Implementation of a computed tomography dose management program across a multinational healthcare organization.

Objectives: Radiation dose index monitoring (RDIM) systems may help identify CT dose reduction opportunities, but variability and complexity of imaging procedures make consistent dose optimization and standardization a challenge. This study aimed to investigate the feasibility to standardize and optimize CT protocols through the implementation of a Dose Excellence Program within a European healthcare network.

Methods: The Dose Excellence Program consisted of a multidisciplinary team that developed standardized organizational adult CT protocols and thresholds for relevant radiation dose indices (RDIs).

Artificial intelligence for reduced dose 18F-FDG PET examinations: a real-world deployment through a standardized framework and business case assessment.

Background: To determine whether artificial intelligence (AI) processed PET/CT images of reduced by one-third of 18-F-FDG activity compared to the standard injected dose, were non-inferior to native scans and if so to assess the potential impact of commercialization.

Materials And Methods: SubtlePET™ AI was introduced in a PET/CT center in Italy. Eligible patients referred for 18F-FDG PET/CT were prospectively enrolled.

Lead exposure in clinical imaging - The elephant in the room.

Purpose: Radiation Protection Apparel (RPA) is used during diagnostic imaging and interventional procedures to minimise incidental radiation exposure. The majority of RPA in use are lead-containing, which has until now been considered safe. A recent single-centre study has demonstrated that the external surface of 63 % of RPA was contaminated with lead dust.

Effect of Hepatic Perfusion on Microwave Ablation Zones in an Ex Vivo Porcine Liver Model.

Purpose: To compare the size of ablation zones derived from nonperfused ex vivo livers with ablation zones created using an ex vivo perfused porcine liver model.

Materials And Methods: Six fresh porcine livers were used to evaluate microwave ablation (MWA). Perfused (n = 3) and nonperfused (n = 3) livers were warmed to 37°C by oxygenated, O-positive human blood reconstituted with Ringer solution, using an organ perfusion circuit.

Perivascular parenchymal extension of the ablation zone following liver microwave ablation.

A 69-year-old man who presented with abdominal discomfort was, on examination, found to have a palpable abdominal mass. Contrast-enhanced CT showed a mass arising from the inferior vena cava, which biopsy confirmed to be a leiomyosarcoma. One month after chemoradiotherapy, CT demonstrated a new 15 mm solitary central right liver metastasis.

Lung carcinoma with hypertrophic osteoarthropathy in a teenager.

Hypertrophic osteoarthropathy (HOA) characterised by arthralgia, clubbing and periosteal proliferation of long bones, is rarely encountered in children and adolescents. Whereas in adults over 80% of cases are associated with malignancy, in children the majority of cases are due to non-neoplastic causes such as cystic fibrosis, bilary atresia and congenital heart disease. Up to 5% of adults with lung cancer demonstrate signs of HOA.

MR imaging of nonmalignant penile lesions.

Magnetic resonance (MR) imaging is potentially useful in the assessment of many benign penile diseases. When T1- and T2-weighted sequences are used, MR imaging can clearly delineate the tunica albuginea and can be used to diagnose penile fracture and Peyronie disease; in both conditions, MR imaging may help refine the surgical approach. It is also useful in cases of priapism; in these cases, intravenously administered contrast material can help assess the viability of the corpora cavernosa and the presence of penile fibrosis.

MR imaging of prostate after treatment with high-intensity focused ultrasound.

Purpose: To prospectively evaluate magnetic resonance (MR) imaging findings after high-intensity focused ultrasound (HIFU) treatment of the prostate and to correlate them with clinical and histologic findings.

Materials And Methods: Local ethics committee approval and informed consent were obtained. Fifteen consecutive men aged 46-70 years with organ-confined prostate cancer underwent ultrasonographically guided ablation of the whole prostate.

The incidence of chronic scrotal pain after vasectomy: a prospective audit.

Objective: To assess the extent of scrotal pain in men before and after vasectomy, to produce accurate data for the benefit of men considering this procedure, and hence improved informed consent about the outcomes, as chronic scrotal pain after vasectomy is a poorly quantified clinical problem.

Patients And Methods: Between November 2004 and January 2006 nine surgeons carried out vasectomies in 625 men (mean age 39.9 years, sd 5.

Visually directed high-intensity focused ultrasound for organ-confined prostate cancer: A proposed standard for the conduct of therapy.

Objective: To propose a standard for the conduct of visually directed transrectal high-intensity focused ultrasound (HIFU) and to offer a formal description of the changes observed on B-mode ultrasonography (US) during this procedure. We describe our early experience of using two different treatment methods; algorithm-based HIFU and visually directed HIFU for the treatment of organ-confined prostate cancer.

Patients And Methods: Between November 2004 and October 2005, 34 men were treated using the Sonablate-500 (Focus Surgery, Indianapolis, IN, USA) as primary therapy for T1 or T2 prostate cancer.

To what extent does the prostate-specific antigen nadir predict subsequent treatment failure after transrectal high-intensity focused ultrasound therapy for presumed localized adenocarcinoma of the prostate?

Objective: To explore the association between the prostate-specific antigen (PSA) nadir after transrectal high-intensity focused ultrasound (HIFU) therapy for organ-confined prostate cancer and subsequent treatment failure, as defined by the presence of residual disease at biopsy 6 months after treatment.

Patients And Methods: Between January 1999 and January 2005, 115 patients in a Japanese hospital were treated using a transrectal HIFU system (Sonablate, Focus Surgery, IN, USA) for presumed localized adenocarcinoma of the prostate. All treatments were primary and none of the patients had received hormone therapy.

The effect of neoadjuvant androgen suppression on prostate cancer-related outcomes after high-intensity focused ultrasound therapy.

Objective: To explore the effect of neoadjuvant androgen suppression (AS) compared to no AS on cancer-related outcomes after radical high-intensity focused ultrasound (HIFU) therapy for men with presumed organ-confined prostate cancer.

Patients And Methods: Between January 1999 and January 2005, 250 patients underwent HIFU for presumed localized adenocarcinoma of the prostate; 154 had received neoadjuvant hormonal therapy and 96 had not. The primary outcome measure was treatment failure, as defined by the presence of prostate cancer on the biopsy taken 6 months after HIFU.