Establishing and Running a Three-dimensional and Advanced Imaging Laboratory.

Multidetector CT technology has advanced during the past 2 decades from single-digit numbers of sections to 320-section CT scanners. The ability to perform three-dimensional (3D) postprocessing of acquired data has accompanied this technical progress. Multiple considerations are involved in developing and deploying a 3D and advanced imaging laboratory to provide postprocessing for both CT and MRI examinations.

Developing an automated database for monitoring ultrasound- and computed tomography-guided procedure complications and diagnostic yield.

Monitoring complications and diagnostic yield for image-guided procedures is an important component of maintaining high quality patient care promoted by professional societies in radiology and accreditation organizations such as the American College of Radiology (ACR) and Joint Commission. These outcome metrics can be used as part of a comprehensive quality assurance/quality improvement program to reduce variation in clinical practice, provide opportunities to engage in practice quality improvement, and contribute to developing national benchmarks and standards. The purpose of this article is to describe the development and successful implementation of an automated web-based software application to monitor procedural outcomes for US- and CT-guided procedures in an academic radiology department.

An interactive RADIANCE toolkit for customizable CT dose monitoring and reporting.

The need for tools to monitor imaging-related radiation has grown dramatically in recent years. RADIANCE, a freely available open-source dose-monitoring tool, was developed in response to the need for an informatics solution in this realm. A number of open-source as well as commercial solutions have since been developed to enable radiology practices to monitor radiation dose parameters for modalities ranging from computed tomography to radiography to fluoroscopy.

Using the Microsoft Kinect for patient size estimation and radiation dose normalization: proof of concept and initial validation.

Monitoring patients' imaging-related radiation is currently a hot topic, but there are many obstacles to accurate, patient-specific dose estimation. While some, such as easier access to dose data and parameters, have been overcome, the challenge remains as to how accurately these dose estimates reflect the actual dose received by the patient. The main parameter that is often not considered is patient size.

A modern experience with saccular aortic aneurysms.

Objective: Repair of saccular aortic aneurysms (SAAs) is frequently recommended based on a perceived predisposition to rupture, despite little evidence that these aneurysms have a more malignant natural history than fusiform aortic aneurysms.

Methods: The radiology database at a single university hospital was searched for the computed tomographic (CT) diagnosis of SAA between 2003 and 2011. Patient characteristics and clinical course, including the need for surgical intervention, were recorded.

Presentation, complications, and natural history of penetrating atherosclerotic ulcer disease.

Objectives: Increased utilization of computed tomography angiography (CTA) has increased the radiologic diagnosis of penetrating atherosclerotic ulcers (PAUs), which are defined as the ulceration of atherosclerotic plaque through the internal elastic lamina into the aortic media. However, the presentation, treatment indications, and natural history of this disease process remain unclear.

Methods: The radiology database at a single university hospital was searched retrospectively for the CTA diagnosis of PAU from January 2003 to June 2009.

Development of automated detection of radiology reports citing adrenal findings.

The aim of this study was to determine the feasibility of automated detection of adrenal nodules, a common finding on CT, using a newly developed search engine that mines dictated radiology reports. To ensure Health Insurance Portability and Accountability Act compliance, we utilized a preexisting de-identified database of 32,974 CT reports from February 1, 2009 to February 28, 2010. Common adrenal descriptors from 29 staff radiologists were used to develop an automated rule-based algorithm targeting adrenal findings.

RADIANCE: An automated, enterprise-wide solution for archiving and reporting CT radiation dose estimates.

There is growing interest in the ability to monitor, track, and report exposure to radiation from medical imaging. Historically, however, dose information has been stored on an image-based dose sheet, an arrangement that precludes widespread indexing. Although scanner manufacturers are beginning to include dose-related parameters in the Digital Imaging and Communications in Medicine (DICOM) headers of imaging studies, there remains a vast repository of retrospective computed tomographic (CT) data with image-based dose sheets.

