Radiology Centers Research Articles

Estimation of Age Using Kvaal Technique Based on Cone-beam Computed Tomography Images of Mandibular Canine Teeth in Bojnourd

Background and Objective: Identifying age in anthropology and forensic medicine and examining the proper development of children and adolescents is important. Age estimation techniques using teeth are of particular value. This study tends to evaluate the accuracy of age estimation by Kvaal technique using CBCT images of mandibular canine teeth in a sample of Iranian population. Materials and Methods: In this crossvalidation study, data from 140 samples of records of patients aged 15 years and older, during 2018-2019, available at a private oral and maxillofacial radiology center in Bojnourd was used. The parameters used in Kvaal technique were measured in mandibular canine teeth on CBCT images of patients. Results: Using multiple linear regression model to correlate parameters of Kvaal technique based on CBCT images of mandibular canine teeth and age with stepwise method showed that variables pulp length/root length, pulp width/root width in the middle, length teeth/root length were significant in predicting age (p<0.05 in all 3 cases). According to the above method, age = 551/5-500 (M) was obtained which was able to estimate age in 35% of the samples. The mean age of the patients was estimated to be 7.9 years, which is acceptable. Conclusion: Kvaal formula was significant for use in Iranian population. The regression formula obtained from the control group could also be generalized to the test group.

TOWARD NATIONAL CT DIAGNOSTIC REFERENCE LEVELS IN THE UNITED ARAB EMIRATES: A MULTICENTER REVIEW OF CT DOSE INDEX AND DOSE LENGTH PRODUCT.

This multicenter study evaluated computed tomography dose index volume (CTDIvol) and dose length product (DLP) to contribute to establishing computed tomography (CT) national diagnostic reference levels (NDRLs) in the United Arab Emirates (UAE). Data from 240 patients, who underwent CT head, chest, abdomen-pelvis and urography examinations, were analyzed, including patient age, sex and weight, CTDIvol (mGy) and DLP (mGy cm). The proposed DRLs for each examination were calculated as the third quartile. DRLs are proposed using CTDIvol (mGy) and DLP (mGy cm) for CT head (67 and 1189, respectively), chest (8 and 302, respectively), abdomen-pelvis (28 and 1122, respectively) and urography (20 and 714, respectively). These values are comparable with the initial NDRLs and published international DRLs. Baseline values for International Radiology Center (IRC) CT DRLs were calculated on frequently performed CT examinations. Implementation of DRL values improves dose optimization based on procedures, scanner type and patient characteristics while maintaining acceptable image quality and diagnostic confidence.

COVID-19 impact assessment on the French radiological centers: a nationwide survey.

PurposeTo determine the impact of the COVID-19 on the CT activities in French radiological centers during the epidemic peak.Materials and methodsA cross-sectional prospective CT scan survey was conducted between March 16 and April 12, 2020, in accordance with the local IRB. Seven hundred nine radiology centers were invited to participate in a weekly online survey. Numbers of CT examinations related to COVID-19 including at least chest (CTcovid) and whole chest CT scan activities (CTchest) were recorded each week. A sub-analysis on French departments was performed during the 4 weeks of the study. The impact of the number of RT-PCRs (reverse transcriptase polymerase chain reactions) on the CT workflow was tested using two-sample t test and Pearson’s test.ResultsFive hundred seventy-seven structures finally registered (78%) with mean response numbers of 336 ± 18.9 (323; 351). Mean CTchest activity per radiologic structure ranged from 75.8 ± 133 (0–1444) on week 12 to 99.3 ± 138.6 (0–1147) on week 13. Mean ratio of CTcovid on CTchest varied from 0.36 to 0.59 on week 12 and week 14 respectively. There was a significant relationship between the number of RT-PCR performed and the number of CTcovid (r = 0.73, p = 3.10−16) but no link with the number of positive RT-PCR results.ConclusionIn case of local high density COVID-19, CT workflow is strongly modified and redirected to the management of these specific patients.Key Points • Over the 4-week survey period, 117,686 chest CT (CT total ) were performed among the responding centers, including 61,784 (52%) CT performed for COVID-19 (CT covid ). • Across the country, the ratio CTcovid/CTtotal varied from 0.36 to 0.59 and depended significantly on the local epidemic density (p = 0.003). • In clinical practice, in a context of growing epidemic, in France, chest CT was used as a surrogate to RT-PCR for patient triage. Electronic supplementary materialThe online version of this article (10.1007/s00330-020-07035-w) contains supplementary material, which is available to authorized users.

