Biomedical Imaging And Intervention Journal[JOURNAL]
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200 papers
Quality assurance of TomoDirect treatment plans using I'mRT MatriXX.
Kong C, Yu S, Cheung K … +4 more , Geng H, Ho Y, Lam W, Wong W
Biomed Imaging Interv J · 2012 Apr · PMID 22970070 · Full text
PURPOSE: To evaluate the performance of 2D-array I'mRT MatriXX for dose verification of TomoDirect treatment plans. METHODS: In this study, a 2D-array ion chamber device - the I'mRT MatriXX and Multicube Phantom from IBA...
PURPOSE: To evaluate the performance of 2D-array I'mRT MatriXX for dose verification of TomoDirect treatment plans. METHODS: In this study, a 2D-array ion chamber device - the I'mRT MatriXX and Multicube Phantom from IBA - was used for dose verification of different TomoDirect plans. Pre-treatment megavoltage computed tomography (MVCT) was performed on the phantom setup for position correction. After the irradiation of treatment plans on the I'mRT MatriXX and Multicube Phantom, the measured doses of coronal planes were compared with those from the planning calculations for verification. The results were evaluated by comparing the absolute dose difference in the high dose region as well as the gamma analysis of the 2D-dose distributions on the coronal plane. The comparison was then repeated with the measured dose corrected for angular dependence of the MatriXX. RESULTS: When angular dependence is taken into account, the passing rate of gamma analysis is over 90% for all measurements using the MatriXX. If there is no angular dependence correction, the passing rate of gamma analysis worsens for treatment plans with dose contribution from the rear. The passing rate can be as low as 53.55% in extreme cases, i.e. where all doses in the treatment plan are delivered from the rear. CONCLUSION: It is important to correct the measured dose for angular dependence when verifying TomoDirect treatment plans using the MatriXX. If left uncorrected, a large dose discrepancy may be introduced to the verification results.
Effective connectivity between superior temporal gyrus and Heschl's gyrus during white noise listening: linear versus non-linear models.
Hamid K, Yusoff A, Rahman M … +2 more , Mohamad M, Hamid A
Biomed Imaging Interv J · 2012 Apr · PMID 22970069 · Full text
PURPOSE: This fMRI study is about modelling the effective connectivity between Heschl's gyrus (HG) and the superior temporal gyrus (STG) in human primary auditory cortices. MATERIALS #ENTITYSTARTX00026; METHODS: Ten heal...
PURPOSE: This fMRI study is about modelling the effective connectivity between Heschl's gyrus (HG) and the superior temporal gyrus (STG) in human primary auditory cortices. MATERIALS #ENTITYSTARTX00026; METHODS: Ten healthy male participants were required to listen to white noise stimuli during functional magnetic resonance imaging (fMRI) scans. Statistical parametric mapping (SPM) was used to generate individual and group brain activation maps. For input region determination, two intrinsic connectivity models comprising bilateral HG and STG were constructed using dynamic causal modelling (DCM). The models were estimated and inferred using DCM while Bayesian Model Selection (BMS) for group studies was used for model comparison and selection. Based on the winning model, six linear and six non-linear causal models were derived and were again estimated, inferred, and compared to obtain a model that best represents the effective connectivity between HG and the STG, balancing accuracy and complexity. RESULTS: Group results indicated significant asymmetrical activation (p(uncorr) < 0.001) in bilateral HG and STG. Model comparison results showed strong evidence of STG as the input centre. The winning model is preferred by 6 out of 10 participants. The results were supported by BMS results for group studies with the expected posterior probability, r = 0.7830 and exceedance probability, ϕ = 0.9823. One-sample t-tests performed on connection values obtained from the winning model indicated that the valid connections for the winning model are the unidirectional parallel connections from STG to bilateral HG (p < 0.05). Subsequent model comparison between linear and non-linear models using BMS prefers non-linear connection (r = 0.9160, ϕ = 1.000) from which the connectivity between STG and the ipsi- and contralateral HG is gated by the activity in STG itself. CONCLUSION: We are able to demonstrate that the effective connectivity between HG and STG while listening to white noise for the respective participants can be explained by a non-linear dynamic causal model with the activity in STG influencing the STG-HG connectivity non-linearly.
Pelvic lipomatosis: US and CT diagnosis.
