Cumulative diagnostic imaging radiation exposure in premature neonates.

Background: To date, there has been limited work evaluating the total cumulative effective radiation dose received by infants in the neonatal intensive care unit. Most previous publications report that the total radiation dose received falls within the safe limits but does not include all types of ionizing radiation studies typically performed on this vulnerable patient population. We aimed to provide an estimate of the cumulative effective ionizing radiation dose (cED) in microSieverts (μSv) received by premature infants ≤32 weeks from diagnostic studies performed throughout their NICU stay, and predictors of exposures.

Outcomes following adoption of a standardized protocol for abscess drain management in pediatric appendicitis.

Background/purpose: Though evidence-based clinical pathways for the diagnosis and treatment of pediatric appendicitis have been established, protocols guiding management of percutaneous abscess drains are lacking. We hypothesized a drain management protocol utilizing drain output and clinical factors instead of fluoroscopic drain studies would reduce interventional radiologic procedures without adversely impacting clinical outcomes.

Methods: A standardized protocol was uniformly adopted at a tertiary-care children's hospital in April 2016.

Survey of peer review programs among pediatric radiologists: report from the SPR Quality and Safety Committee.

During the last 15 years, peer review has been widely incorporated into radiology quality improvement programs. However, current implementations are variable and carry concerns, including subjectivity of numerical scores and a sense of merely satisfying regulatory requirements. The Society for Pediatric Radiology (SPR) Quality and Safety Committee sought to evaluate the state of peer review programs in pediatric radiology practices, including implementation methods, perceived functions, strengths and weaknesses, and opportunities for improvement.

Pediatric CT radiation exposure: where we were, and where we are now.

Since the turn of the last millennium, the pediatric radiology community has blazed a patient-quality and safety trail in helping to effectively address the public and the news media's concerns about the implications of ionizing radiation from CT scanners in children. As such, this article (1) reviews the potential deleterious effects of ionizing radiation, (2) discusses why limiting radiation exposure in children is so important, (3) tells the history of pediatric CT radiation exposure concerns, (4) explains the interventions that took place to address these concerns and (5) touches on the current school of thought on pediatric CT dose reduction.

Effect of Radiology Study Flow on Report Turnaround Time.

Objective: The purpose of this study was to assess the importance of relative value unit (RVU) flow and other factors in report turnaround time (TAT) in emergency radiologic operations.

Materials And Methods: RVU flow was defined as the normalized (to 60 minutes) total work RVUs for studies performed in a given time interval of 30 minutes (RVU flow 30) or 60 minutes (RVU flow 60). Twenty-five weekday emergency radiology shifts each for four radiologists were randomly selected.

Improving Novice Radiology Trainees' Perception Using Fine Art.

Purpose: To determine if fine art perception training improved performance in novice radiology trainees.

Methods: On the first day of their residency, 15 radiology residents underwent a basic radiology perception test in which they were shown 15 different radiographs that each had a significant abnormality. This was followed by a focused session of interpretation training at a local art gallery where art experts taught the trainees how to thoroughly analyze a painting.

Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report.

Background: Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children.

Screening for Pediatric Blunt Cerebrovascular Injury: Review of Literature and a Cost-Effectiveness Analysis.

Background: Timely and accurate screening for pediatric blunt cerebrovascular injury (BCVI) is important in order to administer appropriate anticoagulation therapy thus preventing stroke. The recommended criteria for screening in children are not clear. We performed a systematic review of the literature for screening and management of BCVI in children and designed a cost-effectiveness analysis in order to determine the optimal strategy for managing pediatric BCVI from a societal perspective.

Postnatal sonographic spectrum of prenatally detected abdominal and pelvic cysts.

Objective: The purpose of this article is to illustrate the sonographic findings of a spectrum of neonatal abdominal and pelvic cystic lesions.

Conclusion: Neonatal abdominal and pelvic cystic lesions can arise from many organs, and they have a broad differential diagnosis. Distinctive sonographic findings may be present and can help establish the correct cause and guide proper management.

Evaluation of a BeadXpress assay for a 151-mutation and variant CFTR screening panel after 11,000 samples: implications for practice.

We created a 151-mutation and variant screening panel for cystic fibrosis transmembrane regulator (CFTR) using the Illumina Inc. BeadXpress platform (San Diego, CA). The laboratory developed test was validated using a third-party blinding of a set of 450 samples split with an authority laboratory that provides a large panel CFTR screening and 50 diverse controls admixed randomly.

Early assessment of the efficacy of digital infrared thermal imaging in pediatric extremity trauma.

Young children or those with intellectual disability with trauma to an extremity often undergo radiographs of the whole limb. The objective of the study was to assess the efficacy of digital infrared thermal images (DITI) in pediatric extremity trauma. We hypothesized fractures to be associated with local hyperthermia, detectable with DITI, which could direct focused radiographs.

Ayurvedic herbal medicine and lead poisoning.

Although the majority of published cases of lead poisoning come from occupational exposures, some traditional remedies may also contain toxic amounts of lead. Ayurveda is a system of traditional medicine that is native to India and is used in many parts of world as an alternative to standard treatment regimens. Here, we report the case of a 58-year-old woman who presented with abdominal pain, anemia, liver function abnormalities, and an elevated blood lead level.

A survey of emergency physician-performed ultrasound: implications for academic radiology departments.

