Monday, July 30, 2007

Radiology Grand Rounds XIV

Here is a case of leaking aneurysm for the Radiology Grand Rounds submitted by Dr MGK Murthy of Teleradiology Providers

Concept of the Radiology Grand Rounds is available at- Radiology Grand Rounds.

Saturday, July 28, 2007

Image case-Osteosarcoma

Here is another case a 20 year old boy with a lower femoral swelling pain. CT scan done in a remote area was referred to us via Teleradiology.

Note the characteristic Spiculated (Sunray appearance) periosteal reaction & characteristic osseous destruction.

Friday, July 20, 2007

Teleradiology business models

I found an interesting article in J Telemed Telecare. 2005;11(6):271-5 on various business models followed by various teleradiology providers worldwide. According to Mun Sk et al A number of new diagnostic radiology services have emerged which use teleradiology. The main themes include: (1) stand-alone teleradiology practice; (2) the "Nighthawk"/on-call coverage; (3) solo radiologist practice; (4) expert/second-opinion teleradiology; (5) a global virtual radiology service based on workload sharing and reallocation.

In our own company Teleradiology Providers we follow the model of expert opinion as we have done in various centres around Delhi and Second opinions as sent over to us & sharing of work in the inetrnational market.

Wednesday, July 18, 2007

No radiology professionals in the google advisory board!!

Google’s decision to set up an advisory group has sparked controversy as well as congratulation. While the lack of nursing professionals or health librarians has caused a storm of protest on health blogs, it also appears it’s also a ‘no show’ from the radiology community too. The stated composition includes healthcare experts from “provider organizations, consumer and disease-based groups, physician organizations, research institutions, policy foundations, and other fields”.While the list of participants is impressive there’s no obvious representation from medical imaging professionals. In response the head of the American College for Radiology (ACR) Arl Van Moore wrote to Google to say it was pleased to hear that the advisory group was being established: "However, it is unfortunate, and frankly quite puzzling, that Google has apparently chosen not include a representative from radiology, a vital, and increasingly far reaching area of medicine."
Author: Stuart Hall

Maganese in brain on MRI

"Manganese (Mn) accumulation in the brain is detected as symmetrical high signal intensity in the globus pallidi on T1-weighted MR images without an abnormal signal on T2-weighted images. Mn accuulation in the brain is due to acquired or congenital diseases of the abdomen including hepatic cirrhosis with a portosystemic shunt, congenital biliary atresia, primary biliary cirrhosis, congenital intrahepatic portosystemic shunt without liver dysfunction, Rendu-Osler-Weber syndrome with a diffuse intrahepatic portosystemic shunt, and patent ductus venosus. Other causes of Mn accumulation in the brain are Mn overload from total parenteral nutrition and welding-related Mn intoxication."

Neuroradiology 2007 Jul 12; [Epub ahead of print]

Monday, July 16, 2007

PACS reporting room-How Dark Should It be?

According to RSNA news Not pitch black, but about 40-25 lux, comparable to a dim hotel room at night, according to one study.

RSNA News May 2007 (p 13-14).

Hat tip--MidEssexRay

Saturday, July 14, 2007

Submissions are requested for the Upcoming Radiology Grand Rounds

Next Radiology Grand Rounds will be hosted on last sunday 29-7-2007 of this month at John Hopkins MRI by Christopher , so hurry send all your Radiology Related submissions to me at or to christopher at

If you are not familiar with the concept of the Radiology Grand Rounds check out the archive and concept here-Radiology Grand Rounds

Radiology Wiki

"Recent developments in online collaborative technologies such as Wikipedia ( have demonstrated the potential usefulness of an online reference resource produced as the collective effort of many users. Although this type of resource has enjoyed success in the public arena, however, its value remains unproved in the academic community. RadiologyWiki ( applies the technology and methods of collaborative authorship to create a dynamic online radiology educational resource. The World Wide Web site capitalizes on the core technology of Wikipedia, allowing individuals with little technical experience to easily create, categorize, and search for articles by using a standard Web browser."
Ref- The Free Radiology Resource That Anyone Can Edit. Jonathan L. Streeter, Michael T. Lu, and Frank J. Rybicki. RadioGraphics 2007;27:1193-1200

Thursday, July 12, 2007

Teleradiology In NEJM

Is Telemedicine A New Phenomenon?

