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Current Problems in Diagnostic Radiology

Shaileshkumar Garge, Shyamkumar N Keshava, Vinu Moses
We describe a novel technique for facilitating recanalization of intrahepatic inferior vena cava (IVC) via the transjugular approach in patients with short segmental hepatic IVC occlusion, where a transjugular liver biopsy cannula provides additional support to the catheter-wire combination and trans-abdominal ultrasound helps in positioning the tip of the cannula at the stump of suprahepatic IVC.
August 3, 2016: Current Problems in Diagnostic Radiology
Vlad V Simianu, Anna Shamitoff, Daniel S Hippe, Benjamin D Godwin, Jabi E Shriki, Frederick T Drake, Ryan B O Malley, Suresh Maximin, Sarah Bastawrous, Mariam Moshiri, Jean H Lee, Carlos Cuevas, Manjiri Dighe, David Flum, Puneet Bhargava
PURPOSE: Computed tomography (CT) is a fast and ubiquitous tool to evaluate intra-abdominal organs and diagnose appendicitis. However, traditional CT reporting does not necessarily capture the degree of uncertainty and indeterminate findings are still common. The purpose of this study was to evaluate the reproducibility of a standardized CT reporting system for appendicitis across a large population and the system's impact on radiologists' certainty in diagnosing appendicitis. METHODS: Using a previously described standardized reporting system, eight radiologists retrospectively evaluated CT scans, blinded to all clinical information, in a stratified random sample of 237 patients from a larger cohort of patients imaged for possible appendicitis (2010-2014)...
August 2, 2016: Current Problems in Diagnostic Radiology
Katharina Martini, Borna K Barth, Kai Higashigaito, Stephan Baumueller, Hatem Alkadhi, Thomas Frauenfelder
To determine the lowest CT radiation dose-level at maintained image-quality and high sensitivity for detection of pulmonary-nodules in obesity. Single-energy CT with tin-filtration was performed in a chest-phantom with solid pulmonary-nodules simulating over-weight and obesity. CTDIvol of the standard-protocol was 0.41 mGy, subsequent scans were obtained at 1/2 and 1/4 dose-levels. Images were reconstructed using FBP and advanced-modeled iterative reconstruction (ADMIRE). Noise, image-quality, and sensitivity for nodule-detection were assessed...
August 2, 2016: Current Problems in Diagnostic Radiology
Yiyan Liu
Focal lung uptake without corresponding lesions or abnormalities on computed tomography (CT) scan poses a dilemma in the interpretation of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). A limited number of case reports have previously suggested an artifactual or iatrogenic nature of the uptake. In the present study, 8 relevant cases were included within a retrospective search of the database. Medical records were reviewed for follow-up radiological and pathologic information...
July 30, 2016: Current Problems in Diagnostic Radiology
Hazel Asumu, Yvonne Estrin, Tan-Lucien H Mohammed, Nupur Verma
Benign metastasizing leiomyoma is a rare diagnosis in women with history of uterine leiomyomata. Distant metastasis may occur anywhere but is most commonly seen to the lungs. The age of presentation is often young to mid age, with patients often having a history of hysterectomy or myomectomy for uterine leiomyomata. The clinical course of these patients is most often indolent. However, the size and number of nodules can result in pulmonary symptoms. Differentiating benign metastasizing leiomyoma from malignant metastatic disease, including from leiomyosarcoma, is important to avoid unnecessary procedures or delayed treatment...
July 28, 2016: Current Problems in Diagnostic Radiology
Puneet Bhargava
No abstract text is available yet for this article.
November 2016: Current Problems in Diagnostic Radiology
Ameya Jagdish Baxi, Sina Tavakoli, Daniel Vargas, Carlos S Restrepo
Crests, bands, chords, and membranes can be seen within the different cardiac chambers, with variable clinical significance. They can be incidental or can have clinical implications by causing hemodynamic disturbance. It is crucial to know the morphology and orientation of normal structures, aberrant or accessory muscles, and abnormal membranes to diagnose the hemodynamic disturbance associated with them. Newer generation computed tomographic scanners and faster magnetic resonance imaging sequences offer high spatial and temporal resolution allowing for acquisition of high resolution images of the cardiac chambers improving identification of small internal structures, such as papillary muscles, muscular bands, chords, and membranes...