Computed tomographic pattern of intracerebral calcifications in a radiology center in Benghazi, Libya

Abstract Background: Intracranial calcification (ICC) is frequently seen in noncontrast computed tomography (NCCT) in both adult and pediatric populations. Aim: We performed this study in order to illustrate and provide data regarding the CT pattern of ICC among adult patients. Setting and Design: This was a retrospective study of patients who underwent nonenhanced CT of the brain in the radiology center in Benghazi, Libya. Materials and Methods: This was a retrospective analysis of patients who underwent NCCT of the head at a radiology center in Benghazi, Libya, from the period of May to December 2017. NCCT scan head was performed with a standardized protocol, using axial and bone window images as well as Hounsfield unit measurement for final evaluation. CT aspects of ICCs were illustrated. Data were expressed as median and ranges (numerical) or as number and percentage (categorical). Nonparametric Mann–Whitney U-test was used for comparison between unpaired groups. Results: We determined ICC in 159 patients, of which 88 (55%) were male. The median age was 66 (19–95) years. The most common site of ICC is pineal body representing 138 (86.8%), followed by choroid plexus, 136 (85.5%), falx cerebri 31 (19.5%), and basal ganglia 18 (11%). Calcification of the middle cerebral artery was seen in two patients only. Conclusions: We determined the frequency of different intracerebral calcifications in adult patients which provide new data in our setting that can be utilized in clinical use. This finding is similar to that reported in other studies.

Ultrasound diagnosis of cervical lymph node metastases in patients with first diagnosed papillary thyroid cancer and in patients previously treated surgically and admitted for radioactive iodine therapy

Purpose of the study. To evaluate the potentialities of ultrasound method in diagnosing cervical lymph node metastasis in patients with first diagnosed papillary thyroid cancer (group 1) and in patients previously treated surgically at different clinics of the Russian Federation and subsequently admitted to the A.F.Tsyb Medical Radiological Research Center — Branch of the National Medical Research Radiological Center to receive radioactive iodine therapy (group 2).Patients and methods. Patients with PTC were divided into two groups. Group 1 included 649 patients with first diagnosed PTC. All the patients underwent thyroidectomy and level VI lymph node neck dissection at the clinic of the A.F.Tsyb Medical Radiological Research Center — Branch of the National Medical Research Radiological Center. Of these patients, 92 patients underwent cervical lymph node dissection including levelsII–III–IV and 9 patients underwent cervical lymph node dissection including level VB. Group 2 consisted of 2875 patients who had previously received surgery at different clinics of the Russian Federation. Subsequently, they were admitted to our institution to receive radioactive iodine therapy. In 291 of these patients, cervical lymph node metastases were found and reoperations were performed: in 89 cases at level VI, in 170 cases at levels II–III–IV and in 32 cases at level VB. The detected metastases were verified histologically.Results. Histology confirmed the presence of nodal metastasis in 57.6% of 649 patients in group 1, and in 10.1% of 241 patients in group 2. In group 1, the incidence of metastatic disease in level VI nodes was 73% and in group 2, it was 30.6%. Metastases in levels II–III–IV were noted in 24.6% of patients in group 1, and in 58.4% of patients in group 2. Level VB metastasis was found in 2.4% of patients in group 1, and in 11% of patients in group 2. Multiple metastases were detected in 75.4% of patients in group 1, and in 20.3% of patients in group 2.Conclusion. Central lymph node metastasis was observed in 73% of patients who were first diagnosed with PTC and treated with thyroidectomy and prophylactic level VI cervical lymph node dissection. In group 2, solitary metastases to lateral lymph nodes occurred more frequently after surgical treatment for PTC, which suggested that the primary treatment was insufficiently radical.

Organization of a Fine-Needle Aspiration Clinic With Cytopathologist-Radiologist Cooperation: An Alternative Way to Rome.

