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Epiploic AppendagitisClinical History: A 42-year-old woman with no significant past medical history presented with three days of sharp left sided abdominal pain with associated nausea and anorexia.
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Evidence-based medicine meets diagnostic radiologyEvidence-based medicine is not a new concept. Hippocrates noted over 2000 years ago that while medicine is a mix of science and opinion, "the former begets knowledge, the latter ignorance."
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Three-T evolves to meet speed vs. quality balanceThe feasibility of 3T MR as a general-purpose clinical imaging modality is an ongoing controversy. Although whole-body 3T MRI has been available for several years, most systems to date have been sold to university hospitals and research facilities.
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Image IQ: 45-year-old Female, Routine Screening Mammogram Abnormality45-year-old female with abnormality on routine screening mammogram, underwent breast reduction surgery 2 years prior.
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Indications expand for fetal MR imagingFetal MRI has become established in clinical practice over the past decade. MRI is indicated when conditions do not favor fetal ultrasound such as cases of maternal obesity or anhydramnios.1 It has also been shown that fetal MRI may discriminate among tissue components that do not display impedance differences on ultrasound; for instance, laminae in the developing brain.2 These advantages, along with MR's ability to delineate small structures, such as cranial nerves, has furthered its use as an adjunct to ultrasound in fetal imaging.1 Applications for fetal MRI are growing. The development of improved methods for fetal imaging, including availability of ultrafast sequences,3 has also furthered adoption.
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MR imaging confirms early promise in bladder cancerUrinary bladder carcinoma is the second most common malignant tumor in the urogenital tract. This cancer causes 5000 deaths each year in Germany and 10,400 in the U.S., affecting men more often than women.
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Dynamic contrast-enhanced MR imaging finally comes of ageTumors require new blood vessels in order to grow beyond a few millimeters in size. Once this "angiogenic switch" is thrown, a series of events occur that lead to the progression and spread of cancer. The vessels formed by tumors are not only larger and more numerous but also more permeable than normal vessels1 (Figure 1). Thus, when a patient with a tumor is injected with a gadolinium-chelate MR contrast agent, the tumor enhances more than the surrounding normal tissue.
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Integration bolsters workstation designMost of the literature on PACS in radiology has focused on the quality and implementation of the systems themselves. Other articles have described the use of multiple monitor systems, discussing the optimal number of monitors per PACS workstation or whether LCDs can replace conventional CRT monitors. The prime concern of radiologists, however, is the design of the PACS workstation and how it functions in practice. Some recent articles on this topic update earlier publications that evaluated user satisfaction with commercially available workstations.
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Kidney tumor ablation treats nonsurgical candidatesOver 35,000 new cases of renal cell carcinoma occurred in the U.S. in 2001,1 most of them detected as incidental imaging findings on CT, MR, or ultrasound.2,3 Since most of these tumors are relatively small when detected, the classic clinical triad of flank pain, hematuria, and palpable mass is now rarely encountered. Many of these incidentally discovered RCCs are also slow growing. Bosniak et al showed that RCCs smaller than or equal to 3.5 cm grow at an average rate of 0 to 1.1 cm/year (mean 0.36 cm/year).4
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Nuclear medicine gains traction from PET/CT, new radioisotopesRapid technological developments, in terms of both instrumentation and radiopharmaceuticals, are making nuclear medicine an increasingly relevant part of daily clinical practice, according to Prof. Peter Ell, director of the Institute of Nuclear Medicine at University College London.&qu
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PACS reading protocols tame information overloadThe imaging data generated in a typical episode of patient care is too much and generally too complex for radiologists to manage unassisted. Harnessing this information and converting it into better health outcomes is the objective of PACS developers, who think that computerized protocols for image presentation will help break the logjam.
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Radiology must confront outsourcing challengesTeleradiology has apparently come of age. Imaging examinations can be sent via high-speed connections to anywhere in the world, at increasingly low cost. Teleradiology also appears to be a profitable business. Take, for example, the services emerging to cover the night shift for U.S. radiologists. Teleradiology Solutions and TeleDiagnosys Services are just two of the many enterprises in the field, both offering this service from a base in India.