Yesilkaya Y, Duymus M, Topcuoglu M
Biomed Imaging Interv J · 2012 Apr · PMID 22970068 · Full text
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A rare case of an appendiceal mass masquerading as a pelvic tumour and causing bilateral hydronephrosis.
Abdul Rashid S, Ab Hamid S, Mohamad Saini S … +1 more , Muridan R
Biomed Imaging Interv J · 2012 Apr · PMID 22970067 · Full text
Diagnosing acute appendicitis in children can be difficult due to atypical presenting symptoms. While there are reported cases of acute appendicitis or appendiceal masses causing unilateral hydronephrosis, bilateral hydr...
Diagnosing acute appendicitis in children can be difficult due to atypical presenting symptoms. While there are reported cases of acute appendicitis or appendiceal masses causing unilateral hydronephrosis, bilateral hydronephrosis as a complication of appendiceal mass is very rare. We report a case of a child who presented with cardinal symptomatology associated with the urogenital tract. Ultrasound (US) investigation showed a pelvic mass causing bilateral hydronephrosis. An initial diagnosis of a pelvic teratoma was made based on the US and computed tomography (CT) scan findings. The final diagnosis of an appendiceal mass causing bilateral hydronephrosis was established intraoperatively.
Medical physics aspects of cancer care in the Asia Pacific region: 2011 survey results.
Kron T, Azhari H, Voon E … +19 more , Cheung K, Ravindran P, Soejoko D, Inamura K, Han Y, Ung N, Bold L, Win U, Srivastava R, Meyer J, Farrukh S, Rodriguez L, Kuo M, Lee J, Kumara A, Lee C, Krisanachinda A, Nguyen X, Ng Kh
Biomed Imaging Interv J · 2012 Apr · PMID 22970066 · Full text
BACKGROUND: Medical physicists are essential members of the radiation oncology team. Given the increasing complexity of radiotherapy delivery, it is important to ensure adequate training and staffing. The aim of the pres...
BACKGROUND: Medical physicists are essential members of the radiation oncology team. Given the increasing complexity of radiotherapy delivery, it is important to ensure adequate training and staffing. The aim of the present study was to update a similar survey from 2008 and assess the situation of medical physicists in the large and diverse Asia Pacific region. METHODS: Between March and July 2011, a survey on profession and practice of radiation oncology medical physicists (ROMPs) in the Asia Pacific region was performed. The survey was sent to senior physicists in 22 countries. Replies were received from countries that collectively represent more than half of the world's population. The survey questions explored five areas: education, staffing, work patterns including research and teaching, resources available, and job satisfaction. RESULTS AND DISCUSSION: Compared to a data from a similar survey conducted three years ago, the number of medical physicists in participating countries increased by 29% on average. This increase is similar to the increase in the number of linear accelerators, showing that previously identified staff shortages have yet to be substantially addressed. This is also highlighted by the fact that most ROMPs are expected to work overtime often and without adequate compensation. While job satisfaction has stayed similar compared to the previous survey, expectations for education and training have increased somewhat. This is in line with a trend towards certification of ROMPs. CONCLUSION: As organisations such as the International Labour Organization (ILO) start to recognise medical physics as a profession, it is evident that despite some encouraging signs there is still a lot of work required towards establishing an adequately trained and resourced medical physics workforce in the Asia Pacific region.
Social radiology: Where to now?
Ho E
Biomed Imaging Interv J · 2012 Jan · PMID 22970065 · Full text
Radiology is a relatively high-cost and high-maintenance aspect of medicine. Expertise is constantly required, from acquisition to its use and quality assurance programmes. However, it is an integral part of healthcare p...
Radiology is a relatively high-cost and high-maintenance aspect of medicine. Expertise is constantly required, from acquisition to its use and quality assurance programmes. However, it is an integral part of healthcare practice, from disease diagnosis, surveillance and prevention to treatment monitoring. It is alarming that two thirds of the world is deficient in or lacks even basic diagnostic imaging. Developing and underdeveloped countries need help in improving medical imaging. Help is coming from various organisations, which are extending hands-on teaching and imparting knowledge, as well as training trainers to increase the pool of skilled practitioners in the use of imaging equipment and other aspects of radiology services. The scene for social radiology is changing and set to positively impact the world in the (near) future.
Dialysis catheter fibrin sheath stripping: a useful technique after failed catheter exchange.
