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Biomedical Imaging And Intervention Journal[JOURNAL]

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Gartner duct cyst in pregnancy presenting as a prolapsing pelvic mass.

Arumugam A, Kumar G, Si L … +1 more , Vijayananthan A

Biomed Imaging Interv J · 2007 Oct · PMID 21614298 · Full text

Gartner duct cysts are the remnants of the Wolffian duct and they are rarely seen in adulthood. We present a case of a pregnant patient with a prolapsing vaginal mass. A diagnosis of Gartner duct cyst was made after MRI... Gartner duct cysts are the remnants of the Wolffian duct and they are rarely seen in adulthood. We present a case of a pregnant patient with a prolapsing vaginal mass. A diagnosis of Gartner duct cyst was made after MRI was performed. The Gartner duct cyst was drained when the patient went into labour allowing vaginal delivery to be performed.

Role of radiosynovectomy in the treatment of rheumatoid arthritis and hemophilic arthropathies.

Das B

Biomed Imaging Interv J · 2007 Oct · PMID 21614297 · Full text

Radiosynovectomy is a novel method of treatment for several acute and chronic inflammatory joint disorders. A small amount of a beta-emitting radionuclide is injected into the affected joint delivering a radiation dose o... Radiosynovectomy is a novel method of treatment for several acute and chronic inflammatory joint disorders. A small amount of a beta-emitting radionuclide is injected into the affected joint delivering a radiation dose of 70 to 100 Gy to the synovia. The proliferative tissue is destroyed, secretion of fluid and accumulation of inflammation causing cellular compounds stops and the joint surfaces become fibrosed, providing long term symptom relief. The radionuclides are injected in colloidal form so that they remain in the synovium and are not transported by lymphatic vessels causing radiation exposure to other organs. Complete reduction of knee joint swelling has been seen in above 40% and pain relief in 88% of patients. Wrist, elbow, shoulder, ankle and hip joints showed significant improvement in 50-60% and restoration of normal function and long term pain relief has been achieved in about 70% of small finger joints. In hemophilic arthropathies complete cessation of bleeding in about 60% and improved mobility in 75% of patients has been reported.

Bronchogenic cyst with multiple complications.

Marshall G, Cheah C, Lenzo N

Biomed Imaging Interv J · 2007 Oct · PMID 21614296 · Full text

Bronchogenic cysts are a rare type of mediastinal mass thought to arise from abnormal budding of the embryologic foregut. This paper presents a rare case of a 32-year-old male who developed multiple serious complications... Bronchogenic cysts are a rare type of mediastinal mass thought to arise from abnormal budding of the embryologic foregut. This paper presents a rare case of a 32-year-old male who developed multiple serious complications from a bronchial cyst. This rare presentation is discussed and the role of CT and MR imaging in making the diagnosis is highlighted.

The impact of lesion vascularisation on tumours detection by electrical impedance scanning at 200 Hz.

