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PubMed1998

Dental radiography after age 25 years, amalgam fillings and tumours of the central nervous system.

The aim of the study was to investigate the importance of diagnostic dental radiography and amalgam fillings as risk factors for tumours of the central nervous system (CNS). This population-based case-control study included subjects aged 25-74 years, living in the catchment area of the Neurosurgery Department of Uppsala University Hospital in Sweden. A total of 192 cases of glioma, 99 cases of meningioma and 42 cases of acoustic neurinoma were identified between 1987 and 1990. A control group of 343 subjects was matched on age, gender and parish. Information about dental exposure was obtained by a self-administered questionnaire and from dental records. For those who had a dental radiography at least once a year after age 25 years, a relative risk of 2.1 (95% confidence interval (CI) 1.0-4.3) was seen for meningioma, while for other subgroups of CNS tumours the relative risk was close to unity. No association was observed between the number of amalgam fillings and CNS tumours. In conclusion, there was no clear evidence that dental radiography or amalgam fillings is related to the development of tumours of the CNS.

Adult↗
PubMed1999

[Conventional dental radiography and future prospectives].

Until recently, conventional dental radiology was performed by dentists and orofacial surgeons. Due to the rapid development of radiological technique, the demand of radiological advice is increasing. The radiologists see more and more dental patients in their daily routine. The aim of this article is to give an overview on established dental radiology and a glimpse into the future. Conventional dental radiology and digital radiography are presently in use. Intraoral technique comprises dental films, bite-wing views and occlusal radiographs. Panoramic views and cephalometric radiographs are done with extraoral technique. Digital radiography lacks all processes in behalf of film development. It leads to dose reduction and enables image manipulation.

Cephalometry↗
PubMed2000

Updated quality assurance self-assessment exercise in intraoral and panoramic radiography. American Academy of Oral and Maxillofacial Radiology, Radiology Practice Committee.

This updated self-assessment exercise for the dental team by the Radiology Practice Committee of the American Academy of Oral and Maxillofacial Radiology is intended to produce the highest quality diagnostic radiographs while keeping patient exposure as low as is reasonably achievable. To continue to provide the best radiographic services to patients, those involved in dental radiography need to be aware of the latest changes and advances in dental radiography and need to use them in their practice.

Credentialing↗
PubMed2006

Current practice in conventional and digital intraoral radiography: problems and solutions.

In summary, it can be said for digital radiography that digital exposures can be taken just as well as dental film exposures. The problems found when using holders for the paralleling technique are similar in conventional and digital radiography. Good intraoral x-ray images can be produced as a rule with practice, good will and a skilful hand. The bisected angle technique should no longer be used, as this no longer corresponds to the state of the art and of dental medicine. It is therefore important that all intraoral dental exposures are taken with corresponding holders and the paralleling technique. Thus, the bite wing and measuring exposures are no longer taken with the finger or other aids, but suitable holders are used. However, being able to place the film, the storage phosphor or the sensor in the oral cavity correctly is just as important as the choice of exposure technique. Theoretical knowledge and practical skill are therefore closely related.

Equipment Design↗
PubMed1999

Arthritis of the finger joints: a comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging.

OBJECTIVE: A prospective study was performed comparing conventional radiography, 3-phase bone scintigraphy, ultrasound, and magnetic resonance imaging (MRI) with precontrast and dynamic postcontrast examinations in 60 patients with various forms of arthritis including rheumatoid arthritis (RA), spondyl-arthropathy, and arthritis associated with connective tissue disease. METHODS: A total of 840 finger joints were examined clinically and by all 4 imaging methods. Experienced investigators blinded to the clinical findings and diagnoses analyzed all methods independently of each other. The patients were divided into 2 groups. Group 1 included 32 patients (448 finger joints) without radiologic signs of destructive arthritis (Larsen grades 0-1) of the evaluated hand and wrist and group 2 included 28 patients (392 finger joints) with radiographs revealing erosions (Larsen grade 2) of the evaluated hand and/or wrist. RESULTS: Clinical evaluation, scintigraphy, MRI, and ultrasound were each more sensitive than conventional radiography in detecting inflammatory soft tissue lesions as well as destructive joint processes in arthritis patients in group 1. All differences were statistically significant. We found ultrasound to be even more sensitive than MRI in the detection of synovitis. MRI detected erosions in 92 finger joints (20%; 26 patients) in group 1 that had not been detected by conventional radiography. CONCLUSION: Our data indicate that MRI and ultrasound are valuable diagnostic methods in patients with arthritis who have normal findings on radiologic evaluation.

Adult↗
PubMed1992

Imaging strategies in the evaluation of soft-tissue hemangiomas of the extremities: correlation of the findings of plain radiography, angiography, CT, MRI, and ultrasonography in 12 histologically proven cases.

