Chan R, Kumar G, Abdullah B
… +4 more, Ng Kh, Vijayananthan A, Mohd Nor H, Liew Y
Biomed Imaging Interv J
· 2011 Apr · PMID 22287986
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OBJECTIVE: To optimize the delay time before the initiation of arterial phase scan in the detection of focal liver lesions in contrast enhanced 5 phase liver CT using the bolus tracking technique. PATIENTS AND METHODS: D...OBJECTIVE: To optimize the delay time before the initiation of arterial phase scan in the detection of focal liver lesions in contrast enhanced 5 phase liver CT using the bolus tracking technique. PATIENTS AND METHODS: Delay - the interval between threshold enhancement of 100 hounsfield unit (HU) in the abdominal aorta and commencement of the first arterial phase scan. Using a 16 slice CT scanner, a plain CT of the liver was done followed by an intravenous bolus of 120 ml nonionic iodinated contrast media (370 mg I/ml) at the rate of 4 mL/s. The second phase scan started immediately after the first phase scan. The portal venous and delay phases were obtained at a fixed delay of 60 s and 90 s from the beginning of contrast injection. Contrast enhancement index (CEI) and subjective visual conspicuity scores for each lesion were compared among the three groups. RESULTS: 84 lesions (11 hepatocellular carcinomas, 17 hemangiomas, 39 other hypervascular lesions and 45 cysts) were evaluated. CEI for hepatocellular carcinomas appears to be higher during the first arterial phase in the 6 seconds delay group. No significant difference in CEI and mean conspicuity scores among the three groups for hemangioma, other hypervascular lesions and cysts. CONCLUSION: The conspicuity of hepatocellular carcinomas appeared better during the early arterial phase using a bolus tracking technique with a scan delay of 6 seconds from the 100 HU threshold in the abdominal aorta.
Chan M, Yang J, Song Y
… +3 more, Burman C, Chan P, Li S
Biomed Imaging Interv J
· 2011 Apr · PMID 22287985
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PURPOSE: The imaging characteristics of two popular kV cone-beam CT (CBCT) and two MVCT systems utilised in image-guided radiation therapy (IGRT) were evaluated. MATERIALS AND METHODS: The study was performed on Varian C...PURPOSE: The imaging characteristics of two popular kV cone-beam CT (CBCT) and two MVCT systems utilised in image-guided radiation therapy (IGRT) were evaluated. MATERIALS AND METHODS: The study was performed on Varian Clinac iX, Elekta Synergy S, Siemens Oncor, and Tomotherapy. A CT phantom (Catphan-504, Phantom Laboratory, Salem, NY) was scanned for measurements of image quality including image noise, uniformity, density accuracy, spatial resolution, contrast linearity, and contrast resolution. The measurement results were analysed using in-house image analysis software. Reproducibility, position correction, and geometric accuracy were also evaluated with markers in a smaller alignment phantom. The performance evaluation compared volumetric image properties from these four systems with those from a conventional diagnostic CT (CCT). RESULTS: It was shown that the linearity of the two kV CBCT was fairly consistent with CCT. The Elekta CBCT with half-circle 27-cm FOV had higher CT numbers than the other three systems. The image noises of the Elekta kV CBCT, Siemens MV CBCT, and Tomotherapy fan-beam CT (FBCT) are about 2-4 times higher than that of the Varian CBCT. The spatial resolutions of two kV CBCTs and two MV CBCTs were 8-11 lp/cm and 3-5 lp/cm, respectively. CONCLUSION: Elekta CBCT provided a faster image reconstruction and low dose per scan for half-circle scanning. Varian CBCT had relatively lower image noise. Tomotherapy FBCT had the best uniformity.
Biomed Imaging Interv J
· 2011 Apr · PMID 22287984
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Breast lymphoma is an uncommon neoplasm affecting the breast and is extremely rare in males. While gynaecomastia is common and in most cases benign, it can sometimes result from significant pathology and the physician sh...Breast lymphoma is an uncommon neoplasm affecting the breast and is extremely rare in males. While gynaecomastia is common and in most cases benign, it can sometimes result from significant pathology and the physician should keep in mind the possible diseases that can lead to gynaecomastia. This paper reports a case of lymphoma presenting as unilateral gynaecomastia. The paper discusses the differential diagnosis and emphasises the points that should raise the suspicion of pathology.Mammography, high resolution ultrasound and biopsy findings are discussed and literature survey is presented.
