Radiology RSS : Gourt

Chief of Radiology Position, Northern Arizona, No Call, No Nights, No Weekends, #3099 :: Arizona :: Timeline Recruiting

Northern Arizona Gateway to the Grand Canyon Employed Salary + Stipend No Call, No Nights, No Weekends The Flagstaff area makes the perfect home with some of the most spectacular scenery in the

100% Structured Big XII Academic Neuroradiology, Major Metro of 1+ Million, #3470 :: Oklahoma :: Timeline Recruiting

This academic position has constructed a highly rewarding neuroradiology program for you. Enjoy the benefits of practicing alongside a large, supportive and innovative cast in a state-of-the-art

2 Hours to Chicago, Detroit, $500K + Sign-On, $100K in Additional Benefits, #3449 :: Michigan :: Timeline Recruiting

This physician-led multispecialty Radiology practice has constructed a highly rewarding practice program for its physicians. Enjoy the benefits of practicing alongside a large, supportive and innovative

Radiology Directorship, $500K Base Salary, No State Tax, #3473 :: Texas :: Timeline Recruiting

Join a dedicated team as the Director of an established Radiology Department. Have the flexibility to make your own decisions and to be truly valued as an expert in your field. Along with the autonomy

Women's Imaging Radiology Opportunity in Southeast Florida! :: Florida :: CompHealth Inc

Job 9110255 Join an solid, established and growing group with an opportunity for an excellent Women's Imager and Radiologist in a beautiful Southeast Florida Coastal setting. Need is for radiologist

General Radiologist with Mammography for Northern, CA :: California :: CompHealth Inc

Job 92277 BC, Radiologist needed for a stable and growing group in Northern, CA. Must be able to read all General Modalities. Also must be skilled in Mammography as well as Breast US. Full Benefits,

Pacific Northwest, 1 Hour to the Pacific, #2205 :: Oregon :: TimeLine Advantage

Pacific Northwest Radiology Opportunity25,000 Signing BonusOne Year to Partnership Join three other Radiologists in an established group and be ramped up immediately. Also enjoy a light call schedule

General Radiology need in Atlanta Suburb :: Georgia :: CompHealth Inc

Job 9111124 Need a Board Certified Diagnostic Radiologist that is skilled in all realms of Radiology: MRI, CT, PF, US, Mammo, and light IR. Competitive compensation, and excellent benefits. 6 weeks

Interventional radiologist needed in TX :: Texas :: CompHealth Inc

Job 9111093 Stable 6 person group seeks interventional radiologist to help cover 300+bed medical center. Outstanding starting salary Partnership track position Partners earning over 450,000 Great vacation

Diagnostic radiologist needed in TX :: Texas :: CompHealth Inc

Job 9111095 Stable 6 person group seeks diagnostic radiologist to help cover 300+bed medical center. Outstanding starting salary Partnership track position Partners earning over 450,000 Great vacation

Greater Boston area :: Massachusetts :: Medical Search International

Radiologists- Greater Boston A large Medical Center 35 minutes outside of Boston is seeking a Radiologist to join their multidisciplinary hospital based group. Opportunity for private practice and or

Southern Virginia :: Virginia :: Medical Search International

A prestigious Medical Center located in a beautiful community in Southern Virginia is seeking a Radiologist to join their multidisciplinary group. Opportunity for private practice and or partnership

Several Locations :: New Jersey :: Medical Search International

Wonderful locums assignment for BC Neuroradiologists in New Jersey. Several locations. Length of contract is 2-6 months with an option to extend. 40 hour work week (5 days per week). Candidate must

South Florida :: Florida :: Health Search, Inc.

Client has a new contract in South Florida to staff, great location. Diagnostic or Interventional Radilogists needed. 10 weeks vac, 350- 500K, Various call schedules to choose from. 800 650-1001

NATIONWIDE :: Texas :: Physician Referral Network

Physician Referral Network is your best source to learn about the latest practice opportunities. We are not a recruiting firm, so we promise you'll never be pressured to look at or take a position that

Western PA :: Pennsylvania :: Health Search, Inc.

Interventional...Diagnostic...Neuro...MSK...all specialties needed. Will Support hospital and 2 Ctrs. 500K+. Call Nicole for more details.

Central FL :: Florida :: Health Search, Inc.

Diagnostic/ Interventional Radiologist for central Florida group, Partner in 2 yrs. 400K to start 600K after Partner, call for details. 800 650-1001.Several other opportunities in Florida, as well as

Gulf Coast :: Florida :: Health Search, Inc.

Pediatric specialty Radiologist needed for hospital on gulf coast of florida. call 800 650-1001 or email.

Gulf coast :: Florida :: Health Search, Inc.

Rare opptny for a Pediatric Radiologist on gulf coast of Florida call 800 650-1001

Maryland :: Maryland :: U.S.Physician Resources Intl, Inc.

U.S.Physician Resources is hiring radiologists for an excellent practice in Maryland. Full time job opportunity with all benefits. Income will be discussed during the interview process. j1 and h1 accepted.

Vertebral artery duplication and aneurysms: 64-slice multidetector CT findings

A rare case of combined soft-tissue and intraosseous arteriovenous malformation of the hand with diffuse periosteal elevation: imaging appearances

Intractable bronchopleural fistula caused by radiofrequency ablation: endoscopic bronchial occlusion with silicone embolic material

Absence of uterine arteries discovered at fibroid embolisation

Chordoma masquerading as a nerve root tumour a clinical lesson

CT appearance of persistent left superior vena cava, anomalous right superior pulmonary venous return into the right-sided superior vena cava and a sinus venosus-type atrial septal defect

Characteristics of in vivo radiotherapy dosimetry

Joint symposium 2009 on carbon ion radiotherapy

A description of CT features of Clostridium difficile infection of the small bowel in four patients and a review of literature

Conventional MRI and magnetisation transfer imaging of the brain and optic pathway in primary open-angle glaucoma

Gastric bezoars: reassessment of clinical and radiographic findings in 19 patients

Percutaneous radiofrequency ablation of small hepatocellular carcinoma invisible on both ultrasonography and unenhanced CT: a preliminary study of combined treatment with transarterial chemoembolisation

Warthins tumour: a retrospective case series

Reduction of dose to the female breast as a result of spectral optimisation for high-contrast thoracic CT imaging: a phantom study

Therapeutic effect of balloon-occluded retrograde transvenous obliteration for gastric varices in relation to haemodynamics in the short gastric vein

Optimisation techniques in vaginal cuff brachytherapy

Implantation of fiducial markers for image guidance in prostate radiotherapy: patient-reported toxicity

Personnel radiation dose considerations in the use of an integrated PETCT scanner for radiotherapy treatment planning

Thorax set-up verification with multiple oblique treatment portal images

Brain: non-infective and non-neoplastic manifestations of HIV

Persistent scrotal lesion

Magnetic Resonance Imaging in the Visualization of Benign Tumors and Tumor-like Lesions of Hand and Wrist

Publication year: 2010Source: Current Problems in Diagnostic Radiology, Volume 39, Issue 1, January-February 2010, Pages 1-16Tarkan, Ergun , Hatice, Lakadamyali , Alihan, Derincek , Nefise, Cagla Tarhan , Ahmet, OzturkThe differential diagnosis of benign tumors and tumor-like lesions of the hand and wrist region is important with regard to choosing the therapy (medical versus surgical), or to decide to just follow-up the lesion. In most of the cases the proper analysis of MRI findings in correlation with the patient's history is sufficient to meet a specific diagnosis. However, diagnostic confusion is not uncommon as there are numerous lesions affecting the hand and wrist region. This pictorial essay offers a practical radiological approach to benign tumors and tumor-like lesions of the hand and wrist region based on most frequently observed...

Cross-Sectional Imaging of Primary Thoracic Sarcomas with Histopathologic Correlation: A Review for the Radiologist

Publication year: 2010Source: Current Problems in Diagnostic Radiology, Volume 39, Issue 1, January-February 2010, Pages 17-29Jonathan R., Dillman , Perry G., Pernicano , Jonathan B., McHugh , Anil K., Attili , Bassem, Mourany , ...Numerous forms of primary sarcoma can arise from the heart, pericardium, great vessels, lungs, chest wall, and breasts. Magnetic resonance imaging and computed tomography currently play important roles in determining the extent of primary thoracic sarcoma involvement, potential for resectability, and response to therapy. The purpose of this article is to review the various forms of primary sarcoma that may affect the thorax as well as illustrate pertinent cross-sectional radiologic findings with histopathologic correlation.