Journal of Ultrasound in MedicineVolume 40, Issue 1 p. 183-185 Commentary Organization of a Fine-Needle Aspiration Clinic With Cytopathologist-Radiologist Cooperation An Alternative Way to Rome Nadir Paksoy MD, MIAC, Corresponding Author Nadir Paksoy MD, MIAC nadirpaksoy@gmail.com orcid.org/0000-0001-6913-1496 Cytopathology/Fine-Needle Aspiration Private Practice, Izmit, Kocaeli, TurkeyAddress correspondence to Nadir Paksoy, MD, MIAC, Cytopathology/Fine-Needle Aspiration Private Practice, Hurriyet Caddesi 125/17, 41300 Izmit, Kocaeli, Turkey. E-mail: nadirpaksoy@gmail.comSearch for more papers by this authorKadri Yazal MD, Kadri Yazal MD Private Konrad Radiology Center, Izmit, Kocaeli, TurkeySearch for more papers by this author Nadir Paksoy MD, MIAC, Corresponding Author Nadir Paksoy MD, MIAC nadirpaksoy@gmail.com orcid.org/0000-0001-6913-1496 Cytopathology/Fine-Needle Aspiration Private Practice, Izmit, Kocaeli, TurkeyAddress correspondence to Nadir Paksoy, MD, MIAC, Cytopathology/Fine-Needle Aspiration Private Practice, Hurriyet Caddesi 125/17, 41300 Izmit, Kocaeli, Turkey. E-mail: nadirpaksoy@gmail.comSearch for more papers by this authorKadri Yazal MD, Kadri Yazal MD Private Konrad Radiology Center, Izmit, Kocaeli, TurkeySearch for more papers by this author First published: 12 June 2020 https://doi.org/10.1002/jum.15370 This work was presented in part by Dr Paksoy at the 42nd European Congress of Cytology; June 16–19, 2019; Malmössan, Malmö, Sweden; during the Symposium of Interventional Cytopathology. All of the other authors of this article have reported no disclosures. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume40, Issue1January 2021Pages 183-185 RelatedInformation

Abstract D125: Disparities in cervical cancer mortality across the Siberian related ethnic regions: The Republic of Sakha, the Republic of Khakassia, Buryatia, the Altai Republic, and Tuva (2007-2017)

Abstract Introduction. Cervical cancer mortality (CCM) varies throughout Russia, including Siberia. Nevertheless, disparities in CCM of Siberian native ethnic population have not yet been investigated. The objective of this study was to determine the differences of CCM during 2007-2017 in Siberian regions, where gene related ethnic groups live – the Republic of Sakha (Sakha), Buryatia, the Republic of Khakassia (Khakassia), the Altai Republic (Altai) and Tuva. Four out of these five regions, except for Sakha, geographically located in the south of Siberia. Sakha is located in the northern part of Siberia. Methods. Annual mortality rates from cervical cancer were analyzed from 2007 to 2017. This data was obtained from the annual reports entitled “Malignant neoplasms in Russia (incidence and mortality)” of P. Hertzen Moscow Oncology Research Institute - branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation. Age-adjusted mortality rates (per 100,000 populations) were compared for each region - Sakha, Buryatia, Khakassia, Altai and Tuva. Kruskal-Wallis H-test was used to determine the statistically significant differences in CCM variances of three or more regions and Mann-Whitney U test for two regions. T-test was used to determine the statistically significant differences in paired CCM rates. Differences with a probability less than the significance level of 0.05 were considered as a statistically significant. Results. Comparisons showed CCM heterogeneity between all five regions of Siberia. The highest CCM rates from 2007 to 2017 were found in Buryatia - the average value of CCM rates (avCCM) is 11.46. CCM rates in this region from 2007 to 2017 were significantly higher than in all other regions, except for the Tuva. The lowest mortality rates during the observed timeframe were detected in Sakha, avCCM - 5.82. Mortality rates in Sakha during this timeframe were significantly lower compared to the other four regions. CCM rates comparison of Altai (avCCM - 9.85), Tuva (avCCM - 9.62) and Khakassia (avCCM - 7.76) did not reveal the significance of the differences between these three regions (although was close to significance). But when paired comparison of CCM variances was used, the CCM rates in Tuva were significantly higher than in Khakassia. When all regions’ CCM rates in 2007 to 2017 were compared, then no significant changes of four regions, except for Altai, were found. In the Altai, compared to 2007, the mortality rate in 2017 significantly decreased, about 2 times (7.61 vs. 15.97). Conclusion. Despite the genetic relationships of the native ethnic populations of Siberia, CCM in the analyzed regions between 2007 and 2017 differs. The highest CCM were observed in Buryatia. The lowest mortality rates were detected in Sakha. CCM rates for the Altai, Tuva and Khakassia were not significantly different. CCM in the Altai in 2007 compared to 2017 decreased twice. The same comparison in Sakha, Khakassia, Buryatia and Tuva showed no changes. Citation Format: Irina V. Kononova, Sargylana N. Mamaeva, Maria P. Kirillina, Petr V. Nikiforov. Disparities in cervical cancer mortality across the Siberian related ethnic regions: The Republic of Sakha, the Republic of Khakassia, Buryatia, the Altai Republic, and Tuva (2007-2017) [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr D125.