Biomed Imaging Interv J
· 2011 Oct · PMID 22279505
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Lecture-based teaching promotes a passive interaction with students. Opportunities to modify this format are available to enhance the overall learning experience for both students and instructors. The description for a d...Lecture-based teaching promotes a passive interaction with students. Opportunities to modify this format are available to enhance the overall learning experience for both students and instructors. The description for a discussion-based learning format is presented as it applies to a graduate curriculum with technical (formal mathematical derivation) topics. The presented hybrid method involves several techniques, including problem-based learning, modeling, and online lectures, eliminating didactic lectures. The results from an end-of-course evaluation show that the students appear to prefer the modified format over the more traditional methodology of "lecture only" contact time. These results are motivation for further refinement and continued implementation of the described methodology in the current course and potentially other courses within the department graduate curriculum.
Biomed Imaging Interv J
· 2011 Oct · PMID 22279504
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This short case report discusses the various aspects of penile fracture, which is a rare entity. Nevertheless, the incidence of penile fractures is on the rise due to the increased use of performance-enhancing drugs. An...This short case report discusses the various aspects of penile fracture, which is a rare entity. Nevertheless, the incidence of penile fractures is on the rise due to the increased use of performance-enhancing drugs. An individual with a penile fracture should seek immediate medical referral. Prompt diagnosis and management is necessary to prevent undesirable after-effects as discussed. Emphasis is made on how imaging with ultrasound enables a quick and complete assessment of this mishap.
Biomed Imaging Interv J
· 2011 Oct · PMID 22279503
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Pre-operative embolisation of vertebral metastases has been known to effectively devascularise hypervascular vertebral tumours and to reduce intra-operative bleeding. However, the complications that occur during the proc...Pre-operative embolisation of vertebral metastases has been known to effectively devascularise hypervascular vertebral tumours and to reduce intra-operative bleeding. However, the complications that occur during the procedure are rarely reported. This case study attempts to highlight one rare complication, which is epidural tumoural haemorrhage intra-procedure. It may occur due to the fragility of the tumour and presence of neovascularisation. A small arterial dissection may also have occurred due to a slightly higher pressure exerted during injection of embolising agent. Haemostasis was secured via injection of Histoacryl into the area of haemorrhage. The patient was able to undergo the decompression surgery and suffered no direct complication from the haemorrhage.
Chitapanarux I, Chitapanarux T, Tharavichitkul E
… +4 more, Mayurasakorn S, Siriwittayakorn P, Yamada S, Lorvidhaya V
Biomed Imaging Interv J
· 2011 Oct · PMID 22279502
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OBJECTIVE: To evaluate the activity and safety of adding oxaliplatin to a standard chemoradiotherapy schema, including 5-fluorouracil (5-FU)/folinic acid (FA), in locally-advanced rectal cancer (LARC). METHODS: Two cycle...OBJECTIVE: To evaluate the activity and safety of adding oxaliplatin to a standard chemoradiotherapy schema, including 5-fluorouracil (5-FU)/folinic acid (FA), in locally-advanced rectal cancer (LARC). METHODS: Two cycles of oxaliplatin 130 mg/m(2) plus FA 20 mg/m(2) bolus for 5 days and 5-FU 350 mg/m(2) continuous infusion for 5 days were given during week 1 and 4 of pelvic radiotherapy 46 Gy. Patients with a T3/4 and/or node-positive rectal tumour were eligible. Surgery was performed 4-6 weeks after radiotherapy. The primary endpoint was to determine the rate of pathological response. Secondary endpoints were to assess the rate of clinical response and the safety profile. RESULTS: Between March 2005 and January 2009, a total of 35 patients were enrolled. The pathological down-staging rate was 79% with a pathological complete response rate of 17%. The overall clinical response rate (assessed by computed tomography or transrectal ultrasound) was 77%. Grade 3 diarrhoea and Grade 3 neutropaenia were reported in 14% and 11% of the patients, respectively. Eleven patients did not undergo surgery: four of them refused the operation, and seven patients were inoperable due to disease progression. In 24 patients who had surgery, a sphincter-preserving procedure could be performed in 29%. At the median follow-up time of 28.1 months, 25 patients (71%) survived with no evidence of disease. CONCLUSION: The promising results in terms of pathological response, and the associated good safety profile of a regimen of oxaliplatin plus 5-FU/FA with concomitant radiotherapy, suggest that the regimen could be used in LARC.
