scholarly journals Impact of Focused Echocardiography on Scan Time and Diagnostic Quality in Patients with COVID-19

2020 ◽  
Vol 33 (11) ◽  
pp. 1415-1416
Author(s):  
Csilla Jozsa ◽  
Bassey Ussen ◽  
Ricardo Monteiro ◽  
Roma Bingcang ◽  
Guy Lloyd ◽  
...  
Keyword(s):  
Diagnostic Quality ◽  
Scan Time ◽  
Focused Echocardiography

Minimizing contrast medium doses to diagnose pulmonary embolism with 80-kVp multidetector computed tomography in azotemic patients

2009 ◽  
Vol 50 (2) ◽  
pp. 181-193 ◽  
Author(s):  
F. Holmquist ◽  
K. Hansson ◽  
F. Pasquariello ◽  
J. Björk ◽  
U. Nyman
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Body Weight ◽  
Pulmonary Artery ◽  
Multidetector Computed Tomography ◽  
Routine Practice ◽  
Dose Length Product ◽  
Diagnostic Quality ◽  
Scan Time ◽  
Noise Ratio

Background: In diagnosing acute pulmonary embolism (PE) in azotemic patients, scintigraphy and magnetic resonance imaging are frequently inconclusive or not available in many hospitals. Computed tomography is readily available, but relatively high doses (30–50 g I) of potentially nephrotoxic iodine contrast media (CM) are used. Purpose: To report on the diagnostic quality and possible contrast-induced nephropathy (CIN) after substantially reduced CM doses to diagnose PE in azotemic patients using 80-peak kilovoltage (kVp) 16-row multidetector computed tomography (MDCT) combined with CM doses tailored to body weight, fixed injection duration adapted to scan time, automatic bolus tracking, and saline chaser. Material and Methods: Patients with estimated glomerular filtration rate (eGFR) <50 ml/min were scheduled to undergo 80-kVp MDCT using 200 mg I/kg, and those with eGFR ≥50 ml/min, 120-kVp MDCT with 320 mg I/kg. Both protocols used an 80-kg maximum dose weight and a fixed 15-s injection time. Pulmonary artery density and contrast-to-noise ratio were measured assuming 70 Hounsfield units (HU) for a fresh clot. CIN was defined as a plasma creatinine rise >44.2 µmol/l from baseline. Results: 89/148 patients (63/68 females) underwent 80-/120-kVp protocols, respectively, with 95% of the examinations being subjectively excellent or adequate. Mean values in the 80-/120-kVp cohorts regarding age were 82/65 years, body weight 66/78 kg, effective mAs 277/117, CM dose 13/23 g I, pulmonary artery density 359/345 HU, image noise (1 standard deviation) 24/21 HU, contrast-to-noise ratio 13/13, and dose-length product 173/258 mGy·cm. Only 1/65 and 2/119 patients in the 80- and 120-kVp cohorts, respectively, with negative CT and no anticoagulation suffered non-fatal thromboembolism during 3-month follow-up. No patient developed CIN. Conclusion: 80-kVp 16-row MDCT with optimization of injection parameters may be performed with preserved diagnostic quality, using markedly reduced CM doses compared with common routine practice, which should be to the benefit of patients at risk of CIN.

Abstract 226: Impact of Reporting Cardiac Magnetic Resonance Examination Duration on the Total Scan Time: A Tertiary Academic Health Care Hospital Experience

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Manavjot S Sidhu ◽  
Heidi Lumish ◽  
Shanmugam Uthamalingam ◽  
Leif-Christopher Engel ◽  
Mannudeep Kalra ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Wilcoxon Test ◽  
Care Hospital ◽  
Diagnostic Quality ◽  
Scan Time ◽  
Two Samples ◽  
Significant Difference ◽  
Simple Step ◽  
Time Allotment

