Thursday, November 30, 2006

PET imaging for Carotid Plaque Evaluation

In Vivo 18 F-Fluorodeoxyglucose Positron Emission Tomography Imaging Provides a Noninvasive Measure of Carotid Plaque Inflammation in Patients
By Dr. Ahmed Tawakol et al
"Given the importance of inflammation in atherosclerosis, authors sought to determine if atherosclerotic plaque inflammation could be measured noninvasively in humans using positron emission tomography (PET). Seventeen patients with severe carotid stenoses underwent FDG-PET imaging 3 h after FDG administration (13 to 25 mCi), after which carotid plaque FDG uptake was determined as the ratio of plaque to blood activity (target to background ratio, TBR). Less than 1 month after imaging, subjects underwent CEA, after which carotid specimens were processed to identify macrophages (staining with anti-CD68 antibodies). There was a significant correlation between the PET signal from the carotid plaques and the macrophage staining from the corresponding histologic sections. Authors established that FDG-PET imaging can be used to assess the severity of inflammation in carotid plaques in patients."

Monday, November 27, 2006

"Under The Table" Imaging

Found this very interesting article on Read the full article its very accurate.
"What is an under-the-table imaging request? Most radiologists encounter it at some point in their career, be it a foot radiograph for a nurse whose big toe was crushed by a stretcher wheel, a chest radiograph for a coughing ER physician or a gallbladder ultrasound for a healthy-looking resident with right upper quadrant pain. Instead of going through proper channels, the above patients may approach a radiologist or even a radiologic technologist directly and ask for what they think is an appropriate imaging study. There are multiple reasons why such unofficial imaging should be categorically denied and all patients should be directed to seek proper medical attention."

Radiology Grand Rounds VI Are Up

Radiology Grand Rounds VI are finally up at one of the Best Radiology Blogs-
Spot Diagnosis

Check it out and enjoy the best in the world of Radiology this month!

Friday, November 24, 2006

Posterior reversible encephalopathy syndrome (PRES)

Excellent case with images here- ARRS Case Of the Day
"PRES presents with nonspecific signs and symptoms including headaches, confusion, visual disturbances, elevated blood pressure and seizures. Clinical findings are not sufficiently specific to establish the diagnosis, however, magnetic resonance imaging (MRI) pattern is often characteristic and represents an essential component of the diagnosis of PRES. PRES is an acute episode of vasogenic edema in the cerebral white matter, with a predilection for the posterior temporal, parietal and occipital regions. The vasogenic edema is likely due to autoregulatory dysfunction and endothelial dysfunction. The explanation for predilection for the posterior circulation is uncertain. Non enhanced CT shows patchy bilateral white matter nonconfluent hypodensity, and contrast enhanced CT images show variable mild patchy punctuate enhancement. The findings in the subcortical white-matter are hyperintense on T2-weighted images, hypointense or isointense on diffusion-weighted images, and hyperintense on apparent diffusion coefficient (ADC) images. PRES has been described with a number of medical conditions including hypertensive encephalopathy, eclampsia, and cytotoxic and immunosuppressive drugs (i.e. cisplatin, cyclosporin, tacrolimus, antiretroviral therapy, and erythropoietin). The reversibility of the clinical and radiologic abnormalities is dependent on prompt control of blood pressure and/or discontinuing the offending drug. If unrecognized, conversion to irreversible cytotoxic edema may occur. Rapidly developing, fluctuating or intermittent hypertension is a particular risk. "

Radiology Job Market


"Our field faces a multitude of threats: reduced reimbursement, self-referral, radiation safety issues, and a heightened awareness by all payors that we are an important component of healthcare costs. But in the face of our recent growth in demand, our supply is woefully inadequate, leaving us quite vulnerable. While some individuals may appreciate the relative shortage because it results in short-term higher salaries and wages, it may be the proverbial battle success in a lost war. We will have failed as a specialty if we allow a shortage of our own making to lead to our diminution. As it takes at least six years from "match day" to train a radiologist, action must happen soon."

Wednesday, November 22, 2006

Submissions are requested for the Sixth Radiology Grand Rounds

Dear Readers
Sixth Radiology Grand Rounds is coming up on the last sunday of this month, on 26-11-2006. If you have anything from the world of Radiology send it over fast so that it can be included in this issue.
Send submissions to-
Scheduled host- Spot Diagnosis

Tuesday, November 21, 2006

More on CT Radiation concerns

Source and Full article -Medscape
"If a diagnostic procedure increases cancer risk, should patients be informed of that risk? Apparently not, at least for one procedure performed more than 150,000 times a day in the United States. CT scans use multiple x-rays to create three-dimensional images that are diagnostically useful but expose people to far more radiation than conventional x-rays. In fact, one CT scan exposes a patient to the lower range of radiation received by some Nagasaki bombing survivors. Up to one in a thousand patients will develop cancer from this exposure.Sixty million CT scans a year will thus cause cancer in thousands of people. Yet most consent forms are silent about this."