Biomed Imaging Interv J
· 2011 Oct · PMID 22279501
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This paper describes an extremely rare case of a huge aneurysmal bone cyst (ABC) in the pelvis, occurring in the patient's 5(th) decade of life. The patient presented with a history of painless huge pelvic mass for 10 ye...This paper describes an extremely rare case of a huge aneurysmal bone cyst (ABC) in the pelvis, occurring in the patient's 5(th) decade of life. The patient presented with a history of painless huge pelvic mass for 10 years. Plain radiograph and computed tomography showed huge expansile lytic lesion arising from the right iliac bone. A biopsy was performed and histology confirmed diagnosis of aneurysmal bone cyst. Unfortunately, the patient succumbed to profuse bleeding from the tumour.
Biomed Imaging Interv J
· 2011 · PMID 22279500
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John Cameron has made significant contributions to the field of Medical Physics. His contributions encompassed research and development, technical developments and education. He had a particular interest in the education...John Cameron has made significant contributions to the field of Medical Physics. His contributions encompassed research and development, technical developments and education. He had a particular interest in the education of medical physicists in developing countries. Structured clinical training is also an essential component of the professional development of a medical physicist. This paper considers aspects of the clinical training and education of medical physicists in South-East Asia and the challenges facing the profession in the region if it is to keep pace with the rapid increase in the amount and technical complexity of medical physics infrastructure in the region.
Urairat J, Asavaphatiboon S, Singhara Na Ayuthaya S
… +1 more, Pongnapang N
Biomed Imaging Interv J
· 2011 · PMID 22279499
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PURPOSE: This study was carried out to assess the radiation dose to patients undergoing interventional radiology procedures at Ramathibodi Hospital, Bangkok, Thailand. METHODS: Data were collected from 60 patients under...PURPOSE: This study was carried out to assess the radiation dose to patients undergoing interventional radiology procedures at Ramathibodi Hospital, Bangkok, Thailand. METHODS: Data were collected from 60 patients under transarterial oily-chemoembolisation (TOCE) and femoral angiography performed with the Toshiba Infinix model VC-i FPD single plane system. Data were also collected from 60 patients who underwent brain arteriovenous malformations (AVM) and dural-arteriovenous fistula (DAVF) embolisation, performed with the Toshiba Infinix model VF-i bi-plane systems. A built-in air kerma area product (KAP) meter calibrated in situ was used for the skin dose calculation. RESULTS: The calibration coefficient of air kerma area product meter at tube voltage between 50 kV and 100 kV was found to vary within ± 5.07%, ± 7.2%, ± 4.86 % from calibration coefficient of 80 kV for a single-plane, tube 1 and tube 2 of bi-plane x-ray system, respectively. Mean air kerma area product values were 90.99 ± 52.89, 31.02 ± 17.92, 33.11 ± 23.99 (Frontal), 35.01 ± 19.10 (Lateral), 50.15 ± 44.76 (Frontal), 97.31 ± 44.12 (Lateral) Gy-cm(2) for transarterial oily-chemoembolisation, femoral angiography, diagnostic cerebral angiography, therapeutic cerebral angiography, respectively. The therapeutic cerebral angiography procedure was found to give the highest entrance dose, number of images and fluoroscopy time: 362.63 cGy (Lateral), 1015 images (Lateral) and 126 minutes, respectively. However, the highest air kerma area product value was from transarterial oily-chemoembolisation with 264.37 Gy-cm(2). There were 2 cases of therapeutic cerebral angiography, where the patient entrance dose was higher than 3 Gy in the frontal view, which reached the deterministic threshold for temporary epilation. CONCLUSION: Very wide variationswere found in patient dose from different interventional procedures. There is a need for a dose record system to provide feedback to radiologists who perform the procedures; especially in cases where the dose exceeds the deterministic threshold.
