Bits and bytes: the future of radiology lies in informatics and information technology.

Unlabelled: Advances in informatics and information technology are sure to alter the practice of medical imaging and image-guided therapies substantially over the next decade. Each element of the imaging continuum will be affected by substantial increases in computing capacity coincident with the seamless integration of digital technology into our society at large. This article focuses primarily on areas where this IT transformation is likely to have a profound effect on the practice of radiology.

Endovascular MR-guided Renal Embolization by Using a Magnetically Assisted Remote-controlled Catheter System.

Purpose To assess the feasibility of a magnetically assisted remote-controlled (MARC) catheter system under magnetic resonance (MR) imaging guidance for performing a simple endovascular procedure (ie, renal artery embolization) in vivo and to compare with x-ray guidance to determine the value of MR imaging guidance and the specific areas where the MARC system can be improved. Materials and Methods In concordance with the Institutional Animal Care and Use Committee protocol, in vivo renal artery navigation and embolization were tested in three farm pigs (mean weight 43 kg ± 2 [standard deviation]) under real-time MR imaging at 1.5 T.

Patient-directed Internet-based Medical Image Exchange: Experience from an Initial Multicenter Implementation.

Rationale And Objectives: Inefficient transfer of personal health records among providers negatively impacts quality of health care and increases cost. This multicenter study evaluates the implementation of the first Internet-based image-sharing system that gives patients ownership and control of their imaging exams, including assessment of patient satisfaction.

Materials And Methods: Patients receiving any medical imaging exams in four academic centers were eligible to have images uploaded into an online, Internet-based personal health record.

New-Generation Laser-lithographed Dual-Axis Magnetically Assisted Remote-controlled Endovascular Catheter for Interventional MR Imaging: In Vitro Multiplanar Navigation at 1.5 T and 3 T versus X-ray Fluoroscopy.

Purpose: To assess the feasibility of multiplanar vascular navigation with a new magnetically assisted remote-controlled (MARC) catheter with real-time magnetic resonance (MR) imaging at 1.5 T and 3 T and to compare it with standard x-ray guidance in simulated endovascular catheterization procedures.

Materials And Methods: A 1.

Digital subtraction MR angiography roadmapping for magnetic steerable catheter tracking.

Purpose: To develop a high temporal resolution MR imaging technique that could be used with magnetically assisted remote control (MARC) endovascular catheters.

Materials And Methods: A technique is proposed based on selective intra-arterial injections of dilute MR contrast at the beginning of a fluoroscopic MR angiography acquisition. The initial bolus of contrast is used to establish a vascular roadmap upon which MARC catheters can be tracked.

Magnetically assisted remote-controlled endovascular catheter for interventional MR imaging: in vitro navigation at 1.5 T versus X-ray fluoroscopy.

Purpose: To compare in vitro navigation of a magnetically assisted remote-controlled (MARC) catheter under real-time magnetic resonance (MR) imaging with manual navigation under MR imaging and standard x-ray guidance in endovascular catheterization procedures in an abdominal aortic phantom.

Materials And Methods: The 2-mm-diameter custom clinical-grade microcatheter prototype with a solenoid coil at the distal tip was deflected with a foot pedal actuator used to deliver 300 mA of positive or negative current. Investigators navigated the catheter into branch vessels in a custom cryogel abdominal aortic phantom.

Magnetic catheter manipulation in the interventional MR imaging environment.

Purpose: To evaluate deflection capability of a prototype endovascular catheter, which is remotely magnetically steerable, for use in the interventional magnetic resonance (MR) imaging environment.

Materials And Methods: Copper coils were mounted on the tips of commercially available 2.3-3.

Magnetically-Assisted Remote Controlled Microcatheter Tip Deflection under Magnetic Resonance Imaging.

X-ray fluoroscopy-guided endovascular procedures have several significant limitations, including difficult catheter navigation and use of ionizing radiation, which can potentially be overcome using a magnetically steerable catheter under MR guidance. The main goal of this work is to develop a microcatheter whose tip can be remotely controlled using the magnetic field of the MR scanner. This protocol aims to describe the procedures for applying current to the microcoil-tipped microcatheter to produce consistent and controllable deflections.

CT radiation dose: what can you do right now in your practice?

Objective: The purpose of this article is to review reasonable measures that community radiologists can realistically implement as a response to the current increased public concern regarding CT radiation risk.

Conclusion: Potential measures include provision of patient information material, review of CT protocols and indications, promotion of alternative studies, use of decision support software, automatic tube current modulation, bismuth shields, improved image reconstruction algorithms, empowerment of technologists to adjust protocols, and calculation of radiation dose for possible reporting.

RF Heating of MRI-Assisted Catheter Steering Coils for Interventional MRI.

Rationale And Objectives: The aim of this study was too assess magnetic resonance imaging (MRI) radiofrequency (RF)-related heating of conductive wire coils used in magnetically steerable endovascular catheters.

Materials And Methods: A three-axis microcoil was fabricated onto a 1.8Fr catheter tip.

Steerable catheter microcoils for interventional MRI reducing resistive heating.

Rationale And Objectives: The aims of this study were to assess resistive heating of microwires used for remote catheter steering in interventional magnetic resonance imaging and to investigate the use of alumina to facilitate heat transfer to saline flowing in the catheter lumen.

Materials And Methods: A microcoil was fabricated using a laser lathe onto polyimide-tipped or alumina-tipped endovascular catheters. In vitro testing was performed on a 1.

An update survey of academic radiologists' clinical productivity.

Rationale And Objectives: The total number of procedures and their relative value units (RVUs) were used to measure the productivity of radiologists. Besides variations in productivity due to differences in the percentage of clinical effort, baseline productivity also varies among clinical subspecialty sections. The authors' previous research used the full-time equivalent (FTE) as the unit to adjust for differences in the percentage of clinical effort and a set of adjustment factors (or calibration constants) to modify the default work RVUs according to types of procedures.

Magnetically-assisted remote control (MARC) steering of endovascular catheters for interventional MRI: a model for deflection and design implications.

Current applied to wire coils wound at the tip of an endovascular catheter can be used to remotely steer a catheter under magnetic resonance imaging guidance. In this study, we derive and validate an equation that characterizes the relationship between deflection and a number of physical factors: theta/sin(gamma-theta) = nIABL/EI(A) where theta is the deflection angle, n is the number of solenoidal turns, I is the current, A is the cross-sectional area of the catheter tip, B is the magnetic resonance (MR) scanner main magnetic field, L is the unconstrained catheter length, E is Young's Modulus for the catheter material, and I(A) is the area moment of inertia, and y is the initial angle between the catheter tip and B. Solenoids of 50, 100, or 150 turns were wound on 1.

Quality--a radiology imperative: report of the 2006 Intersociety Conference.

Recent publications by the Institute of Medicine have pointed out the many medical errors that occur and the adverse effect of those errors on patient outcomes. These errors are often the result of problems within our health care systems. In an effort to improve patient care outcomes, many health care providers have developed improved policies and practices.

The inappropriate use of imaging studies: a report of the 2004 Intersociety Conference.

The participants of the 2004 Intersociety Conference met to discuss the growing problem of self-referral. The United States spends more of its gross national product on health care than other countries, especially Japan and those in Western Europe. Imaging accounts for a large and growing portion of those costs.