Twelve patients with the histologic diagnosis of soft-tissue hemangioma of the extremities (nine intramuscular, two subcutaneous, and one synovial) were evaluated in a retrospective study using plain film radiography (n = 12), angiography (n = 8), computed tomography (CT; n = 4), magnetic resonance imaging (MRI; n = 3), and ultrasonography (US; n = 2). In eight of nine intramuscular lesions, the plain film demonstration of phleboliths suggested the diagnosis, while the plain radiographs were normal in three. Angiograms showed the pathognomonic features of soft-tissue hemangioma in six patients. MRI was characteristic in all three patients: The lesion demonstrated intermediate signal intensity on T1-weighted spin echo images and extremely bright signal on T2-weighting. US showed a hypoechoic soft-tissue mass in one case and a mixed echo pattern in the other. In one case, a central echogenic focus with acoustic shadowing consistent with a calcified phlebolith was identified, and one lesion exhibited increased color flow and low resistance arterial Doppler signal. CT showed a nonspecific mass in one of four cases and a mass with phleboliths in three. If a deep hemangioma is suspected, we recommend initial imaging with plain radiography followed by MRI. US may be useful in confirming the presence of a mass in doubtful cases or if MRI is unavailable. CT offers no distinct advantage over the combined use of plain radiography and MRI. Although angiography demonstrated the pathognomonic features in all six deeply situated lesions, because of its invasiveness it should be reserved chiefly for those patients undergoing surgical resection.

Adolescent↗
PubMed1986

Magnification radiography in osteomyelitis.

Osteomyelitis often eludes early diagnosis because plain film radiography is too insensitive and radionuclide bone scanning is nonspecific. In this study, 90 diabetic patients were studied with plain film and magnification radiographs of their feet. Among the 24 patients with osteomyelitis, plain radiographs suggested the diagnosis in 14 patients and magnification radiography was diagnostic in 18 of these patients. Thus, magnification radiography offers some diagnostic advantage in patients suspected of having osteomyelitis.

Adult↗
PubMed2000

Impact of digital radiography on clinical workflow.

It is commonly accepted that digital radiography (DR) improves workflow and patient throughput compared with traditional film radiography or computed radiography (CR). DR eliminates the film development step and the time to acquire the image from a CR reader. In addition, the wide dynamic range of DR is such that the technologist can perform the quality-control (QC) step directly at the modality in a few seconds, rather than having to transport the newly acquired image to a centralized QC station for review. Furthermore, additional workflow efficiencies can be achieved with DR by employing tight radiology information system (RIS) integration. In the DR imaging environment, this provides for patient demographic information to be automatically downloaded from the RIS to populate the DR Digital Imaging and Communications in Medicine (DICOM) image header. To learn more about this workflow efficiency improvement, we performed a comparative study of workflow steps under three different conditions: traditional film/screen x-ray, DR without RIS integration (ie, manual entry of patient demographics), and DR with RIS integration. This study was performed at the Cleveland Clinic Foundation (Cleveland, OH) using a newly acquired amorphous silicon flat-panel DR system from Canon Medical Systems (Irvine, CA). Our data show that DR without RIS results in substantial workflow savings over traditional film/screen practice. There is an additional 30% reduction in total examination time using DR with RIS integration.

Appointments and Schedules↗
PubMed2000

A new needle-crystalline computed radiography detector.

The most successful digital radiography detectors to date have been storage phosphor plates used in computed radiography (CR). The detector is cheap, has good producibility, and is robust. Direct radiography (DR) systems are being developed based on flat-panel technology. Better image quality is claimed for some DR systems. On the other hand, DR detectors have low producibility and robustness, and a high price. A new CR detector is being developed at Agfa that combines the advantages of CR and DR. It is a storage phosphor plate made up of needle-shaped crystals. The phosphor efficiently converts absorbed x-ray quanta into photostimulable centers for efficient read out. It has a large dynamic range and its emission is efficiently detected with both photomultiplier tube (PMT) and charge coupled device (CCD). It is shown that CR systems based on the new detector offer image quality that matches that of the best DR systems.

Computer Storage Devices↗
PubMed1995

Clinical usefulness of digital radiography in the gastrointestinal tract: efficacy of magnification method.

We assessed the performance capabilities of image intensifier digital radiography (II DR) in the detection of minute lesions in patients with early stomach cancer. The DR system was a prototype II DR system developed by Toshiba Corp (Tokyo, Japan). This system was able to acquire images with a 1,024- x 1,024-pixel matrix and 12 bits. Radiography was performed using a 0.3-mm tube focus. For the detectability of early stomach cancer, DR was judged to be superior to conventional screen-film system (CFSS) (DR superior, 55.7%; CFSS superior, 22.6%). In depicting the characteristics of the surface of the lesion, DR was also judged to be superior to CFSS (DR superior, 56.6%; CFSS superior, 17.0%). The II DR system used in this study was able to achieve almost the same spatial resolution as conventional radiography using the magnification method. It was also able to visualize subtle findings of early gastric cancer more clearly by the use of postprocessing. In addition, II DR has the advantages of reducing the patient exposure dose and permitting the acquisition of real-time images.