Background: The core components of a quality improvement (QI) program focus on consistent, high-quality service delivery. We report our experience with a QI program focused on cardiac magnetic resonance (CMR) examination duration reduction. Methods: Department policy for the scan time allotment for a clinical CMR examination was reviewed. Medical records of all patients who underwent CMR examination from January 2010 to December 2010 were reviewed. Scan duration from time of the initial to the final image acquisition was recorded. An intervention was implemented from January 2011 to September 2011 to report the scan durations weekly to all CMR physicians. Monthly comparisons were performed between the 2010 and 2011 exams. No changes were made in department protocols. Results: The allotted time for a CMR examination was 90 minutes. From January to September 2010, the mean (±SD) scan duration for CMR examinations was 105 (± 32) minutes, as compared with a mean of 87 (±21) minutes for the same months in 2011. Comparison between the 2010 and 2011 scan durations using a Wilcoxon test indicated a significant difference between the two samples (p<0.05; Figure 1). The percentage of all scans exceeding 120 minutes in duration decreased from 27.4% (n=529) in 2010 to 5.3% (n=451) in 2011. The indications for CMR examinations were found to be similar between 2011 and 2010 (p<0.05). All exams were reported to be of diagnostic quality. Conclusions: The simple step of publicly reporting weekly scan durations to house staff and attending physicians resulted in significant reduction in CMR scan durations, with preserved diagnostic quality. We propose that increased awareness led to higher efficiency.

scholarly journals Evaluation of accelerated motion-compensated 3d water/fat late gadolinium enhanced MR for atrial wall imaging

2021 ◽  
Author(s):  
Camila Munoz ◽  
Iain Sim ◽  
Radhouene Neji ◽  
Karl P. Kunze ◽  
Pier-Giorgio Masci ◽  
...  
Keyword(s):  
Image Quality ◽  
Respiratory Motion ◽  
Invasive Technique ◽  
Atrial Wall ◽  
Gadolinium Enhancement ◽  
Diagnostic Quality ◽  
Accelerated Motion ◽  
Non Invasive ◽  
Scan Time ◽  
Wall Imaging

Abstract Objective 3D late gadolinium enhancement (LGE) imaging is a promising non-invasive technique for the assessment of atrial fibrosis. However, current techniques result in prolonged and unpredictable scan times and high rates of non-diagnostic images. The purpose of this study was to compare the performance of a recently proposed accelerated respiratory motion-compensated 3D water/fat LGE technique with conventional 3D LGE for atrial wall imaging. Materials and methods 18 patients (age: 55.7±17.1 years) with atrial fibrillation underwent conventional diaphragmatic navigator gated inversion recovery (IR)-prepared 3D LGE (dNAV) and proposed image-navigator motion-corrected water/fat IR-prepared 3D LGE (iNAV) imaging. Images were assessed for image quality and presence of fibrosis by three expert observers. The scan time for both techniques was recorded. Results Image quality scores were improved with the proposed compared to the conventional method (iNAV: 3.1 ± 1.0 vs. dNAV: 2.6 ± 1.0, p = 0.0012, with 1: Non-diagnostic to 4: Full diagnostic). Furthermore, scan time for the proposed method was significantly shorter with a 59% reduction is scan time (4.5 ± 1.2 min vs. 10.9 ± 3.9 min, p < 0.0001). The images acquired with the proposed method were deemed as inconclusive less frequently than the conventional images (expert 1/expert 2: 4/7 dNAV and 2/4 iNAV images inconclusive). Discussion The motion-compensated water/fat LGE method enables atrial wall imaging with diagnostic quality comparable to the current conventional approach with a significantly shorter scan of about 5 min.

scholarly journals Radial self-navigated native magnetic resonance angiography in comparison to navigator-gated contrast-enhanced MRA of the entire thoracic aorta in an aortic patient collective

