be communicated as a percentage rather than as a textual expression. Conclusion: There was poor reproducibility in clinicians' interpretations of many expressions used by radiologists to communicate their level of diagnostic confidence. Use of percentages to convey diagnostic confidence within reports may mitigate this source of ambiguity in radiologists' communication with clinicians. - Highlights: • Clinicians recorded certainty associated with

Computer-aided diagnosis for classifying benign versus malignant thyroid nodules based on ultrasound images: A comparison with radiologist-based assessments

Energy Technology Data Exchange (ETDEWEB)

Chang, Yongjun [School of Electrical Engineering, Korea Advanced Institute of Science and Technology, 291, Daehak-ro, Yuseong-gu, Daejeon 34141 (Korea, Republic of); Paul, Anjan Kumar [Funzin, Inc., 148 Ankuk-dong, Jongro-gu, Seoul 03060 (Korea, Republic of); Kim, Namkug, E-mail: namkugkim@gmail.com; Baek, Jung Hwan; Choi, Young Jun [Department of Radiology, University of Ulsan College of Medicine, 388-1 Pungnap2-dong, Songpa-gu, Seoul 05505 (Korea, Republic of); Ha, Eun Ju [Department of Radiology, Ajou University School of Medicine, Wonchon-Dong, Yeongtong-Gu, Suwon 16499 (Korea, Republic of); Lee, Kang Dae; Lee, Hyoung Shin [Department of Otolaryngology Head and Neck Surgery, Kosin University College of Medicine, 34 Amnamdong, Seu-Gu, Busan 49267 (Korea, Republic of); Shin, DaeSeock; Kim, Nakyoung [MIDAS Information Technology, Pangyo-ro 228, Bundang-gu, Seongnam-si, Gyeonggi 13487 (Korea, Republic of)

2016-01-15

Purpose: To develop a semiautomated computer-aided diagnosis (CAD) system for thyroid cancer using two-dimensional ultrasound images that can be used to yield a second opinion in the clinic to differentiate malignant and benign lesions. Methods: A total of 118 ultrasound images that included axial and longitudinal images from patients with biopsy-confirmed malignant (n = 30) and benign (n = 29) nodules were collected. Thyroid CAD software was developed to extract quantitative features from these images based on thyroid nodule segmentation in which adaptive diffusion flow for active contours was used. Various features, including histogram, intensity differences, elliptical fit, gray-level co-occurrence matrixes, and gray-level run-length matrixes, were evaluated for each region imaged. Based on these imaging features, a support vector machine (SVM) classifier was used to differentiate benign and malignant nodules. Leave-one-out cross-validation with sequential forward feature selection was performed to evaluate the overall accuracy of this method. Additionally, analyses with contingency tables and receiver operating characteristic (ROC) curves were performed to compare the performance of CAD with visual inspection by expert radiologists based on established gold standards. Results: Most univariate features for this proposed CAD system attained accuracies that ranged from 78.0% to 83.1%. When optimal SVM parameters that were established using a grid search method with features that radiologists use for visual inspection were employed, the authors could attain rates of accuracy that ranged from 72.9% to 84.7%. Using leave-one-out cross-validation results in a multivariate analysis of various features, the highest accuracy achieved using the proposed CAD system was 98.3%, whereas visual inspection by radiologists reached 94.9% accuracy. To obtain the highest accuracies, “axial ratio” and “max probability” in axial images were most frequently included in the

UK energy policy ambition and UK energy modelling-fit for purpose?

International Nuclear Information System (INIS)

Strachan, Neil

2011-01-01

Aiming to lead amongst other G20 countries, the UK government has classified the twin energy policy priorities of decarbonisation and security of supply as a 'centennial challenge'. This viewpoint discusses the UK's capacity for energy modelling and scenario building as a critical underpinning of iterative decision making to meet these policy ambitions. From a nadir, over the last decade UK modelling expertise has been steadily built up. However extreme challenges remain in the level and consistency of funding of core model teams - critical to ensure a full scope of energy model types and hence insights, and in developing new state-of-the-art models to address evolving uncertainties. Meeting this challenge will facilitate a broad scope of types and geographical scale of UK's analytical tools to responsively deliver the evidence base for a range of public and private sector decision makers, and ensure that the UK contributes to global efforts to advance the field of energy-economic modelling. - Research highlights: → Energy modelling capacity is a critical underpinning for iterative energy policy making. → Full scope of energy models and analytical approaches is required. → Extreme challenges remain in consistent and sustainable funding of energy modelling teams. → National governments that lead in global energy policy also need to invest in modelling capacity.

Safe Use of Contrast Media: What the Radiologist Needs to Know.

Science.gov (United States)

Beckett, Katrina R; Moriarity, Andrew K; Langer, Jessica M

2015-10-01

Iodinated and gadolinium-based contrast media are used on a daily basis in most radiology practices. These agents often are essential to providing accurate diagnoses, and are nearly always safe and effective when administered correctly. However, reactions to contrast media do occur and can be life threatening. Therefore, it is critical for faculty and staff to know how reactions to contrast agents manifest and how to treat them promptly. The decline in renal function seen occasionally after intravenous administration of iodinated contrast agents is poorly understood and likely multifactorial, and its association with the contrast medium may be overemphasized. However, it is important that radiologists be aware of current understanding and strategies to decrease the incidence of renal dysfunction. Nephrogenic systemic fibrosis, a skin disease, is an adverse reaction related to use of some gadolinium-based contrast agents in patients with chronic renal failure. The types of gadolinium most often associated with this condition and the indications for withholding gadolinium are important and are discussed in this article. The use of enteric contrast agents and contrast agents during pregnancy and nursing are reviewed briefly. Current knowledge for safe use of contrast media and key concepts that all radiologists should know are summarized in this review. © RSNA, 2015.

Novel Method to Improve Radiologist Agreement in Interpretation of Serial Chest Radiographs in the ICU

Directory of Open Access Journals (Sweden)

Denise A Castro

2015-01-01

Full Text Available Objectives: To determine whether a novel method and device, called a variable attenuation plate (VAP, which equalizes chest radiographic appearance and allows for synchronization of manual image windowing with comparison studies, would improve consistency in interpretation. Materials and Methods: Research ethics board approved the prospective cohort pilot study, which included 50 patients in the intensive care unit (ICU undergoing two serial chest radiographs with a VAP placed on each one of them. The VAP allowed for equalization of density and contrast between the patients′ serial chest radiographs. Three radiologists interpreted all the studies with and without the use of VAP. Kappa and percent agreement was used to calculate agreement between radiologists′ interpretations with and without the plate. Results: Radiologist agreement was substantially higher with the VAP method, as compared to that with the non-VAP method. Kappa values between Radiologists A and B, A and C, and B and C were 46%, 55%, and 51%, respectively, which improved to 73%, 81%, and 66%, respectively, with the use of VAP. Discrepant report impressions (i.e., one radiologist′s impression of unchanged versus one or both of the other radiologists stating improved or worsened in their impression ranged from 24 to 28.6% without the use of VAP and from 10 to 16% with the use of VAP (χ2 = 7.454, P < 0.01. Opposing views (i.e., one radiologist′s impression of improved and one of the others stating disease progression or vice versa were reported in 7 (12% cases in the non-VAP group and 4 (7% cases in the VAP group (χ2 = 0.85, P = 0.54. Conclusion: Numerous factors play a role in image acquisition and image quality, which can contribute to poor consistency and reliability of portable chest radiographic interpretations. Radiologists′ agreement of image interpretation can be improved by use of a novel method consisting of a VAP and associated software and has the potential

Solar energy: a UK assessment

Energy Technology Data Exchange (ETDEWEB)

1976-01-01

A panel convened by UK-ISES to analyze all aspects of solar energy systems and to assess the potential for solar energy utilization and research and development needs in the UK and for export is reported. Topics covered include: solar energy in relation to other energy sources; international solar energy research and development program; the physical nature of solar energy and its availability in the UK and other countries; thermal collection, storage, and low-temperature applications; solar energy and architecture; solar thermal power systems; solar cells; agricultural and biological systems; photochemical systems; social, legal, and political considerations with particular reference to the UK; and future policy on solar research and development for the UK. (WDM)

Australian primary health care nurses most and least satisfying aspects of work.

Science.gov (United States)

Halcomb, Elizabeth; Ashley, Christine

2017-02-01

To identify the aspects of working in Australian primary health care that nurses rate as the most and least satisfying. The nursing workforce in Australian primary health care has grown exponentially to meet the growing demand for health care. To maintain and further growth requires the recruitment and retention of nurses to this setting. Understanding the factors that nurses' rate as the most and least satisfying about their job will inform strategies to enhance nurse retention. A cross-sectional online survey. Nurses employed in primary health care settings across Australia were recruited (n = 1166) to participate in a survey which combined items related to the respondent, their job, type of work, clinical activities, job satisfaction and future intention, with two open-ended items about the most and least satisfying aspects of their work. Patient interactions, respect, teamwork, collegiality and autonomy were identified as the most satisfying professional aspects of their role. Personal considerations such as family friendly work arrangements and a satisfactory work-life balance were also important, overriding negative components of the role. The least satisfying aspects were poor financial support and remuneration, lack of a career path, physical work environment and time constraints. National restructuring of the primary health care environment was seen as a barrier to role stability and ability to work to a full scope of practice. This study has identified a range of positive and negative professional and personal aspects of the primary health care nursing role, which may impact on staff recruitment and retention. Findings from the study should be considered by employers seeking to retain and maximise the skills of their primary health care workforce. Understanding the factors that nurses perceive as being the most and least satisfying aspects of the work is can open up dialogue about how to improve the working experience of nurses in primary health care. �

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

Science.gov (United States)

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

2016-04-01

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

Mortality from cancer and all causes among British radiologists

International Nuclear Information System (INIS)

Smith, P.G.; Doll, R.

1981-01-01

The mortality of men who joined a British radiological society between 1897 and 1954 has been compared with that of (i) all men in England and Wales, (ii) men in social class 1, and (iii) male medical practitioners. Radiologists who entered the profession before 1921 suffered a death rate from cancer 75% higher than that of medical practitioners. Among these men there was a statistically significant excess of deaths from cancers of the pancreas (6 against 1.9 expected), lung (8 against 3.7), and skin (6 against 0.8), and from leukaemia (4 against 0.7). There were 72 deaths from cancer among men who entered the study after 1920 and 68.6 deaths were expected, based upon rates among medical practitioners. For no individual cancer site did the observed number of deaths exceed the expected number. There was some evidence, however, that the ratio of observed to expected cancer increased with the duration of time that men were included in the study. Among those followed for more than 30 years there were 30 deaths against 22.1 expected. It is not possible to make a close estimate of the dose of radiation received by the men in this study, but those who entered between 1920 and 1945 could have received an accumulated whole-body dose of the order of 1-5 Gy(100 to 500 rad). For all non-cancer causes of death combined, the death rate among radiologists is lower than that among all men in England and Wales, men in social class 1, and male medical practitioners. The data offer no support for the concept of a non-specific aging effect of radiation. (author)

Applying a social network analysis (SNA) approach to understanding radiologists' performance in reading mammograms

Science.gov (United States)

Tavakoli Taba, Seyedamir; Hossain, Liaquat; Heard, Robert; Brennan, Patrick; Lee, Warwick; Lewis, Sarah

2017-03-01

Rationale and objectives: Observer performance has been widely studied through examining the characteristics of individuals. Applying a systems perspective, while understanding of the system's output, requires a study of the interactions between observers. This research explains a mixed methods approach to applying a social network analysis (SNA), together with a more traditional approach of examining personal/ individual characteristics in understanding observer performance in mammography. Materials and Methods: Using social networks theories and measures in order to understand observer performance, we designed a social networks survey instrument for collecting personal and network data about observers involved in mammography performance studies. We present the results of a study by our group where 31 Australian breast radiologists originally reviewed 60 mammographic cases (comprising of 20 abnormal and 40 normal cases) and then completed an online questionnaire about their social networks and personal characteristics. A jackknife free response operating characteristic (JAFROC) method was used to measure performance of radiologists. JAFROC was tested against various personal and network measures to verify the theoretical model. Results: The results from this study suggest a strong association between social networks and observer performance for Australian radiologists. Network factors accounted for 48% of variance in observer performance, in comparison to 15.5% for the personal characteristics for this study group. Conclusion: This study suggest a strong new direction for research into improving observer performance. Future studies in observer performance should consider social networks' influence as part of their research paradigm, with equal or greater vigour than traditional constructs of personal characteristics.

Advanced Renal Cell Carcinoma: Role of the Radiologist in the Era of Precision Medicine.

Science.gov (United States)

Shinagare, Atul B; Krajewski, Katherine M; Braschi-Amirfarzan, Marta; Ramaiya, Nikhil H

2017-08-01

For the past decade, advanced renal cell carcinoma (RCC) has been at the forefront of oncologic innovation. Our rapidly evolving understanding of the molecular and genetic basis of RCC has revolutionized the management of advanced RCC; 10 novel molecular targeted agents and immune checkpoint inhibitor have received U.S. Food and Drug Administration approval for treatment of advanced RCC in a little over a decade. Amid this progress, imaging has assumed a central role in metastatic surveillance and follow-up of advanced RCC. State-of-the-art knowledge of the molecular basis of RCC and its treatment and imaging will help ensure that the radiology community remains relevant and central in the care of patients with advanced RCC. This article will review developments in management of advanced RCC from a radiologist's perspective to highlight our clinical role. It will describe how the underlying molecular mechanisms of RCC provide specific targets for novel anticancer agents. The relationship between the mechanisms of action of these novel anticancer agents and the imaging appearance of tumor response will be discussed, along with the available tumor response criteria and their strengths and weaknesses, thus assisting radiologists in response assessment in the setting of clinical trials or routine practice. The class- and drug-specific toxicities and complications associated with the novel anticancer agents will be summarized, since these are frequently missed or misinterpreted and require the radiologist's input in prompt detection and management. The potential role of radiogenomics and texture analysis in the management of advanced RCC will also be discussed. © RSNA, 2017.

Incomplete fissures in severe emphysematous patients evaluated with MDCT: Incidence and interobserver agreement among radiologists and pneumologists

Energy Technology Data Exchange (ETDEWEB)

Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Department of Radiology, University Hospital of the School of Medicine of Ribeirao Preto - University of Sao Paulo, Av. Bandeirantes 3900, Campus Universitario Monte Alegre, 14048 900 Ribeirao Preto, SP (Brazil); Puderbach, Michael [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Gompelmann, Daniela; Eberhardt, Ralf; Herth, Felix [Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Heussel, Claus Peter [Department of Diagnostic and Interventional Radiology, University of Heidelberg, Neuenheimer Feld 110, 69120 Heidelberg (Germany); Chest Clinic (Thoraxklinik), University of Heidelberg, Amalienstr. 5,69126 Heidelberg (Germany)

2012-12-15

Objective: Pulmonary fissures completeness predicts efficacy in endobronchial valves (EBV) implantation, a new lobar volume reduction therapy for severe emphysematous patients. We assessed the incidence of incomplete fissures and the interobserver agreement in its evaluation with MDCT, in severe emphysematous patients prior to EBV implantation. Materials and Methods: Volumetric thin-section CT scans of 35 patients (CODP GOLD 3/4, heterogeneous emphysema) were retrospectively reviewed by 2 pneumologists, 1 general and 2 experienced chest radiologists, independently and blinded for treatment outcome, and the pulmonary fissures were classified as either complete or incomplete. Interobserver agreement was assessed with Kappa index (KI). Results: Agreement between all readers for the left oblique, right oblique and horizontal fissure was, respectively, moderate (KI = 0.53), fair (KI = 0.37) and moderate (KI = 0.42). Highest agreement (99/105 fissures) was observed among experienced radiologists, being for left oblique, right oblique and horizontal, respectively, almost perfect (KI = 0.79), perfect (KI = 1.0) and moderate (KI = 0.52). These 2 reviewers found that all of 35 patients had at least one incomplete fissure, with a proportion of incomplete fissures assigned as 74/65%, 85/85% and 91/88%, respectively for the left oblique, right oblique and horizontal fissures. Conclusions: Pneumologists and radiologists agreed fairly to moderately in fissures analysis, while the experienced chest radiologists reached the highest clinically adequate agreement of 94%. We believe that clinical routine visual analysis of the fissures integrity can be done with a good degree of confidence in MDCT images, and experienced readers might be required. Also, a higher than expected incidence of incomplete fissures was described in our studied population.

Incomplete fissures in severe emphysematous patients evaluated with MDCT: Incidence and interobserver agreement among radiologists and pneumologists

International Nuclear Information System (INIS)

Koenigkam-Santos, Marcel; Puderbach, Michael; Gompelmann, Daniela; Eberhardt, Ralf; Herth, Felix; Kauczor, Hans-Ulrich; Heussel, Claus Peter

2012-01-01

Objective: Pulmonary fissures completeness predicts efficacy in endobronchial valves (EBV) implantation, a new lobar volume reduction therapy for severe emphysematous patients. We assessed the incidence of incomplete fissures and the interobserver agreement in its evaluation with MDCT, in severe emphysematous patients prior to EBV implantation. Materials and Methods: Volumetric thin-section CT scans of 35 patients (CODP GOLD 3/4, heterogeneous emphysema) were retrospectively reviewed by 2 pneumologists, 1 general and 2 experienced chest radiologists, independently and blinded for treatment outcome, and the pulmonary fissures were classified as either complete or incomplete. Interobserver agreement was assessed with Kappa index (KI). Results: Agreement between all readers for the left oblique, right oblique and horizontal fissure was, respectively, moderate (KI = 0.53), fair (KI = 0.37) and moderate (KI = 0.42). Highest agreement (99/105 fissures) was observed among experienced radiologists, being for left oblique, right oblique and horizontal, respectively, almost perfect (KI = 0.79), perfect (KI = 1.0) and moderate (KI = 0.52). These 2 reviewers found that all of 35 patients had at least one incomplete fissure, with a proportion of incomplete fissures assigned as 74/65%, 85/85% and 91/88%, respectively for the left oblique, right oblique and horizontal fissures. Conclusions: Pneumologists and radiologists agreed fairly to moderately in fissures analysis, while the experienced chest radiologists reached the highest clinically adequate agreement of 94%. We believe that clinical routine visual analysis of the fissures integrity can be done with a good degree of confidence in MDCT images, and experienced readers might be required. Also, a higher than expected incidence of incomplete fissures was described in our studied population.

Coronary anomalies: what the radiologist should know*

Science.gov (United States)

Neves, Priscilla Ornellas; Andrade, Joalbo; Monção, Henry

2015-01-01

Coronary anomalies comprise a diverse group of malformations, some of them asymptomatic with a benign course, and the others related to symptoms as chest pain and sudden death. Such anomalies may be classified as follows: 1) anomalies of origination and course; 2) anomalies of intrinsic coronary arterial anatomy; 3) anomalies of coronary termination. The origin and the proximal course of anomalous coronary arteries are the main prognostic factors, and interarterial course or a coronary artery is considered to be malignant due its association with increased risk of sudden death. Coronary computed tomography angiography has become the reference method for such an assessment as it detects not only anomalies in origination of these arteries, but also its course in relation to other mediastinal structures, which plays a relevant role in the definition of the therapeutic management. Finally, it is essential for radiologists to recognize and characterize such anomalies. PMID:26379322

The Institute: yesterday and tomorrow

International Nuclear Information System (INIS)

Ross, W.M.

1980-01-01

A brief historical outline is given of the British Institute of Radiology (BIR) and its forebears, starting in 1897 with the Rontgen Society. Brief mention is made of the careers and achievements of some of the 75 radiologists who have served as President since that date. The organisation and functions of the BIR, both in the UK and further afield, are discussed, together with interactions between the multidisciplinary BIR, other professional bodies and the Government. The relationship with the Royal College of Radiologists is of particular interest. (U.K.)

MR imaging of the pelvis: a guide to incidental musculoskeletal findings for abdominal radiologists.

Science.gov (United States)

Gaetke-Udager, Kara; Girish, Gandikota; Kaza, Ravi K; Jacobson, Jon; Fessell, David; Morag, Yoav; Jamadar, David

2014-08-01

Occasionally patients who undergo magnetic resonance imaging for presumed pelvic disease demonstrate unexpected musculoskeletal imaging findings in the imaged field. Such incidental findings can be challenging to the abdominal radiologist, who may not be familiar with their appearance or know the appropriate diagnostic considerations. Findings can include both normal and abnormal bone marrow, osseous abnormalities such as Paget's disease, avascular necrosis, osteomyelitis, stress and insufficiency fractures, and athletic pubalgia, benign neoplasms such as enchondroma and bone island, malignant processes such as metastasis and chondrosarcoma, soft tissue processes such as abscess, nerve-related tumors, and chordoma, joint- and bursal-related processes such as sacroiliitis, iliopsoas bursitis, greater trochanteric pain syndrome, and labral tears, and iatrogenic processes such as bone graft or bone biopsy. Though not all-encompassing, this essay will help abdominal radiologists to identify and describe this variety of pelvic musculoskeletal conditions, understand key radiologic findings, and synthesize a differential diagnosis when appropriate.

Radiologist's exposition during the radioscopy of the digestive tract in esophagus-gastro-duodenum studies

International Nuclear Information System (INIS)

Montanez, O.; Blanco, D.

1988-01-01

The results of personal dosimetry confirm that one of the most exposed groups to the ionizing radiations is those of Radiologists who work with radioscopy of the digestive tract. However, the particular conditions of the exposition complicate the interpretation of the reading for the values obtained on the dosimeter. In order to improve such interpretation, it has done simultaneous measurements with the routine dosimeter and with thermoluminescent dosimeters (TLD) of lithium fluoride(LiF). It has selected eight places on the worker's body and located such dosimeters, so that the dose was integrated during thirty studies. It could verify that, if the dosimeter is located in agreement with the recommendations of the International Commission of Radiological Protection(ICRP), the reading overestimates in several times the dose in whole body(or effective dose). It has also considered that the amount of such procedures done by the radiologist is limited in this case, by the effective dose

Cephalometric landmark variability among orthodontists and dentomaxillofacial radiologists: a comparative study

Energy Technology Data Exchange (ETDEWEB)

Durao, Ana Paula Reis; Ferreira, Afonso P. [Dept.of Faculty of Dental Medicine, University of Porto, Porto (Portugal); Morosolli, Aline [Dept.of Surgery, Dentistry School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul (Brazil); Pittayapat, Pisha [Dept.of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok (Thailand); Bolstad, Napat [Dept.of Clinical Dentistry, Faculty of Health Science, UiT The Arctic University of Norway, Tromso (Norway); Jacobs, Reinhilde [Dept.of Oral Imaging Center, OMFS-IMPATH Research Group, Dept. of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven (Belgium)

2015-12-15

The aim this study was to compare the accuracy of orthodontists and dentomaxillofacial radiologists in identifying 17 commonly used cephalometric landmarks, and to determine the extent of variability associated with each of those landmarks. Twenty digital lateral cephalometric radiographs were evaluated by two groups of dental specialists, and 17 cephalometric landmarks were identified. The x and y coordinates of each landmark were recorded. The mean value for each landmark was considered the best estimate and used as the standard. Variation in measurements of the distance between landmarks and measurements of the angles associated with certain landmarks was also assessed by a subset of two observers, and intraobserver and interobserver agreement were evaluated. Intraclass correlation coefficients were excellent for intraobserver agreement, but only good for interobserver agreement. The least reliable landmark for orthodontists was the gnathion (Gn) point (standard deviation [SD], 5.92 mm), while the orbitale (Or) was the least reliable landmark (SD, 4.41 mm) for dentomaxillofacial radiologists. Furthermore, the condylion (Co)-Gn plane was the least consistent (SD, 4.43 mm). We established that some landmarks were not as reproducible as others, both horizontally and vertically. The most consistently identified landmark in both groups was the lower incisor border, while the least reliable points were Co, Gn, Or, and the anterior nasal spine. Overall, a lower level of reproducibility in the identification of cephalometric landmarks was observed among orthodontists.

Cephalometric landmark variability among orthodontists and dentomaxillofacial radiologists: a comparative study

International Nuclear Information System (INIS)

Durao, Ana Paula Reis; Ferreira, Afonso P.; Morosolli, Aline; Pittayapat, Pisha; Bolstad, Napat; Jacobs, Reinhilde

2015-01-01

The aim this study was to compare the accuracy of orthodontists and dentomaxillofacial radiologists in identifying 17 commonly used cephalometric landmarks, and to determine the extent of variability associated with each of those landmarks. Twenty digital lateral cephalometric radiographs were evaluated by two groups of dental specialists, and 17 cephalometric landmarks were identified. The x and y coordinates of each landmark were recorded. The mean value for each landmark was considered the best estimate and used as the standard. Variation in measurements of the distance between landmarks and measurements of the angles associated with certain landmarks was also assessed by a subset of two observers, and intraobserver and interobserver agreement were evaluated. Intraclass correlation coefficients were excellent for intraobserver agreement, but only good for interobserver agreement. The least reliable landmark for orthodontists was the gnathion (Gn) point (standard deviation [SD], 5.92 mm), while the orbitale (Or) was the least reliable landmark (SD, 4.41 mm) for dentomaxillofacial radiologists. Furthermore, the condylion (Co)-Gn plane was the least consistent (SD, 4.43 mm). We established that some landmarks were not as reproducible as others, both horizontally and vertically. The most consistently identified landmark in both groups was the lower incisor border, while the least reliable points were Co, Gn, Or, and the anterior nasal spine. Overall, a lower level of reproducibility in the identification of cephalometric landmarks was observed among orthodontists

Does horizon entropy satisfy a quantum null energy conjecture?

