6 December 2008
7 November 2008
BoneXpert is a software product that computes bone age automatically based using the Greulich-Pyle and the Tanner-Whitehouse systems. It is installed on a PC and can be set up as a "PACS listener" so that the radiographer can send the hand x-ray (as a DICOM file) from PACS to the BoneXpert PC, where the analysis is carried out automatically in 10 seconds. The images then appear on the BoneXpert PC with the patient details and the name of the referring physician.
1 November 2008
I've been rich and I've been poor. Believe me, rich is better.
24 October 2008
ref: Camara, C. G., Escobar, J. V., Hird, J. R. & Putterman, S. J. Nature 455, 1089–1092 (2008).
Nature News Published online 22 October 2008 doi:10.1038/news.2008.1185
(Thanks to BoingBoing)
The brain continues to be represented using projections first devised in Renaissance Italy to illustrate the head; and for the neuroscientist 600 years later, Piero's little known illustrations provide a remarkable legacy of graphic representation that endures to this day
Perspectives, The art of medicine: Piero della Francesca's projections and neuroimaging today
The Lancet 2008; 372:1378-1379
17 October 2008
A new firm called Telerays has developed a novel Web-based auction approach to teleradiology services that calls for readings to be awarded to the lowest bidder. The company is currently recruiting radiologists to sign up to provide readings and is marketing its services to hospitals and imaging centers.Read more in Aunt Minnie
19 September 2008
Gustav Klutsis. (Latvian, 1895-1944). Maquette for Radio-Announcer. 1922. Painted cardboard, paper, wood, thread, and metal brads, 45 3/4 x 14 1/2 x 14 1/2" (106.1 x 36.8 x 36.8 cm). Sidney and Harriet Janis Collection Fund. Museum of Modern Art, New York. http://www.moma.org/
I gave a talk this morning to our surgeons about "Personalising your Internet" by using Web 2.0 applications like iGoogle, Google Reader, Google Docs, CiteuLike, and so on, which I have posted on Slideshare. (Link)
Another site I have been playing with is Survey Pro (http://www.esurveyspro.com/), which allows you to set up online surveys. There are free and paid versions. It's easy to use, and worth looking at if you ever want to conduct an online survey.
9 September 2008
1069 patients were referred to the University Hospital of North Staffordshire to the 14-day urgent colorectal cancer referral service. Of these, 108 patients were referred as having a 'palpable rectal tumour'. Only 32 of the 108 were found to have a rectal lesion on examination in the hospital. Ten tumours were missed by GPs' DREs.
C. W. Ang, R. Dawson, C. Hall and M. Farmer Colorectal Disease
Published Online: 14 Sep 2007
15 August 2008
15 July 2008
11 July 2008
St George and the Dragon (1502) Scuola di San Giorgio degli Schiavoni, Venice from the Web Gallery of Art
This is fantastic! I've been looking for something like this for ages, and it is likely to be incredibly useful, as it can be difficult getting information about these products from people not employed by the vendors.
In addition to information about interventional devices, there is a training section with instructional videos of interventional procedures, and a global interventional forum for discussing cases. They are expanding into imaging equipment as well, and the site has a review of the Zonare ultrasound system. Coming up next year, from the same team, is 'Which Medical Device'.
Things are not so simple anymore. The various manufacturers have adopted quite different appoaches to high-end CT. Here's a nice article in Aunt Minnie, based on a talk by Matthias Prokop:
10 July 2008
7 July 2008
The authors of this study found that
CT was better tolerated and more sensitive but less specific than fluoroscopy for detecting occult anastomotic leak.Radiological detection of post-oesophagectomy anastomotic leak a comparison between multidetector CT and fluoroscopy
by: S Upponi, A Ganeshan, H Dcosta, M Betts, N Maynard, H Bungay, A Slater
British Journal of Radiology, Vol. 81, No. 967. (July 2008), pp. 545-548.