Mohamad Ali A, Uhwut E, Liew S
Biomed Imaging Interv J · 2012 Jan · PMID 22970064 · Full text
Fibrin sheath formation around long-term haemodialysis catheter is a common cause of failed dialysis access. Treatment options include pharmacological and mechanical methods. This paper reports a case of failed dialysis...
Fibrin sheath formation around long-term haemodialysis catheter is a common cause of failed dialysis access. Treatment options include pharmacological and mechanical methods. This paper reports a case of failed dialysis access due to fibrin sheath encasement. Pharmacologic thrombolysis, mechanical disruption using guide wire and catheter exchange had failed to address the issue. Eventually, fibrin sheath stripping using the loop snare technique was able to successfully restore the catheter function.
Congenital renal anomalies detected in adulthood.
Muttarak M, Sriburi T
Biomed Imaging Interv J · 2012 Jan · PMID 22970063 · Full text
OBJECTIVE: To document the types of congenital renal anomalies detected in adulthood, the clinical presentation and complications of these renal anomalies, and the most useful imaging modality in detecting a renal anomal...
OBJECTIVE: To document the types of congenital renal anomalies detected in adulthood, the clinical presentation and complications of these renal anomalies, and the most useful imaging modality in detecting a renal anomaly. MATERIALS AND METHODS: This study was approved by the institutional review board and informed consent was waived. Between January 2007 and January 2011, the clinical data and imaging studies of 28 patients older than 18 years diagnosed with renal anomaly at the authors' institution were retrospectively reviewed. Renal anomalies in this study included only those with abnormality in position and in form. RESULTS: Of these 28 patients, 22 underwent imaging studies and their results constituted the material of this study. Of the 22 patients, 14 had horseshoe kidneys (HSK), four had crossed renal ectopia and four had malrotation. Sixteen patients were men and six were women. The patients ranged in age from 19 to 74 years (mean age 51.1 years). Clinical presentations were abdominal pain (13), fever (13), haematuria (4), palpable mass (2), asymptomatic (2), polyuria (1) dysuria (1), blurred vision (1), and headache with weakness of left extremities (1). Imaging studies included abdominal radiograph (15), intravenous pyelography (IVP) (8), retrograde pyelography (RP) (4), ultrasonography (US) (7), and computed tomography (CT) (9). Associated complications included urinary tract stones (17), urinary tract infection (16), hydronephrosis (12), and tumours (2). Abdominal radiograph suggested renal anomalies in nine out of 15 studies. IVP, RP, US and CT suggested anomalies in all patients who had these studies performed. However, CT was the best imaging modality to evaluate anatomy, function and complications of patients with renal anomalies. CONCLUSION: HSK was the most common renal anomaly, with abdominal pain and fever being the most common presentations. UTI and stones were the most common complications. IVP, RP, US and CT can be used to diagnose renal anomalies but CT is the best imaging modality to evaluate renal anatomy, function and its complications.
Precocious puberty in children: A review of imaging findings.
Faizah M, Zuhanis A, Rahmah R … +4 more , Raja A, Wu L, Dayang A, Zulfiqar M
Biomed Imaging Interv J · 2012 Jan · PMID 22970062 · Full text
OBJECTIVES: This review was aimed at determining the imaging findings in patients with precocious puberty. RESULTS: Within a period of 8 years (from 2002 to 2010) there were 53 patients diagnosed with precocious puberty....
OBJECTIVES: This review was aimed at determining the imaging findings in patients with precocious puberty. RESULTS: Within a period of 8 years (from 2002 to 2010) there were 53 patients diagnosed with precocious puberty. Out of the 53 patients, 37 had undergone diagnostic imaging to detect the possible organic causes of precocious puberty. Imaging findings were positive in 31 patients and out of that, 3 patients had 2 findings each (34 abnormalities). Of the patients with positive imaging findings, central precocious puberty (gonadotrophin-dependent) was more common (81%; 25/31) and the causes included: tuber cinereum hamartoma (n = 10), glioma (n = 6), pineal gland tumour (n = 4), hydrocephalous (n = 3), arachnoid cyst (n = 2) and others (n = 3). Peripheral precocious puberty (gonadotrophin-independent) causes included: testicular adrenal rest tumour (n = 3), adrenal carcinoma (n = 1), ovarian granulosa thecal cell tumour (n = 1), and tuberous sclerosis (n = 1). CONCLUSION: Positive imaging findings were observed in 84% (31/37) of the subjects. Hypothalamic hamartoma was the most common imaging finding in central precocious puberty while testicular adrenal rest tumour was the most common imaging finding in peripheral precocious puberty.
