An Optimized CT Protocol for Detecting Suspected Cauda Equina Syndrome: A Comparative Analysis with MRI.

Background And Purpose: Lumbar disc herniation, potentially leading to nerve root compression and cauda equina syndrome, is typically evaluated using MR imaging. However, the limited availability of MR imaging outside regular hours in certain health care systems poses considerable challenges. This purpose of this study was to prospectively evaluate the diagnostic accuracy of an optimized CT lumbar spine protocol as a potential alternative to MR imaging in assessing suspected neural compression.

AI-accelerated prostate MRI: a systematic review.

Background: Prostate cancer ranks among the most prevalent cancers affecting men globally. While conventional MRI serves as a diagnostic tool, its extended acquisition time, associated costs, and strain on healthcare systems, underscore the necessity for more efficient methods. The emergence of AI-acceleration in prostate MRI offers promise to mitigate these challenges.

Validating the safety of low-dose CTPA in pregnancy: results from the OPTICA (Optimised CT Pulmonary Angiography in Pregnancy) Study.

Background: Pulmonary embolism (PE) is a leading cause of pregnancy-related mortality. CT pulmonary angiogram (CTPA) is the first-line advanced imaging modality for suspected PE in pregnancy at institutes offering low-dose techniques; however, a protocol balancing safety with low dose remains undefined. The wide range of CTPA doses reported in pregnancy suggests a lack of confidence in implementing low-dose techniques in this group.

An evaluation of the practice of image-guided lumbar puncture.

Objective: The purpose of this study was to evaluate the technical success and complication rates of image-guided lumbar puncture (IGLP) and to evaluate for differences in approach employed to help establish the optimum technique.

Methods: A retrospective search of the hospital picture archiving and communications system was performed to identify all IGLPs that had taken place over a 5-year period. Radiology reports and the electronic medical record were examined to identify technical parameters and complications associated with each procedure.

Evaluation of image quality of diffusion weighted readout segmentation of long variable echo-trains MR pulse sequence for lumbosacral nerve imaging at 3T.

Background: Limited magnetic resonance (MR) pulse sequences facilitate lumbosacral nerve imaging with acceptable image quality. This study aimed to evaluate the impact of parameter modification for Diffusion Weighted Image (DWI) using Readout Segmentation of Long Variable Echo-trains (RESOLVE) sequence with opportunities for improving the visibility of lumbosacral nerves and image quality.

Methods: Following ethical approval and acquisition of informed consent, imaging of an MR phantom and twenty healthy volunteers (n=20) was prospectively performed with 3T MRI scanner.

An update on epidural steroid injections: is there still a role for particulate corticosteroids?

Epidural steroid injections (ESIs) play an important role in the multifaceted management of neck and back pain. Corticosteroid preparations used in ESIs may be considered "particulate" or "non-particulate" based on whether they form a crystalline suspension or a soluble clear solution, respectively. In the past two decades, there have been reports of rare but severe and permanent neurological complications as a result of ESI.

Breast Shielding Combined With an Optimized Computed Tomography Pulmonary Angiography Pregnancy Protocol: A Special Use-Case for Shielding?

Objectives: To determine the impact of breast shields on breast dose and image quality when combined with a low-dose computed tomography pulmonary angiography (CTPA) protocol for pregnancy.

Methods: A low-dose CTPA protocol, with and without breast shields, was evaluated by anthropomorphic phantom and 20 prospectively recruited pregnant participants from January to October 2019. Thermoluminescent dosimeters measured surface and absorbed breast dose in the phantom and surface breast dose in participants.

A Two-Stage De-Identification Process for Privacy-Preserving Medical Image Analysis.

Identification and re-identification are two major security and privacy threats to medical imaging data. De-identification in DICOM medical data is essential to preserve the privacy of patients' Personally Identifiable Information (PII) and requires a systematic approach. However, there is a lack of sufficient detail regarding the de-identification process of DICOM attributes, for example, what needs to be considered before removing a DICOM attribute.

Shelling the myth: allergies to Iodine containing substances and risk of reaction to Iodinated contrast media.

Purpose: In excess of 100 million procedures using iodinated radio-contrast media are conducted each year. There is a common misunderstanding regarding the links between allergy to iodinated substances and the risk of allergic reaction to intravenous iodinated contrast agents. These perceived risks are managed via administration of corticosteroids or avoidance of iodinated contrast altogether.

Nomenclature for groin pain in athletes.

Currently, there is much variation in the terminology used to describe groin pain in athletes. Several groups have attempted to reach consensus on nomenclature in this area. This article outlines the current status of groin pain nomenclature for the radiologist, highlighting inherent heterogeneity, recent attempts to reach a consensus, the need for a radiological consensus and why imprecise terminology should be avoided when reporting.

Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented echo-planar diffusion weighted MR neurography.

Objectives: To investigate the accuracy of Diffusion Weighted Imaging (DWI) using the Readout Segmentation of Long Variable Echo-trains (RESOLVE) sequence in detecting lumbosacral nerve abnormalities.

Methods: Following institutional ethics committee approval, patients with sciatica-type lower limb radicular symptoms (n = 110) were recruited and prospectively scanned using 3T MRI. Additional participants (n = 17) who underwent neurophysiological testing (EMG/NCV), were also prospectively studied.

Structured reporting in portable chest radiographs: An essential tool in the diagnosis of COVID-19.