Cutaneous Melanoma: Role of Ultrasound in the Assessment of Locoregional Spread

Publication year: 2010Source: Current Problems in Diagnostic Radiology, Volume 39, Issue 1, January-February 2010, Pages 30-36Orlando, Catalano , Alfredo, SianiThis article illustrates the various aspects of locoregional spread of cutaneous melanoma, as imaged with grayscale ultrasound (US) and Doppler techniques. High-resolution US allows recognition of small, clinically occult melanomatous foci within the skin and lymph nodes. Consequently, it plays a major role in locoregional staging and follow-up of patients with cutaneous melanoma. We discuss the possibilities and limitations of US in the initial staging (primary melanoma, satellite metastasis, in-transit metastasis, and lymphadenopathy), selection for sentinel lymph node biopsy procedure, patient follow-up, detection of recurrence, and US-guided intervention.

Dual-Source Cardiac Computed Tomographic Technique, Anatomy, and Normal Variants

Publication year: 2010Source: Current Problems in Diagnostic Radiology, Volume 39, Issue 1, January-February 2010, Pages 37-50Todd, Noce , Neil, Gupta , Anthony, Posteraro , Christine, KimThe advent of fast multislice computed tomography (CT) has ushered in a new era in the noninvasive evaluation of the heart. Cardiac structures can now be quickly evaluated with exquisite detail in a noninvasive manner. Cardiac CT is increasingly being used for the noninvasive evaluation of coronary arteries, procedural planning, and evaluating chest pain in certain clinical situations. Dual-source CT is a recent technological development that has helped improve spatial and temporal resolution for cardiac CT imaging. It is one of many “next generation” CT technologies that are now pushing image quality to new levels. The interpreting radiologist must now...

Upcoming Articles

Publication year: 2010Source: Current Problems in Diagnostic Radiology, Volume 39, Issue 1, January-February 2010, Page IBC[No author name available]

In Recent Issues

Publication year: 2010Source: Current Problems in Diagnostic Radiology, Volume 39, Issue 1, January-February 2010, Page OBC[No author name available]

Acute Knee Dislocation: Review of an Elusive Entity

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 6, November-December 2009, Pages 237-250Sangita, Kapur , Robert D., Wissman , Michael, Robertson , Sadhna, Verma , Michael C., Kreeger , ...The knee consists of three articulations: the patellofemoral, the tibiofemoral, and the proximal tibiofibular joint. Any of these joints can dislocate. Dislocations are uncommon, tend to spontaneously reduce, and can be difficult to detect on clinical examination. There are, however, telltale imaging features and the radiologist may be the first to suggest the correct diagnosis. A timely diagnosis is important as some forms are associated with limb-threatening complications. Lateral patellofemoral dislocation, in the acute setting, is typically an injury of young athletes and usually spontaneously reduces at the time of trauma. In transient lateral dislocation, contusions may be seen in...

Multidetector Computed Tomography Findings of Dense Pulmonary Emboli in Oncologic Patients

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 6, November-December 2009, Pages 251-263Alberto, Villanueva , Maria Lourdes, Díaz , Armando, Sánchez , Eva, Castañer , Gorka, Bastarrika , ...Pulmonary embolism is a frequent condition for which multidetector computed tomography (MDCT) plays an important role in its detection. Occasionally, on MDCT studies, dense linear branching opacities may be found within the pulmonary vessels. They represent dense emboli within the pulmonary arteries (DEPA). These may occur in oncologic patients that undergo specific treatments or interventional procedures, such as cement embolus from vertebroplasty, catheter or coil migration after embolization procedures, radioactive seed embolus in patients treated with local brachytherapy for prostate, lung, or liver cancer, and also in chronic pulmonary embolism. Usually DEPA does not have any clinical significance but may...

Computed Tomographic Appearances of Hepatic Vascular Lesions

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 6, November-December 2009, Pages 264-273Lye Quen, Hon , Arul, Ganeshan , Sarfraz, Nazir , Sara, Upponi , Helen, Bungay , ...Improvements in Imaging technology have revolutionized liver imaging and allowed the recognition of abnormalities arising from various architectural components such as vessels and biliary ducts of the liver. A spectrum of various hepatic vascular disorders as demonstrated by multidetector CT (MDCT) is presented in this review article.

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 6, November-December 2009, Page IBC[No author name available]

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 6, November-December 2009, Page OBC[No author name available]

Hysterosalpingography: Technique and Applications

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 5, September-October 2009, Pages 199-205Athanasios, Chalazonitis , Ioanna, Tzovara , Fotios, Laspas , Petros, Porfyridis , Nikos, Ptohis , ...Hysterosalpingography (HSG) remains an important radiologic procedure in the investigation of infertility and has become a commonly performed examination due to recent advances of reproductive medicine. HSG demonstrates the morphology of the uterine cavity, the lumina, and the patency of the fallopian tubes. In this review article, we present the technical parameters of the examination, indications, contraindications, and possible complications of HSG. We also illustrate a variety of abnormalities of the uterus and fallopian tubes that can be detected accurately with HSG. We believe that, with the increased demand for HSG, radiologists should be familiar with HSG technique and the...

Non-Electrocardiogram-Gated Multidetector-Row Computed Tomography Findings of Cardiac Pathology in Oncologic Patients

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 5, September-October 2009, Pages 206-217Maria Lourdes, Díaz , Alberto, Villanueva , Gorka, Bastarrika , Beatriz, Zudaire , Loreto García, del Barrio , ...Multidetector-row computed tomography (MDCT) plays an essential role in oncologic imaging as the modality of mapping out the treatment strategy at staging, assessing response to the treatment, and following up patient outcome after the treatment. Even without electrocardiogram gating, MDCT provides accurate information about the heart. In the group of oncologic patients, different tumoral and non-tumoral-related heart disorders can be found, for example, metastatic cardiac involvement (approximately 10% of patients with lung or breast cancer will develop metastases to the heart), paraneoplastic cardiac disorders, non-tumor-related heart disorders, and chemotherapy- and radiotherapy-related cardiac side effects. MDCT plays a role in the...

Pediatric Cranial Doppler Sonography in Children: Non-Sickle Cell Applications

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 5, September-October 2009, Pages 218-227Amy M., Soetaert , Lisa H., Lowe , Christopher, FormenThis article presents an overview of transcranial Doppler, well known for its use as a screening tool in children with sickle cell disease. However, there are many other pediatric applications in which cranial Doppler ultrasound can supply otherwise unavailable information regarding neurovascular flow dynamics. Images illustrate examples of normal anatomy and pathologic conditions that can be evaluated with cranial Doppler ultrasound. Characteristic imaging features of various pediatric applications of cranial Doppler ultrasound are discussed and illustrated. This image presentation discusses cranial Doppler ultrasound technique and normal findings and illustrates various pediatric disorders including benign enlargement of the subarachnoid space versus...

Radiological Manifestations of Skeletal Lymphoma

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 5, September-October 2009, Pages 228-236John, O'Neill , Karen, Finlay , Eric, Jurriaans , Lawrence, FriedmanLymphoreticular neoplasms primarily arise in extraskeletal locations with skeletal involvement usually secondary to hematogenous spread or by direct invasion from surrounding involved lymph nodes or soft tissues. Primary lymphoma of bone is relatively rare in comparison. Lymphoma encompasses Hodgkin's and non-Hodgkin's disease, Burkitt's lymphoma, and mycosis fungoides. Skeletal disease may present with symptoms localized to the site of bone involvement, as an incidental finding on imaging for other reasons, or as part of the staging of the disease. It is important that the radiologist is cognizant of the many presentations of skeletal lymphoma. We present a review of the radiological...

