Diagnostic Imaging Procedures Research Articles

Estimating the effects of cancer screening in clinical practice settings: The role of selective uptake and suboptimal adherence along the cancer screening continuum.

Randomized controlled trials (RCTs) are the gold standard in determining efficacy of cancer screening tests. Yet, systematic differences between RCT and the general populations eligible for screening raise concerns about the generalizability and relevance of RCT findings to guide the development and dissemination of cancer screening programs. Observational studies from clinical practice settings have documented selective uptake in screening - i.e., variation across subgroups regarding who is screened and not screened - as well as suboptimal adherence to screening recommendations, including follow-up of positive findings with subsequent imaging studies and diagnostic invasive procedures. When the effectiveness of a screening intervention varies across subgroups, and there is selective uptake and suboptimal adherence to screening in clinical practice relative to that in the RCT, the effects of screening reported in RCTs are not expected to generalize to clinical practice settings. Understanding the impacts of selective uptake and suboptimal adherence on estimates of the effectiveness of cancer screening in clinical practice will generate evidence that can be used to inform future screening recommendations and enhance shared decision-making tools.

Workforce evaluation in the field of radiation oncology: National data from a limited-resource setting.

e13576 Background: The workforce shortage in the field of radiation oncology is a critical challenge in developing countries. This study's main objective was to evaluate the workload of radiation oncologists (RO) in Armenia. Methods: In this cross-sectional study, the adapted questionnaire from Gunasekera et al. (2021) survey was used. The study setting was the only two RO centers operating in Armenia (public and private). For data collection purposes, census sampling was done and self-administered questionnaires were distributed. The data collection time frame was 15-25 July 2023. Descriptive statistics was done to analyze and present data through portions. Results: In total, data on 16 ROs and residents was collected. The ratio of ROs per million population was 6 in 2023, in Armenia. Primary consultations in median lasted 25 minutes (range: 10-40 mins). Similarly, consults of the patients on active treatment lasted in median of 12.5 minutes (min-60 mins). The median duration of follow-up oncology care consults was 7.5 minutes per day (range: 10- 40 mins). In terms of clinic hours, physicians in public settings reported spending a median of 50 hours per week. According to the respondents, on average radiation therapy specialists allocated 50% of their working time to providing direct patient care, 35% to fulfilling administrative responsibilities, 5% to educational and teaching endeavors, and 10% to conducting scientific research. The median radiation therapy delay was 1 week. Namely, treatment delay in the non-metastatic setting was 1․19, and in the metastatic setting 1 week. By the ROs, the most common barriers to delivering cancer care were treatment high cost (68%, n=11), lack of access to imaging (18.7%, n=3) and pathological (18.7%, n=3) diagnostic procedures, and lack of physicians' time to dedicate to patients (31%, n=5). Conclusions: Our study offers some insight into the radiation oncology workload in Armenia. From this research, we conclude that Armenian healthcare is understaffed in terms of radiation oncologists and medical physicists compared to other upper-middle-income and high-income income countries. Moreover, the median daily workload of the ROs exceeds the upper limit of the amount of consults suggested by the international societies. Hence, further research is required for a detailed evaluation of the RO workforce and specific intervention development that will be able to address this issue in Armenia and other resource-limited settings.

High-resolution computed tomography with scattered X-ray radiation and a single pixel detector

X-ray imaging is a prevalent technique for non-invasively visualizing the interior of the human body and other opaque samples. In most commercial X-ray modalities, an image is formed by measuring the X-rays that pass through the object of interest. However, despite the potential of scattered radiation to provide additional information about the object, it is often disregarded due to its inherent tendency to cause blurring. Consequently, conventional imaging modalities do not measure or utilize these valuable data. In contrast, we propose and experimentally demonstrate a high resolution technique for X-ray computed tomography (CT) that measures scattered radiation by exploiting computational ghost imaging (CGI). We show that the resolution of our method can exceed 500 µm, which is approximately an order of magnitude higher than the typical resolution of X-ray imaging modalities based on scattered radiation. Our research reveals a promising technique for incorporating scattered radiation data in CT scans to improve image contrast and resolution while minimizing radiation exposure for patients. The findings of our study suggest that our technique could represent a significant advancement in the fields of medical and industrial imaging, with the potential to enhance the accuracy and safety of diagnostic imaging procedures.