Sternal Variation: Anatomical-Forensic Analysis

Background&#x0D; The aim of this study was to analyze the extent and uniqueness of anatomical variations of the sternum bone, to assess its applicability for forensic analysis, especially for individual human identification.&#x0D; Methods and Findings&#x0D; Evaluations involved 501 computer tomography scans performed at the Medical Radiology Center, Manaus city, Amazonas, Brazil, and 427 skeletons belonging to the Collection of Identified Human Skeletons of the Center for Studies in Forensic Anthropology (CEAF), of the University of Pernambuco (UPE), Pernambuco, Brazil. Forms of morphological variations were evaluated, including the presence of foramina, fissures, and incomplete total or partial fusions, as well as forms of xiphoid process termination, and the presence of surgical sutures. Overall, summing computed tomographic images and skeletons, the sternal foramen was present in some 23% of samples, with a greater proportion in males (14%), while in females the frequency was 8.6%.&#x0D; Conclusions&#x0D; The qualitative analysis of the sternum bone is simple to apply and represents an important potential source of information in a human identification process.

Interventional Radiology Procedures for COVID-19 Patients: How we Do it.

With astonishing speed, COVID-19 has become a global pandemic. As it is uncertain when the pandemic will be controlled, it is crucial for procedurists of all stripes to be familiar and confident in performing procedures for COVID-19 patients to prevent intra-hospital infection. In this article, we will detail our approach on how to perform interventional procedures for COVID-19 patients at the bedside in the isolation room and with the patient transferred to the interventional radiology centre. These workflows have been developed in conjunction with multiple other stakeholders within our hospital, drawing from valuable lessons we have learnt from the SARS outbreak of 2003.

The use of rocks in lieu of bricks and concrete as radiation shielding barriers at low gamma and nuclear medicine energies

Occupational and public radiation exposure could be minimized with the use of rocks. Rocks are relatively high-density materials, which could be used as a protective shielding barrier at facilities where ionizing radiation is used. These can include medical diagnostic radiology (Dental, Mammography, General and CT) and nuclear medicine (NM) centers. There is need to know potential shielding capabilities of rocks at low gamma and nuclear medicine energies; and compare with brick and concrete. In the present study, mass attenuation coefficients (MACs), effective atomic number (EAN) and effective electron density (EED) of the different rock samples were determined using WinXCom computer program and other relevant equations at 20, 30, 40, 60, 140 (Tc-99 m) and 364 keV (I-131). The results were compared with that of concrete and brick at the energies of interest. The result of this work shows that rocks are better used instead of concrete and brick at 20, 30, 40 and 60 keV. At 140 and 364 keV, all the considered materials performed nearly same which implies all could be used while the optimum considering all other necessary factors should be preferred.