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Building Awareness of the Changing Radiology LandscapeUnderstanding the radiology group practice environment is essential before planning or executing any operational plan. Here’s how to build that awareness.
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Radiologic signs more than double sensitivity of MR imaging of kneeRadiologists can make a more accurate preoperative diagnosis of damage to knee cartilage by using four radiologic signs, according to a study from Duke University Medical Center. Using the signs to identify the extent and type of damage to knee cartilage makes interpreting MRI with a higher degree of accuracy easier for any radiologist, regardless of level of expertise.
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After two decades, it's time to bid farewell and thanksAs I embark on a new episode in my journalistic career, I can reflect on the past 17 years as the editor of Diagnostic Imaging Europe and Diagnostic Imaging Asia Pacific.
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How to make the case for new equipmentFunding is a constant challenge for imaging departments, and equipment needs can sometimes get lost or forgotten on the road to achieving targets in health systems. We may find ourselves left with an aging equipment portfolio in an ever-changing technological marketplace, amid growing public demand for timely diagnostic studies.
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Solid groundwork leads to rapid PACS acceptanceThe introduction of PACS in a hospital opens up a new world for its users. The impact of PACS on the organization is huge. The new system brings about a dramatic change in workflow, and users must invest time and effort in learning to work with it.
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MR-guided biopsies pose major challengesAccurate needle placement requires instrumentationfor good imaging contrast and high spatial resolution
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Focus on technique helps CT colonographyGood results require thorough patient preparation, dual positioning during imaging, and experienced readers
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Personalized Medicine Advances Toward RadiologyThere’s growing interest in companion imaging diagnostics for personalized care. Using imaging agents for personalized medicine ultimately benefits patients.
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Administrators wrestle with new challenges and skill setsThe radiologists are frustrated and do not understand why things just don't seem to be getting done anymore. After their long-time manager retired, they decided to hire someone with an MBA, but he has been struggling to understand radiology operations. His mistakes have not been too damaging-so far-but he seems overwhelmed and unhappy. How can the job be that difficult?
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CT colonography bests conventional screening in cost-effectiveness testA new study has found that virtual colonoscopy with the removal of lesions 6 mm or greater is more cost-effective and just as clinically effective as optical colonoscopy or flexible sigmoidoscopy that targets polyps regardless of size.
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Diagnostic Quality Viewer Doesn't Mean Cleared to DiagnoseNot all diagnostic image viewers are the same. Know what questions to ask before making a purchasing decision.
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Imaging unveils internal secrets of drug traffickersThe proliferation of narcotics use over the past decades has been accompanied by a rise in drug smuggling. Meticulous vigilance by international customs and national authorities has led traders to adopt sophisticated and ingenious methods of drug transport.
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Solid groundwork leads to rapid PACS acceptanceThe introduction of PACS in a hospital opens up a new world for its users. The impact of PACS on the organization is huge. The new system brings about a dramatic change in workflow, and users must invest time and effort in learning to work with it.
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MR imaging illuminates elbow joint disordersThe elbow is a complex joint. It links the shoulder and the hand, enhances the flexibility of hand motion, and transmits generated forces. The most common elbow injuries are related to chronic overuse, although the joint is vulnerable to acute trauma as well.1 It may also be affected by disease or infection.
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MR imaging throws light on causes of epilepsyAn epileptic seizure is the external manifestation of a functional cerebral disorder that can affect 10% of the world's population. Virtually any brain abnormality can irritate vulnerable neurons and produce epileptic seizures. The nature and characteristics of the seizure depend on the part of the brain involved in the disturbance.
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Case Of The MonthA 13-year-old girl presents with abdominal pain, right lower quadrant tenderness, guarding, elevated lipase, and a history of gastroesophageal reflux disease.
