Diagnostic imaging of the ear, nose and throat (ENT) area has traditionally been carried out with medical CT, MRI and standard radiography. Nowadays there is a transition towards using more cone-beam computed tomography (CBCT) for certain diagnostic tasks in these areas. The successful introduction of a CBCT system for ENT applications, in addition to applications in the dental field where the method already plays a major role, is described here.
by Dr Jorma J
Digital social media networks permeate the lives of many people in developed and developing nations. In other words, when a disaster occurs anywhere on the planet, with dire consequences for the local population, the news can instantly be relayed to an international audience. The marriage of social media and disaster medicine and management was inevitable. However, the power of these networks, with both negative and positive consequences, is just now beginning to be realised and harnessed by the medical community in responding to disasters.
by Dr Paul S. Dhillon and Dr Fergal H. Cummins
What is social media?
Social media is a nebulous term which was first used in 2004 according to the Miriam-Webster Dictionary. In 2010 Andreas Kaplan and Michael Haenlein attempted to define social media1  as a ‘group of Internet-based applications that build on the ideological and technological foundations of Web 2.0, and that allow the creation and exchange of user-generated content’. An essential factor in their definition was that the users of the technology are not passive in receiving information, but now had the ability to directly influence the generation of information and act as local hubs within their own communities to propagate messages and ideas.
There is a gamut of different forms of social media available to the public and business. The more commonly known and used are Facebook and Twitter, but this is not the complete remit of social media which also include different forms such as blogs, micro-blogging, wikis, photo streams, video, social bookmarking, RSS feeds, podcasting, professional networks, and social email. This list is by no means exhaustive as there are some types of social media that defy definition at this time.
One issue that cannot be argued is that social media have fundamentally changed the way people interact with each other. Borders are much more liquid: as long as an Internet or mobile connection is available, international media are accessible. One
The number of peer-reviewed papers covering the field of hybrid imaging is burgeoning, 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.
Physical attributes, limitations, and future potential for PET and SPECT.
Garcia EV. J Nucl Cardiol. 2011 Dec 10.
Advances in SPECT and PET imaging hardware, software, and radiotracers are vastly improving the non-invasive evaluation of myocardial perfusion and function. In contrast to traditional dual-headed, sodium iodide crystal and photomultiplier cameras with mechanical collimators, new SPECT camera designs utilise novel collimators and solid-state detectors that convert photons directly to electrical signals. These cameras simultaneously collect data from as many as 76 small detectors narrowly focused on the heart. New noise regularisation and resolution recovery/noise reduction reconstruction software interprets emitted counts more efficiently and thus more effectively discriminates between useful signals and noise. As a result, shorter acquisition times and/or lower tracer doses produce higher quality SPECT images than were possible before. PET perfusion imaging has benefitted from the introduction of novel detectors that now allow true 3D imaging, new radiopharmaceuticals, and precise attenuation correction (AC). These developments have resulted in perfusion images with higher spatial and contrast resolution that may be acquired in shorter protocols and/or with less patient radiation exposure than traditional SPECT. Hybrid SPECT/CT and PET/CT cameras utilise transmission computed tomographic (CT) scans for AC, and offer the additional clinical advantages of evaluating coronary calcium, myocardial anatomy (including non-invasive CT angiography), myocardial function and myocardial perfusion in a single imaging procedure.
Bone scintigraphy in breast cancer: added value of hybrid SPECT-CT and its impact on patient management.
Sharma P et al. Nucl Med Commun 2011 Dec 7.
This study evaluated the incremental value of single-photon emission computed tomography-computed tomography (SPECT-CT) over planar scintigraphy and SPECT alone for equivocal bone scintigraphy lesions in patients with breast cancer and to assess its impact on patient management. A total of 102 patients with 115 equivocal lesions on planar scintigraphy underwent SPECT and SPECT-CT of selected volume. Images were evaluated in separate sessions to minimise recall bias. A scoring scale of 1-5 was used, where 1 is definitely metastatic, 2 is probably metastatic, 3 is indeterminate, 4 is probably benign, and 5 is definitely benign. With receiver operating characteristic analysis, area under the curves was constructed for each modality. Clinical/imaging follow-up and/or histopathology were taken as the reference standard. There were 52 indeterminate lesions on planar scintigraphy, 15 on SPECT, and three on SPECT-CT. Area under the curve for SPECT-CT was significantly larger compared with planar scintigraphy (P<0.001) and SPECT (P=0.033). This improvement was mostly for lytic lesions (P<0.0001). In patients (n=67) in whom the lesions under evaluation were the only lesions and hence whose management was decided, SPECT-CT was superior to SPECT (P=0.045) and planar scintigraphy (P <0.001). SPECT-CT is thus better than planar scintigraphy and SPECT alone for characterising equivocal bone scintigraphy lesions in patients with breast cancer and can have a significant impact on patient management. Combined anatomical and functional imaging using coronary CT angiography and myocardial perfusion SPECT in symptomatic adults with abnormal origin of a coronary artery.
Uebleis C et al. Int J Cardiovasc Imaging. 2011 Dec 7.
There has been a lack of standardised workup guidelines for patients with congenital abnormal origin of a coronary artery from the opposite sinus (ACAOS). This study evaluated the use of cardiac hybrid imaging using multi-detector row CT (MDCT) for coronary CT angiography (Coronary CTA) and stress-rest myocardial perfusion SPECT (MPS) for comprehensive diagnosis of symptomatic adult patients with ACAOS. Seventeen symptomatic patients (12 men; 54
Picture Archiving and Communication Systems (PACS) enable efficient digital storage and remote communication of images from multiple medical imaging modalities. While PACS have significantly reduced the physical overload of managing medical image archives, they have also introduced a challenging mental overload to the radiologist in interpreting imaging findings. In this brief communication, we make the point that content-based retrieval approaches for decision support, such as the CaReRa project, can ease the radiological interpretation process.
by Dr Ceyhun Burak Akg
IT transforms University Hospital Hamburg-Eppendorf
Imagine a hospital without any paper. This is just one of many consequences of streamlining processes in a 1,400-bed hospital that treats 50,000 inpatients, 250,000 outpatients and 50,000 emergency patients every year, the objective being to be able to deal with more serious issues.
In 2004, faced with annual losses of 37 million euro, decision makers at the University Hospital Hamburg-Eppendorf (UKE) realised that a turnaround was essential to save the hospital and serious action had to be taken. This involved improving internal structures and processes, along with implementing appropriate IT support systems, both in a complete new building infrastructure.
‘Managers opted to restructure the organisation, re-engineer processes, and modernise buildings’, explained Dr Peter Gocke, the outgoing chief information officer (CIO). Clearly the focus was on processes, with a direct impact on the IT strategy. In turn, Health IT transformed the quality of care.
Finding a solution