Science.gov (United States)

Fu, Zicao; Marolf, Donald

2016-12-01

A modern version of the idea that the area of event horizons gives 4G times an entropy is the Hubeny-Rangamani causal holographic information (CHI) proposal for holographic field theories. Given a region R of a holographic QFTs, CHI computes A/4G on a certain cut of an event horizon in the gravitational dual. The result is naturally interpreted as a coarse-grained entropy for the QFT. CHI is known to be finitely greater than the fine-grained Hubeny-Rangamani-Takayanagi (HRT) entropy when \\partial R lies on a Killing horizon of the QFT spacetime, and in this context satisfies other non-trivial properties expected of an entropy. Here we present evidence that it also satisfies the quantum null energy condition (QNEC), which bounds the second derivative of the entropy of a quantum field theory on one side of a non-expanding null surface by the flux of stress-energy across the surface. In particular, we show CHI to satisfy the QNEC in 1  +  1 holographic CFTs when evaluated in states dual to conical defects in AdS3. This surprising result further supports the idea that CHI defines a useful notion of coarse-grained holographic entropy, and suggests unprecedented bounds on the rate at which bulk horizon generators emerge from a caustic. To supplement our motivation, we include an appendix deriving a corresponding coarse-grained generalized second law for 1  +  1 holographic CFTs perturbatively coupled to dilaton gravity.

Volumetry of Artificial Pulmonary Nodules in Ex Vivo Porcine Lungs: Comparison of Semi-automated Volumetry and Radiologists' Performance

Energy Technology Data Exchange (ETDEWEB)

Jeong, Ju Hyeon; Kim, Jin Hwan; Kim, Song Soo [Chungnam National University Hospital, Daejeon (Korea, Republic of); Jeon, Ho Sang [Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of); Lee, Hyun Ju [Seoul National University Hospital, Seoul (Korea, Republic of); Park, Noh Hyuck [Kwandong University College of Medicine, Myungji Hospital, Goyang (Korea, Republic of); Cho, Gyu Seong [KAIST, Daejeon (Korea, Republic of)

2010-10-15

With the advent of MSCT, the detection rate of small pulmonary nodules is markedly greater. However, there is no definite diagnostic clue to differentiate between malignant and benign nodules, except for the interval growth in small nodule less than 1 cm in diameter. We evaluated the accuracy of computer aided volumetry (CAV) and compared it with 4 radiologists' measurement. Fifteen artificial nodules that were embedded in the ex vivo porcine lung were scanned by MSCT. The diameters and volumes of nodules were independently measured three times, at 5-day intervals, and by four radiologists as well as by CAV. We evaluated the accuracy of the measurements on the basis of the true diameter and volume of the nodules. Using a paired t-test and a Bland-Altman plot, we evaluated whether there was a statistically significant difference between the radiologists' measurements and the CAV. The accuracy of the manual measurements by radiologists revealed a statistically significant difference from the true diameter and volume of the artificial nodules (p<0.01). Conversely, the accuracy of CAV did not show a statistically significant difference with the true nodule diameter and volume (p>0.01) The results of this study suggest that CAV is an accurate and useful tool to evaluate the volume of pulmonary nodules and can eventually be used to differentiate malignant and benign nodules as well as evaluate the therapeutic response of lung cancer.

Turning the tide : tidal power in the UK

OpenAIRE

Sustainable Development Commission

2007-01-01

Contents: Turning the tide : tidal power in the UK -- Executive summary -- Tidal power in the UK : research report 1 : UK tidal resource assessment -- Tidal power in the UK : research report 2 : tidal technologies overview -- Tidal power in the UK : research report 3 : Severn barrage proposals -- Tidal power in the UK : research report 4 : Severn non-barrage options -- Tidal power in the UK : research report 5 : UK case studies. Summarised in the Welsh language version of the executive ...

In-Person Communication Between Radiologists and Acute Care Surgeons Leads to Significant Alterations in Surgical Decision Making.

Science.gov (United States)

Dickerson, Elliot C; Alam, Hasan B; Brown, Richard K J; Stojanovska, Jadranka; Davenport, Matthew S

2016-08-01

The aim of this study was to determine if direct in-person communication between an acute care surgical team and radiologists alters surgical decision making. Informed consent was waived for this institutional review board-exempt, HIPAA-compliant, prospective quality improvement study. From January 29, 2015 to December 10, 2015, semiweekly rounds lasting approximately 60 min were held between the on-call acute care surgery team (attending surgeon, chief resident, and residents) and one of three expert abdominal radiologists. A comprehensive imaging review was performed of recent and comparison examinations for cases selected by the surgeons in which medical and/or surgical decision making was pending. All reviewed examinations had available finalized reports known to the surgical team. RADPEER interradiologist concordance scores were assigned to all reviewed examinations. The impression and plan of the attending surgeon were recorded before and after each in-person review. One hundred patients were reviewed with 11 attending surgeons. The in-person meetings led to changes in surgeons' diagnostic impressions in 43% (43 of 100) and changes in medical and/or surgical planning in 43% (43 of 100; 20 acute changes, 23 nonacute changes, 19 changes in operative management) of cases. There were major discrepancies (RADPEER score ≥3) between the impression of the reviewing radiologist and the written report in 11% of cases (11 of 100). Targeted in-person collaboration between radiologists and acute care surgeons is associated with substantial and frequent changes in patient management, even when the original written report contains all necessary data. The primary mechanism seems to be promotion of a shared mental model that facilitates the exchange of complex information. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The radiologist's responsibilities for the radiation protection of patients; Obligations du radiologue pour la radioprotection des patients

Energy Technology Data Exchange (ETDEWEB)

Etard, C. [Institut de Radioprotection et de Surete Nucleaire, 92 - Fontenay-aux-Roses (France)

2010-11-15

The obligations of the radiologist for the radiation protection of patients include a review of the appropriateness of the examination and optimization of the protocol. Both internal and external quality assurance programs are mandatory. The specific tasks and their frequency are defined by the AFSSAPS. The radiology report of procedures performed over radiosensitive regions must include the delivered dose. The imaging technique must be optimized based on published guidelines or law for the most frequent examinations. All radiologists should be familiar with radiation protection. Incidents should be reported to the Nuclear Safety Authority. (author)

PACS or the future of the radiologist's working place

International Nuclear Information System (INIS)

Meyer-Ebrecht, D.

1988-01-01

PACS (picture archiving and communication systems) is a synonym for the replacement of the traditional photographic film by means of technologies that will communicate and store images exclusively in digital form. Digital mass storage will replace the film archives and will be linked to all image sources by means of a data communication network. More significantly, PACS will also introduce a novel type of image-evaluation modality, the diagnostic image work station. Images will be displayed on TV monitors. In addition, a variety of support functions will become available for image handling and processing. The replacement of the light box by a digital work station will definitely cause dramatic changes in the radiologist's work. (orig.) [de

Osteoradionecrosis of the mandible: through a radiologist's eyes

International Nuclear Information System (INIS)

Deshpande, S.S.; Thakur, M.H.; Dholam, K.; Mahajan, A.; Arya, S.; Juvekar, S.

2015-01-01

Head and neck malignancies constitute a major cause of morbidity and mortality all over the world. Radiotherapy plays a pivotal role in the management of these tumours; however, it has associated complications, with mandibular osteoradionecrosis (ORN) being one of the gravest orofacial complications. Early diagnosis, extent evaluation, and detection of complications of ORN are imperative for instituting an appropriate management protocol. ORN can closely mimic tumour recurrence, the differentiation of which has obvious clinical implications. The purpose of the present review is to acquaint the radiologist with the imaging features of mandibular ORN and the ways to differentiate ORN from tumour recurrence

UK retail marketing survey 94

International Nuclear Information System (INIS)

Anon.

1994-01-01

This document draws together data on the United Kingdom (UK) petroleum market up to the end of 1993. Lists include suppliers of petrol to the UK market listed by brand name, a regional breakdown of petrol and derv outlets, UK outlets which retail derv. Average retail prices for motor spirit and derv per litre are given as are sites fitted with Vapour Recovery equipment. Other tables shown indicate various companies' share of the market in terms of the percentage of petrol sites, including supermarkets. The volumes of motor spirit and derv delivered to retail and commercial customers between 1984 and 1993 is also given. (UK)

Junior Radiologists' Forum (JRF): National trainee survey

International Nuclear Information System (INIS)

Ilyas, S.; Beatie, A.; Pettet, G.; Kharay, A.; Hedayati, V.; Hameed, S.; McCleery, M.A.; Papadakos, N.; Chari, B.

2014-01-01

Aim: To gather information in order to highlight areas within training that could be improved and share ideas of good practice and, in addition, to compare national results with those of local training schemes. Materials and methods: A request to participate in the survey was emailed to 1158 radiology trainees across 36 UK training schemes in October 2012. The electronic replies were anonymous. The survey remained active for 6 weeks. The data were collated and analysed by members of the JRF. The survey itself was divided into seven sections, covering a diverse range of topics. Results: Six hundred and four trainees from 36 UK training schemes completed the survey, resulting in a response rate of 52%. - Highlights: • First Radiology specific national survey, written by trainees. • Training schemes can benchmark their performance against a national average. • Also can share areas of good practice; and highlight those that need improvement. • Summary of the results, highlighting the most pertinent findings from each section

Maximum-principle-satisfying space-time conservation element and solution element scheme applied to compressible multifluids

KAUST Repository

Shen, Hua; Wen, Chih-Yung; Parsani, Matteo; Shu, Chi-Wang

2016-01-01

A maximum-principle-satisfying space-time conservation element and solution element (CE/SE) scheme is constructed to solve a reduced five-equation model coupled with the stiffened equation of state for compressible multifluids. We first derive a sufficient condition for CE/SE schemes to satisfy maximum-principle when solving a general conservation law. And then we introduce a slope limiter to ensure the sufficient condition which is applicative for both central and upwind CE/SE schemes. Finally, we implement the upwind maximum-principle-satisfying CE/SE scheme to solve the volume-fraction-based five-equation model for compressible multifluids. Several numerical examples are carried out to carefully examine the accuracy, efficiency, conservativeness and maximum-principle-satisfying property of the proposed approach.

Maximum-principle-satisfying space-time conservation element and solution element scheme applied to compressible multifluids

KAUST Repository

Shen, Hua

2016-10-19

A maximum-principle-satisfying space-time conservation element and solution element (CE/SE) scheme is constructed to solve a reduced five-equation model coupled with the stiffened equation of state for compressible multifluids. We first derive a sufficient condition for CE/SE schemes to satisfy maximum-principle when solving a general conservation law. And then we introduce a slope limiter to ensure the sufficient condition which is applicative for both central and upwind CE/SE schemes. Finally, we implement the upwind maximum-principle-satisfying CE/SE scheme to solve the volume-fraction-based five-equation model for compressible multifluids. Several numerical examples are carried out to carefully examine the accuracy, efficiency, conservativeness and maximum-principle-satisfying property of the proposed approach.

Innovative UK Approaches to Acquisition Management

Science.gov (United States)

2009-05-01

Financial and Operational Imperatives Size of UK armed forces UK Industry ? Political influence PFI / PPP Increased Scrutiny - NAO “ Commercialisation “ of the...acquisition KNOWLEDGE (EXPERIENCE – Lessons learned) KNOWLEDGE (Training) KNOWLEDGE ( Education ) OPTIMAL OPERATIONAL PERFORMANCE Operational Capability UK

Social balance as a satisfiability problem of computer science.

Science.gov (United States)

Radicchi, Filippo; Vilone, Daniele; Yoon, Sooeyon; Meyer-Ortmanns, Hildegard

2007-02-01

Reduction of frustration was the driving force in an approach to social balance as it was recently considered by Antal [T. Antal, P. L. Krapivsky, and S. Redner, Phys. Rev. E 72, 036121 (2005)]. We generalize their triad dynamics to k-cycle dynamics for arbitrary integer k. We derive the phase structure, determine the stationary solutions, and calculate the time it takes to reach a frozen state. The main difference in the phase structure as a function of k is related to k being even or odd. As a second generalization we dilute the all-to-all coupling as considered by Antal to a random network with connection probability wcomputer science. The phase of social balance in our original interpretation then becomes the phase of satisfaction of all logical clauses in the satisfiability problem. In common to the cases we study, the ideal solution without any frustration always exists, but the question actually is as to whether this solution can be found by means of a local stochastic algorithm within a finite time. The answer depends on the choice of parameters. After establishing the mapping between the two classes of models, we generalize the social-balance problem to a diluted network topology for which the satisfiability problem is usually studied. On the other hand, in connection with the satisfiability problem we generalize the random local algorithm to a p-random local algorithm, including a parameter p that corresponds to the propensity parameter in the social balance problem. The qualitative effect of the inclusion of this parameter is a bias towards the optimal solution and a reduction of the needed simulation time.

Orthology and paralogy constraints: satisfiability and consistency.

Science.gov (United States)

Lafond, Manuel; El-Mabrouk, Nadia

2014-01-01

A variety of methods based on sequence similarity, reconciliation, synteny or functional characteristics, can be used to infer orthology and paralogy relations between genes of a given gene family  G. But is a given set  C of orthology/paralogy constraints possible, i.e., can they simultaneously co-exist in an evolutionary history for  G? While previous studies have focused on full sets of constraints, here we consider the general case where  C does not necessarily involve a constraint for each pair of genes. The problem is subdivided in two parts: (1) Is  C satisfiable, i.e. can we find an event-labeled gene tree G inducing  C? (2) Is there such a G which is consistent, i.e., such that all displayed triplet phylogenies are included in a species tree? Previous results on the Graph sandwich problem can be used to answer to (1), and we provide polynomial-time algorithms for satisfiability and consistency with a given species tree. We also describe a new polynomial-time algorithm for the case of consistency with an unknown species tree and full knowledge of pairwise orthology/paralogy relationships, as well as a branch-and-bound algorithm in the case when unknown relations are present. We show that our algorithms can be used in combination with ProteinOrtho, a sequence similarity-based orthology detection tool, to extract a set of robust orthology/paralogy relationships.

Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists

Energy Technology Data Exchange (ETDEWEB)

Taslakian, Bedros, E-mail: btaslakian@gmail.com [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Faraj, Walid, E-mail: wf07@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Khalife, Mohammad, E-mail: mk12@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); El-Merhi, Fadi, E-mail: fe19@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Saade, Charbel, E-mail: cs39@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Hallal, Ali, E-mail: ah05@aub.edu.lb [Department of General Surgery, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon); Haydar, Ali, E-mail: ah24@aub.edu.lb [Department of Radiology, American University of Beirut Medical Center, Riad El-Solh 1107 2020—PO Box: 11-0236, Beirut (Lebanon)

2015-08-15

Highlights: • Portal hypertension is the pathological increase in portal venous pressure. • Surgical portosystemic shunting is an accepted methods to decrease portal venous pressure. • Surgical portosystemic shunts are divided into selective and nonselective. • Shunt thrombosis is a serious complication, resulting in shunt dysfunction. • Imaging is essential in the assessment of the shunt function and anatomy. - Abstract: Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications.

Lung nodule detection in pediatric chest CT: quantitative relationship between image quality and radiologist performance.

Science.gov (United States)

Li, Xiang; Samei, Ehsan; Barnhart, Huiman X; Gaca, Ana Maria; Hollingsworth, Caroline L; Maxfield, Charles M; Carrico, Caroline W T; Colsher, James G; Frush, Donald P

2011-05-01

To determine the quantitative relationship between image quality and radiologist performance in detecting small lung nodules in pediatric CT. The study included clinical chest CT images of 30 pediatric patients (0-16 years) scanned at tube currents of 55-180 mA. Calibrated noise addition software was used to simulate cases at three nominal mA settings: 70, 35, and 17.5 mA, resulting in quantum noise of 7-32 Hounsfield Unit (HU). Using a validated nodule simulation technique, lung nodules with diameters of 3-5 mm and peak contrasts of 200-500 HU were inserted into the cases, which were then randomized and rated independently by four experienced pediatric radiologists for nodule presence on a continuous scale from 0 (definitely absent) to 100 (definitely present). The receiver operating characteristic (ROC) data were analyzed to quantify the relationship between diagnostic accuracy (area under the ROC curve, AUC) and image quality (the product of nodule peak contrast and displayed diameter to noise ratio, CDNR display). AUC increased rapidly from 0.70 to 0.87 when CDNR display increased from 60 to 130 mm, followed by a slow increase to 0.94 when CDNR display further increased to 257 mm. For the average nodule diameter (4 mm) and contrast (350 HU), AUC decreased from 0.93 to 0.71 with noise increased from 7 to 28 HU. We quantified the relationship between image quality and the performance of radiologists in detecting lung nodules in pediatric CT. The relationship can guide CT protocol design to achieve the desired diagnostic performance at the lowest radiation dose.

Assessment of surgical portosystemic shunts and associated complications: The diagnostic and therapeutic role of radiologists

International Nuclear Information System (INIS)

Taslakian, Bedros; Faraj, Walid; Khalife, Mohammad; Al-Kutoubi, Aghiad; El-Merhi, Fadi; Saade, Charbel; Hallal, Ali; Haydar, Ali

2015-01-01

Highlights: • Portal hypertension is the pathological increase in portal venous pressure. • Surgical portosystemic shunting is an accepted methods to decrease portal venous pressure. • Surgical portosystemic shunts are divided into selective and nonselective. • Shunt thrombosis is a serious complication, resulting in shunt dysfunction. • Imaging is essential in the assessment of the shunt function and anatomy. - Abstract: Surgical portosystemic shunting, the formation of a vascular connection between the portal and systemic venous circulation, has been used as a treatment to reduce portal venous pressure. Although the use of portosystemic shunt surgery in the management of portal hypertension has declined during the past decade in favour of alternative therapies, and subsequently surgeons and radiologists became less familiar with the procedure, it remains a well-established treatment. Knowledge of different types of surgical portosystemic shunts, their pathophysiology and complications will help radiologists improve communication with surgeons and enhance their understanding of the diagnostic and therapeutic role of radiology in the assessment and management of these shunts. Optimal assessment of the shunt is essential to determine its patency and allow timely intervention. Both non-invasive and invasive imaging modalities complement each other in the evaluation of surgical portosystemic shunts. Interventional radiology plays an important role in the management of complications, such as shunt thrombosis and stenosis. This article describes the various types of surgical portosystemic shunts, explains the anatomy and pathophysiology of these shunts, illustrates the pearls and pitfalls of different imaging modalities in the assessment of these shunts and demonstrates the role of radiologists in the interventional management of complications

Multipath Detection Using Boolean Satisfiability Techniques

Directory of Open Access Journals (Sweden)

Fadi A. Aloul

2011-01-01

Full Text Available A new technique for multipath detection in wideband mobile radio systems is presented. The proposed scheme is based on an intelligent search algorithm using Boolean Satisfiability (SAT techniques to search through the uncertainty region of the multipath delays. The SAT-based scheme utilizes the known structure of the transmitted wideband signal, for example, pseudo-random (PN code, to effectively search through the entire space by eliminating subspaces that do not contain a possible solution. The paper presents a framework for modeling the multipath detection problem as a SAT application. It also provides simulation results that demonstrate the effectiveness of the proposed scheme in detecting the multipath components in frequency-selective Rayleigh fading channels.

Main lines of reorganization of the system of postgraduate training of radiologists

International Nuclear Information System (INIS)

Pavlov, A.S.; Kostromina, K.N.; Datsenko, V.S.

1988-01-01

The authors have summed up the experience accumulated over 20 years at the Chair of Clinical Radiology of the Central Order of Lenin Institute of Advanced Medical Training. Doctors majoring in this field, usually radiologists at the age over 35 when their creative initiative is on a decrease. Therfore the authors have proposed numerous measures aimed at the improvement of the system of training in radiology and an increase in the number of young specialists

The UK biomass industry

International Nuclear Information System (INIS)

Billins, P.

1998-01-01

A brief review is given of the development of the biomass industry in the UK. Topics covered include poultry litter generation of electricity, gasification plants fuelled by short-rotation coppice, on-farm anaerobic digestion and specialized combustion systems, e.g. straw, wood and other agricultural wastes. (UK)

Solving satisfiability problems by the ground-state quantum computer

International Nuclear Information System (INIS)

Mao Wenjin

2005-01-01

A quantum algorithm is proposed to solve the satisfiability (SAT) problems by the ground-state quantum computer. The scale of the energy gap of the ground-state quantum computer is analyzed for the 3-bit exact cover problem. The time cost of this algorithm on the general SAT problems is discussed

Report on primate supply for biomedical scientific work in the UK. EUPREN UK Working Party.

Science.gov (United States)

Owen, S; Thomas, C; West, P; Wolfensohn, S; Wood, M

1997-10-01

A Working Party of the UK group of European Primate Resources Network (EUPREN) considered primate supply for scientific work in the UK. Through a questionnaire, which achieved a very good response, it obtained details of primate use, sources and breeding in the UK and it put forward options to ensure that animal welfare is the best possible whilst ensuring continued supply. The questionnaire showed that contract research laboratories and pharmaceutical companies use about 80% of the 4233 primates used annually at the moment, with the rest accounted for by academic establishments and public sector laboratories. Fifty-four per cent are cynomolgus macaques (Macaca fascicularis), of which nearly 90% are captive-bred outside the European Union (EU), the remainder being bred in the UK. Nearly 90% of cynomolgus macaques are used by only five institutions. Thirty-seven per cent of primates used are marmosets (Callithrix jacchus jacchus), all of which are bred in the UK. Most of the rest are rhesus macaques (Macaca mulatta), about half of which are captive-bred outside the EU, the other half being bred in the UK. Overall primate use has increased from about 3000 per year in 1990 and users predict that requirements for all species except baboons (Papio sp.) will be maintained or increase. Marmoset breeding in the UK is already closely matched to use, and it could be increased reasonably easily if necessary. Some of the existing breeding centres of macaques in the UK would be prepared to consider expanding to supply others, although investment and imported breeding stock would be needed and it is likely that a large investment would be needed to breed a significant fraction of the macaque use in the UK. A further problem is that the users of only about 10% of the cynomolgus macaques said that they could replace this species by rhesus macaques, which are easier to breed in the UK. The questionnaire showed that much of the use of macaques would be transferred to other countries

The opinion and experiences of Dutch orthopedic surgeons and radiologists about diagnostic musculoskeletal ultrasound imaging in primary care: a survey.

Science.gov (United States)

Scholten-Peeters, Gwendolijne G M; Franken, Nicole; Beumer, Annechien; Verhagen, Arianne P

2014-04-01

The use of diagnostic musculoskeletal ultrasound (DMUS) in primary health care has increased in the recent years. Nevertheless, there are hardly any data concerning the reliability, accuracy and treatment consequences of DMUS used by physical therapists or general practitioners. Moreover, there are no papers published about how orthopedic surgeons or radiologists deal with the results of DMUS performed in primary care. Therefore, our aim is to evaluate the opinion, possible advantages or disadvantages and experiences of Dutch orthopedic surgeons and radiologists about DMUS in primary care. A cross-sectional survey in which respondents completed a self-developed questionnaire to determine their opinion, experiences, advantages, disadvantages of performing DMUS in primary care. Questionnaires were sent to 838 Dutch orthopedic surgeons and radiologists of which 213 were returned (response rate 25.4%). Our respondents saw no additional value for health care for diagnostic DMUS in primary care. DMUSs were generally repeated in secondary care. They perceived more disadvantages than advantages of performing DMUS in primary care. Mentioned disadvantages were: 'false positive results' (71.4%), 'lack of experience' (70%), 'insufficient education' (69.5%), not able to relate the outcomes of DMUS with other forms of diagnostic imaging' (65.7%), and 'false negative results' (65.3%). Radiologists and orthopedic surgeons sampled in the Netherlands show low trust in DMUS knowledge of physical therapists and general practitioners. The results should be interpreted with caution because of the small response rate and the lack of representativeness to other countries. Published by Elsevier Ltd.

Feasibility of using a biowatch to monitor GSR as a measure of radiologists' stress and fatigue

Science.gov (United States)

Krupinski, Elizabeth A.; MacKinnon, Lea; Reiner, Bruce I.

2015-03-01

We have been investigating the impact of fatigue on diagnostic performance of radiologists interpreting medical images. In previous studies we found evidence that eye strain could be objectively measured and that it correlates highly with degradations in diagnostic accuracy as radiologists work long hours. Eye strain however can be difficult to measure in a non-invasive and continuous manner over the work day so we have been investigating other ways to measure physiological stress and fatigue. In this study we evaluated the feasibility of using a commercially available biowatch to measure galvanic skin response (GSR), a well known indicator of stress. 10 radiology residents wore the biowatch for about 8 hours during their normal work day and data were automatically collected at 10 Hz. They completed the Swedish Occupational Fatigue Inventory (SOFI) at the start and finish of the day. GSR values (microsiemens) ranged from 0.14 to 38.27 with an average of 0.50 (0.28 median). Overall GSR tended to be fairly constant as the day progressed, but there were definite spikes indicating higher levels of stress. SOFI scores indicated greater levels of fatigue and stress at the end of the work day. Although further work is needed, GSR measurements obtained via an easy to wear watch may provide a means to monitor stress/fatigue and alert radiologists when to take a break from interpreting images to avoid making errors.

What the Rheumatologist Is Looking for and What the Radiologist Should Know in Imaging for Rheumatoid Arthritis

DEFF Research Database (Denmark)

Teh, James; Østergaard, Mikkel

2017-01-01

This article outlines what the rheumatologist is looking for and wants to know in the clinical diagnosis and imaging of rheumatoid arthritis, and what the radiologist should know to facilitate this....

Hewitt launches Research Councils UK

CERN Multimedia

2002-01-01

"Trade and Industry Secretary Patricia Hewitt today launched 'Research Councils UK' - a new strategic partnership that will champion research in science, engineering and technology across the UK" (1 page).

UK ignores treaty obligations

International Nuclear Information System (INIS)

Roche, P.

1995-01-01

A detailed critique is offered of United Kingdom (UK) political policy with respect to the Non-Proliferation Treaty, an interim agreement valid while nuclear disarmament was supposed to occur, by a representative of Greenpeace, the anti-nuclear campaigning group. The author argues that the civil and military nuclear programmes are still firmly linked, and emphasises his opinions by quoting examples of how UK politicians have broken treaty obligations in order to pursue their own political, and in some cases financial, goals. It is argued that the treaty has failed to force nuclear countries to disarm because of its promoted civil nuclear power programmes. (U.K.)