Biomed Imaging Interv J
· 2011 · PMID 22279497
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PURPOSE: To ascertain the effectiveness of the clinical, tutorial-based component of teaching and the clinical assessment method in the Bachelor of Medical Imaging Science at Curtin University of Technology (CUT), Perth,...PURPOSE: To ascertain the effectiveness of the clinical, tutorial-based component of teaching and the clinical assessment method in the Bachelor of Medical Imaging Science at Curtin University of Technology (CUT), Perth, Western Australia. MATERIALS AND METHODS: In mid-2006, second- and third-year students enrolled in CUT's Medical Imaging Science degree were asked to complete a questionnaire assessing the Objective Structured Clinical Examination (OSCE) evaluation program and clinical teaching. Thirty-three of 57 students answered questions about demographics and their opinions of the laboratory sessions, clinical placements and the OSCEs. RESULTS: Seventy-six per cent of students were satisfied with their laboratory sessions and clinical placements. Sixty-four percent of respondents indicated that the OSCE was not an objective evaluation, but 82% of students felt the OSCE was an effective test of their radiography skills and knowledge, and believed that they were able to evaluate and care for a patient during the OSCE. CONCLUSION: Overall, the surveyed students believed that the practical skills explored in laboratory sessions helped improve clinical training outcomes; however, only 33% of the students were satisfied that the OSCE was an appropriate assessment of their clinical training in hospitals.
Biomed Imaging Interv J
· 2011 · PMID 22279496
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Foreign body granuloma is a reaction to either a biodegradable substance or inert material. In a breast cancer patient who had undergone an excision or mastectomy with axillary clearance, a foreign body granuloma in the...Foreign body granuloma is a reaction to either a biodegradable substance or inert material. In a breast cancer patient who had undergone an excision or mastectomy with axillary clearance, a foreign body granuloma in the axilla may be misinterpreted as an axillary lymph node. We report our experience with a case of cotton-ball granuloma of the axilla in a breast cancer patient, which mimics a lymph node radiologically from the CT scan, mammogram and ultrasonography. Following biopsy and excision, the mass was diagnosed histologically as a foreign body granuloma.
Rozman Z, Thambidorai RR, Zaleha AM
… +2 more, Zakaria Z, Zulfiqar MA
Biomed Imaging Interv J
· 2011 · PMID 22279495
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PURPOSE: This study aims to evaluate the effectiveness of intralesional bleomycin sclerotherapy in the treatment of lymphangioma in children and to determine the incidence of complications in the treatment. METHODS: This...PURPOSE: This study aims to evaluate the effectiveness of intralesional bleomycin sclerotherapy in the treatment of lymphangioma in children and to determine the incidence of complications in the treatment. METHODS: This is a retrospective study of 24 children diagnosed with lymphangioma and treated with intralesional injection of bleomycin aqueous solution from January 1999 to December 2004. RESULTS: Complete resolution was seen in 63% (15/24) of lesions, 21% (5/24) had good response and 16% (4/24) had poor response. The tumour recurred in 2 patients. Two other patients had abscess formation at the site of injection. No other serious complications or side effects were observed. CONCLUSION: Intralesional bleomycin therapy was very effective in the treatment of lymphangioma. Our results were comparable to other published studies. Bleomycin administered as intralesional injection was found to be safe as there was no serious complication or side effect observed in this study.
Biomed Imaging Interv J
· 2011 · PMID 21655117
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The role of surgery in the morbidly obese is becoming more prominent. There are a variety of surgical approaches which can be used and radiology plays a crucial role in post operative follow up, particularly in the manag...The role of surgery in the morbidly obese is becoming more prominent. There are a variety of surgical approaches which can be used and radiology plays a crucial role in post operative follow up, particularly in the management of complications. Many general radiologists remain unfamiliar with both the normal and abnormal appearances after bariatric surgery and this pictorial review aims to bridge this gap.
