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PubMedDate not supplied

Emergency medicine radiology: a new challenge in radiology.

Emergency medicine is a recent discipline which relies much on emergency radiology. Emergency physicians are developing specific diagnostic work-ups and therapies for emergency conditions and exploring specific management of the department, attesting of a growing interest in emergency medicine radiology. In this article we give a survey of the history of emergency medicine radiology and we discuss this rather young subdiscipline of radiology.

Emergency Medicine↗
PubMed2005

Current issues of interventional radiology in Canada: a national survey by the Canadian Interventional Radiology Association.

OBJECTIVE: To determine current issues facing the field of interventional radiology (IR) in Canada. METHODS: An anonymous online survey was emailed to all members of the Canadian Interventional Radiology Association. The survey was open for 1 month. RESULTS: A total of 83 survey responses were received (of an estimated possible 233). Responses regarding demographics, aspects of practice, research, and IR trainee education were collected. CONCLUSIONS: Several issues were identified as pertinent to Canadian interventional radiologists, including a current and future drought of interventional radiologists, a lack of women in the profession, inadequate protected research time for those in academic practice, a lack of protected clinical time, concern regarding turf issues with other specialties, division between interventional and diagnostic radiology, and the ideal profile of the future interventional radiologist. The field of interventional radiology (IR) continues to develop, expand, and mature at a rapid pace. As the field is still relatively young, several issues are bound to arise. It is important therefore to stay abreast of the current trends and opinions of practitioners within the field.

Canada↗
PubMed2002

[Radiological technologists view about dose reduction techniques in interventional radiology].

We classified radiation exposure in interventional radiology into medical exposure and occupational exposure, and examined dose reduction and optimization from the point of view of radiological technologists. Radiologists and radiological technologists should share knowledge and information about dose reduction for patients and operators, and should maintain good relations and a good environment to further the management of dose reduction in clinical practice.

Humans↗
PubMed1995

VIA-RAD: a blackboard-based system for diagnostic radiology. Visual Interaction Assistant for Radiology.

The work described in this article presents an approach to the integration of computer-displayed radiological images with cooperative computerized assistance for decision-making. The VIA-RAD system (Visual Interaction Assistant for Radiology) is a blackboard-based architecture, founded on extensive data collection and analysis in the domain of diagnostic radiology, together with cognitive modeling of the interaction between perception and problem-solving. The details of this system are presented in terms of domain knowledge representation and domain knowledge mapping. A small prototype of the system has been implemented and tested with radiology subjects, and the results of this study are also described.

Artificial Intelligence↗
PubMed2005

Hospital management of mass radiological casualties: reassessing exposures from contaminated victims of an exploded radiological dispersal device.

One of the key issues in the aftermath of an exploded radiological dispersal device from a terrorist event is that of the contaminated victim and the concern among healthcare providers for the harmful exposures they may receive in treating patients, especially if the patient has not been thoroughly decontaminated. This is critically important in the event of mass casualties from a nuclear or radiological incident because of the essential rapidity of acute medical decisions and that those who have life- or limb-threatening injuries may have treatment unduly delayed by a decontamination process that may be unnecessary for protecting the health and safety of the patient or the healthcare provider. To estimate potential contamination of those exposed in a radiological dispersal device event, results were used from explosive aerosolization tests of surrogate radionuclides detonated with high explosives at the Sandia National Laboratories. Computer modeling was also used to assess radiation dose rates to surgical personnel treating patients with blast injuries who are contaminated with any of a variety of common radionuclides. It is demonstrated that exceptional but plausible cases may require special precautions by the healthcare provider, even while managing life-threatening injuries of a contaminated victim from a radiological dispersal device event.

Decontamination↗
PubMed2006

Radiology of severe acute respiratory syndrome (SARS): the emerging pathologic-radiologic correlates of an emerging disease.

Severe acute respiratory distress syndrome (SARS) caused by SARS-associated coronavirus (SARS-CoV) is a systemic infection that clinically manifests as progressive pneumonia. During the initial phases of infection the virus causes pauci-inflammatory alveolar and interstitial edema that result in imaging abnormalities dominated by ground glass opacities (GGO). Severe SARS cases can develop radiologic and pathologic findings of diffuse alveolar damage. Although radiologic evidence of acute bronchiolitis is absent, SARS-CoV also infects ciliated airway epithelium, probably accounting for respiratory transmissibility of the virus. Radiologic recovery from SARS can be complete, but computed tomography images often show persistent GGO and reticular opacities, some of which reflect pathologic findings of fibrosis. Long-term follow-up imaging of survivors shows gradual decrease of GGO and reticulation with persistent air trapping in some patients. The latter is evidence of small airway disease that is not radiologically evident at the onset of the disease.