Malich A, Scholz B, Kott A … +3 more , Facius M, Fischer D, Freesmeyer M

Biomed Imaging Interv J · 2007 Oct · PMID 21614295 · Full text

OBJECTIVE: Cancer cells exhibit altered local dielectric properties compared to normal cells. These properties are measurable as a difference in electrical conductance using electrical impedance scanning (EIS). EIS is at... OBJECTIVE: Cancer cells exhibit altered local dielectric properties compared to normal cells. These properties are measurable as a difference in electrical conductance using electrical impedance scanning (EIS). EIS is at present not sufficiently accurate for clinical routine despite its technological advantages. To modify the technology and increase its accuracy, the factors that influence precision need to be analysed and identified. While size, depth, localisation and invasiveness affect sensitivity, vascularisation might show an increased conductance and thus might affect specificity. SUBJECTS AND METHODS: All patients were investigated with EIS (TransScan TS 2000, Migdal Ha Emek, Israel) Planned DCE-MRI prior to histological clarification were included (295 lesions). Dynamic enhancements were assigned scores after analysis of subtracted images after application of Gd-DTPA. D1: strong enhancement of >100% from initial signal obtained on native T1weighted sequence; D2: moderate enhancement 50-100%; D3: enhancement similar to glandular tissue, <50%; D4: subtle or no enhancement, less then surrounding glandular tissue. RESULTS: 89/113 malignant and 107/182 benign findings were visible by a focal increased conductance and/or capacitance using EIS (Sensitivity 79%, Specificity 59%). DCE-MRI was aborted due to claustrophobia in 17/295 cases. MR was used and out of 278 completed MR examinations, 101/104 malignant and 141/174 benign lesions were correctly diagnosed as benign or malignant leading to a sensitivity of 97% and a specificity of 81%. D1 benign lesions were positive in EIS in 33/55 cases suggesting a specificity of 44.4%. This value increases significantly with decreased vascularity to 68.9% (D2-4; 82/119). Out of 60 fibroadenomatous lesions, 10/23 fibroadenomas in class 1 had no focal increased conductance or capacitance and were thus considered as non-suspicious in EIS. The same result was applicable for the 29/37 benign lesions with a D2-4 contrast uptake (43.5% vs. 78.4%, p<.01). CONCLUSION: Vascularisation influences the measurable conductance at low frequency and therefore partially causes the insufficiently low specificity of EIS. Impedance measurements at frequencies in a range of 0.1 KHz to 1 MHz are required . According to theoretical and in vitro studies this might increase the accuracy of EIS technology. © 2007 Biomedical Imaging and Intervention Journal. All rights reserved.

Multislice CT angiography in abdominal aortic aneurysm treated with endovascular stent grafts: evaluation of 2D and 3D visualisations.

Sun Z

Biomed Imaging Interv J · 2007 Oct · PMID 21614294 · Full text

Endovascular repair of abdominal aortic aneurysms has been introduced into the clinical practice for more than a decade and has been confirmed to be an effective alternative to conventional open surgery, especially in pa... Endovascular repair of abdominal aortic aneurysms has been introduced into the clinical practice for more than a decade and has been confirmed to be an effective alternative to conventional open surgery, especially in patients with co-morbid medical conditions. Helical CT angiography is the preferred imaging method in the follow-up of endovascular repair. Recent introduction of multislice CT scanners has augmented its diagnostic role in this area. Diagnostic value of multlislice CT has been complemented by a series of 3D post-processings, which assist vascular surgeons in accurately assessing the effect of endovascular repair by providing additional information when compared to conventional 2D axial images. These reconstructions include multiplanar reformation, curved multiplanar reconstruction, shaded surface display, maximum intensity projection, volume rendering and virtual endoscopy. This article aims to demonstrate the generation of these 2D/3D reconstructions based on multislice CT data acquired from a group of patients with abdominal aortic aneurysm following endovascular repair. A brief introduction of generating each reconstruction was provided; potential clinical applications of each reconstruction were briefly discussed. Images were presented in a dynamic format with the aim of allowing the reader to easily understand the post-processing of these reconstructions.

IUPESM: the international umbrella organisation for biomedical engineering and medical physics.

Nagel J

Biomed Imaging Interv J · 2007 Jul · PMID 21614293 · Full text

An account of the development, aims and activities of the International Union for Physical and Engineering Sciences in Medicine (IUPESM) is presented. Associations with the International Council of Science (ICSU) and the... An account of the development, aims and activities of the International Union for Physical and Engineering Sciences in Medicine (IUPESM) is presented. Associations with the International Council of Science (ICSU) and the World Health Organization (WHO) are leading to exciting new projects towards improving global health, healthcare, quality of life and support of health technologies in developing countries.

Scientific writing and publishing: its importance to radiologists.

Peh W

Biomed Imaging Interv J · 2007 Jul · PMID 21614292 · Full text

Scientific writing and publication marks the endpoint of research that has been performed, completed, peer reviewed and accepted, and complements teaching and training, clinical service and patient care. Writing has nume... Scientific writing and publication marks the endpoint of research that has been performed, completed, peer reviewed and accepted, and complements teaching and training, clinical service and patient care. Writing has numerous benefits, one of the most important ones being the inherent training undertaken to better appreciate and evaluate the published work of others. Effective scientific writing is an important component of a radiologist's practice, and should be cultivated at an early stage of the career.