Purpose: To date, the majority of chest imaging studies in COVID-19 pneumonia have focused on CT. Evidence for the utility of chest radiographs (CXRs) in this population is less robust. Our objectives were to develop a systematic approach for reporting likelihood of COVID-19 pneumonia on CXRs, to measure the interobserver variability of this approach and to evaluate the diagnostic performance of CXRs compared to real-time reverse transcription polymerase chain reaction (RT-PCR).

Pareidolia in Radiology Education: A Randomized Controlled Trial of Metaphoric Signs in Medical Student Teaching.

Objective: A radiology sign that references a resemblance to something which is not actually present within an image has been termed a 'metaphoric' sign. Metaphoric signs are widely described in the literature and commonly used in teaching as a form of pattern recognition, or 'pareidolia'. However, the educational benefit of metaphoric signs has not been previously assessed.

Complications in image-guided musculoskeletal injections.

Objective: To establish the incidence and define the nature of complications occurring following image-guided musculoskeletal injections at our institution.

Materials And Methods: All patients undergoing image-guided musculoskeletal injection during the study period (16/3/2016 to 24/01/2020) were included. Departmental records were reviewed to identify all patients describing possible complications following injection, what therapy was required (if any) and what the outcome was.

Correction to: Septal bowing and pulmonary artery diameter on computed tomography pulmonary angiography are associated with short-term outcomes in patients with acute pulmonary embolism.

The above article was published online with an error in an author's last name: It should be Muzikansky (and not Muzikanski). The correct name is presented here. The original article has been corrected.

Septal bowing and pulmonary artery diameter on computed tomography pulmonary angiography are associated with short-term outcomes in patients with acute pulmonary embolism.

Purpose: Patients with acute pulmonary embolism (PE) can quickly deteriorate and the condition has high mortality due to right ventricular (RV) failure. Immediately available predictors of adverse outcome are of major interest to the treating physician in the acute setting. The purpose of the present study was to evaluate if easily attainable measurements of RV function from the diagnostic computed tomography pulmonary angiography (CTPA) provide information for fast risk stratification in patients with acute PE.

Implementation of an acute DVT ambulatory care pathway in a large urban centre: current challenges and future opportunities.

Background: Ambulatory management of isolated acute deep venous thrombosis (DVT) is the recommended standard of care in selected populations. However, in practice a significant number of patients continue to be managed as in-patients.

Objectives: In this study we aimed to evaluate acute DVT treatment pathways in our emergency department (ED) in practice and to identify barriers to outpatient management.

Incorporating Cone-Beam CT Into the Diagnostic Algorithm for Suspected Radiocarpal Fractures: A New Standard of Care?

The purpose of this study was to assess the result of adding cone-beam CT to the standard imaging algorithm for patients with suspected radiographically occult traumatic radiocarpal fractures. A prospective review was performed on all patients who had cone-beam CT investigation of acute wrist pain after normal initial radiographs. Patients with no identified fractures were clinically reassessed and referred for MRI if concern for a fracture persisted.

The OPTICA study (Optimised Computed Tomography Pulmonary Angiography in Pregnancy Quality and Safety study): Rationale and design of a prospective trial assessing the quality and safety of an optimised CTPA protocol in pregnancy.

Background: CTPA is the gold standard investigation for evaluating suspected pulmonary embolism (PE) in the general population however is sometimes considered second line in pregnant and post-partum patients with a normal CXR due to its higher breast dose and the increased radio-sensitivity of breast tissue during this period. Guidelines advocating for scintigraphy over CTPA, however, quote significantly higher breast doses than those achievable with optimised low dose strategies. Defining the radiation dose achievable with a specific low-dose CTPA protocol is therefore imperative.

Evidenced-based radiology? A single-institution review of imaging referral appropriateness including monetary and dose estimates for inappropriate scans.

Background: There has been a year on year increase in imaging requests at our academic institution. The iRefer guidelines are produced by the Royal College of Radiologists in the UK and are designed to prevent inappropriate imaging and radiation exposure. They have been available to general practitioners and hospital physicians in Ireland since March 2015.

An acute stroke CT imaging algorithm incorporating automated perfusion analysis.

In this paper, we propose a CT imaging algorithm for patients presenting with suspected acute stroke that incorporates automated CT perfusion (CTP) imaging. The algorithm details evaluation of the non-contrast CT (NCCT) for hemorrhage and acute ischemia, calculation of ASPECTS, with performance and interpretation of CTP if appropriate. In particular, we consider the key steps in expeditious interpretation of non-contrast CT and CT angiography in the context of suspected acute ischemic stroke.

To tube or not to tube? Utilising a tubeless antegrade ureteric stenting system in a tertiary referral hospital.

Introduction: To assess the benefits and complications of developing a practice of single-stage primary ureteral stenting in a university hospital.

Methods: A practice change developed from the traditional practice of multi-stage stenting to single-episode stent placement. To evaluate this change of practice, we retrospectively analysed data of 70 patients who underwent primary tubeless antegrade ureteric stenting and compared this group to the previous 54 patients who had a covering nephrostomy.

Subtraction multiphase CT angiography: A new technique for faster detection of intracranial arterial occlusions.

Objective: To describe and evaluate a novel technical development to improve detection of intracranial vessel occlusions using multiphase CT angiography (MPCTA).

Materials And Methods: The institutional ethics committee approved the study. Fifty patients (30 consecutive distal (M2 or smaller) anterior circulation occlusions, ten M1 occlusions, ten cases without occlusion) presenting with suspected AIS who underwent MPCTA were included.