Monday, November 13, 2006

More on Gadolinium adverse effects

"Europeans find more gadolinium-related adverse reactions
Problems with gadolinium-containing contrast agents administered to patients with renal impairment are more common than originally estimated. The lack of awareness among radiologists about the potential dangers for those at high risk is striking, according to researchers. In June 2006, the FDA advised against giving gadolinium-containing contrast agents during MRI exams to patients with renal impairment. The warning came after the Danish Medicines Agency reported that 25 patients with kidney failure developed a life-threatening condition known as nephrogenic systemic fibrosis (NSF, previously known as nephrogenic fibrosing dermopathy). "

Saturday, November 11, 2006

Doctor Google!

"THE practice of "Googling" for a diagnosis could help doctors and patients accurately identify their ailments, research suggests. A study has found that putting symptoms into the Google internet search engine produced the right diagnosis in the majority of cases. But experts warned that relying on the internet could be dangerous to patients and the web should be used with caution. It is thought that doctors carry two million facts in their heads to help them diagnose illnesses, but with medical knowledge expanding rapidly, even this may not be enough. "

Wednesday, November 08, 2006

A New Radiological Image Library

Just Discovered this new site-Radiology Picture of the Day which features a new medical image daily, with a brief description.
Discovered some very characterstic CT scan finding of this interesting case on this site-
"Epiploic appendagitis is an inflammatory / ischaemic process involving an appendix epiploica of the colon. The characteristic CT appearance is shown: a fat-density ovoid structure adjacent to colon, with a thin high-density rim; surrounding inflammatory fat stranding. The diagnosis can be confidently made with CT, and exploratory surgery avoided. The condition can be expected to resolve in around 7 days."
Full case with high resolution image and many more such cases here-
A Site by Dr Dr Laughlin Dawes

Holoprosencephaly And Patau Syndrome

"Holoprosencephaly is a group of disorders characterized by failure of diverticulation and cleavage of prosencephalon at the rostral end of primitive neural tube and hypoplasia or aplasia of premaxillary segment of face. Incidence of holoprosencephaly is 6-12 /1000 live birth and 40/1000 in embryos with recurrence rate of 6% for non chromosomal form and 13% for autosomal dominant form. It is most frequently seen in trisomy 13 &18 and can be caused by teratogen as in infant of diabetic mother."
Read the full article with images (Free Full Text Available)

Friday, November 03, 2006

Undergoing CT in Pregnancy-Drink Barium Sulphate As An Internal Shield!

"Study used a phantom to prospectively examine the attenuating effect of barium sulfate as an internal shield to protect the fetus. The control radiation dose was 3.60 mSv ± 0.54 (standard deviation) with the water slab at near field, where the uterus dome is at near term, and 0.507 mSv ± 0.07 with the water slab at far field, the uterus position during early gestation. Scattered radiation was attenuated 13% and 21% with 2% barium sulfate and 87% and 96% with 40% barium sulfate, as calculated in the near and far fields, respectively, and 99% with the 1-mm lead sheet. Study results in the phantom experiment suggest that fetal irradiation during maternal chest CT can be reduced substantially with barium shielding. "
Internal Barium Shielding to Minimize Fetal Irradiation in Spiral Chest CT: A Phantom Simulation Experiment
David K. Yousefzadeh, MD, Matthew B. Ward, MD and Chester Reft, PhD
Hat Tip- PengRad

Wednesday, November 01, 2006

Stories about X-Ray Vision and Superman

While there are devices currently extant which can "see" through clothing, these are quite bulky and it is unlikely that any "X-ray goggles" could be made with modern technology.

"In fictional stories, X-ray vision has generally been portrayed as the ability to see through layers of objects at the discretion of the holder of this superpower. The goal is usually to see through clothing, usually to determine if someone is carrying a concealed weapon, but sometimes for more salacious reasons.
The best known figures with "x-ray vision" are the fictional superhero Superman who once had a heat producing function before that power was separated as heat vision, and the protagonist of the 1963 film X (aka X: The Man with the X-Ray Eyes).
At least in the first Superman movie, Superman's X-ray vision could see through female character Lois Lane's clothing to see the color of her underwear. This implies it had nothing to do with actual X-rays, since color is a matter of spectral properties at optical frequencies. In the movie Superman Returns, Superman uses the X-ray vision to see into the interior of Lois Lane's body in order to check for internal injuries."


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