6 July 2008
Looking for an RSS feed for a journal? Can't find it on their website? You could try googling it, or you could look in Medworm. I was looking for an RSS feed for Clinical Radiology and found it through Medworm. They didn't have one for the British Journal of Radiology, though, and I couldn't find it on the BIR site either, but located it via Google.
As an aside, I used to use iGoogle as a means of getting RSS feeds, but have since switched to Google reader. On iGoogle, a maximum of 9 items are displayed, which is not sufficient for all the articles in one issue of a journal. I also find Google reader easier to organise. I'm sure there are lots of other feed readers out there, but I seem to do most things through Google, and the reader works fine for me, so I haven't bothered to try any of the others.
5 July 2008
The British National Health Service started on 5 July 1948, 60 years ago today.
The online Guardian has an interesting page to mark this event, with lots of articles and features, and I recently posted a 1948 public information film explaning the new service, as well as a clip from Michael Moore's film Sicko, which you can see here.
4 July 2008
Wait times for MRI and CT scans in Ontario - and probably elsewhere in Canada - could be reduced by cutting back on unnecessary scans ordered by doctors, a new study suggests.The title of this post is taken from an article in the website of the Canadian Broadcasting Corporation (CBC). Radiologists might smile wearily, but I guess it's intended for the general public who may not be aware of what we all take for granted. In fact, there are some interesting findings about variations in imaging utilisation and the diagnostic yield of various common investigations. The authors of the study suggest that:
"I think all of Canada is experiencing challenges with wait times. And I guess our message would be if you can cut down the inappropriate use, then you can actually improve access for the people who actually will benefit," lead author Dr. John You said.
The province should develop a web-based ordering system that would capture, in real time, the reasons why imaging tests are ordered and test results. Such a system would make it easier to audit the appropriateness of ordering patterns.Read more here.
The study is said to have been published in the June issue of the Canadian Association of Radiologists Journal but I couldn't find it in the table of contents. Perhaps they meant July.
3 July 2008
Apparently they've placed an order at the Royal London.
It can be connected to the internet and function as a normal Mac laptop, and I guess you could install Osirix on it and use it as a DICOM workstation.
28 June 2008
Buscopan (hyoscine-N-butylbromide) is widely used as a spasmolytic for barium enemas, CT colonography, and abdominal MRI to improve the quality of the examination. It's a safe drug: safer than many people realise. Here is some sensible advice from the authors of a recent review article
All radiologists and radiographers either supervising examinations where this drug is used or those administering it directly to the patient need to be aware of the true contraindications. This should not include all patients with ischaemic heart disease or those with glaucoma. We would recommend that only patients with unstable cardiac disease have Buscopan withheld and that all patients are told to attend hospital immediately if, following the examination, they develop painful, blurred vision, in one or both eyes.R. Dyde, A.H. Chapman, R. Gale, A. Mackintosh and D.J.M. Tolan
Precautions to be taken by radiologists and radiographers when prescribing hyoscine-N-butylbromide
Clinical Radiology 2008 July; 63 (7): 739-743.
I really can't figure out why it's not licensed in the United States. In the US it is approved for the treatment of flatulent colic in horses although not if the horses are going to be eaten by humans. (Link to product info)
26 June 2008
the Radiology Assistant is the educational web site of the Radiological Society of The Netherlands, focusing on common radiological issues in a problem oriented way for radiology residents and radiologists.
This is an excellent site and a superb source of reference, with lots of succinct articles written by experts in the field. Highly recommended. Check it out. It's been added as a link in the sidebar of this blog.
22 June 2008
...the hunt for a better funding model is never called off, with each new foray unfolding along similar lines. It begins with the NHS being judged as seriously underperforming. The real reason for this, whether admitted by the government of the day or not, is because not enough money is being spent on it. Early in the hunt comes sightings of the "bottomless pit" of insatiable healthcare demands, quickly followed by assertions that substantial increases in healthcare spending are "unsustainable." When asked for their advice, economists tell politicians that a tax based system provides governments and patients with the best deal. As a sideshow to the main event are the hucksters, peddling their own funding models, hoping that some of the billions spent on the NHS might end up in their pockets, or those of their backers.Tony Delamothe, BMJ 2008;336:1410-1412 (21 June), doi:10.1136/bmj.a292
Free full text
Here is an excerpt from Michael Moore's Sicko (2007).