Hybrid imaging is the future of molecular imaging.

Hicks R, Lau E, Binns D

Biomed Imaging Interv J · 2007 Jul · PMID 21614291 · Full text

Correlative imaging has long been used in clinical practice and particularly for the interpretation of nuclear medicine studies wherein detailed anatomical information is often lacking. Previously, side-by-side compariso... Correlative imaging has long been used in clinical practice and particularly for the interpretation of nuclear medicine studies wherein detailed anatomical information is often lacking. Previously, side-by-side comparison or software co-registration techniques were applied but suffered from technical limitations related to the differing geometries of the imaging equipment, differences in the positioning of patients and displacement of mobile structures between studies. The development of the first hybrid PET and CT device struck a chord with the medical imaging community that is still ringing loudly throughout the world. So successful has been the concept of PET-CT that none of the major medical imaging manufacturers now offers stand-alone PET scanners. Following close behind this success, SPECT-CT devices have recently been adopted by the nuclear medicine community, already compelled by the benefits of hybrid imaging through their experience with PET-CT. Recent reports of adaptation of PET detectors to operate within the strong magnetic field of MRI scanners have generated further enthusiasm. Prototype PET-MRI devices are now in development. The complementary anatomical, functional and molecular information provided by these techniques can now be presented in an intuitive and aesthetically-pleasing format. This has made end-users more comfortable with the results of functional imaging techniques than when the same information is presented independently. Despite the primacy of anatomical imaging for locoregional disease definition, the molecular characterisation available from PET and SPECT offers unique complementary information for cancer evaluation. A new era of cancer imaging, when hybrid imaging will be the primary diagnostic tool, is approaching.

Technology and its clinical application in the field of computer-assisted radiology and surgery.

Inamura K, Lemke H

Biomed Imaging Interv J · 2007 Jul · PMID 21614290 · Full text

The field of computer-assisted radiology and surgery involves a wide spectrum of topics based on medicine, physics, computer science and even sociology. The progress of development and recent trends in this field is desc... The field of computer-assisted radiology and surgery involves a wide spectrum of topics based on medicine, physics, computer science and even sociology. The progress of development and recent trends in this field is described in this paper. Firstly, the chronological change in presented papers in past international conferences of Computer Assisted Radiology and Surgery (CARS) from 1985 to 2007 is illustrated in terms of topics, which are grouped into six main categories. Secondly, new directions and related topics are described by means of an example of a digital operating room. Problems in the operation room (OR) and solution concepts are pointed out while a therapy imaging and model management system (TIMMS) is presented as a possible solution. Finally, patient modelling related topics for CARS are listed.

Status and future prospects of biomedical engineering: a Japanese perspective.

Kikuchi M

Biomed Imaging Interv J · 2007 Jul · PMID 21614289 · Full text

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Quality care and safety know no borders.

Borgstede J, Wilcox P

Biomed Imaging Interv J · 2007 Jul · PMID 21614288 · Full text

The public, governmental agencies, and payers expect medical professional organisations to develop practice guidelines and technical standards. The American College of Radiology proactively addresses these topics as well... The public, governmental agencies, and payers expect medical professional organisations to develop practice guidelines and technical standards. The American College of Radiology proactively addresses these topics as well as other quality and safety interests including appropriateness criteria and accreditation. The College is also actively involved in development of a national radiology data base to collect data regarding quality and safety metrics in multiple areas. In addition, the College has developed RADPEER™, a simple, cost-effective process that allows peer review to be performed during the routine interpretation of current images. This paper discusses the efforts of the ACR in all of these areas.

EFOMP: the European roof for medical physics.

Schlegel W

Biomed Imaging Interv J · 2007 Jul · PMID 21614287 · Full text

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Inverting the organisational pyramid.

Hendee W

Biomed Imaging Interv J · 2007 Jul · PMID 21614286 · Full text

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Quality service in radiology.

Hoe J

Biomed Imaging Interv J · 2007 Jul · PMID 21614285 · Full text

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Leadership and management in quality radiology.