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 5, September-October 2009, Page IBC[No author name available]

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 5, September-October 2009, Page OBC[No author name available]

Multidetector Computed Tomography of the Acute Abdomen in the Immunocompromised Host: A Pictorial Review

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Pages 145-155Simon P., Spencer , Niall, Power , Rodney H., ReznekImmunocompromised patients include those receiving chemotherapy for malignant disease, post-transplant patients, patients with acquired immunodeficiency syndrome (AIDS), and those receiving steroids for autoimmune diseases. Advances in transplantation, oncology, and the treatment of AIDS have extended these patients' life expectancies and thereby increased the immunocompromised population. Classical clinical signs of abdominal sepsis may be absent in the immunocompromised host. Consequently, the radiologist is increasingly called on to diagnose specific acute intra-abdominal complications associated with immunodeficiency. This review describes the etiology of the acute abdomen in this heterogeneous group of immunocompromised patients, causes including opportunistic infections, neutropenic enterocolitis, complications of therapy, and...

Positron Emission Tomography/Computed Tomography Potential Pitfalls and Artifacts

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Pages 156-169Xia, Wang , Spencer, KochWith the recent use of 18-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) for tumor staging and treatment response, it is important to recognize many pitfalls, artifacts, and benign uptakes that are commonly encountered. Normal physiology can explain many regions of increased FDG activity, as well as incidental benign tumors and benign metabolic conditions. Recognition of characterization of benign causes and physiologic variants for FDG uptake are discussed to avoid improper characterization as a malignancy. A basic understanding of PET/computed tomographic physics is also discussed, in relation to attenuation correction artifacts caused by metallic implants and contrast agents in the gastrointestinal tract,...

Diagnosis and Management of Pseudoaneurysms: An Update

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Pages 170-188Baljendra S., Kapoor , Heather L., Haddad , Souheil, Saddekni , Mark E., Lockhart“Pseudoaneurysm” is a term that describes disruption of an artery with patent flow in a defined space beyond the confines of the vessels. A pseudoaneurysm can involve any vascular bed and is usually associated with direct arterial injury or erosion of an artery by an adjacent tumor or inflammation. In this article, we discuss different clinical settings and various imaging modalities such as ultrasound, computerized tomography, magnetic resonance imaging, as well as conventional angiography used for the diagnosis of pseudoaneurysms. We also describe the role of newer endovascular, percutaneous, and traditional surgical approaches for the treatment of visceral and peripheral...

The Great Mimicker: Fat Necrosis of the Breast—Magnetic Resonance Mammography Approach

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Pages 189-197Sergi, Ganau , Lidia, Tortajada , Fernanda, Escribano , Xavier, Andreu , Melcior, SentísFat necrosis of the breast is a common benign inflammatory process resulting from injury to breast fat. The pathogenesis of fat necrosis helps to explain its imaging features, which range from benign to malignant-appearing findings. This article reviews the role of magnetic resonance mammography and other conventional imaging techniques in the differential diagnosis of fat necrosis.

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Page IBC[No author name available]

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 4, July-August 2009, Page OBC[No author name available]

Computed Tomographic Appearance of Chest Ports and Catheters: A Pictorial Review for Noninterventional Radiologists

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Pages 99-110Maria Lourdes, Díaz , Alberto, Villanueva , Maria Jose, Herraiz , Jose Juan, Noguera , Alberto, Alonso-Burgos , ...Medical practice has expanded the need for long-term central venous catheterization. Chest ports play an important role in the management of oncology patients who need frequent blood products, chemotherapy, and other intravenous drugs. Imaging-guided placement of chest ports and catheters (CR) is a safe and efficacious procedure. Moreover, many cases of catheter-induced central thrombosis go unrecognized, but the incidence of pulmonary embolism in this group may be as high as 12%. Multi-detector computed tomography represents the main imaging method in the follow-up of oncologic patients. We review the radiologic features, mainly on multi-detector computed tomography, of CR commonly used for...

Ultrasound of Wrist Pain

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Pages 111-125Srinivasan, Harish , John, O'Neill , Karen, Finlay , Erik, Jurriaans , Lawrence, FriedmanUltrasound is a valuable imaging modality for evaluation of patients presenting with wrist pain. An important advantage is the ability to correlate the site of pain or discomfort with the underlying sonographic appearance. The capacity to dynamically assess the wrist and use the contralateral asymptomatic wrist for comparison purposes are strengths of ultrasound as a diagnostic tool. This pictorial review deals with the sonographic assessment of the commonly encountered wrist pathologies.

Magnetic Resonance Imaging of the Liver and Biliary Tree in Children

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Pages 126-134Pedro A.B., Albuquerque , D. Alicia, Morales Ramos , Ricardo, FaingoldMagnetic resonance imaging (MRI) is a great modality for the assessment of the liver and biliary tree in the pediatric population. In this review, we illustrate and discuss MRI technique and a variety of congenital abnormalities and acquired conditions including infectious, inflammatory, metabolic, benign, and malignant processes. The role of magnetic resonance angiography and magnetic resonance venography is discussed in hepatic tumors and portal hypertension. Magnetic resonance cholangiopancreatography protocol is also addressed. Although ultrasound remains a screening tool and computer tomography is readily available, MRI accurately depicts the pathology, leading to a better understanding of the disease process with optimal...

Radiofrequency and Microwave Ablation of the Liver, Lung, Kidney, and Bone: What Are the Differences?

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Pages 135-143Christopher L., BraceRadiofrequency (RF) ablation is becoming an accepted treatment modality for many tumors of the liver and is being explored for tumors in the lung, kidney, and bone. While RF energy is the most familiar heat source for tissue ablation, it has certain limitations that may hamper its efficacy in these new organ systems. Microwave energy may be a better source for tissue ablation but has technical hurdles that must be overcome as well. This article outlines the physics behind RF and microwave heating, discusses relevant properties of the liver, lung, kidney, and bone for thermal ablation and examines the roles...

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Page IBC[No author name available]

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 3, May-June 2009, Page OBC[No author name available]

Technical Essentials of Hepatic Doppler Sonography

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 53-60Min Ju, Kim , Kyoung Won, Kim , So Yeon, Kim , Jeong Kon, Kim , Hyung Jin, Won , ...Doppler ultrasound is an important diagnostic tool for detecting hepatic vascular abnormalities, especially following liver transplantation. Doppler ultrasound has an advantage over computed tomography or other imaging modalities in that it is noninvasive, can be used intraoperatively or immediately postoperatively at the patient's bedside, and is free from radiation hazard. Doppler ultrasound is also sensitive to very slow flow and is not limited by an optimal temporal window because it is a real-time examination. However, this examination is highly operator-dependent. For a proper evaluation of patient hemodynamic status, optimization of Doppler parameters and liberal use of spectral analysis will help...

Microwave Ablation Technology: What Every User Should Know

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 61-67Christopher L., BraceMicrowave ablation is a relatively new technology under development and testing to treat the same types of cancer that can be treated with radiofrequency ablation. Microwave energy has several possible benefits over radiofrequency energy for tumor ablation but, because clinical microwave ablation systems are not widespread, the underlying principles and technologies may not be as familiar. The basic microwave ablation system contains many of the same components as a radiofrequency ablation system: a generator, a power distribution system, and an interstitial applicator. This article attempts to provide an overview of each of these components, outline their functions and roles, and...

Practical Applications of Nuclear Medicine in Imaging Breast Cancer

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 68-83Ba.D., Nguyen , Michael C., Roarke , Patricia J., Karstaedt , Christian J., Ingui , Panol C., RamThe rise in incidence, morbidity, and mortality of breast cancer has triggered multiple imaging efforts to detect this malignancy early, stage it accurately, and monitor it with precision in the posttherapeutic course. Among different imaging modalities, nuclear medicine provides an important contribution to the clinical management of breast cancer. This article discusses four practical applications based on the use of radionuclides in the evaluation of breast malignancy, focusing on scintimammography, preoperative tumor localization procedure using radioactive seeds, sentinel nodal scintigraphy, and F-18 fluorodeoxyglucose positron emission tomography/computed tomography.