Emergencies in radiology: a survey of radiologist and radiology trainees

International Nuclear Information System (INIS)

Craig, Simon; Naidoo, Parmanand

2014-01-01

Emergencies in radiology are infrequent but potentially lethal. Australian and New Zealand radiologists are advised to undergo resuscitation training at least every three years; however, little is known about their experience and confidence in managing common emergencies relevant to their clinical practice. This paper describes the current experience and confidence of radiologists and radiology trainees in Australia and New Zealand in the management of common medical emergencies. A cross-sectional online survey of trainees and fellows of the Royal Australian and New Zealand College of Radiology collected data on training and learning preferences relating to resuscitation and life-support skills, access to emergency medical care, and knowledge, confidence and ability in managing a variety of medical emergencies. There were 602 responses to the survey (response rate 23.4%). The majority of respondents were interested in learning more about the management of contrast reactions, cardiac arrest, ischaemic chest pain and basic life support. Self-rated knowledge, confidence and ability were higher in respondents who had completed life-support training within the previous three years. In this group, however, more than 40% rated their ability at managing contrast reactions as poor or fair, while more than 60% rated their ability as poor or fair for management of cardiac arrest, basic life support, advanced life support and dosing of adrenaline. Preferred resuscitation training modalities included simulation, small-group tutorials and workshops. Self-reported level of skill and expertise in the management of potential emergencies in radiology is suboptimal among a large number of respondents. Consideration should be given to addressing this by improving access to specific training.

Cochlear implant: what the radiologist should know; Implante coclear: o que o radiologista precisa saber

Energy Technology Data Exchange (ETDEWEB)

Gomes, Natalia Delage; Couto, Caroline Laurita Batista; Gaiotti, Juliana Oggioni; Costa, Ana Maria Doffemond; Ribeiro, Marcelo Almeida; Diniz, Renata Lopes Furletti Caldeira, E-mail: nataliadelagegomes@gmail.com [Hospital Mater Dei, Belo Horizonte, MG (Brazil). Unidade de Radiologia e Diagnostico por Imagem

2013-05-15

Cochlear implant is the method of choice in the treatment of deep sensorineural hypoacusis, particularly in patients where conventional amplification devices do not imply noticeable clinical improvement. Imaging findings are crucial in the indication or contraindication for such surgical procedure. In the assessment of the temporal bone, radiologists should be familiar with relative or absolute contraindication factors, as well as with factors that might significantly complicate the implantation. Some criteria such as cochlear nerve aplasia, labyrinthine and/or cochlear aplasia are still considered as absolute contraindications, in spite of studies bringing such criteria into question. Cochlear dysplasias constitute relative contraindications, among them labyrinthitis ossificans is highlighted. Other alterations may be mentioned as complicating agents in the temporal bone assessment, namely, hypoplasia of the mastoid process, aberrant facial nerve, otomastoiditis, otosclerosis, dehiscent jugular bulb, enlarged endolymphatic duct and sac. The experienced radiologist assumes an important role in the evaluation of this condition. (author)

Measuring and managing radiologist workload: application of lean and constraint theories and production planning principles to planning radiology services in a major tertiary hospital.

Science.gov (United States)

MacDonald, Sharyn L S; Cowan, Ian A; Floyd, Richard; Mackintosh, Stuart; Graham, Rob; Jenkins, Emma; Hamilton, Richard

2013-10-01

We describe how techniques traditionally used in the manufacturing industry (lean management, the theory of constraints and production planning) can be applied to planning radiology services to reduce the impact of constraints such as limited radiologist hours, and to subsequently reduce delays in accessing imaging and in report turnaround. Targets for imaging and reporting were set aligned with clinical needs. Capacity was quantified for each modality and for radiologists and recorded in activity lists. Demand was quantified and forecasting commenced based on historical referral rates. To try and mitigate the impact of radiologists as a constraint, lean management processes were applied to radiologist workflows. A production planning process was implemented. Outpatient waiting times to access imaging steadily decreased. Report turnaround times improved with the percentage of overnight/on-call reports completed by a 1030 target time increased from approximately 30% to 80 to 90%. The percentage of emergency and inpatient reports completed within one hour increased from approximately 15% to approximately 50% with 80 to 90% available within 4 hours. The number of unreported cases on the radiologist work-list at the end of the working day reduced. The average weekly accuracy for demand forecasts for emergency and inpatient CT, MRI and plain film imaging was 91%, 83% and 92% respectively. For outpatient CT, MRI and plain film imaging the accuracy was 60%, 55% and 77% respectively. Reliable routine weekly and medium to longer term service planning is now possible. Tools from industry can be successfully applied to diagnostic imaging services to improve performance. They allow an accurate understanding of the demands on a service, capacity, and can reliably predict the impact of changes in demand or capacity on service delivery. © 2013 The Royal Australian and New Zealand College of Radiologists.

Real-Time Tele-Mentored Low Cost "Point-of-Care US" in the Hands of Paediatricians in the Emergency Department: Diagnostic Accuracy Compared to Expert Radiologists.

Directory of Open Access Journals (Sweden)

Floriana Zennaro

Full Text Available The use of point-of-care ultrasonography (POC US in paediatrics is increasing. This study investigated the diagnostic accuracy of POC US in children accessing the emergency department (ED when performed by paediatricians under the remote guidance of radiologists (TELE POC.Children aged 0 to 18 years accessing the ED of a third level research hospital with eight possible clinical scenarios and without emergency/severity signs at the triage underwent three subsequent US tests: by a paediatrician guided remotely by a radiologist (TELE POC; by the same radiologist (UNBLIND RAD; by an independent blinded radiologist (BLIND RAD. Tele-radiology was implemented using low cost "commercial off-the-shelf" (COTS equipment and open-source software. Data were prospectively collected on predefined templates.Fifty-two children were enrolled, for a total of 170 ultrasound findings. Sensitivity, specificity, positive and negative predictive values of TELE POC were: 93.8, 99.7, 96.8, 99.4 when compared to UNBLIND RAD and 88.2, 99.7, 96.8, 98.7 when compared to BLIND RAD. The inter-observers agreement between the paediatricians and either the unblind or blind radiologist was excellent (k = 0.93. The mean duration of TELE POC was 6.3 minutes (95% CI 4.1 to 8.5. Technical difficulties occurred in two (3.8% cases. Quality of the transmission was rated as fair, good, very good and excellent in 7.7%, 15.4%, 42.3% and 34.6% of cases respectively, while in no case was it rated as poor.POC US performed by paediatricians in ED guided via tele-radiology by an expert radiologist (TELE POC produced reliable and timely diagnoses. Findings of this study, especially for the rarer conditions under evaluation, need further confirmation. Future research should investigate the overall benefits and the cost savings of using tele-ultrasound to perform US "at children's bedsides", under remote guidance of expert radiologists.

UK 2009-2010 repeat station report

Directory of Open Access Journals (Sweden)

Thomas J.G. Shanahan

2013-03-01

Full Text Available The British Geological Survey is responsible for conducting the UK geomagnetic repeat station programme. Measurements made at the UK repeat station sites are used in conjunction with the three UK magnetic observatories: Hartland, Eskdalemuir and Lerwick, to produce a regional model of the local field each year. The UK network of repeat stations comprises 41 stations which are occupied at approximately 3-4 year intervals. Practices for conducting repeat station measurements continue to evolve as advances are made in survey instrumentation and as the usage of the data continues to change. Here, a summary of the 2009 and 2010 UK repeat station surveys is presented, highlighting the measurement process and techniques, density of network, reduction process and recent results.

Assessment of deep myometrial invasion of endometrial cancer on MRI: added value of second-opinion interpretations by radiologists subspecialized in gynaecologic oncology

Energy Technology Data Exchange (ETDEWEB)

Woo, Sungmin [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kim, Sang Youn [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Cho, Jeong Yeon; Kim, Seung Hyup [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine and Kidney Research Institute, Seoul (Korea, Republic of)

2017-05-15

To investigate the added value of secondary reports issued by radiologists subspecializing in gynaecologic imaging for determining deep myometrial invasion of endometrial cancer on MRI. Initial (from referring institutions) and secondary (by subspecialized radiologists) interpretations of MRI of 55 patients with endometrial cancer were retrospectively reviewed. A radiologist blinded to clinicopathological information assessed both reports for the presence of deep myometrial invasion. Reference standard was based on hysterectomy specimens. Kappa coefficients (k) were used to measure their concordance. McNemar testing and receiver operating characteristic (ROC) analysis was used to compare sensitivities, specificities and areas under the curves (AUCs). Deep myometrial invasion was present in 25 (45.5 %) patients. Among 27.3 % (15/55; k = 0.458) patients with discrepant results, secondary interpretations were correct in 10 (66.7 %) cases. Sensitivity was higher in secondary than in initial reports (76.0 % vs. 48.0 %, p = 0.039) while no significant difference was seen in specificity (70.0 % vs. 76.7 %, p = 0.668). At ROC analysis, there was a tendency for higher AUCs in secondary reports (0.785 vs 0.669, p = 0.096). Secondary readings of MRI by subspecialized gynaecologic oncologic radiologists may provide incremental value in determining deep myometrial invasion of endometrial cancer. (orig.)

Improving the false-negative rate of CT in acute appendicitis-Reassessment of CT images by body imaging radiologists: A blinded prospective study

International Nuclear Information System (INIS)

Poortman, Pieter; Lohle, Paul N.M.; Schoemaker, Cees M.; Cuesta, Miguel A.; Oostvogel, Henk J.M.; Lange-de Klerk, Elly S.M. de; Hamming, Jaap F.

2010-01-01

Purpose: To compare the accuracy of computed tomography (CT) analyzed by individual radiology staff members and body imaging radiologists in a non-academic teaching hospital for the diagnosis of acute appendicitis. Patients and methods: In a prospective study 199 patients with suspected acute appendicitis were examined with unenhanced CT. CT images were pre-operatively analyzed by one of the 12 members of the radiology staff. In a later stage two body imaging radiologist reassessed all CT images without knowledge of the surgical findings and without knowledge of the primary CT diagnosis. The results, independently reported, were correlated with surgical and histopathologic findings. Results: In 132 patients (66%) acute appendicitis was found at surgery, in 67 patients (34%) a normal appendix was found. The sensitivity of the primary CT analysis and of the reassessment was 76% and 88%, respectively; the specificity was 84% and 87%; the positive predictive value was 90% and 93%; the negative predictive value was 64% and 78%; and the accuracy was 78% and 87%. Conclusion: Reassessment of CT images for acute appendicitis by body imaging radiologists results in a significant improvement of sensitivity, negative predictive value and accuracy. To prevent false-negative interpretation of CT images in acute appendicitis the expertise of the attending radiologist should be considered.

Improving the false-negative rate of CT in acute appendicitis-Reassessment of CT images by body imaging radiologists: A blinded prospective study

Energy Technology Data Exchange (ETDEWEB)

Poortman, Pieter [Department of Surgery, St Elisabeth Hospital, Tilburg (Netherlands)], E-mail: ppoortman@wlz.nl; Lohle, Paul N.M. [Department of Surgery, St Elisabeth Hospital, Tilburg (Netherlands)], E-mail: plohle@elisabeth.nl; Schoemaker, Cees M. [Department of Surgery, St Elisabeth Hospital, Tilburg (Netherlands)], E-mail: mcschoemaker@elisabeth.nl; Cuesta, Miguel A. [Department of Surgery, VU Medical Centre, Amsterdam (Netherlands)], E-mail: ma.cuesta@vumc.nl; Oostvogel, Henk J.M. [Department of Surgery, St Elisabeth Hospital, Tilburg (Netherlands)], E-mail: h.oostvogel@elisabeth.nl; Lange-de Klerk, Elly S.M. de [Department of Epidemiology and Biostatistics, VU Medical Centre, Amsterdam (Netherlands)], E-mail: esm.delange@vumc.nl; Hamming, Jaap F. [Department of Surgery, Leiden University Medical Centre (Netherlands)], E-mail: j.f.hamming@lumc.nl

2010-04-15

Purpose: To compare the accuracy of computed tomography (CT) analyzed by individual radiology staff members and body imaging radiologists in a non-academic teaching hospital for the diagnosis of acute appendicitis. Patients and methods: In a prospective study 199 patients with suspected acute appendicitis were examined with unenhanced CT. CT images were pre-operatively analyzed by one of the 12 members of the radiology staff. In a later stage two body imaging radiologist reassessed all CT images without knowledge of the surgical findings and without knowledge of the primary CT diagnosis. The results, independently reported, were correlated with surgical and histopathologic findings. Results: In 132 patients (66%) acute appendicitis was found at surgery, in 67 patients (34%) a normal appendix was found. The sensitivity of the primary CT analysis and of the reassessment was 76% and 88%, respectively; the specificity was 84% and 87%; the positive predictive value was 90% and 93%; the negative predictive value was 64% and 78%; and the accuracy was 78% and 87%. Conclusion: Reassessment of CT images for acute appendicitis by body imaging radiologists results in a significant improvement of sensitivity, negative predictive value and accuracy. To prevent false-negative interpretation of CT images in acute appendicitis the expertise of the attending radiologist should be considered.

Pediatric anesthesia and neurotoxicity. What the radiologist needs to know

Energy Technology Data Exchange (ETDEWEB)

Barton, Katherine; Nickerson, Joshua P.; Higgins, Timothy [The University of Vermont College of Medicine, Department of Radiology, Burlington, VT (United States); Williams, Robert K. [The University of Vermont College of Medicine, Department of Anesthesiology, Burlington, VT (United States)

2018-01-15

The use of cross-sectional imaging in the pediatric population continues to rise, particularly the use of MRI. Limiting motion artifact requires cooperative subjects who do not move during imaging, so there has been an increase in the need for pediatric sedation or anesthesia. Over the last decade, concern has increased that exposure to anesthesia might be associated with long-term cognitive deficits. In this review we report current understanding of the effects of anesthesia on the pediatric population, with special focus on long-term developmental and cognitive outcomes, and suggest how radiologists can use new technologies or imaging strategies to mitigate or minimize these potential risks. (orig.)

Pediatric anesthesia and neurotoxicity. What the radiologist needs to know

International Nuclear Information System (INIS)

Barton, Katherine; Nickerson, Joshua P.; Higgins, Timothy; Williams, Robert K.

2018-01-01

The use of cross-sectional imaging in the pediatric population continues to rise, particularly the use of MRI. Limiting motion artifact requires cooperative subjects who do not move during imaging, so there has been an increase in the need for pediatric sedation or anesthesia. Over the last decade, concern has increased that exposure to anesthesia might be associated with long-term cognitive deficits. In this review we report current understanding of the effects of anesthesia on the pediatric population, with special focus on long-term developmental and cognitive outcomes, and suggest how radiologists can use new technologies or imaging strategies to mitigate or minimize these potential risks. (orig.)

Complementary Set Matrices Satisfying a Column Correlation Constraint

OpenAIRE

Wu, Di; Spasojevic, Predrag

2006-01-01

Motivated by the problem of reducing the peak to average power ratio (PAPR) of transmitted signals, we consider a design of complementary set matrices whose column sequences satisfy a correlation constraint. The design algorithm recursively builds a collection of $2^{t+1}$ mutually orthogonal (MO) complementary set matrices starting from a companion pair of sequences. We relate correlation properties of column sequences to that of the companion pair and illustrate how to select an appropriate...

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

Science.gov (United States)

Claikens, B

1998-08-01

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

Planning and performing spine surgery with CT/MPR: A primer for radiologists

International Nuclear Information System (INIS)

Camp, P.; Kerber, C.W.

1985-01-01

Few things are more discouraging to a surgeon than the patient who has continued bitter complaints after spine surgery. We often show our discouragement by refusing even to name these patients;instead we depersonalize them, calling them ''failed backs.'' The most common cause of the failed-back syndrome is probably an error in the original decision to operate. Many patients have unsolved psychosocial problems that the surgeon may not recognize. Even though we are critical of this lapse in surgical judgment, the most experienced and cautious physician occasionally makes these mistakes. Not all failed backs are psychosocial in origin. The advent of computerized tomography with multiplanar reconstruction (CT/MPR) has demonstrated several large and important subsets of patients whose operation has failed not for psychosocial reasons but for a lack of appreciation of unrecognized pathology. In a small minority of cases, the surgeon has operated on the wrong interspace. In most, though, important pathology was overlooked and not operated on because the technology to see it was unavailable. In order that the radiologist can better understand the problems encountered by the surgeon, the authors now review the most common of these problems and outline how specific abnormalities are diagnosed and treated. The evaluation of back disease is a complex undertaking, and the partnership between radiologist and surgeon is an essential one

Role of radiologists in CAD life-cycle

Energy Technology Data Exchange (ETDEWEB)

Pietka, Ewa, E-mail: ewa.pietka@polsl.pl [Silesian University of Technology, Faculty of Automatic Control, Electronics and Computer Science, ul. Akademicka 16, 44-100 Gliwice (Poland); Kawa, Jacek, E-mail: jacek.kawa@polsl.pl [Silesian University of Technology, Faculty of Automatic Control, Electronics and Computer Science, ul. Akademicka 16, 44-100 Gliwice (Poland); Spinczyk, Dominik, E-mail: dominik.spinczyk@polsl.pl [Silesian University of Technology, Faculty of Automatic Control, Electronics and Computer Science, ul. Akademicka 16, 44-100 Gliwice (Poland); Badura, Pawel, E-mail: pawel.badura@polsl.pl [Silesian University of Technology, Faculty of Automatic Control, Electronics and Computer Science, ul. Akademicka 16, 44-100 Gliwice (Poland); Wieclawek, Wojciech, E-mail: wojciech.wieclawek@polsl.pl [Silesian University of Technology, Faculty of Automatic Control, Electronics and Computer Science, ul. Akademicka 16, 44-100 Gliwice (Poland); Czajkowska, Joanna, E-mail: joanna.czajkowska@polsl.pl [Silesian University of Technology, Faculty of Automatic Control, Electronics and Computer Science, ul. Akademicka 16, 44-100 Gliwice (Poland); Rudzki, Marcin, E-mail: marcin.rudzki@polsl.pl [Silesian University of Technology, Faculty of Automatic Control, Electronics and Computer Science, ul. Akademicka 16, 44-100 Gliwice (Poland)

2011-05-15

A modern CAD (computer-aided diagnosis) system development involves a multidisciplinary team whose members are experts in medical and technical fields. This study indicates the activities of medical experts at various stages of the CAD design, testing, and implementation. Those stages include a medical analysis of the diagnostic problem, data collection, image analysis, evaluation, and clinical verification. At each stage the physicians knowledge and experience are indispensable. The final implementation involves integration with the existing Picture Archiving and Communication System. The term CAD life-cycle describes an overall process of the design, testing, and implementation of a system that in its final form assists the radiologists in their daily clinical routine. Four CAD systems (applied to the bone age assessment, Multiple Sclerosis detection, lung nodule detection, and pneumothorax measurement) developed in our laboratory are given as examples of how consecutive stages are developed by the multidisciplinary team. Specific advantages of the CAD implementation that include the daily clinical routine as well as research and education activities are discussed.

Role of radiologists in CAD life-cycle

International Nuclear Information System (INIS)

Pietka, Ewa; Kawa, Jacek; Spinczyk, Dominik; Badura, Pawel; Wieclawek, Wojciech; Czajkowska, Joanna; Rudzki, Marcin

2011-01-01

A modern CAD (computer-aided diagnosis) system development involves a multidisciplinary team whose members are experts in medical and technical fields. This study indicates the activities of medical experts at various stages of the CAD design, testing, and implementation. Those stages include a medical analysis of the diagnostic problem, data collection, image analysis, evaluation, and clinical verification. At each stage the physicians knowledge and experience are indispensable. The final implementation involves integration with the existing Picture Archiving and Communication System. The term CAD life-cycle describes an overall process of the design, testing, and implementation of a system that in its final form assists the radiologists in their daily clinical routine. Four CAD systems (applied to the bone age assessment, Multiple Sclerosis detection, lung nodule detection, and pneumothorax measurement) developed in our laboratory are given as examples of how consecutive stages are developed by the multidisciplinary team. Specific advantages of the CAD implementation that include the daily clinical routine as well as research and education activities are discussed.

UK Announces Intention to Join ESO

Science.gov (United States)

2000-11-01

Summary The Particle Physics and Astronomy Research Council (PPARC) , the UK's strategic science investment agency, today announced that the government of the United Kingdom is making funds available that provide a baseline for this country to join the European Southern Observatory (ESO) . The ESO Director General, Dr. Catherine Cesarsky , and the ESO Community warmly welcome this move towards fuller integration in European astronomy. "With the UK as a potential member country of ESO, our joint opportunities for front-line research and technology will grow significantly", she said. "This announcement is a clear sign of confidence in ESO's abilities, most recently demonstrated with the construction and operation of the unique Very Large Telescope (VLT) on Paranal. Together we will look forward with confidence towards new, exciting projects in ground-based astronomy." It was decided earlier this year to place the 4-m UK Visible and Infrared Survey Telescope (VISTA) at Paranal, cf. ESO Press Release 03/00. Following negotiations between ESO and PPARC, a detailed proposal for the associated UK/ESO Agreement with the various entry modalities will now be presented to the ESO Council for approval. Before this Agreement can enter into force, the ESO Convention and associated protocols must also be ratified by the UK Parliament. Research and key technologies According to the PPARC press release, increased funding for science, announced by the UK government today, will enable UK astronomers to prepare for the next generation of telescopes and expand their current telescope portfolio through membership of the European Southern Observatory (ESO). The uplift to its baseline budget will enable PPARC to enter into final negotiations for UK membership of the ESO. This will ensure that UK astronomers, together with their colleagues in the ESO member states, are actively involved in global scale preparations for the next generation of astronomy facilities. among these are ALMA

UK Royal Navy WWII Logbooks

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — In 2006, the UK and NOAA's Climate Database Modernization Program (CDMP) funded the imaging of approximately 8,000 Royal Navy logbooks in the UK National Archives...

Using a satisfiability solver to identify deterministic finite state automata

NARCIS (Netherlands)

Heule, M.J.H.; Verwer, S.

2009-01-01

We present an exact algorithm for identification of deterministic finite automata (DFA) which is based on satisfiability (SAT) solvers. Despite the size of the low level SAT representation, our approach seems to be competitive with alternative techniques. Our contributions are threefold: First, we

Health Care Price Transparency and Communication: Implications for Radiologists and Patients in an Era of Expanding Shared Decision Making.

Science.gov (United States)

Sadigh, Gelareh; Carlos, Ruth C; Krupinski, Elizabeth A; Meltzer, Carolyn C; Duszak, Richard

2017-11-01

The purpose of this article is to review the literature on communicating transparency in health care pricing, both overall and specifically for medical imaging. Focus is also placed on the imperatives and initiatives that will increasingly impact radiologists and their patients. Most Americans seek transparency in health care pricing, yet such discussions occur in fewer than half of patient encounters. Although price transparency tools can help decrease health care spending, most are used infrequently and most lack information about quality. Given the high costs associated with many imaging services, radiologists should be aware of such initiatives to optimize patient engagement and informed shared decision making.

First-trimester emergencies: a radiologist's perspective.

Science.gov (United States)

Phillips, Catherine H; Wortman, Jeremy R; Ginsburg, Elizabeth S; Sodickson, Aaron D; Doubilet, Peter M; Khurana, Bharti

2018-02-01

The purpose of this article is to help the practitioner ensure early diagnosis and response to emergencies in the first trimester by reviewing anatomy of the developing embryo, highlighting the sonographic appearance of common first-trimester emergencies, and discussing key management pathways for treating emergent cases. First-trimester fetal development is a stepwise process that can be challenging to evaluate in the emergency department (ED) setting. This is due, in part, to the complex anatomy of early pregnancy, subtlety of the sonographic findings, and the fact that fewer than half of patients with ectopic pregnancy present with the classic clinical findings of a positive pregnancy test, vaginal bleeding, pelvic pain, and tender adnexa. Ultrasound (US) has been the primary approach to diagnostic imaging of first-trimester emergencies, with magnetic resonance imaging (MRI) and computed tomography (CT) playing a supportive role in a small minority of cases. Familiarity with the sonographic findings diagnostic of and suspicious for early pregnancy failure, ectopic pregnancy, retained products of conception, gestational trophoblastic disease, failed intrauterine devices, and complications associated with assisted reproductive technology (ART) is critical for any emergency radiologist. Evaluation of first-trimester emergencies is challenging, and knowledge of key imaging findings and familiarity with management pathways are needed to ensure early diagnosis and response.

Scattered radiation dose to radiologist's cornea, thyroid and gonads while performing some x-ray fluoroscopic investigations

International Nuclear Information System (INIS)

Chougle, Arun

1993-01-01

The mankind has been immensely benefited from discovery of X-ray and it has found wide spread application in diagnosis and treatment. Radiation is harmful and can produce somatic and genetic effects in the exposed person. International Commission on Radiation Protection (ICRP) has recommended a system of dose limitation based on principle of ALARA. All the efforts should be made to keep the radiation dose to the radiation worker as low as possible. Fluoroscopy gives maximum dose to the patient and staff and hence we have attempted to quantify the scattered radiation dose to the cornea, thyroid and gonads of the radiologist performing fluoroscopic examinations such as barium meal, barium swallow, barium enema, myelography, histerosalpingography and fracture reduction. Thermoluminescence dosimetry (TLD) method using CaSO 4 :Dy TLD disc was employed for these measurements. Use of lead apron has reduced the dose to radiologist's gonad. (author). 3 refs., 4 tabs

Pub Culture in the U.K.

Institute of Scientific and Technical Information of China (English)

孙鑫

2015-01-01

In the U.K., pubs can be seen everywhere. They play an important role in the British society. How pubs came into being in the U.K.? Why is pub culture formed and what makes it prosperous? What effects does pub culture make on British society both in the past and in the present? Does any British character be shown in pub culture in the U.K.? In this paper, I will give a brief in-troduction of pub culture's history and development in the U.K.. Besides, the above questions will be explored and analyzed one by one.

Radiation exposure of the radiologist's eye lens during CT-guided interventions.

