Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “RADIOGRAPHY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 703 records · Page 39Linked to original sources
PubMed2001

The solitary pulmonary nodule on chest radiography: can we really tell if the nodule is calcified?

OBJECTIVE: This study was designed to assess the ability of radiologists to accurately detect calcification within a solitary pulmonary nodule with chest radiography. MATERIALS AND METHODS: Thirty-five solitary pulmonary nodules that were examined by both posteroanterior and lateral chest radiography and on thin-section CT were retrospectively identified. Fourteen radiologists blinded to the results of CT assessed the nodules for the presence or absence of calcification using chest radiographs alone. The radiologists then assigned one of six values on the basis of their confidence in that assessment. The accuracy and confidence values for each nodule were analyzed on the basis of the presence or absence of calcification as seen on CT. Receiver operating characteristic (ROC) curves were generated. RESULTS: The positive predictive value of a "definitely calcified" assessment was 0.93. Combining all levels of radiologists' confidence, the sensitivity of the chest radiograph in the detection of calcium was 0.50 and the specificity was 0.87. There was no difference in the confidence levels reported between the calcified and noncalcified nodules, and there was no correlation of nodule size with accuracy or confidence level. CONCLUSION: The ability of radiologists to detect calcium in a solitary pulmonary nodule by chest radiography was low, as defined by the ROC data. Of the "definitely calcified" nodules, up to 7% may not be calcified and may be potentially malignant. Without documentation of long-term stability, a low threshold for recommending CT may be appropriate.

Aged↗
PubMed2002

Technologists' productivity when using PACS: comparison of film-based versus filmless radiography.

OBJECTIVE: The objective of this study was to assess the impact of filmless operation and computed radiography on technologists' examination times compared with conventional film-based operation and film-screen radiography. CONCLUSION: Compared with conventional film-screen operation, filmless operation using computed radiography was associated with a significant decrease in technologist examination times in the performance of general radiographic examinations. This decrease in technologist examination times in a filmless environment offers the potential for increased productivity with resulting personnel savings and improved operational efficiency.

Efficiency↗
PubMed2004

Lateral neck radiography versus direct video rhinoscopy in assessing adenoid size.

OBJECTIVE: To evaluate the usefulness of adynamic lateral neck radiographs and dynamic video rhinoscopy in assessing adenoid size and the relationship of these methods to associated symptoms and thus the severity of the disease. METHODS: Children with suspected adenoid hypertrophy underwent standard lateral neck soft tissue radiographs: the percentage of airway occlusion, adenoid to nasopharynx (AN) ratio, airway to soft palate ratio, and adenoid thickness were assessed by a radiologist. The percentage of airway closure was assessed by direct fibre-optic rhinoscopy in an ear, nose, and throat clinic. Associated clinical symptoms were assessed by parents using a standardized questionnaire, evaluating the severity of symptoms (snoring, sleep apnea, mouth breathing, and otitis media) to give a total symptom score out of 16. RESULTS: Nonparametric statistical analysis using Spearman's correlation coefficients was performed on 32 patients. There was a weak correlation, which approaches significance, between the percentage of airway occlusion assessed by fibre-optic rhinoscopy and the total symptom score (r = .344, p = .054). However, this correlation becomes significant when the frequency of otitis media is omitted (r = .367, p = .039). There was also a significant correlation between airway occlusion assessed by rhinoscopy and the percentage of airway occlusion as determined by lateral neck radiography (r = .431, p = .014). There was no correlation between any of the measurements taken by lateral soft tissue neck radiography and total symptom score. CONCLUSION: Dynamic video rhinoscopy is more accurate at assessing adenoid hypertrophy, and the percentage of airway occlusion, as estimated by video rhinoscopy, is better correlated to the severity of symptoms than are values obtained by lateral neck radiography.

Adenoidectomy↗
PubMed2001

Comparison of results of thoracic radiography, cytologic evaluation of bronchoalveolar lavage fluid, and histologic evaluation of lung specimens in dogs with respiratory tract disease: 16 cases (1996-2000).