Multidetector Computed Tomography of the Mesocolon: Review of Anatomy and Pathology

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 84-90Iswaran, Ramachandran , Peter, Rodgers , Moshier, Elabassy , Rakesh, SinhaThe anatomy of the mesocolon can be seen on multidetector computed tomography (MDCT) scans, and its most important anatomic landmarks are the mesocolic vessels. The high spatial resolution of the current generation scanner coupled with the ability to generate high quality multiplanar images is very helpful in the delineation of the mesocolon. These vessels include the ileocolic and right colic vessels for the ascending mesocolon, the middle colic vessels for the transverse mesocolon, and the inferior mesenteric vein for the sigmoid and descending mesocolon. Knowledge of the anatomic landmarks of the mesocolon can help the radiologist identify the pathways for...

Magnetic Resonance Arthrography of Superior Labrum Anterior-Posterior Lesions: A Practical Approach to Interpretation

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 2, March-April 2009, Pages 91-97Eugene, LinSuperior labrum anterior and posterior (SLAP) lesions are well-evaluated with magnetic resonance (MR) arthography. This article discusses a practical approach to interpretation of MR arthrography exams for the evaluation of suspected SLAP lesions.

Issues in Imaging Malignant Neoplasms of the Female Reproductive System

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Pages 1-16Nagaraj-Setty, Holalkere , Avinash M., Katur , Susanna I., LeeRadiological evaluation of malignant neoplasms of the female reproductive system is invaluable in the initial diagnosis, staging, treatment planning, and follow-up management. Radiologists serving as consultants for the general primary care internist, gynecologists, and specialists in gynecologic oncology should be familiar with the strengths and limitations of various modalities used to evaluate gynecologic cancer patients. This article discusses the most common female reproductive tract neoplasms (ie, cervical, endometrial, and ovarian cancers) and the role of ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography in their diagnosis and management. Imaging features that impact on clinical diagnostic or treatment algorithms...

Pharyngeal Dysphagia: What the Radiologist Needs to Know

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Pages 17-32Patrick D., Grant , Desiree E., Morgan , Francis J., Scholz , Cheri L., CanonDysphagia is defined as difficulty in swallowing. Oropharyngeal dysphagia is defined as difficulty in moving the bolus from the mouth to the esophagus. The best initial evaluation of suspected oropharyngeal dysphagia is a barium study which can evaluate motility of the oropharynx and hypopharynx and provide double-contrast views that may identify structural or mucosal abnormalities. Pharyngeal diverticula, Zenker's and Killian–Jamieson diverticula, and pharyngeal pouches are readily identified on these studies. Zenker's diverticula are the commonest diverticulum implicated in pharyngeal dysphagia and typically occur in the setting of cricopharyngeal dysfunction. The radiologist must not only diagnose these diverticula but also understand...

Vascular Closure Devices: A Comparative Overview

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Pages 33-43Lye-Quen, Hon , Arul, Ganeshan , Steven Mark, Thomas , Dinuke, Warakaulle , Jagalpathy, Jagdish , ...The use of closure devices is widespread and becoming more common. Radiologists performing arterial access procedures should be aware of when and how to use them, as well as the advantages and disadvantages of various devices, and any complications that may occur. This review intends to provide an overview of these devices, focusing on how they work, their efficacy in achieving hemostasis, any risks associated with their use, and our view as to which should be used for particular indications. There are three main categories of vascular closure devices: collagen based, suture based, and staples and clips. Newer generation devices...

Radiofrequency Ablation of Lung Lesions: Practical Applications and Tips

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Pages 44-52A. Molly, Roy , Clare, Bent , Tim, FotheringhamRadiofrequency ablation (RFA) therapy is a minimally invasive technique that can be used in the management of inoperable non-small-cell lung cancer and for palliation in selected patients with pulmonary metastases. Surgical resection remains the gold standard of treatment; however, many patients are ineligible due to comorbidities or poor cardiopulmonary reserve. Others may simply decline radical surgical intervention. Alternative treatment options are limited mainly to chemotherapy and external beam radiation. With the development of RFA, a new promising technique has evolved that can be offered to many, as an alternative choice or as part of combination therapy. The published results of...

Upcoming Articles

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Page IBC[No author name available]

In Recent Issues

Publication year: 2009Source: Current Problems in Diagnostic Radiology, Volume 38, Issue 1, January-February 2009, Page OBC[No author name available]

Magnetic Resonance Imaging Features of the Discrete Epiphyseal Radiolucency: A Problem-Solving Approach to Differential Diagnosis

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 6, November-December 2008, Pages 243-261José M., Mellado , Jenny T., Bencardino , Laura, Pérez del PalomarDiscrete radiolucencies in the epiphysis of the long bones may be a major radiographic finding in many arthropathies and synovial-based processes, and also in various osteolytic tumors and tumor-like lesions. In addition, a number of miscellaneous bone disorders, particularly infection and avascular necrosis, may present as discrete epiphyseal radiolucencies. Magnetic resonance imaging is frequently used in the diagnostic workup of these lesions. Our purpose was to review and illustrate, in a problem-solving approach, the potential contributions of magnetic resonance imaging in the characterization of discrete epiphyseal radiolucent lesions.

Computed Tomography and Magnetic Resonance Imaging Features of Lesions of the Renal Medulla and Sinus

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 6, November-December 2008, Pages 262-278Paul, Nikolaidis , Helena, Gabriel , Kathleen, Khong , Michael, Brusco , Nancy, Hammond , ...The kidneys can harbor a wide variety of lesions, many of which can be visualized by computed tomography and magnetic resonance imaging. In this article, the pertinent renal anatomic relationships as well as the histologic composition and function of the renal medulla and sinus are reviewed. Additionally, computed tomography and magnetic resonance imaging features of renal sinus and medullary lesions in adult patients are presented. This article reviews the salient imaging features of various malignant, benign neoplastic, and nonneoplastic lesions of the sinus and medulla.

Computed Tomographic Enterography and Enteroclysis: Pearls and Pitfalls

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 6, November-December 2008, Pages 279-287Hetal, Dave-Verma , Scott, Moore , Ajay, Singh , Noel, Martins , John, ZawackiComputed tomographic (CT) enterography and enteroclysis improve visualization of the small bowel mucosa and wall in comparison with traditional CT and fluoroscopic studies by distending the small bowel through enteric hyperhydration with a negative contrast agent. Although CT enterography is performed with oral hyperhydration, CT enteroclysis requires the placement of an enteroclysis tube, often in patients who are unable to orally consume the amount of liquid. When tolerated, CT enterography is often preferred due to its lack of invasiveness. Magnetic resonance enterography and enteroclysis are other modalities that are still being studied and show promise in the imaging of small...

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Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Page IFC[No author name available]

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Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Page i[No author name available]

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Page ii[No author name available]

More Than Just Stones: A Pictorial Review of Common and Less Common Gallbladder Pathologies

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Pages 189-202Janice, Ash-Miles , Huw, Roach , Jim, Virjee , Mark, CallawayAlthough stone disease is by far the most commonly encountered pathology of the gallbladder, there are several other important disease processes affecting it. These include adenomyomatosis, cholesterolosis, polyps, porcelain gallbladder, acalculous cholecystitis, xanthogranulomatous cholecystitis, emphysematous cholecystitis, gallbladder cancer, and gallbladder hemorrhage. The purpose of this article was to review the different gallbladder pathologies encountered in everyday radiological practice and to describe their features in the standard imaging modalities.

Ultrasound-Guided Therapeutic Procedures in the Musculoskeletal System

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Pages 203-218Jose Luis, del CuraUltrasound allows the exploration of most of the musculoskeletal system, including lytic bone lesions. Its flexibility, availability, and low cost make it the best tool to guide interventional therapeutic procedures in any musculoskeletal system lesion visible on ultrasound. These techniques include drainages of abscesses, bursitis, hematomas or muscular strains, treatment of cystic lesions (ganglions, Baker's cysts), arthrocentesis, injection of substances in joints and soft tissues, and aspiration of calcific tendinitis. Although the puncture of joints for arthrocentesis and injection of substances are performed by clinicians using palpation, the use of ultrasound guidance improves the effectiveness of the technique especially for...

Ultrasound of Muscle

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Pages 219-230Marianna, Vlychou , James, TehThis pictorial review illustrates the ultrasound appearances of pathological conditions affecting muscle with particular emphasis on extended field-of-view imaging.

