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Archive for month: August, 2020
Radiologists retain a key role, not least in cancer screening and prevention
The first International Day of Radiology (IDoR) on November 8, a joint initiative of the European Society of Radiology (ESR), the Radiological Society of North America (RSNA) and the American College of Radiology (ACR) aims at highlighting the role played by radiology and medical imaging in modern medicine while helping raise the public profile of the radiologist. The date commemorates the day Wilhelm Conrad R
Obtaining more information: Uncontrasted Computed Tomography or ultrasound?
This article compares uncontrasted Computed Tomography (CT) with ultrasound examinations over a period of a year (from May 2011 to May 2012) with data obtained from a private practice PACS database. All the uncontrasted studies which had been performed were considered for the study: 339 patients were included in the research done for this investigation. The uncontrasted CT request forms, images and radiologist reports were audited by the author. Although the answer seems obvious, the outcome of the study revealed much more than initially anticipated.
by Dr Jaco Parsons
For a radiologist working in a private practice, it is of the utmost importance to give the referring clinician detailed information about the patient. It is also essential to use the right tools to make a correct and speedy diagnosis for the sake of the patient. Bearing this basic principle in mind, the question arose whether uncontrasted Computed Tomography gives better delineation of pathology than ultrasound.
In the South African context, medical aid is mainly private and thus very costly. Therefore, when the radiologist has to determine the type of investigation, it is often easier to take the route of least resistance and opt for the cheaper choice. Ethically, this may be doing the patient an injustice and may cause a delay in reaching the right diagnosis.
Study sample of CT
The data used comprised a set of 339 patients which were then entered and analysed. No distinction was made between male and female patients; the mean age was 48 years. In total, 193 (56.9%) studies were negative for the specific request. Twenty-four different types of requests were registered; the main request categories included 173 (51%) for ureteric stones, 84 (24.7%) abdominal pain, 13 (3.8%) appendicitis and 9 (2.6%) diverticulitis. Based on the main requests, it became clear that the following requests were negative: 112 (64.7%) for ureteric stones; 39 (46.4%) for abdominal pain; 13 (46.1%) for appendicitis; and 5 (55.5%) for diverticulitis.
In total, 62 (18%) studies had ureteric stones, 48 (14%) renal stones, 23 (6.7%) diverticulae, 22 (6.5%) renal cysts, 15 (4.4%) lumbo-sacral spondylosis, 15 (4.4%) hernias, 14 (4.1%) appendicitis and 13 (3.8%) gall stones. Moreover, there were 46 different
How the medical imaging and healthcare IT industries are contributing to a safer, more sustainable healthcare system
Medical imaging is a highly innovative, advanced technology serving the patient and contributing to increasing life expectancy while potentially helping to control healthcare costs. Diagnosis is the foundation of medicine and new diagnostics
Hospital goes fully digital Moving to wireless DRX-1 technology
International Hospital spoke to Professor Johan De Mey, the Head of the Department of Radiology at UZ Brussel hospital in Brussels. With nearly 800 beds, the hospital is one of the seven university hospitals in Belgium with around 200 000 patient contacts a year in radiology across a variety of disciplines. Professor De Mey talks about how upgrading their existing mobile equipment from phosphor plates to high quality DR technology has delivered higher productivity, excellent image quality and enhanced patient care.
Q. UZ Brussels finally achieved full digital status across the hospital. What are the advantages for the patients and the staff?
We first partnered with Carestream over a decade ago with the installation of PACS and with the introduction of Carestream DRX equipment. There are so many advantages. First of all, there is no image loss which is very important in emergency situations. What
Scientific literature: molecular imaging
The number of peer-reviewed papers covering the field of molecular imaging 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, International Hospital presents a few key literature abstracts from the clinical and scientific literature chosen by our editorial board as being particularly worthy of attention.
Non-invasive imaging of PI3K/Akt/mTOR signalling in cancer
Snehal MG, Pritha R. Am J Nucl Med Mol Imaging 2012; 2(4): 418-431.
