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Why women want prenatal ultrasound in normal pregnancy, by Gudex C, Nielsen BL, Madsen M in Ultrasound Obstet Gynecol 2006 Jan 24;27(2):145-150
"A postal questionnaire was completed by 370 pregnant women with no apparent obstetric risk factors, who had expressed a desire to have ultrasound scanning in their current pregnancy. The women were asked to indicate, from a list of 12 items, their three most important reasons for wanting scanning.
The items most frequently identified as important reasons for ultrasound were to check for fetal abnormalities (60% of women), to see that all was normal (55%) and for own reassurance (44%). Lower income was related to wanting to see the baby and wanting an ultrasound picture; higher income was related to checking that all was normal and for own reassurance. Women in their first pregnancy were more likely to want themselves and the father to see the baby,women who had given birth previously were more likely to want reassurance , as were women with a previous miscarriage or induced abortion. It would appear that women in normal pregnancy have specific reasons for wanting prenatal ultrasound that are influenced by sociodemographic, obstetric and attitudinal factors. "
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Posted in
January 2006
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In an Article by von Schulthess GK, Steinert HC, Hany TF in Radiology 2006 Feb;238(2):405-22.Integrated PET/CT: Current Applications and Future Directions, The authors discuss the rationale behind and role of PET/CT in oncological imaging with PET giving the functional information and CT adding the anatomical edge.
"For the past 5 years, combined positron emission tomography (PET) and computed tomography (CT), or PET/CT, has grown because the PET portion provides information that is very different from that obtainable with other imaging modalities. However, the paucity of anatomic landmarks on PET images makes a consistent "hardware fusion" to anatomic cross-sectional data extremely useful. Clinical experience indicates a single direction: Addition of CT to PET improves specificity foremost, but also sensitivity, and the addition of PET to CT adds sensitivity and specificity in tumor imaging. Thus, PET/CT is a more accurate test than either of its individual components and is probably also better than side-by-side viewing of images from both modalities."
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Posted in
January 2006
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Following is an article from my column Medical Imaging from The Medical Blog Network.
This Article is about what should a person expect in MRI examination.
Initially all the formalities and paper work is checked. Jewelry, watches, coins, keys, cell phones and credit cards are incompatible with the magnetic resonance imaging procedure. These objects can be attracted by the magnet on the imager or distort the images. Certain articles of clothing, such as metal zippers, wires, and belt buckles, are also incompatible with the imaging. Some contradictions to MRI are-cardiac pacemaker, cochlear implants, metal filings, shrapnel, or ferromagnetic clips or pins in the body. MR scanner is long tunnel like structure. Some claustrophobic individuals may get anxious in such a situation.Initially the MR technician puts an imaging coil around the part to be examined. Examination takes around 30-60minutes. The changing magnetic field gradients create a knocking sound which may be distressing to some where wearing of ear plugs is advised. The MR technician operates the imaging system from the control room. In addition there is a computer room and a reading room where a Radiologist with view-box reports the MR scans. In addition to a technician, and a Radiologist, there are some nursing personnel also to aid in basic nursing procedure.Finally MRI is interpreted by a Radiologist and the end result is used in addition to the clinical scenario by the referring physician for further management.
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Posted in
January 2006
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Just came across this excellent teaching files for Pulmonary Pathologies. Something which we all agree is that Chest Radiology forms the basis of all examinations whether in Medical School or Residency Programs. This particular link has an option to test your skill by trying to diagnose the cases on the Diagnosis Off mode and then check your diagnosis by switching on the Diagnosis. A real stimulating exercise for all especially Radiology Residents.
Link here- http://www.ctisus.com/lmodules/lung/index.html
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Posted in
January 2006
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Here is one beautiful article by Leonard Berlin, MD, FACR, is chairman, Department of Radiology, Rush North Shore Medical Center, Skokie, Ill, and professor of radiology, Rush Medical College, Chicago.
A Manifesto for Truth-in-Mammography Advertising
From cigarettes to pharmaceuticals to financial services, all advertisements feature a disclaimer: Why not those for mammography?