Dosimetric evaluation of radiation dose rate effect in respiratory gated intensity modulated radiation therapy.
Khamfongkhruea C, Tannanonta C, Thongsawad S
Biomed Imaging Interv J · 2012 Jan · PMID 22970061 · Full text
PURPOSE: To investigate the dosimetric accuracy of the sliding window gated IMRT compared with the static treatment, using varying dose rates. MATERIALS AND METHODS: This study measured changes in output and diode array...
PURPOSE: To investigate the dosimetric accuracy of the sliding window gated IMRT compared with the static treatment, using varying dose rates. MATERIALS AND METHODS: This study measured changes in output and diode array response with changing dose rate, verified the precision of the motion table, and measured changes in dose distribution accuracy with film and diodes at two depths with changing dose rate. During 4DCT (4 Dimensional Computed Tomography), the patient's respiratory signals and target motion were recorded and imported to the XY4D simulation table of SUN NUCLEAR Corporation to simulate the patient's respiration and tumour motion. A single field of each sliding window IMRT plan with 30º wedge and one for lung cancer were used in this study. Three irradiating conditions, static and moving target with and without gating, were applied to both plans. RESULTS: The standard deviations of output, with the dose rates changing from 300-600 MU/min, were 0.065 cGy and 0.169 cGy for the ionisation chamber and diode, respectively. The verification of the motion table shows very good precision with 9.98 ± 0.02 cm (true value = 10.0 cm). The measurements by MapCheck show the gamma index of the planned absolute dose distribution in static and moving targets with gating, resulting in more than 96% passing for all dose rates. The absolute dose distribution measured by film for the static target was agreeable with the value of moving target with gating. CONCLUSION: The sliding window gated IMRT technique is able to deliver an accurate dose to a moving target with the dose rate of 300-600 MU/min that is suitable for clinical treatment.
Anatomical variations of pulmonary venous drainage in Thai people: multidetector CT study.
Wannasopha Y, Oilmungmool N, Euathrongchit J
Biomed Imaging Interv J · 2012 Jan · PMID 22970060 · Full text
OBJECTIVE: To evaluate the patterns of pulmonary venous drainage into the left atrium and to determine the frequency of each variant of pulmonary venous anatomy. MATERIALS AND METHODS: After institutional review board ap...
OBJECTIVE: To evaluate the patterns of pulmonary venous drainage into the left atrium and to determine the frequency of each variant of pulmonary venous anatomy. MATERIALS AND METHODS: After institutional review board approval (No. 09JUL011148), 300 studies of thoracic multidetector computed tomography were retrospectively reviewed for the anatomical features of the pulmonary vein and its drainage pattern into the left atrium. The percentage of each pattern was calculated. RESULTS: The anatomy of pulmonary venous drainage in 300 patients (150 male and 150 female, mean age 60.16 years) showed some variation. In the right pulmonary vein, the most common drainage pattern was two ostia (90.33%), followed by three to five ostia (6.33%) and a single ostium (3.33%). There were one or two separate middle lobe vein ostia in groups of more than two openings. On the left side, there were two patterns; a single venous ostium (59%) was much more common than two ostia (41%). In both right and left pulmonary veins, there were five cases (2 male, 3 female) that had a single pulmonary venous ostium, bilaterally. However, there were only 17 cases (5.67%), out of 300 enrolled in this study, that had bilateral pulmonary venous ostial variations. CONCLUSION: A classification system to succinctly describe pulmonary venous drainage patterns was developed. In left-sided drainage, a single left pulmonary ostium was the most common variation. The right-sided venous drainage varied more in both number and pattern than those of the left side; nevertheless, bilateral pulmonary venous ostial variation was not frequently found.
Multislice CT of the head and body routine scans: Are scanning protocols adjusted for paediatric patients?
Sun Z, Al Ghamdi K, Baroum I
Biomed Imaging Interv J · 2012 Jan · PMID 22970059 · Full text
PURPOSE: To investigate whether the multislice CT scanning protocols of head, chest and abdomen are adjusted according to patient's age in paediatric patients. MATERIALS AND METHODS: Multislice CT examination records of...