Science.gov (United States)

Heusch, Philipp; Kröpil, Patric; Buchbender, Christian; Aissa, Joel; Lanzman, Rotem S; Heusner, Till A; Ewen, Klaus; Antoch, Gerald; Fürst, Günther

2014-02-01

In the past decade the number of computed tomography (CT)-guided procedures performed by interventional radiologists have increased, leading to a significantly higher radiation exposure of the interventionalist's eye lens. Because of growing concern that there is a stochastic effect for the development of lens opacification, eye lens dose reduction for operators and patients should be of maximal interest. To determine the interventionalist's equivalent eye lens dose during CT-guided interventions and to relate the results to the maximum of the recommended equivalent dose limit. During 89 CT-guided interventions (e.g. biopsies, drainage procedures, etc.) measurements of eye lens' radiation doses were obtained from a dedicated dosimeter system for scattered radiation. The sensor of the personal dosimeter system was clipped onto the side of the lead glasses which was located nearest to the CT gantry. After the procedure, radiation dose (µSv), dose rate (µSv/min) and the total exposure time (s) were recorded. For all 89 interventions, the median total exposure lens dose was 3.3 µSv (range, 0.03-218.9 µSv) for a median exposure time of 26.2 s (range, 1.1-94.0 s). The median dose rate was 13.9 µSv/min (range, 1.1-335.5 µSv/min). Estimating 50-200 CT-guided interventions per year performed by one interventionalist, the median dose of the eye lens of the interventional radiologist does not exceed the maximum of the ICRP-recommended equivalent eye lens dose limit of 20 mSv per year.

Imaging Algorithms for Evaluating Suspected Rotator Cuff Disease: Society of Radiologists in Ultrasound Consensus Conference Statement

Science.gov (United States)

Jacobson, Jon A.; Benson, Carol B.; Bancroft, Laura W.; Bedi, Asheesh; McShane, John M.; Miller, Theodore T.; Parker, Laurence; Smith, Jay; Steinbach, Lynne S.; Teefey, Sharlene A.; Thiele, Ralf G.; Tuite, Michael J.; Wise, James N.; Yamaguchi, Ken

2013-01-01

The Society of Radiologists in Ultrasound convened a panel of specialists from a variety of medical disciplines to reach a consensus about the recommended imaging evaluation of painful shoulders with clinically suspected rotator cuff disease. The panel met in Chicago, Ill, on October 18 and 19, 2011, and created this consensus statement regarding the roles of radiography, ultrasonography (US), computed tomography (CT), CT arthrography, magnetic resonance (MR) imaging, and MR arthrography. The consensus panel consisted of two co-moderators, a facilitator, a statistician and health care economist, and 10 physicians who have specialty expertise in shoulder pain evaluation and/or treatment. Of the 13 physicians on the panel, nine were radiologists who were chosen to represent a broad range of skill sets in diagnostic imaging, different practice types (private and academic), and different geographical regions of the United States. Five of the radiologists routinely performed musculoskeletal US as part of their practice and four did not. There was also one representative from each of the following clinical specialties: rheumatology, physical medicine and rehabilitation, orthopedic surgery, and nonoperative sports medicine. The goal of this conference was to construct several algorithms with which to guide the imaging evaluation of suspected rotator cuff disease in patients with a native rotator cuff, patients with a repaired rotator cuff, and patients who have undergone shoulder replacement. The panel hopes that these recommendations will lead to greater uniformity in rotator cuff imaging and more cost-effective care for patients suspected of having rotator cuff abnormality. © RSNA, 2013 PMID:23401583

Domestic heat pumps in the UK. User behaviour, satisfaction and performance

Energy Technology Data Exchange (ETDEWEB)

Caird, S.; Roy, R.; Potter, S. [Design Innovation Group, Dept. Design, Development, Environment and Materials, Faculty of Mathematics, Computing and Technology, The Open University, Milton Keynes, MK7 6AA (United Kingdom)

2012-08-15

Consumer adoption of microgeneration technologies is part of the UK strategy to reduce carbon emissions from buildings. Domestic heat pumps are viewed as a potentially important carbon saving technology, given the ongoing decarbonisation of the electricity supply system. To address the lack of independent evaluation of heat pump performance, the Energy Saving Trust undertook the UK's first large-scale heat pump field trial, which monitored 83 systems in real installations. As part of the trial, the Open University studied the consumers' experience of using a domestic heat pump. An in-depth user survey investigated the characteristics, behaviour, and satisfactions of private householders and social housing residents using ground source and air source heat pumps for space and/or water heating, and examined the influence of user-related factors on measured heat pump system efficiency. The surveys found that most users were satisfied with the reliability, heating, hot water, warmth and comfort provided by their system. Analysis of user characteristics showed that higher system efficiencies were associated with greater user understanding of their heat pump system, and more continuous heat pump operation, although larger samples are needed for robust statistical confirmation. The analysis also found that the more efficient systems in the sample were more frequently located in the private dwellings than at the social housing sites and this difference was significant. This is explained by the interaction between differences in the systems, dwellings and users at the private and social housing sites. The implications for heat pump research, practice and policy are discussed.

On the satisfiability of quantum circuits of small treewidth

Czech Academy of Sciences Publication Activity Database

de Oliveira Oliveira, Mateus

2017-01-01

Roč. 61, č. 2 (2017), s. 656-688 ISSN 1432-4350 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : treewidth * satisfiability of quantum circuits * tensor networks * Merlin-Arthur protocols Subject RIV: BA - General Mathematics OBOR OECD: Pure mathematics Impact factor: 0.645, year: 2016 https://link.springer.com/article/10.1007%2Fs00224-016-9727-8

An audit of ultrasonography performed and reported by trainee radiologists.

Science.gov (United States)

Eze, K C; Marchie, T T; Eze, C U

2009-01-01

Proforma information, instructions and procedures of training in radiology are lacking in Nigeria. To describe the errors in ultrasonography performed by unsupervised trainee radiologists. The radiology records of all ultrasound scans (USS) carried out and all reports that came back to the unit of the authors on account of misdiagnosis, doubtful diagnosis, misinformation or error in the reports were studied. The patients with the returned reports were rescanned where available by consultants and the collected data analysed. A total of 4680 patients had ultrasound studies without supervision resulting in 605 (12.93%) queried reports. The USS scans of 235 (5.02%) patients were repeated with consultants in attendance resulting in significant change in reports of 95 (2.03%) patients. Analysis of the request cards of 605 queried reports showed omission of relevant clinical information 463 (76.53%), outright wrong information 65 (10.73%),and unconventional abbreviations 139 (22.98%), while 493 (81.49%) were completed by a nurse, medical student or junior resident. Typographical errors comprised 174 (28.76%) of the 605 queried reports. False negative error was the highest type of error seen in 55 (57.89%) of the 95 patients with significant change in their report after repeat scan as lesions not detected were not documented. Trainee radiologists make significant errors in carrying out and reporting ultrasonography without adequate direct supervision of the study by their training consultants. Majority of the errors originate from lack of accurate filling of the patients request cards by the requesting physicians, lack of adequate preparation for the intended study, and typographical errors in writing reports. False negative reports are by far the greatest cause of errors recorded as lesions not detected were not documented.

GM2 gangliosidosis in a UK study of children with progressive neurodegeneration: 73 cases reviewed.

Science.gov (United States)

Smith, Nicholas J; Winstone, Anne Marie; Stellitano, Lesley; Cox, Timothy M; Verity, Christopher M

2012-02-01

To report the demographic, phenotypic, and time-to-diagnosis characteristics of children with GM2 gangliosidosis referred to the UK study of Progressive Intellectual and Neurological Deterioration. Case notification is made via monthly surveillance card, administered by the British Paediatric Surveillance Unit to all UK-based paediatricians; children with GM2 gangliosidosis were identified from cases satisfying inclusion in the UK study of Progressive Intellectual and Neurological Deterioration and analysed according to phenotypic and biochemical categories. Between May 1997 and January 2010, 73 individuals with GM2 gangliosidoses were reported: 40 with Tay-Sachs disease, 31 with Sandhoff disease, and two with GM2 activator protein deficiency. Together they account for 6% (73/1164) of all diagnosed cases of progressive intellectual and neurological deterioration. The majority (62/73) were sporadic index cases with no family history. Children of Pakistani ancestry were overrepresented in all subtypes, particularly juvenile Sandhoff disease, accounting for 10 of 11 notified cases. Infantile-onset variants predominated (55/73); the mean age at onset of symptoms was 6.2 and 4.7 months for infantile-onset Tay-Sachs and Sandhoff disease respectively, and 26.2 and 34.7 months for the corresponding juvenile-onset variants. Time to diagnosis averaged 7.4 months and 28.0 months in infantile- and juvenile-onset disease respectively. GM2 gangliosidosis is a significant cause of childhood neurodegenerative disease; timely diagnosis relies upon improved clinical recognition, which may be increasingly important as specific therapies become available. There is a potential benefit from the introduction of screening programmes for high-risk ethnic groups. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

Radiology services for children in HIV- and TB-endemic regions: scope for greater collaboration between radiologists and clinicians caring for children

International Nuclear Information System (INIS)

Dramowski, Angela; Morsheimer, Megan M.; Schaaf, H.S.; Rabie, Helena; Sorour, Gillian; Cotton, Mark F.; Frigati, Lisa

2009-01-01

There is limited literature documenting the interaction between radiologists and clinicians caring for children, especially in regions where HIV and tuberculosis (TB) are endemic. The dual burden of these diseases in resource-limited settings creates unique challenges for radiographic interpretation and utilization. This review aims to heighten awareness of issues confronting radiologists and clinicians caring for children and to encourage greater collaboration between these two disciplines in HIV- and TB-endemic regions. The Child-Friendly Healthcare Initiative is discussed, emphasizing opportunities to promote child friendliness in radiology services. (orig.)

What every radiologist should know about paediatric echocardiography

International Nuclear Information System (INIS)

Sorantin, Erich; Heinzl, Bernd

2014-01-01

Congenital heart defects (CHD) occur in less than one percent of all newborns. Echocardiography represents the imaging modality of choice for morphological and functional assessment. In childhood the different CHD types can be diagnosed trustfully and can be performed bedside. In the follow-up of CHD cross sectional imaging plays an important role and therefore it is essential for the radiologist to know the features, challenges and limitations of echocardiography. Within this review article a systematic approach for morphological and functional assessment of the heart will is given along with representative example images. In addition, typical echocardiographic findings in common CHD is presented. In older children, adolescents and grown-ups with CHD (GUCH) echocardiography suffers from limitations – partially due to skeletal deformations and lung emphysema. In particular right ventricular function assessment is not always possible by echocardiography. Therefore strengths and limitations of echocardiography will be discussed the role of cardiac magnetic resonance imaging (cMRI) and cardiac computed tomography (cCT) emphasized

What every radiologist should know about paediatric echocardiography

Energy Technology Data Exchange (ETDEWEB)

Sorantin, Erich, E-mail: erich.sorantin@medunigraz.at [Division of Pediatric Radiology, Department of Radiology, Medical University Graz, Auenbruggerplatz 34, A-8036 Graz (Austria); Heinzl, Bernd [Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Medical University Graz, Auenbruggerplatz 34, A-8036 Graz (Austria)

2014-09-15

Congenital heart defects (CHD) occur in less than one percent of all newborns. Echocardiography represents the imaging modality of choice for morphological and functional assessment. In childhood the different CHD types can be diagnosed trustfully and can be performed bedside. In the follow-up of CHD cross sectional imaging plays an important role and therefore it is essential for the radiologist to know the features, challenges and limitations of echocardiography. Within this review article a systematic approach for morphological and functional assessment of the heart will is given along with representative example images. In addition, typical echocardiographic findings in common CHD is presented. In older children, adolescents and grown-ups with CHD (GUCH) echocardiography suffers from limitations – partially due to skeletal deformations and lung emphysema. In particular right ventricular function assessment is not always possible by echocardiography. Therefore strengths and limitations of echocardiography will be discussed the role of cardiac magnetic resonance imaging (cMRI) and cardiac computed tomography (cCT) emphasized.

Ocular health among radiologists in the age of PACS: is it time for our profession to open its eyes to this issue in light of existing European legislation?

LENUS (Irish Health Repository)

Halpenny, D

2012-12-01

The regular use of visual display units (VDUs) at work has been shown to cause the development of a constellation of symptoms ranging from dry eyes to temporary myopia. European workers who use VDUs are now protected under detailed legislation enacted by the European Union (Directive 90\\/270\\/EEC). The use of picture archiving and communications systems, which are almost ubiquitous in European countries, means that, as a profession, radiologists fall under the remit of this legislation. This paper aims to assess the impact that full implementation of this law would have on a radiologist\\'s practice and to more broadly examine the issue of eye care as an occupational health issue in radiology. The authors conclude that eye care in the setting of regular VDU use among radiologists is an important quality control and occupational health issue. There is a clear legal basis requiring employers to provide regular eye examinations and reporting breaks. In the absence of leadership from employers on this issue individual radiologists have a responsibility to ensure that their work practices reflect the legal situation and minimise the effect of eye strain on their performance.

Introducing wood pellet fuel to the UK

Energy Technology Data Exchange (ETDEWEB)

Cotton, R A; Giffard, A

2001-07-01

Technical and non-technical issues affecting the introduction of wood pellet-fired heating to the UK were investigated with the aim of helping to establish a wood pellet industry in the UK. The project examined the growth and status of the industry in continental Europe and North America, reviewed relevant UK standards and legislation, identified markets for pellet heating in the UK, organised workshops and seminars to demonstrate pellet burning appliances, carried out a trial pelletisation of a range of biomass fuels, helped to set up demonstration installations of pellet-fired appliances, undertook a promotional campaign for wood pellet fuel and compiled resource directories for pellet fuel and pellet burning appliances in the UK. The work was completed in three phases - review, identification and commercialisation. Project outputs include UK voluntary standards for wood pellet fuel and combustion appliances, and a database of individuals with an interest in wood pellet fuel.

Maximizing the probability of satisfying the clinical goals in radiation therapy treatment planning under setup uncertainty

International Nuclear Information System (INIS)

Fredriksson, Albin; Hårdemark, Björn; Forsgren, Anders

2015-01-01

Purpose: This paper introduces a method that maximizes the probability of satisfying the clinical goals in intensity-modulated radiation therapy treatments subject to setup uncertainty. Methods: The authors perform robust optimization in which the clinical goals are constrained to be satisfied whenever the setup error falls within an uncertainty set. The shape of the uncertainty set is included as a variable in the optimization. The goal of the optimization is to modify the shape of the uncertainty set in order to maximize the probability that the setup error will fall within the modified set. Because the constraints enforce the clinical goals to be satisfied under all setup errors within the uncertainty set, this is equivalent to maximizing the probability of satisfying the clinical goals. This type of robust optimization is studied with respect to photon and proton therapy applied to a prostate case and compared to robust optimization using an a priori defined uncertainty set. Results: Slight reductions of the uncertainty sets resulted in plans that satisfied a larger number of clinical goals than optimization with respect to a priori defined uncertainty sets, both within the reduced uncertainty sets and within the a priori, nonreduced, uncertainty sets. For the prostate case, the plans taking reduced uncertainty sets into account satisfied 1.4 (photons) and 1.5 (protons) times as many clinical goals over the scenarios as the method taking a priori uncertainty sets into account. Conclusions: Reducing the uncertainty sets enabled the optimization to find better solutions with respect to the errors within the reduced as well as the nonreduced uncertainty sets and thereby achieve higher probability of satisfying the clinical goals. This shows that asking for a little less in the optimization sometimes leads to better overall plan quality

1000-Case Reader Study of Radiologists' Performance in Interpretation of Automated Breast Volume Scanner Images with a Computer-Aided Detection System.

Science.gov (United States)

Xu, Xiaojing; Bao, Lingyun; Tan, Yanjuan; Zhu, Luoxi; Kong, Fanlei; Wang, Wei

2018-05-28

The objective of our study was to assess, in a reader study, radiologists' performance in interpretation of automated breast volume scanner (ABVS) images with the aid of a computer-aided detection (CADe) system. Our study is a retrospective observer study with the purpose of investigating the effectiveness of using a CADe system as an aid for radiologists in interpretation of ABVS images. The multiple-reader, multiple-case study was designed to compare the diagnostic performance of radiologists with and without CADe. The study included 1000 cases selected from ABVS examinations in our institution in 2012. Among those cases were 206 malignant, 486 benign and 308 normal cases. The cancer cases were consecutive; the benign and normal cases were randomly selected. All malignant and benign cases were confirmed by biopsy or surgery, and normal cases were confirmed by 2-y follow-up. Reader performance was compared in terms of area under the receiver operating characteristic curve, sensitivity and specificity. Additionally, the reading time per case for each reader was recorded. Nine radiologists from our institution participated in the study. Three had more than 8 y of ultrasound experience and more than 4 y of ABVS experience (group A); 3 had more than 5 y of ultrasound experience (group B), and 3 had more than 1 y of ultrasound experience (group C). Both group B and group C had no ABVS experience. The CADe system used was the QVCAD System (QView Medical, Inc., Los Altos, CA, USA). It is designed to aid radiologists in searching for suspicious areas in ABVS images. CADe results are presented to the reader simultaneously with the ABVS images; that is, the radiologists read the ABVS images concurrently with the CADe results. The cases were randomly assigned for each reader into two equal-size groups, 1 and 2. Initially the readers read their group 1 cases with the aid of CADe and their group 2 cases without CADe. After a 1-mo washout period, they re-read their group 1

UK experience of planning the nuclear contribution to the UK power programme

International Nuclear Information System (INIS)

Catchpole, S.; Jenkin, F.P.

1977-01-01

The paper outlines U.K. experience in planning nuclear programmes. It examines the factors which have determined the size of such programmes together with those factors which have influenced their implementation. The paper also discusses the role which the utility has played in the deployment of nuclear power in the U.K. At present, nuclear energy can only be utilised on a large scale via the electricity route and the forecasting of electricity demand is therefore a key element in determining the size of the nuclear programme. Other important issues which affect the nuclear contribution are: national fuel policies, discontinuities in price and availability of imported fossil fuels, plant capital costs, fuel price relativities, plant siting, rate of introduction of new nuclear systems, manufacturer's capability, public attitudes towards nuclear power and financing. These issues are dealt with in some detail including their relative importance in the U.K. The paper also discusses the contribution of the various nuclear bodies in the U.K. in securing the implementation of the nuclear programmes. From the inception of nuclear power in the U.K., it has been recognised that a major utility has a central role to play not only in commercial operation but also in the procurement of plant and materials. As explained in the paper this ''informed buyer'' approach, which is being increasingly adopted by other major utilities, calls for an organisation and technical infrastructure far more complex than is the case for fossil plants. The requirements of safety, which is unambiguously the responsibility of the utility, and of high availability of plant operation demand a rigorous approach to design, quality assurance, project management, construction and operation. To this must be added sound research and development and staff training facilities. The paper explains how experience in these vital areas has been built up

Radiation exposure to patient and radiologist during transcatheter arterial embolization therapy for hepatocellular carcinoma. Multicenter study in Japan

International Nuclear Information System (INIS)

Ishiguchi, T.; Nakamura, H.; Okazaki, M.

2000-01-01

Transcatheter arterial embolization (TAE) is now most commonly used as a treatment of hepatocellular carcinoma. Present multicenter study was carried out to evaluate radiation exposure to patients and interventional radiologists during the procedure. Thirty-nine procedures of TAE for hepatocellular carcinoma in eight institutes were analyzed. Radiation exposure to the patients and the interventional radiologists were evaluated with LiF thermoluminescence dosimeters (TLDs) placed on the patient's skin at the posterior hepatic portion and the pelvis and the operator's forehead and abdomen (in front and back of the lead apron). A real-time dosimeter was also used to evaluate skin dose of the patient. TAE was performed by angiographic techniques, using a microcatheter advanced to the hepatic artery branch(es) under the guidance of X-ray fluoroscopy and digital subtraction angiography (DSA), and then injecting chemotherapeutic agents mixed with oily contrast material and followed by gelatin sponge particles. The mean fluoroscopic time was 21 minutes and the mean number of DSA acquisition was 6. TLD dosimetry showed that the mean entrance surface dose of the patient at the hepatic portion was 973±681 mSv (mean±SD), and the anterior skin dose at the pelvis was 0.98±0.69 mSv. The doses of the radiologist were 0.04±0.04 mSv at the forehead, 0.15±0.19 mSv at the abdomen in front of the lead apron, and 0.005±0.01 mSv behind it. The real-time dosimetry showed that 56% of the surface dose at the hepatic portion was from DSA and 44% was from fluoroscopy. The radiation exposure to the patients and the interventional radiologists during TAE for hepatocellular carcinoma was considered to be acceptable when proper techniques are used. Further effort to reduce radiation doses during the procedure will be directed toward both digital angiographic and fluoroscopic techniques. (author)

IEA PVPS Task 1 - UK Expert. Final report

Energy Technology Data Exchange (ETDEWEB)

Gunning, R.

2003-07-01

The paper relates to work carried out under contract to the UK Renewable Energy Programme, and describes the terms of reference of the UK representation in the IEA PVPS Task 1 which provides a forum for exchange of information on photovoltaic (PV) technology between 21 participating countries. The main benefit derived by the UK is access to international expertise in PV technology. Using information obtained from participation in Task 1, the UK produces a National Survey Report which reports on developments in PV technology in the UK over the previous 12 months. The report covers installed capacity, prices, budgets and costs: it is freely available on the UK PVPS website. The newsletter PV Power, is prepared and distributed biannually - 18 issues have been published by mid-2003. IT Power is currently the UK representative on the IEA PVPS Task 1.

Some properties of the functions satisfying Bell's inequalities in relation to quantum mechanics

International Nuclear Information System (INIS)

Roussel, P.

1986-01-01

A detailed comparison of Bell's inequalities (B.I.) and quantum mechanics (Q.M.) in an E.P.R.B. situation is given. It is first shown that Q.M. violates the original (3 directions) or generalized (4 directions) B.I. almost everywhere. The properties of functions satisfying the original B.I. are then derived and compared to Q.M. predictions. Finally, the behaviour of functions which satisfy B.I. and attempt to fit Q.M. is described. Altogether, an incompatibility is shown to be stronger than that resulting from just the usual examination

Studies on urokinase (UK) therapy of thromboembolic diseases

International Nuclear Information System (INIS)

Wakayama, Ryuji; Satake, Kisaburo; Hisamatsu, Tokugoro; Fukase, Masaichi

1974-01-01

In order to determine the urokinase (UK) concentration in blood, a radioimmunoassay method was developed, in which a radioactive material labeled with 125 I-Na was used. In this method, the movement of UK in blood and the relationship between the UK concentration and fibrinolytic activity were studied with the following results: 1) The concentration of UK in normal human blood was found to be 6.84 +- 2.53 PKU early in the morning with an apparent daily rythmic fluctuation in concentration. 2) With an intravenous drip of 20,000 to 30,000 PKU, the UK concentration increased 6 to 8 PKU/ml above the early morning value, then in one to two hours it returned to the previous value once again. In some of the cases, a slight, transient decrease occurred. 3) Following the UK drip, UK concentration in the blood and fibrinolytic activity varied in a parallel fashion. Plasminogen and antiplasmin levels were not altered by administration of only 20,000 to 30,000 PKU of UK. Fibrinogen was lowered, but the fluctuation was within the physiological range. (S. Oyama)

Measuring and managing radiologist workload: application of lean and constraint theories and production planning principles to planning radiology services in mahjor tertiary hospital

International Nuclear Information System (INIS)

MacDonald, Sharyn L.S.; Cowan, Ian A.; Floyd, Richard; Mackintosh, Stuart; Graham, Rob; Jenkins, Emma; Hamilton, Richard

2013-01-01

We describe how techniques traditionally used in the manufacturing industry (lean management, the theory of constraints and production planning) can be applied to planning radiology services to reduce the impact of constraints such as limited radiologist hours, and to subsequently reduce delays in accessing imaging and in report turnaround. Targets for imaging and reporting were set aligned with clinical needs. Capacity was quantified for each modality and for radiologists and recorded in activity lists. Demand was quantified and forecasting commenced based on historical referral rates. To try and mitigate the impact of radiologists as a constraint, lean management processes were applied to radiologist workflows. A production planning process was implemented. Outpatient waiting times to access imaging steadily decreased. Report turnaround times improved with the percentage of overnight/on-call reports completed by a 1030 target time increased from approximately 30% to 80 to 90%. The percentage of emergency and inpatient reports completed within one hour increased from approximately 15% to approximately 50% with 80 to 90% available within 4 hours. The number of unreported cases on the radiologist work-list at the end of the working day reduced. The average weekly accuracy for demand forecasts for emergency and inpatient CT, MRI and plain film imaging was 91%, 83% and 92% respectively. For outpatient CT, MRI and plain film imaging the accuracy was 60%, 55% and 77% respectively. Reliable routine weekly and medium to longer term service planning is now possible. Tools from industry can be successfully applied to diagnostic imaging services to improve performance. They allow an accurate understanding of the demands on a service, capacity, and can reliably predict the impact of changes in demand or capacity on service delivery.

The Canadian Association of Radiologists national standards for technology

International Nuclear Information System (INIS)

Hynes, D.M.

1997-01-01

Unlike any other technological development before it, teleradiology is revolutionizing the diagnostic medical imaging field by enabling broad access to radiological images. Images can today be transmitted between departments or between hospitals. Doctors in remote areas can share images with specialists in larger centres for consultation. Physicians can access hospital records from their office or home computer. Teleradiology also offers valuable educational opportunities. Like other technologies, however, the implementation and continuing development of teleradiology requires careful consideration of issues related to image quality, patient care, security of patient records, and other important matters. The following standard was prepared by the CAR Expert Advisory Panel on Teleradiology Standards in collaboration with the Ontario Association of Radiologists Teleradiology Committee to provide a model for teleradiology applications. The standard is based upon U.S. standards prepared by the American College of Radiology. (author). 21 refs

The role of the interventional radiologist in enteral alimentation.

Science.gov (United States)

Given, M F; Lyon, S M; Lee, M J

2004-01-01

The provision of enteral nutrition through the placement of gastrostomy/gastrojejunostomy tubes is a well-established procedure. Traditionally, these catheters have been placed either surgically or endoscopically; however, over the past two decades interventional radiologists have increasingly performed these procedures successfully. The perceived advantages of this route lie in the reported lower morbidity and mortality rates. In addition, percutaneous radiologically guided (PRG) catheters may be placed in certain subgroups of patients in whom it would be technically difficult or impossible by other routes, e.g., patients with head and neck or oesophageal tumours. The aim of this review is to describe the techniques of radiologically placed gastrostomy/gastrojejunostomy, discuss its indications and contraindications, describe any associated potential complications and compare PRG results with the more established techniques of open surgical and endoscopic placement. We also describe some recent procedural and catheter modifications.