OBJECTIVE: To compare results of thoracic radiography, cytologic evaluation of bronchoalveolar lavage (BAL) fluid, and histologic evaluation of biopsy and necropsy specimens in dogs with respiratory tract disease and to determine whether histologic evaluation provides important diagnostic information not attainable by the other methods. DESIGN: Retrospective study. ANIMALS: 16 dogs. PROCEDURE: BAL fluid was classified as normal, neutrophilic, eosinophilic, mononuclear, mixed, neoplastic, or nondiagnostic. Radiographic abnormalities were classified as interstitial, bronchial, bronchointerstitial, or alveolar. Histologic lesions were classified as inflammatory, fibrotic, or neoplastic, and the predominant site of histologic lesions was classified as the alveoli, interstitium, or airway. RESULTS: The predominant radiographic location of lesions correlated with the histologic location in 8 dogs. Of 11 dogs with histologic evidence of inflammatory disease, 8 had inflammatory BAL fluid. Of the 2 dogs with histologic evidence of neoplasia, 1 had BAL fluid suggestive of neoplasia, and the other had BAL fluid consistent with septic purulent inflammation. Two dogs without any histologic abnormalities had mononuclear or nondiagnostic BAL fluid. Two dogs with histologic evidence of fibrosis had mononuclear or mixed inflammatory BAL fluid. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that although thoracic radiography, cytologic evaluation of BAL fluid, and histologic evaluation of lung specimens are complementary, each method has limitations in regard to how well results reflect the underlying disease process in dogs with respiratory tract disease. Lung biopsy should be considered in cases where results of radiography and cytology are nondiagnostic.

Animals↗
PubMedDate not supplied

Chest radiography in the follow-up of breast cancer.

The significance of routine chest radiography in the follow-up of breast cancer was evaluated. This evaluation also included correlation of symptoms with site of intrathoracic relapse. Ten per cent of the patients developed intrathoracic recurrence; 54 per cent thereof were asymptomatic. Eighty-six per cent of the intrathoracic relapses appeared within five years. The significance of prognostic factors was obvious: a higher stage or grade gave a higher risk of intrathoracic relapses. The presence of symptoms was dependent on the site of relapse. The disease-free survival and survival after recurrence were not significantly different in symptomatic and asymptomatic patients. The contribution of routine chest radiography to the detection of relapses in asymptomatic patients was poor: one positive finding among 263 chest radiographic examinations. Routine chest radiography should be limited to high risk groups (stage II, III and grade III), preferably within the first five years after the primary treatment.

Breast Neoplasms↗
PubMed1989

Ultrasonography and radiography of the hip in infants.

Both hip joints in 156 children, aged 2 months to 2 years, were examined by ultrasonography (ultrasound) and radiography. Pathologic findings were based on an increased acetabular index, bony defects of the lateral acetabular rim, and lateral and/or proximal displacement of the proximal femur. Each hip was classified as normal, dysplasia, subluxation, or dislocation. The same diagnosis was reached by ultrasound and radiography in 303 of the 312 hips. The accordance was good in normal joints, in subluxation, and in dislocation. However in 7 of the 15 hips with radiographic dysplasia, ultrasound was normal. These patients were not treated, and spontaneous normalization or improvement occurred in all of them. One parameter only, the distance from the lateral margin of the ossification center of the femoral head to Perkins' line, was measured by both ultrasound and radiography; the correlation was high (r = 0.73). We recommend ultrasound as the primary imaging technique when congenital dislocation is suspected clinically.

Aging↗
PubMedDate not supplied

Thoracic radiography, bronchoalveolar lavage cytopathology, and pulmonary parenchymal histopathology: a comparison of diagnostic results in 11 cats.

The purpose of this study was to compare the diagnostic results and value of thoracic radiography, bronchoalveolar lavage (BAL) fluid cytopathology, and lung histopathology in 11 cats with spontaneous respiratory disease in which radiography and cytopathology were inadequate in establishing a definitive diagnosis. In these cats, radiographic patterns were characterized as bronchial (n=6), interstitial (n=3), and alveolar (n=2); other features included hyperinflation (n=3), bronchiectasis (n=2), pleural fissure lines (n=2), pulmonary nodules (n=2), atelectasis (n=1), and a tracheal mass (n=1). Bronchoalveolar lavage fluid was unremarkable in two cats. Abnormal BAL fluid showed inflammation (n=5), hemorrhage (n=2), epithelial hyperplasia (n=1), or was suspicious for neoplasia (n=1). Histopathological evaluation revealed inflammation (n=8), neoplasia (n=2), and vascular congestion (n=1). The predominant radiographic location of disease correlated with the same histopathological location in seven cats, and the cytopathological class of BAL fluid was consistent with the histopathological class of disease in seven cats. There was poor correlation between the types of cells found in the BAL fluid and the pathologist's prediction of the types of cells likely to be found in the BAL fluid based on the amount and type of airway cellularity seen on histopathological examination. The results of this study suggest that in some cats, BAL fluid cytopathology does not always correlate with the type of pulmonary disease identified on histopathology. In respiratory diseases where radiography and cytopathology fail to provide a definitive diagnosis, histopathological examination of the lung may be necessary.