Does Higher Price Transparency Imply Lower Prices and Less Price Dispersion in Healthcare Markets? An Empirical Analysis of the Effects of Compliance with the Hospital Price Transparency Final Rule in the Greater Los Angeles Area

<p class="MsoNormal" style="margin-top: 12pt; text-align: justify;"><span lang="EN-US" style="font-family: 'times new roman', times, serif; font-size: 14pt;">The Hospital Price Transparency Final Rule aims at reducing the cost of healthcare in the United States by making information about the prices of medical services more readily available to market participants. The economic rationale is that higher price transparency should reduce the level and the dispersion of prices by disincentivizing hospitals from charging higher prices than possible. Using data on 3789 prices for three diagnostic imaging procedures and on the compliance with the rule for 86 acute care hospitals in the Greater Los Angeles area, we test the hypothesis that price levels and price dispersion are lower among hospitals that are more compliant. We do not reject this hypothesis, although we do not observe strictly decreasing relationships in all analyses. Prices are lower at hospitals with high or medium compliance than at hospitals with low compliance, but there is not a clear difference between hospitals with high and hospitals with medium compliance. Prices are less dispersed among hospitals with high compliance than among hospitals with low compliance, but the evidence for hospitals with medium compliance is less clear. We conclude that high compliance with the Hospital Price Transparency Final Rule implies lower prices and less price dispersion among hospitals.</span></p>

Medical Imaging in Pregnancy: Safety, Appropriate Utilization, and Alternative Modalities for Imaging Pregnant Patients.

This article reviews the existing literature on diagnostic and medical imaging of pregnant women, the risks and safety measures of different medical imaging modalities, and alternative modalities for imaging pregnant patients. Different medical imaging modalities such as MRI, CT scan, ultrasound, nuclear medicine, and X-ray imaging help to evaluate women with recognized or unrecognized pregnancies and identify any underlying complications among pregnant patients. Fetuses are more sensitive to radiation and the effects of medical imaging as compared to adults since they have a rapidly developing cell system. During cell proliferation, migration, and differentiation, fetuses suffer greatly from imaging radiationsince they are developing under a dynamic system. To ensure safety, pregnant women should discuss the benefits and risks of medical imaging with their physicians. In addition, radiologists should not perform any medical imaging procedure without the patient's consent, unless the patient cannot make any sound decision. Fetal risks of medical imaging include slow growth and development of the fetus, abortion, malformations, impaired brain function, abnormal childhood growth, and neurological development. Diagnostic imaging procedures are necessary when a condition that needs medical evaluation arises during pregnancy such as appendicitis.

Go Green in Neuroradiology: towards reducing the environmental impact of its practice.

Raising public awareness about the relevance of supporting sustainable practices is required owing to the phenomena of global warming caused by the rising production of greenhouse gases. The healthcare sector generates a relevant proportion of the total carbon emissions in developed countries, and radiology is estimated to be a major contributor to this carbon footprint. Neuroradiology markedly contributes to this negative environmental effect, as this radiological subspecialty generates a high proportion of diagnostic and interventional imaging procedures, the majority of them requiring high energy-intensive equipment. Therefore, neuroradiologists and neuroradiological departments are especially responsible for implementing decisions and initiatives able to reduce the unfavourable environmental effects of their activities, by focusing on four strategic pillars-reducing energy, water, and helium use; properly recycling and/or disposing of waste and residues (including contrast media); encouraging environmentally friendly behaviour; and reducing the effects of ionizing radiation on the environment. The purpose of this article is to alert neuroradiologists about their environmental responsibilities and to analyse the most productive strategic axes, goals, and lines of action that contribute to reducing the environmental impact associated with their professional activities.