Lau L

Biomed Imaging Interv J · 2007 Jul · PMID 21614284 · Full text

The practice of medical imaging and interventional radiology are undergoing rapid change in recent years due to technological advances, workload escalation, workforce shortage, globalisation, corporatisation, commerciali... The practice of medical imaging and interventional radiology are undergoing rapid change in recent years due to technological advances, workload escalation, workforce shortage, globalisation, corporatisation, commercialisation and commoditisation of healthcare. These professional and economical changes are challenging the established norm but may bring new opportunities. There is an increasing awareness of and interest in the quality of care and patient safety in medical imaging and interventional radiology. Among the professional organisations, a range of quality systems are available to address individual, facility and system needs. To manage the limited resources successfully, radiologists and professional organisations must be leaders and champion for the cause of quality care and patient safety. Close collaboration with other stakeholders towards the development and management of proactive, long-term, system-based strategies and infrastructures will underpin a sustainable future in quality radiology. The International Radiology Quality Network can play a useful facilitating role in this worthwhile but challenging endeavour.

Medical politics 101.

Abdullah B, Ng Kh

Biomed Imaging Interv J · 2007 Jul · PMID 21614283 · Full text

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Radiation dose optimisation in biomedical imaging and intervention.

Rehani M

Biomed Imaging Interv J · 2007 Apr · PMID 21614282 · Full text

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Is the glass half full or half empty?

Abdullah B, Ng Kh

Biomed Imaging Interv J · 2007 Apr · PMID 21614281 · Full text

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Optimisation in fluoroscopy.

Axelsson B

Biomed Imaging Interv J · 2007 Apr · PMID 21614280 · Full text

Optimisation of radiation protection in fluoroscopy is important since the procedure could lead to relatively high absorbed doses both in patients and personnel resulting in acute radiation injury. Optimisation procedure... Optimisation of radiation protection in fluoroscopy is important since the procedure could lead to relatively high absorbed doses both in patients and personnel resulting in acute radiation injury. Optimisation procedures include adjustment of the fluoroscopy equipment such as exposure factors as well as proper use of automatic brightness control and pulsed fluoroscopy. It is also important to gain the benefits of image processing and the higher sensitivity of flat panel detectors as compared to image intensifier-TV systems.Proper positioning of the patient with respect to detector and X-ray tube is of fundamental importance to image quality and radiation dose to the patient. Both image quality and radiation dose are also affected by the methodology used with parameters such as magnification factor, increased filtration, use of last-image-hold and the use of a grid.There is a direct relation between patient dose and the absorbed dose to the personnel since this is mostly due to scattered radiation from the patient. If the correct methodology and the correct radiation protection devices are used, the absorbed dose to the personnel could be minimised to acceptable levels even for those working with complex procedures.In order to have an organised review of all aspects of optimisation, it is recommendable to have an active quality system at the department. This system should define responsibilities and tasks for persons involved.

Dose management in CT facility.

Tsapaki V, Rehani M

Biomed Imaging Interv J · 2007 Apr · PMID 21614279 · Full text

Computed Tomography (CT) examinations have rapidly increased in number over the last few years due to recent advances such as the spiral, multidetector-row, CT fluoroscopy and Positron Emission Tomography (PET)-CT techno... Computed Tomography (CT) examinations have rapidly increased in number over the last few years due to recent advances such as the spiral, multidetector-row, CT fluoroscopy and Positron Emission Tomography (PET)-CT technology. This has resulted in a large increase in collective radiation dose as reported by many international organisations. It is also stated that frequently, image quality in CT exceeds the level required for confident diagnosis. This inevitably results in patient radiation doses that are higher than actually required, as also stressed by the US Food and Drug Administration (FDA) regarding the CT exposure of paediatric and small adult patients. However, the wide range in exposure parameters reported, as well as the different CT applications reveal the difficulty in standardising CT procedures. The purpose of this paper is to review the basic CT principles, outline the recent technological advances and their impact in patient radiation dose and finally suggest methods of radiation dose optimisation.
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