Communicable Diseases, Emerging↗
PubMed2004

Is it possible to predict radiological damage in early rheumatoid arthritis (RA)? A report on the occurrence, progression, and prognostic factors of radiological erosions over the first 3 years in 866 patients from the Early RA Study (ERAS).

Our aim was to assess the occurrence, progression, and prognostic features for radiological damage in early rheumatoid arthritis (RA). We recruited an inception cohort of patients from rheumatology departments in 9 hospitals beginning in 1986. Standard clinical and laboratory assessments and radiographs of hands and feet were made at baseline and yearly, and scored using Larsen's method. The study included 866 patients with radiographic scores at baseline and at 3 years, of whom 279 (32%) had erosive damage at baseline, and 609 (70%) by 3 years. Baseline and first-year values for Larsen erosion score, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), hemoglobin, nodules, swollen joint count, grip strength, duration of symptoms, and presence of RA-associated shared epitope were all risk factors for 3 year radiological outcome. In the non-erosive group at baseline (68%), high RF and ESR correctly predicted erosions or not by 3 years in 67%. Severity of erosions was correctly predicted by Larsen and swollen joint scores at baseline (82% correct), and Larsen score and ESR at one year (90% correct). In conclusion, most patients had evidence of radiological erosions by 3 years, despite early treatment with conventional drug therapy. Prognosis for radiological outcome was possible using routinely obtained clinical and laboratory measures. Ninety percent correct classification, even at one year, is likely to be useful to clinicians managing treatment options in early RA.

Adult↗
PubMed1993

The clinical and radiological evaluation of primary brain neoplasms in children, Part II: Radiological evaluation.

Data collected over the past 8 years on the radiological appearance of common pediatric primary brain neoplasms are presented. An emphasis is placed on the newer radiological imaging modality of magnetic resonance imaging (MRI). Part I of this article emphasized the clinical evaluation of these brain neoplasms. Three hundred eighty-five children with known brain neoplasms ranging in age from newborn to 18 years were evaluated with one or all of the following radiological modalities: MRI, computed tomography (CT), water-soluble myelography (WSM), WSM with CT, and angiography. Contrast-enhanced MRI and CT scans both were accurate in delineating these brain neoplasms although MRI provided better resolution and delineation than CT. Angiography provided information on the vascularity of the neoplasms and their relationship to prominent arterial and venous structures. Water-soluble myelography with CT and gadolinium-enhanced MRI of the spine were equally accurate in demonstrating metastatic spread to the spinal canal and spinal cord. Magnetic resonance imaging with gadolinium was more accurate than CT with contrast in demonstrating recurrent or residual neoplasm at the operative site and metastatic spread to the brain. Magnetic resonance imaging with gadolinium is the best radiological modality to fully evaluate pediatric brain neoplasms.

Brain↗
PubMed1976

The radiological differentiation between ulcerative and granulomatous colitis by double contrast radiology.

The purpose of this report is to illustrate the value of the double contrast technic for the detection of early changes of colitis and for the differentiation between ulcerative and granulomatous colitis. Fifty consecutive patients with radiologically-diagnosed nonspecific colitis are included and the radiographs, endoscopic and pathologic reports and photographs were reviewed. On radiological grounds ulcerative colitis were diagnosed in 23 patients and granulomatous colitis in 27 patients. There were no radiologically indeterminate cases. Follow-up information was obtained by colectomy in nine patients, colonoscopy in nine patients and sigmoidoscopy in the remainder. In no case did the endoscopic or pathologic diagnosis conflict with the radiological diagnosis. With the double contrast technic, very fine mucosal detail can be seen including features such as granular mucosa, "aphthoid" ulcers and discontinuous disease which are not demonstrable by the conventional single contrast barium enema. This detailed mapping of the nature and extent of disease facilitates the differential diagnosis between ulcerative and granulomatous colitis.

Colitis, Ulcerative↗
PubMed1993

An integrated picture archiving and communications system-radiology information system in a radiological department.

In this report we present an integrated picture archiving and communication system (PACS)--radiology information system (RIS) which runs as part of the daily routine in the Department of Radiology at the University of Graz. Although the PACS and the RIS have been developed independently, the two systems are interfaced to ensure a unified and consistent long-term archive. The configuration connects four computer tomography scanners (one of them situated at a distance of 1 km), a magnetic resonance imaging scanner, a digital subtraction angiography unit, an evaluation console, a diagnostic console, an image display console, an archive with two optical disk drives, and several RIS terminals. The configuration allows the routine archiving of all examinations on optical disks independent of reporting. The management of the optical disks is performed by the RIS. Images can be selected for retrieval via the RIS by using patient identification or medical criteria. A special software process (PACS-MONITOR) enables the user to survey and manage image communication, archiving, and retrieval as well as to get information about the status of the system at any time and handle the different procedures in the PACS. The system is active 24 hours a day. To make the PACS operation as independent as possible from the permanent presence of a system manager (electronic data processing expert), a rule-based expert system (OPERAS; OPERating ASsistant) is in use to localize and eliminate malfunctions that occur during routine work. The PACS-RIS reduces labor and speeds access to images within radiology and clinical departments.