Application of Cognitive Information Systems in Medical Image Semantic Analysis

Cognitive information systems create a new class of intelligent systems focused on semantic data analysis tasks. Such systems are based on cognitive resonance processes, which use a knowledge-based perception model, to analyze and semantically classify visual data. Such systems can therefore be used for image analysis and classification, including semantic analysis of medical images, aimed at supporting diagnostic processes and determining the severity of lesions visualized by diagnostic imaging methods. This paper will describe various types of cognitive information systems designed for lesion recognition in selected abdominal and coronary structures, as well as skeletal parts of the human body, made visible by the application of various modalities in medical diagnostic imaging procedures. In this paper, a new generation of cognitive systems will also be described, and when compared to existing systems, will have the ability to perform extended cognitive resonance processes. Inference based on extended resonance inference allows the system to acquire additional knowledge, as well as expand the knowledge base used for semantic analysis. This paper will also propose the implementation of new efficient formal grammars, which increase the efficiency of lesion recognition in selected medical images to over 90%.

Venous thromboembolism swine model with reflux-induced venous hypertension

ObjectiveThis study describes a novel swine model of venous thromboembolism (VTE) with reflux-induced venous hypertension. MethodsSix pigs underwent disruption of the tricuspid chordae tendineae to create reflux and venous hypertension in the femoral vein. The vein was traumatized 2 to 3 weeks later by repeated withdrawal of a slightly overinflated occlusion balloon across the lumen, followed by balloon occlusion of the outflow. A small amount of thrombin was injected into the traumatized vein segment immediately after outflow occlusion. Thrombosis of the traumatized vein evolved into an organized thrombus seven weeks later. The histological features of the harvested post-thrombotic femoral vein were studied with hematoxylin and eosin and Trichrome stains. ResultsIn all six pigs, initial disruption of the chordae tendineae was successfully performed to create tricuspid reflux and venous hypertension. After two-stage sequential procedures, a thrombus formed in the target femoral vein segment. Histology of the harvested thrombotic vein showed features of an organizing thrombus with collagen formation and fibrosis. ConclusionsThe novel swine VTE model may serve as a platform for developing and testing human-sized therapeutic procedures and devices in translational venous research. Clinical RelevanceThis study describes a swine model of VTE created by incorporating all three elements of Virchow’s triad. The model uniquely incorporates reflux-induced venous hypertension, which may be used in studying venous insufficiency and VTE in those with systemic venous hypertension. Likewise, this model may serve as a platform for development and evaluation of diagnostic imaging or therapeutic procedures and devices in subjects with systemic venous hypertension.

Greater tuberosity morphology is altered in individuals with symptomatic isolated supraspinatus tendon tears.

In the presence of an isolated supraspinatus tear, the force applied to the greater tuberosity is reduced, which may lead to bony morphologic changes. Thus, diagnostic or surgical identification of landmarks to properly repair the torn tendon might be difficult if the anatomy of the greater tuberosity is altered. The objectives of the study were to assess the presence of the superior, middle, and inferior facets of the greater tuberosity in individuals with symptomatic isolated supraspinatus tendon tears and the associations between tear size, tear location and presence of each facet. Thirty-seven individuals with symptomatic isolated supraspinatus tendon tears were recruited to participate in the study. Individuals underwent a high-resolution computed tomography scan of the involved shoulder and images were segmented to generate subject specific models of each humerus. The vertices comprising each facet were identified; however, if even a single vertex comprising the facet was missing, the facet was considered altered. Percentage agreement for correctly identifying the presence of each facet was determined using 2 additional observers and 5 randomly selected humeri. Ultrasonography was performed to assess anterior-posterior (AP) tear size and tear location. Outcome parameters included presence of the superior, middle, and inferior facets; AP tear size; and tear location. Point-biserial correlations were used to determine the associations between AP tear size, tear location, and presence of the superior, middle, and inferior facets. Supraspinatus tear size and tear location was 13.1±6.1 mm (range, 1.9-28.3 mm) and 2.0±4.4 mm from the posterior edge of the long head of the biceps tendon (range, 0.0-19.0 mm), respectively. Overall, the superior, middle, and inferior facets were not altered in 24.3%, 29.7%, and 45.9% of individuals, respectively. Percentage agreement between observers was 83.4% on average. No associations were found between tear size or tear location and presence of the superior, middle, or inferior facet (P values ranged from .19 to .74). Individuals with symptomatic isolated supraspinatus tears experience significant alterations in the bony morphology of the greater tuberosity that were irrespective of supraspinatus tear size and location. This information is useful for radiologists and orthopedic surgeons as the altered anatomy may influence the ability to identify important anatomic landmarks during diagnostic imaging or surgical procedures.