Data Display↗
PubMed1994

Double-contrast barium enema study with computed radiography: assessment in detection of colorectal polyps.

Feasibility and diagnostic performance of digital radiography in gastrointestinal imaging have not been fully investigated. We performed double-contrast barium enema study with computed radiography (CR-DCBE) on a routine basis, and the efficacy of this system for detection of colorectal polyps was investigated. The files of 76 patients, who had undergone both CR-DCBE and colonoscopy, were reviewed by two observers who were blinded to the colonoscopic findings. The radiation dose of CR-DCBE was reduced to 50% of conventional film-screen system. By using colonoscopic findings as a reference, the sensitivity and positive predictive value for colorectal polyps were 66% to 71% and 32% to 41%, respectively. There was no significant interobserver difference. The use of postprocessing with gray-scale reversal and edge enhancement did not significantly improve the results. The sensitivity for polyps smaller than 1 cm was comparable with published data of conventional film-screen systems. Our preliminary results show that CR-DCBE has an acceptable sensitivity for detection of colorectal polyps. It is suggested that the use of CR is a promising approach to digital gastrointestinal radiography.

Adult↗
PubMed2004

Management of pediatric radiation dose using Agfa computed radiography.

Radiation dose to patients and its management have become important considerations in modern radiographic imaging procedures, but they acquire particular significance in the imaging of children. Because of their longer life expectancy, children exposed to radiation are thought to have a significantly increased risk of radiation-related late sequelae compared to adults first exposed to radiation later in life. Therefore, current clinical thinking dictates that dose in pediatric radiography be minimized, while simultaneously ensuring sufficient diagnostic information in the image, and reducing the need for repeat exposures. Dose management obviously starts with characterization and control of the exposure technique. However, it extends farther through the imaging chain to the acquisition system, and even to the image processing techniques used to optimize acquired images for display. Further, other factors, such as quality control procedures and the ability to handle special pediatric procedures, like scoliosis exams, also come into play. The need for dose management in modern radiography systems has spawned a variety of different solutions, some of which are similar across different manufacturers, and some of which are unique. This paper covers the techniques used in Agfa Computed Radiography (CR) systems to manage dose in a pediatric environment.

Child↗
PubMed2007

Radiography after unexpected death in infants and children compared to autopsy.

BACKGROUND: Postmortem radiography may reveal skeletal and soft-tissue abnormalities of importance for the diagnosis of cause of death. OBJECTIVE: To review the radiographs of children under 3 years of age who had died suddenly and unexpectedly. To compare the radiological and autopsy findings evaluating possible differences in children dying of SIDS and of an explainable cause. MATERIALS AND METHODS: A total of 110 consecutive skeletal surveys performed between 1998 and 2002 were reviewed. All but one were performed before autopsy and comprised AP views of the appendicular and axial skeleton and thorax/abdomen, lateral views of the axial skeleton and thorax, and two oblique views of the ribs. Radiography and autopsy findings were compared. RESULTS: Causes of death were classified as SIDS/borderline SIDS (n = 52) and non-SIDS (n = 58), with one case of abuse. In 102 infants there were 150 pathological findings, 88 involving the chest, 24 skeletal, and 38 miscellaneous findings. The radiological-pathological agreement was poor concerning pulmonary findings. Skeletal findings were sometimes important for the final diagnosis. CONCLUSIONS: Radiography revealed many skeletal and soft-tissue findings. Pulmonary pathology was most frequently found, but showed poor agreement with autopsy findings. Recognizing skeletal findings related to abuse is important, as these may escape recognition at autopsy.

Autopsy↗
PubMed1997

Pediatric musculoskeletal computed radiography.

BACKGROUND: In conventional radiography, a film-screen system serves as the X-ray detector and the film also functions as an archival and display medium. Unlike film-screen radiography, these functions are uncoupled in computed radiography (CR). CR uses conventional radiographic equipment to expose an image on a storage phosphor plate instead of a film-screen combination. OBJECTIVE: To review the basic concepts of CR and to provide a background for discussion of specific musculoskeletal applications of CR in children. MATERIALS AND METHODS: Various aspects of musculoskeletal CR in children are presented based on our 4 years' experience and a review of the literature. RESULTS: A greater amount of scatter capture occurs with storage phosphor CR than with a film-screen system in the 70- to 120-kVp range. This is attributed to a lower K-absorption edge of barium in the barium fluorohalide (BaFBr) compound used in the imaging plate. A significant reduction of scatter to primary radiation, improvement in bony trabecular sharpness, and improvement in line pair resolution can be achieved in pediatric musculoskeletal imaging using an air gap without an increase in the skin entrance dose as compared to the non-grid table top technique. With CR, in addition to proper radiographic exposure technique, one needs to preprogram and select the optimal processing technique for each anatomic region, projection and age group of the child. CONCLUSION: The main advantages of CR in pediatric musculoskeletal imaging consist of a reduction in radiation dose for many applications, improved contrast resolution, near elimination of repeat radiographs related to exposure errors, and digital processing capabilities for image enhancement, storage, retrieval, display and transmission. The current limitations of CR include the moderately high start-up cost, the long learning curve to produce optimal films, and the reduced spatial resolution.