Magnetic Resonance Imaging Findings of Golf-Related Injuries

Publication year: 2008Source: Current Problems in Diagnostic Radiology, Volume 37, Issue 5, September-October 2008, Pages 231-241Joseph, Sutcliffe , Justin Q., Ly , Amy, Kirby , Douglas P., BeallInjuries related to participation in golf are becoming more common given the increasing popularity of the sport itself. Golf is considered to be an activity associated with a moderate risk for sports injuries. Golf injuries are usually attributable to overuse or traumatic mechanisms and primarily occur at the elbow, wrist, shoulder, and lumbar spine. None of these injuries are unique to golf, but each of these injuries represent the most common injuries associated with golfing. This article reviews a wide range of injuries that are encountered in golfers and describes the magnetic resonance imaging findings of each of these injuries.

Re: CT "invisible" lesion of the major salivary glands-a diagnostic pitfall of contrast-enhanced CT.

Related Articles Re: CT "invisible" lesion of the major salivary glands-a diagnostic pitfall of contrast-enhanced CT. Clin Radiol. 2009 Nov;64(11):1137 Authors: Thomas R, Burke C, Howlett D PMID: 19822250 [PubMed - indexed for MEDLINE]

Re: A CT reconstruction artefact that mimics acute subdural haemorrhage.

Related Articles Re: A CT reconstruction artefact that mimics acute subdural haemorrhage. Clin Radiol. 2009 Nov;64(11):1136-7 Authors: Wells IT, Manghat N PMID: 19822249 [PubMed - indexed for MEDLINE]

A gossypiboma-induced pathological fracture of the proximal femur.

Related Articles A gossypiboma-induced pathological fracture of the proximal femur. Clin Radiol. 2009 Nov;64(11):1132-5 Authors: Suh DH, Yoon JR, Kang KB, Han SB, Kim HJ, Lee SJ PMID: 19822248 [PubMed - indexed for MEDLINE]

Rupture of an aneurysm of Vieussens' arterial ring presenting as acute cardiac tamponade.

Related Articles Rupture of an aneurysm of Vieussens' arterial ring presenting as acute cardiac tamponade. Clin Radiol. 2009 Nov;64(11):1129-31 Authors: Owen AR, Moten SC, Molan MP PMID: 19822247 [PubMed - indexed for MEDLINE]

Imaging and staging of haemophilic arthropathy.

Related Articles Imaging and staging of haemophilic arthropathy. Clin Radiol. 2009 Nov;64(11):1119-28 Authors: Jelbert A, Vaidya S, Fotiadis N Arthropathy is one of the most disabling consequences of haemophilia. The management of this condition has been revolutionized by the introduction of prophylactic treatment with clotting factor replacements. In order for benefits of this treatment to be monitored, the severity of any joint disease needs to be accurately assessed. Diagnostic imaging is used to objectively evaluate haemophilic arthropathy (HA). There are several established scoring systems for grading HA based on conventional radiography and magnetic resonance imaging (MRI). In this review the role of the different imaging methods in the evaluation of HA are discussed, the established staging systems are presented, and an explanation of why MRI is becoming the primary method of joint imaging in HA is provided. PMID: 19822246 [PubMed - indexed for MEDLINE]

Visualization of normal intra-parotid facial nerve on MR: BTFE or GRASS?

Related Articles Visualization of normal intra-parotid facial nerve on MR: BTFE or GRASS? Clin Radiol. 2009 Nov;64(11):1115-8 Authors: Tsang JC, Yip WH, Lau CS, Li KM, Lee YY, Wong JK, Ahuja AT PMID: 19822245 [PubMed - indexed for MEDLINE]

Lymphoplasmacytic sclerosing cholangitis: assessment of clinical, CT, and pathological findings.

Related Articles Lymphoplasmacytic sclerosing cholangitis: assessment of clinical, CT, and pathological findings. Clin Radiol. 2009 Nov;64(11):1104-14 Authors: Itoh S, Nagasaka T, Suzuki K, Satake H, Ota T, Naganawa S AIM: To assess the clinical, computed tomography (CT), and pathological findings in patients with lymphoplasmacytic sclerosing cholangitis. MATERIALS AND METHODS: Fifteen consecutive patients (four women and 11 men, mean age 71 years) with lymphoplasmacytic sclerosing cholangitis and without the characteristic features of underlying disorders causing benign biliary strictures were retrospectively recruited. Two radiologists evaluated multiphase contrast-enhanced CT images acquired with 0.5 or 1-mm collimation. One pathologist performed all histological examinations, including IgG4 immunostaining. RESULTS: The intrahepatic biliary ducts showed dilatation in all 15 patients, but only seven presented with jaundice. Although laboratory data were not available in all patients, serum gammaglobulin and IgG levels were elevated in five of six patients and six of eight patients, respectively. Anti-nuclear antibody was detected in three of six patients. The involved biliary ducts showed the following CT findings: involvement of the hilar biliary duct (14/15), a mean wall thickness of 4.9 mm, a smooth margin (10/15), a narrow but visible lumen (6/15), hyper-attenuation during the late arterial phase (9/15), homogeneous hyper-attenuation during the delayed phase (11/11), and no vascular invasion (14/15). Abnormal findings in the pancreas and urinary tract were detected in eight of 15 patients. In 13 patients with adequate specimens, moderate to severe lymphoplasmacytic infiltration associated with dense fibrosis was observed. Infiltration of IgG4-positive plasma cells was moderate or severe in nine patients and minimal or absent in four patients. CONCLUSION: Lymphoplasmacytic sclerosing cholangitis exhibits relatively characteristic clinical and CT findings, although they are not sufficiently specific for differentiation from other biliary diseases. PMID: 19822244 [PubMed - indexed for MEDLINE]

Factors associated with gender difference in the intima-media thickness of the common carotid artery.

Related Articles Factors associated with gender difference in the intima-media thickness of the common carotid artery. Clin Radiol. 2009 Nov;64(11):1097-103 Authors: Tan TY, Lu CH, Lin TK, Liou CW, Chuang YC, Schminke U AIM: To investigate the gender differences associated with a thinner intima-media thickness (IMT) of the common carotid artery (CCA) in women. MATERIALS AND METHODS: In a sample of 218 consecutive healthy volunteers comprising 110 men and 108 women, the IMT of the CCA was measured using B-mode ultrasonography. Blood pressure, fasting blood sugar, body mass index (BMI), blood lipid profile, homocysteine, folic acid, uric acid, high sensitive C-reactive protein, and thiobarbituric acid reactive substances (TBARS) levels were measured and compared with each other in both genders. RESULTS: The IMT of the CCA was significantly thinner in women than in men (p=0.012). Blood pressure, fasting plasma glucose, BMI, low-density lipoprotein cholesterol, triglycerides, homocysteine, uric acid, and TBARS were significantly (p<0.05) lower, folic acid and high-density lipoprotein cholesterol (HDL-C) were significantly (p<0.0001) higher in women compared with men. Multivariable logistic regression analysis revealed that higher serum levels of homocysteine, uric acid, and TBARS, and lower serum levels of HDL-C were significantly (p<0.05) associated with male sex. Multiple linear regression analysis further revealed that age, sex, and BMI were independently associated with CCA IMT. CONCLUSIONS: The IMT of the CCA was thinner in women than in men. Traditional vascular risk factors explain only a small amount of variance in multivariate regression models supporting the hypothesis that other behavioural, sex hormone-related or genetic factors, which have not been sufficiently explored so far, may play a role in the gender differences of IMT. PMID: 19822243 [PubMed - indexed for MEDLINE]

Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction.