Variations in wait times for imaging services: a register-based study of self-reported wait times for specific examinations in Norway

BackgroundWhile the number of medical images has increased substantially, the demand has outpaced access, resulting in long wait times in many countries. Long wait times are a key problem for patient safety and quality of care as they can result in prolonged suffering, delayed diagnosis and treatment, as well as poorer prognosis and loss of lives. Surprisingly, little is known about wait times for imaging services.ObjectiveInvestigate wait times for specific imaging services in Norway and to compare wait times with the total number of examinations and their development over time.MethodsData from the wait time registry at the Norwegian Directorate of Health from 2018 to 2021 as well as data on outpatient imaging provided by the Norwegian Health Economics Administration (HELFO) and in-patient data afforded by fourteen hospital trusts and hospitals in Norway were analysed. Data include the total number of imaging examinations according to the Norwegian Classification of Radiological Procedures (NCRP). Analyses were performed with descriptive statistics.ResultsWait times vary through the months of the year. Conventional X-ray (XR) had the shortest wait times (3.0-4.4 weeks), and Magnetic Resonance Imaging (MRI) and ultrasound (US) had the lengthiest (8.7–12.0 and 7.9–11.4 weeks respectively). The wait times were lengthiest during the summer and winter holidays. Variations in wait times were also found for specific examination types between Norway’s four public health regions. In addition, there was variation over time within the health regions. The wait times with the private health providers were substantially lower than with the public health providers. From 2018 to 2021, the wait time for MRIs increased by 6.6%, while the number of examinations (per 10,000) increased by 8.6%. Those regions with the highest number of examinations per 1,000 inhabitants per year had the lowest wait times.ConclusionWait times for diagnostic imaging procedures varied with time, region, and modality in Norway from 2018 to 2021. Long wait times may entail many negative consequences for patients, professionals, and the healthcare system. Reducing long wait times is an obvious way to improve the quality, safety, and efficiency of care.

Practical Considerations for Obtaining Perioperative Transesophageal Echocardiography Accreditation: Collective Experiences at Early-Adopting Centers

The Intersocietal Accreditation Commission (IAC) is a non-profit accrediting organization committed to ensuring the quality of diagnostic imaging and related procedures. It is comprised of a collaboration of stakeholders, spanning numerous medical professionals and specialties. In a recent initiative, IAC Echocardiography introduced a new accreditation specifically for Perioperative Transesophageal Echocardiography (PTE). This accreditation process is anchored in rigorous clinical peer review to ensure diagnostic quality and report accuracy, thus maintaining high standards of medical care.The authors represent the inaugural four sites to achieve IAC accreditation for PTE who have collaborated to share their experiences in achieving this accreditation. This review endeavors to offer actionable insights and proven solutions to navigate the accreditation journey for others. Mirroring the IAC Standards and Guidelines for PTE accreditation, this review is divided into three pivotal sections: 1) organization of a perioperative echocardiography service, including stakeholder engagement to facilitate the application for accreditation; 2) performance of examinations and reporting; and 3) instituting quality improvement strategies and establishing a robust program.The pursuit of accreditation in PTE is to transcend a mere compliance exercise. It signifies a dedication to excellence, continual growth, and above all to the well-being of patients.

Development of Porous MoO2 Pellet Target for 99Mo/99mTc Generator.

