Saturday, April 29, 2006

Radiology Jobs And Opportunities

Now Sumer's Radiology Site -The Top Radiology Magazine has a Job Section.
Radiology Jobs
An Online Portal for Radiology Jobs. Kindly post Radiology Related Job Vacancies here by emailing me at-
"Radiology Jobs"

cartoon from

Cartoon by Dave Walker. Find more cartoons you can freely re-use on your blog at We Blog Cartoons.

Wednesday, April 26, 2006

Interesting article Mortality associated with contrast media in AJR

Deaths attributed to X-ray contrast media on U.S. death certificates.
Wysowski DK, Nourjah P
"From 1999 through 2001, deaths attributed to the International Classification of Diseases (ICD) code for contrast media occurred at the rate of 1.1-1.2 per million contrast media packages distributed. An analysis of 1999 death certificates indicated that most deaths attributed to contrast media predictably were associated with renal failure or nephropathy and anaphylaxis or allergic reactions. Risk assessment of the comparative safety of classes or agents was limited by lack of specific contrast media names. Names of administered contrast agents should be recorded in patients' medical records and communicated to primary care physicians and certifiers of death in the event of serious sequelae after an identified recent radiologic procedure."

Monday, April 24, 2006

Radiology Quiz-Musculoskeletal Radiology

Quiz Section
What is the radiological finding in the Xray of the arm and what are the associated conditions? Give your answers in the comments section. The winners and the correct answers will be published here next week. [Real Straight forward one :-)]
Richa, Mona
TAR Syndrome, Holt Oram, Ectodermal Dysplasia, Fanconi syndrome, Trisomies

Saturday, April 22, 2006

Diagnostic Imaging in Pulmonary Embolism

Imaging of pulmonary embolism
"If a diagnosis of pulmonary embolism (PE) has not been excluded after the initial clinical assessment and chest X-ray, the options for further evaluation include V/Q scintigraphy and CT. CT pulmonary angiography allows the pulmonary arterial system to be visualised and inter-observer agreement is generally very good for a diagnosis of PE. The advantage of CT over other imaging techniques is that it also demonstrates other aspects of the thoracic anatomy and facilitates alternative diagnoses. This is important since up to two-thirds of patients with suspected PE may eventually receive a different diagnosis. The advent of spiral MDCT provides a powerful tool for diagnosis of PE that is currently being compared with various combinations of tests in the PIOPED II study. CT is undoubtedly very valuable for the diagnosis of PE, but in order to reduce radiation exposure, it should be the last step in a sequential clinical evaluation."

Thursday, April 20, 2006

Mr Tom Cruise-Doing Ultrasound yourself is irresponsible

Experts Warn of Dangers of Do-It-yourself Ultrasounds
"Experts argue that actor Tom Cruise's claim to be qualified to perform unsupervised ultrasound exams on his fiancĂ©, Katie Holmes, because he "read the manual" that came with the machine was irresponsible.Experts also called the move potentially dangerous, and that due to Cruise’s celebrity status, may have incorrectly influenced others to place their unborn children at risk by performing such exams with no medical supervision."
Well, ultrasound is a safe examination and is routinely done in pregnancy but still it is not to be done everyday like the way Tom Cruise is advocating. Laboratory studies have shown that ultrasound can produce physical effects in tissue, such as mechanical vibrations and rise in temperature, particularly when used for a prolonged period of time. It is strongly advocated that ultrasound images should be interpreted by properly trained physicians and the results discussed with the parents and treating physicians in order to plan for the best care of the baby and mother.

Wednesday, April 19, 2006

Radiation Humour

Just discovered this while net surfing here- More X-Ray Humour , Check out the site for such Funny X-ray stuff :-)
To My Dearest,
My colleague, we are like Beatrice and Dante;Dido and Aeneas. As sure as angular momentum is conserved, our professional love will endure the entropy of the universe. Your Barium Enema Films are as moving as Bach's ascending canon. Please meet me wearing only your Thyroid Shield at the Dark Room. We will study your TeleRAD and analyze the composition of barium and gastrograffin.
Yours Radiatingly,
Secret Xray Tech"

Impact of Obesity on Medical Imaging

"Americans are getting larger—much larger, which is no secret to radiologists or radiologic technologists. Very obese patients often exceed imaging table weight maximums and bore/gantry limitations, and frequently their body fat impedes rendering of quality diagnostic images. While patients must take responsibility for their own health, equipment vendors and the clinical community are equally invested in solving the weighty matter of obesity in medical imaging. Everything from plain X-ray to ultrasound, MRI and CT can be affected by obesity to the extent that the images can be very difficult to interpret."
All Radiologists have written sometime or the other in the reports of the patient-poor visualization due to obesity. This is common knowledge the size of the patient affects the quality of imaging study. Sometimes the issue is not poor visualization, it is inability to fit in to the machine, so vendors are now realising this fact and producing bigger machines. Common man understands that obesity leads to heart disease etc but is unaware that his/her diagnsotic studies may be hampered by his size. Approach to this problem has to be two prong-one on the part of the vendors to make bigger machines and other on the part of the people to realise the perils of obesity.