The role of the interventional radiologist in enteral alimentation

Energy Technology Data Exchange (ETDEWEB)

Given, M.F.; Lyon, S.M.; Lee, M.J. [Department of Academic Radiology, Beaumont Hospital, Dublin 9 (Ireland); Royal College of Surgeons in Ireland, St. Stephen' s Green, Dublin 2 (Ireland)

2004-01-01

The provision of enteral nutrition through the placement of gastrostomy/gastrojejunostomy tubes is a well-established procedure. Traditionally, these catheters have been placed either surgically or endoscopically; however, over the past two decades interventional radiologists have increasingly performed these procedures successfully. The perceived advantages of this route lie in the reported lower morbidity and mortality rates. In addition, percutaneous radiologically guided (PRG) catheters may be placed in certain subgroups of patients in whom it would be technically difficult or impossible by other routes, e.g., patients with head and neck or oesophageal tumours. The aim of this review is to describe the techniques of radiologically placed gastrostomy/gastrojejunostomy, discuss its indications and contraindications, describe any associated potential complications and compare PRG results with the more established techniques of open surgical and endoscopic placement. We also describe some recent procedural and catheter modifications. (orig.)

Typical Werner states satisfying all linear Bell inequalities with dichotomic measurements

Science.gov (United States)

Luo, Ming-Xing

2018-04-01

Quantum entanglement as a special resource inspires various distinct applications in quantum information processing. Unfortunately, it is NP-hard to detect general quantum entanglement using Bell testing. Our goal is to investigate quantum entanglement with white noises that appear frequently in experiment and quantum simulations. Surprisingly, for almost all multipartite generalized Greenberger-Horne-Zeilinger states there are entangled noisy states that satisfy all linear Bell inequalities consisting of full correlations with dichotomic inputs and outputs of each local observer. This result shows generic undetectability of mixed entangled states in contrast to Gisin's theorem of pure bipartite entangled states in terms of Bell nonlocality. We further provide an accessible method to show a nontrivial set of noisy entanglement with small number of parties satisfying all general linear Bell inequalities. These results imply typical incompleteness of special Bell theory in explaining entanglement.

Supporting UK adaptation: building services for the next set of UK climate projections

Science.gov (United States)

Fung, Fai; Lowe, Jason

2016-04-01

As part of the Climate Change Act 2008, the UK Government sets out a national adaptation programme to address the risks and opportunities identified in a national climate change risk assessment (CCRA) every five years. The last risk assessment in 2012 was based on the probabilistic projections for the UK published in 2009 (UKCP09). The second risk assessment will also use information from UKCP09 alongside other evidence on climate projections. However, developments in the science of climate projeciton, and evolving user needs (based partly on what has been learnt about the diverse user requirements of the UK adaptation community from the seven years of delivering and managing UKCP09 products, market research and the peer-reviewed literature) suggest now is an appropriate time to update the projections and how they are delivered. A new set of UK climate projections are now being produced to upgrade UKCP09 to reflect the latest developments in climate science, the first phase of which will be delivered in 2018 to support the third CCRA. A major component of the work is the building of a tailored service to support users of the new projections during their development and to involve users in key decisions so that the projections are of most use. We will set out the plan for the new climate projections that seek to address the evolving user need. We will also present a framework which aims to (i) facilitate the dialogue between users, boundary organisations and producers, reflecting their different decision-making roles (ii) produce scientifically robust, user-relevant climate information (iii) provide the building blocks for developing further climate services to support adaptation activities in the UK.

Nuclear power and the UK

International Nuclear Information System (INIS)

Murphy, St.

2009-01-01

This series of slides describes the policy of the UK government concerning nuclear power. In January 2008 the UK Government published the White Paper on the Future of Nuclear Power. The White Paper concluded that new nuclear power stations should have a role to play in this country's future energy mix. The role of the Government is neither to build nuclear power plants nor to finance them. The White Paper set out the facilitative actions the Government planned to take to reduce regulatory and planning risks associated with investing in new nuclear power stations. The White Paper followed a lengthy period of consultation where the UK Government sought a wide variety of views from stakeholders and the public across the country on the future of nuclear power. In total energy companies will need to invest in around 30-35 GW of new electricity generating capacity over the next two decades. This is equivalent to about one-third of our existing capacity. The first plants are expected to enter into service by 2018 or sooner. The Office for Nuclear Development (OND) has been created to facilitate new nuclear investment in the UK while the Nuclear Development Forum (NDF) has been established to lock in momentum to secure the long-term future of nuclear power generation in the UK. (A.C.)

Equation satisfied by electron-electron mutual Coulomb repulsion energy density functional

OpenAIRE

Joubert, Daniel P.

2011-01-01

The electron-electron mutual Coulomb repulsion energy density functional satisfies an equation that links functionals and functional derivatives at N-electron and (N-1)-electron densities for densities determined from the same adiabatic scaled external potential for the N-electron system.

Evaluation of chromosomal aberrations in radiologists and medical radiographers chronically exposed to ionising radiation

International Nuclear Information System (INIS)

Kasuba, V.; Rozgaj, R.; Jazbec, A.

2005-01-01

Chromosomal aberrations are fairly reliable indicators of damage induced by ionising radiation. This study included 180 radiologists and medical radiographers (technicians) and 90 controls who were not occupationally exposed to ionising radiation. All exposed subjects were routinely monitored with film badge, and none was exposed to a radiation dose exceeding the limit for occupational exposure recommended by the International Commission on Radiological Protection (ICRP). Two hundred metaphases for each person were scored. The frequencies of acentric fragments, dicentrics, ring chromosomes and chromosomal exchanges were determined and compared to those obtained in the control group. Chromosome aberrations were analysed using Poisson regression for profession, age, sex, smoking and years of exposure. Age, smoking, diagnostic exposure to X-rays and occupation were found to correlate with the occurrence of acentric fragments. The influence of exposure duration on the frequency of acentric fragments was greater in medical radiographers than in radiologists. Smoking and sex were found to correlate with the occurrence of dicentric chromosomes, which were more common in men than in women. As chromosome aberrations exceeded the expected level with respect to the absorbed dose, our findings confirm the importance of chromosome analysis as a part of regular medical check-up of subjects occupationally exposed to ionising radiation.(author)

Evaluation of non-radiologist physicians' knowledge on aspects related to ionizing radiation in imaging

International Nuclear Information System (INIS)

Madrigano, Renata Rodrigues; Abrao, Karen Cristine; Regacini, Rodrigo; Puchnick, Andrea

2014-01-01

Objective: to assess the non-radiologist physicians' knowledge on the use of ionizing radiation in imaging. Materials and Methods: cross-sectional study utilizing an anonymous questionnaire responded by physicians in clinical and surgical specialties, divided into two parts as follows: one including questions about the physicians' characteristics, frequency of imaging studies requests and participation in professional updating events, and another part including multiple choice questions approaching general knowledge about radiation, optimization principles and radioprotection. Results: from a total of 309 questionnaires, 120 (38.8%) were responded, 50% by physicians in surgical specialties and 50% in clinical specialties; respectively 45% and 2.5% of physicians responded that magnetic resonance imaging and ultrasonography use ionizing radiation. Overall, the average grade was higher for surgical specialists with no significant difference, except for the question about exposure in pregnant women (p = 0.047). Physicians who are professionally updated, particularly those attending clinical meetings (p = 0.050) and participating in teaching activities (p = 0.047), showed statistically superior knowledge about ionizing radiation as compared with others. Conclusion: the non-radiologist physicians' is heterogeneous and in some points needs to be improved. Multidisciplinary clinical meetings and teaching activities are important ways to disseminate information on the subject. (author)

Sustainability in the UK construction minerals industry

OpenAIRE

Mitchell, Clive

2015-01-01

Sustainability in the UK construction minerals industry Clive Mitchell, Industrial Minerals Specialist, British Geological Survey, Nottingham, UK Email: Sustainability is not just about environmental protection it also concerns biodiversity, community relations, competence, employment, geodiversity, health and safety, resource efficiency, restoration and stakeholder accountability. The UK construction minerals industry aims to supply essential materials in a sustainabl...

The future of UK gas producers

International Nuclear Information System (INIS)

Hallas, P.A.

1991-01-01

Traditionally, an oil company wishing to develop UK gas reserves almost always faced a protracted gas sales negotiation with British Gas. British Gas then had an effective monopoly in the resale of that gas to final consumers. This traditional pattern is now in a process of fundamental change, as a result of recent UK gas market re-regulation and the emergence of a new large scale opportunity to sell gas for power generation. The impact of these changes is still not very well understood outside a relatively small group of gas specialists but is likely to be significant for British Gas, consumers and UK gas producers. This paper outlines the background to the recent changes, the possible future of UK gas marketing and the likely impact on gas producers in the North Sea

The effect of fossil energy and other environmental taxes on profit incentives for change in an open economy: Evidence from the UK

International Nuclear Information System (INIS)

Webster, Allan; Ayatakshi, Sukanya

2013-01-01

This paper argues that the underlying supply and demand analysis of fossil energy and other environmental taxes needs further elaboration when a country (a) introduces national fossil energy or environmental taxes and (b) is open to international trade at given world prices. We provide evidence that such conditions are plausible for many sectors in the UK. A key implication is that the short run effects of such taxes should not be felt in final good prices, since these are determined in world markets, but in terms of underlying profitability. These changes in underlying profits provide two key incentives for producers—to change to more environmentally friendly production techniques and to switch resources to production of less environmentally harmful goods. Using input—output techniques we provide evidence for the UK to show how existing fossil energy and other “green” taxes have affected underlying profitability. The evidence shows quite strong profit incentives to shift resources from a small number of energy intensive industries to others. - Highlights: • Energy taxes affect profits more than prices for sectors trading at world prices. • This study suggests that many sectors in the UK satisfy these conditions. • Our evidence suggests that few sectors are strongly affected by energy taxes. • Energy taxes have a strong effect relative to other possible environmental taxes

Work-Life and Well-Being in U.K. Therapeutic Prison Officers: A Thematic Analysis.

Science.gov (United States)

Walker, Emma J; Egan, Helen H; Jackson, Craig A; Tonkin, Matthew

2018-06-01

Previous research has clearly demonstrated the positive impact of therapeutic interventions on offenders' well-being. Much less is known about the impact on prison staff facilitating and delivering such interventions. We employed qualitative methodology to capture a deeper understanding of the work of therapeutic prison officers. Seven prison officers working in a U.K. Category B therapeutic community prison were interviewed about their working lives, including their own participation in therapy. Following a thematic analysis approach, key findings indicated that the physical and cultural work environment was very important to staff; the therapeutic element of their job role, although demanding, was both satisfying and rewarding; and that working in a therapeutic prison environment provided the opportunity for personal as well as professional development. We conclude that further attention should be given to the unique nature of therapeutic prison work and the positive impact it can have on well-being at work.

UK manufacturers construction joint venture

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-07-01

This report examines the legal and commercial framework for UK manufacturers to collaborate in a construction venture for a small combustion/steam cycle power plant fueled with biomass. The integration of technology and project plan, the working capital and capitalisation, financial aspects, the market plan, turnkey packages, joint venture entities, and collaboration are discussed. (UK)

The medline UK filter: development and validation of a geographic search filter to retrieve research about the UK from OVID medline.

Science.gov (United States)

Ayiku, Lynda; Levay, Paul; Hudson, Tom; Craven, Jenny; Barrett, Elizabeth; Finnegan, Amy; Adams, Rachel

2017-07-13

A validated geographic search filter for the retrieval of research about the United Kingdom (UK) from bibliographic databases had not previously been published. To develop and validate a geographic search filter to retrieve research about the UK from OVID medline with high recall and precision. Three gold standard sets of references were generated using the relative recall method. The sets contained references to studies about the UK which had informed National Institute for Health and Care Excellence (NICE) guidance. The first and second sets were used to develop and refine the medline UK filter. The third set was used to validate the filter. Recall, precision and number-needed-to-read (NNR) were calculated using a case study. The validated medline UK filter demonstrated 87.6% relative recall against the third gold standard set. In the case study, the medline UK filter demonstrated 100% recall, 11.4% precision and a NNR of nine. A validated geographic search filter to retrieve research about the UK with high recall and precision has been developed. The medline UK filter can be applied to systematic literature searches in OVID medline for topics with a UK focus. © 2017 Crown copyright. Health Information and Libraries Journal © 2017 Health Libraries GroupThis article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

The cross-cultural importance of satisfying vital needs.

Science.gov (United States)

Alvarez, Allen Andrew A

2009-11-01

Ethical beliefs may vary across cultures but there are things that must be valued as preconditions to any cultural practice. Physical and mental abilities vital to believing, valuing and practising a culture are such preconditions and it is always important to protect them. If one is to practise a distinct culture, she must at least have these basic abilities. Access to basic healthcare is one way to ensure that vital abilities are protected. John Rawls argued that access to all-purpose primary goods must be ensured. Amartya Sen and Martha Nussbaum claim that universal capabilities are what resources are meant to enable. Len Doyal and Ian Gough identify physical health and autonomy as basic needs of every person in every culture. When we disagree on what to prioritize, when resources to satisfy competing demands are scarce, our common needs can provide a point of normative convergence. Need-based rationing, however, has been criticized for being too indeterminate to give guidance for deciding which healthcare services to prioritize and for tending to create a bottomless-pit problem. But there is a difference between needing something (first-order need) and needing to have the ability to need (second-order need). Even if we disagree about which first-order need to prioritize, we must accept the importance of satisfying our second-order need to have the ability to value things. We all have a second-order need for basic healthcare as a means to protect our vital abilities even if we differ in what our cultures consider to be particular first-order needs.

Implications of sustainability constraints on UK bioenergy development: Assessing optimistic and precautionary approaches with UK MARKAL

International Nuclear Information System (INIS)

McDowall, Will; Anandarajah, Gabrial; Dodds, Paul E.; Tomei, Julia

2012-01-01

Bioenergy is an important renewable energy resource. However, assessments of the future of bioenergy are beset with uncertainty and contested values, suggesting that a precautionary approach to bioenergy resource development may be warranted. This paper uses UK MARKAL to examine the implications of adopting a precautionary approach to bioenergy development in the UK. The paper reports a detailed review of UK bioenergy resources and sustainability constraints, and develops precautionary and optimistic resource scenarios. The paper then examines the implications of these scenarios using the energy systems model MARKAL, finding that a precautionary approach adds to the cost of decarbonisation, but does not significantly alter the optimal technology mix. In particular, biomass and co-firing CCS emerge as optimal technologies across scenarios. The question of UK land availability for bioenergy production is highlighted within the paper. With less land available for bioenergy production, the costs of decarbonisation will rise; whereas if more land is available for bioenergy, then less land is available for either food production or ecosystem conservation. This paper quantifies one side of this trade-off, by estimating the additional costs incurred when UK land availability for bioenergy production is constrained. - Highlights: ► We assess UK bioenergy resources under optimistic and precautionary approaches. ► Using MARKAL, we find that sustainability constraints add to decarbonisation costs. ► Preferred use of bioenergy is similar in optimistic and precautionary cases. ► Best use of bioenergy is heat and power, not transport, if CCS is available. ► The marginal value of additional land availability to the energy system is high.

Incidental abdominopelvic findings on expanded field-of-view lumbar spinal MRI: frequency, clinical importance, and concordance in interpretation by neuroimaging and body imaging radiologists

International Nuclear Information System (INIS)

Maxwell, A.W.P.; Keating, D.P.; Nickerson, J.P.

2015-01-01

Aim: To characterize the frequency of identification, clinical importance, and concordance in interpretation of incidental abdominopelvic findings identified on routine lumbar spinal MRI using supplemental expanded field-of-view (FOV) coronal imaging. Materials and methods: All lumbar spinal MRI reports over a 12-month period were retrospectively reviewed for the presence of incidental abdominopelvic findings identified using expanded FOV coronal imaging. Medical records were used to identify those findings that received follow-up, which were then categorized according to final diagnosis and classified as “indeterminate,” “likely clinically unimportant,” and “likely clinically important”. All cases that received follow-up were blindly and independently re-reviewed by a neuroimaging radiologist and body-imaging radiologist, and reviewer performances were compared to assess for agreement with regard to lesion significance, need for follow-up, and other parameters. Results: In total, 2067 reports were reviewed: 687 (33.2%) featured one or more incidental abdominopelvic findings, and 102 (4.9%) findings received further evaluation. Of these, 11 (10.9%) were classified as “indeterminate,” 50 (49%) as “likely clinically unimportant,” and 41 (40.1%) were classified as “likely clinically important.” Excellent agreement was observed between the reviewing radiologists for all evaluated parameters. Conclusion: The addition of an expanded FOV coronal sequence to the standard lumbar spinal MRI protocol was associated with the identification of a large number of incidental abdominopelvic findings, the minority of which represent likely clinically important findings. Most incidental findings were confidently dismissed by a neuroimaging radiologist as likely clinically unimportant without utilization of additional clinical or radiographic resources. - Highlights: • Expanded field-of-view (FOV) MRI improves detection of important incidental findings. �

18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography-Based Radiotherapy Target Volume Definition in Non-Small-Cell Lung Cancer: Delineation by Radiation Oncologists vs. Joint Outlining With a PET Radiologist?

International Nuclear Information System (INIS)

Hanna, Gerard G.; Carson, Kathryn J.; Lynch, Tom; McAleese, Jonathan; Cosgrove, Vivian P.; Eakin, Ruth L.; Stewart, David P.; Zatari, Ashraf; O'Sullivan, Joe M.; Hounsell, Alan R.

2010-01-01

Purpose: 18 F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has benefits in target volume (TV) definition in radiotherapy treatment planning (RTP) for non-small-cell lung cancer (NSCLC); however, an optimal protocol for TV delineation has not been determined. We investigate volumetric and positional variation in gross tumor volume (GTV) delineation using a planning PET/CT among three radiation oncologists and a PET radiologist. Methods and Materials: RTP PET/CT scans were performed on 28 NSCLC patients (Stage IA-IIIB) of which 14 patients received prior induction chemotherapy. Three radiation oncologists and one PET radiologist working with a fourth radiation oncologist independently delineated the GTV on CT alone (GTV CT ) and on fused PET/CT images (GTV PETCT ). The mean percentage volume change (PVC) between GTV CT and GTV PETCT for the radiation oncologists and the PVC between GTV CT and GTV PETCT for the PET radiologist were compared using the Wilcoxon signed-rank test. Concordance index (CI) was used to assess both positional and volume change between GTV CT and GTV PETCT in a single measurement. Results: For all patients, a significant difference in PVC from GTV CT to GTV PETCT exists between the radiation oncologist (median, 5.9%), and the PET radiologist (median, -0.4%, p = 0.001). However, no significant difference in median concordance index (comparing GTV CT and GTV FUSED for individual cases) was observed (PET radiologist = 0.73; radiation oncologists = 0.66; p = 0.088). Conclusions: Percentage volume changes from GTV CT to GTV PETCT were lower for the PET radiologist than for the radiation oncologists, suggesting a lower impact of PET/CT in TV delineation for the PET radiologist than for the oncologists. Guidelines are needed to standardize the use of PET/CT for TV delineation in RTP.

18F-fluorodeoxyglucose positron emission tomography/computed tomography-based radiotherapy target volume definition in non-small-cell lung cancer: delineation by radiation oncologists vs. joint outlining with a PET radiologist?

Science.gov (United States)

Hanna, Gerard G; Carson, Kathryn J; Lynch, Tom; McAleese, Jonathan; Cosgrove, Vivian P; Eakin, Ruth L; Stewart, David P; Zatari, Ashraf; O'Sullivan, Joe M; Hounsell, Alan R

2010-11-15

(18)F-Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) has benefits in target volume (TV) definition in radiotherapy treatment planning (RTP) for non-small-cell lung cancer (NSCLC); however, an optimal protocol for TV delineation has not been determined. We investigate volumetric and positional variation in gross tumor volume (GTV) delineation using a planning PET/CT among three radiation oncologists and a PET radiologist. RTP PET/CT scans were performed on 28 NSCLC patients (Stage IA-IIIB) of which 14 patients received prior induction chemotherapy. Three radiation oncologists and one PET radiologist working with a fourth radiation oncologist independently delineated the GTV on CT alone (GTV(CT)) and on fused PET/CT images (GTV(PETCT)). The mean percentage volume change (PVC) between GTV(CT) and GTV(PETCT) for the radiation oncologists and the PVC between GTV(CT) and GTV(PETCT) for the PET radiologist were compared using the Wilcoxon signed-rank test. Concordance index (CI) was used to assess both positional and volume change between GTV(CT) and GTV(PETCT) in a single measurement. For all patients, a significant difference in PVC from GTV(CT) to GTV(PETCT) exists between the radiation oncologist (median, 5.9%), and the PET radiologist (median, -0.4%, p = 0.001). However, no significant difference in median concordance index (comparing GTV(CT) and GTV(FUSED) for individual cases) was observed (PET radiologist = 0.73; radiation oncologists = 0.66; p = 0.088). Percentage volume changes from GTV(CT) to GTV(PETCT) were lower for the PET radiologist than for the radiation oncologists, suggesting a lower impact of PET/CT in TV delineation for the PET radiologist than for the oncologists. Guidelines are needed to standardize the use of PET/CT for TV delineation in RTP. Copyright © 2010 Elsevier Inc. All rights reserved.

Deciding why and when to use CT in children: a radiologist's perspective

International Nuclear Information System (INIS)

Frush, Donald P.

2014-01-01

Defining what is appropriate or inappropriate with respect to CT scanning is challenging. There are a variety of influences on scan utilization in children, some more widely recognized and acknowledged than others. It is important to understand the contribution of these elements as we move toward improved utilization. This must be through partnerships and shared efforts and accountability. These efforts include improved resources such as consensus appropriateness criteria and guidelines including decision rules and support. But there also need to be trench-based strategies on the part of practicing radiologists to model cooperative behavior rather than blame-centered behavior. (orig.)

Assessment of deep myometrial invasion of endometrial cancer on MRI: added value of second-opinion interpretations by radiologists subspecialized in gynaecologic oncology.

Science.gov (United States)

Woo, Sungmin; Kim, Sang Youn; Cho, Jeong Yeon; Kim, Seung Hyup

2017-05-01

To investigate the added value of secondary reports issued by radiologists subspecializing in gynaecologic imaging for determining deep myometrial invasion of endometrial cancer on MRI. Initial (from referring institutions) and secondary (by subspecialized radiologists) interpretations of MRI of 55 patients with endometrial cancer were retrospectively reviewed. A radiologist blinded to clinicopathological information assessed both reports for the presence of deep myometrial invasion. Reference standard was based on hysterectomy specimens. Kappa coefficients (k) were used to measure their concordance. McNemar testing and receiver operating characteristic (ROC) analysis was used to compare sensitivities, specificities and areas under the curves (AUCs). Deep myometrial invasion was present in 25 (45.5 %) patients. Among 27.3 % (15/55; k = 0.458) patients with discrepant results, secondary interpretations were correct in 10 (66.7 %) cases. Sensitivity was higher in secondary than in initial reports (76.0 % vs. 48.0 %, p = 0.039) while no significant difference was seen in specificity (70.0 % vs. 76.7 %, p = 0.668). At ROC analysis, there was a tendency for higher AUCs in secondary reports (0.785 vs 0.669, p = 0.096). Secondary readings of MRI by subspecialized gynaecologic oncologic radiologists may provide incremental value in determining deep myometrial invasion of endometrial cancer. • Deep myometrial invasion is an important prognostic factor in endometrial cancer. • Assessment of deep myometrial invasion is often discrepant between initial and secondary reports. • Secondary reports showed higher sensitivity and accuracy. • Secondary review of MRI may provide incremental value in endometrial cancer patients.

Indoor air quality: a UK perspective

International Nuclear Information System (INIS)

Wadge, A.

1995-01-01

Outdoor air quality has generally improved in the UK over the last 2 decades but during this period changing conditions within the home have tended to reduce ventilation and increase the opportunity for accumulation of undesirable levels of indoor air pollutants. Information obtained from laboratory and epidemiological studies suggest that indoor air pollutants are an important cause of avoidable morbidity and mortality in the UK. This paper reviews the major indoor air pollutants of concern in the UK and considers some of the special issues relevant to indoor environment. (author) 3 figs., 37 refs

Mini-gastric bypass to control morbid obesity and diabetes mellitus: What radiologists need to know

Energy Technology Data Exchange (ETDEWEB)

Park, Hyun Jeong [Dept. of Radiology, Chung-Ang University Hospital, Seoul (Korea, Republic of); Hong, Seong Sook; Hwang, Ji Young; Hur, Kyung Yul [Soonchunhyang University Seoul Hospital, Seoul (Korea, Republic of)

2015-04-15

Laparoscopic mini-gastric bypass surgery is a safe and simple surgical intervention for treating morbid obesity and diabetes mellitus and is now being performed more frequently. Radiologists must be critical in their postoperative evaluation of these patients. In this pictorial review, we explain and illustrate the surgical technique, normal postoperative anatomy, and associated complications as seen on imaging examinations, including fluoroscopy and computed tomography.

Prospects for UK fuel cells component suppliers

Energy Technology Data Exchange (ETDEWEB)

Wilcox, C.; Tunnicliffe, M.

2002-07-01

This report examines the capabilities of the UK fuel cell industry in meeting the expected increase in demand, and aims to identify all UK suppliers of fuel cell components, evaluate their products and match them to fuel cell markets, and identify components where the UK is in a competitive position. Component areas are addressed along with the need to reduce costs and ensure efficient production. The well established supplier base in the UK is noted, and the car engine manufacturing base and fuel supply companies are considered. The different strengths of UK suppliers of the various types of fuel cells are listed. The future industry structure, the opportunities and dangers for business posed by fuel cells, the investment in cleaner technologies by the large fuel companies, opportunities for catalyst suppliers, and the residential combined heat and power and portable electronics battery markets are discussed.