Technetium-99m(99mTc) is used worldwide in 85% of nuclear medicine diagnostic imaging procedures. We developed porous MoO2 pellets as an alternative to reactor-based targets in an (n,γ) reaction for producing Technetium-99m (99mTc) in nuclear medicine. The pellets, formed through a manufacturing process involving mixing, sintering, eluting, and drying, offer advantages such as selective dissolution and improved yield. This research offers a potential solution for stable 99mTc production, focusing on porous molybdenum dioxide (MoO2) as a target material due to its insolubility in water. Using potassium molybdate (K2MoO4) as a pore former, we developed porous MoO2 pellets that facilitate efficient technetium extraction and target recycling. This approach offers control over pore formation and shows promise in addressing supply challenges and enhancing 99mTc production.

Implementation of a Shielding Guideline for Pediatric Patients Receiving Intraoperative Ionizing Radiation

Abstract Introduction Approximately 350 million diagnostic radiation imaging procedures are performed on pediatric patients annually. This population is at a greater risk of developing cancer after exposure to ionizing radiation because of a higher intake, accumulation, and increased sensitivity to radiation as well as a long-life expectancy postexposure. Methods This quality improvement project used convenience sampling with a pre–post design to evaluate two independent samples: (a) pediatric intraoperative staff members including registered nurses and scrub technicians and (b) pediatric patients receiving intraoperative ionizing radiation imaging. Outcome measures included pediatric intraoperative staff knowledge and confidence of education for intraoperative shielding (preimplementation: n = 9; postimplementation: n = 6). Shielding audits were performed to assess for frequency of shield placement to radiosensitive organs and accuracy of shield placement (preimplementation: n = 26; postimplementation: n = 27). Results Data analysis showed improvement in staff confidence related to gonad shield placement (p = .013) and self-reported frequency of gonad shield use (p = .032). Knowledge scores showed nonsignificant improvement (p = .076). Shielding audits showed statistically significant improvement in shield placements for thyroid, gonads, and breast tissue (p < .05). Discussion The pediatric population has unique characteristics to consider when making decisions about shielding practice. This project discusses these characteristics, considerations for “exception-based shielding,” and how to improve the rates of shielding in situations where the practice is appropriate.

Comparative measurements of surface body temperature of horses using infrared thermography

Infrared thermography is a painless, non-invasive method that can be used to improve the physiological assessment and health of the horse, and as an alternative, or in combination with other imaging methods and diagnostic procedures. The main advantage of thermography is the detection of subclinical signs of inflammation before the onset of clinical signs of pathology. The aim of this pilot study was to determine the surface body temperature of six clinically healthy horses in indoor conditions. The horses` bodies were laterally scanned on the left and right sides and were divided into the following regions: neck, shoulder, thoracic limb, back, thigh and pelvic limb. The abdominal region of the horses was scanned individually in ventral projection. The average temperature of each region was calculated. An approximately equal thermal symmetry was observed between both sides of the horse’s body.

The Impact of Downstream Procedures on Lung Cancer Screening Adherence

Objective(1) Evaluate downstream procedures after lung cancer screening (LCS), including imaging and invasive procedures, in screened individuals without screen-detected lung cancer. (2) Determine the association between repeat LCS and downstream procedures and patient characteristics. MethodsIndividuals receiving LCS between January 1, 2015, and November 30, 2020, from Optum’s deidentified Clinformatics Data Mart Database were included. Individuals with lung cancer after LCS were excluded. We determined frequency and costs of downstream procedures after LCS, including diagnostic imaging (chest CT, PET, or CT using fluorine-18-2-fluoro-2-deoxy-D-glucose imaging) and invasive procedures (bronchoscopy, needle biopsy, thoracic surgery). A generalized estimating equation was used to model repeat LCS as a function of downstream procedures and patient characteristics. The primary outcome was repeat screening within 1 year of index LCS, and a secondary analysis evaluated the outcome of repeat screening with 2 years of index LCS. ResultsIn all, 23,640 individuals receiving 30,521 LCS examinations were included in the primary analysis; 17.7% of LCS examinations (5,414 of 30,521) prompted downstream testing, with chest CT within 4 months being most common (9.1%, 2,769 of 30,521). At multivariable analysis adjusted for patient characteristics, the occurrence of a downstream diagnostic imaging test or invasive procedure was associated with a decreased likelihood of repeat annual LCS (adjusted odds ratio, 95% confidence interval: 0.38, 0.34-0.44; adjusted odds ratio, 95% confidence interval: 0.75, 0.63-0.90, respectively). DiscussionDownstream imaging and invasive procedures after LCS are potential barriers to LCS adherence. Efforts to reduce false-positives at LCS and reduce patient costs from downstream procedures are likely necessary to ensure that downstream workup after LCS does not discourage screening adherence.