MRI in Rheumatoid Arthitis

Magnetic resonance imaging of the hand in rheumatoid arthritis : New scientific insights and practical application.
"Magnetic resonance imaging (MRI) is a sensitive diagnostic modality for the detection of inflammatory changes in peripheral joints. Nevertheless, the widespread clinical use of MRI in assessing patients with early rheumatoid arthritis is still hampered by the technical complexity and higher cost of MRI compared with conventional radiography. The MRI changes associated with rheumatoid arthritis are synovitis, tenosynovitis, erosions, and bone marrow edema."

Leasing of CT Scanners

GE, Physician Partnerships International to Offer Leasing of CT Scanners
"Physician Partnerships International, through its subsidiary Cardiology Imaging Associates, has entered into an agreement with GE Healthcare Financial to offer leasing services for the use of 64 slice CT (Computerized Axial Tomography) scanners. Tibitts states: "This is exciting for us. It presents us with a unique business opportunity to put both cardiologist and radiologists, and possibly other physicians, together to provide an excellent quality of patient care for 64 slice CT, with probable cost savings to the patients." "And by the way no significant up front capital from the physicians. It is just a typical lease, first and last month up front," Tibitts added. "

Source- Monitor Daily

Monday, April 17, 2006

How much is "Sumer's Radiology Site" worth?

Inspired by Tristan Louis's research into the value of each link to Weblogs Inc, this little applet uses Technorati's API which computes and displays your blog's worth using the same link to dollar ratio as the AOL-Weblogs Inc deal.

Friday, April 14, 2006

Limitations of MRI in Multiple Sclerosis

Caution needed over role of MRI in diagnosing multiple sclerosis

"Magnetic resonance imaging (MRI) on its own has limited ability to rule out or confirm a diagnosis of multiple sclerosis in patients with a single attack of neurological dysfunction. Whiting and colleagues conducted a systematic review of 29 studies that evaluated the diagnostic accuracy of MRI for multiple sclerosis. Most studies were of poor quality and had short term follow-up. Even when MRI showed many lesions, it could not accurately confirm multiple sclerosis. Similarly, the absence of lesions could not accurately rule out the diagnosis."
BMJ 2006;332 (15 April), doi:10.1136/bmj.332.7546.0

Wednesday, April 12, 2006

CT and Radiation Concerns

"Helical (aka slip ring or multidetector) computed tomography (CT) has revolutionized diagnostic cross-sectional imaging by enabling the scanning of a volume of tissue instead of scanning the patient one slice at a time. This technology, combined with further advances in data handling, has allowed radiologists an unprecedented ability to image the body and reconstruct data in multiple planes with little loss of resolution in ever shorter times. It is important for us to recognize that, as in anything in medicine or life, this incredible technology comes with a price. That price is increased radiation exposure.
A recent study from Sweden reviewed the cognitive ability of young men applying for the Swedish military who had been exposed to low-dose irradiation in infancy for cutaneous cranial hemangiomas. Brain dosage was estimated and correlated significantly with subsequent poor school performance, attendance, and cognitive ability. "
From an interesting article in Medscape-CT Scans and Cancer: How One Radiologist Is Safeguarding His Patients by Robert Chevrier .
What we should all realise particularly in kids we should be careful about ordering repeated CT scans say for minor Head Injury or ordering a CT scan when it has been repeatedly normal. One Head CT is equivalent to 150 CXRs and Risk versus benefit analysis should be done before ordering a CT scan.

Tuesday, April 11, 2006

Sleep Deprivation leads to Medical Errors by Doctors

Effect of reducing interns' work hours on serious medical errors in intensive care units.By Landrigan CP et al in N Engl J Med 2004 Oct 28;351(18):1838-48.
"Although sleep deprivation has been shown to impair neurobehavioral performance, few studies have measured its effects on medical errors. Authors conducted a prospective, randomized study comparing the rates of serious medical errors made by interns while they were working according to a traditional schedule with extended (24 hours or more) work shifts every other shift (an "every third night" call schedule) and while they were working according to an intervention schedule that eliminated extended work shifts and reduced the number of hours worked per week. Interns made substantially more serious medical errors when they worked frequent shifts of 24 hours or more than when they worked shorter shifts. Eliminating extended work shifts and reducing the number of hours interns work per week can reduce serious medical errors in the intensive care unit. "


Abdominal pregnancy is extremely rare, but even more unusual is the prolonged retention of an advanced abdominal pregnancy with lithopedion formation. Lithopedion is a rare obstetrical outcome of an undiagnosed and untreated advanced abdominal pregnancy, mostly found incidentally.
Just came across this case on , an amazing Radiograph...
Here is a link to case of-
"75 year old female with hematuria. Scout of IVP reveals a calcified fetus overlying the right iliac wing. On further questioning the patient claims that she "lost" a baby when she was younger, but did not seek medical care at the time."