Austria↗
PubMed2002

[New international networks in radiology graduate and continuing education: www.eurorad.org--a EAR Project for online publication of radiological data].

Eurorad (www.eurorad.org) is a joint project of EAR and has support of 27 national and 8 subspeciality radiology societies. Eurorad is the first noncommercial radiological publication that is exclusively based on the internet as a communication line with all steps of submission, reviewing and publication being performed online. Eurorad wants to build up a huge and exhaustive case file of diagnostic and interventional radiology. Like all scientific publications, Eurorad bases on an editor in chief and 13 section editors who are responsible for organizing each section of Eurorad. Each section has a number of peer reviewer with an overall total of more than 100. For submission and publication, all cases are structured in the same manner with case report, method and discussion. For the time being, Eurorad hosts 779 cases, of whom 346 are free available on the net. The actual rejection rate is 4.5%, other cases are under review.

Curriculum↗
PubMed2001

Technology and archives in radiology research: a sampling analysis of articles published in the AJR and Radiology. American Journal of Roentgenology.

OBJECTIVE: Our aim was to determine the use of advanced technology and archiving and the contribution of countries other than United States in the articles published in the American Journal of Roentgenology (AJR) and Radiology. We analyzed the association of these features with the type of research, the main technical features of the modalities used, and the countries of origin. MATERIALS AND METHODS: We determined the proportion of articles published in 18 randomly selected issues of the AJR and Radiology that required advanced imaging techniques and relied on the analysis of archived data. "Advanced technology" was defined as imaging techniques that serve a purpose other than simple anatomic imaging or that are not widely available because of the high cost of the technology, such as functional imaging and computer programming designed for an individual study or simulation studies. We analyzed the association of these features with the country of origin, the topic, and the methodology used. RESULTS: Sixteen percent of the studies required advanced technology. MR imaging, CT, and sonography were the most frequently used modalities (31%, 27%, and 15% of studies, respectively). Archiving was used in 37% of the studies, and 67% of the original articles were prospective. The articles most commonly originated in North America (67%), Europe (20%), and Asia (12%). CONCLUSION: Only a small percentage of published research studies required advanced technology and approximately one third of the studies used archiving. These results may suggest that other criteria, such as the design of the study, its relevance for daily clinical use, and the originality of the paper, have a major impact on the acceptance of papers in clinically oriented radiology journals.

Periodicals as Topic↗
PubMedDate not supplied

Role of a radiologic technologist trained as a physician assistant in diagnostic radiology.

This article describes a program for physican assistants in diagnostic radiology at the University of Kentucky, currently the only one in the country. Available only to graduates of AMA-approved radiologic technology programs who have two years of field experience, it consists of two additional years of intensive education in many aspects of radiological medicine.

Curriculum↗
PubMed2003

Evidence-based radiology: how to quickly assess the validity and strength of publications in the diagnostic radiology literature.

The aim of this study was to show how evidence-based medicine (EBM) techniques can be applied to the appraisal of diagnostic radiology publications. A clinical scenario is described: a gastroenterologist has questioned the diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) in a patient who may have common bile duct (CBD) stones. His opinion was based on an article on MRCP published in "Gut." The principles of EBM are described and then applied to the critical appraisal of this paper. Another paper on the same subject was obtained from the radiology literature and was also critically appraised using explicit EBM criteria. The principles for assessing the validity and strength of both studies are outlined. All statistical parameters were generated quickly using a spreadsheet in Excel format. The results of EBM assessment of both papers are presented. The calculation and application of confidence intervals (CIs) and likelihood ratios (LRs) for both studies are described. These statistical results are applied to individual patient scenarios using graphs of conditional probability (GCP). Basic EBM principles are described and additional points relevant to radiologists discussed. Online resources for EBR practice are identified. The principles of EBM and their application to radiology are discussed. It is emphasized that sensitivity and specificity are point estimates of the "true" characteristics of a test in clinical practice. A spreadsheet can be used to quickly calculate CIs, LRs and GCPs. These give the radiologist a better understanding of the meaning of diagnostic test results in any patient or population of patients.

Confidence Intervals↗
PubMed1998

Relevant radiological anatomy of the pig as a training model in interventional radiology.