Patient involvement and expectations during CT scans. Tinkering to involve patients and offer care in radiographic practice

IntroductionThis study investigated how patients expected and experienced to be put first and cared for in diagnostic imaging settings and how putting the patient first was operationalized in practice. MethodsA qualitative field study was conducted in two Danish hospitals to investigate patients’ expectations and experiences of care and involvement during CT examinations.Data collection methods included semi-structured interviews and participant observations of five examination cases. Three Computed Tomography (CT) guided lung biopsy intervention studies and two conventional CT studies of the chest of patients being investigated for lung cancer in Fast Track Cancer Referral Programs (FTCRP) were included. ResultsPatients reported low expectations of receiving care and being involved during examinations. Perceptions of receiving care predominantly consisted of being received in a kind, personalized manner. Expectations of involvement in the procedure were reported in terms of readiness to do as they were told, complying with requests put to each patient.Concepts of care and involvement were challenged in their formal meanings and found to be entangled in complex interactions within sociotechnical boundaries. ConclusionPatient's expectations of receiving care and being involved in the diagnostic imaging procedures, were expressed in noncommittal terms, and were overshadowed by patients' focus on getting through the examination, in order to get an answer to their tentative diagnose. The concepts of care and patient involvement were negotiated and reconceptualized within the sociotechnical framework of the diagnostic imaging situation of the individual patient. The concept of “tinkering” is suggested as a means of understanding how patientcare is performed during diagnostic imaging procedures. Implications for practiceIssues were identified that may help professionals to put “the patient first”, thus, improving patient centered care.

A new 124Xe irradiation system for 123I production

Since 2001, Nuclear and Energy Research Institute IPEN-CNEN has produced weekly ultrapure iodine-123, using a manual irradiation system, fully developed in IPEN. Iodine-123 radiopharmaceuticals have been produced and distributed to hospitals and clinics of nuclear medicine, where several diagnostic imaging procedures for thyroid, brain and cardiovascular functions are performed. Due to the short half-life and emission of low-energy photons, this radioisotope becomes suitable for diagnosis in children. In the present work, the technical and constructive aspects of a new fully automated irradiation system, dedicated to 123I routine production, employing enriched xenon-124 gas as the target material is presented. This new system consists of a target, a water and helium cooling system, a cryogenic system, an electric power system, and a control and process monitoring unit, composed of supervisory software, connected to a programmable logic controller via personal computer. In this new concept, there is no need for human intervention during radioisotope production, reducing the possibility of eventual failures or incidents involving radioactive material. By using this new system, a specific yield of 2.70 mCi/μAh per irradiation was achieved in validation runs, and after three years of routine production of iodine-123, the system showed reliability and resilience.

Impact of the COVID-19 pandemic on therapeutic interventional oncology procedures and diagnostic CT/MRI examinations at a German university hospital.

