D. Pinto dos Santos

Erfassung und Monitoring der radiologischen Strahlenexposition

Strategies for reducing radiation exposure are an important part of optimizing medical imaging and therefore a relevant quality factor in radiology. Regarding the medical radiation exposure, computed tomography has a special relevance. The use of the integrating the healthcare enterprise (IHE) radiation exposure monitoring (REM) profile is the upcoming standard for organizing and collecting exposure data in radiology. Currently most installed base devices do not support this profile generating the required digital imaging and communication in medicine (DICOM) dose structured reporting (SR). For this reason different solutions had been developed to register dose exposure measurements without having the dose SR object.Registration and analysis of dose-related parameters is required for constantly optimizing examination protocols, especially computed tomography (CT) examinations based on the latest research results in order to minimize the individual radiation dose exposure from medical imaging according to the principle as low as reasonably achievable (ALARA).

Effect of Kernels Used for the Reconstruction of MDCT Datasets on the Semi-Automated Segmentation and Volumetry of Liver Lesions

PURPOSE To evaluate the effect of different reconstruction kernels on the semi-automated segmentation of liver lesions in MDCT. MATERIALS AND METHODS A total 62 liver lesions were measured by three independent radiologists with the semi-automated segmentation software Oncology-Prototype (Fraunhofer MEVIS, Siemens Healthcare, Germany) using MDCT datasets (3-mm slice thickness, 2-mm increment) reconstructed with standard, soft and detailed kernels (Philips B, A and D). To ensure objective measurements, only lesions with satisfactory initial segmentation were included, and manual correction was not used. The effective diameter and volume were recorded for each lesion. Segmentation in the soft and detailed kernel datasets was performed by copying the initial seeds position from the standard kernel dataset. RESULTS The mean effective lesion diameter was 19.9 ± 9.7 mm using the standard kernel. Comparing the three kernels, no significant differences were found. The mean difference was 1% ± 6% for the standard kernel compared to the soft kernel, 3% ± 13% for the standard kernel vs. the detailed kernel and 2% ± 9% for the soft kernel compared to the detailed kernel. The intra-class correlation coefficients were > 0.96 in all cases. CONCLUSION The semi-automated segmentation and volumetry of liver lesions shows reliable measurements regardless of the kernel used for reconstruction of the MDCT dataset. KEY POINTS ► Semi-automated segmentation and volumetry of liver lesions is reliable regardless of the kernel used for reconstruction of the MDCT dataset. ► Until today the gold standard for the evaluation of tumor response has been unidimensional manual measurement. ► Volumetric measurements could improve the assessment of tumor growth.

Therapy response evaluation of malignant lymphoma in a multicenter study: comparison of manual and semiautomatic measurements in CT.

PURPOSE Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting. MATERIALS AND METHODS MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bi-dimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST. RESULTS Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6%. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements. CONCLUSION Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6% in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach. KEY POINTS ► Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients ► Manual lymph node evaluation with uni-dimensional parameters is inferior to semi-automatic analysis in a multicenter setting ► Semi-automatic quantitative software tools should be introduced in clinical study evaluation.

IT-Systeme in der Radiologie und IT-Systeme für den Radiologen@@@IT systems in radiology and IT systems for radiologists

ZusammenfassungDie Radiologie besitzt bekanntermaßen eine Vorreiterrolle bei der Einführung und Verwendung von klinischen IT-Systemen. Radiologieinformationssystem (RIS) und Picture Archiving and Communication System (PACS) sind dabei die Grundpfeiler der modernen digitalen Radiologie. Dieser Artikel gibt einen Überblick über die wichtigsten Grundlagen und Funktionen dieser Systeme und zeigt Ausblicke auf die aktuellen Entwicklungen.AbstractRadiology plays an important role in introduction and use of information technology (IT) systems in the daily clinical routine. The radiology information system (RIS) and picture archiving and communication system (PACS) are the main systems used in a digital radiology department. In this article the basic principles and functions of these systems and trends in development are described.

IT-Systeme in der Radiologie und IT-Systeme für den Radiologen

ZusammenfassungDie Radiologie besitzt bekanntermaßen eine Vorreiterrolle bei der Einführung und Verwendung von klinischen IT-Systemen. Radiologieinformationssystem (RIS) und Picture Archiving and Communication System (PACS) sind dabei die Grundpfeiler der modernen digitalen Radiologie. Dieser Artikel gibt einen Überblick über die wichtigsten Grundlagen und Funktionen dieser Systeme und zeigt Ausblicke auf die aktuellen Entwicklungen.AbstractRadiology plays an important role in introduction and use of information technology (IT) systems in the daily clinical routine. The radiology information system (RIS) and picture archiving and communication system (PACS) are the main systems used in a digital radiology department. In this article the basic principles and functions of these systems and trends in development are described.

Erfassung und Monitoring der radiologischen Strahlenexposition@@@Registration and monitoring of radiation exposure from radiological imaging

Strategies for reducing radiation exposure are an important part of optimizing medical imaging and therefore a relevant quality factor in radiology. Regarding the medical radiation exposure, computed tomography has a special relevance. The use of the integrating the healthcare enterprise (IHE) radiation exposure monitoring (REM) profile is the upcoming standard for organizing and collecting exposure data in radiology. Currently most installed base devices do not support this profile generating the required digital imaging and communication in medicine (DICOM) dose structured reporting (SR). For this reason different solutions had been developed to register dose exposure measurements without having the dose SR object.Registration and analysis of dose-related parameters is required for constantly optimizing examination protocols, especially computed tomography (CT) examinations based on the latest research results in order to minimize the individual radiation dose exposure from medical imaging according to the principle as low as reasonably achievable (ALARA).