Care at a distance (also called in absentia care), is an old practice which was often conducted via post; there has been a long and successful history of in absentia health care, which - thanks to modern communication technology - has metamorphosed into what we know as modern telemedicine. In its early manifestations, African villagers used smoke signals to warn people to stay away from the village in case of serious disease. In the early 1900s, people living in remote areas in Australia used two-way radios, powered by a dynamo driven by a set of bicycle pedals, to communicate with the Royal Flying Doctor Service of Australia. [1]

In the NEJM, Dr. Robert Steinbrook takes a look at how Teleradiology has changed the field of Radiology:
The rapid expansion of teleradiology will benefit other physicians and their patients if it improves the quality, availability, and timeliness of interpretations. More specialty radiologists may be available to read more specialty studies. Many hospitals, including small and rural facilities, may be able to improve the quality of their radiology services. The flexibility with regard to hours and lifestyle may make radiology more attractive as a profession. Although its role within the United States appears to be limited, international teleradiology can link countries that have radiologists with those that lack them. [2,3]
2. N Engl J Med. 2007 Jul 5;357(1):5-7. The age of teleradiology.Steinbrook R.

Wednesday, July 11, 2007

High strength MRI-Adverse Effects

Biologic Effects of 3 Tesla (T) MR Imaging Comparing Traditional 1.5 T and 0.6 T in 1023 Consecutive Outpatients. J Neuroimaging 2007 Jul;17(3):241-5. Weintraub MI, Khoury A, Cole SP.
" The recent use of high and ultra-high magnetic field (MF) systems (3.0 T and above) have raised concerns about biologic effects and safety. Sensory symptoms (magnetophosphenes, dizziness/vertigo, headaches, metallic taste, pain changes, and cognitive effects) have been reported. According to the authors-- New onset symptoms occurred predominantly with 3 T and female preponderance. Vertigo/dizziness , headache, spine pain occurred more frequently on 3 T, whereas magnetophosphenes and metallic mouth symptoms occurred principally in 1.5 T. Symptoms of vertigo/dizziness, headaches, and magnetophosphenes were more commonly seen in individuals undergoing brain MRIs but other body sites were also represented. Although no harmful effects, an unexpected high rate of 14% of individuals experienced sensory stimulation in both 3 T and 1.5 T units. Females appear to be more magnetically sensitive."

Friday, July 06, 2007

Freiberg Infarction-Case Report

"Points to remember-infarction because it is supposed to be trauma realted common in adolescents comes with pain women more than men.usually conservative management will do. Surgery is the option for non responders.D/D will be osteomyelitis in this joint gets involved usually proximal phalanx may be involved too.
Case submitted by Dr (Col) MGK Murthy & Dr David Kiran,Consultant Teleradiology Providers

Wednesday, July 04, 2007

Gopubmed -- useful search engine

There are some changes in which makes it more useful to all-

The first major change is that MeSHPubmed is now included in GoPubMed. Gene Ontology (GO) and Medical Subject Headings (MeSH) are now integrated into one application. This change was requested by many users and enables the joint search in molecular biology and medicine!

Novel award winning text mining method for automated recognition of protein names.

When i used for this for a few searches i found the results more useful and exactly what i was looking for and i am looking to use this more often. Seems like a good idea!!

Tuesday, July 03, 2007

One Stop Urinary Tract Imaging

In Abdom Imaging. 2007 Feb 14, Dillman JR et al discuss the role of and various indications, specific techniques, image reconstruction/reformatting, detection of pathology, and pitfalls related to CTU. Article is entitled "Multi-detector CT urography: a one-stop renal and urinary tract imaging modality."

According to them-"Multi-detector computed tomography urography (CTU) is a robust imaging modality for evaluation of the kidneys and urinary tract. When compared to excretory urography (EU), CTU's superior contrast resolution appears to more effectively detect and characterize numerous benign and malignant conditions involving the kidneys, upper urinary tracts, and urinary bladder. "

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