A Stochastic Model for Prioritized Outpatient Scheduling in a Radiology Center

This paper discussed the scheduling problem of outpatients in a radiology center with an emphasis on priority. To more compatibility to real-world conditions, we assume that the elapsed times in different stages to be uncertain that follow from the specific distribution function. The objective is to minimize outpatients’ total spent time in a radiology center. The problem is formulated as a flexible open shop scheduling problem and a stochastic programming model. By considering the specific distribution function for uncertain variables, deterministic mixed integer linear programming (MILP) is developed such that the proposed problem can be solved by a linear programming solver in small size. Besides an effective heuristic method is proposed for the moderate size problem. To indicate the applicability of the proposed model, it has been applied to a real radiology center. The results from the proposed optimization models indicate an increase in outpatients’ satisfaction, as well as the improving of the efficiency and productivity of the radiology center.

MP42-15 WHICH IS THE VALUE OF A NEGATIVE MPMRI IN RULING OUT ADVERSE PATHOLOGICAL OUTCOMES AT RADICAL PROSTATECTOMY? A RETROSPECTIVE ANALYSIS ON 212 PROSTATIC LOBES

You have accessJournal of UrologyImaging/Radiology: Uroradiology II (MP42)1 Apr 2020MP42-15 WHICH IS THE VALUE OF A NEGATIVE MPMRI IN RULING OUT ADVERSE PATHOLOGICAL OUTCOMES AT RADICAL PROSTATECTOMY? A RETROSPECTIVE ANALYSIS ON 212 PROSTATIC LOBES Andrea Iseppi*, Raffaele Inzillo, Chiara Del Prete, Luca Sarchi, Beatrice Filippi, Stefano Toso, Guarino Giulio, Ahmed Eissa, Maria Chiara Sighinolfi, Stefano Puliatti, Giampaolo Bianchi, Salvatore Micali, and Bernardo Rocco Andrea Iseppi*Andrea Iseppi* More articles by this author , Raffaele InzilloRaffaele Inzillo More articles by this author , Chiara Del PreteChiara Del Prete More articles by this author , Luca SarchiLuca Sarchi More articles by this author , Beatrice FilippiBeatrice Filippi More articles by this author , Stefano TosoStefano Toso More articles by this author , Guarino GiulioGuarino Giulio More articles by this author , Ahmed EissaAhmed Eissa More articles by this author , Maria Chiara SighinolfiMaria Chiara Sighinolfi More articles by this author , Stefano PuliattiStefano Puliatti More articles by this author , Giampaolo BianchiGiampaolo Bianchi More articles by this author , Salvatore MicaliSalvatore Micali More articles by this author , and Bernardo RoccoBernardo Rocco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000891.015AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Multiparametric Magnetic resonance imaging (mpMRI) has gained increasingly acceptance for the detection of clinically significant prostate cancer (PCa). Targeting approaches using mpMRI directed biopsies are currently under investigation. The aim of the current study is to evaluate the diagnostic accuracy to detect csPCa of mpMRI targeted plus saturation sampling compared to saturation sampling alone; furthermore, we aim to assess the value of a negative mpMRI to rule out adverse pathological outcomes at radical prostatectomy (RP). To that purpose, we performed a side specific analysis of prostatic lobes from RP specimens METHODS: From our prospectively collected data base of > 500 mpMRI-targeted plus saturation prostate biopsy, 106 men with a PCa diagnosis who underwent radical prostatectomy were considered. mpMRI were performed at 3 different radiological centres; in case of a PIRADS >=3 lesion a targeted sampling was carried out, whereas systematic saturation sampling was performed for each lobe in all cases. 212 prostatic lobes were definitely available for analysis with respect to mpMRI findings. The primary outcome was the detection rate of csPCa at RP (ISUP >=2) for targeted plus saturation sampling compared to saturation sampling alone. As secondary endpoints, the positive predictive value and negative predictive value of mpMRI were calculated with regards to csPCa detection RESULTS: A total of 111 lobes had a csPCa, whereas 101 lobes had an ISUP 1. 163 lobes were pT2, 49 had extracapsular extension of PCa. 63,6% (135/212) prostatic lobes had a positive mpMRI and underwent targeted + saturation sampling, whereas the remaining 77 lobes (36,4%) were negative and had only saturation biopsy. The detection rate of csPCA was 55% (75/135) for mpMRI positive lobes and 46,7% (36/77) for mpMRI negative lobes (p=0,217). A pT3 was evident in 5 lobes with a negative mpMRI (6,4%). Positive predictive value of mpMRI was 55,5%; negative predictive value to rule out csPCa was 53,2%. Targeted biopsy of a single mpMRI-positive lobe would have missed 36/111 (32,4%) lobes with csPCa CONCLUSIONS: In our subgroups of patients with PCa managed with RP, the detection rate of csPCa did not differ significantly between targeted plus saturation and saturation sampling alone. If only a targeted approach is performed, the low predictive value of a negative mpMRI may account for an underestimation of tumor burden and extension. Since surgical tailoring is based on pre-operative assessment of local staging and the dissection relies on the knowledge of the side specific amount of PCa, mpMRI with targeted sampling alone can adversely affect surgical success and oncologic outcome Source of Funding: No © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e609-e609 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrea Iseppi* More articles by this author Raffaele Inzillo More articles by this author Chiara Del Prete More articles by this author Luca Sarchi More articles by this author Beatrice Filippi More articles by this author Stefano Toso More articles by this author Guarino Giulio More articles by this author Ahmed Eissa More articles by this author Maria Chiara Sighinolfi More articles by this author Stefano Puliatti More articles by this author Giampaolo Bianchi More articles by this author Salvatore Micali More articles by this author Bernardo Rocco More articles by this author Expand All Advertisement PDF downloadLoading ...

