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Posts Tagged ‘CT’

The tumors were desolate and well restricted of patients with surgicopathologic staging of nerve sheath tumor of the cervical vagus, over MR and CT studies.

On magnetic resonance imaging, the tumors were heterogeneously bright on T2WI, with strong inhomogeneous postgadolinium enhancement.

 

The medical research study was conducted by Gopinathan Anil and Tiong-Yong Tan from Department of Radiology, Changi General Hospital, Singapore.

The study is available in American Journal of Roentgenology. Nerve sheath tumor is nervous system neoplasm – and emergence of it from the cervical vagus are uncommon. The research objective was to assess the role of Magnetic resonance imaging and Computed tomography in the diagnosis of these unusual neoplasms.

About 11 patients with surgicopathologic staging of nerve sheath tumor of the cervical vagus were selected had been referred to the institute from January 1999-2009, and their clinical data along with MR and CT studies were retroactively assessed. The tumors were appraised pertaining to: number, location, morphology, signal intensity/attenuation, patterns of mass effect and enhancement characteristics etc.

About the results, the tumors were desolate and well restricted. On computed tomography – 2 tumors were predominantly isodense, 8 were hypodense with poor enhancement; one had manifold cystic regions with enhancing solid components. On magnetic resonance imaging, the tumors in a heterogenous manner were bright on T2WI, with strong inhomogeneous postgadolinium enhancement. Subsequent were observed in some of patients: split fat sign, fascicular, entering and exiting nerve, hyperintense rim sign etc.

The common carotid artery was found anteriorly displaced in eight of the patients; except for a patient with posterolateral displacement, it maintained a neutral position for 2 of the patients. With exclusion of two, than other patients – the tumor acted as separation in between internal jugular vein and carotid artery.

Note: The spectrum of MRI and CT characteristics and patterns of mass effect of nerve sheath tumor of the cervical vagus were put forward as conclusion, along with observations for which we direct you more through http://www.ajronline.org

Computed tomography has higher detection risk for hypovascular liver tumors in obese patients – noise filter improves image quality.

 

The medical research study was conducted by Sebastian T. Schindera, Jaled Charimo Torrente, Thomas D. Ruder, Hanno Hoppe, Daniele Marin, Rendon C. Nelson and Zsolt Szucs-Farkas from Institute of Diagnostic, Interventional, and Pediatric Radiology, University Hospital Berne, University of Berne, Freiburgstrasse, Berne, Switzerland and Department of Radiology, Duke University Medical Center, Durham, NC.

The study is available in online journal of American Roentgen Ray Society, and the research objective was to assess impact of Multidetector computed tomography on obese patients for hypovascular liver tumors, and noise-filter effects in detection of lesion and on the image quality.

Two water containers were utilized by, for to imitate intermediate and obese patients, and liver phantom with 45 hypovascular tumors – of varied diameters was submerged in both. With 64-MDCT scanner both the containers were scanned by; the data gathered of CT from large phantom was postprocessed through noise filter.

Contrast-to-noise-ratio of tumors and image noise was gauged, and three independent radiology readers followed-up on with tumor detection methods.

There was image noise reduction by 42% in the large phantom, due to noise filter application. For filtered and non-filtered large phantom, the contrast-to-noise ratio of tumors were lower, in comparison to that of intermediate phantom. Fewer tumors were identified out on an average in filtered (19%) and non-filtered large phantom (25%), in comparison with the intermediate phantom.

Conclusion: Noise filter improves image quality in obese patients, but hypovascular liver tumors with computed tomography has higher detection risk in them.

MRI & CT cross-sectional imaging is vital for determination of stage of distant and local cancer spread.

 

The medical research study was conducted by Nishat Bharwani, Andrea G. Rockall, Anju Sahdev, Maria Gueorguiev, William Drake, Ashley B. Grossman and Rodney H. Reznek from Imaging Department, St. Bartholomew’s Hospital, and Department of Endocrinology, Barts & The London NHS Trust, London, United Kingdom.

The medical research review is available online in American Journal of Roentgenology. Adrenocortical carcinoma (ACC) is a malignant neoplastic disorder of the adrenal glands, and arises from the cortical moietie of the suprarenal glands.