Artifacts↗
PubMedDate not supplied

Specimen radiography: an assessment method for reduction mammaplasty materials.

Although, one out of every eight women has a risk of developing breast cancer, the reported incidence of breast carcinoma detection in reduction mammaplasty materials is rather low. To our knowledge, specimen radiography, which is used for breast biopsies has not been used for the assessment of breast reduction materials. We investigated the applicability of specimen radiography and its potential benefits in detection of the breast pathologies, especially malignancies in reduction mammaplasty materials. Forty patients scheduled for reduction mammaplasty operation were included. In all cases an inferior pedicle reduction technique was preferred and the radiographs of the resected breast tissues were taken immediately. The radiographs were evaluated for any possible pathologic appearance and all abnormal findings were marked. For the histopathologic evaluation, in addition to the random sampling of the pathologist, any marked areas were also microscopically examined. In two cases fibrocystic changes were found in radiographs and the same results were obtained in the histological examination. No false negative mammogram was seen. Specimen radiography, which is applicable for breast reduction materials is an easy and cheap method and does not cause any patient discomfort. It seems that the radiographs of reduction mammaplasty materials are useful to provide guidance to the pathologist during tissue sampling for microscopic examination especially when large amounts of breast tissue is excised.

Adult↗
PubMed1997

Paraffin tissue block radiography of nonpalpable lesions with calcifications detected at mammography: 5-year consecutive series of surgically excised cases.

The objective of our study was to evaluate paraffin tissue block radiography following biopsy for breast calcifications at a center for population-based mammography screening. During a 5-year period, we radiographed tissue blocks from 259 breast specimens excised because of nonpalpable calcifications. A total of 124 cases were examined retrospectively and 135 cases were examined prospectively. In 34 of 94 (36 %) retrospectively examined cases with calcifications, the histopathological diagnosis was ductal cancer in situ with or without invasive cancer, compared with 3 of 30 (10 %) cases without calcifications. In 6 cases a primary benign histopathological diagnosis was changed to malignant due to the use of tissue block radiography. Tissue block radiography is a valuable adjunctive method to assure that areas containing calcifications are examined by histopathology.

Breast↗
PubMed2005

[Imaging techniques in rheumatology: conventional radiography in rheumatoid arthritis].

Conventional radiography is still regarded the gold standard for imaging techniques in rheumatoid arthritis (RA). It is a very important tool for the diagnosis, the differential diagnosis, and the evaluation of the course and prognosis of the disease. Special advantages of conventional radiography are the worldwide availability and experience with the method over decades and the relatively low costs. Moreover, x-rays can be stored and re-evaluated over long periods of time. Joint damage caused by RA can be quantified by means of scoring methods. The amount of destruction correlates well with functional disability over time. The inhibition of damage progression seen on radiographs is the most important characteristic of a DMARD. Typical radiographic changes are part of the ACR classification criteria of RA. Technically, bone structure can be demonstrated with a high local resolution better than with all other imaging techniques, whereas only indirect conclusions can be drawn concerning soft tissue and cartilage lesions. This review includes recommendations given by the "Commission on Imaging Techniques" of the German Society of Rheumatology regarding technical and personal preconditions, costs, indication as well as practical performance of radiography in RA. In addition, radiographic changes that can be expected in RA including destruction and repair are discussed briefly.

Arthritis, Rheumatoid↗
PubMed2002

Digital radiography for the field: a portable prototype.

The US military has been investigating methods for improving radiographic support for field medical operations. The purpose of this project was to develop and test a portable digital radiography (DR) system to determine its feasibility for field operations. A prototype portable digital radiography device was designed and assembled using a commercially available DR sensor. The sensor and necessary hardware were mounted into a ruggedized aluminum case. The device underwent testing in the hospital and field environments. The prototype rapidly provided digital radiographs in a variety of settings. Shortcomings of the device affecting usability and reliable operation were identified. The successful construction and operation of a portable digital radiography prototype shows that such a device is feasible for field applications. The prototype requires further modification and testing to improve its usability and reliability, and to explore other potential applications, both military and civilian.

Computer Systems↗