November 2016: Current Problems in Diagnostic Radiology
Sirishma Kalli, Michael Lanfranchi, Andrew Alexander, Shital Makim, Phoebe E Freer
Although primary breast cancer is the most common malignancy identified by breast imaging, extramammary malignancies may also rarely be encountered. These uncommon lesions may reflect primary neoplasms of nonmammary origin as well as secondary metastatic lesions, and include lymphoma, melanoma, neuroendocrine tumors, gastrointestinal tract malignancies, and angiosarcoma among other entities. Malignant extramammary breast lesions may be encountered during routine mammographic screening, identified during the diagnostic evaluation of a palpable breast abnormality, or may be detected incidentally during imaging of other organs of interest...
November 2016: Current Problems in Diagnostic Radiology
Puneet Bhargava
No abstract text is available yet for this article.
September 2016: Current Problems in Diagnostic Radiology
Richard Ha, Eralda Mema, Xiaotao Guo, Victoria Mango, Elise Desperito, Jason Ha, Ralph Wynn, Binsheng Zhao
The magnetic resonance imaging (MRI) background parenchymal enhancement (BPE) and its clinical significance as a biomarker of breast cancer risk has been proposed based on qualitative studies. Previous BPE quantification studies lack appropriate correlation with BPE qualitative assessments. The purpose of this study is to validate our three-dimensional BPE quantification method with standardized BPE qualitative cases. An Institutional Review Board-approved study reviewed 500 consecutive magnetic resonance imaging cases (from January 2013-December 2014) using a strict inclusion criteria and 120 cases that best represented each of the BPE qualitative categories (minimal or mild or moderate or marked) were selected...
September 2016: Current Problems in Diagnostic Radiology
Jason C Hoffmann, Ayushi Singh, Sameer Mittal, Yuri Peterkin, Jonathan Flug
Over the past 10 years, there has been increased attending-level image interpretation during what has typically been considered the on-call period. The purpose of this study is to survey radiology attending physicians and assess their perceptions about how the presence of radiology attending physicians during the on-call period affects patient care and resident education. Two hundred eighty-eight radiology attendings completed the online survey. 70% believe that after hours final reads by radiology attendings improves patient care...
September 2016: Current Problems in Diagnostic Radiology
Larson D Hsu, Carolyn L Wang, Toshimasa J Clark
We confirmed that computed tomography (CT) attenuation values of pixels in an adrenal nodule approximate a Gaussian distribution. Building on this and the previously described histogram analysis method, we created an algorithm that uses mean and standard deviation to estimate the percentage of negative attenuation pixels in an adrenal nodule, thereby allowing differentiation of adenomas and nonadenomas. The institutional review board approved both components of this study in which we developed and then validated our criteria...
September 2016: Current Problems in Diagnostic Radiology
Nadja Kadom, Karin Sloan, Gouri Gupte, Louis Golden, Stephanie Coleman, Avneesh Gupta, Kristen Lloyd-Baugnon, James Moses
Quality improvement (QI) skills in radiology are required as part of the Accreditation Council for Graduate Medical Education Diagnostic Radiology Milestones competencies. Although feasibility of QI curricula has been demonstrated in radiology before, there are still barriers to widespread implementation. Here, we share our experience with designing the curriculum structure and selecting content. We describe the QI projects that have been performed and discuss lessons learned, including successes, challenges, and future directions...
September 2016: Current Problems in Diagnostic Radiology
Eira Roth, Michael Hoff, Michael L Richardson, Alice S Ha, Jack Porrino
Among articles within the radiology literature, few present the manifestations of magnetic resonance imaging artifacts in a clinically oriented manner. Recognizing such artifacts is imperative given the increasing clinical use of magnetic resonance imaging and the emphasis by the American Board of Radiology on practical physics applications. The purpose of this article is to present magnetic resonance physics principles visually and conceptually in the context of common musculoskeletal radiology artifacts and their solutions, described using nonmathematical explanations...