Related Articles Dual-energy CT angiography of pelvic and lower extremity arteries: dual-energy bone subtraction versus manual bone subtraction. Clin Radiol. 2009 Nov;64(11):1088-96 Authors: Yamamoto S, McWilliams J, Arellano C, Marfori W, Cheng W, Mcnamara T, Quinones-Baldrich WJ, Ruehm SG AIM: To analyse the effect of dual-energy bone subtraction (DEBS) on the image quality of peripheral computed tomography (CT) angiograms. MATERIALS AND METHODS: Twenty patients underwent dual-energy CT angiography of the pelvic and lower extremity arteries using commercially available equipment. Two different methods of image processing were employed for each CT angiographic dataset: (1) DEBS, and (2) manual bone subtraction (MBS). Effects on vessel visibility and artificial vessel alterations were compared. RESULTS: Bone removal, and the resultant visibility of vessel segments, were significantly better with DEBS than with MBS (p=0.011). The overall frequency of vessel-related alterations was lower in MBS compared with DEBS (p=0.001). Specifically, in the 249 vessel segments with calcified plaques, MBS generated fewer vessel alterations than DEBS (p<0.001). In the 309 vessel segments without calcified plaques, there was no difference in vessel alteration between the two techniques (p=0.22). CONCLUSION: DEBS facilitates bone removal in peripheral CT angiography, but generates more vessel alterations, particularly in the presence of calcified plaque. PMID: 19822242 [PubMed - indexed for MEDLINE]

Ultrasonic microbubble contrast agents and the transplant kidney.

Related Articles Ultrasonic microbubble contrast agents and the transplant kidney. Clin Radiol. 2009 Nov;64(11):1081-7 Authors: Kay DH, Mazonakis M, Geddes C, Baxter G AIM: To evaluate the potential application of microbubble agents in the immediate post-transplant period, by studying contrast uptake and washout, and to correlate these values with clinical indices, and thus, assess the potential prognostic value of this technique. MATERIALS AND METHODS: The study group comprised 20 consecutive renal transplant patients within 7 days of transplantation. Sonovue was administered as an intravenous bolus with continuous imaging of the transplant kidney at low mechanical index (MI) for 1 min post-injection. These data were analysed off-line by two observers, and time intensity curves (TIC) for the upper, mid, and lower poles constructed. Within each pole, a region of interest (5 mm square) was placed over the cortex, medullary pyramid, and interlobar artery, resulting in a total of nine TIC for each patient. TIC parameters included the arrival time (AT), time to peak (TTP), peak intensity (Max), gradient of the slope (M), and the area under curve (AUC). RESULTS: For both observers there was good agreement for all values measured from the cortex and medulla, but poor interobserver correlation for the vascular values. In addition, there was only agreement for these values in the upper and mid-pole of the transplant with poor agreement for the lower pole values. The mid-pole of the transplant kidney was chosen as the point of measurement for subsequent studies. Mid-pole values were correlated with clinical data and outcome over the 3-month post-transplant period. Renal microbubble perfusion correlated with the transplant estimated glomerular filtration rate (eGFR) at 3 months post-transplantation (p=0.016). DISCUSSION: In conclusion, this is the first study to confirm reproducibility of the Sonovue TIC data in transplant patients and to quantify regional variation and perfusion. The statistically significant estimates of transplant perfusion may be of future benefit to transplant recipients and potentially utilized as a prognostic tool. However, a more in depth study will be required to support or refute these early study findings. PMID: 19822241 [PubMed - indexed for MEDLINE]

Contrast-to-noise ratios of liver lesions using subtraction imaging on multiphase 64-detector row CT.

Related Articles Contrast-to-noise ratios of liver lesions using subtraction imaging on multiphase 64-detector row CT. Clin Radiol. 2009 Nov;64(11):1075-80 Authors: Grand DJ, Beland M, Dupuy D, Mayo-Smith WW AIM: To measure contrast-to-noise ratios of liver lesions on conventional enhanced and digitally subtracted multidetector row computed tomography (CT) images. MATERIALS/METHODS: This study was approved by our hospital internal review board (IRB) and all collected data were evaluated in a Health Insurance Portability and Accountability Act (HIPAA)-compliant manner. Subtracted datasets, using pixel-by-pixel subtraction of the post-contrast images from the pre-contrast images, were created from the 64 detector-row CT of patients undergoing three-phase examination of the liver (unenhanced, arterial phase, and portal venous phase). Regions of interest were used to calculate the contrast-to-noise ratios between the lesions and the background liver parenchyma on both the post-contrast and subtracted datasets using the following formula: (Lesion mean (HU) - Liver mean (HU))/standard deviation of mean outside patient (HU). These ratios were compared using a mixed linear statistical model. RESULTS: Contrast-to-noise ratios were calculated for 64 lesions in 50 consecutive patients. Of the 64 lesions, 42 were hypervascular and 22 were hypovascular. Subtracted datasets yielded statistically significant higher contrast-to-noise ratios of hypervascular lesions compared to normal liver parenchyma (p<0.0001). Subtraction did not yield a statistically significant improvement in contrast-to-noise ratios for hypovascular liver lesions (p=0.16). CONCLUSION: Post-processed subtraction CT images generate increased contrast-to-noise ratios for hypervascular liver lesions. As this technique is easy to perform and does not involve additional radiation exposure, it should be considered when evaluating for suspected hypervascular lesions. PMID: 19822240 [PubMed - indexed for MEDLINE]

Diffusion-weighted imaging in predicting and monitoring the response of uterine cervical cancer to combined chemoradiation.

Related Articles Diffusion-weighted imaging in predicting and monitoring the response of uterine cervical cancer to combined chemoradiation. Clin Radiol. 2009 Nov;64(11):1067-74 Authors: Liu Y, Bai R, Sun H, Liu H, Zhao X, Li Y AIM: To investigate the ability of diffusion-weighted imaging (DWI) to predict and monitor the response of uterine cervical cancer to combined chemoradiation using apparent diffusion coefficients (ADCs). MATERIALS AND METHODS: Seventeen women (mean age 48.5 years) with uterine cervical cancer received conventional magnetic resonance imaging (MRI) and DWI prior to chemoradiation and after 1 and 2 months of therapy. A subgroup of eight also had MRI and DWI repeated after 15 days of therapy. Treatment response was determined according to changes in tumour size after 2 months of therapy and was classified as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). Pretreatment ADCs were compared between the different disease response groups, and dynamic changes of ADCs in each group were observed. Pearson's correlation test was calculated between those ADC parameters and tumour response. RESULTS: Pretreatment ADCs for CR were significantly lower than those of PR (p=0.005). Negative correlation was found between pretreatment ADCs and percentage size reduction after 2 months of chemoradiation (p=0.016). The percentage ADC change after 1 month correlated positively with percentage size reduction after 2 months of therapy (p=0.021). ADCs after 15 days of therapy increased significantly compared with pretreatment ones (p=0.001); however, the longest tumour diameter showed no statistically significant change (p=0.078). CONCLUSION: ADCs may have the potential to be used to predict and monitor the response of uterine cervical cancer to therapy. PMID: 19822239 [PubMed - indexed for MEDLINE]

Non-invasive evaluation of liver cirrhosis using ultrasound.

Related Articles Non-invasive evaluation of liver cirrhosis using ultrasound. Clin Radiol. 2009 Nov;64(11):1056-66 Authors: Goyal N, Jain N, Rachapalli V, Cochlin DL, Robinson M Ultrasound (US) is essential in both assessment of the potentially cirrhotic liver and surveillance of selected patients with chronic hepatitis as liver biopsy can be misleading or inaccurate in up to 25% of cases. Various techniques are already in routine use, such as grey-scale imaging, Doppler US, and contrast-enhanced US (CEUS), while newer techniques such as elastography and hepatic vein transit time (HVTT) have the potential to exclude patients without significant fibrosis or cirrhosis; however, they are operator dependent and require specific software. Grey-scale imaging may demonstrate changes, such as volume redistribution, capsule nodularity, parenchymal nodularity, and echotexture changes. The Doppler findings in the hepatic and portal veins, hepatic artery, and varices allow assessment of liver cirrhosis. However, the operator needs to be aware of limitations of these techniques. Low mechanical index CEUS plays an important role in the assessment of complications of cirrhosis, such as hepatocellular carcinoma and portal vein thrombus. Optimized US technique is crucial for accurate diagnosis of the cirrhotic liver and its complications. PMID: 19822238 [PubMed - indexed for MEDLINE]

Imaging the lungs in patients treated for lymphoma.

