Beukenlaan 137
5616 VD Eindhoven
The Netherlands
+31 85064 55 82
info@interhospi.com
PanGlobal Media IS not responsible for any error or omission that might occur in the electronic display of product or company data.
Archive for month: August, 2020
Paediatric cancer and imaging
According to World Health Organisation data, cancer accounted for 13% of all deaths globally in 2008. Largely because age is a fundamental and unmodifiable risk factor, and the average age of the world population is rising, deaths from cancer are projected to increase to over 11 million per annum by 2030. However on world cancer day earlier this month the really good news was that the survival of children with solid tumours has increased from 30% up to 90% within four decades. Of course this dramatic improvement is the result of multidisciplinary efforts involving more effective treatment as well as diagnosis, but improved imaging techniques have played an enormous role in the continually improving survival rate.
The imaging techniques used at diagnosis, and for evaluating tumour response during and after therapy as well as before and after resection, include ultrasonography, CT, MRI, PET or combinations of these modalities, depending on local conditions and the healthcare professionals involved. But in spite of the developments in modern imaging, which are inexorably lowering the dose of radiation to which patients are exposed during procedures, imaging does involve potentially dangerous ionising radiation that may induce other cancers in later life. There is a small, but crucially not zero risk, one which is greater in paediatric patients. An article published last month by authors from the Harvard and Johns Hopkins medical schools reported that in the USA CT scans are proliferating, with seven to eight million per year being performed on paediatric patients. The authors state that many of these paediatric scans are either not justified or could be carried out with imaging techniques involving lower or no radiation, such as MRI and ultrasonography. Should a CT scan really be indicated, paediatric CT protocols should be optimised based on the patient
The 10 most important technologies for hospitals − Part 1
The ECRI Institute is a US-based, independent, non-profit organisation that researches the best approaches to improving the safety, quality and cost-effectiveness of patient care. ECRI Institute experts have compiled a Top 10 list of important technologies and technology-related issues that hospital and health system leaders should pay close attention to this year. The list takes into account the convergence of critical economic, patient safety, reimbursement, and regulatory pressures. The effort began with an open call for nominations throughout the ECRI Institute. This resulted in a nominated list of more than 30 technologies and related issues. The list was then circulated among key ECRI Institute thought leaders who individually ranked their Top 10 choices. Once all rankings were compiled, the top 5 technologies emerged fairly quickly. A number of technologies competed for rankings 6 to 10, so a ratings consensus panel was convened to reach agreement on the final Top 10.
For the benefits of its readers in healthcare communities outside the USA, International Hospital presents the essence of the ECRI Top10 watch list in a series of three articles to be published in consecutive issues of the magazine. In this first article, we take a look at the three imaging technologies ranking number 3, 4 and 8 in the Top 10
Number 3. Digital Breast Tomosynthesis
Adoption of full-field digital mammography since it became commercially available in the United States in 2000 has been slow because of controversies that included costs, data storage needs, disagreement about risks and benefits of screening by age group, and trade-offs between how to reduce false positives without increasing false negatives. As of July 2011, 22% of mammography facilities still operated film-based mammography.
Enter the new twist on full-field digital mammography
Medical Imaging Special: Selection of peer-reviewed literature on ultrasonography
The number of peer-reviewed papers covering the field of ultrasonography is huge, to such an extent that it is frequently difficult for healthcare professionals to keep up with the literature. As a special service to our readers, IHE presents a few key literature abstracts from the clinical and scientific literature chosen by our editorial board as being particularly worthy of attention.
Heart failure secondary to dilated cardiomyopathy: a role for emergency physician bedside ultrasonography.
Sivitz A, Nagdev A. Pediatr Emerg Care. 2012 Feb;28(2):163-6.
Heart failure as a result of cardiomyopathy is an uncommon presentation in the pediatric emergency department (PED). The initial presenting symptoms in these cases are often nonspecific and may be confused with more common paediatric illnesses. This article reports the case of a 3-year-old girl initially discharged from a PED after routine evaluation of vomiting and diarrhoea with a diagnosis of acute gastroenteritis, only to return one week later in heart failure from a dilated cardiomyopathy. A bedside ultrasound performed by the emergency physician in the PED allowed for the initiation of appropriate, rapid, goal-directed therapy and expedited timely transport to a facility with paediatric cardiothoracic surgery. Dilated cardiomyopathy and the role of emergency physician echocardiography is reviewed.
The validity of ultrasonography in the diagnosis of zygomaticomaxillary complex fractures.
Ogunmuyiwa SA et al. Int J Oral Maxillofac Surg. 2012 Feb 3.
This study determined the sensitivity, specificity, positive and negative predictive values of ultrasonography in detecting zygomaticomaxillary complex fractures, and highlighted factors that may affect the validity of ultrasonography in these diagnoses. Twenty-one patients with suspected fractures of the zygomaticomaxillary complex were included in this prospective study. All the patients had plain radiographic and computed tomography (CT) investigations. All underwent ultrasonographic examination of the affected region using an ultrasound machine with a 7.5MHz probe. The different radiologists were not aware of the results of the other two investigations. Statistical significance was inferred at P<0.05. The validity of ultrasonography varied with fracture sites with a sensitivity of 100% for zygomatic arch fractures, 90% for infraorbital margin fractures and 25% for frontozygomatic suture separation. Specificity was 100% for the three types of fracture. There was no statistically significant difference in the ability of CT and ultrasonography to diagnose fractures from various zygomaticomaxillary complex fracture sites (P=0.47). Ultrasonography appears to be a valid tool for the diagnosis of zygomatic arch and displaced infraorbital margin fractures. Imaging inflammatorybreast cancer.
Alunni JP. Diagn Interv Imaging. 2012 Feb;93(2):95-103.
Carcinomatous mastitis is a severe form of breast cancer and its diagnosis is essentially clinical and histological. The first examination to perform is still mammography, not only to provide evidence supporting this diagnosis but also to search for a primary intramammary lesion and assess local/regional spread. It is essential to study the contralateral breast for bilaterality. Ultrasound also provides evidence supporting inflammation, but appears to be better for detecting masses and analysing lymph node areas. The role of MRI is debatable, both from a diagnostic point of view and for monitoring during treatment, and should be reserved for selected cases. An optimal, initial radiological assessment will enable the patient to be monitored during neoadjuvant chemotherapy.
Current role of ultrasound in chronic liver disease: surveillance, diagnosis and management of hepatic neoplasms.
Irshad A, Anis M, Ackerman SJ. Curr Probl Diagn Radiol. 2012 Mar;41(2):43-51.
Despite certain inherent limitations in evaluating chronic liver disease on routine gray-scale US, it is still widely used for the initial evaluation in patients suspected of liver disease as well as for hepatocellular carcinoma (HCC) screening in patients with known cirrhosis. Due to recent advances in digital technology and US imaging software, various new computer protocols have been incorporated in the new US equipment. This in turn has resulted in a great improvement in image quality and image resolution. Consequently, the increased ability of US to better characterise the liver texture in general has enabled sonographers to identify subtle changes in the liver texture and delineate smaller masses in the liver with greater success.