E Kotter

Detection and characterization of benign focal liver lesions with multislice CT.

MDCT is a rapidly evolving technique that significantly improves CT imaging for several indications including depiction of focal benign lesions. Imaging mainly profits from improved longitudinal spatial resolution allowing high-quality non-axial reformations and 3D reconstructions and CT angiography as well as rapid accurate multiphase imaging with short breath-holding periods. This review provides an overview of the current status of MDCT with respect to liver imaging and the implications for characterizing benign focal liver lesions. MDCT currently allows the acquisition of thin slices in daily routine diagnostics providing an improved detection rate of small liver lesions. Whereas large benign focal liver lesions exhibit typical patterns of morphology, attenuation and perfusion, which also may be assessed with single-slice scanners, small lesions remain challenging even with MDCT, since the specific criteria for confident diagnosis become more ambiguous. Here, MR imaging provides more detailed information about tissue components and the availability of liver-specific contrast agents, adding further impact to this technique. With respect to dose considerations, the number of necessary multiphase scans as well as the application of very thin collimation should be strictly checked for each patient undergoing MDCT based on the individual clinical situation and question.

Intelligent image retrieval based on radiology reports

AbstractObjectivesTo create an advanced image retrieval and data-mining system based on in-house radiology reports.MethodsRadiology reports are semantically analysed using natural language processing (NLP) techniques and stored in a state-of-the-art search engine. Images referenced by sequence and image number in the reports are retrieved from the picture archiving and communication system (PACS) and stored for later viewing. A web-based front end is used as an interface to query for images and show the results with the retrieved images and report text. Using a comprehensive radiological lexicon for the underlying terminology, the search algorithm also finds results for synonyms, abbreviations and related topics.ResultsThe test set was 108 manually annotated reports analysed by different system configurations. Best results were achieved using full syntactic and semantic analysis with a precision of 0.929 and recall of 0.952. Operating successfully since October 2010, 258,824 reports have been indexed and a total of 405,146 preview images are stored in the database.ConclusionsData-mining and NLP techniques provide quick access to a vast repository of images and radiology reports with both high precision and recall values. Consequently, the system has become a valuable tool in daily clinical routine, education and research.Key Points• Radiology reports can now be analysed using sophisticated natural language-processing techniques.n • Semantic text analysis is backed by terminology of a radiological lexicon.n • The search engine includes results for synonyms, abbreviations and compositions.n • Key images are automatically extracted from radiology reports and fetched from PACS.n • Such systems help to find diagnoses, improve report quality and save time.

A stress MRI of the shoulder for evaluation of ligamentous stabilizers in acute and chronic acromioclavicular joint instabilities

To show the feasibility of a stress magnetic resonance imaging (MRI) as a new method for simultaneous evaluation of the morphology and the functional integrity of the acromioclavicular joint (ACJ) ligamentous stabilizers.

Comparison of the Radiation Dose from Cone Beam Computed Tomography and Multidetector Computed Tomography in Examinations of the Hand

PURPOSEnComparison of radiation dose of cone beam computed tomography (CBCT) and multidetector computed tomography (MDCT) in examinations of the hand.nnnMATERIALS AND METHODSnDose calculations were carried out by means of Monte Carlo simulations in MDCT and CBCT. A corpse hand was examined in a 320-row MDCT scanner and a dedicated extremities CBCT scanner with standard protocols and multiple low-dose protocols. The image quality of the examinations was evaluated by 5 investigators using a Likert scale from 1 (very good) to 5 (very poor) regarding depiction of cortical bone, cancellous bone, joint surfaces, soft tissues and artifacts. For a sum of ratings of all structures <u200a50 a good overall image quality was expected. The studies with at least good overall image quality were compared with respect to the dose.nnnRESULTSnThe dose of the standard examination was 13.21 (12.96 to 13.46 CI) mGy in MDCT and 7.15 (6.99 to 7.30 CI) mGy in CBCT. The lowest dose in a study with good overall image quality was 4.54 (4.43 to 4.64 CI) mGy in MDCT and 5.72 (5.59 to 5.85 CI) mGy in CBCT.nnnCONCLUSIONnAlthough the dose of the standard protocols in the CBCT is lower than in the MDCT, the MDCT can realize a good overall image quality at a lower dose than the CBCT. Dose optimization of CT examination protocols for the hand is useful in both modalities, the MDCT has an even greater potential for optimization.nnnKEY POINTSn•u2007Low dose examinations of the hand are feasible in CBCT and MDCT.•u2007In default settings CBCT has a lower dose than MDCT.•u2007MDCT enables a good image quality at a lower dose than CBCT. Citation Format: •u2007Neubauer J, Neubauer C, Gerstmair A etu200aal. Comparison of the Radiation Dose from Cone Beam Computed Tomography and Multidetector Computed Tomography inxa0Examinations of the Hand. Fortschr Röntgenstr 2016; 188: 488u200a-u200a493.

Effiziente Qualitätsmanagementdokumentation durch Einführung eines neuen, dynamischen Qualitätsmanagementhandbuchs nach DIN EN ISO 9001:2000

PURPOSEnEvaluation of the impact of a new, dynamic computer-aided quality manual application (QMA) regarding the acceptance and efficiency of a quality management system (QMS) according to DIN EN ISO 9001:2000.nnnMATERIALS AND METHODnThe QMA combines static pages of HTML with active content generated from an underlying database. Through user access rights, a hierarchy is defined to create and administer quality documents. Document workflow, feedback management and employee survey were analyzed to compare the performance of the new QMH with the formerly used static version.nnnRESULTSnIntegration of a document editor and automated document re-approval accelerated the document process by an average of 10 min. In spite of an increase of the yearly document changes of 60%, the administration effort was reduced by approximately 160 h. Integration of the feedback management system into the QMA decreased handling time from an average of 16.5 to 3.4 days. Simultaneously the number of feedback messages increased from 160 in 2005 to 306 in 2006. Employee satisfaction was raised (old: 3.19+/-1.02, new: 1.91+/-0.8). The number of users who partook in the QMA more than once a week also increased from 29.5% to 60%.nnnCONCLUSIONnThe computer-aided quality manual application constitutes the basis for the success of our QMS. The possibility to actively participate in the quality management process has led to broad acceptance and usage by the employees. The administration effort was able to be tremendously decreased as compared to conventional QMS.

Comparison of the diagnostic accuracy of cone beam computed tomography and radiography for scaphoid fractures

The aim of this study was to evaluate and compare the diagnostic accuracy, the inter-rater agreement and raters’ certainty of cone beam computed tomography (CBCT) and radiography for the detection of scaphoid fractures. Our hypothesis is that the CBCT has a higher diagnostic accuracy for scaphoid fractures than radiography. We retrospectively analysed patients who underwent both radiography and CBCT examinations within 4 days to rule out a scaphoid fracture over a 2-year period in our institution. 4 blinded radiologists and orthopaedic surgeons independently rated the images regarding the presence of a scaphoid fracture. The reference standard was evaluated by two radiologists in a consensus reading. Inter-rater correlation was evaluated, pooled sensitivity, specificity, positive and negative predictive values were calculated and compared. 102 patients met the inclusion criteria. 52% of them had a scaphoid fracture. The inter-rater correlation was higher in the CBCT compared to radiography (Pu2009<u20090.001). Sensitivity, specificity, positive and negative predictive values were higher for CBCT than for radiography (Pu2009<u20090.019). Observers’ fracture classifications showed a higher correlation with the reference standard in the CBCT. Observers’ certainty for fracture detection and classification were higher in the CBCT. CBCT shows a higher diagnostic accuracy for scaphoid fractures than radiography.