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Martina Correa Londono ◽  
Nino Trussardi ◽  
Verena C. Obmann ◽  
Davide Piccini ◽  
Michael Ith ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Image Quality ◽  
Magnetic Resonance Angiography ◽  
Thoracic Aorta ◽  
Aortic Root ◽  
Aortic Disease ◽  
Ascending Aorta ◽  
Scan Time ◽  
Contrast Enhanced

Abstract Background The native balanced steady state with free precession (bSSFP) magnetic resonance angiography (MRA) technique has been shown to provide high diagnostic image quality for thoracic aortic disease. This study compares a 3D radial respiratory self-navigated native MRA (native-SN-MRA) based on a bSSFP sequence with conventional Cartesian, 3D, contrast-enhanced MRA (CE-MRA) with navigator-gated respiration control for image quality of the entire thoracic aorta. Methods Thirty-one aortic native-SN-MRA were compared retrospectively (63.9 ± 10.3 years) to 61 CE-MRA (63.1 ± 11.7 years) serving as a reference standard. Image quality was evaluated at the aortic root/ascending aorta, aortic arch and descending aorta. Scan time was recorded. In 10 patients with both MRA sequences, aortic pathologies were evaluated and normal and pathologic aortic diameters were measured. The influence of artifacts on image quality was analyzed. Results Compared to the overall image quality of CE-MRA, the overall image quality of native-SN-MRA was superior for all segments analyzed (aortic root/ascending, p < 0.001; arch, p < 0.001, and descending, p = 0.005). Regarding artifacts, the image quality of native-SN-MRA remained superior at the aortic root/ascending aorta and aortic arch before and after correction for confounders of surgical material (i.e., susceptibility-related artifacts) (p = 0.008 both) suggesting a benefit in terms of motion artifacts. Native-SN-MRA showed a trend towards superior intraindividual image quality, but without statistical significance. Intraindividually, the sensitivity and specificity for the detection of aortic disease were 100% for native-SN-MRA. Aortic diameters did not show a significant difference (p = 0.899). The scan time of the native-SN-MRA was significantly reduced, with a mean of 05:56 ± 01:32 min vs. 08:51 ± 02:57 min in the CE-MRA (p < 0.001). Conclusions Superior image quality of the entire thoracic aorta, also regarding artifacts, can be achieved with native-SN-MRA, especially in motion prone segments, in addition to a shorter acquisition time.

scholarly journals A Real-Time, Automatic, and Dynamic Scheduling and Control System for PET Patients Based on Wearable Sensors

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1104
Author(s):  
Shin-Yan Chiou ◽  
Kun-Ju Lin ◽  
Ya-Xin Dong
Keyword(s):  
Control System ◽  
Real Time ◽  
Human Error ◽  
Dynamic Scheduling ◽  
Wearable Sensors ◽  
Time Data ◽  
Scan Time ◽  
Number Of Patients ◽  
And Control ◽  
Automatic Scheduling

Positron emission tomography (PET) is one of the commonly used scanning techniques. Medical staff manually calculate the estimated scan time for each PET device. However, the number of PET scanning devices is small, the number of patients is large, and there are many changes including rescanning requirements, which makes it very error-prone, puts pressure on staff, and causes trouble for patients and their families. Although previous studies proposed algorithms for specific inspections, there is currently no research on improving the PET process. This paper proposes a real-time automatic scheduling and control system for PET patients with wearable sensors. The system can automatically schedule, estimate and instantly update the time of various tasks, and automatically allocate beds and announce schedule information in real time. We implemented this system, collected time data of 200 actual patients, and put these data into the implementation program for simulation and comparison. The average time difference between manual and automatic scheduling was 7.32 min, and it could reduce the average examination time of 82% of patients by 6.14 ± 4.61 min. This convinces us the system is correct and can improve time efficiency, while avoiding human error and staff pressure, and avoiding trouble for patients and their families.