Animals↗
PubMed2003

[Investigation of beam quality for digital chest radiography with RbBr:Tl(+) photostimulable storage phosphors].

Beam quality for digital chest radiography in digital radiography systems (DR systems) with RbBr:Tl(+) photostimulable storage phosphors was investigated. Measurements of overall Wiener spectrum (overall WS) and observer performance experiments by means of Scheffé's method of paired comparisons were performed under the same exposure (5.16x10(-7)C/kg) at the X-ray detector of DR systems (sampling distance: 175 micro m, 2,048x2,048 pixels, 12 bits, look-up table: THX2) with a phantom lung and metacryl plates. Overall WS values were indicated to be inferior at higher tube voltages. All of the overall WS values were greater than those of screen film systems (HGM/UR1:S/F) at radiographic density 0.50, which was considered the density of the mediastinum and the area below the diaphragm (low density area), and at radiographic densities 1.00 and 1.50, considered as lung, WS values of S/F were located between the overall WS values of 80 kV and 100 kV, and 120 kV and 140 kV, respectively. Evaluation of visibility including mediastinum, lung, and total were indicated to be superior at the lower tube voltages. In evaluation of the mediastinum, the base image, which was obtained by 100 kV tube voltage (effective energy: 46.0 kV) in this study, was not significant from 90 kV to 110 kV tube voltages (range, +/-10 kV), and in-lung and total evaluations were not significant from 90 kV to 120 kV (range, -10 kV to +20 kV), and from 80 kV to 120 kV (range, +/-20 kV) tube voltages by 99% confidence interval. In conclusion, optimal beam quality for digital chest radiography with RbBr:Tl(+) photostimulable storage phosphors was considered to be less than 110 kV tube voltage (effective energy, 47.9 keV) in 0.1 mm copper and 3.8 mm aluminum total filtration. In this case, the granularity in low-density areas were inferior to those of S/F systems but nearly equal to the middle and high-density areas of chest images, and exposure dose was 14.3% lower than that of the base image obtained by 100 kV (effective energy, 46.0 keV) tube voltage in this study.

Bromides↗
PubMed2004

[Gonad protective effect of radiation protective apron in chest radiography].

Depending on the facility, a radiation protective apron (protector) is used to protect the gonad from radiation exposure in chest radiography. To determine the necessity of using a protector during chest radiography, we measured the effect of the protector on the gonad in this study. First, using a human body phantom, we measured the absorbed dose of the female gonad with and without the protector, using a thermoluminescence dosimeter (TLD), and confirmed its protective effect. Using the protector, the absorbed dose was reduced to 28+/-2% and 39+/-4% for field sizes of 14 x 17 inch and 14 x 14 inch, respectively. Next, we used Monte Carlo simulation and confirmed, not only the validity of the actual measurement values, but also the fact that the influence of radiation on the absorbed dose of the gonad was mostly from scattered radiation from inside the body for the 14 x 17 inch field size, and also from the X-ray tube for the 14 x 14 inch field size. Although a certain protective effect is achieved by using the protector, the radiation dose to the gonad is only a few microGy even without a protector. Thus, the risk of a genetic effect would be as small as 10(-8). Given that acceptable risk is below 10(-6), we conclude the use of a radiation protective apron is not necessary for diagnostic chest radiography.

Female↗
PubMed2004

Lung cancer screening with sputum cytologic examination, chest radiography, and computed tomography: an update for the U.S. Preventive Services Task Force.

