Tuesday 26 May 2009

Articles from Critical Care Medicine

Link to journal online
Greer, David M. MD, MA
Multimodal magnetic resonance imaging for determining prognosis in patients with traumatic brain injury-Promising but not ready for primetime .[Editorial]
Critical Care Medicine. 37(4):1523-1524, April 2009.

Baker, Stephen MD, MPH
Trauma computed tomography and radiation dose: A matter of concern .[Editorial]
Critical Care Medicine. 37(4):1508-1509, April 2009.

Salottolo, Kristin MPH; Bar-Or, Raphael BS; Fleishman, Matthew MD; Maruyama, Gen et al
Current utilization and radiation dose from computed tomography in patients with trauma .[Article]
Critical Care Medicine. 37(4):1336-1340, April 2009.
Abstract
Objective: To quantify the cumulative effective dose of radiation received during hospitalization after traumatic injury and to compare the computed tomography (CT) utilization practices for two time periods in patients with trauma.Design: A retrospective analysis of radiologic and medical data.Setting: A level I trauma center.Patients: Consecutively admitted adult patients with trauma with moderate to severe injuries (injury severity score >8), an intensive care unit (ICU) length of stay of one or more days, who were directly admitted and not transferred to another acute care center.Measurements and Main Results: CT examination means and utilization were compared for April through August, 2003 and April to August, 2007. Cumulative effective doses were calculated for the 2007 period, and patients with a high radiation dose (>100 mSv) were identified. One hundred sixty-five adult patients with trauma were included. An increase in mean CT examinations per patient was observed in the 2007 period compared with the 2003 period, overall (4.41 vs. 3.44, p = 0.002) and among subsets of patients. The overall increase remained significant after adjustment for patient demographics (p = 0.05). The mean cumulative effective dose per patient was 11.13 mSv in 2007; 9% of patients received a dose >=100 mSv.Conclusions: Patients with trauma are at an increased risk of adverse effects from CT studies, because they receive high doses of radiation, and the number of CT examinations that patients receive is increasing with time. We recommend that risk of radiation be prospectively monitored and estimated by hospitals through the use of CT examination count per patient.

Schweickert, William D. MD; Herlitz, Jean RN; Pohlman, Anne S. ; Gehlbach, Brian K. et al
A randomized, controlled trial evaluating postinsertion neck ultrasound in peripherally inserted central catheter procedures.
Source Critical Care Medicine. 37(4):1217-1221, April 2009.
Abstract Objective: Insertion of peripherally inserted central catheters (PICCs) at the bedside may result in tip malposition. This study was designed to evaluate whether the addition of ultrasound (US) inspection of the ipsilateral neck provides immediate recognition of PICCs in aberrant position facilitating catheter reposition before completion of the procedure.
Design: Randomized, controlled trial.Setting: University-affiliated hospital.Patients: Totally, 300 patients ordered for PICC placement.Interventions: Patients were randomized to either postinsertion US inspection of the ipsilateral neck (intervention, n = 151) or to usual practice (control, n = 149). In the intervention group, catheters detected by US to be traveling within the ipsilateral internal jugular vein (IJ), were further adjusted before procedural completion. All procedures included US localization of the peripheral vein and postprocedural chest radiograph to assess catheter tip position. The primary end point was defined as the rate of PICC tip malposition in the ipsilateral IJ as detected by postprocedure chest radiograph. The secondary end point was procedure duration.
Measurements and Main Results: In the control arm, 140 of 149 PICC placement attempts (94%) were completed, including 11 procedures with catheter tips terminating in the ipsilateral IJ (7.9%). In the intervention arm, 142 of 151 attempts (94.7%, p = 0.98) were completed; one procedure resulted in a catheter tip in the ipsilateral IJ (0.7%, p = 0.007). Eleven intervention procedures included successful PICC repositioning during the initial procedure based on US detection of malposition. The median duration of the procedure in the control group was 8 minutes (6-10.5 minutes) and increased to 9.0 minutes (7-11 minutes) in the intervention group.
Conclusions: Bedside PICC placement morbidity can be reduced via US inspection of the ipsilateral neck for PICC tip malposition in the IJ. This modality can guide catheters to be successfully repositioned during the initial procedure.