An algorithm for intelligent sorting of CT-related dose parameters.

Imaging centers nationwide are seeking innovative means to record and monitor computed tomography (CT)-related radiation dose in light of multiple instances of patient overexposure to medical radiation. As a solution, we have developed RADIANCE, an automated pipeline for extraction, archival, and reporting of CT-related dose parameters. Estimation of whole-body effective dose from CT dose length product (DLP)--an indirect estimate of radiation dose--requires anatomy-specific conversion factors that cannot be applied to total DLP, but instead necessitate individual anatomy-based DLPs.

Informatics in radiology: automated structured reporting of imaging findings using the AIM standard and XML.

Quantitative and descriptive imaging data are a vital component of the radiology report and are frequently of paramount importance to the ordering physician. Unfortunately, current methods of recording these data in the report are both inefficient and error prone. In addition, the free-text, unstructured format of a radiology report makes aggregate analysis of data from multiple reports difficult or even impossible without manual intervention.

Automated extraction of radiation dose information for CT examinations.

Exposure to radiation as a result of medical imaging is currently in the spotlight, receiving attention from Congress as well as the lay press. Although scanner manufacturers are moving toward including effective dose information in the Digital Imaging and Communications in Medicine headers of imaging studies, there is a vast repository of retrospective CT data at every imaging center that stores dose information in an image-based dose sheet. As such, it is difficult for imaging centers to participate in the ACR's Dose Index Registry.

Use of a Dedicated Server to Perform Coronal and Sagittal Reformations in Trauma Examinations.

The purpose of this study was to evaluate the impact of implementing an automated process for generating coronal and sagittal reformatted images on radiologist workflow. When performing trauma-related CT examinations of the cervical, thoracic, and lumbar spine at our institution, technologists manually generate coronal and sagittal reconstructions at the scanner console and send these images to a picture archiving and communication system (PACS) for interpretation by radiologists and clinical viewing. Although certain PACS, thin-client three-dimensional systems, and CT scanners are capable of automatically generating reconstructed or reformatted images, the systems at our institution do not support this functionality.

Use of high-frequency jet ventilation for respiratory immobilization during coronary artery CT angiography.

Multidetector ECG-gated CT angiography permits imaging of structures such as the coronary arteries and pulmonary veins with peripheral administration of contrast media. Respiratory motion artifact limits the applicability of this technique in critically ill patients due to an inability to cooperate with prolonged breath holds necessary for quality images. A case in which high-frequency jet ventilation via an uncuffed tracheostomy tube in an unmedicated patient permitted respiratory immobilization sufficient to acquire diagnostic images, is presented.

Radiologist use of and perceived need for patient data access.

Given the increasing volume of radiological exams, the decreasing frequency of direct communication with the referring provider, and the distribution of patient data over many clinical systems, radiologists often do not have adequate clinical information at the time of interpretation. We have performed a survey of radiologists to determine the need and actual utilization of patient data at the time of image interpretation. Our findings demonstrate that most radiologists want more clinical information when interpreting images and that this information would impact their report, but they are discouraged by the time it takes to access this information.

Informatics in radiology (infoRAD): survey of personal digital assistant use in radiology.

There has been widespread adoption of personal digital assistants (PDAs) within medicine in recent years. However, information on the prevalence and usage of these devices among radiologists is limited. A survey was designed and mailed to randomly selected members of the Radiological Society of North America to determine the percentage of PDA users, their use patterns, and the types of applications that they would like to see in the future.

MR microscopy of normal human brain.

MR microscopy at 9.4T depicts the architecture of the brain in exquisite detail, including the individual laminae of the cortex, the individual nuclei of the basal ganglia, the thalami, subthalami and metathalami, and the orientations and relationship among the dominant nuclei and white matter tracts of the brain. The authors believe that these anatomic relations will ultimately be displayed in vivo as clinical MR scanners begin to operate at field strengths of 4.