BACKGROUND: Lung cancer is the leading cause of cancer-related death in the United States and worldwide. No major professional organizations, including the U.S. Preventive Services Task Force (USPSTF), currently recommend screening for lung cancer. PURPOSE: To examine the evidence evaluating screening for lung cancer with chest radiography, sputum cytologic examination, and low-dose computed tomography (CT) to aid the USPSTF in updating its recommendation on lung cancer screening. DATA SOURCES: MEDLINE, the Cochrane Library, reviews, editorials, and experts. STUDY SELECTION: Studies that evaluated mass screening programs for lung cancer involving the tests of interest were selected. All studies were reviewed, but only studies with control groups were rated in quality since these would most directly influence the USPSTF screening recommendation. DATA EXTRACTION: Data were abstracted to data collection forms. Studies were graded according to criteria developed by the USPSTF. DATA SYNTHESIS: None of the 6 randomized trials of screening for lung cancer with chest radiography alone or in combination with sputum cytologic examination showed benefit among those screened. All studies were limited because some level of screening occurred in the control population. Five case-control studies from Japan suggested benefit to both high- and low-risk men and women. All studies were limited by potential healthy screenee bias. Six cohort studies showed that when CT was used to screen for lung cancer, lung cancer was diagnosed at an earlier stage than in usual clinical care. However, these studies did not have control groups, making mortality evaluation difficult. In addition, the studies demonstrated a high rate of false-positive findings. CONCLUSIONS: Current data do not support screening for lung cancer with any method. These data, however, are also insufficient to conclude that screening does not work, particularly in women. Two randomized trials of screening with chest radiography or low-dose CT are currently under way and will better inform lung cancer screening decisions.

Evidence-Based Medicine↗
PubMed1998

Small bowel obstruction in rats: diagnostic accuracy of sonography versus radiography.

Our purposes were to determine whether sonography can distinguish between obstructed and nonobstructed rats and to compare the diagnostic accuracy of sonography and radiography in the diagnosis of small bowel obstruction. Nonstrangulating small bowel obstruction was created in 19 rats; sham laparotomies were performed in 18 controls. Serial radiographs and sonograms, including duplex Doppler sonography, were obtained. Bowel diameter and bowel wall thickness were evaluated retrospectively. Bowel diameter, bowel wall thickness, and resistive indices increased in the animals with obstruction; controls remained unchanged (P = 0.002). Sonography demonstrated a significantly higher diagnostic accuracy than radiography at 24 hours and beyond (P = 0.023). Ultrasonography is sensitive and more accurate than radiography in diagnosing small bowel obstruction using objective criteria in the animal model.

Analysis of Variance↗
PubMed1999

Contrast media radiography in patients with retrosternal irrigation drainage for severe sternal wound infection.

Severe wound infection after open-heart surgery is a potentially life-threatening complication, which is mostly treated by re-operation with debridement, and insertion of closed irrigation drainage. Until now there is no consensus about the appropriate duration of irrigation therapy. Since the retrosternal irrigation cavity is likely to become continually smaller as the infection heals, this study was intended to answer the question, as to whether this process can be made visible by the use of contrast media radiography, and whether this information could be used to determine when an irrigation therapy can safely be discontinued. In 1997, 34 patients suffered from sternal wound healing disturbances which required re-operation at our institution (incidence = 0.97%). During the re-operation, a closed retrosternal irrigation drainage was inserted. Of the 34 patients contrast media radiography examinations were carried out on the first, 4th and 12th postoperative day (POD), which consisted of an antero-posterior x-ray of the chest after contrast media injection through each inlet tube. At POD 4 and 12 in the majority of cases, the retrosternal irrigation cavity became smaller when compared with the previous x-ray examination. Only in three of the non-survivors there was a huge irrigation cavity visible at the 12th POD, which sometimes even included the pleural cavity. We conclude that in patients with mediastinitis treated by insertion of a closed irrigation drainage, the retrosternally irrigated cavity seems to become smaller over the therapeutic course of treatment. This process can be visualized by contrast media radiography. Results from this examination should be included in decision making about the best time for discontinuation of the irrigation therapy.

Anti-Infective Agents, Local↗
PubMed1999

[Follow-up chest radiography in surgical breast cancer patients].