"The allegation of a delay in the diagnosis of breast cancer is the leading cause of medical malpractice litigation in the United States today, and has been for the past decade. Of all medical malpractice lawsuits lodged against radiologists, the most frequent cause is the allegation of a missed breast cancer on mammography. Why has "missed breast cancer" risen to first place in the medical malpractice standings? Author suggests that it is because we have oversold mammography. We have marketed mammography without informing the public all that we know about not only the benefits, but more important the limitations and potential harms of mammography. "
Read The Full Article Here-
A Manifesto for Truth-in-Mammography Advertising
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Posted in
January 2006
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Feed2Podcast automatically converts blog text to audio via Text-to-Speech. It turns the last 7 items from my RSS feed into a podcast.
Listen Here
Blog readers can listen to the posts immediately or subscribe to the automatically generated podcast and listen with an iPod later.The text is read by a computer-generated voice. Click on the button in the sidebar of this blog: "Blog2Podcast. Listen now"
The Brilliant Concept via-
Clinical Cases and Images - Blog
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Posted in
January 2006
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Radiologist's misdiagnosis endangers 17 (Source United Press International)
"At least 17 British women's lives are at risk because a suspended radiologist wrongly told them they were clear of breast cancer, reports said Tuesday. The unnamed doctor -- the only radiologist at Trafford General and North Manchester General in the Manchester, England, area -- was suspended last April based on co-workers' concerns about the accuracy of his diagnoses, Sky News and The Times of London reported. Nearly 2,500 mammograms read by the radiologist since April 2003 were rechecked, 28 of which were misdiagnosed. "
Mammography per se has its own limitations and public should be educated about the possibility of false negative in this test. And so that they develop reasonable expectations of this test or more and more Radiologists will shy away from this test.
Interpretations of mammograms can be difficult because a normal breast can appear differently for each woman. Also, the appearance of an image may be compromised if there is powder or salve on the breasts or if you have undergone breast surgery. Because some breast cancers are hard to visualize, a radiologist may want to compare the image to views from previous examinations. Not all cancers of the breast can be seen on mammography.
Reference- http://www.radiologyinfo.org/content/mammogram.htm#Limits
From the literature-
N J Med. 2005 Jan-Feb;102(1-2):45-9.
"Concerns about screening mammography include questions of efficacy, high recall rates, false positives, and age at which to institute annual screening. Annual screening mammography can decrease breast cancer mortality by 45% in women over fifty and 23% in women between forty and fifty years of age. Patient recall rates and accuracy of interpretation vary among radiologists. Suggestions for improving accuracy of mammographic interpretation include continuing education with emphasis on quality of interpretation, computer-assisted detection, double reading, increased volume per reader, and performance-related skills testing. Having fewer radiologists reading more mammograms may result in decreased patient access to mammography services. Poor reimbursement for mammography and high prevalence of breast cancer-related litigation are disincentives for radiologists to provide mammography services; these issues must be addressed to ensure patient access to mammography. The public must be educated so that reasonable expectations on the benefits and limitations of mammography will develop."
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Posted in
January 2006
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Chest Radiographs Negative for One in Five Acute Heart Failure Patients
"Nearly one in five patients admitted to an emergency department with decompensated heart failure will have negative chest radiography results, a new analysis of registry data suggests.
The findings are consistent with past research suggesting that the test will find no signs of congestion in a substantial proportion of acute heart failure patients. The chest X-ray is still really an invaluable tool in the emergency physician's workup of heart failure But physicians who suspect heart failure in a patient should not conclude it isn't there if a chest radiograph is negative."
Reference- Ann Emerg Med 2006;47:13-21.
Source- Reuters Health Information
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Posted in
January 2006
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"Google has proved very useful to physicians and clinical researchers. As one fellow told his professor during grand rounds in a New York hospital, "I entered the salient features into Google, and [the diagnosis] popped right up" (Giustini, BMJ, 12/24/05).
Google operates both the general search engine, as well as Google Scholar. Google Scholar is not linked to the general search engine but instead uses an algorithm to targeted so-called scholarly material. Google also offers an image search, which is useful to clinicians who can search clinical cases and then find corresponding images online. This image search is particularly useful for radiologits as this speciality is an image based science."
Reference and More Info on Role of Google in Helath here-
Paging Dr. Google By Jane Sarasohn-Kahn
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Posted in
January 2006
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There have been a lot of queries regarding where to access Online Indian Medical journals. medIND is a One point resource of peer reviewed Indian biomedical literature covering full text of IndMED journals. It has been designed to provide quick and easy access through searching or browsing. Now it includes Indian Journal Of Radiology and Imaging too.
Here is the link-
http://medind.nic.in/
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Posted in
January 2006
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