PURPOSE: To investigate whether the multislice CT scanning protocols of head, chest and abdomen are adjusted according to patient's age in paediatric patients. MATERIALS AND METHODS: Multislice CT examination records of paediatric patients undergoing head, chest and abdomen scans from three public hospitals during a one-year period were retrospectively reviewed. Patients were categorised into the following age groups: under 4 years, 5-8 years, 9-12 years and 13-16 years, while the tube current was classified into the following ranges: < 49 mA, 50-99 mA, 100-149 mA, 150-199 mA, > 200 mA and unknown. RESULTS: A total of 4998 patient records, comprising a combination of head, chest and abdomen CT scans, were assessed, with head CT scans representing nearly half of the total scans. Age-based adjusted CT protocols were observed in most of the scans with higher tube current setting being used with increasing age. However, a high tube current (150-199 mA) was still used in younger patients (0-8 years) undergoing head CT scans. In one hospital, CT protocols remained constant across all age groups, indicating potential overexposure to the patients. CONCLUSION: This analysis shows that paediatric CT scans are adjusted according to the patient's age in most of the routine CT examinations. This indicates increased awareness regarding radiation risks associated with CT. However, high tube current settings are still used in younger patient groups, thus, optimisation of paediatric CT protocols and implementation of current guidelines, such as age-and weight-based scanning, should be recommended in daily practice.
Fine needle aspiration of lung lesion: Lateral and transpectoral approach.
Smith K
Biomed Imaging Interv J · 2012 Jan · PMID 22970058 · Full text
A 69 year-old man presented with an incidental finding on radiograph of a lesion in the left upper lobe. CT indicated it was likely to be a neoplasm and CT-guided FNA was requested. The lesion was located medial to the s...
A 69 year-old man presented with an incidental finding on radiograph of a lesion in the left upper lobe. CT indicated it was likely to be a neoplasm and CT-guided FNA was requested. The lesion was located medial to the scapula so a creative approach was utilised to gain access to the lesion. This study discusses the approach used and why it reduced patient risk compared to a more conventional procedure. The sample was positive for neoplasm and there were no complications arising from the procedure.
The History of AOSR: Asian Oceanian Society of Radiology.
Leong LL, Hare WS, Thomson KR
Biomed Imaging Interv J · 2011 Oct · PMID 22970057 · Full text
Abstract loading — click title to view on PubMed.
Radiofrequency ablation of a misdiagnosed Brodie's abscess.
Chan R, Abdullah B, Aik S … +1 more , Tok Ch
Biomed Imaging Interv J · 2011 Apr · PMID 22291860 · Full text
Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RF...
Radiofrequency ablation (RFA) therapy is recognised as a safe and effective treatment option for osteoid osteoma. This case report describes a 27-year-old man who underwent computed tomography (CT)-guided percutaneous RFA for a femoral osteoid osteoma, which was diagnosed based on his clinical presentation and CT findings. The patient developed worsening symptoms complicated by osteomyelitis after the procedure. His clinical progression and subsequent MRI findings had led to a revised diagnosis of a Brodie's abscess, which was further supported by the eventual resolution of his symptoms following a combination of antibiotics treatment and surgical irrigations. This case report illustrates the unusual MRI features of osteomyelitis mimicking soft tissue tumours following RFA of a misdiagnosed Brodie's abscess and highlights the importance of a confirmatory histopathological diagnosis for an osteoid osteoma prior to treatment.
Do the majority of Malaysian women have dense breasts on mammogram?
Zulfiqar M, Rohazly I, Rahmah M
Biomed Imaging Interv J · 2011 Apr · PMID 22291859 · Full text
PURPOSE: TO DETERMINE: (i) the mammographic parenchymal patterns in Malaysian women and whether the breasts are dense on mammogram; (ii) the effect of age on breast density; (iii) the effect of parity on breast density;...