Interdisciplinary shock-room care: tasks for the radiologist from the viewpoint of the trauma surgeon; Interdisziplinaere Schockraumversorgung: Die Aufgaben der Radiologie aus unfallchirurgischer Sicht

Energy Technology Data Exchange (ETDEWEB)

Mutschler, W.; Kanz, K.G. [Chirurgische Klinik und Poliklinik, Klinikum Innenstadt der Universitaet Muenchen (Germany)

2002-07-01

Efficient resuscitation of major trauma requests an interdisciplinary communication between trauma surgeons, anaesthesiologists and radiologists. Trauma outcome is significantly influenced by horizontal trauma team organisation and coherence to clinical algorithms, which allow fast diagnosis and intervention. A radiologist present on patients arrival in the trauma room provides a major impact on trauma care. Nevertheless optimal integration in the trauma team implies profound knowledge of the priorities of advanced trauma life support and trauma algorithms. His or her involvement is not limited to patient care only, also active participation in trauma room design, interdisciplinary algorithm development and trauma research are essential tasks for radiologists devoted to emergency radiology. Based on the pathophysiology of polytrauma and the structure of German trauma system, current concepts and proven clinical algorithms with special regard to the radiologist and his duties and tasks will are presented. (orig.) [German] Modernes Schockraummanagement mit dem Auftrag der zeitoptimierten Vernetzung diagnostischer und therapeutischer Handlungsablaeufe erfordert eine direkte Einbindung der Radiologie in das Schockraumteam im Sinne einer horizontalen Kommunikation zwischen Unfallchirurgie, Radiologie und Anaesthesie. Direkte Einbindung bedeutet dabei Einflussnahme auf Struktur- und Prozessqualitaet, Qualitaetsmanagement und interdisziplinaere Weiterentwicklung von Schockraumalgorithmen. Ausgehend von der Pathophysiologie des Polytraumas und der an Zeitgewinn orientierten Versorgungskette werden aktuelle diagnostische und therapeutische Algorithmen dargestellt und daraus die Aufgaben und Bedeutung der Radiologie im Schockraum abgeleitet. (orig.)

Direct Interactive Public Education by Breast Radiologists About Screening Mammography: Impact on Anxiety and Empowerment.

Science.gov (United States)

Lee, Jiyon; Hardesty, Lara A; Kunzler, Nathan M; Rosenkrantz, Andrew B

2016-01-01

Anxiety has been called a "harm" of screening mammography. The authors provided direct, interactive education to lay audiences and measured these sessions' impact on anxiety and any increased understanding of breast cancer screening. Academic breast radiologist provided seven 1-hour sessions of structured lectures and question-and-answer periods. Lay language and radiologic images were used to discuss disease background, screening guidelines, and areas of debate. One hundred seventeen participants (mean age, 45 ± 15 years) completed voluntary, anonymous, institutional review board-approved pre and postsession questionnaires relaying their attitudes regarding screening and the impact of the sessions. Results are summarized descriptively. Mean reported anxiety regarding screening (on a scale ranging from 1-5; 1 = no anxiety) was 2.5 ± 1.3. Anxiety was attributed to unknown results (56.4%), anticipation of pain (21.8%), known risk factors (14.5%), general uncertainty (12.7%), waiting for results (9.1%), possibility of more procedures (3.6%), and personal breast cancer history (3.6%). Ninety-seven percent reported that immediate results would lower anxiety (78% of those women indicated a 75%-100% decrease in anxiety); 93% reported that radiologist consultation with images would lower anxiety (75.6% indicated a 75%-100% decrease in anxiety). After the lecture, women reported (on a scale ranging from 1-5) increased understanding of the topic (4.7 ± 0.6), encouragement to screen (4.6 ± 0.7), and reduced anxiety (4.0 ± 1.1). Ninety-seven percent to 100% provided correct responses to these questions: rationale for screening in the absence of family history, recall does not equate to cancer diagnosis, benefit of prior films, and continued importance of physical examination. Attendees of radiologist-provided direct public lectures reported decreased anxiety and improved knowledge regarding screening mammography. The resultant reduced anxiety ("harm") and educational

The Unfair Commercial Practices Directive in the UK

NARCIS (Netherlands)

M. Koutsias (Marios); C. Willett (Chris)

2013-01-01

markdownabstract__Abstract__ This article shows that the UK has blended preventive and traditional UK criminal enforcement techniques to implement the UCPD; these techniques have been 'Europeanised' by the UCPD unfairness concepts; and the UCPD may also cause UK private law to be Europeanised in

Finer Distinctions: Variability in Satisfied Older Couples' Problem-Solving Behaviors.

Science.gov (United States)

Rauer, Amy; Williams, Leah; Jensen, Jakob

2017-06-01

This study utilized observational and self-report data from 64 maritally satisfied and stable older couples to explore if there were meaningful differences in how couples approached marital disagreements. Using a typology approach to classify couples based on their behaviors in a 15-minute problem-solving interaction, findings revealed four types of couples: (1) problem solvers (characterized by both spouses' higher problem-solving skills and warmth), (2) supporters (characterized by both spouses' notable warmth), (3) even couples (characterized by both spouses' moderate problem-solving skills and warmth), and (4) cool couples (characterized by both spouses' greater negativity and lower problem-solving skills and warmth). Despite the differences in these behaviors, all couples had relatively high marital satisfaction and functioning. However, across nearly all indices, spouses in the cool couple cluster reported poorer marital functioning, particularly when compared to the problem solvers and supporters. These findings suggest that even modest doses of negativity (e.g., eye roll) may be problematic for some satisfied couples later in life. The implications of these typologies are discussed as they pertain to practitioners' efforts to tailor their approaches to a wider swath of the population. © 2015 Family Process Institute.

Statement about UK referendum on the EU

CERN Multimedia

2016-01-01

Dear Colleagues, Many people have expressed their concerns about the consequences of the 23 June vote in the UK for CERN, and for the UK’s relationship with CERN. CERN is an intergovernmental organisation subject to its own treaty. We are not part of the European Union, and several of our Member States, including Switzerland, in which we are headquartered, are not EU Members. Britain’s membership of CERN is not affected by the UK electorate’s vote to leave the European Union. We look forward to continuing the very constructive relationship we have shared with the UK, one of our founding members, long into the future. CERN was founded on the principle of international collaboration, and our success over the years is built on that. We will continue to work proactively to encourage ever-greater international collaboration in particle physics, and to help ensure that the UK continues to play a very active role. UK nationals remain eligible for all categories of employment at CERN, a...

UK nuclear terrorism insurance arrangements: an overview

International Nuclear Information System (INIS)

Tetley, M. G.

2004-01-01

The risk of terrorism in the UK is not new, but since the New York World Trade Centre attacks in 2001, the potential scale of any terrorist attack has required a considerable reassessment. With UK foreign policy closely aligned to that of the USA, the UK security services now consider it is simply a matter of when and no longer if the UK is attacked. For insurers of any type this fact would cause concern; for insurers involved in high profile and potentially catastrophic loss targets such as nuclear power plants, any attack could have a severe impact on solvency and shareholder's funds. This paper's objective is to describe the terrorism insurance arrangements put in place in the U.K. both before and after the September 2001 attacks. These arrangements have been designed both to safeguard insurers' solvency and to ensure that the nuclear industry and general public can continue to be reassured by the availability of insurance should an attack ever occur.(author)

Towards a Framework for Generating Tests to Satisfy Complex Code Coverage in Java Pathfinder

Science.gov (United States)

Staats, Matt

2009-01-01

We present work on a prototype tool based on the JavaPathfinder (JPF) model checker for automatically generating tests satisfying the MC/DC code coverage criterion. Using the Eclipse IDE, developers and testers can quickly instrument Java source code with JPF annotations covering all MC/DC coverage obligations, and JPF can then be used to automatically generate tests that satisfy these obligations. The prototype extension to JPF enables various tasks useful in automatic test generation to be performed, such as test suite reduction and execution of generated tests.

The future of the UK gas network

International Nuclear Information System (INIS)

Dodds, Paul E.; McDowall, Will

2013-01-01

The UK has an extensive natural gas pipeline network supplying 84% of homes. Previous studies of decarbonisation pathways using the UK MARKAL energy system model have concluded that the low-pressure gas networks should be mostly abandoned by 2050, yet most of the iron pipes near buildings are currently being replaced early for safety reasons. Our study suggests that this programme will not lock-in the use of gas in the long-term. We examine potential future uses of the gas network in the UK energy system using an improved version of UK MARKAL that introduces a number of decarbonisation options for the gas network including bio-methane, hydrogen injection to the natural gas and conversion of the network to deliver hydrogen. We conclude that hydrogen conversion is the only gas decarbonisation option that might enable the gas networks to continue supplying energy to most buildings in the long-term, from a cost-optimal perspective. There is an opportunity for the government to adopt a long-term strategy for the gas distribution networks that either curtails the iron mains replacement programme or alters it to prepare the network for hydrogen conversion; both options could substantially reduce the long-term cost of supplying heat to UK buildings. - Highlights: • We examine the long-term future of the UK gas pipe networks using the UK MARKAL model. • The iron mains replacement programme will not lead to gas infrastructure lock-in. • Bio-methane and hydrogen injection have only a small role in our future scenarios. • The most cost-optimal strategy might be to convert the networks to deliver hydrogen. • Adopting a long-term gas strategy could reduce the cost of providing heat in the UK

Clinical Applications of 3D Printing: Primer for Radiologists.

Science.gov (United States)

Ballard, David H; Trace, Anthony Paul; Ali, Sayed; Hodgdon, Taryn; Zygmont, Matthew E; DeBenedectis, Carolynn M; Smith, Stacy E; Richardson, Michael L; Patel, Midhir J; Decker, Summer J; Lenchik, Leon

2018-01-01

Three-dimensional (3D) printing refers to a number of manufacturing technologies that create physical models from digital information. Radiology is poised to advance the application of 3D printing in health care because our specialty has an established history of acquiring and managing the digital information needed to create such models. The 3D Printing Task Force of the Radiology Research Alliance presents a review of the clinical applications of this burgeoning technology, with a focus on the opportunities for radiology. Topics include uses for treatment planning, medical education, and procedural simulation, as well as patient education. Challenges for creating custom implantable devices including financial and regulatory processes for clinical application are reviewed. Precedent procedures that may translate to this new technology are discussed. The task force identifies research opportunities needed to document the value of 3D printing as it relates to patient care. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

[Which foot deformities should be radiologist be familiar with?

Science.gov (United States)

von Stillfried, E

2018-05-01

Most deformities of the foot are visible at birth and can be diagnosed without imaging. They can be divided into congenital flexible, congenital structural and acquired foot deformities. The most common congenital flexible foot deformity in children is the metatarsus adductus, which usually requires no long-term therapy. Regarding congenital structural deformities, such as the clubfoot and talus verticalis, plaster therapy should be started during the first week of life, so that by the end of the first year of life and the beginning of the verticalization, a pain-free resilient foot with normal function is present. Imaging is usually only necessary if a relapse arises. Coalitio of the tarsal bones is often visible only in the course of growth through the development of a rigid flatfoot and always requires imaging to confirm the diagnosis. This article is intended to give the radiologist an overview of the most important deformities and to inform about their course and therapy.

Computed tomography for preoperative planning in total hip arthroplasty: what radiologists need to know

Energy Technology Data Exchange (ETDEWEB)

Huppertz, Alexander [Charite - University Hospitals Berlin, Department of Radiology, Berlin (Germany); Imaging Science Institute Charite, Berlin (Germany); Radmer, Sebastian [Proendo, Orthopedic Surgery, Berlin (Germany); Wagner, Moritz; Hamm, Bernd [Charite - University Hospitals Berlin, Department of Radiology, Berlin (Germany); Roessler, Torsten [Klinikum Ernst von Bergmann, Department of Trauma and Orthopedic Surgery, Potsdam (Germany); Sparmann, Martin [Proendo, Orthopedic Surgery, Berlin (Germany); Charite - University Hospital, Berlin (Germany)

2014-08-15

The number of total hip arthroplasties is continuously rising. Although less invasive surgical techniques, sophisticated component design, and intraoperative navigation techniques have been introduced, the rate of peri- and postoperative complications, including dislocations, fractures, nerve palsies, and infections, is still a major clinical problem. Better patient outcome, faster recovery and rehabilitation, and shorter operation times therefore remain to be accomplished. A promising strategy is to use minimally invasive techniques in conjunction with modular implants, aimed at independently reconstructing femoral offset and leg length on the basis of highly accurate preoperative planning. Plain radiographs have clear limitations for the correct estimation of hip joint geometry and bone quality. Three-dimensional assessment based on computed tomography (CT) allows optimizing the choice and positions of implants and anticipating difficulties to be encountered during surgery. Postoperative CT is used to monitor operative translation and plays a role in arthroplastic quality management. Radiologists should be familiar with the needs of orthopedic surgeons in terms of CT acquisition, post-processing, and data transfer. The CT protocol should be optimized to enhance image quality and reduce radiation exposure. When dedicated orthopedic CT protocols and state-of-the-art scanner hardware are used, radiation exposure can be decreased to a level just marginally higher than that of conventional preoperative radiography. Surgeons and radiologists should use similar terminology to avoid misunderstanding and inaccuracies in the transfer of preoperative planning. (orig.)

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

Science.gov (United States)

Fridell, Kent; Ekberg, Jessica

2016-06-01

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

Evaluation of the efficacy of the guideline on reading CT images of malignant pleural mesothelioma with reference CT films for improving the proficiency of radiologists

Energy Technology Data Exchange (ETDEWEB)

Zhou, Huashi, E-mail: zhouhua@u-fukui.ac.jp [Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture, 910-1193 (Japan); Tamura, Taro, E-mail: tarou@u-fukui.ac.jp [Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture, 910-1193 (Japan); Kusaka, Yukinori, E-mail: kusakayk@gmail.com [Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture, 910-1193 (Japan); Suganuma, Narufumi, E-mail: nsuganuma@kochi-u.ac.jp [Department of Environmental Medicine, Kochi University School of Medicine (Japan); Subhannachart, Ponglada, E-mail: pongladas@gmail.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi, 11000 (Thailand); Vijitsanguan, Chomphunut, E-mail: Chompoo_vj@yahoo.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi, 11000 (Thailand); Noisiri, Weeraya, E-mail: weeraya_tat@yahoo.com [Central Chest Disease Institute of Thailand, 39 Moo 9, Tiwanon Road, Muang Nonthaburi, 11000 (Thailand); Hering, Kurt G., E-mail: k.g.hering@t-online.de [Department of Diagnostic Radiology, Radiooncology and Nuclear Medicine, Radiological Clinic, Miner' s Hospital, Radiologische Klinik, Lansppaschaftskranhaus Dortmund, Wieckesweg 27, 44309, Dortmund (Germany); Akira, Masanori, E-mail: akira@kch.hosp.go.jp [Department of Radiology, National Hospital Organization Kinki-Chuo Chest Medical Center, 1180 Nagasone-cho, Kita-ku, Sakai, Osaka, 591-8555 (Japan); Itoh, Harumi, E-mail: hitoh@fmsrsa.fukui-med.ac.jp [Department of Environmental Health, School of Medicine University of Fukui, 23-3 Shimoaitsuki, Matsuoka, Eihezi-cho, Fukui Prefecture, 910-1193 (Japan); Department of Radiology, School of Medicine, University of Fukui, 23-3 Shimoaitsuki Matsuoka, Eiheizi-cho, Fukui Prefecture, 910-1193 (Japan); and others

2013-01-15

Purpose: To assess the efficacy of the developed guideline on reading CT images of malignant pleural mesothelioma for improving radiologists’ reading proficiency. Materials and Methods: Three radiologists independently read the CT films of 22 cases including definite mesothelioma and non-mesothelioma cases at two times before and after studying the malignant pleural mesothelioma CT Guideline. The sensitivity and specificity for mesothelioma were calculated and compared between the 1st and 2nd trials. The kappa statistics was examined for agreement with experts for mesothelioma probability and for mesothelioma features recorded by three radiologists. Results: After studying the mesothelioma CT Guideline, the sensitivity for mesothelioma shown by the three radiologists at the 2nd trial was 100%, 100% and 80%, which were higher than 80%, 85% and 60% at the 1st trial, respectively. The average kappa for agreement between radiologists and experts on dichotomized mesothelioma probability were 0.69 (good) at the 2nd trial vs. 0.38 (fair) at the 1st trial. The average kappa for the agreement with experts for each of 7 features by three radiologists were 0.52–0.80 at the 2nd trial, which were significantly higher than 0.34–0.58 at the 1st trial (Wilcoxon Signed Rank Test: P < 0.01), and as to five features “unilateral pleural effusion”, “nodular pleural thickening”, “tumoral encasement of lung”, “mediastinal pleural thickening”, and “diminished lung”, they achieved good agreement with average kappa of 0.61–0.80. Conclusion: The developed mesothelioma CT Guideline was suggested to have substantial effect in improving the radiologists’ proficiency for reading CT images of mesothelioma, and may contribute to accurate diagnosis of mesothelioma.

Evaluation of the efficacy of the guideline on reading CT images of malignant pleural mesothelioma with reference CT films for improving the proficiency of radiologists

International Nuclear Information System (INIS)

Zhou, Huashi; Tamura, Taro; Kusaka, Yukinori; Suganuma, Narufumi; Subhannachart, Ponglada; Vijitsanguan, Chomphunut; Noisiri, Weeraya; Hering, Kurt G.; Akira, Masanori; Itoh, Harumi

2013-01-01

Purpose: To assess the efficacy of the developed guideline on reading CT images of malignant pleural mesothelioma for improving radiologists’ reading proficiency. Materials and Methods: Three radiologists independently read the CT films of 22 cases including definite mesothelioma and non-mesothelioma cases at two times before and after studying the malignant pleural mesothelioma CT Guideline. The sensitivity and specificity for mesothelioma were calculated and compared between the 1st and 2nd trials. The kappa statistics was examined for agreement with experts for mesothelioma probability and for mesothelioma features recorded by three radiologists. Results: After studying the mesothelioma CT Guideline, the sensitivity for mesothelioma shown by the three radiologists at the 2nd trial was 100%, 100% and 80%, which were higher than 80%, 85% and 60% at the 1st trial, respectively. The average kappa for agreement between radiologists and experts on dichotomized mesothelioma probability were 0.69 (good) at the 2nd trial vs. 0.38 (fair) at the 1st trial. The average kappa for the agreement with experts for each of 7 features by three radiologists were 0.52–0.80 at the 2nd trial, which were significantly higher than 0.34–0.58 at the 1st trial (Wilcoxon Signed Rank Test: P < 0.01), and as to five features “unilateral pleural effusion”, “nodular pleural thickening”, “tumoral encasement of lung”, “mediastinal pleural thickening”, and “diminished lung”, they achieved good agreement with average kappa of 0.61–0.80. Conclusion: The developed mesothelioma CT Guideline was suggested to have substantial effect in improving the radiologists’ proficiency for reading CT images of mesothelioma, and may contribute to accurate diagnosis of mesothelioma

Changes in Breast Density Reporting Patterns of Radiologists After Publication of the 5th Edition BI-RADS Guidelines: A Single Institution Experience.

Science.gov (United States)

Irshad, Abid; Leddy, Rebecca; Lewis, Madelene; Cluver, Abbie; Ackerman, Susan; Pavic, Dag; Collins, Heather

2017-10-01

The objective of our study was to determine the impact of 5th edition BI-RADS breast density assessment guidelines on density reporting patterns in our clinical practice. PenRad reporting system was used to collect mammographic breast density data reported by five radiologists: 16,907 density assignments using 5th edition BI-RADS guidelines were compared with 19,066 density assessments using 4th edition guidelines. Changes in the density assessment pattern were noted between the 4th and 5th edition guidelines, and agreement in density distribution was compared using the intraclass correlation coefficient. A chi-square analysis was conducted for each reader to examine the change in the proportion of dense versus nondense assignments and on each category type to examine specific changes in proportion of density assignments from the 4th to the 5th edition. All reported p values are two-sided, and statistical significance was considered at the p densities (p < 0.001), 2.6% increase in heterogeneously dense (p < 0.001), and 0.4% decrease in extremely dense assessments (p = 0.15). Comparing the dense with nondense categories, there was a 2.3% overall increase in the dense assessments (p < 0.001) using 5th edition guidelines, mainly in the heterogeneously dense category. Two radiologists showed increased dense assessments (p < 0.001) using the 5th edition, and three radiologists showed no change (p = 0.39, 0.67, and 0.76). There was an overall increase in the dense assessments using the 5th edition, but individual radiologists in our clinical practice showed a variable adaptation to new guidelines.

Tumor Size Evaluation according to the T Component of the Seventh Edition of the International Association for the Study of Lung Cancer's TNM Classification: Interobserver Agreement between Radiologists and Computer-Aided Diagnosis System in Patients with Lung Cancer

International Nuclear Information System (INIS)

Kim, Jin Kyoung; Chong, Se Min; Seo, Jae Seung; Lee, Sun Jin; Han, Heon

2011-01-01

To assess the interobserver agreement for tumor size evaluation between radiologists and the computer-aided diagnosis (CAD) system based on the 7th edition of the TNM classification by the International Association for the Study of Lung Cancer in patients with lung cancer. We evaluated 20 patients who underwent a lobectomy or pneumonectomy for primary lung cancer. The maximum diameter of each primary tumor was measured by two radiologists and a CAD system on CT, and was staged based on the 7th edition of the TNM classification. The CT size and T-staging of the primary tumors was compared with the pathologic size and staging and the variability in the sizes and T stages of primary tumors was statistically analyzed between each radiologist's measurement or CAD estimation and the pathologic results. There was no statistically significant interobserver difference for the CT size among the two radiologists, between pathologic and CT size estimated by the radiologists, and between pathologic and CT staging by the radiologists and CAD system. However, there was a statistically significant interobserver difference between pathologic size and the CT size estimated by the CAD system (p = 0.003). No significant differences were found in the measurement of tumor size among radiologists or in the assessment of T-staging by radiologists and the CAD system.

Use of OsiriX in developing a digital radiology teaching library.

Science.gov (United States)

Shamshuddin, S; Matthews, H R

2014-10-01

Widespread adoption of digital imaging in clinical practice and for the image-based examinations of the Royal College of Radiologists has created a desire to provide a digital radiology teaching library in many hospital departments around the UK. This article describes our experience of using OsiriX software in developing digital radiology teaching libraries. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Computer modelling of the UK wind energy resource: UK wind speed data package and user manual

Energy Technology Data Exchange (ETDEWEB)

Burch, S F; Ravenscroft, F

1993-12-31

A software package has been developed for IBM-PC or true compatibles. It is designed to provide easy access to the results of a programme of work to estimate the UK wind energy resource. Mean wind speed maps and quantitative resource estimates were obtained using the NOABL mesoscale (1 km resolution) numerical model for the prediction of wind flow over complex terrain. NOABL was used in conjunction with digitised terrain data and wind data from surface meteorological stations for a ten year period (1975-1984) to provide digital UK maps of mean wind speed at 10m, 25m and 45m above ground level. Also included in the derivation of these maps was the use of the Engineering Science Data Unit (ESDU) method to model the effect on wind speed of the abrupt change in surface roughness that occurs at the coast. With the wind speed software package, the user is able to obtain a display of the modelled wind speed at 10m, 25m and 45m above ground level for any location in the UK. The required co-ordinates are simply supplied by the user, and the package displays the selected wind speed. This user manual summarises the methodology used in the generation of these UK maps and shows computer generated plots of the 25m wind speeds in 200 x 200 km regions covering the whole UK. The uncertainties inherent in the derivation of these maps are also described, and notes given on their practical usage. The present study indicated that 23% of the UK land area had speeds over 6 m/s, with many hill sites having 10m speeds over 10 m/s. It is concluded that these `first order` resource estimates represent a substantial improvement over the presently available `zero order` estimates. (18 figures, 3 tables, 6 references). (author)

The Interobserver Agreement between Residents and Experienced Radiologists for Detecting Pulmonary Embolism and DVT with Using CT Pulmonary Angiography and Indirect CT Venography

International Nuclear Information System (INIS)

Yavas, Ulas Savas; Calisir, Cuneyt; Ozkan; Ibrahim Ragip

2008-01-01

We wanted to prospectively evaluate the interobserver agreement between radiology residents and expert radiologists for interpreting CT images for making the diagnosis of pulmonary embolism (PE). We assessed 112 consecutive patients, from April 2007 to August 2007, who were referred for combined CT pulmonary angiography and indirect CT venography for clinically suspected acute PE. CT scanning was performed with a 64x0.5 collimation multi-detector CT scanner. The CT studies were initially interpreted by the radiology residents alone and then the CT images were subsequently interpreted by a consensus of the resident plus an experienced general radiologist and an experienced chest radiologist. Two of the 112 CTs were unable to be interpreted (1.7%). Pulmonary artery clots were seen on 36 of the thoracic CT angiographies (32%). The interobserver agreement between the radiology residents and the consensus interpretation was good (a kappa index of 0.73). All of the disagreements (15 cases) were instances of overcall by the resident on the initial interpretation. Deep venous thrombosis was detected in 72% (26 of 36) of the patients who had PE seen on thoracic CT. The initial and consensus interpretations of the CT venography images disagreed for two cases (kappa statistic: 0.96). It does not seem adequate to base the final long-term treatment of PE on only the resident's reading, as false positives occurred in 13% of such cases. Timely interpretation of the CT pulmonary angiography and CT venography images should be performed by experienced radiologists for the patients with suspected PE

Understanding the internet, website design and intranet development: a primer for radiologists

Energy Technology Data Exchange (ETDEWEB)

Perriss, R.W. [Department of Radiology, John Radcliffe Hospital, Headington, Oxford (United Kingdom); Graham, R.N.J. [Department of Radiology, John Radcliffe Hospital, Headington, Oxford (United Kingdom); Scarsbrook, A.F. [Department of Radiology, John Radcliffe Hospital, Headington, Oxford (United Kingdom)]. E-mail: andyscarsbrook1@aol.com

2006-05-15

The internet has become an essential part of daily life for almost all radiologists and yet few fully understand how this works or how best to harness the technology within the workplace. This article will explore the basics of computer networking which has allowed the internet to become a valuable resource. In addition, the process of designing and implementing a website or intranet site for the benefit of radiology departmental administration and education will be discussed. The options of how to develop a website, what to include, and how to achieve this using easy to use, freely available and low-cost software will also be explored.