Enhanced use of cross-sectional imaging for inappropriate causes and reasons has led to greater amount of adrenocortical carcinomas recognized out coincidentally at an early cancer stage. Identification of distinctive imaging, clinical/biochemical findings is essential for swift analysis and medical intervention for early relevant remedies/therapies.

Conclusion: MRI & CT cross-sectional imaging is vital for determination of stage of distant and local cancer spread. At present, complete surgical removal  is one potentially curative therapy for Adrenocortical carcinoma, as the information gathered through computed tomography and magnetic resonance imaging is vital for surgical guidance and for effective patient management and care.

A fresh study that is conducted at the Massachusetts General Hospital (MGH) by the medical research team shows a new direction to the improved usage of Computed Tomography (CT) scanning in the assessment of abdominal pain. Use of CT in  emergency care departments aid physicians diagnose swiftly.

The study was published in the February issue of the American Journal of Roentgenology. CT scans altered the treatment strategies for almost half of the patients, and considerably reduced possible hospital admissions for unnecessary tests and examinations that incur needless cost.

The report speaks about the importance of CT scanning in the emergency care departments, in terms of necessary policy significant factors! Researchers evaluated out on how the usage of Computed Tomography (CT) for patients with abdominal pain makes an impact on the thought pattern of physician, about the diagnosis they carry out, keeping up with confidence for a better treatment plan, and the team found out that it affected all in a balanced way! Medical diagnostic imaging has become popular in for to trim down healthcare costs, and research team believes that the usage of Computed Tomography (CT) in the emergency care departments can definitely enhance the competence in many medical conditions, but they lacked enough evidences to back up the declaration, and for the very reason the research team chose abdominal pain than any other symptoms/disorders, for the study, as the very disorder (abdominal pain) is common, and has no clearly defined clinical/medical guidelines obtainable for other common symptoms directing to CT, similar to headache!

In during 2006 and 2008 (utilizing the time period of about 15 months), the physicians that were in the MGH Emergency Department who ordered for CT scans for patients that came up with abdominal pain (not related to traumatic injury) were asked to find time with a questionnaire, for both before and after the scanning results! The questionnaire was comprised of questions related to physicians’ present diagnosis of the possible symptomatic cause, their confidence level in the diagnosis, and their anticipated treatment suggestions! The complete set of questionnaires are available (on the care provided to about 584 patients) for analysis!

On the surprising note, the CT scan results altered the analysis/diagnosis of about 49 percent of the patients, and the management plan/strategy for about 42 percent! Researchers found from the result that the number of patients (samples) that would probably have been kept for observation for additional diagnostic/analytical procedures, trimmed down to about 44 percent, and the total amount of mapped hospital submissions even got reduced by 20 percent, in a an astonishing way! They realized that the CT scanning vitally improved the confidence level of physicians in their diagnostic pattern, both when the scan altered, and when it did not alter the pre-scan analysis and judgment, but the development showed less in staff physicians/doctors in comparison to resident physicians! Researchers say, poor diagnostic certainty will always lead to poor choice/decision making for treatment planning, but on the other, improved confidence in the treatment/technique will always improve treatment planning, and even help in trimming down needless utilization of hospital/healthcare resources!

On the concluding note, the researchers green signaled CT scan as to be a vital tool for providing patients with relevant and apt care, on time! Though the research team did not include cost analysis in their study, but they were confident that their results suggesting CT scan will definitely trim down the usage of other diagnostic tests and procedures, as CT proved well in many instances for to lower down overall cost, showed instant diagnostic results, and demonstrated hugely saving on time needed for to move patients through emergency care departments!

Researchers at the Mayo clinic are researching on how to reduce the radiation dose during CT (Computed Tomography) perfusion studies, which is being popular as the diagnostic test for cerebrovascular accidents (stroke).

The researchers presented their findings at the 52nd Annual Meeting of the American Association of Physicists in Medicine on July 20 in Philadelphia. The presentation was titled “20-Fold Dose Reduction Using a Gradient Adaptive Bilateral Filter: Demonstration Using in Vivo Animal Perfusion CT.”

Dr. McCollough, diagnostic radiologist and colleagues at the  Mayo Clinic created a novel image-processing algorithm and experimented in animals and proved that it can produce high quality perfusion images at around 20 times less radiation exposure to the patient when compared to normal CT perfusion protocols. A CT perfusion scan takes arond 30 seconds after radio-iodine contrast injection revealing the areas of decreased vascular perfusion. The different images are superimposed for better quality and accurate diagnosis.