PURPOSE: We investigated to what extent the diagnostic findings of chest radiography can improve prognosis and treatment in surgical breast cancer patients. We also reviewed the literature and our personal findings to choose the optimal follow-up frequency to meet therapeutical and management needs, including radiation protection. MATERIAL AND METHODS: We retrospectively reviewed 1556 chest radiographs of 195 surgical patients with M0 breast cancer performed January 1990 to December 1996. Patient's history and clinical data were accurately reviewed to investigate the relation between protocol type and results. The maximalist or intensive protocol featured 3 chest radiographs a year, even in the absence of any specific signs; the results were reviewed in terms of early diagnosis and prolongation of life. RESULTS: Only 13% of the examinations had been performed following a specific clinical indication, while 87% had been performed for a generic referral. Recurrences were found in 0.6% only of the latter examinations, which means that radiography provided no diagnostic improvement or important change in treatment in as much as 99.4% of cases. In 1997 radiographic follow-up was made triannual instead of biannual as it used to be. DISCUSSION AND CONCLUSIONS: In the absence of specific clinical indications, chest radiography can be performed in the two projections once a year. More aggressive protocols requiring more frequent examinations are not justified, as the patient's life expectancy is not increased. Yearly examinations permit to meet economic and management needs, with a better use of time, staff and materials. Moreover, the clinical-diagnostic yield is not affected by the skipping of unselected examinations. Finally, another pro is the technical thoroughness of the examination with orthogonal projections and the possibility to use ionizing radiations, which improves the management of clinical risks. Maximum radiologist-oncologist cooperation in clinical practice can improve both diagnostic efficiency and treatment efficacy, by reducing the population dose and rationalizing the use of human, instrumental, structural and financial resources.

Breast Neoplasms↗
PubMed2001

Role of chest radiography after the insertion of a subclavian vein catheter for ambulatory chemotherapy.

OBJECTIVE: To determine the need for routine chest radiography after the insertion of a catheter via the subclavian vein for ambulatory chemotherapy. METHODS: The case notes of all patients who had undergone catheter insertion between 1994 and 1998 were reviewed retrospectively. RESULTS: Of 3844 cases, there were 52 (1.4%) complications detected on chest radiographs after catheter insertion, 46 of which were pneumothoraces; 15 of the 46 patients had a clinical risk factor at insertion (technical difficulty or symptoms), and 14 had a risk factor after insertion (respiratory symptoms and signs). For 22 (47.8%) pneumothoraces, there was no clinical risk factor identified; 3 of these patients required intercostal drain insertion. Other complications (n = 6) included catheter malposition and kinking, and chest radiography made an important contribution to management in at least 1 of these cases. CONCLUSION: In approximately 0.1% of cases of catheter insertion in the subclavian vein, chest radiography detected a clinically occult complication significant enough to require intervention.

Adult↗
PubMed2002

Radiography for low back pain: a randomised controlled trial and observational study in primary care.

BACKGROUND: Lumbar spine radiography has limited use in diagnosing the cause of acute low back pain. Consensus-based guidelines recommend that lumbar spine x-rays are not used routinely. However there have been no studies of the effect of referral for radiography at first presentation with low back pain in primary care. AIM: To compare short and long-term physical, social, and psychiatric outcomes for patients with low back pain who are referred or not referred for lumbar spine x-ray at first presentation in general practice. DESIGN OF STUDY: A randomised unblinded controlled trial with an observational arm to enable comparisons to be made with patients not recruited to the trial. SETTING: Ninety-four general practices in south London and the South Thames region. METHOD: Patients consulting their general practitioner (GP) with low back pain at first presentation were recruited to a randomised controlled trial (RCT) or to an observational group. Patients in the trial were randomly allocated to immediate referral for x-ray or to no referral. All patients were asked to complete questionnaires initially, and then at six weeks and one year after recruitment. RESULTS: Six hundred and fifty-nine patients were recruited over 26 months: 153 to the randomised trial and 506 to the observational arm. In the RCT referral for x-ray had no effect on physical functioning, pain or disability, but was associated with a small improvement in psychological wellbeing at six weeks and one year. These findings were supported by the observational study in which there were no differences between the groups in physical outcomes after adjusting for length of episode at presentation; however, those referred for x-ray had lower depression scores. CONCLUSIONS: Referral for lumbar spine radiography for first presentation of low back pain in primary care is not associated with improved physical functioning, pain or disability. The possibility of minor psychological improvement should be balanced against the high radiation dose involved.

Adult↗
PubMed2002

[The place of radiography in endodontic treatment carried out in general practice in Dakar].