Related Articles Imaging the lungs in patients treated for lymphoma. Clin Radiol. 2009 Nov;64(11):1048-55 Authors: Vargas HA, Hampson FA, Babar JL, Shaw AS The lymphomas are a heterogeneous group of malignancies, which exhibit a range of different molecular features, genetics, and clinical presentations. Consequently, therapeutic approaches and clinical outcomes differ greatly. Following therapy, the thorax may be a site of disease recurrence, but infection, drug reactions, and radiation pneumonitis are commonly encountered. We present a comprehensive review of these conditions, focussing on their radiological appearances, in order that radiologists may better engage their colleagues in haemato-oncology. PMID: 19822237 [PubMed - indexed for MEDLINE]

Will MRI screening deliver the expected survival advantage in BRCA 1 carriers?

Related Articles Will MRI screening deliver the expected survival advantage in BRCA 1 carriers? Clin Radiol. 2009 Nov;64(11):1045-7 Authors: Hamilton LJ, Evans AJ, Cornford EJ, Rakha EA, Ellis IO, Foulkes WD PMID: 19822236 [PubMed - indexed for MEDLINE]

RE: Magnetic resonance spectroscopy of the brain: review of metabolites and clinical applications.

Related Articles RE: Magnetic resonance spectroscopy of the brain: review of metabolites and clinical applications. Clin Radiol. 2009 Oct;64(10):1042-3 Authors: Rae C PMID: 19748013 [PubMed - indexed for MEDLINE]

RE: Incidental breast masses detected by computed tomography: are any imaging features predictive of malignancy?

Related Articles RE: Incidental breast masses detected by computed tomography: are any imaging features predictive of malignancy? Clin Radiol. 2009 Oct;64(10):1041-2 Authors: Jakanani G, Al-Attar M PMID: 19748012 [PubMed - indexed for MEDLINE]

CT-guided sacroplasty for the treatment of zone II sacral insufficiency fractures.

Related Articles CT-guided sacroplasty for the treatment of zone II sacral insufficiency fractures. Clin Radiol. 2009 Oct;64(10):1037-40 Authors: Douis H, James SL PMID: 19748011 [PubMed - indexed for MEDLINE]

Invasive uraemic calcinosis of the hip.

Related Articles Invasive uraemic calcinosis of the hip. Clin Radiol. 2009 Oct;64(10):1035-6 Authors: Gibson C, Robbins P, Guy S PMID: 19748010 [PubMed - indexed for MEDLINE]

MR enterography in the evaluation of small bowel dilation.

Related Articles MR enterography in the evaluation of small bowel dilation. Clin Radiol. 2009 Oct;64(10):1026-34 Authors: Cronin CG, Lohan DG, Browne AM, Alhajeri AN, Roche C, Murphy JM Magnetic reasonance (MR) enterography enables high contrast resolution depiction of the location and cause of bowel obstruction through a combination of predictable luminal distension and multiplanar imaging capabilities. Furthermore, because the patient is not exposed to ionizing radiation, sequential "dynamic" MR imaging can be performed repeatedly over time further facilitating depiction of the site and/or the cause of obstruction. With increasing availability of MR imaging and standardization of the oral contrast medium regimens, it is likely that this technique will assume an ever-increasing role in the evaluation of small bowel dilation in the coming years. We illustrate the utility of MR enterography in the evaluation of small bowel dilation, whether it be mechanical, functional (e.g., ileus), or related to infiltrative mural disease. PMID: 19748009 [PubMed - indexed for MEDLINE]

Imaging of paediatric liver tumours with pathological correlation.

Related Articles Imaging of paediatric liver tumours with pathological correlation. Clin Radiol. 2009 Oct;64(10):1015-25 Authors: Das CJ, Dhingra S, Gupta AK, Iyer V, Agarwala S Paediatric hepatic tumours are relatively rare with malignant lesions being twice as frequent as benign neoplasms and are mostly metastases. Imaging has a significant role in the evaluation of most paediatric liver tumours. Differentiating benign from malignant tumours is important as it significantly affects treatment decisions. We present the characteristic radiological and pathological features of the most common paediatric liver tumours. PMID: 19748008 [PubMed - indexed for MEDLINE]

Needle placement accuracy during stereotactic localization mammography.

Related Articles Needle placement accuracy during stereotactic localization mammography. Clin Radiol. 2009 Oct;64(10):1009-14 Authors: Green DH AIM: To derive a mathematical model to describe the relationship between lesion position in the breast and measurements derived from the stereoradiographs to enable more accurate sampling of a lesion during stereotactic mammographic needle placement. MATERIALS AND METHODS: The affect that registration errors have on the accuracy of needle placement when identifying the lesion on the stereoradiographs was investigated using the mathematical model. RESULTS: The focus-to-film distance of the x-ray tube and the horizontal distance of the lesion from the centre of rotation have little effect on error. Registration errors for lesions lying at a greater perpendicular distance in the breast from the centre of rotation produce smaller localization errors when compared with lesions sited closer. Lesion registration errors during marking of the stereoradiographs are exacerbated by decreasing the angle of x-ray tube swing. CONCLUSIONS: When problems are encountered in making an accurate registration of the lesion on the stereoradiographs, consider the following error reducing strategies: (1) employ an approach that places the lesion the maximum distance away from the film cassette; (2) avoid reducing the angle of tube swing; and (3) consider sampling superficial and deep to, as well as at, the location indicated. The possibility of erroneous tissue sampling should be borne in mind when reviewing the pathology report. PMID: 19748007 [PubMed - indexed for MEDLINE]

Prospective comparison of 3D FIESTA versus fat-suppressed 3D SPGR MRI in evaluating knee cartilage lesions.

Related Articles Prospective comparison of 3D FIESTA versus fat-suppressed 3D SPGR MRI in evaluating knee cartilage lesions. Clin Radiol. 2009 Oct;64(10):1000-8 Authors: Li X, Yu C, Wu H, Daniel K, Hu D, Xia L, Pan C, Xu A, Hu J, Wang L, Peng W, Li F AIM: To prospectively compare the accuracy of three-dimensional fast imaging employing steady-state acquisition (3D FIESTA) sequences with that of fat-suppressed three-dimensional spoiled gradient-recalled (3D SPGR) in the diagnosis of knee articular cartilage lesions, using arthroscopy as the reference standard. MATERIALS AND METHODS: Fifty-eight knees in 54 patients (age range 21-82 years; mean 36 years) were prospectively evaluated by using sagittal 3D FIESTA and sagittal fat-suppressed 3D SPGR sequences. Articular cartilage lesions were graded on MRI and during arthroscopy with a modified Noyes scoring system. Sensitivity, specificity, and accuracy were assessed. Interobserver agreement was determined with kappa statistics. RESULTS: The performance of 3D FIESTA sequences (sensitivity, specificity, and accuracy were 80, 94, and 92%, respectively, for reader 1 and 76, 94, and 90%, respectively, for reader 2) was similar to that of fat-suppressed 3D SPGR sequences (sensitivity, specificity, and accuracy were 82, 92, and 90%, respectively, for reader 1 and 82, 90, and 88%, respectively, for reader 2) in the detection of knee articular cartilage lesions. The interobserver agreement varied from fair to good to excellent (kappa values from 0.43-0.83). CONCLUSION: 3D FIESTA has good diagnostic performance, comparable with fat-suppressed 3D SPGR in evaluating knee cartilage lesions, and it can be incorporated into routine knee MRI protocols due to the short acquisition time. PMID: 19748006 [PubMed - indexed for MEDLINE]

Kimura's disease: imaging patterns on computed tomography.

Related Articles Kimura's disease: imaging patterns on computed tomography. Clin Radiol. 2009 Oct;64(10):994-9 Authors: Gopinathan A, Tan TY AIM: To define the role of computed tomography (CT) in identifying and classifying the imaging patterns of diagnostic value in Kimura's disease of the head and neck. METHODS: A retrospective study was undertaken comprising 13 patients with histopathological evidence of Kimura's disease. The patients' clinical and pathological records were reviewed against a detailed analysis of their CT images performed from the base of the skull to the arch of the aorta. RESULTS: Both well-defined, nodular masses, as well as ill-defined plaque-like infiltrative masses were seen in the subcutaneous tissue of the head and neck region. All patients had lesions adjacent to the major salivary glands. The parotid gland was affected in 10 of the 13 cases and the submandibular gland was affected in the rest. Contrast enhancement was variable. More than half of the cases had associated lymphadenopathy. Some of them showed atrophy of the skin and subcutaneous fat overlying the subcutaneous masses. Blood eosinophilia was a consistent feature in all the cases. CONCLUSION: The patterns of distribution, morphology, and enhancement of the lesions in Kimura's disease that can be demonstrated at CT, enables a confident, non-invasive diagnosis of this condition, in an appropriate clinical context. PMID: 19748005 [PubMed - indexed for MEDLINE]

Radiology errors: are we learning from our mistakes?