Financial efficiency estimation for a dental radiology laboratory.

Background and aimsConsidering nowadays trend among dentists to install a radiology laboratory beside their current practice, we proposed to investigate the aspect of financial efficiency related to such investment.MethodsWe evaluate two existing options: simple investment, consisting of intra-oral equipment and accessories, or investment in a radiology center that includes panoramic and CBCT equipment. The initial investment includes equipment acquisition, fitting out of the location, radiology accreditation and other miscellaneous expenses. Costs were estimated based on current quotations on the specific market available in Romania. We also described a financial model to estimate the financial risk.ResultsThe analysis was made under the assumptions that the laboratory is operated by the dentist who made the investment in the form of a legal person and paying corporate tax like all Romanian entities. The analysis took into account current fees for different types of X-rays, usual expenses of such a laboratory, and describes the approach to this analysis, starting with the initial investment estimation and forecast of revenues and expenses. Based on these projections and assessment of the working capital, we have built the cash flows forecast. Following a risk analysis we could assess the financial efficiency of the two investment alternatives.ConclusionsOur study reveals that the radiology center represents a more profitable investment due to the higher economic return rate.

Schnelle MRT-Sequenzen für die akute neurologische Abklärung

Neurological symptoms account for approximately 30% of emergency room (ER) visits. Clinical outcome often relies on atimely diagnosis and treatment initiation. Clinical imaging requirements are fast availability and high diagnostic value. Availability and quality of magnetic resonance imaging (MRI) in emergency rooms outside of core hours are limited compared to computed tomography (CT). Common reasons are infrastructural accessibility (hospitals using outpatient radiology centers), alack of experienced and qualified staff and high patient compliance requirements. However, in aneurological emergency setting, MRI may show relevant advantages over CT in certain areas, such as diagnosis of stroke. Advances in MRI technology have led to shorter exam times and robust motion reduction strategies. Common fast sequences and time reduction techniques for imaging of neurological emergencies are presented in this article. Recommendations for specific sequences or techniques depend on the institute's MRI hardware and software components. If available, parallel imaging is highly recommended for imaging of neurological emergencies. Imaging of neurological emergencies requires fast, significant and motion insensitive standard acquisitions. Additional sequences should be acquired dependent on clinical and standard protocol imaging findings. An MRI emergency protocol is introduced for the most common neurologic emergencies including recommendations for fast MRI sequences and techniques for imaging time reduction.

Assessing the Burden of Packaging and Recyclability of Single-Use Products in Interventional Radiology.