An investigation conducted over dental surgeons of 52 dental offices in Dakar and it's near suburb (40 from private sector and 12 from public and quasi-public) has shown that the use of retro-alveolar radiography during endodontic treatment was not systematic, due to the price of retro-alveolar film, waste of time and relative facility of the endodontic treatment of monoradicular teeth. The preparatory negative is favored (32.70%) particularly by private dental surgeons, who use two retro-alveolar films for endodontic treatment: pre and post operative radiography (30%). The immediate post operator control is executed only in case of post-operator pains by public and quasi-public dental surgeons (16.67%) with one retro-alveolar film on average for the endodontic treatment; at term any radiographic control is done. Three retro-alveolar films per endodontic treatment were exceptionally used (9.61%) and offset incidences (15%) are not much used as well as support-films (angulators). The retro-alveolar radiography is still a reliable guide for a clinical success in endodontic treatment with a minimum of three retro-alveolar films and offset incidences.

Dental Pulp Cavity↗
PubMed2002

Observer variation in detecting lymphadenopathy on chest radiography.

OBJECTIVE: To assess inter- and intra-observer agreement in the detection of lymphadenopathy on chest radiography in children at risk for tuberculosis. PATIENTS AND METHODS: Retrospective examination of the antero-posterior and lateral chest radiographs of children aged 1 month to 11 years discharged from the short-stay ward of the Red Cross Children's Hospital, Cape Town, with a diagnosis of tuberculosis or pneumonia. Four paediatric pulmonologists viewed the radiographs independently. The main outcome measures were inter- and intra-observer agreement on the presence or absence of lymphadenopathy, reported as present, absent or equivocal, and expressed as weighted kappa statistics. RESULTS: Weighted kappa for the six pairs of observers ranged from 0.14 (95%CI 0.02-0.30) to 0.52 (95%CI 0.35-0.69). After a 3-month interval, intra-observer agreement ranged from 0.44 (95%CI 0.25-0.62) to 0.71 (95%CI 0.56-0.87). The average weighted kappa for inter-observer agreement was 0.33, and the average intra-observer kappa was 0.55. CONCLUSIONS: There was 'fair' inter- and 'moderate' intra-observer agreement among paediatric pulmonologists in detecting lymphadenopathy on chest radiography in children. Caution is necessary when basing clinical decisions on the presence of lymphadenopathy on chest radiography.

Child↗
PubMedDate not supplied

Mobile radiography CQI: an inter-national study.

Mobile or bedside radiography has been and is a staple diagnostic and follow-up tool used readily by the many medical disciplines, such as cardiology, surgery, orthopedics, pediatrics, neonatology, etc. Ironically, in the past a student or the least qualified technologist was sent to perform the bedside exam. Moreover, it was almost expected that poor but acceptable film quality would result or that repeat films were almost always to be taken. Inefficiency with respect to quality of exam, the time the exam takes, or film repeats can be costly. The price of inefficiency is the cost involved in doing things incorrectly or not in the most efficient manner, i.e., incurring inefficiencies instead of operating in an ideal manner. The purpose of this study was to compare the total cost of inefficiently organized, scheduled and performed mobile radiography at three large teaching hospitals in various locations and of diverse patient loads, as a means of determining how best to increase utilization and performance. The study was performed at the 489-bed New England Deaconess Hospital (NEDH), the 644-bed Sentara Norfolk General Hospital (SNGH), and the 1500-bed Rheinische Westfalische Technische Hochschule (RWTH) in Aachen, Germany. Similar standardized study methods were utilized at all three institutions where extended observation of mobile utilization, areas of inefficiency, time wasted per episode and number of episodes per time period were determined. Data were loggedin at three standardized time periods, summated, and then multiplied by technologist hourly pay rate. This sum was extrapolated over 52 weeks to give the total annual cost of inefficiently organized mobile radiography. For NEDH the cost of total inefficiency was $75,453, for SNGH $49,586, while for RWTH it was $9,519. Eighteen areas of inefficiency were identified and grouped, such as lack of spatial cohesiveness and lack of communication leading to film duplication, etc. While inefficiencies in the delivery of hospital based health care are well known, this study attempts to quantify and determine a dollar value for each process found as inefficient. Key inefficiencies were found to be common at large hospitals no matter whether in the United States or Europe. These impairments are responsible for a disproportionate share of overall inefficiency, and their elimination (achievable by simple solutions) would result in drastic cost reductions (ranging from 40-75% at the institutions studied). Thus this study is important in view of spiralling costs, as it is a key component of total quality management (TQM) in radiology and a continuous quality improvement (CQI) tool for mobile radiology specifically.

Efficiency, Organizational↗