Understanding the internet, website design and intranet development: a primer for radiologists

International Nuclear Information System (INIS)

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

2006-01-01

The internet has become an essential part of daily life for almost all radiologists and yet few fully understand how this works or how best to harness the technology within the workplace. This article will explore the basics of computer networking which has allowed the internet to become a valuable resource. In addition, the process of designing and implementing a website or intranet site for the benefit of radiology departmental administration and education will be discussed. The options of how to develop a website, what to include, and how to achieve this using easy to use, freely available and low-cost software will also be explored

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

Energy Technology Data Exchange (ETDEWEB)

Taslakian, Bedros, E-mail: btaslakian@gmail.com [NYU Langone Medical Center, Department of Radiology (United States); Sebaaly, Mikhael Georges, E-mail: ms246@aub.edu.lb; Al-Kutoubi, Aghiad, E-mail: mk00@aub.edu.lb [American University of Beirut Medical Center, Department of Diagnostic Radiology (Lebanon)

2016-03-15

Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care 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.

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

International Nuclear Information System (INIS)

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

2016-01-01

Performing an interventional procedure imposes a commitment on interventional radiologists to conduct the initial patient assessment, determine the best course of therapy, and provide long-term care 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

RCR audit of compliance with UK guidelines for the prevention and detection of acute kidney injury in adult patients undergoing iodinated contrast media injections for CT.

Science.gov (United States)

Cope, L H; Drinkwater, K J; Howlett, D C

2017-12-01

To determine radiology departmental compliance with current UK guidance on contrast-induced acute kidney injury (CI-AKI) and to provide data on the incidence of clinically significant post-contrast AKI (PC-AKI) in computed tomography (CT) practice. A questionnaire was sent to all UK acute National Health Service (NHS) providers (NHS boards in Scotland, local health boards in Wales, NHS trusts in England and health and social care trusts in Northern Ireland) to assess compliance of provider protocols with current UK guidelines for the prevention, recognition, and management of CI-AKI. Audit data were collected for 40 consecutive fit outpatients and 40 consecutive acutely unwell patients/inpatients from hospitals within each participating provider to assess clinical compliance. Eighty-nine of 172 (52%) health service providers responded, and data on 7,159 contrast-enhanced CT examinations were provided. Compliance with guidelines was poor with wide variation in clinical practice. The observed incidence of clinically significant (requiring treatment or resulting in death) PC-AKI was zero in 3,590 outpatients, although two patients developed AKI due to other causes (sepsis and progressive malignancy). Fourteen out of 3,569 (0.4%) patients in the inpatient group developed clinically significant PC-AKI, and a further 17 patients were identified who met the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI (Electronic Supplementary Material Appendix S1), but did not require active treatment, giving an overall incidence of AKI of 0.9%. In patients at high risk due to impaired renal function prior to the scan, there was no difference in the median serum creatinine (SCr) before and after contrast medium administration in either group. Health service provider protocols and clinical practice demonstrate poor compliance with current UK guidance on CI-AKI. A very low incidence of PC- AKI was demonstrated. Copyright © 2017 The Royal College of Radiologists

Radiologists' Performance for Detecting Lesions and the Interobserver Variability of Automated Whole Breast Ultrasound

International Nuclear Information System (INIS)

Kim, Sung Hun; Kang, Bong Joo; Choi, Byung Gil; Choi, Jae Jung; Lee, Ji Hye; Song, Byung Joo; Choe, Byung Joo; Park, Sarah; Kim, Hyunbin

2013-01-01

To compare the detection performance of the automated whole breast ultrasound (AWUS) with that of the hand-held breast ultrasound (HHUS) and to evaluate the interobserver variability in the interpretation of the AWUS. AWUS was performed in 38 breast cancer patients. A total of 66 lesions were included: 38 breast cancers, 12 additional malignancies and 16 benign lesions. Three breast radiologists independently reviewed the AWUS data and analyzed the breast lesions according to the BI-RADS classification. The detection rate of malignancies was 98.0% for HHUS and 90.0%, 88.0% and 96.0% for the three readers of the AWUS. The sensitivity and the specificity were 98.0% and 62.5% in HHUS, 90.0% and 87.5% for reader 1, 88.0% and 81.3% for reader 2, and 96.0% and 93.8% for reader 3, in AWUS. There was no significant difference in the radiologists' detection performance, sensitivity and specificity (p > 0.05) between the two modalities. The interobserver agreement was fair to good for the ultrasonographic features, categorization, size, and the location of breast masses. AWUS is thought to be useful for detecting breast lesions. In comparison with HHUS, AWUS shows no significant difference in the detection rate, sensitivity and the specificity, with high degrees of interobserver agreement

Radiologists need to be aware of secondary central venous stenosis in patients with SAPHO syndrome

Energy Technology Data Exchange (ETDEWEB)

Suzuki, Mizuho; Kanazawa, Hidenori; Shinozaki, Takeshi; Sugimoto, Hideharu [Jichi Medical University, Department of Radiology, Shimotsuke, Tochigi (Japan)

2017-11-15

We aimed to define central venous stenosis (CVS) caused by sternocostoclavicular hyperostosis as a feature of synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome on routine contrast-enhanced computed tomography (CT) images. The relationship between SAPHO syndrome and CVS without venous thrombosis caused by anterior chest wall compression has not been investigated. Therefore, the present study evaluated CVS in patients with SAPHO syndrome at our hospital. We retrospectively reviewed contrast-enhanced CT images of ten patients with suspected or diagnosed SAPHO syndrome between January 2007 and November 2015. The patients were assessed by contrast-enhanced CT using 16-, 64- or 128-detector row scanners. Two radiologists independently assessed the presence of CVS or obstruction and SAPHO syndrome in a retrospective review of CT images. Six of the ten patients had findings of CVS with SAPHO syndrome. The mean diameter and patency rate at the site of CVS were 1.88 mm and 27.2%, respectively. Stenosis was more significant in terms of the mean diameter of CVS sites than of stenotic sites that crossed the anteroposterior vein (p < 0.05). Radiologists who routinely assess contrast-enhanced CT images should be aware that sternocostoclavicular hyperostosis with SAPHO syndrome could cause secondary CVS. (orig.)

Radiologists' Performance for Detecting Lesions and the Interobserver Variability of Automated Whole Breast Ultrasound

Energy Technology Data Exchange (ETDEWEB)

Kim, Sung Hun; Kang, Bong Joo; Choi, Byung Gil; Choi, Jae Jung; Lee, Ji Hye [Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Song, Byung Joo; Choe, Byung Joo [Department of General Surgery, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Park, Sarah [Department of Internal Medicine, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701 (Korea, Republic of); Kim, Hyunbin [CMC Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, Seoul 137-701 (Korea, Republic of)

2013-07-01

To compare the detection performance of the automated whole breast ultrasound (AWUS) with that of the hand-held breast ultrasound (HHUS) and to evaluate the interobserver variability in the interpretation of the AWUS. AWUS was performed in 38 breast cancer patients. A total of 66 lesions were included: 38 breast cancers, 12 additional malignancies and 16 benign lesions. Three breast radiologists independently reviewed the AWUS data and analyzed the breast lesions according to the BI-RADS classification. The detection rate of malignancies was 98.0% for HHUS and 90.0%, 88.0% and 96.0% for the three readers of the AWUS. The sensitivity and the specificity were 98.0% and 62.5% in HHUS, 90.0% and 87.5% for reader 1, 88.0% and 81.3% for reader 2, and 96.0% and 93.8% for reader 3, in AWUS. There was no significant difference in the radiologists' detection performance, sensitivity and specificity (p > 0.05) between the two modalities. The interobserver agreement was fair to good for the ultrasonographic features, categorization, size, and the location of breast masses. AWUS is thought to be useful for detecting breast lesions. In comparison with HHUS, AWUS shows no significant difference in the detection rate, sensitivity and the specificity, with high degrees of interobserver agreement.

Evaluation of non-radiologist physicians' knowledge on aspects related to ionizing radiation in imaging

Energy Technology Data Exchange (ETDEWEB)

Madrigano, Renata Rodrigues [Hospital Santa Helena, Santo Andre, SP (Brazil); Abrao, Karen Cristine; Regacini, Rodrigo, E-mail: regacini@gmail.com [Universidade Anhembi Morumbi, Sao Paulo, SP (Brazil). Escola de Medicina; Puchnick, Andrea [Universidade Federal de Sao Paulo (EPM/UNIFESP), Sao Paulo, SP (Brazil). Escola Paulista de Medicina

2014-07-15

Objective: to assess the non-radiologist physicians' knowledge on the use of ionizing radiation in imaging. Materials and Methods: cross-sectional study utilizing an anonymous questionnaire responded by physicians in clinical and surgical specialties, divided into two parts as follows: one including questions about the physicians' characteristics, frequency of imaging studies requests and participation in professional updating events, and another part including multiple choice questions approaching general knowledge about radiation, optimization principles and radioprotection. Results: from a total of 309 questionnaires, 120 (38.8%) were responded, 50% by physicians in surgical specialties and 50% in clinical specialties; respectively 45% and 2.5% of physicians responded that magnetic resonance imaging and ultrasonography use ionizing radiation. Overall, the average grade was higher for surgical specialists with no significant difference, except for the question about exposure in pregnant women (p = 0.047). Physicians who are professionally updated, particularly those attending clinical meetings (p = 0.050) and participating in teaching activities (p = 0.047), showed statistically superior knowledge about ionizing radiation as compared with others. Conclusion: the non-radiologist physicians' is heterogeneous and in some points needs to be improved. Multidisciplinary clinical meetings and teaching activities are important ways to disseminate information on the subject. (author)

Measuring and managing radiologist productivity, part 2: beyond the clinical numbers.

Science.gov (United States)

Duszak, Richard; Muroff, Lawrence R

2010-07-01

Radiology practices endeavoring to measure physician productivity, identify and motivate performance outliers, and develop equitable management strategies and policies often encounter numerous challenges. Nonetheless, such efforts are often necessary, in both private and academic settings, for a variety of professional, financial, and personnel reasons. Part 1 of this series detailed metrics for evaluating radiologist productivity and reviewed published benchmarks, focusing on clinical work. This segment expands that discussion to evaluating nonclinical administrative and academic efforts, along with professionalism and quality, outlining advantages and disadvantages of addressing differential productivity, and introducing potential models for practices seeking to motivate physicians on the basis of both their clinical and nonclinical endeavors. Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Research reactor fuel transport in the U.K

Energy Technology Data Exchange (ETDEWEB)

Panter, R [U.K. Atomic Energy Authority, Harwell (United Kingdom)

1983-09-01

This paper describes the containers currently used for transport of fresh or spent fuel elements for Research and Materials Test Reactors in the U.K., their status, operating procedures and some of the practical difficulties. In the U.K., MTR fuel cycle work is almost entirely the responsibility of the U.K. Atomic Energy Authority.

Nuclear prospects in the UK

International Nuclear Information System (INIS)

Hawley, Robert

1993-01-01

During the late 1980s and early 1990s the UK government decided to privatise the UK electricity supply industry. In order to introduce competition into the generation side of the business it was decided that the large generating boards - the Central Electricity Generating Board (CEGB) and in Scotland, the South of Scotland Electricity Board and North of Scotland Hydro Board, - should be split up into smaller companies. In England and Wales two companies were proposed. The larger company National Power would include the nuclear generating business in England and Wales, the smaller company, Power Gen would use fossil generation only. Scotland was also to have two companies, Scottish Power - including Scotland's nuclear stations - and Scottish Hydro. But these were troubled times for the UK nuclear industry. A lot of misinformation was being issued by its opponents, in particular about decommissioning and fuel reprocessing costs. Looking back I can see there were reasons for that. Both National Power and Scottish Power wanted to be absolutely certain that they got the best possible deal and that every imaginable, and unimaginable, cost that may ever arise would be taken care of. This attitude resulted in the estimate of huge liabilities and 'unprecedented guarantees' that the then Secretary of State for Energy in the UK, could not accept

UK creates new funding super-body

Science.gov (United States)

2017-06-01

The UK government has passed its higher-education and research bill, which includes the creation of UK Research and Innovation (UKRI) - a new umbrella organization that will oversee the country’s seven research councils such as the Science and Technology Facilities Council and the Engineering and Physical Sciences Research Council.

UK nuclear installations

International Nuclear Information System (INIS)

Gronow, W.S.

Regulations and conditions for the commissioning of nuclear power plants in the UK, their siting, licence conditions, design safety assessment, inspection during construction and conditions for safety in operation are listed. (J.P.)

UK Chemical Nuclear Data Committee request list - 1990

International Nuclear Information System (INIS)

Nichols, A.L.

1990-03-01

The 1986 UK request list for chemical nuclear data has been reviewed in detail by members of the UK Chemical Nuclear Data Committee. New requirements for data measurements and evaluations have been identified, and specific requests have been withdrawn. A new UK request list has evolved, and is given in the form of tabulations covering measurements and evaluations. (author)

Strategy for energy policy in the UK

International Nuclear Information System (INIS)

Stone, T.

2012-01-01

UK Energy Policy is leading the world in showing how governments can effectively respond to the now widely accepted challenges of security of supply, low-carbon generation and pragmatic implementation. Confidence in the UK as place to invest in new nuclear is very high-there are already 3 developers who have between them already invested over 1 billion, 5 sites are planned to be developed and between 10 and 12 new reactors are planned to be built. To be clear, this is by far the largest commitment to new nuclear in the Western World and swamps in other countries. This achievement is a combination of vision, continuity, political consensus and a group of ministers and officials who are clear in the goals for the long-term sustain ability of an energy policy that will dramatically affect the lives of many generations to come. Recognising the multi-generational obligations and consequences of government policy's key to ensuring that this investment continues, together with the maintenance of the trust that investors have developed in the management of energy policy by the UK government. There is no doubt in the commitment of the UK government to delivering the safe, secure and low-carbon energy future of the UK. The opportunities for businesses and high-quality job creation are undoubted-all that now has to happen is for developers, reactor vendors, construction companies and communities to show how they can together deliver the cheapest form of low-carbon base load to time and to cost and to the benefit of local communities and the UK economy. the world is watching for the UK to show how it can be done. (Author)

The Evolution of Enterprise Imaging and the Role of the Radiologist in the New World.

Science.gov (United States)

Petersilge, Cheryl A

2017-10-01

The concept of enterprise imaging is part of the next frontier in the evolution of health care technology. Incorporating all medical images into a single location integrated with electronic medical records supports care coordination and the ideal of a comprehensive longitudinal medical record. Radiologists have tremendous value to offer in support of the new concept of enterprise imaging, which extends outside the radiology department to encompass all image producers in a health care enterprise.

The dictated report and the radiologist's ethos. An inextricable relationship: Pitfalls to avoid

International Nuclear Information System (INIS)

Baker, Stephen R.

2014-01-01

Radiologists’ reputation as expert image interpreters are in large measured defined by the content of their written reports. Habitually use of terms that reveal a lack of decisiveness will serve to diminish their esteem in the minds of their referrers. Recurrent resort expression to such as questionable, suspicious, cannot rule out, and clinical correlation requested when frequently deployed are examples of phrases that can have a negative effect on the radiologist's ethos

The right scan, for the right patient, at the right time: The reorganization of major trauma service provision in England and its implications for radiologists

International Nuclear Information System (INIS)

Harvey, J.J.; West, A.T.H.

2013-01-01

Major trauma services in England are currently undergoing a radical overhaul with the formation of regional trauma networks and designated major trauma centres (MTCs). Radiology is scheduled to play a key role within major trauma care both in terms of 24/7 access to whole body computed tomography (WBCT) and interventional radiology (IR) services, as well as providing immediate expert imaging guidance to the trauma team. This review examines the rationale behind trauma networks, as well as drawing attention to the new Royal College of Radiologists' standards for major trauma imaging. It attempts to address radiologists' understandable concerns about the inappropriate use of WBCT, radiation dose, and intravenous contrast medium risks. Reporting whole-body CT for trauma patients is difficult, covering multiple body regions, with great pressure to provide a rapid and accurate report to the trauma team. The benefits of standardized reports, dual-radiologist reporting, and the use of organ injury severity grading are explored to aid succinct communication of findings and further guide patient management

Update on Radioactive Waste Management in the UK

International Nuclear Information System (INIS)

Dalton, John; McCall, Ann

2003-01-01

This paper provides a brief background to the current position in the United Kingdom (UK) and provides an update on the various developments and initiatives within the field of radioactive waste management that have been taking place during 2002/03. These include: The UK Government's Department of Trade and Industry (DTi) review of UK energy policy; The UK Government's (Department of Environment, Food and Rural Affairs (Defra) and Devolved Administrations*) consultation program; The UK Government's DTi White Paper, 'Managing the Nuclear Legacy: A Strategy for Action'; Proposals for improved regulation of Intermediate Level Waste (ILW) conditioning and packaging. These various initiatives relate, in Nirex's opinion, to the three sectors of the industry and this paper will provide a comment on these initiatives in light of the lessons that Nirex has learnt from past events and suggest some conclusions for the future

Optimal decision procedures for satisfiability in fragments of alternating-time temporal logics

DEFF Research Database (Denmark)

Goranko, Valentin; Vester, Steen

2014-01-01

We consider several natural fragments of the alternating-time temporal logics ATL*and ATL with restrictions on the nesting between temporal operators and strate-gicquantifiers. We develop optimal decision procedures for satisfiability in these fragments, showing that they have much lower complexi...

NATO mission in Kosovo: historical backgrounds and informations of working as radiologist in the German field hospital

International Nuclear Information System (INIS)

Voelk, M.; Danz, B.

2005-01-01

The first part of this article describes how the NATO mission in Kosovo came into existence and focuses on the historical background and ethnical problems. The second part deals with the working conditions of a radiologist in the German field hospital in Prizren and focuses on the personnel and technical equipment in the radiological department. (orig.) [de

The adult cystic fibrosis patient with abdominal pain: what the radiologist needs to know

Energy Technology Data Exchange (ETDEWEB)

Liong, S.Y.; Awad, D. [Department of Radiology, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom); Jones, A.M. [Department of Respiratory Medicine, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom); Manchester Academic Health Science Centre, University of Manchester, Manchester (United Kingdom); Sukumar, S.A., E-mail: Sathi.Sukumar@uhsm.nhs.u [Department of Radiology, University Hospital of South Manchester, Wythenshawe Hospital, Manchester (United Kingdom)

2011-02-15

As the life expectancy of cystic fibrosis (CF) patients continues to increase, abdominal manifestations of CF are increasingly being encountered by clinicians and radiologists. Imaging plays an important role in the evaluation of adult CF patients with abdominal pain as a cause is often not discernable clinically. Accurate diagnosis is crucial in these patients as some causes may be managed conservatively, whilst others may require surgical intervention. In this review, we describe clinical presentation, imaging findings, and management of adult CF patients presenting with abdominal pain.

The future of learning disabilities nursing in the UK.

Science.gov (United States)

Clapham, Anthony

2014-07-02

This article appraises the report Strengthening the Commitment, which is a UK-wide review of learning disabilities nursing by the UK's four chief nursing officers. Strengthening the Commitment has strategic importance in reviewing progress in the care of people with learning disabilities in the UK. It also has a role in helping to guide future strategies and initiatives addressing the continuing health inequalities experienced by people with learning disabilities throughout the UK.

Constructing space difference schemes which satisfy a cell entropy inequality

Science.gov (United States)

Merriam, Marshal L.

1989-01-01

A numerical methodology for solving convection problems is presented, using finite difference schemes which satisfy the second law of thermodynamics on a cell-by-cell basis in addition to the usual conservation laws. It is shown that satisfaction of a cell entropy inequality is sufficient, in some cases, to guarantee nonlinear stability. Some details are given for several one-dimensional problems, including the quasi-one-dimensional Euler equations applied to flow in a nozzle.

Observers for Systems with Nonlinearities Satisfying an Incremental Quadratic Inequality

Science.gov (United States)

Acikmese, Ahmet Behcet; Corless, Martin

2004-01-01

We consider the problem of state estimation for nonlinear time-varying systems whose nonlinearities satisfy an incremental quadratic inequality. These observer results unifies earlier results in the literature; and extend it to some additional classes of nonlinearities. Observers are presented which guarantee that the state estimation error exponentially converges to zero. Observer design involves solving linear matrix inequalities for the observer gain matrices. Results are illustrated by application to a simple model of an underwater.

Mamma diagnostics for MTRA (medical-radiological personnel)/RT (radiologists); Mammadiagnostik fuer MTRA/RT

Energy Technology Data Exchange (ETDEWEB)

Fischer, Uwe; Baum, Friedemann

2014-07-01

The text book on mamma diagnostics for MTRA (medical-radiological personnel)/RT (radiologists) covers the following issues: Anatomy, development and physiology of mammary glands; tumor development an breast cancer risk; pathology, non-imaging diagnostics; mammography: physical-technical fundamentals; mammography: analogue technique; mammography: digital technique; mammography: quality assurance; mammography: legal questions and radiation protection; mammography: new developments; mammography: setting technique; mammography: use and appraisal; mamma-sonography: technique and methodology; mamma-sonography: assignment and appraisal, mamma-NMR: technique and methodology; mamma-NMR: assignment and appraisal lymph node diagnostics; mamma interventions; biopsy; mamma interventions: marking examination concepts; therapeutic concepts; hygienic concepts; communication and interaction.

Double income tax between UK and US, 1914-1945 – Impact on UK multinationals

OpenAIRE

Izawa, Ryo

2015-01-01

Tax rates on business income in many countries increased enormously during World War I and stayed at a much higher level than before the war. Particularly, the UK multinationals with subsidiaries based elsewhere other than the Empire suffered from the situation because the UK did not provide a foreign tax relief until 1945, when a tax treaty with US was signed. The aim of this paper is to clarify the historical premises of establishment of the tax treaty in 1945. The major premise of this pap...

Operational radiation protection in UK mining

International Nuclear Information System (INIS)

O'Riordan, M.C.

1977-01-01

The radiological conditions of the mining industry (coal-national, coal-private, non-coal) in the UK are described. From the point of view of radiological protection, non-coal miners have the highest occupational exposure of any group in the UK in relation to a recommended limit. From the point of view of general health and safety in non-coal mining, however, the situation does not look no serious. This is illustrated as follows. The US epidemiological study of uranium miners yields, on extrapolation, a risk estimate of some 0.3 deaths annually from lung cancer per 1000 miners exposed to 100 WLM. On the other hand, accident statistics for non-coal mines in the UK yield an estimate of two deaths annually per 1000 miners. Further perspective is given to the problem by the incidence of lung cancer among adult males within the UK, that is, 1.5 cases annually per 1000 persons. Narrow concern for the radiological safety of miners must therefore be tempered with broader concern for the other hazards they face

Indian Diaspora In The UK

Directory of Open Access Journals (Sweden)

L. V. Kulik

2017-01-01

Full Text Available The author traces the history of formation of the Indian diaspora in the UK, evaluates the key trends that characterize the current state of diaspora. The article highlights the level of involvement and participation of diaspora in the evolution of the bilateral relations, as well as the influence of diaspora over home and foreign policy in the UK and India. The diaspora today is not just a unique vibrant connection between the two countries, it has also become a factor of influence over domestic, social and economic affairs in both the UK and India. There is a growing number of Indians among British statesmen and politicians. Indians occupy significant posts in various sectors in Britain, including business and finance. This contributes to strengthening of economic ties between the two countries, particularly important considering Britain’s forthcoming exit from the EU. As to internal political matters, though potential issues exist (those include, for instance, the possible transfer from India into Britain of problematic inter-caste relations, India’s criticism over unbalanced approach to teaching colonial history in British schools, the Indian diaspora due to its’ inherent tolerance and moderation generally plays a stabilizing role in the UK, especially on the background of radicalization of other ethnic communities. For the new India the diaspora today is not just an important source of financing, competences and know-how, it is also a significant lobbying and soft-power instrument. This article is part of a broader research, related to the contemporary relations between the United Kingdom and India. Indian diaspora in the UK is an integral part of the unique centuries-long history that connects the two countries. It is poised to remain a strong factor contributing to interdependence and cooperation between Britain and India in the XXI century.

Characterisation: Challenges and Opportunities - A UK Perspective

International Nuclear Information System (INIS)

Emptage, Matthew; Loudon, David; Mcleod, Richard; Milburn, Helen

2016-01-01

Characterisation plays a very important role in the nuclear industry supporting: the development and implementation of decommissioning strategies/plans (and the optimisation of associated costs through reduction in technical risks); regulatory compliance demonstration; waste prevention/minimisation; evaluation and optimisation of worker radiation doses; and maintaining public confidence. Recognising these important drivers, the UK regulators are working with the UK Nuclear Decommissioning Authority (NDA) to undertake a review of characterisation practice in the UK nuclear (decommissioning) industry. The objective of the characterisation review is to understand the current characterisation challenges and to determine strategic and tactical opportunities (including sharing of standards and guidance, capabilities, learning from experience, good practice, research and development, training, quality assurance) to optimise characterisation practice. The work is being undertaken through review of nuclear operator's characterisation practice, with input from the NDA, the UK regulators, nuclear operators and representatives from the supply chain, and through consideration of good practice case studies. To support this, a catalogue of relevant national/international guidance documents is also be compiled. Finally a workshop with representatives from all parties has taken place to consider the findings and establish a common understanding of challenges and opportunities and to start to consider how they can be addressed. The review is establishing a collective (UK regulator's, NDA; nuclear operator's and supply chain) understanding of opportunities to improve characterisation practice in the UK. The characterisation review process is described and early results are presented and discussed. Subsequent work in 2016 will be required to prioritise the opportunities and to build a consensus to facilitate development and implementation of an improvement plan. The aim

The regulatory framework in the UK

International Nuclear Information System (INIS)

O'Sullivan, R.

1984-01-01

The subject is covered in sections, headed: basic regulatory requirements covering the transport of radioactive material in the UK; responsibility for safety (competent authority; provision of regulations; implementation of regulations (international and national); design of transport flask; safety case; testing; assessment; approval certificate; compliance assurance; administration); advice and information on the regulatory safety standards. (U.K.)

The risk of hydraulic fracturing on public health in the UK and the UK's fracking legislation.