PURPOSE: TO DETERMINE: (i) the mammographic parenchymal patterns in Malaysian women and whether the breasts are dense on mammogram; (ii) the effect of age on breast density; (iii) the effect of parity on breast density; (iv) the difference in breast parenchymal patterns among the major races of women in Malaysia. METHODS: This was a descriptive cross-sectional study of 1,784 patients (981 Malays, 571 Chinese, 214 Indians and 18 others) who had undergone mammography during the 1-year study period. Majority of women (41.7%) were aged between 51 and 60 years and majority (43%) had 3-4 children. The Tabar classification (Pattern I - V) was used to evaluate breast parenchymal patterns on mammogram. Tabar Pattern I was further divided into 3 sub-groups (Pattern IA, IB, and IC). The different patterns were then grouped into dense (IB, IC, IV, V) and not dense (IA, II, III) breasts. The SPSS package was used for statistical analysis. RESULTS: Majority (59%) of Malaysian women had dense breasts (Pattern IB 29%, IC 20%, IV 5%, and V 5%) and 41% did not have dense breasts (Pattern IA 28%, II 6%, and III 7%). Age and parity were inversely related to breast density (p < 0.0001). Chinese women (65.7%) had the highest percentage of dense breasts (p = 0.69, odds ratio = 1.22), followed by the Indians (57.2%) and the Malays (50.5%). CONCLUSION: Majority of women had dense breasts but Pattern IV, which has been associated with increased risk of breast cancer, was seen in only 5% of the women. The breast density reduced steadily with increasing age and parity. There was no statistically significant difference in breast density in the three main races.
A brief history of interventional radiology in Singapore and its current status.
Teo T, Tan B, Tay Kh
Biomed Imaging Interv J · 2011 Apr · PMID 22291858 · Full text
X-ray services were first established in Singapore in 1898. With the opening of the General Hospital in 1926, there was subsequent increase in workload. However, a radiology department was not formed until the 1950s. Ang...
X-ray services were first established in Singapore in 1898. With the opening of the General Hospital in 1926, there was subsequent increase in workload. However, a radiology department was not formed until the 1950s. Angiography was introduced in the same decade initially for diagnosis. By the 1960s and 1970s, both vascular and non-vascular interventions were performed. Subsequently, interventional radiology experienced exponential growth, with newer technology and better facilities established over the past 3 decades. With more trained interventional radiologists, the service is currently available in all public hospitals and in most private hospitals in Singapore today. It is envisaged that structured training and formal credentialing will be established, eventually leading to recognition of interventional radiology as a specialty in its own right.
Diagnostic value of SPECT, PET and PET/CT in the diagnosis of coronary artery disease: A systematic review.
Al Moudi M, Sun Z, Lenzo N
Biomed Imaging Interv J · 2011 Apr · PMID 22287989 · Full text
PURPOSE: The purpose of the study was to investigate the diagnostic value of SPECT, PET and PET/CT in the diagnosis of coronary artery disease, based on a systematic review. MATERIAL AND METHODS: A search of PubMed/Medli...
PURPOSE: The purpose of the study was to investigate the diagnostic value of SPECT, PET and PET/CT in the diagnosis of coronary artery disease, based on a systematic review. MATERIAL AND METHODS: A search of PubMed/Medline and Sciencedirect databases in the English-language literature published over the last 24 years was performed. Only studies with at least 10 patients comparing SPECT, PET or combined PET/CT with invasive coronary angiography in the diagnosis of coronary artery disease (50% stenosis) were included for analysis. Sensitivities and specificities estimates pooled across studies were analysed using a Chi-square test. RESULTS: Twenty-five studies met the selection criteria and were included for the analysis. Ten studies were performed with SPECT alone; while another six studies were performed with PET alone. Five studies were carried out with both PET and SPECT modalities, and the remaining four studies were investigated with integrated PET-CT. The mean value of sensitivity, specificity and accuracy of these imaging modalities for the diagnosis of coronary artery disease was 82% (95%CI: 76 to 88), 76% (95%CI: 70 to 82) and 83% (95%CI: 77 to 89) for SPECT; 91% (95%CI: 85 to 97), 89% (95%CI: 83 to 95) and 89% (95%CI: 83 to 95) for PET; and 85% (95%CI: 79 to 90), 83% (95%CI: 77 to 89) and 88% (95%CI: 82 to 94) for PET/CT, respectively. The diagnostic accuracy of these imaging modalities was dependent on the radiotracers used in these studies, with ammonia resulting in the highest diagnostic value. CONCLUSION: Our review shows that PET has high diagnostic value for diagnosing coronary artery disease, and this indicates that it is a valuable technique for both detection and prediction of coronary artery disease.
Paget's disease of the breast: clinical, imaging and pathologic findings: a review of 16 patients.