Faizah M, Kanaheswari Y, Thambidorai C
… +1 more, Zulfiqar M
Biomed Imaging Interv J
· 2011 · PMID 21655116
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PURPOSE: To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR). MATERIALS AND METHO...PURPOSE: To compare echocontrast cystosonography (ECS) using in-vivo agitated saline with fluoroscopic micturating cystourethrography (MCU) in the detection and grading of vesicoureteric reflux (VUR). MATERIALS AND METHODS: This was a prospective study of 25 children, who had MCU between 2007 and 2009. ECS was performed and findings documented prior to MCU. Baseline renal and bladder sonograms were obtained. The bladder was filled with normal saline followed by introduction of 10-20 mls of air to generate microbubbles. Detection of VUR was based on two sonographic criteria: (1) presence of microbubbles in the pelvicaliceal system (PCS), and (2) increase in dilatation of the PCS. VUR was graded as (1) Grade I: microbubbles seen in ureter only; (2) Grade II: microbubbles seen in non-dilated PCS; and (3) Grade III-V: microbubbles seen in dilated PCS. The ECS findings were compared using MCU as the gold standard. RESULTS: Of the 50 kidney-ureter (K-U) units studied, ECS detected 9 of 10 K-U units with VUR on MCU. ECS did not detect a Grade II VUR. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value for criterion 1 was 90%, 87.5%, 88%, 64.3% and 97%, respectively, compared to criterion 2 which was 70%, 90%, 86%, 64% and 92%, respectively. The grading of VUR was similar on both ECS and MCU except for one case. CONCLUSION: ECS using agitated saline was a sensitive technique for the detection of VUR. ECS grading was comparable with MCU grading of VUR.
Biomed Imaging Interv J
· 2011 · PMID 21655114
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Hepatocellular carcinoma (HCC) is one of the most common cancers, which is mainly a concern in Southeast Asia. Apoptosis resistance in HCC is one of the significant factors for hepatocarcinogenesis and tumour progression...Hepatocellular carcinoma (HCC) is one of the most common cancers, which is mainly a concern in Southeast Asia. Apoptosis resistance in HCC is one of the significant factors for hepatocarcinogenesis and tumour progression. Recent advances of apoptosis resistance mechanisms in HCC could serve as potential targets for molecular imaging, which would be of considerable value to explore the molecular processes involved in HCC progression and to evaluate responses of certain anti-HCC therapies. Disruptions in the balance of anti-apoptotic and pro-apoptotic processes have been found to be involved in apoptosis resistance in HCC. Loss of response to death receptors, transformation of growth factor-β induced apoptosis, upregulation of anti-apoptotic Bcl-2 subgroup, as well as downregulation of pro-apoptotic Bax subgroup and BH3-only subgroup, are associated with apoptosis resistance in HCC. Mutation of p53 gene, dysregulation of NF-κB and survivin are also of interest because of their contribution to HCC development. In this review, the aim is to identify potential targets for molecular imaging of apoptosis resistance in HCC.
Biomed Imaging Interv J
· 2011 · PMID 21655113
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Chronic spine pain poses a peculiar diagnostic and therapeutic challenge due to multiple pain sources, overlapping clinical features and nonspecific radiological findings. Facet joint injection is an interventional pain...Chronic spine pain poses a peculiar diagnostic and therapeutic challenge due to multiple pain sources, overlapping clinical features and nonspecific radiological findings. Facet joint injection is an interventional pain management tool for facet-related spinal pain that can be effectively administered by a radiologist. This technique is the gold standard for identifying facet joints as the source of spinal pain. The major indications for facet injections include strong clinical suspicion of the facet syndrome, focal tenderness over the facet joints, low back pain with normal radiological findings, post-laminectomy syndrome with no evidence of arachnoiditis or recurrent disc disease, and persistent low back pain after spinal fusion. The contraindications are more ancillary, with none being absolute. Like any synovial joint degeneration, inflammation and injury can lead to pain on motion, initiating a vicious cycle of physical deconditioning, irritation of facet innervations and muscle spasm. Image-guided injection of local anesthetic and steroid into or around the facet joint aims to break this vicious cycle and thereby provide pain relief. This outpatient procedure has high diagnostic accuracy, safety and reproducibility but the therapeutic outcome is variable.