The use of swine for teaching purposes in medicine and surgery has largely increased in recent years. Detailed knowledge of the porcine anatomy and physiology is a prerequisite for proper use of pigs as a teaching or an experimental model in interventional radiology. A systematic study of the radiological anatomy was undertaken in more than 100 female pigs aged 6-8 weeks. All studies were performed under general anesthesia in a single session. Animals were sacrificed at the end of the study. Selective angiographies were systematically obtained in all anatomical territories. In other animals CT and MRI examinations were performed and were correlated to anatomical sections and acrylic casts of the vascular structures. Endoscopical examinations of the upper gastrointestinal tract, including retrograde opacification of the biliary and pancreatic ducts, were added in selected animals. The main angiographic aspects of the brain, head and neck, thorax, abdomen, and pelvis were recorded. Similarities and differences in comparison with human anatomy are stressed. Potential applications in interventional radiology are indicated.

Animals↗
PubMed1996

A review of the statistical analysis used in papers published in Clinical Radiology and British Journal of Radiology.

Statistical analysis such as significance testing have become essential features of published medical studies. This has resulted in an increased frequency with which statistics are used, making the interpretation of scientific publications more difficult. There is an extensive array of tests and techniques. The aim of this study is to identify which statistical tests are used in radiology publications. All major articles published in Clinical Radiology and British Journal of Radiology in one year were reviewed. The frequency of statistical methods used was as follows: no statistical method or descriptive statistics only 103 (47%), one type of statistical method 67 (31%), and two or more methods 47 (22%). Statistics dealing with basic inference, decisions, contingency tables or correlation/regression techniques were found in 124 (53%) in which a procedure had been used. Advanced statistics including receiver operating characteristics (ROC), odds ratio, regression techniques, multiway ANOVA, and nonparametric ANOVA studies accounted for only 41 (19%) in which a procedure had been used. We conclude that descriptive analysis and basic statistical techniques account for most of the statistical tests reported. Physicians should concentrate on improving their understanding of basic statistics but advice should be sought from professionals in the fields of biostatistics and epidemiology as to whether the use of more advanced techniques would be more appropriate.

Humans↗
PubMed2003

Radiology scheduling: preferences of users of radiologic services and impact on referral base and extension.

RATIONALE AND OBJECTIVES: To study end-user attitudes and preferences with respect to radiology scheduling systems and to assess implications for retention and extension of the referral base. A study of the institution's historical data indicated reduced satisfaction with the process of patient scheduling in recent years. METHODS: Sixty physicians who referred patients to a single, large academic radiology department received the survey. The survey was designed to identify (A) the preferred vehicle for patient scheduling (on-line versus telephone scheduling) and (B) whether ease of scheduling was a factor in physicians referring patients to other providers. Referring physicians were asked to forward the survey to any appropriate office staff member in case the latter scheduled appointments for patients. Users were asked to provide comments and suggestions for improvement. The statistical method used was the analysis of proportions. RESULTS: Thirty-three responses were received, corresponding to a return rate of 55%. Twenty-six of the 33 respondents (78.8%, P < .01) stated they were willing to try an online scheduling system; 16 of which tried the system. Twelve of the 16 (75%, P < .05) preferred the on-line application to the telephone system, stating logistical simplification as the primary reason for preference. Three (18.75%) did not consider online scheduling to be more convenient than traditional telephone scheduling. One respondent did not indicate any preference. Eleven of 33 users (33.33%, P < .001) stated that they would change radiology service providers if expectations of scheduling ease are not met. CONCLUSION: On-line scheduling applications are becoming the preferred scheduling vehicle. Augmenting their capabilities and availability can simplify the scheduling process, improve referring physician satisfaction, and provide a competitive advantage. Referrers are willing to change providers if scheduling expectations are not met.

Appointments and Schedules↗
PubMed1998

1998 Joseph E. Whitley, MD, Award. Relationship between American College of Radiology in-training examination scores and American Board of Radiology written examination scores. Part 2. Multi-institutional study.

RATIONALE AND OBJECTIVES: The authors assessed the relationship between resident performance on the American College of Radiology in-training examination and subsequent American Board of Radiology written examination. MATERIALS AND METHODS: Percentile scores from the in-training examination (low score, < 20 percentile) and written board examination (low score, < 25 percentile) were collected for 513 residents from 11 university-based programs over a 7-year period. Mean in-training examination scores were compared for the high- and low-score written board examination groups. In-training examination scores were correlated with the written board examination scores. An odds ratio was calculated for the association between in-training examination and written board examination scores; this was adjusted for resident Alpha Omega Alpha (AOA) status, clinical training prior to radiology residency, the year the written board examination was taken, program size, and regional location of the program. RESULTS: The mean in-training examination scores were significantly higher in the high-score than the low-score written board examination group (P = .0001). There was a significant correlation between the in-training examination score and the written board examination score (P = .0001). The crude all-high in-training scores-written board scores odds ratio was 9.618, and the adjusted all-high odds ratio was 7.595. The final model included resident AOA status. CONCLUSION: Resident average in-training examination score was a strong predictor of the written board examination score, as noted in the earlier report. The resident with a low in-training examination score is at risk for poor performance on the written board examination.

Certification↗