September 2016: Current Problems in Diagnostic Radiology
Vahe M Zohrabian, Zain A Husain, Maxwell S Laurans, Veronica L Chiang, Amit Mahajan, Michele H Johnson
Stereotactic body radiation therapy (SBRT) is as an effective method to treat spinal metastases. Imaging is a critical component in the workup of patients who undergo stereotactic radiation treatment. Computed tomographic myelography may be more accurate than magnetic resonance imaging in the delineation of neural elements during SBRT. The task we faced was to offer a standardized method to rapidly and safely obtain high-quality computed tomographic myelography as part of a robust spine SBRT program. In detailing our experience, we support the greater, active participation of radiologists in the multidisciplinary care of patients with spinal metastases, while encouraging other radiologists to foster similar collaborations at their own institutions...
September 2016: Current Problems in Diagnostic Radiology
Kristin Jensen, Hilde Kjernlie Andersen, Anders Tingberg, Claudius Reisse, Erik Fosse, Anne Catrine T Martinsen
Studies on iterative reconstruction techniques on computed tomographic (CT) scanners show reduced noise and changed image texture. The purpose of this study was to address the possibility of dose reduction and improved conspicuity of lesions in a liver phantom for different iterative reconstruction algorithms. An anthropomorphic upper abdomen phantom, specially designed for receiver operating characteristic analysis was scanned with 2 different CT models from the same vendor, GE CT750 HD and GE Lightspeed VCT...
September 2016: Current Problems in Diagnostic Radiology
Ashish Chawla, Jagadish Shenoy, Kabilan Chokkappan, Raymond Chung
Computed tomography and magnetic resonance imaging are widely used for evaluation of patients with nasal masses, playing an integral role in their diagnosis and treatment. Inverted papilloma is a rare tumor of the sinonasal region that demonstrates characteristic imaging appearances. Preoperative diagnosis and precise tumor extent are essential for surgical planning as this tumor grows centrifugally and has high potential to recur following incomplete surgery. This pictorial review aims to illustrate the spectrum of imaging features of inverted papilloma and highlight the key features that are useful for making an accurate diagnosis of this condition...
September 2016: Current Problems in Diagnostic Radiology
Refky Nicola, Khalid W Shaqdan, Shima Aran, Ajay K Singh, Hani H Abujudeh
Endovascular aneurysm repair (EVAR) is a successful technique as well as an excellent alternative to the surgical management of abdominal aortic aneurysms. EVAR has improved the mortality and morbidity of many patients who would have otherwise suffered greatly from the consequences of abdominal aortic aneurysms. However, EVAR is not without complications. Some complications require lifelong surveillance, whereas others may necessitate immediate surgical intervention. We discuss the various modalities available for the surveillance as well as the common complications that can be seen on computed tomography...
September 2016: Current Problems in Diagnostic Radiology
Mohammad Mansouri, Shima Aran, Khalid W Shaqdan, Hani H Abujudeh
The purpose of this article is to provide a rate of safety incident report of adverse events in a large academic radiology department and to share the various types that may occur. This is a Health Insurance Portability and Accountability Act compliant, institutional review board-approved study. Consent requirement was waived. All incident reports from April 2006-September 2012 were retrieved. Events were further classified as follows: diagnostic test orders, identity document or documentation or consent, safety or security or conduct, service coordination, surgery or procedure, line or tube, fall, medication or intravenous safety, employee general incident, environment or equipment, adverse drug reaction (ADR), skin or tissue, and diagnosis or treatment...
July 2016: Current Problems in Diagnostic Radiology
Stephanie Coleman, Nagaraj Setty Holalkere, Julie O׳Malley, Gemma Doherty, Alexander Norbash, Nadja Kadom
Many radiology practices, including academic centers, are moving to in-house 24/7 attending coverage. This could be costly and may not be easily accepted by radiology trainees and attending radiologists. In this article, we evaluated the effects of 24/7 in-house attending coverage on patient care, costs, and qualitative aspects such as trainee education. We retrospectively collected report turnaround times (TAT) and work relative value units (wRVU). We compared these parameters between the years before and after the implementation of 24/7 in-house attending coverage...
July 2016: Current Problems in Diagnostic Radiology
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