Fabrication of silver microstructures via electrohydrodynamic inkjet printing as customizable X-ray marker in bio-structure for biomedical diagnostic imaging

Abstract This audit describes ionizing and non-ionizing diagnostic imaging at a regional trauma centre. All 144 patients (males 79.2%, median age 31 years) met with trauma team activation from 1 January 2015 to 31 December 2015 were included. We used data from electronic health records to identify all diagnostic imaging and report radiation exposure as dose area product (DAP) for conventional radiography (X-ray) and dose length product (DLP) and effective dose for CT. During hospitalization, 134 (93.1%) underwent X-ray, 122 (84.7%) CT, 92 (63.9%) focused assessment with sonography for trauma (FAST), 14 (9.7%) ultrasound (FAST excluded) and 32 (22.2%) magnetic resonance imaging. One hundred and sixteen (80.5%) underwent CT examinations during trauma admissions, and 73 of 144 (50.7%) standardized whole body CT (SWBCT). DAP values were below national reference levels. Median DLP and effective dose were 2396 mGycm and 20.42 mSv for all CT examinations, and 2461 mGycm (national diagnostic reference level 2400) and 22.29 mSv for a SWBCT.

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Hemangioma of the face and neck with phleboliths: Diagnostic imaging with X-ray and CT

JORDI - Journal of Oral Diagnosis ◽

10.5935/2525-5711.20170017 ◽

2017 ◽

Vol 2 ◽

pp. 1-4

Author(s):

Claudia Scigliano Valerio ◽

Pedro Augusto Oliveira Santos Xambre ◽

Bruno César Ladeira Vidigal ◽

Beatriz de Carvalho Silva Rocha ◽

Flávio Ricardo Manzi

Keyword(s):

Diagnostic Imaging ◽

X Ray ◽

The Face

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Design and Synthesis of Nanoparticle Contrast Agents for Spectral (color) X-Ray Imaging

MRS Proceedings ◽

10.1557/opl.2015.460 ◽

2015 ◽

Vol 1719 ◽

Author(s):

Prakash D. Nallathamby ◽

Tracie L. Mcginnity ◽

Lisa E. Cole ◽

Margaret E. Best ◽

Tracy Vargo-Gogola ◽

...

Keyword(s):

Diagnostic Imaging ◽

Contrast Agents ◽

Surface Functionalization ◽

Soft Tissues ◽

National Laboratory ◽

Argonne National Laboratory ◽

Spectral Ct ◽

Shell Nanoparticles ◽

Core Diameter ◽

X Ray

ABSTRACTComputed tomography (CT) is an important tool in clinical diagnostic imaging enabling three-dimensional anatomic imaging at high spatial resolution with short scan times. However, X-ray attenuation differences in physiological fluids and soft tissues are relatively small, requiring the use of contrast agents to achieve sufficient imaging contrast. Recent advances in energy-sensitive X-ray detectors have made spectral (color) CT commercially feasible by unmixing the energy-dependent attenuation profile of different materials and will potentially enable molecular imaging in CT. In order to leverage these capabilities for diagnostic imaging, we are developing a spectral library of nanoparticle contrast agents with K-shell absorption edges spaced at least 10 keV apart. The objective of this study was to demonstrate the ability of spectral CT to simultaneously detect up to three different contrast agents and unmixed their signals to create color images. Gadolinium oxide (Gd), hafnium oxide (Hf) and gold (Au) were chosen due to exhibiting K-edges spaced 10-20 keV apart. Core-shell nanoparticles of each composition were synthesized by various methods to have a core diameter of 15-20 nm and were coated with a silica shell at least 2-4 nm in thickness to create a common platform for surface functionalization. The contrast agents were imaged in a soft tissue equivalent phantom using source-side method for spectral CT imaging. The source-side approach utilized monochromatic synchrotron radiation at the Argonne National Laboratory which, while not clinically applicable, served as a gold standard due to providing the highest spectral resolution. The nanoparticles designed for this study have broad applications in biomedical imaging due to their modular assembly, potential for enabling multi-modal detection, and surface functionalization with biomolecules (e.g., antibodies, peptides or enzymes) for active targeting.

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A national intervention to reduce imaging for low back pain by general practitioners: a retrospective economic program evaluation using Medicare Benefits Schedule data

BMC Health Services Research ◽

10.1186/s12913-019-4773-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Tessa Morgan ◽

Jianyun Wu ◽

Ludmila Ovchinikova ◽

Robyn Lindner ◽

Suzanne Blogg ◽

...