Platinum based drugs are widely used to treat various types of cancers by inducing DNA damage mediated cytotoxicity. However, acquirement of chemoresistance towards platinum based drugs is a common phenomenon and a major hurdle in combating the relapse of the disease. Oncogenesis and chemoresistance are multifactorial maladies which often involve deregulation of one of the prime cell survival pathways, the PI3K/Akt/mTOR signalling cascade. The genetic alterations related to this pathway are often responsible for initiation and/or maintenance of carcinogenesis. Molecular components of this pathway are long being recognized as major targets for therapeutic intervention and have now also emerged as potential tools for diagnosis of cancer. To develop novel therapeutics against the key molecules of PI3K pathway, stringent validation is required using both in-vitro and in-vivo models. Repetitive and non-invasive molecular imaging techniques, a relatively recent field in biomedical imaging, hold great promises for monitoring such diagnosis and therapy. This review introduces the PI3K/Akt/mTOR pathway and its role in acquirement of chemoresistance in various cancers. Further is described how non-invasive molecular imaging approaches are sought to use this PI3K signalling axis for the therapeutics and diagnosis. A theranostic approach using various imaging modalities should be the future of PI3K signalling based drug development venture.
Quantitative longitudinal imaging of vascular inflammation and treatment by Ezetimibe in apoE mice by FMT using new optical imaging biomarkers of cathepsin activity and integrin
Shu-An Lin et al. Inter Jour Mol Imaging. 2012 Sept. Article ID 189254.
Inflammation as a core pathological event of atherosclerotic lesions is associated with the secretion of cathepsin proteases and the expression of integrin. In this study fluorescence molecular tomographic (FMT) noninvasive imaging of these molecular activities was employed using cathepsin sensing (ProSense, CatB FAST) and integrin (IntegriSense) near-infrared fluorescence (NIRF) agents. A statistically significant increase in the ProSense and IntegriSense signal was observed within the chest region of apoE−/− mice () versus C57BL/6 mice starting 25 and 22 weeks on high cholesterol diet, respectively. In a treatment study using ezetimibe (7 mg/kg), there was a statistically significant reduction in the ProSense and CatB FAST chest signal of treated () versus untreated apoE−/− mice at 31 and 21 weeks on high cholesterol diet, respectively. The signal of ProSense and CatB FAST correlated with macrophage counts and was found associated with inflammatory cells by fluorescence microscopy and flow cytometry of cells dissociated from aortas. This report demonstrates that cathepsin and integrin NIRF agents can be used as molecular imaging biomarkers for longitudinal detection of atherosclerosis, and cathepsin agents can monitor anti-inflammatory effects of ezetimibe with applications in preclinical testing of therapeutics and potentially for early diagnosis of atherosclerosis in patients.
18FDG PET-CT imaging detects arterial inflammation and early atherosclerosis in HIV-infected adults with cardiovascular disease risk factors
Yarasheski KE et al. Jour. of Inflammation 2012 June; 9: 26.
Persistent vascular inflammation has been implicated as an important cause for a higher prevalence of cardiovascular disease (CVD) in HIV-infected adults. In several populations at high risk for CVD, vascular 18Fluorodeoxyglucose (18FDG) uptake quantified using 3D-positron emission-computed tomography (PET-CT) has been used as a molecular level biomarker for the presence of metabolically active proinflammatory macrophages in rupture-prone early atherosclerotic plaques. The study hypothesized that 18FDG PET-CT imaging would detect arterial inflammation and early atherosclerosis in HIV-infected adults with modest CVD risk and studied 9 HIV-infected participants with fully suppressed HIV viremia on antiretroviral therapy (8 men, median age 52 yrs, median BMI 29 kg/m2, median CD4 count 655 cells/μL, 33% current smokers) and 5 HIV-negative participants (4 men, median age 44 yrs, median BMI 25 kg/m2, no current smokers). Mean Framingham Risk Scores were higher for HIV-infected persons (9% vs. 2%, p < 0.01). 18FDG (370 MBq) was administered intravenously. 3D-PET-CT images were obtained 3.5 hrs later. 18FDG uptake into both carotid arteries and the aorta was compared between the two groups. Right and left carotid 18FDG uptake was greater (P < 0.03) in the HIV group (1.77
Friedrichshafen Hospital, Germany: Continuing 100-year history of innovation with installation of new DR system
Friedrichshafen is the second largest city on the shores of Lake Constance, in the south of Germany. Over one hundred years ago, the hospital that would become Friedrichshafen Hospital was built here, in line with standards considered modern at that time. The hospital grew in size and scope as the city expanded, and it is now the key provider of care in the area. The recent implementation of Agfa HealthCare
European Respiratory Society 2012: Every breath counts
The annual congress of the European Respiratory Society (ERS) took place in Vienna, Austria, 1-5 September 2012. Some highlights of the scientific programme are presented below.
Multidimensional approach to non-cystic fibrosis bronchiectasis
One of the leading experts in the field of respiratory infections, Miguel Angel Mart