A survey of academic radiology departments shows that the prevalence of emergency room physician-performed ultrasound examinations is high and that providing a 24/7 attending radiology service leads to no significant reduction in physician activity.

An amino acid-based amphoteric liposomal delivery system for systemic administration of siRNA.

We demonstrate a systematic and rational approach to create a library of natural and modified, dialkylated amino acids based upon arginine for development of an efficient small interfering RNA (siRNA) delivery system. These amino acids, designated DiLA₂ compounds, in conjunction with other components, demonstrate unique properties for assembly into monodisperse, 100-nm small liposomal particles containing siRNA. We show that DiLA₂-based liposomes undergo a pH-dependent phase transition to an inverted hexagonal phase facilitating efficient siRNA release from endosomes to the cytosol.

An "a la carte" academic radiology compensation plan: something for everyone.

The mechanism used to compensate faculty members within academic radiology practice poses a complex challenge to radiology administrative leaders. In this article, the authors discuss a novel compensation plan model that addresses many of the demands faced by modern academic radiology practices.

Understanding the cancer-CT conundrum.

It is imperative that responsible clinicians understand the relationship between computed tomography imaging and radiation-induced malignancy risk. As the concept of computed tomography-induced malignancy risk becomes more widespread, it is important that clinicians are well informed and are able to intelligently answer questions and concerns posed by their patients and are able to understand and discuss the issues with their radiologist colleagues. The purpose of this article is to review the history of ionizing radiation exposure growth in diagnostic imaging, to understand the biologic effects of radiation exposure, to define the growth of ionizing radiation from computed tomography in the United States, and to explore available mechanisms that can be used to control excessive patient radiation exposure.

Bio-mimetic surface engineering of plasmid-loaded nanoparticles for active intracellular trafficking by actin comet-tail motility.

Intracellular transport after endosomal escape presents one of the major barriers for efficient non-viral gene delivery because plasmid DNA and synthetic nanoparticulate carriers suffer from significantly restricted diffusion in the cytoplasm. We postulate that forces generated by actin polymerization, a mechanism used by several bacterial pathogens such as Listeria monocytogenes, can be harnessed to propel nanoparticles within the cytoplasm and thereby overcome diffusional limitations associated with gene transport in the cell cytoplasm. In this work, we synthesized and characterized plasmid DNA-containing nanoparticles modified with ActA protein, the single protein in L.

3-D tissue culture systems for the evaluation and optimization of nanoparticle-based drug carriers.

Nanoparticle carriers are attractive vehicles for a variety of drug delivery applications. In order to evaluate nanoparticle formulations for biological efficacy, monolayer cell cultures are typically used as in vitro testing platforms. However, these studies sometimes poorly predict the efficacy of the drug in vivo.

Spatio-temporal modeling of nanoparticle delivery to multicellular tumor spheroids.

The inefficiency of nanoparticle penetration in tissues limits the therapeutic efficacy of such formulations for cancer applications. Recent work has indicated that modulation of tissue architecture with enzymes such as collagenase significantly increases macromolecule delivery. In this study we developed a mathematical model of nanoparticle penetration into multicellular spheroids that accounts for radially dependent changes in tumor architecture, as represented by the volume fraction of tissue accessible to nanoparticle diffusion.

Increased nanoparticle penetration in collagenase-treated multicellular spheroids.

The extracellular matrix of solid tumors presents a transport barrier that restricts nanoparticle penetration, thereby limiting the efficacy of nano-sized delivery vehicles for cancer imaging and therapy. In this study, the effect of nanoparticle size and collagenase treatment on penetration of carboxylated polystyrene nanoparticles was systematically assessed in a multicellular spheroid model. Penetration of the nanoparticles into the spheroid core was limited to particles smaller than 100 nm.

Gold nanoparticles as a versatile platform for optimizing physicochemical parameters for targeted drug delivery.

The development of targeted vehicles for systemic drug delivery relies on optimizing both the cell-targeting ligand and the physicochemical characteristics of the nanoparticle carrier. A versatile platform based on modification of gold nanoparticles with thiolated polymers is presented in which design parameters can be varied independently and systematically. Nanoparticle formulations of varying particle size, surface charge, surface hydrophilicity, and galactose ligand density were prepared by conjugation of PEG-thiol and galactose-PEG-thiol to gold colloids.

Electrostatic force microscopy analysis of lipid miscibility in two-component monolayers.

Electrostatic force microscopy (EFM) was used to assess lipid miscibility and phase behavior in two-component Langmuir-Blodgett (LB) monolayers composed of cationic dioctadecyldimethylammonium bromide (DOMA) and nonionic methyl stearate (SME) lipids. The surface potential measurements were calibrated by applying known bias voltages to the sample during several line scans, thus creating surface potential "scale bars" on the images from which it was determined that circular domains were 50 mV more positive than the surrounding phase. As the spatially averaged surface potential of DOMA was over 400 mV more positive than that of SME, this 50-mV surface potential difference is too low to correspond to lipid phase separation (immiscibility) in the two-component film.

The value of anal endosonography compared with magnetic resonance imaging following the repair of anorectal malformations.

Background: Surgery for anorectal malformations (ARMs) attempts to position the neo-anus anatomically within the anal sphincter complex. Currently, MRI is the imaging modality of choice in determining the position of the neo-anus after reconstructive surgery.

Objective: The aim of this study was to compare the accuracy of anal endosonography (AES) with conventional MRI in demonstrating the anatomy of the neo-anus following repair of ARMs.