After the success in animals, Dr. McCollough and team plans to try the new technique in humans.

“When we use very low doses of radiation to acquire a CT, image graininess can significantly decrease the value of the exam,” says the study’s first author, Juan Carlos Ramirez Giraldo, Mayo Clinic. “With this new algorithm, we are able to maintain the image quality by cross-referencing it with other images collected during the exam.”

Recent study reveals that, the use of physiological and structural images taken from SPECT/CT hybrid imaging can help better diagnose and treat renal-transplant related issues.

Kidney transplant could mean a blessing with no dialysis for more than 15,000 Americans every year. However,complications post surgery are also a common issue. The traditional physican use of two-dimensional planar imaging to evaluate post-renal transplant complications included urinary leak, infection and transplant non-viability or kidney failure.

The study presented at SNM’s 57th Annual Meeting by the Cleveland Clinic. SPECT and CT imaging techniques were compiled to produce a detailed picture of the process of renal functions. The research results showed that three-dimensional SPECT/CT hybrid imaging is best-suited for similar and other disease states. Engaging SPECT/CT imaging may even prevent further imaging studies or invasive biopsies. Thus, avoiding delayed patient care.

About 12 renal transplant cases were involved in the study. Out of those, 10 patients were suspected of urinary leak, one with kidney failure and the other was suspected of experiencing a transplant-associated infections. All patients underwent scan post conventional planar imaging, with non-circular SPECT imaging and low dose non-contrast CT imaging using a hybrid SPECT/CT system. The SPECT/CT usage with Tc99m-MAG3, which is an imaging agent taken up by the kidneys and utilized for detection of renal function, assisted physicians positively diagnose urinary leaks for 70% of the patients when fused imaging exposed fluid outside The anatomical confines of the patients’ urinary system. Similar agent molecular imaging technique also succeeded in recognising kidney failures. The patient injected with In-111 labeled WBC, an agent that helps image leukocyte activity associated with the body’s immune response helped detect infection.

According to Shashi Khandekar, administrator of the nuclear medicine department, Cleveland Clinic, Cleveland, Ohio. “SPECT and CT fused images provide both functional and anatomical information about the kidney, which provides better diagnostic capability and greater confidence to our physicians.”

Computed Tomography (CT) dose is on ECRI Institute’s 2010 list of top 10 technology hazards. Recommendations for regulating CT radiation dose is thus, expanded by the Institute.

High CT radiation doses are being delivered to patients on a daily basis, putting them at an increased risk of developing cancer. Hence, keeping CT radiation dose in check is a high priority safety concern for hospitals. While increased levels of radiations may put patients at risk, diminishing the same, will affect the image quality that may result in incomplete examination or rescanning of the image. The process will expose the patients to even more radiation.

Practical esteem to balance between the degree of radiation are presented in a new guidance article, “CT Radiation Dose: Understanding and Controlling the Risks,” released by ECRI Institute, an independent, nonprofit organization that researches the best modes of care. This comprehensive Health Devices article expands on the recommendations about controlling CT radiation dose published in ECRI Institute’s 2010 Top 10 Technology Hazards list.

ECRI Institute emphasizes that the responsibility also lies with the facility itself, referring physicians, medical physicists, radiation technologists, and CT device manufacturers. The article includes sixteen practical recommendations that every facility should identify with, to help control radiation dose in CT.

The recommendations are set in 5 major sections:

1. protocol optimization,
2. prioritizing dose reduction,
3. patient selection,
4. the technician’s responsibilities,
5. quality assurance.

Dr.Keller, vice president, health technology evaluation and safety, ECRI Institute, considers the latest CT models are created with dose-saving technologies, but they may not be very affordable for many organizations. “In time, these technologies will become more widely installed,” says Keller. “Until then, there are a number of effective strategies every facility can implement to reduce dosage.The article also includes a dedicated section on dose-reduction technologies and the amount of dose savings they each achieve.

In the current scenario, when many doctors and patient advocacy groups are advocating low-dose computed tomography (CT) as a standard screening tool for the diagnosis of lung cancer, researchers have found out that these screening tests lead to higher false positive rates and thereby unnecessary anxiety and follow-up interventions.

Additionally, these tests can lead to potential hazards of radiation exposure and unnecessary health expenditure from the screening tests as well as from unnecessary interventions. Also an indolent lung cancer might not lead to the person’s death.

