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Sensitive method for intraoperative roentgenograms.

A new technique using mammography film has been developed. A portable x-ray machine and mammographic film has been used to obtain excellent intraoperative radiographs of renal calculi. The kidney is exposed through a flank incision. The film is cut to a size and shape that will permit an easy fit behind the kidney. Exposed film is developed in an automatic processor. This technique has facilitated location and removal of small calculi and faintly opaque calculi. Uric acid stones have been demonstrated in vitro. It is an inexpensive technique that requires no special equipment.

Adult↗

Intraoperative Polaroid roentgenograms.

The introduction of a new Polaroid film (TPX) prompted an evaluation of all Polaroid films that are available, and a comparison with Kodak Xomat film was done both in the experimental mode and the clinical situation. Type TPX shows excellent definition but is still an experimental film. All the other Polaroid films (Types 52, 57, and TPX 10 x 8) produce images in twenty seconds. This is really the only advantage over the conventional Kodak X-Omat KS film processed as an x-ray film.

Humans↗

Ineffectiveness of annual chest roentgenograms in tuberculin skin test-positive hospital employees.

Annual routine chest x-ray examinations have been recommended for many years for tuberculin skin test-positive hospital employees who have not received chemoprophylaxis. To examine the case-finding effectiveness of this policy in a university teaching hospital, employee health records covering an 18-year period were reviewed. Pulmonary tuberculosis was diagnosed in four employees during that time period. None of the patients were identified through the routine annual chest x-ray examination. In the study institution the policy requiring routine annual chest x-ray examinations for tuberculin-positive hospital employees who had not received preventive therapy was rescinded. Currently, the first chest x-ray examination is required at the time of skin test conversion, the second 1 year after conversion, and the third 2 years after conversion. Health teaching and counseling regarding the symptoms of tuberculosis have been initiated for tuberculin-positive hospital employees.

Adult↗

Computer-assisted simulation of conventional roentgenograms from three-dimensional computed tomography (CT) data--an aid in the identification of unknown corpses (FoXSIS).

A computer simulation program (Forensic X-ray Simulation and Identification System, FoXSIS) is presented. FoXSIS calculates conventional X-ray summation images using any scanning parameters from three-dimensional CT data records. All those parameters decisive for X-ray morphology are freely selectable for realistic simulations: focus-object distance, object-film distance, centering of the X-ray beam, the location of the object in the patch of rays, brightness and contrast, as well as parallel and central projection. In addition, distance and angle measurements, as well as enlargements of details are possible. The program may be expected to help in the identification of unknown corpses now, and even more in the future on account of the increased use of clinical computed tomographies.

Forensic Medicine↗

Detection of internal mammary lymph node enlargement: comparison of CT scans and conventional roentgenograms.

Sixty-two patients with breast cancer had thoracic computed tomography (CT) scans and conventional chest radiographic (CXR) examinations separated by an average of 29 days. CT served as the gold standard showing 13 cases with enlarged internal mammary nodes 0.4 to 7 cm in diameter. Original CXR interpretations were available. Additionally, these films were reinterpreted, without knowledge of the CT results, with special attention to the retrosternal region on the lateral film including the use of a bright light and comparison to prior lateral views. Original CXR interpretations detected only one (7 cm) enlarged node. Sensitivity was 8% and specificity 100%. Reinterpretation of the CXRs, without knowledge of the CT results, with special attention to the retrosternal region yielded five true positive and seven false positive determinations for a sensitivity of 38% and specificity of 86%. No enlarged node under 2.5 cm in diameter was detected on CXR. Sensitivity of CXR can be considerably improved by careful evaluation of the retrosternal space, but at the cost of considerable increase in false positive examinations. CT is necessary to achieve reasonable sensitivity and specificity in the detection of internal mammary lymphadenopathy.

Breast↗