Related Articles Radiology errors: are we learning from our mistakes? Clin Radiol. 2009 Oct;64(10):988-93 Authors: Mankad K, Hoey ET, Jones JB, Tirukonda P, Smith JT AIM: To question practising radiologists and radiology trainees at a large international meeting in an attempt to survey individuals about error reporting. MATERIALS AND METHODS: Radiologists attending the 2007 Radiological Society of North America (RSNA) annual meeting were approached to fill in a written questionnaire. Participants were questioned as to their grade, country in which they practised, and subspecialty interest. They were asked whether they kept a personal log of their errors (with an error defined as "a mistake that has management implications for the patient"), how many errors they had made in the preceding 12 months, and the types of errors that had occurred. They were also asked whether their local department held regular discrepancy/errors meetings, how many they had attended in the preceding 12 months, and the perceived atmosphere at these meetings (on a qualitative scale). RESULTS: A total of 301 radiologists with a wide range of specialty interests from 32 countries agreed to take part. One hundred and sixty-six of 301 (55%) of responders were consultant/attending grade. One hundred and thirty-five of 301 (45%) were residents/fellows. Fifty-nine of 301 (20%) of responders kept a personal record of their errors. The number of errors made per person per year ranged from none (2%) to 16 or more (7%). The majority (91%) reported making between one and 15 errors/year. Overcalls (40%), under-calls (25%), and interpretation error (15%) were the predominant error types. One hundred and seventy-eight of 301 (59%) of participants stated that their department held regular errors meeting. One hundred and twenty-seven of 301 (42%) had attended three or more meetings in the preceding year. The majority (55%) who had attended errors meetings described the atmosphere as "educational." Only a small minority (2%) described the atmosphere as "poor" meaning non-educational and/or blameful. CONCLUSION: Despite the undeniable importance of learning from errors, many radiologists and institutions do not engage in such practice. Radiologists and radiology departments must continue to improve the process of recording and addressing errors. PMID: 19748004 [PubMed - indexed for MEDLINE]

The impact of European research ethics legislation on UK radiology research activity: a bibliometric analysis.

Related Articles The impact of European research ethics legislation on UK radiology research activity: a bibliometric analysis. Clin Radiol. 2009 Oct;64(10):983-7 Authors: Johnson CA, Toms AP AIM: To determine whether there is evidence of a reduction in radiology research activity in the UK following the implementation of the European research ethics legislation, which came in to force in 2001 and has been widely criticised as an impediment to research. MATERIALS AND METHODS: A bibliometric analysis was performed by searching PubMed for all first-author publications from UK departments of "radiology" or "medical imaging" between 1995 and 2007. Results were sub-categorized into those papers published in the highest cited general radiology journals and by publication type: original research, reviews, and case reports. RESULTS: From 1995 to 2007 the total number of publications rose by 6.5% from 137 to 146 with the increase occurring in non-general radiology journals. Original articles fell from 18 in 1995 to 12 in 2003, but then rose to 24 by 2007 (33% rise). This dip was paralleled by a fall and then recovery in case report publications. The most dramatic change has been in the number of review articles, which has increased more than eightfold from seven in 1995 to 65 in 2007 to become the most common form of publication. CONCLUSION: The overall number of original scientific articles, published by first-author UK radiologists, has increased slightly over the last 12 years despite a temporary fall associated with the introduction of new research ethics legislation. PMID: 19748003 [PubMed - indexed for MEDLINE]

Computer-aided detection (CAD) as a second reader using perspective filet view at CT colonography: effect on performance of inexperienced readers.

Related Articles Computer-aided detection (CAD) as a second reader using perspective filet view at CT colonography: effect on performance of inexperienced readers. Clin Radiol. 2009 Oct;64(10):972-82 Authors: Fisichella VA, Jäderling F, Horvath S, Stotzer PO, Kilander A, Båth M, Hellström M AIM: To evaluate whether computer-aided detection (CAD) as a second reader using perspective filet view [three-dimensional (3D) filet] improves the performance of inexperienced readers at computed tomography colonography (CTC) compared with unassisted 3D filet and unassisted two-dimensional (2D) CTC. MATERIAL AND METHODS: Fifty symptomatic patients underwent CTC and same-day colonoscopy with segmental unblinding. Two inexperienced readers read the CTC studies on 3D filet and 2D several weeks apart. Four months later, readers re-read the cases only evaluating CAD marks using 3D filet. Suspicious CAD marks not previously described on 3D filet were recorded. Jackknife free-response receiver operating characteristic (JAFROC-1) analysis was used to compare the observers' performances in detecting lesions with 3D filet, 2D and 3D filet with CAD. RESULTS: One hundred and three lesions > or =3mm were detected at colonoscopy with segmental unblinding. CAD alone had a sensitivity of 73% (75/103) at a mean false-positive rate per patient of 12.8 in supine and 11.4 in prone. For inexperienced readers sensitivities with 3D filet with CAD were 58% (60/103) and 48% (50/103) with an improvement of 14-16 percentage points (p<0.05) compared with 2D and of 10-11 percentage points (p<0.05) compared with 3D filet. For inexperienced readers, the false-positive rate was 25-41% and 71-200% higher with 3D filet with CAD compared with 3D filet and 2D, respectively. JAFROC-1 analysis showed no significant differences in per-lesion overall performance among reading modes (p=0.8). CONCLUSION: CAD applied as a second reader using 3D filet increased both sensitivity and the number of false positives by inexperienced readers compared with 3D filet and 2D, thus not improving overall performance, i.e., the ability to distinguish between lesions and non-lesions. PMID: 19748002 [PubMed - indexed for MEDLINE]

Hip arthroplasty. Part 2: normal and abnormal radiographic findings.

Related Articles Hip arthroplasty. Part 2: normal and abnormal radiographic findings. Clin Radiol. 2009 Oct;64(10):961-71 Authors: Pluot E, Davis ET, Revell M, Davies AM, James SL This review addresses the normal and abnormal radiographic findings that can be encountered during the follow-up of patients with total hip arthroplasty (THA). The relative significance of different patterns of radiolucency, bone sclerosis, and component position is discussed. The normal or pathological significance of these findings is correlated with design, surface, and fixation of the prosthetic components. It is essential to have a good knowledge of expected and unexpected radiological evolution according to the different types of prostheses. This paper emphasizes the importance of serial studies compared with early postoperative radiographs during follow-up in order to report accurately any sign of prosthetic failure and trigger prompt specialist referral. Basic technical guidelines and schedule recommendations for radiological follow-up are summarized. PMID: 19748001 [PubMed - indexed for MEDLINE]

Hip arthroplasty. Part 1: prosthesis terminology and classification.

Related Articles Hip arthroplasty. Part 1: prosthesis terminology and classification. Clin Radiol. 2009 Oct;64(10):954-60 Authors: Pluot E, Davis ET, Revell M, Davies AM, James SL Hip arthroplasty is an extremely common orthopaedic procedure and there is a wide array of implants that are in current use in the UK. The follow-up of patients who have undergone insertion of a hip prosthesis is shifting from a consultant-lead hospital service towards primary care. As this change in patient care continues it becomes increasingly important that an accurate description of the radiographic features is communicated to the primary-care practitioner so appropriate specialist input can be triggered. This review focuses on the terminology and classification of hip prostheses. This acts as a precursor for Part 2 of this series, which describes the normal and abnormal radiographic findings following hip prosthesis insertion. PMID: 19748000 [PubMed - indexed for MEDLINE]

Incidental findings in "normal" volunteers.

Related Articles Incidental findings in "normal" volunteers. Clin Radiol. 2009 Oct;64(10):951-3 Authors: Woodward CI, Toms AP PMID: 19747999 [PubMed - indexed for MEDLINE]