21 June 2008
Here is the video about the incident:
There has been a lot of grumbling in Britain about the "Stalinist" National Health Service (NHS), but there are worse ways to organise a country's healthcare. I work for the NHS, and I am only too aware of its deficiencies, but those who wish to dismantle it should consider the possible consequences of alternative systems. Privatisation of the previously state-owned British railways did not lead to improved service. There is no inherent reason why a privatised national healthcare system in the UK will fare any better. Railway journeys in the UK are extremely expensive compared to the rest of the UK. I'm always being told how cheap it is to go shopping in the US compared to the UK. What will happen if our healthcare is privatised?
Link: Keep our NHS public
"Someone stepped on me during the last dance."
"Want me to have a look at it?"
"OH MY GOD!!"
I've added the Samurai Radiologist's blog Not Totally Rad to my list. His posts cover all sorts of things other than radiology. There are imaging-related article as well, of course, including this one which reviews studies from the published literature, but may nevertheless be inaccessible from hospital PCs due to "adult content": Radiology comes through for sexual imaging.
My thanks to Vijay, : I found this indirectly via his blog.
1 May 2008
I became aware of an excellent free online interactive anatomy atlas :
through a recent article in Radiology:
Stuart R. Pomerantz Net Assets: Personal Technology for Productivity in Radiology
Radiology 2008 247: 307-310 (DOI: 10.1148/radiol.2472080187)
The article also mentions various other search engines like Yottalook and Goldminer, which are already on the side bar of this blog.
One other tip from the article: if you are looking for CT or MRI protocols, you can, for intnce, put "MRI" and "protocol" as search terms in Yottalook. Because it's a radiology-specific search engine, you get better results than with google.
24 April 2008
PACS monitors are ideally viewed in darkish conditions. These are difficult to achieve in your typical ward or casualty department. This device is designed for use with laptops but can probably be modified for use with single PACS monitors.
Instructions on how to make one:
23 February 2008
A post from the blog of a radiographer who is now a PACS adminstrator:
....recently I have noticed that positioning skills have been declining or Technologists just don’t seem to care much anymore.In summary, the main reasons he gives are:
I have pondered as to why this seems to be happening and have come up with a few theories that I will list below in no particular order as I think they all have a part in the decline of the skills.....
- Modern radiographer training.
- The effects of PACS.
- Radiologists accepting poor quality images.
- CT and MRI (discussed in the comments to the main article).
(From A Ferret's VIew of PACS and Life).
The picture above comes from this site which is worth a look.
15 February 2008
I found this out yesterday via a post on Dr Dalai's blog. It's not just RIS/PACS: Amalga is a "Unified Intelligence System" for healthcare organisations that includes a HIS (Hospital Information System) "built around an Electronic Medical Record (EMR) that includes complete patient and bed management, laboratory, Medication Management, Radiology Information System/Picture Archiving and Communication System (RIS/PACS), pathology, financial accounting, materials management, and human resource systems".
It does look rather interesting. Wait and see.
13 February 2008
- Clinical details re-stated at the beginning of the report.
- Comments on the technical quality of the examination, especially if the examination is suboptimal.
- Mention all organs that have been examined.
- Measurements of abnormal organs, giving a normal range and the measurement of the corresponding normal organ for those with a bilateral presentation.
- Avoid the use of ultrasound terminology unless it is known that the clinician receiving the report has knowledge of such terminology.
- Relate to the clinical question.
- Include significant incidental findings.
- Include differential diagnoses, but not too many.
- Suggest further steps in the investigation of the patient.
- Give advice on further patient management if the referring clinician is a GP or a medical clinician.
- End with a conclusion.