Using Radiology Residents to make up for Labor Shortage-Long Term Implications

Hospitals ponder residents’ role in night call sonography
"Using residents to make up for the shortage of qualified sonographers could undermine medical education and compromise patient care. Clinical demand for ultrasound studies after hours is increasing, and hospitals must juggle staffing to meet that demand. Sometimes sonographers work an in-house shift and perform the scans. Finding sonographers willing to work night shift has become a challenge. But using residents to fill in the gap could undermine their education and, ultimately, affect patient care. Resident on-call duties must always be a balance between educational experience and provision of clinical service. Training programs must be certain that the scanning done by the resident is of educational value and not just an expedient solution to a labor shortage or other business factor."

Sunday, April 09, 2006

Link to a Good post about principles of X-Rays

An excellent post aimed at laypersons about how X-rays were discovered and how they are produced with some details about the physics involved, interesting read for the curious mind.

Indian Radiology and Imaging Association (IRIA) Website

Here is the link to the new official website of Indian Radiology and Imaging Association with interactive quizzes, all about IRIA and memebership information. Must check for Indian Radiologists.

Wednesday, April 05, 2006

CT in Aortic Injury

Critical evaluation of chest computed tomography scans for blunt descending thoracic aortic injury.

"Although aortography has been the long-held "gold standard" for diagnosis of traumatic blunt aortic injury, advances in imaging technology offer less-invasive, more-rapid, and potentially more cost-effective evaluation. Chest CT is an acceptable screening tool based on prerequisite high sensitivity and ease of performance in the trauma patient suspected of having a descending thoracic aortic injury. Three-dimensional software reconstruction of the aorta can aid in diagnosing blunt aortic injury when findings are equivocal, but there will continue to be artifacts and limitations that require aortography for clarification."

Reference- Ann Thorac Surg 2006 Apr;81(4):1339-46.

Changing Trends in Radiology

Interesting Interview entitled-
A Conversation with … Frank Seidelmann, DOSubspecialty radiology – meeting the demand for improved healthcare and medical outcomes, Full interview is available here. It talks about the need for Subspecialization in Radiology. Select Extract here-
"Radiology reading strategies are changing. What is evolving is a three-legged approach, in order to offer the most effective reading strategy tailored to the imaging providers' needs. It is a combination of radiology interpretation providers. The first leg is the on-site general radiologist to handle injections, X-rays, ultrasound, CT and some subspecialty reports that will amount to 70 percent of the cases. The next leg is made up of "hyper-subspecialty" experts (by modality/body part) needed to support specific clinicians who will typically operate virtually and will make up about 20 percent of the report volume. The third leg is the traditional teleradiology or nighthawk providers to handle the night time/emergency reads for about 10 percent of the volume."

Tuesday, April 04, 2006

Radiology Quiz Section-Musculoskeletal System

Radiological Quiz-Musculoskeletal System
Look at the Radiograph and tell the likely diagnosis, please leave your answers in the comments section. Correct answers and the winners will be published here next week.

D/D Osteoid Osteoma

Medical Blogs And Disease Management

Personal blogs help fight diseases
Divya Ramamurthi (From The Hindu)

Many blogs are run by doctors and scientists
Several patients turning to blogs for information
Some details on blogs may not be accurate

"When 42-year-old T. Sumithra's son was diagnosed with Duchenne muscular dystrophy, she wanted to learn more about the condition. She turned to the Internet for information. But instead of pouring through medical sites and trying to understand what they said, Ms. Sumithra turned to personal blogs. "I wanted to find out as much as I could about the condition - recent medical interventions, what happens and why it happens - but I did not want to be put away by the jargon that appeared on medical sites or be scared by what they had to say. So, I turned to blogs," Ms. Sumithra says. She says that she has been able to locate more than 150 blogs on muscular dystrophy. Some with medical information, some on personal stories on how to cope with it, and others with stories of courage and commitment to fight the situation."

Upcoming Conference on Computers in Radiology at Mumbai

RADBIZ - THE BUSINESS & PRACTICE OF RADIOLOGY incorporationg RADBYTES - II (Computers in Radiology)
A new conference will be be held in the first week of May on "The Business of Radiology". Topics will include lectures on "How to buy equipment...", "Finance", "Loan", "Insurance", "Methods of Practice", "Medico-legal Issues", "Marketing", etc. More details are here.

In brief, RADBYTES (Computers in Radiology) will be held on Friday afternoon at KEM Hospital (05 May 2006). RADBIZ (Business and Practice of Radiology) will be held on 06 & 07 May 2006 at Mumbai's ITC Grand Central Sheraton & Towers from 9.00AM - 6.00PM on both days.

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