The ongoing National Lung Screening Trial aims to find out the actual effectiveness of lung cancer screening in saving patient’s lives when there is widespread promotion of lung cancer screening tests especially CT and x-rays among the public by doctors as well as companies.

The Lung Cancer Mortality Reduction Act of 2009 Senate bill states that “significant and rapid improvements in lung cancer mortality can be expected through greater use and access to lung cancer screening tests”.

The details of the research findings titled ‘Cumulative Incidence of False-Positive Test Results in Lung Cancer Screening’ are published in the April issue of the ‘Annals of Internal Medicine’. The lead author of the study is Jennifer Croswell, MD, MPH from the National Institutes of Health.

The researchers state in the journal that there is no ‘solid evidence’ yet about the advantages or disadvantages of screening but the knowledge is important as the people involved are healthy adults.

The study followed up 3318 persons, aged 55 to 74 years, from September 2000 to January 2001 who were randomly assigned to undergo CT or chest x-ray. They had a history of cigarette smoking 30 pack-years or more, and were current smokers or had quit in the past 10 years.

The screening tests were repeated after one year if the baseline examination was negative for lung cancer.

Patients who received one CT scan had a 21 percent risk of a false-positive result, compared with a 9 percent risk for those who had a chest X-ray. The risk was 33 percent for those who underwent two annual CT scans compared with a 15 percent in those who had two chest X-rays.

Seven percent of participants with a false-positive low-dose CT examination and 4% with a false-positive chest x-ray underwent an invasive follow-up procedure.

“The most important thing right now is to try to figure out if this lowers death rates,” Dr. Jennifer M. Croswell told Reuters Health. “Most professional medical societies do not recommend this (lung cancer screening) right now,” she said, “and the reason is because we don’t know if it works.”

Scientists plan to take-up their concerns, regarding radiation hazards from excessive radiology procedures, to the public on tuesday at a Food and Drug Administration (FDA) meeting, The New York Times reports.

The two-day public meeting (March 30th and 31st) is called by FDA to evaluate the issues regarding unnecessary radiation exposure from routine procedures and to discuss steps devicemakers can take to reduce patient exposure to radiation.

The report states that according to reports from FDA and interviews with the agency scientists, the FDA has ignored warnings from government experts regarding riskes from powerful Computed Tomography (CT) scans used for colo-rectal cancer screening.

Cancer risk from unnecessary radiology diagnostic procedures, doctors prescribing unneccesary scans, lack of standardization of CT scanners and other radiation emitting equipment are all much debated issues nowadays with regard to reducing radiation exposure. Use of CT scans for cancer screening in healthy adults is another hot topic.

The average life time dose of diagnostic radiation has increased around 7 times in the last thirty years. The increasing popularity of CT scans, driven by overzealous doctors and companies, is in particular a cumulative factor for this. The radiation emitted by a single whole body scan is equivalent to that emitted by about 500 conventional x-rays. Studies have showed that CT scans increase the cancer risk by about 0.05 percent.

New York Times reports that it is a very difficult position for the patients side because doctors, patient advocacy groups and manufacturers advocate these tests for their econimic interests; radiologists who own and use equipment favour the tests while patient groups are funded by manufacuters or physician groups.

Also the FDA, who has to sort out the issue, is also divided with internal dispute, the newspaper says. A group of agency scientists might testify that the FDA managers ignored their concerns thereby endangering the public.

Researchers at the Henry Ford Hospital analyzed cardiac computed tomography angiography (CCTA) data from 8, 200 patients and found that people with a family history of coronary artery disease has higher risk of developing obstructive CAD (28 percent) and atheromatous coronary artery plaques than those without a family history.

Cardiac computed tomography angiography (CCTA) is a non-invasive imaging test which uses the CT scanner to image blood vessels of the heart. CCTA can see through the coronary artery and measure the extend of the plaques and CAD.

The Henry Ford Hospital study is the largest one to date using CCTA and the results are presented at the 59th annual American College of Cardiology Scientific Sessions in Atlanta.

“This is the first study to show that family history of premature coronary artery disease is a significant predictor of obstructive coronary artery disease using coronary computed tomography,” says Mouaz Al-Mallah, M.D., director of Cardiac Imaging Research at Henry Ford and lead author of the study.