Artificial intelligence-guided image acquisition on patients with implanted electrophysiological devices: results from a pivotal prospective multi-center clinical trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Surette ◽  
A Narang ◽  
R Bae ◽  
H Hong ◽  
Y Thomas ◽  
...  
Keyword(s):  
Qualitative Assessment ◽  
Funding Source ◽  
Software Performance ◽  
Private Company ◽  
Diagnostic Quality ◽  
Icd Leads ◽  
Significant Difference ◽  
Level 3 ◽  
And Function ◽  
The Impact

Abstract Background A novel, recently FDA-authorized software uses deep learning (DL) to provide prescriptive transthoracic echocardiography (TTE) guidance, allowing novices to acquire standard TTE views. The DL model was trained by &gt;5,000,000 observations of the impact of probe motion on image orientation/quality. This study evaluated whether novice-acquired TTE images guided by this software were of diagnostic quality in patients with and without implanted electrophysiological (EP) devices, focusing on RV size and function, which were thought to be sensitive to EP devices. Some aspects of the study have previously been presented. Methods 240 patients (61±16 years old, 58% male, 33% BMI &gt;30 kg/m2, 91% with cardiac pathology) were recruited. 8 nurses without echo experience each acquired 10 view TTEs in 30 patients guided by the software. 235 of the patients were also scanned by a trained sonographer without assistance from the software. 5 Level 3 echocardiographers independently assessed the diagnostic quality of the TTEs acquired by the nurses and sonographers to evaluate the effect of EP devices on DL software performance. Results Nurses using the AI-guided acquisition software acquired TTEs of sufficient quality to make qualitative assessments of right ventricular (RV) size and function in greater than 80% of cases for patients with and without implanted EP devices (Table). There was no significant difference between nurse- and sonographer-acquired scans. Conclusion These results indicate that new DL software can guide novices to obtain TTEs that enable qualitative assessment of RV size even in the presence of implanted EP devices. The results of the comparison to sonographer-acquired exams indicate the software performance is robust to presence of pacemaker/ICD leads visible in the images (Figure). Nurse-acquired TTE with visible ICD lead Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Caption Health, Inc.

Combined Muscle Biopsy and Comprehensive Electrophysiology in General Anesthesia is Valuable in Diagnosis of Neuromuscular Disease in Children

2021 ◽  
Author(s):  
Christina E. Hoei-Hansen ◽  
Marie L. B. Tygesen ◽  
Morten Dunø ◽  
John Vissing ◽  
Martin Ballegaard ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Muscle Biopsy ◽  
Neuromuscular Disease ◽  
Genetic Diagnosis ◽  
Congenital Myasthenic Syndrome ◽  
Diagnostic Quality ◽  
Pathogenic Variants ◽  
Combined Use ◽  
Myasthenic Syndrome ◽  
Size Variability

Abstract Aim The diagnostic workup in patients with delayed motor milestones suspected of having either myopathy or a congenital myasthenic syndrome is complex. Our hypothesis was that performance of a muscle biopsy and neurophysiology including stimulated single-fiber electromyography during an anesthetic procedure, combined with genetic testing has a high diagnostic quality. Materials and Methods Clinical and paraclinical data were retrospectively collected from 24 patients aged from 1 month to 10 years (median: 5.2 years). Results Neurophysiology examination was performed in all patients and was abnormal in 11 of 24. No patients had findings suggestive of a myasthenic syndrome. Muscle biopsy was performed in 21 of 24 and was normal in 16. Diagnostic findings included nemaline rods, inclusion bodies, fiber size variability, and type-II fiber atrophy. Genetic testing with either a gene panel or exome sequencing was performed in 18 of 24 patients, with pathogenic variants detected in ACTA1, NEB, SELENON, GRIN2B, SCN8A, and COMP genes. Conclusion Results supporting a neuromuscular abnormality were found in 15 of 24. In six patients (25%), we confirmed a genetic diagnosis and 12 had a clinical neuromuscular diagnosis. The study suggests that combined use of neurophysiology and muscle biopsy in cases where genetic testing does not provide a diagnosis can be useful in children with delayed motor milestones and clinical evidence of a neuromuscular disease.