With a shift to single-use products in interventional radiology (IR) centres for sterility and cost reasons, it is prudent to consider the burden of packaging and employ efforts to assess and reduce waste, as well as promote recycling wherever possible. This study aimed to quantify the amount of waste in IR packaging and what proportion is recyclable. A range of IR products were weighed using mass scales. Products were assessed for total weight, overall waste, and potentially recyclable waste. Waste was defined as any packaging which was not considered vital to the product to perform its duty and thus was for packaging or shipping purposes. Products were pooled into one of the following categories: catheters and sheaths, wires, needles, devices, coils, and packs/ancillary. Seventy-two different products were collected from 26 manufacturers to represent a range of items. The weight of all products was 12,466g (median 51, range 2-1600), and weight of waste was 6830.7g (median 34, range 1.1-732). The weight of recyclable waste was 5202.2g (median 11.5, range 0-701). There were median 2 waste packages per item (range 1-5). The proportion of waste of the overall weight was 54.8% and of this, 76% of all waste was potentially recyclable. There is a significant burden of waste in manufactured IR products, and while a high proportion is recyclable, we encourage manufacturers of IR products and devices to consider alternative means of transport and packaging of products which will reduce the overall waste burden. Level 3.

Diagnostic Reference Levels for computed tomography in Austria: A 2018 nationwide survey on adult patients

PurposeTo define National Diagnostic Reference Levels (NDRLs) for computed tomography (CT) for Austria on adult patients. MethodIn the course of a nationwide survey on common CT-examinations between June 2018 and November 2018, datasets were requested from all Austrian hospitals and radiology centers with CT-scanners. All facilities were asked to report a minimum sample of 10 representative dose length product (DLP) values per examination type and CT-scanner, including information about scan sequences, iterative reconstruction (IR) algorithms and, if available, patient data. Examination types included into the survey were the most common CT-indications for the anatomic regions head, facial bones, thorax, abdomen and pelvis. 3rd quartiles of CT-scanner median DLPs were calculated and compared to Austrian and international NDRLs. ResultsFor 76 % of all operating CT-scanners, DLP data was submitted varying from 13 to 172 scanners per examination type. Mean year of manufacture of the CT-scanners was 2011, ranging from 2003 to 2018. In 66 % of the examinations, IR was used. 3rd quartile is on average 21 % lower for scanners using IR algorithms as opposed to scanners or protocols not using IR. In the case of gender differences, the DLP for females is on average 17 % lower than for males. ConclusionsThe new recommendations for CT NDRLs for Austria based on a nationwide survey are on average 13 % lower than the current Austrian NDRLs and correspond well to recent German and Swiss NDRLs. 3rd quartiles for DLP are dependent on gender, the use of IR and year of manufacture of the CT-scanners.

Skeletal open bite cranial base characteristics in young Latin-American individuals with class I, II and III malocclusions: An observational study

This study aimed to compare cranial base linear and angular measurements between individuals with skeletal open bite and different sagittal skeletal relationships. This observational and cross-sectional study included 101 lateral radiographs of young Latin-American individuals with skeletal open bite that met the inclusion criteria and were collected from a private radiological centre. Three groups were formed. Groups 1, 2 and 3 included individuals with skeletal open bite (negative overbite and FMA>30°) and Class I (n=31), II (n=35) and III (n=35) sagittal skeletal relationship, respectively. The anterior and posterior cranial bases (SN and SBa), and cranial base angles (BaSN and ArSN) were measured. Groups were compared with one-way analysis of variance and post-hoc Scheffé tests. The influence of predictor variables on the cranial base were evaluated with linear regressions (α=0.05). The cranial base angles were significantly smaller (approximately 3° to 5°) in the skeletal open bite Class III group (BaSN=127.97°±5.86°, ArSN=120.19°±6.12°) when compared with the other groups. BaSN angle, Class I versus Class III (p<0.001) and Class II versus Class III (p<0.001). ArSN angle, Class I versus Class III (p=0.005) and Class II versus Class III (p=0.026). Multiple linear regressions showed that sex had a significant influence on both cranial base dimensions with men showing larger values than women. Skeletal open bite Class III individuals show a smaller cranial base angle than Skeletal open bite Class I or II individuals.