Muttarak M, Siriya B, Kongmebhol P … +2 more , Chaiwun B, Sukhamwang N
Biomed Imaging Interv J · 2011 Apr · PMID 22287988 · Full text
OBJECTIVES: To determine the clinical, imaging and pathological findings of Paget's disease of the breast. MATERIALS AND METHODS: Approval by Institutional Review Board was granted and informed consent was waived. Retros...
OBJECTIVES: To determine the clinical, imaging and pathological findings of Paget's disease of the breast. MATERIALS AND METHODS: Approval by Institutional Review Board was granted and informed consent was waived. Retrospective review of the pathological diagnosis of 2,361 women with breast carcinoma between January 2004 and April 2010 revealed 27 patients with Paget's disease of the breast. The clinical, mammographic and ultrasonographic images were retrospectively reviewed. RESULTS: The prevalence of Paget's disease of the breast was 1.14% of all breast carcinoma at this institution. Of the 27 patients with Paget's disease, only 16 had imaging studies and this group constituted the basis of this study. All 16 patients were women, with ages ranging from 36-68 years (mean age 50.31 years). Eleven patients presented with clinical findings suggestive of Paget's disease of the breast. Seven of these 11 patients also had associated palpable mass(es). Four patients presented with a palpable mass alone and one presented with bloody nipple discharge alone. Mammography was performed in all 16 patients and ultrasonography (US) in 15 patients. Of the 16 mammographic studies, two were negative. Of the 15 US studies, three were negative. Of these three negative US studies, two also had negative mammography and one had pleomorphic microcalcifications on mammogram. US was helpful in detecting multifocality in two patients. Mammography was 100% positive in patients who presented with palpable breast mass(es) and bloody nipple discharge, but 50% positive in patients who had clinically suggestive Paget's disease alone. Almost all patients (15/16) had underlying breast malignancies. Seven patients had multifocality or multicentricity. Modified radical mastectomy was performed in 13 patients, simple mastectomy in two, and wide local excision in one patient. Pathological findings were ductal carcinoma in situ (DCIS) (n = 3), invasive ductal carcinoma (IDC) (n = 10), metaplastic carcinoma (n = 1), invasive lobular carcinoma (ILC) (n = 1), and only Paget's disease of the nipple without underlying breast carcinoma (n = 1). CONCLUSION: Patients with Paget's disease of the breast have a high incidence of an underlying breast carcinoma. Most of the patients in this study presented late and were more likely to have positive mammograms. Mammography should be performed to identify the underlying breast carcinoma. Those who have only nipple areolar changes and no palpable mass have less positive mammography and less invasive carcinoma.
Reference Dosimetry according to the New German Protocol DIN 6800-2 and Comparison with IAEA TRS 398 and AAPM TG 51.
Zakaria A, Schuette W, Younan C
Biomed Imaging Interv J · 2011 Apr · PMID 22287987 · Full text
The preceding DIN 6800-2 (1997) protocol has been revised by a German task group and its latest version was published in March 2008 as the national standard dosimetry protocol DIN 6800-2 (2008 March). Since then, in Germ...
The preceding DIN 6800-2 (1997) protocol has been revised by a German task group and its latest version was published in March 2008 as the national standard dosimetry protocol DIN 6800-2 (2008 March). Since then, in Germany the determination of absorbed dose to water for high-energy photon and electron beams has to be performed according to this new German dosimetry protocol. The IAEA Code of Practice TRS 398 (2000) and the AAPM TG-51 are the two main protocols applied internationally. The new German version has widely adapted the methodology and dosimetric data of TRS-398. This paper investigates systematically the DIN 6800-2 protocol and compares it with the procedures and results obtained by using the international protocols. The investigation was performed with 6 MV and 18 MV photon beams as well as with electron beams from 5 MeV to 21 MeV. While only cylindrical chambers were used for photon beams, the measurements of electron beams were performed by using cylindrical and plane-parallel chambers. It was found that the discrepancies in the determination of absorbed dose to water among the three protocols were 0.23% for photon beams and 1.2% for electron beams. The determination of water absorbed dose was also checked by a national audit procedure using TLDs. The comparison between the measurements following the DIN 6800-2 protocol and the TLD audit-procedure confirmed a difference of less than 2%. The advantage of the new German protocol DIN 6800-2 lies in the renouncement on the cross calibration procedure as well as its clear presentation of formulas and parameters. In the past, the different protocols evoluted differently from time to time. Fortunately today, a good convergence has been obtained in concepts and methods.
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