Contrast-agent free evaluation of cardiomyopathies with T1 mapping and the new fast strain-encoded (fSENC) magnetic resonance imaging

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Hirschberg ◽  
O Paul ◽  
J Salatzki ◽  
F Andre ◽  
J Riffel ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Agent ◽  
T1 Mapping ◽  
Hypertensive Heart Disease ◽  
Study Groups ◽  
Resonance Imaging ◽  
Gadolinium Enhancement ◽  
Scan Time ◽  
Normal Individuals

Abstract Background Cardiomyopathies (CMP) may cause impairment of cardiac function and structure. Cardiac Magnetic Resonance Imaging (CMR) is used for analysis and risk stratification of CMP by Late Gadolinium Enhancement (LGE). However, T1 mapping (T1) and fast strain encoded (f-SENC) sequences allow contrast-free and faster exams. The aim of this study was to characterize CMP by T1 and f-SENC to develop a faster and safer CMR protocol (fast-CMR). Methods CMP scans from our CMR database were retrospectively analyzed. All patients were scanned at 1.5T/3T scanner. Study groups were divided as follows: Patients with normal findings, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), hypertensive heart disease (HHD) and cardiac amyloidosis. Global T1 times, longitudinal (GLS) and circumferential (GCS) strain using f-SENC of study groups were compared to healthy individuals (controls). Scan time and amount of gadolinium-based contrast agent (CA) in CMR-protocol with LGE were compared to fast-CMR. Results 174 patients and 31 controls were recruited. T1 times, GLS and GCS were similar between controls and normal individuals. T1 times were significantly increased (p&lt;0.05), while GLS and GCS were significantly reduced (p&lt;0.05) in all CMR study groups compared to controls (Table 1). Using fast-CMR 21 (±6) min of scan time were saved, about 47%, and 9 (±2) ml of CA were saved per patient. Conclusion Normal findings could be identified by fast-CMR without contrast agent. Fast CMR might also be a useful tool to identify different forms of CMP. Funding Acknowledgement Type of funding source: None

scholarly journals Understanding PI-QUAL for prostate MRI quality: a practical primer for radiologists

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Francesco Giganti ◽  
Alex Kirkham ◽  
Veeru Kasivisvanathan ◽  
Marianthi-Vasiliki Papoutsaki ◽  
Shonit Punwani ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Signal To Noise Ratio ◽  
High Signal ◽  
Diagnostic Quality ◽  
Prostate Mri ◽  
Prostate Imaging ◽  
Dynamic Contrast Enhanced ◽  
Diffusion Weighted ◽  
Contrast Enhanced

AbstractProstate magnetic resonance imaging (MRI) of high diagnostic quality is a key determinant for either detection or exclusion of prostate cancer. Adequate high spatial resolution on T2-weighted imaging, good diffusion-weighted imaging and dynamic contrast-enhanced sequences of high signal-to-noise ratio are the prerequisite for a high-quality MRI study of the prostate. The Prostate Imaging Quality (PI-QUAL) score was created to assess the diagnostic quality of a scan against a set of objective criteria as per Prostate Imaging-Reporting and Data System recommendations, together with criteria obtained from the image. The PI-QUAL score is a 1-to-5 scale where a score of 1 indicates that all MR sequences (T2-weighted imaging, diffusion-weighted imaging and dynamic contrast-enhanced sequences) are below the minimum standard of diagnostic quality, a score of 3 means that the scan is of sufficient diagnostic quality, and a score of 5 implies that all three sequences are of optimal diagnostic quality. The purpose of this educational review is to provide a practical guide to assess the quality of prostate MRI using PI-QUAL and to familiarise the radiologist and all those involved in prostate MRI with this scoring system. A variety of images are also presented to demonstrate the difference between suboptimal and good prostate MR scans.

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