Keyword(s):

Time Series ◽

Low Back Pain ◽

Back Pain ◽

Diagnostic Imaging ◽

Ct Scan ◽

Ct Scans ◽

Low Back ◽

X Ray ◽

Lower Back ◽

Program Costs

Abstract Background The overuse of diagnostic imaging for low back pain (LBP) in Australia results in unnecessary cost to the health system and, for patients, avoidable exposure to radiation. The 2013 NPS MedicineWise LBP program aimed to reduce unnecessary diagnostic imaging for non-specific acute LBP in the Australian primary care setting. The LBP program delivered referral pattern feedback, a decision support tool and patient information to 19,997 (60%) of registered Australian general practitioners (GPs). This study describes the findings from evaluation of the effectiveness of the 2013 LBP program at reducing X-ray and computed tomography (CT) scans of the lower back, and the financial costs and benefits of the program to the government funder. Methods The effectiveness of the 2013 LBP program was evaluated using population-based time-series analysis of administrative claims data of Medicare Benefits Schedule (MBS) funded X-ray and CT scan services of the lower back. The CT scan referral trend of non-GP health professionals was used as an observational control group in a Bayesian structural time-series model. A retrospective cost–benefit analysis and cost-effectiveness analysis was conducted using program costs from organisational records and reimbursement data from the MBS. Results The 2013 NPS MedicineWise LBP program was associated with a statistically significant 10.85% relative reduction in the volume of CT scans of the lumbosacral region, equating to a cost reduction to the MBS of AUD$11,600,898. The best available estimate of program costs was AUD$141,154. Every dollar of funding spent on the 2013 LBP program saved AUD$82 of funding to the MBS for CT scan reimbursements. Therefore, from the perspective of the Australian Government Department of Health, the 2013 LBP program was cost saving. The program cost AUD$2.82 per CT scan averted in comparison to the scenario of no program. No association between the 2013 NPS MedicineWise LBP program and the volume of X-ray items on the MBS was observed. Conclusions The 2013 NPS MedicineWise LBP program reduced CT scan referral by GPs, in line with the program’s messages and clinical guidelines. Reducing this low-value care produced savings to the health system that exceeded the costs of program implementation.

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LO008: Assessment of the need for diagnostic imaging in extremity injuries by advanced care paramedics

CJEM ◽

10.1017/cem.2016.45 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S32-S33

Author(s):

P. Froese ◽

M.B. Butler ◽

S.G. Campbell ◽

K. Magee ◽

R.P. Mackinley

Keyword(s):

Diagnostic Imaging ◽

Patient Flow ◽

Body Part ◽

Initial Assessment ◽

X Rays ◽

Convenience Sample ◽

Predictive Values ◽

X Ray ◽

Subsequent Test ◽

Extremity Injuries

Introduction: Emergency department (ED) crowding is a national challenge. Initiatives to help address this at our ED include the use of a six-bed fast-track unit staffed by advanced-care paramedics (ACPs). Institutional byelaws only allow diagnostic imaging (DI) ordering by physicians (MD). An ACP requesting DI at the time of first assessment would likely improve patient flow. We investigated whether ACPs can safely and cost-effectively request DI for extremity injuries without increasing cost or exposing patients to unnecessary radiation. Methods: A prospective evaluation of a convenience sample of patients presenting with an extremity injury sustained within 48 hours of presentation. At time of initial assessment, the ACP, following specific guidelines, recorded whether or not they believed an x-ray was indicated, and if so, what DI views they felt appropriate. Their opinion was blinded from the physician subsequently assessing the patient. An ACP opinion of the need for DI was compared with the subsequent test ordered by the MD. The MD decision to order DI was considered ‘gold standard’. Opinions were considered “matched” if the MD ordered DI of the same body part that the ACP believed was indicated. Sensitivity, specificity, positive predictive and negative predictive values (PPV, NPV) were calculated. Using data from our ED information system, we estimated the time that would have been saved by allowing ACPs to order DI. Results: Of 199 patients 192 images were ordered and 89 fractures were diagnosed. ACPs and MDs agreed that DI was necessary 94.70% of the time (95% CI: {90.6%, 97.4%}). There were 8 x-rays the ACP did not order that the MD did order, of which one showed a fracture. Twice, the ACP would have ordered an x-ray that the MD did not. In terms of identifying the need for DI, ACPs were 95.8% sensitive and 71.4% specific. The PPV was 98.9% (95% CI: {95.8%, 99.8%}), and the NPV was 38.5% (95% CI: {15.1%, 67.7%}). On average, ACP opinion of DI indication was made 54.1 minutes (95% CI: {48.0, 60.2}) earlier that of the MD. Conclusion: The overall agreement between MDs and ACPs was almost 95%. ACPs are more likely to under-order x-rays than to over-order them, lowering the risk of increasing radiation exposure and cost. ACP DI ordering may decrease the time of processing of patients with extremity injuries by almost an hour.

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