Articles from Anesthesia and Analgesia

Link to journal online
Wachtel, Ruth E. ; Dexter, Franklin ; Dow, Angella J.
Growth Rates in Pediatric Diagnostic Imaging and Sedation
Anesthesia & Analgesia. 108(5):1616-1621, May 2009.
Abstract
BACKGROUND: Workload has increased greatly over the past decade for anesthesia providers administering general anesthesia and/or sedation for pediatric diagnostic imaging.METHODS: Data from an academic medical center were studied over a 12-yr period. Growth in the number of children 0-17 yr of age undergoing magnetic resonance imaging (MRI) and/or computerized tomography (CT) scans who received care from anesthesia providers was compared with the increase in the total number of MRI and CT procedures performed in children. Anesthesia providers included anesthesiologists, residents, Certified Registered Nurse Anesthetists, and student Certified Registered Nurse Anesthetists. Toward the end of the study, a team of sedation nurses was employed by the hospital to administer moderate sedation. They provided an alternative to anesthesia providers from the anesthesia department, who usually administered general anesthesia. Use of sedation nurses versus anesthesia providers, and the relationship to scan duration and patient age, were studied over a 6-mo period.RESULTS: The number of children receiving care from anesthesia providers for MRI and CT scans grew at the same 8%-9% annual rate as the number of scans performed. The percentage of children receiving anesthesia care did not change over the 12 yr. Creation of a nurse sedation team that provided moderate sedation did not alter the number of children receiving care from anesthesia providers but did increase the total number of children receiving hypnotics. Anesthesia was rarely used for scans shorter than 30 min in duration. Increases in scan duration were associated with increased utilization of anesthesia providers for both MRI and CT after stratifying by age. An age of 3-5 yr was associated with the highest rates of anesthesia care.CONCLUSIONS: Future workload for anesthesia providers administering general anesthesia and/or sedation for pediatric diagnostic imaging will depend on trends in the total number of scans performed. Workload may also be sensitive to factors that increase scan duration or alter the percentage of patients in the 3-5 yr age group. It may additionally depend on reimbursements from insurance companies.

Gadhinglajkar, Shrinivas ; Sreedhar, Rupa
Surgery for Anomalous Origin of Left Coronary Artery From Pulmonary Artery: The Utility of Intraoperative Transesophageal Echocardiography.
Anesthesia & Analgesia. 108(5):1470-1472, May 2009.


Yang, Ping-Liang ; Wong, David T. ; Dai, Shuang-Bo ; Song, Hai-Bo
The Feasibility of Measuring Renal Blood Flow Using Transesophageal Echocardiography in Patients Undergoing Cardiac Surgery. [Review]
Anesthesia & Analgesia. 108(5):1418-1424, May 2009.
Abstract
BACKGROUND: There is no reliable method to monitor renal blood flow intraoperatively. In this study, we evaluated the feasibility and reproducibility of left renal blood flow measurements using transesophageal echocardiography during cardiac surgery.METHODS: In this prospective noninterventional study, left renal blood flow was measured with transesophageal echocardiography during three time points (pre-, intra-, and postcardiopulmonary bypass) in 60 patients undergoing cardiac surgery. Sonograms from 6 subjects were interpreted by 2 blinded independent assessors at the time of acquisition and 6 mo later. Interobserver and intraobserver reproducibility were quantified by calculating variability and intraclass correlation coefficients.RESULTS: Patients with Doppler angles of >30[degrees] (20 of 60 subjects) were eliminated from renal blood flow measurements. Left renal blood flow was successfully measured and analyzed in 36 of 60 (60%) subjects. Both interobserver and intraobserver variability were <10%.>

Tuesday 19 May 2009

Radiology (USA) Vol 251 No 2 2009

pp. 309-335
Science to Practice: Will Molecular MR Imaging Play a Role in Identification and Treatment of Patients with Vulnerable Atherosclerotic Plaques?.
Sosnovik, D.E.
p. 336
Mark G. Watson, Executive Director, Radiological Society of North America.
Drayer, B.P.
pp. 311-312
Noninvasive Carotid Artery Imaging: Caution Ahead.
Kallmes, D.F.
pp. 313-316
The Radiology Report of the Future.
Hall, F.M.
pp. 317-338
Vessel Growth and Function: Depiction with Contrast-enhanced MR Imaging.
Oostendorp, M.; Post, M.J.; Backes, W.H.
pp. 339-346
Small Breast Cancers: In Vivo Percutaneous US-guided Radiofrequency Ablation with Dedicated Cool-Tip Radiofrequency System.
Manenti, G.; Bolacchi, F.; Perretta, T.; Cossu, E.; Pistolese, C.A.; Buonomo, O.C. et al
pp. 347-358
Full-Field Digital versus Screen-Film Mammography: Comparison within the UK Breast Screening Program and Systematic Review of Published Data.
Vinnicombe, S.; Pereira, S.M.P.; McCormack, V.A.; Shiel, S.; Perry, N.; dos Santos Silva, I.M.
pp. 359-368
Learning Curve for Coronary CT Angiography: What Constitutes Sufficient Training?.
Pugliese, F.; Hunink, M.G.M.; Gruszczynska, K.; Alberghina, F.; Malago, R. et al
pp. 369-379
Mural Crohn Disease: Correlation of Dynamic Contrast-enhanced MR Imaging Findings with Angiogenesis and Inflammation at Histologic Examination-Pilot Study.
Taylor, S.A.; Punwani, S.; Rodriguez-Justo, M.; Bainbridge, A.; Greenhalgh, R. et al
pp. 380-387
Perianal Crohn Disease: Evaluation of Dynamic Contrast-enhanced MR Imaging as an Indicator of Disease Activity.
Horsthuis, K.; Lavini, C.; Bipat, S.; Stokkers, P.C.F.; Stoker, J.
pp. 388-397
Hepatic Lesions: Improved Image Quality and Detection with the Periodically Rotated Overlapping Parallel Lines with Enhanced Reconstruction Technique-Evaluation of SPIO-enhanced T2-weighted MR Images.
Hirokawa, Y.; Isoda, H.; Maetani, Y.S.; Arizono, S.; Shimada, K.; Okada, T. et al
pp. 398-407
Renal Lesions: Characterization with Diffusion-weighted Imaging versus Contrast-enhanced MR Imaging.
Taouli, B.; Thakur, R.K.; Mannelli, L.; Babb, J.S.; Kim, S.; Hecht, E.M.; Lee, V.S.; Israel, G.M.
pp. 408-414
Prostate Cancer: Detection of Lymph Node Metastases Outside the Routine Surgical Area with Ferumoxtran-10-enhanced MR Imaging.
Heesakkers, R.A.M.; Jager, G.J.; Hovels, A.M.; de Hoop, B.; van den Bosch, H.C.M. et al
pp. 415-421
Bladder Cancer: Diagnosis with Diffusion-weighted MR Imaging in Patients with Gross Hematuria.
Abou-El-Ghar, M.E.; El-Assmy, A.; Refaie, H.F.; El-Diasty, T.
pp. 422-428
Head and Neck Squamous Cell Carcinoma: CT Perfusion Can Help Noninvasively Predict Intratumoral Microvessel Density.
Ash, L.; Teknos, T.N.; Gandhi, D.; Patel, S.; Mukherji, S.K.
pp. 429-438
Atherosclerosis and Matrix Metalloproteinases: Experimental Molecular MR Imaging in Vivo.
Amirbekian, V.; Aguinaldo, J.G.S.; Amirbekian, S.; Hyafil, F.; Vucic, E.; Sirol, M. et al
pp. 439-446
Medial Plica Syndrome of the Knee: Diagnosis with Dynamic Sonography.
Paczesny, L.; Kruczynski, J.
pp. 447-456
High-Grade Soft-Tissue Sarcomas: Tumor Response Assessment-Pilot Study to Assess the Correlation between Radiologic and Pathologic Response by Using RECIST and Choi Criteria.
Stacchiotti, S.; Collini, P.; Messina, A.; Morosi, C.; Barisella, M.; Bertulli, R. et al
pp. 457-466
Gadofosveset-enhanced MR Angiography of Carotid Arteries: Does Steady-State Imaging Improve Accuracy of First-Pass Imaging? Comparison with Selective Digital Subtraction Angiography.
Anzidei, M.; Napoli, A.; Marincola, B.C.; Nofroni, I.; Geiger, D.; Zaccagna, F. et al
pp. 467-475
Distinguishing Tumefactive Demyelinating Lesions from Glioma or Central Nervous System Lymphoma: Added Value of Unenhanced CT Compared with Conventional Contrast-enhanced MR Imaging.
Kim, D.S.; Na, D.G.; Kim, K.H.; Kim, J.-h.; Kim, E.; La Yun, B.; Chang, K.-H.
pp. 476-484
Depressive Disorders: Focally Altered Cerebral Perfusion Measured with Arterial Spin-labeling MR Imaging.
Lui, S.; Parkes, L.M.; Huang, X.; Zou, K.; Chan, R.C.K.; Yang, H.; Zou, L.; Li, D. et al
pp. 485-492
Motor Homunculus: Passive Mapping in Healthy Volunteers by Using Functional MR Imaging-Initial Results.
Kocak, M.; Ulmer, J.L.; Ugurel, M.S.; Gaggl, W.; Prost, R.W.
pp. 493-502
Carotid Artery Stenosis: Accuracy of Noninvasive Tests-Individual Patient Data Meta-Analysis.
Chappell, F.M.; Wardlaw, J.M.; Young, G.R.; Gillard, J.H.; Roditi, G.H. et al
pp. 503-510
Multiple Sclerosis: Hyperintense Dentate Nucleus on Unenhanced T1-weighted MR Images Is Associated with the Secondary Progressive Subtype.
Roccatagliata, L.; Vuolo, L.; Bonzano, L.; Pichiecchio, A.; Mancardi, G.L.
pp. 511-516
Pediatric ^9^9^mTc-DMSA SPECT Performed by Using Iterative Reconstruction with Isotropic Resolution Recovery: Improved Image Quality and Reduced Radiopharmaceutical Activity.
Sheehy, N.; Tetrault, T.A.; Zurakowski, D.; Vija, A.H.; Fahey, F.H.; Treves, S.T.
pp. 517-524
Utilization of Imaging in Pregnant Patients: 10-year Review of 5270 Examinations in 3285 Patients-1997-2006.
Lazarus, E.; DeBenedectis, C.; North, D.; Spencer, P.K.; Mayo-Smith, W.W.
pp. 525-534
Sickle Cell Disease: Ratio of Blood Flow Velocity of Intracranial to Extracranial Cerebral Arteries-Initial Experience.
Pawlak, M.A.; Krejza, J.; Rudzinski, W.; Kwiatkowski, J.L.; Ichord, R et al
pp. 535-542
Renal Transplant: Nonenhanced Renal MR Angiography with Magnetization-prepared Steady-State Free Precession.
Liu, X.; Berg, N.; Sheehan, J.; Bi, X.; Weale, P.; Jerecic, R.; Carr, J.
pp. 543-547
Enhancing Transjugular Intrahepatic Portosystemic Shunt Puncture by Using Three-dimensional Path Planning Based on the Back Projection of Two Two-dimensional Portographs.
Adamus, R.; Pfister, M.; Loose, R.W.R.
pp. 548-556
Knee Cartilage: Efficient and Reproducible Segmentation on High-Spatial-Resolution MR Images with the Semiautomated Graph-Cut Algorithm Method.
Shim, H.; Chang, S.; Tao, C.; Wang, J.-H.; Kwoh, C.K.; Bae, K.T.
pp. 557-565
Radiofrequency Ablation of the Liver: Determination of Ablative Margin at MR Imaging with Impaired Clearance of Ferucarbotran-Feasibility Study.
Mori, K.; Fukuda, K.; Asaoka, H.; Ueda, T.; Kunimatsu, A.; Okamoto, Y.; Nasu, K. et al
pp. 566-573
Lung Morphology in the Elderly: Comparative CT Study of Subjects over 75 Years Old versus Those under 55 Years Old.
Copley, S.J.; Wells, A.U.; Hawtin, K.E.; Gibson, D.J.; Hodson, J.M.; Jacques, A.E.T et al
pp. 574-582
Contrast-enhanced Harmonic Compound US of the Spleen to Increase Staging Accuracy in Patients with Hodgkin Lymphoma: A Prospective Study.
Picardi, M.; Soricelli, A.; Pane, F.; Zeppa, P.; Nicolai, E.; De Laurentiis, M. et al
pp. 583-589
Correlation of Carotid Plaque Neovascularization Detected by Using Contrast-enhanced US with Clinical Symptoms.
Xiong, L.; Deng, Y.-B.; Zhu, Y.; Liu, Y.-N.; Bi, X.-J.
pp. 590-598
Endoleak Detection with CT Angiography in an Abdominal Aortic Aneurysm Phantom: Effect of Tube Energy, Simulated Patient Size, and Physical Properties of Endoleaks.
Szucs-Farkas, Z.; Semadeni, M.; Bensler, S.; Patak, M.A.; von Allmen, G. et al
pp. 599-604
Chondroblastoma: Radiofrequency Ablation-Alternative to Surgical Resection in Selected Cases.
Rybak, L.D.; Rosenthal, D.I.; Wittig, J.C.

British Journal of Radiology Vol 82 No 976 2009

pp. 265-266
The cost effectiveness of in vivo dosimetry is not proven.
Mackay, R.I.; Williams, P.C.
pp. 267-271
Safety and efficacy of a rate control protocol for cardiac CT.
Roberts, W.T.; Wright, A.R.; Timmis, J.B.; Timmis, A.D.
pp. 272-278
Detectability of peripheral lung cancer on chest radiographs: effect of the size, location and extent of ground-glass opacity.
Hayashi, H.; Ashizawa, K.; Uetani, M.; Futagawa, S.; Fukushima, A.; Minami, K.
pp. 279-285
The role of MR cholangiopancreatography in the evaluation of pregnant patients with acute pancreaticobiliary disease.
Oto, A.; Ernst, R.; Ghulmiyyah, L.; Hughes, D.; Saade, G.; Chaljub, G.
pp. 286-290
The effectiveness of lymphangiography as a treatment method for various chyle leakages.
Matsumoto, T.; Yamagami, T.; Kato, T.; Hirota, T.; Yoshimatsu, R.; Masunami, T.; Nishimura, T.
pp. 291-295
Non-invasive assessment of saphenous vein graft patency in asymptomatic patients.
Campbell, P.G.; Teo, K.S.L.; Worthley, S.G.; Kearney, M.T.; Tarique, A. et al
pp. 296-302
Potential Irish dose reference levels for cardiac interventional examinations.
D Helft, C.J.; Brennan, P.C.; McGee, A.M.; McFadden, S.L.; Hughes, C.M.; Winder, J.R.; Rainford, L.A.
pp. 303-312
A large-scale multicentre study of patient skin doses in interventional cardiology: dose-area product action levels and dose reference levels.
Bogaert, E.; Bacher, K.; Lemmens, K.; Carlier, M.; Desmet, W.; De Wagter, X. et al
pp. 313-320
Effect of tube current on diagnostic image quality in paediatric cerebral multidetector CT images.
Ledenius, K.; Gustavsson, M.; Johansson, S.; Stalhammar, F.; Wiklund, L.-M.
pp. 321-327
The effect of treatment position, prone or supine, on dose-volume histograms for pelvic radiotherapy in patients with rectal cancer.
Drzymala, M.; Hawkins, M.A.; Henrys, A.J.; Bedford, J.; Norman, A.; Tait, D.M.
pp. 328-331
Dose verification of intensity-modulated arc therapy using an ERGO++ treatment planning system and Elekta internal multileaf collimators for prostate cancer treatment.
Yoda, K.; Nakagawa, K.; Shiraishi, K.; Okano, Y.; Ohtomo, K.; Pellegrini, R.G.
pp. 332-336
Locally advanced rectal cancer: histopathological correlation and predictive accuracy of serial MRI after neoadjuvant chemotherapy.
Johnston, D.F.; Lawrence, K.M.; Sizer, B.F.; Arulampalam, T.H.A.; Motson, R.W. et al
pp. 337-342
MRI assessment of cardiac amyloidosis: experience of six cases with review of the current literature.
Seeger, A.; Klumpp, B.; Kramer, U.; Stauder, N.I.; Fenchel, M.; Claussen, C.D.; Miller, S.
pp. 344-347
A young woman with multiple cardiac mass lesions.
Shah, J.R.; Joshi, A.; Patkar, D.
pp. 348-351
Effective dose: a flawed concept that could and should be replaced. Comments on a paper by D J Brenner (Br J Radiol 2008:81:521-3).
Dietze, G.; Harrison, J.D.; Menzel, H.G.

Radiology Management Vol 31 No 2 2009

pp. 18-29
Subjective Normative Factors Impacting Technology Adoption in an Imaging Department: Implications for Practice.
Kowalczyk, N.; Stein, D.
pp. 30-35
Recent Developments and Key Legal Issues Impacting Diagnostic Imaging Services, Part 2.
Dresevic, A.; Kalmowitz, C.F.
pp. 41-45
Portable CT Imaging of Acute Stroke Patients in the Emergency Department.
Weinreb, D.B.; Stahl, J.E.
pp. 46-50
The Benefits of Integrating CVIIS and PACS.
Christian, C.
p. 6
Governmental and managerial regulations are relevant to the every day work of an imaging administrator-both are discussed in this issue.
Murphy, D.L.
pp. 7-10
Molly and Me: There are a surprising number of health benefits to pet ownership that can also benefit those of us in management positions.
Lipcamon, J.D.
pp. 11-13
Advance Beneficiary Notice: New Name, New Look, New Requirements.
Buck, S.L.
pp. 14-15
Adapting to a New Workspace.
Edge, R.
pp. 16-17
Coding for Urinary Tract Interventions.
Miller, J.
pp. 27-38
HR 6331: Medicare Mandated Imaging Accreditation.
Kroken, P.
pp. 39-40
Imaging Administrator's Road Rules.
Boyd, G.
pp. 52-55
Capital Budgeting: The Characteristics of Imaging Projects, Part 3.
Yoder, E.