Science.gov (United States)

Reap, Elisabeth

2015-01-01

Hydraulic fracturing to extract natural gas from shale rock is a new, rapidly expanding industry in the United States (US). However, there is concern that these operations could be having large negative impacts such as groundwater contamination, increased air pollution and seismic events. The United Kingdom (UK) is looking at the potential for emulating the success of 'shale gas' in the US. Differences in population density and geological conditions mean that the public health impacts recorded in the US cannot be directly extrapolated to the UK. There is limited academic literature available but findings suggest that the UK government is not fully recognising the inherent risks of hydraulic fracturing exposed by this literature. Government reports suggest a reliance on engineering solutions and better practice to overcome problems found in the US when evidence suggests that there are inherent risks and impacts that cannot be eliminated. This study applies US results to approximate the impact of one exposure pathway, inhalation of hydrocarbons by the public from operational air emissions over the 30 year lifetime of a well and finds that 7.2 extra cancer cases from exposure to air contamination would be expected in the UK if all test sites, approved test sites and test sites awaiting approval as of January 2015 went on to extract gas. In conclusion, limited assessment of the public health implications of hydraulic fracturing operations is available but the UK government appears to not be applying the precautionary principle to potentially significant legislation.

Gas prices in the UK: markets and insecurity supply

International Nuclear Information System (INIS)

Wright, P.

2006-01-01

In this article, Professor P. Wright argues that the high and volatile gas price experienced by UK consumers over the last 3 years are the result of the extend of liberalization in the UK - which has made UK prices much more sensitive to insecurities of supply. Businesses pay the cost of this, straightaway, while the strategies which gas companies have used to respond to heightened price risks means domestic consumers also bear the cost of higher supply-markups. The prospect of high levels of demand in bad winters then just adds to price risk and its associated costs. The implication of this analysis is that it is illogical for the UK's regulator and government to blame the UK's high prices on the slow progress of liberalization in the rest of Europe - greater liberalization in Europe might simply replicate the UK's price difficulties throughout Europe

The UK gas market in transition to competition

International Nuclear Information System (INIS)

Helm, D.

1997-01-01

Virtually every aspect of the UK gas market is currently experiencing rapid change and major uncertainties. The fast-track to full competition in 1998 requires a new customer-handling infrastructure, new rules and new marketing strategies.The introduction of competition in the UK is proving more complex than most of its architects assumed. The UK provides considerable evidence not only on market design but also the management of the transitional process. The path from a state-owned monopoly through privatisation to competition is overviewed, and some of the lessons are considered which other countries (and the European Commission) contemplating reforms may glean from the UK experience. (R.P.)

Observers for a class of systems with nonlinearities satisfying an incremental quadratic inequality

Science.gov (United States)

Acikmese, Ahmet Behcet; Martin, Corless

2004-01-01

We consider the problem of state estimation from nonlinear time-varying system whose nonlinearities satisfy an incremental quadratic inequality. Observers are presented which guarantee that the state estimation error exponentially converges to zero.

Development opportunities for the UK offshore wind industry

International Nuclear Information System (INIS)

1999-01-01

This report summarises the results of a study investigating the UK's ability to compete for the construction of offshore wind farms. The European offshore wind farm market is examined, and the UK offshore construction equipment and wind farm construction methods are analysed, and recommendations for a purpose build or modified construction vessel are presented. The appendix gives UK construction companies addresses and contact names

ERCP-the role of radiologist or what the endoscopist needs to know

International Nuclear Information System (INIS)

Manova, G.; Totev, M.

2012-01-01

Endoscopic retrograde cholangiopancreatography (ERCP) is an interdisciplinary endoscopic-radiologic method for diagnosis and treatment of the diseases of the biliary and pancreatic ducts. The procedure requires an excellent technical experience and high professional qualification of the medical team. The cannulation of the papilla of Vater and the contrast imaging of the hepatobiliary tree and the pancreatic duct need co-operation between the radiologist and endoscopist for interpretation of the findings - malignant or benign stenosis, choledocholithiasis, iatrogenic lesions. The undertaken endoscopic therapeutic procedures are performed under fluoroscopic guidance as well as the subsequent assessment of their effective - stone extraction, stent placement, etc. The good collaboration of the team during each stage of the procedure can guarantee its success. (authors)

The 28. Congress of the Scientific Society of US radiologists and oncologists

International Nuclear Information System (INIS)

Pereslegin, I.A.; Zolotkov, A.G.

1987-01-01

Some reports of the 28th Congress of the Scientific Society of US Radiologists and Oncologists are reviewed. Promising effect of hyperthermia and irradiation in case of superficial tumors (recurrences and metastases of mammary gland carcinoma in thoracic wall) and limited potentialities in case of internal tumors are pointed out. A matter of interest is a series of reports on ten-year controlled clinical investigations and radiotherapy in comparison with radical mastectomy at early stages of mammary gland carcinoma. The reports contain information on application of principally new methods of X-ray, combined, complex and medicinal treatment of tumor of many localizations. Some radiotherapeutic methods were renewed, in particular, method of high dose interoperational irradiation

Radiation Exposure of Interventional Radiologists During Computed Tomography Fluoroscopy-Guided Renal Cryoablation and Lung Radiofrequency Ablation: Direct Measurement in a Clinical Setting

Energy Technology Data Exchange (ETDEWEB)

Matsui, Yusuke, E-mail: wckyh140@yahoo.co.jp; Hiraki, Takao, E-mail: takaoh@tc4.so-net.ne.jp; Gobara, Hideo, E-mail: gobara@cc.okayama-u.ac.jp; Iguchi, Toshihiro, E-mail: i10476@yahoo.co.jp; Fujiwara, Hiroyasu, E-mail: hirofujiwar@gmail.com; Kawabata, Takahiro, E-mail: tkhr-kwbt@yahoo.co.jp [Okayama University Medical School, Department of Radiology (Japan); Yamauchi, Takatsugu, E-mail: me9248@hp.okayama-u.ac.jp; Yamaguchi, Takuya, E-mail: me8738@hp.okayama-u.ac.jp [Okayama University Hospital, Central Division of Radiology (Japan); Kanazawa, Susumu, E-mail: susumu@cc.okayama-u.ac.jp [Okayama University Medical School, Department of Radiology (Japan)

2016-06-15

IntroductionComputed tomography (CT) fluoroscopy-guided renal cryoablation and lung radiofrequency ablation (RFA) have received increasing attention as promising cancer therapies. Although radiation exposure of interventional radiologists during these procedures is an important concern, data on operator exposure are lacking.Materials and MethodsRadiation dose to interventional radiologists during CT fluoroscopy-guided renal cryoablation (n = 20) and lung RFA (n = 20) was measured prospectively in a clinical setting. Effective dose to the operator was calculated from the 1-cm dose equivalent measured on the neck outside the lead apron, and on the left chest inside the lead apron, using electronic dosimeters. Equivalent dose to the operator’s finger skin was measured using thermoluminescent dosimeter rings.ResultsThe mean (median) effective dose to the operator per procedure was 6.05 (4.52) μSv during renal cryoablation and 0.74 (0.55) μSv during lung RFA. The mean (median) equivalent dose to the operator’s finger skin per procedure was 2.1 (2.1) mSv during renal cryoablation, and 0.3 (0.3) mSv during lung RFA.ConclusionRadiation dose to interventional radiologists during renal cryoablation and lung RFA were at an acceptable level, and in line with recommended dose limits for occupational radiation exposure.

Radiation Exposure of Interventional Radiologists During Computed Tomography Fluoroscopy-Guided Renal Cryoablation and Lung Radiofrequency Ablation: Direct Measurement in a Clinical Setting.

Science.gov (United States)

Matsui, Yusuke; Hiraki, Takao; Gobara, Hideo; Iguchi, Toshihiro; Fujiwara, Hiroyasu; Kawabata, Takahiro; Yamauchi, Takatsugu; Yamaguchi, Takuya; Kanazawa, Susumu

2016-06-01

Computed tomography (CT) fluoroscopy-guided renal cryoablation and lung radiofrequency ablation (RFA) have received increasing attention as promising cancer therapies. Although radiation exposure of interventional radiologists during these procedures is an important concern, data on operator exposure are lacking. Radiation dose to interventional radiologists during CT fluoroscopy-guided renal cryoablation (n = 20) and lung RFA (n = 20) was measured prospectively in a clinical setting. Effective dose to the operator was calculated from the 1-cm dose equivalent measured on the neck outside the lead apron, and on the left chest inside the lead apron, using electronic dosimeters. Equivalent dose to the operator's finger skin was measured using thermoluminescent dosimeter rings. The mean (median) effective dose to the operator per procedure was 6.05 (4.52) μSv during renal cryoablation and 0.74 (0.55) μSv during lung RFA. The mean (median) equivalent dose to the operator's finger skin per procedure was 2.1 (2.1) mSv during renal cryoablation, and 0.3 (0.3) mSv during lung RFA. Radiation dose to interventional radiologists during renal cryoablation and lung RFA were at an acceptable level, and in line with recommended dose limits for occupational radiation exposure.

Musculoskeletal ultrasound imaging of the plantar forefoot in patients with rheumatoid arthritis: inter-observer agreement between a podiatrist and a radiologist

Directory of Open Access Journals (Sweden)

Bowen Catherine J

2008-07-01

Full Text Available Abstract Background The use of musculoskeletal ultrasound (MSUS in the diagnosis and management of foot and ankle musculoskeletal pathology is increasing. Due to the wide use of MSUS and the depth and breadth of training required new proposals advocate tailored learning of the technique to discrete fields of practice. The aims of the study were to evaluate the inter-observer agreement between a MSUS radiologist and a podiatrist, who had completed basic skills training in MSUS, in the MSUS assessment of the forefoot of patients with Rheumatoid Arthritis. Methods A consecutive sample of thirty-two patients with rheumatoid arthritis was assessed for presence of synovitis, erosions and bursitis within the forefoot using MSUS. All MSUS assessments were performed independently on the same day by a podiatrist and one of two Consultant Radiologists experienced in MSUS. Results Moderate agreement on image acquisition and interpretation was achieved for bursitis (kappa 0.522; p Conclusion This study demonstrated good inter-observer agreement between a podiatrist and radiologist on MSUS assessment of the forefoot, particularly for bursitis and erosions, in patients with rheumatoid arthritis. There is scope to further evaluate and consider the role of podiatrists in the MSUS imaging of the foot following appropriate training and also in the development of reliable protocols for MSUS assessment of the foot.

Real Hypersurfaces of Nonflat Complex Projective Planes Whose Jacobi Structure Operator Satisfies a Generalized Commutative Condition

Directory of Open Access Journals (Sweden)

Theocharis Theofanidis

2016-01-01

Full Text Available Real hypersurfaces satisfying the condition ϕl=lϕ(l=R(·,ξξ have been studied by many authors under at least one more condition, since the class of these hypersurfaces is quite tough to be classified. The aim of the present paper is the classification of real hypersurfaces in complex projective plane CP2 satisfying a generalization of ϕl=lϕ under an additional restriction on a specific function.

Measuring and managing radiologist productivity, part 1: clinical metrics and benchmarks.

Science.gov (United States)

Duszak, Richard; Muroff, Lawrence R

2010-06-01

Physician productivity disparities are not uncommonly debated within radiology groups, sometimes in a contentious manner. Attempts to measure productivity, identify and motivate outliers, and develop equitable management policies can present challenges to private and academic practices alike but are often necessary for a variety of professional, financial, and personnel reasons. This is the first of a two-part series that will detail metrics for evaluating radiologist productivity and review published benchmarks, focusing primarily on clinical work. Issues and limitations that may prevent successful implementation of measurement systems are explored. Part 2 will expand that discussion to evaluating nonclinical administrative and academic activities, outlining advantages and disadvantages of addressing differential productivity, and introducing potential models for practices seeking to motivate physicians on the basis of both clinical and nonclinical work.

Lung volume reduction of pulmonary emphysema: the radiologist task.

Science.gov (United States)

Milanese, Gianluca; Silva, Mario; Sverzellati, Nicola

2016-03-01

Several lung volume reduction (LVR) techniques have been increasingly evaluated in patients with advanced pulmonary emphysema, especially in the last decade. Radiologist plays a pivotal role in the characterization of parenchymal damage and, thus, assessment of eligibility criteria. This review aims to discuss the most common LVR techniques, namely LVR surgery, endobronchial valves, and coils LVR, with emphasis on the role of computed tomography (CT). Several trials have recently highlighted the importance of regional quantification of emphysema by computerized CT-based segmentation of hyperlucent parenchyma, which is strongly recommended for candidates to any LVR treatment. In particular, emphysema distribution pattern and fissures integrity are evaluated to tailor the choice of the most appropriate LVR technique. Furthermore, a number of CT measures have been tested for the personalization of treatment, according to imaging detected heterogeneity of parenchymal disease. CT characterization of heterogeneous parenchymal abnormalities provides criteria for selection of the preferable treatment in each patient and improves outcome of LVR as reflected by better quality of life, higher exercise tolerance, and lower mortality.

Radiation biology for pediatric radiologists

International Nuclear Information System (INIS)

Hall, Eric J.

2009-01-01

The biological effects of radiation result primarily from damage to DNA. There are three effects of concern to the radiologist that determine the need for radiation protection and the dose principle of ALARA (As Low As Reasonably Achievable). (1) Heritable effects. These were thought to be most important in the 1950s, but concern has declined in recent years. The current ICRP risk estimate is very small at 0.2%/Sv. (2) Effects on the developing embryo and fetus include weight retardation, congenital anomalies, microcephaly and mental retardation. During the sensitive period of 8 to 15 weeks of gestation, the risk estimate for mental retardation is very high at 40%/Sv, but because it is a deterministic effect, there is likely to be a threshold of about 200 mSv. (3) Carcinogenesis is considered to be the most important consequence of low doses of radiation, with a risk of fatal cancer of about 5%/Sv, and is therefore of most concern in radiology. Our knowledge of radiation carcinogenesis comes principally from the 60-year study of the A-bomb survivors. The use of radiation for diagnostic purposes has increased dramatically in recent years. The annual collective population dose has increased by 750% since 1980 to 930,000 person Sv. One of the principal reasons is the burgeoning use of CT scans. In 2006, more than 60 million CT scans were performed in the U.S., with about 6 million of them in children. As a rule of thumb, an abdominal CT scan in a 1-year-old child results in a life-time mortality risk of about one in a thousand. While the risk to the individual is small and acceptable when the scan is clinically justified, even a small risk when multiplied by an increasingly large number is likely to produce a significant public health concern. It is for this reason that every effort should be made to reduce the doses associated with procedures such as CT scans, particularly in children, in the spirit of ALARA. (orig.)

The UK and British Gas: Any future for Norwegian gas

International Nuclear Information System (INIS)

Jungles, P.

1996-01-01

The paper deals with the UK natural gas market and the future for Norwegian gas in the UK. The role of the British Gas in the domestic and European markets is discussed. Topics are: The UK gas supply market; the UK upstream gas market and the Interconnector; the European market, competition and deregulation; the prospects for Norwegian gas

Quantifying the Extent of Emphysema : Factors Associated with Radiologists' Estimations and Quantitative Indices of Emphysema Severity Using the ECLIPSE Cohort

NARCIS (Netherlands)

Gietema, Hester A.; Mueller, Nestor L.; Fauerbach, Paola V. Nasute; Sharma, Sanjay; Edwards, Lisa D.; Camp, Pat G.; Coxson, Harvey O.

Rationale and Objectives: This study investigated what factors radiologists take into account when estimating emphysema severity and assessed quantitative computed tomography (CT) measurements of low attenuation areas. Materials and Methods: CT scans and spirometry were obtained on 1519 chronic

Cancer Research UK | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

Cancer Research UK. Cancer Research UK. https://www.cancerresearchuk.org/. The Economics of Tobacco Control Research Initiative. The Economics of Tobacco Control Research Initiative funds innovative fiscal policy research supporting tobacco control in low and middle-income countries. View more. The Economics ...

Second-opinion interpretations of gynecologic oncologic MRI examinations by sub-specialized radiologists influence patient care

International Nuclear Information System (INIS)

Lakhman, Yulia; Vargas, Hebert Alberto; Sosa, Ramon E.; Hricak, Hedvig; Sala, Evis; D'Anastasi, Melvin; Micco, Maura; Scelzo, Chiara; Nougaret, Stephanie; Chi, Dennis S.; Abu-Rustum, Nadeem R.

2016-01-01

To determine if second-opinion review of gynaecologic oncologic (GynOnc) magnetic resonance imaging (MRI) by sub-specialized radiologists impacts patient care. 469 second-opinion MRI interpretations rendered by GynOnc radiologists were retrospectively compared to the initial outside reports. Two gynaecologic surgeons, blinded to the reports' origins, reviewed all cases with discrepancies between initial and second-opinion MRI reports and recorded whether these discrepancies would have led to a change in patient management defined as a change in treatment approach, counselling, or referral. Histopathology or minimum 6-month imaging follow-up were used to establish the diagnosis. Second-opinion review of GynOnc MRIs would theoretically have affected management in 94/469 (20 %) and 101/469 (21.5 %) patients for surgeons 1 and 2, respectively. Specifically, second-opinion review would have theoretically altered treatment approach in 71/469 (15.1 %) and 60/469 (12.8 %) patients for surgeons 1 and 2, respectively. According to surgeons 1 and 2, these treatment changes would have prevented unnecessary surgery in 35 (7.5 %) and 31 (6.6 %) patients, respectively, and changed surgical procedure type/extent in 19 (4.1 %) and 12 (2.5 %) patients, respectively. Second-opinion interpretations were correct in 103 (83 %) of 124 cases with clinically relevant discrepancies between initial and second-opinion reports. Expert second-opinion review of GynOnc MRI influences patient care. (orig.)

A review of the UK fast reactor programme

International Nuclear Information System (INIS)

Picker, C.; Ainsworth, K.F.

1998-01-01

The general position with regard to nuclear power and fast reactors in the UK during 1996 is described. The main UK Government-funded fast reactor research and development programme was concluded in 1993, to be replaced by a smaller programme which is mainly funded and managed by British Nuclear Fuels plc. The main focus of this programme sustains the UK participation in the European Fast Reactor (EFR) collaboration and the broader international links built-up over the previous decades. The status of fast reactor studies made in the UK in 1996 is outlined and, with respect to the Prototype Fast Reactor at Dounreay, a report of progress with the closure studies, fuel reprocessing and decommissioning activities is provided. (author)

Only Moderate Intra- and Inter-observer Agreement between Radiologists and Surgeons when Grading Blunt Paediatric Hepatic Injury on CT Scan

NARCIS (Netherlands)

Nellensteijn, D. R.; ten Duis, H. J.; Oldenziel, J.; Polak, W. G.; Hulscher, J. B. F.

2009-01-01

Introduction: The American Pediatric Surgical Association developed guidelines for the management of haemodynamically stable children with hepatic or splenic injury, based on grade of injury on CF scan. This study investigated the intra- and inter-observer agreement of radiologists, paediatric

Fossil resource trade balances. Emerging trends for the UK

International Nuclear Information System (INIS)

Papathanasopoulou, Eleni; Jackson, Tim

2008-01-01

The aim of this paper is to examine the extent to which the UK can be classified as a net importer of fossil resources and a creator of pollution havens abroad between 1968 and 2000. Using input-output techniques and a derived Resource Flow Classification System, both the physical trade balance (PTB) and pollution trade balance (UTB) associated with fossil resource use are computed. The PTB shows that between 1968 and the early 1980's the UK is presented as a net importer of direct fossil resource flows. Between 1984 and 2000, the UK is identified as a net exporter of direct fossil resources. These trends are primarily explained by the UK's discovery and commercial production of North Sea oil and gas fields in the late 1970s. On the other hand, the UTB shows that over the whole period the indirect used flows attributable to the UK's exports are higher than those attributable to its imports. These findings suggest that the UK did not create pollution havens abroad from the use of fossil resources between 1968 and 2000. However, it is noticeable in both cases that from 1995 the UK's position as a net exporter has been decreasing considerably. Maturing North Sea oil and gas fields set against increasing demands for fossil fuels and imported goods is signalling a return to the UK's pre-1984 dependence on direct imported fossil resources and the possible creation of pollution havens abroad. Knowledge of these trends contributes to the evidence base for the UK's changing import and export structure and the potential environmental repercussions at home and abroad. (author)

Fossil resource trade balances. Emerging trends for the UK

Energy Technology Data Exchange (ETDEWEB)

Papathanasopoulou, Eleni; Jackson, Tim [Centre for Environmental Strategy, University of Surrey, Guildford, Surrey, GU2 7TH (United Kingdom)

2008-06-15

The aim of this paper is to examine the extent to which the UK can be classified as a net importer of fossil resources and a creator of pollution havens abroad between 1968 and 2000. Using input-output techniques and a derived Resource Flow Classification System, both the physical trade balance (PTB) and pollution trade balance (UTB) associated with fossil resource use are computed. The PTB shows that between 1968 and the early 1980's the UK is presented as a net importer of direct fossil resource flows. Between 1984 and 2000, the UK is identified as a net exporter of direct fossil resources. These trends are primarily explained by the UK's discovery and commercial production of North Sea oil and gas fields in the late 1970s. On the other hand, the UTB shows that over the whole period the indirect used flows attributable to the UK's exports are higher than those attributable to its imports. These findings suggest that the UK did not create pollution havens abroad from the use of fossil resources between 1968 and 2000. However, it is noticeable in both cases that from 1995 the UK's position as a net exporter has been decreasing considerably. Maturing North Sea oil and gas fields set against increasing demands for fossil fuels and imported goods is signalling a return to the UK's pre-1984 dependence on direct imported fossil resources and the possible creation of pollution havens abroad. Knowledge of these trends contributes to the evidence base for the UK's changing import and export structure and the potential environmental repercussions at home and abroad. (author)

Leading change to create a healthy and satisfying work environment.

Science.gov (United States)

Sanders, Carolyn L; Krugman, Mary; Schloffman, Danielle H

2013-01-01

Nurse executives must take a leadership role in creating a healthy work environment for nurses and all disciplines. Engaging in partnerships and empowering clinical nurses to construct the solutions to barriers that may stand in the way of the goal of a satisfied and healthy workforce are important strategies toward success. This publication outlines many projects a 3-time Magnet-designated academic hospital has implemented, working with our shared leadership councils, to meet the standards for a healthy work environment. These initiatives, from the unit to the hospital level, included standardizing a culture change of uninterrupted meal breaks, the creation of intensive care unit Zen rooms, strategies to better manage increased patient volumes, best practices for facility design, enhancing physician-nurse relations, and a hospital wellness program. Data were benchmarked against national nurse and employee surveys to compare progress and report outcomes. Two important nursing organization structures that have contributed to the success of a healthy and satisfied nursing work environment include UEXCEL, a longstanding clinical nurse professional practice program, and the hospital's 11-year participation in the University HealthSystem Consortium/American Association of Colleges of Nursing National Post-Baccalaureate Nurse Residency Program. A highly engaged, well-educated, and committed nursing workforce, nurtured by a strong leadership team, has created a positive work environment characterized by low turnover and high retention.

Influence on UK Nuclear Regulation from the Fukushima Daiichi Accident

International Nuclear Information System (INIS)

Savage, R.

2016-01-01

This paper provides an overview of the UKs response to the Fukushima Daiichi Accident and highlights the influence that this has had on UK nuclear regulation since March 2011. ONR’s Incident Suite was staffed from the first day of the accident and remained active on a 24 hours basis for over two weeks. The purpose was to provide advice to the UK government specifically prompt assurance of why this accident couldn’t take place in the UK and practical advice in relation to the 17,000 UK nationals in Japan at that time. In the early phase of the accident ONR took part in international cooperation with the US, Canadian and French regulators in order to determine the actual technical status of the Fukushima Daiichi power plant units. The UK Secretary of State requested that the ONR Chief Inspector identify any lessons to be learnt by the UK nuclear industry and in doing so cooperate and coordinate with international colleagues. The Interim report was produced (May 2011) this focused on civil NPP’s, provided background to radiation, technology and regulations. This report compared the Japan situation with the UK and identified 11 conclusions and 26 recommendations.

UK114, a YjgF/Yer057p/UK114 family protein highly conserved from bacteria to mammals, is localized in rat liver peroxisomes

International Nuclear Information System (INIS)

Antonenkov, Vasily D.; Ohlmeier, Steffen; Sormunen, Raija T.; Hiltunen, J. Kalervo

2007-01-01

Mammalian UK114 belongs to a highly conserved family of proteins with unknown functions. Although it is believed that UK114 is a cytosolic or mitochondrial protein there is no detailed study of its intracellular localization. Using analytical subcellular fractionation, electron microscopic colloidal gold technique, and two-dimensional gel electrophoresis of peroxisomal matrix proteins combined with mass spectrometric analysis we show here that a large portion of UK114 is present in rat liver peroxisomes. The peroxisomal UK114 is a soluble matrix protein and it is not inducible by the peroxisomal proliferator clofibrate. The data predict involvement of UK114 in peroxisomal metabolism

Accuracy and efficiency of radiologists reporting CT studies from a multiscreen electronic workstation

International Nuclear Information System (INIS)

Foley, W.D.; Lawson, T.L.; Erickson, S.J.

1988-01-01

This paper describes a limited picture archiving communication system linking, a via fiber optic cable, two computed tomographic (CT) scanners, and a double-screen (1,000-line monitors) display station with a 600-megabyte image memory evaluated for accuracy and efficiency in the generation of a radiology report. Twenty preselected CT studies (an average of 30 images per study, ten with prior examination for comparison) in cases with pathologically or clinically proved diagnoses were read by five radiologists, in random order, from both the electronic display console and conventional multiformat images. All cases were reread after 1-month interval in a different random order viewing sequence and the opposite viewing modality

Cost viability of 3D printed house in UK

Science.gov (United States)

Tobi, A. L. Mohd; Omar, S. A.; Yehia, Z.; Al-Ojaili, S.; Hashim, A.; Orhan, O.

2018-03-01

UK has been facing housing crisis due to the rising price of the property on sale. This paper will look into the viability of 3D printing technology as an alternative way for house construction on UK. The analysis will be carried out based on the data until the year of 2014 due to limited resources availability. Details cost breakdown on average size house construction cost in UK were analysed and relate to the cost viability of 3D printing technology in reducing the house price in UK. It is found that the 3D printing generates saving of up to around 35% out of total house price in UK. This cost saving comes from the 3D printed construction of walls and foundations for material and labour cost.