Background Ionization Radiation in Radiography Centers in Ahvaz, Iran

Background: Exposure to ionizing radiation has harmful health effects. Research shows that people spend more their time indoors than outdoors. Therefore, the indoor background ionizing radiation can pose a noticeable health risk. Objectives: Since it is well established that ionizing radiation can lead to serious health problems, the present study aimed to evaluate the level of ionizing radiation in the background environment in radiological centers in Ahvaz, Iran. Methods: The evaluation of indoor and outdoor background ionizing radiation levels was carried out by using the calibrated digital Geiger-Muller counter (S.E. International Inc., USA) in five radiography centers. The background radiation was measured both indoor and outdoor of the selected radiology centers in four locations. The measured locations included behind the door of the X-ray room, outdoor, waiting room for the people, and the reception section in each center. The measurements were done with a device held one meter above the floor. Results: The indoor radiation levels were 0.13 ± 0.004, 0.11 ± 0.004, 0.13 ± 0.004, 0.16 ± 0.007, and 0.16 ± 0.006 µSv/h for centers a, b, c, d, and e, respectively, and the outdoor radiation levels were 0.12 ± 0.02, 0.11 ± 0.01, 0.10 ± 0.00, 0.12 ± 0.01, and 0.13 ± 0.00 µSv/h, respectively. Conclusions: The mean equivalent dose in this study was lower than the standard level (1 mSv/y); therefore, the radiology centers were safe.

Evaluation of Ionizing Radiation in Five Private Radiology Centers in Khuzestan

Background: Nowadays ionizing radiation is widely used in medicine, research and industry. In medicine, ionizing radiation is used to diagnose diseases and in high doses to treat diseases such as cancer. Undoubtedly, most exposure to artificial sources is in the field of medical and diagnostic radiology. Therefore, practitioners in the field of diagnostic radiography and patients are exposed to ionizing radiation and its risks. On the other hand, despite the advantages and efficacy of diagnostic radiation in the medical field, overall less attention is paid to optimizing and controlling protection in medical radiation. Therefore, the aim of this study was to evaluate the background ionizing radiation in Ahwaz diagnostic radiography centers. Methods: Ionization radiation levels were measured in and out of each center using gamma spectroscopy (Radiation Alert Inspector-EXP 15109) at a, b, c, d and e radiographic centers within one meter above the Earth's surface. Radiation levels within each center were measured at four locations (outside of center, secretary desk, and patient waiting room and behind the radiology room) both in X-ray machine operating and non-operating condition. The obtained data were analyzed by SPSS software. Results: The inside ionization radiation dose in a, b, c, d and e radiographic centers were 0.121, 0.119, 0.126, 0132 and 0.128 μSv/h respectively. The outside ionization radiation dose in a, b, c, d and e radiographic centers were 0.094, 0.092, 0.093, 0.112 and 0.101 μSv/h respectively. Equivalent annual dose within and outside selected radiology centers were lower than the threshold (1 mSv / year). Conclusion: The results show that the ionizing radiation dose of the X-ray equipment examined in the radiology centers of Ahwaz is lower than the global standard.

Evaluation of maxillary sinus anatomical variations and lesions: A retrospective analysis using cone beam computed tomography

IntroductionThe residual bone height in the posterior edentulous maxilla is frequently limited by the maxillary sinuses. Sinus floor elevation (SFE) is then considered to restore sufficient bone height. The preoperative analysis of the maxillary sinus is necessary for the success of this surgery. Therefore, we investigated the frequency of maxillary sinus anatomic variations and lesions by using cone beam computed tomography (CBCT). Materials and methodsWe retrospectively analysed all CBCTs performed at a private radiological center between January and November 2014. The following anatomical variations and lesions were assessed: sinus ventilation, sinus septa, the sinus totally compartmentalized, the hypoplastic sinus, sinus aplasia, the prolapsed sinus, thickness of the anterolateral wall, the position of antral artery, mucosa thickening, sinus opacity, the polyps and the cysts. ResultsA total of 300 cone beam images were analyzed. The findings consisted in: ventilation 91%, septa 34.66%, total compartmentalized sinus 6%, hypoplastic sinus 5%, aplastic sinus 0%, prolapsed sinus 1.66%, endorsed position of the antral artery 53%, submucosa position 43%, thickening of the sinus mucosa 41%, sinus opacity 4%, polyps and the cysts 20.33%. The average thickness of the anterolateral wall was about 1.16±0.48mm. ConclusionThe maxillary sinus has great interindividual anatomical variability. The cone beam is highly beneficial for the analysis of the anatomical structures in relationships with any sinus surgery.