- Be clear and give a comprehensive description even if the findings are normal.
- There was no substantial difference between the preferences of GPs, medical and surgical referrers, although surgeons do not appear to value recommendations for further management of patients.
- All groups of clinicians are happy for radiologists/sonographers to arrange follow-up examinations, but examinations should not be cancelled without discussion with the referring clinician.
Leigh will be leaving us shortly to work in Colchester, and we'll miss her. Good luck, and thanks for everything, Leigh.
12 February 2008
We have three Carl's Tables, and like them very much. Now there's a new version, available in Spring 2008, with even more features, such as electric monitor adjustment, independent task lighting, and even an "air circulation system" with two adjustable air ports, like the air conditioning in a car. Very nice, but at US$12950 it's just slightly more than we can afford right now.
More details on the Anthro site, including comparison charts, and a video of Carl himself playing the banjo.
9 February 2008
A new ultrasound technique developed at Duke University known as Acoustic Radiation Force Impulse imaging (ARFI) improves visualisation of liver tumours by using the elasticity or stiffness of the tumour to improve contrast between it and the surrounding tissue.
(Credit: Image courtesy of Pratt School of Engineering, Duke University)
Siemens are working on a prototype.
There have been several articles about this in radiology websites, but I thought this one, from a non-medical scientific site, provided a nice summary:
This is the article:
In vivo visualization of abdominal malignancies with acoustic radiation force elastography
B J Fahey et al 2008 Phys. Med. Biol. 53 279-293
One fifth of the world's helium supplies are used in for cooling the superconducting magnets used in MRI scanners. Now supplies of helium are running out.
As it says in this article, Goodbye Helium, Goodbye Brainscans.
Here's another article.
28 January 2008
22 January 2008
PostureMinder uses any standard, off-the-shelf webcam to continually check your posture while you work. If you slump or lean consistently for a minute or two at a time, the software detects this and provides an an on-screen reminder to help you avoid spending long periods in these damaging postures.
A useful add-on for your PACS workstation? It's only £29.
14 January 2008
It is important to avoid such side effects of frequent hand washing, in part because they can reduce compliance and also because fissures and lesions on damaged hands are more susceptible to colonization by microorganisms, thereby fostering transmission. Multiple steps can be taken to minimize skin irritation associated with hand hygiene.
- First, a hand-friendly hygiene agent should be readily available. Alcohol-based hand rubs containing emollients are better tolerated by health care personnel than plain soap or antimicrobial soap alone.
- Second, health care workers need to be reminded of the value of regular frequent use of hand-care products such as hand lotions or creams. In one study at the University of Wisconsin, Madison, Wis, scheduled use of an oil-containing lotion improved skin condition and led to a 50% increase in hand
washing frequency among health care personnel who initially suffered from long-standing hand irritation.
- Routine hand washing with soap and water after using an alcohol-based rub can lead to dermatitis and should be avoided.
Hand Hygiene Lisa R. Delaney, and Richard B. Gunderman Radiology 2008;246:15-19
9 January 2008
According to an article in Health Imaging News,
GE Healthcare has created a vendor-independent educational program designed specifically for biomedical and technical professionals to enhance their knowledge of IT concepts for healthcare.
While searching, I came across an interesting Healthcare IT blog, run by Adam Chee in Singapore:
www.binaryhealthcare.com, to which I've added a link on this site.
7 January 2008
The aim of Radiopaedia.org is to develop an online text where information is up to date and relevant to the needs of radiology staff, both registrars and consultants. In addition, the wiki format will allow discussion of topics and resolution of areas of confusion. There are many worthwhile online resources already, however most are not collaborative and therefore lack the ability to respond to users needs.
Anyone can create an article. Anyone can edit an existing one. Contributions remain logged to your name, and can be included in your CV, along with a link to your User Page.
Due to the immediacy of editing, new information can be introduced immediately when it becomes available. Errors can be corrected immediately, with no need to wait for the next edition.
Among other things there's a useful section on "Staging etc". Check it out: