New compression paddle for wire localization in mammography.

Rationale And Objectives: Current wire localization compression paddles provide a limited access window with no compression in this window. We describe a new compression paddle that addresses these issues and report on preliminary patient testing.

Materials And Methods: Four mechanical engineering students collaborated with a medical physicist, a radiographer, and two radiologists.

Multi-modality CADx: ROC study of the effect on radiologists' accuracy in characterizing breast masses on mammograms and 3D ultrasound images.

Rationale And Objectives: To investigate the effect of a computer-aided diagnosis (CADx) system on radiologists' performance in discriminating malignant and benign masses on mammograms and three-dimensional (3D) ultrasound (US) images.

Materials And Methods: Our dataset contained mammograms and 3D US volumes from 67 women (median age, 51; range: 27-86) with 67 biopsy-proven breast masses (32 benign and 35 malignant). A CADx system was designed to automatically delineate the mass boundaries on mammograms and the US volumes, extract features, and merge the extracted features into a multi-modality malignancy score.

Academic radiology and the emergency department: does it need changing?

Rational And Objectives: The increasing importance of imaging for both diagnosis and management in patient care has resulted in a demand for radiology services 7 days a week, 24 hours a day, especially in the emergency department (ED). We hypothesized the resident preliminary reports were better than generalist radiology interpretations, although inferior to subspecialty interpretations.

Materials And Methods: Total radiology volume through our Level I pediatric and adult academic trauma ED was obtained from the radiology information system.

Contrast-enhanced CT accurately detects hemorrhage in torso trauma: direct comparison with angiography.

Objective: To assess the ability of contrast enhanced computed tomography (CECT) to detect active hemorrhage and other vascular injuries in chest, abdominal, and pelvic trauma patients, using angiographic findings and need for intervention as paired gold standards.

Methods: We obtained approval from the Institutional review board for a retrospective search of the radiology information system: seeking trauma patients undergoing angiography within 24 hours of CECT for chest, abdominal, or pelvic injuries. CECT protocol was standard trauma CT, not specialized for CT angiography.

Costs of achieving high patient compliance after recall from screening mammography.

Objective: The purpose of our study was to document the hidden costs in achieving high recall patient compliance from an off-site screening mammography program.

Materials And Methods: This study was approved by our institutional review board. At our institution, no patient was placed in final BI-RADS assessment category 3, 4, or 5 without a diagnostic study.

Malignant and benign breast masses on 3D US volumetric images: effect of computer-aided diagnosis on radiologist accuracy.

Purpose: To retrospectively investigate the effect of using a custom-designed computer classifier on radiologists' sensitivity and specificity for discriminating malignant masses from benign masses on three-dimensional (3D) volumetric ultrasonographic (US) images, with histologic analysis serving as the reference standard.

Materials And Methods: Informed consent and institutional review board approval were obtained. Our data set contained 3D US volumetric images obtained in 101 women (average age, 51 years; age range, 25-86 years) with 101 biopsy-proved breast masses (45 benign, 56 malignant).

Effects on breast MRI of artifacts caused by metallic tissue marker clips.

Objective: The purpose of our study was to investigate MR artifacts related to tissue marker clips used in breast imaging procedures.

Materials And Methods: Breast phantoms were created using gelatin doped with gadolinium. Four commercially available tissue marker clips were evaluated.

Mammographic density measured with quantitative computer-aided method: comparison with radiologists' estimates and BI-RADS categories.

Purpose: To retrospectively compare computer-aided mammographic density estimation (MDEST) with radiologist estimates of percentage density and Breast Imaging Reporting and Data System (BI-RADS) density classification.

Materials And Methods: Institutional Review Board approval was obtained for this HIPAA-compliant study; patient informed consent requirements were waived. A fully automated MDEST computer program was used to measure breast density on digitized mammograms in 65 women (mean age, 53 years; range, 24-89 years).

Breast masses: computer-aided diagnosis with serial mammograms.

Purpose: To retrospectively evaluate effects of computer-aided diagnosis (CAD) involving an interval change classifier (which uses interval change information extracted from prior and current mammograms and estimates a malignancy rating) on radiologists' accuracy in characterizing masses on two-view serial mammograms as malignant or benign.

Materials And Methods: The data collection protocol had institutional review board approval. Patient informed consent was waived for this HIPAA-compliant retrospective study.

ROC study of the effect of stereoscopic imaging on assessment of breast lesions.

An observer performance study was conducted to evaluate the usefulness of assessing breast lesion characteristics with stereomammography. Stereoscopic image pairs of 158 breast biopsy tissue specimens were acquired with a GE Senographe 2000D full field digital mammography system using a 1.8x magnification geometry.

Improvement in radiologists' characterization of malignant and benign breast masses on serial mammograms with computer-aided diagnosis: an ROC study.

Purpose: To evaluate the effects of computer-aided diagnosis (CAD) on radiologists' characterization of masses on serial mammograms.

Materials And Methods: Two hundred fifty-three temporal image pairs (138 malignant and 115 benign) obtained from 96 patients who had masses on serial mammograms were evaluated. The temporal pairs were formed by matching masses of the same view from two different examinations.

An observer study comparing spot imaging regions selected by radiologists and a computer for an automated stereo spot mammography technique.

We are developing an automated stereo spot mammography technique for improved imaging of suspicious dense regions within digital mammograms. The technique entails the acquisition of a full-field digital mammogram, automated detection of a suspicious dense region within that mammogram by a computer aided detection (CAD) program, and acquisition of a stereo pair of images with automated collimation to the suspicious region. The latter stereo spot image is obtained within seconds of the original full-field mammogram, without releasing the compression paddle.

Computerized characterization of breast masses on three-dimensional ultrasound volumes.

We are developing computer vision techniques for the characterization of breast masses as malignant or benign on radiologic examinations. In this study, we investigated the computerized characterization of breast masses on three-dimensional (3-D) ultrasound (US) volumetric images. We developed 2-D and 3-D active contour models for automated segmentation of the mass volumes.

Sensitivity of noncommercial computer-aided detection system for mammographic breast cancer detection: pilot clinical trial.

Purpose: To evaluate a noncommercial computer-aided detection (CAD) program for breast cancer detection with screening mammography.

Materials And Methods: A CAD program was developed for mammographic breast cancer detection. The program was applied to 2,389 patients' screening mammograms at two geographically remote academic institutions (institutions A and B).

Pulmonary involvement in pediatric lymphoma.

Background: The prevalence of pulmonary lymphoma in the pediatric age group is not documented in the literature.

Objective: This study was designed to assess the prevalence of pulmonary parenchymal lymphoma in children with Hodgkin disease (HD), non-Hodgkin lymphoma (NHL) and post-transplant lymphoproliferative disorder (PTLD).

Materials And Methods: A 10-year retrospective analysis of 161 lymphoma patients (62 girls and 99 boys), mean age of 12.

Pediatric renal pelvic fullness: an ultrasonographic dilemma.

Purpose: We conducted a prospective study to define normal renal pelvic size in children.

Materials And Methods: Institutional Review Board approved consent was obtained to perform renal ultrasound during excretory urography (IVP) scheduled for medical management. Mean patient age (17 females, 11 males) was 5.

The effect of screening sonography on the positive rate of enemas for intussusception.

Background: The referring physicians at our institution used the enema as a diagnostic test in children with suspected intussusception.

Objective: To determine the change in rate of positive enema findings performed for suspected intussusception with the intervention of screening ultrasound (US).

Materials And Methods: Since October 1995, 224 children (mean age 2.

Computed tomographic diagnosis of unsuspected pyelonephritis in children.

Objective: To emphasize the utility of computed tomography (CT) in the diagnosis of pyelonephritis in children with complex comorbidities.

Methods: We retrospectively reviewed the CT imaging studies and medical records of 12 patients (8 girls, 4 boys; aged 2-18 years [mean 8.6 yr]) who did not have a classic presentation of pyelonephritis but were diagnosed by CT.

Decreasing rate of fatty involution at screening mammography.

Rationale And Objectives: This study was performed to document the perceived decrease in fatty involution at screening mammography during the past decade and evaluate the influence of hormone replacement therapy (HRT).

Materials And Methods: In December 1996, the mammograms of 261 consecutive screening patients with a comparison study obtained 5 years earlier were evaluated, and their breasts were categorized according to Breast Imaging Reporting and Data System categories for breast density. The women, aged 50-59 years, included 119 who had been receiving HRT for 0.

Continuous quality improvement process to track lost radiographs and reduce losses.

Objective: To describe a quality improvement process that was initiated in a Department of Radiology to reduce the number of incomplete or "lost" imaging studies and decrease the time from the initiation of an imaging study to printing of the final report.

Methods: Incomplete cases were defined as those imaging studies that did not have a signed final report more than 3 days and less than 90 days after imaging. A computer program was written to generate a monthly incomplete case list from the radiology information system database; each step in the process, from patient arrival to final report printing, was analyzed and a list of root causes (for the incomplete cases) was developed.

Digital mammography: observer performance study of the effects of pixel size on the characterization of malignant and benign microcalcifications.

Rationale And Objectives: The authors performed this study to evaluate the effects of pixel size on the characterization of mammographic microcalcifications by radiologists.

Materials And Methods: Two-view mammograms of 112 microcalcification clusters were digitized with a laser scanner at a pixel size of 35 microm. Images with pixel sizes of 70, 105, and 140 microm were derived from the 35-microm-pixel size images by averaging neighboring pixels.

Journal publications in radiologic education: a review of the literature, 1987-1997.

Rationale And Objectives: This study was designed to analyze articles on radiologic education quantitatively and qualitatively, comparing those published in 1987-1997 with those published in 1966-1986.

Materials And Methods: An initial literature search used four major databases to identify and retrieve articles related to radiologic education. Additional articles were identified through manual cross-checking of references from the original articles.

Congenital cystic adenomatoid malformation: impact of prenatal diagnosis and changing strategies in the treatment of the asymptomatic patient.

Objective: This study was designed to assess the effect of prenatal sonographic diagnosis on the treatment of congenital cystic adenomatoid malformation of the lung.

Materials And Methods: The medical records of 27 patients with pathologically proven congenital cystic adenomatoid malformations were retrospectively reviewed. Patients were divided into four groups based on mode of presentation: with or without abnormal findings on prenatal sonography and with or without symptoms at birth.

Limitations of student evaluations of curriculum.

Rationale And Objectives: Medical student surveys are used extensively in the development and modification of curriculum. The purpose of this study was to look at medical student surveys of a radiology lecture series, evaluating the accuracy of student perceptions of learning and factors affecting them.

Materials And Methods: After a "Case of the Week" lecture series, 156 3rd-year medical students returned a survey evaluating the experience with 10 questions on a four-point scale (1 = disagree, 4 = agree very much) and took a clinical competency assessment (CCA) examination with a radiology substation.