The COVID-19 pandemic led to the implementation of severe restrictions on public life in Germany and a reduction in the number of non-COVID patients presenting for care. The aim of this study was to measure the impact on the number of therapeutic interventional oncology procedures in relation to diagnostic imaging studies at a high-volume radiology department. The numbers of therapeutic interventional oncology procedures and diagnostic CT/MRI examinations for the years 2010 to 2021 were extracted using the hospital information system. Monthly data from January 2010 to December 2019 were used to build forecasting models for the timeframe from January 2020 to December 2021. Real procedure numbers were compared with predicted numbers to calculate residual differences, which were considered statistically significant if the real number was outside the 95 % confidence interval (p < 0.05). During the first German lockdown (March/April 2020), the number of outpatient CT/MRI examinations decreased significantly, with a less pronounced decrease of overall CT/MRI numbers. The second German lockdown (January-May 2021) led to lower than predicted outpatient CT numbers, whereas outpatient MRI numbers in part even exceeded predicted numbers and overall CT/MRI numbers stayed within confidence limits. The lockdowns had a more pronounced negative effect on the number of oncological MRI examinations compared to CT examinations. The number of therapeutic interventional oncology procedures showed no significant decrease during both lockdowns. Lockdown measures had minor impact on the number of therapeutic interventional oncology procedures, possibly due to a shift from more resource-intensive therapies like surgery towards interventional oncology. The overall numbers of diagnostic imaging decreased during the first lockdown, while the second lockdown had less negative impact. The number of oncological MRI examinations was affected most severely. To avoid adverse outcomes, specific protocols for patient management during future pandemic outbreaks should be implemented and continuously adapted. · COVID-19 lockdowns had minor effect on therapeutic interventional oncology procedures.. · Numbers of diagnostic outpatient imaging procedures dropped markedly, especially during the first lockdown.. · The number of oncological MRI examinations showed a significant decrease during both lockdowns.. · Nebelung H, Radosa CG, Schön F et al. Impact of the COVID-19 pandemic on therapeutic interventional oncology procedures and diagnostic CT/MRI examinations at a German university hospital. Fortschr Röntgenstr 2023; 195: 707 - 712.

Extended Reality in Diagnostic Imaging-A Literature Review.

The utilization of extended reality (ER) has been increasingly explored in the medical field over the past ten years. A comprehensive analysis of scientific publications was conducted to assess the applications of ER in the field of diagnostic imaging, including ultrasound, interventional radiology, and computed tomography. The study also evaluated the use of ER in patient positioning and medical education. Additionally, we explored the potential of ER as a replacement for anesthesia and sedation during examinations. The use of ER technologies in medical education has received increased attention in recent years. This technology allows for a more interactive and engaging educational experience, particularly in anatomy and patient positioning, although the question may be asked: is the technology and maintenance cost worth the investment? The results of the analyzed studies suggest that implementing augmented reality in clinical practice is a positive phenomenon that expands the diagnostic capabilities of imaging studies, education, and positioning. The results suggest that ER has significant potential to improve diagnostic imaging procedures' accuracy and efficiency and enhance the patient experience through increased visualization and understanding of medical conditions. Despite these promising advancements, further research is needed to fully realize the potential of ER in the medical field and to address the challenges and limitations associated with its integration into clinical practice.

Macrophthalmos mimics microphthalmos in an 8-month-old Great Swiss Mountain Dog

An 8-month-old Great Swiss Mountain dog was presented with a suspected right-sided microphthalmos, malformed and blind globe which was present since birth. On magnetic resonance imaging an ellipsoid macrophthalmos with absence of the normal retrobulbar tissue was detected. Histology revealed a dysplastic uvea with unilateral cyst formation associated with mild lymphohistiocytic inflammation. The ciliary body covered the posterior side of the lens unilaterally and showed focal metaplastic bone formation. Slight cataract formation as well as diffuse panretinal atrophy and intravitreal retinal detachment was evident. Preoperative diagnostic imaging procedure is recommended in eyes that clinically demonstrate as microphthalmos and are planned to be enucleated. As described in this case report the bulbus may be macrophthalmic which potentially complicates the enucleation. The performance of such a procedure at a site with ophthalmologic and soft tissue expertise is advisable. To the authors' knowledge this is the first report of a macrophthalmos with multiple ocular defects in a dog.