Clinical/methodological problem: The identification of clinically significant prostate carcinomas while avoiding overdiagnosis of low-malignant tumors is a challenge in routine clinical practice. Standard radiologic procedures: Multiparametric magnetic resonance imaging (MRI) of the prostate acquired and interpreted according to PI-RADS (Prostate Imaging Reporting and Data System Guidelines) is accepted as a clinical standard among urologists and radiologists. Methodological innovations: The PI-RADS guidelines have been newly updated to version 2.1 and, in addition to more precise technical requirements, include individual changes in lesion assessment. Performance: The PI-RADS guidelines have become crucial in the standardization of multiparametric MRI of the prostate and provide templates for structured reporting, facilitating communication with the referring physician. Evaluation: The guidelines, now updated to version 2.1, represent a refinement of the widely used version 2.0. Many aspects of reporting have been clarified, but some previously known limitations remain and require further improvement of the guidelines in future versions.
Introduction: Stenoses in the path of arteriovenous fistulas (AVF) for hemodialysis are a very prevalent problem and there is long experience in their treatment by percutaneous angioplasty (PTA). These procedures, however, involve non-negligible equipment requirements, exposure to radiation and intravenous contrast that are not beneficial for the patient and make their performance more complex. This study reviews our initial experience with Doppler ultrasound-guided angioplasty. Methods: Prospective cohort of patients with native AVF dysfunction due to significant venous stenosis treated by Doppler echo-guided PTA. AVF puncture, lesion catheterization, balloon localization and inflation, and outcome verification were performed under ultrasound guidance. Only one fistulography was performed before and another one after dilatation. As a control, the cases performed during the same period by the usual angiographic method were also collected. Results: Between February 2015 and September 2018, 51 PTAs were performed on native AVF, of which 27 were echogenic (mean age, 65.3 years; 63% male). The technical success rate was 96%. In 26% of cases, PTA was repeated due to residual stenosis after angiographic imaging. There were 7.3% periprocedural complications. 92% of the AVFs were punctured at 24 hours. Primary patency at 1 month, 6 months and 1 year was 100%, 64.8% and 43.6%, and assisted patency was 100%, 87.2% and 74.8%. There were no significant differences in immediate or late results with respect to angiographically guided AVF angioplasty. Conclusions: AVF-PTA can be performed safely and effectively guided by Doppler ultrasound, which simplifies the logistics required for its performance, although we still need to improve the capacity for early verification of the result with this imaging technique.
Background: Through the development of robust techniques and their comprehensive validation, cardiac magnetic resonance imaging (CMR) has developed a wide range of indications in its almost 25 years of clinical use. The recording of cardiac volumes and systolic ventricular function as well as the characterization of focal myocardial scars are now part of standard CMR imaging. Recently, the introduction of accelerated image acquisition technologies, the new imaging methods of myocardial T1 and T2 mapping and 4-D flow measurements, and the new post-processing technique of myocardial feature tracking have gained relevance. Method: This overview is based on a comprehensive literature search in the PubMed database on new CMR techniques and their clinical application. Results and conclusion: This article provides an overview of the latest technical developments in the field of CMR and their possible applications based on the most important clinical questions.
In the process of X-ray transmission imaging, the mutual occlusion between structures will lead to the image information overlap, and the computed tomography (CT) method is often required to obtain the structure information at different depths, but with low efficiency. To address these problems, an X-ray focused on imaging algorithm based on multi-line scanning is proposed, which only requires the scene target to pass through the detection area along a straight line to extract multi-view information, and uses the optical field reconstruction theory to achieve the de-obscured reconstruction of the structure at a specified depth with high real-time. The results of multi-line scan and X-ray reconstruction of the target show that the proposed method can reconstruct the information of any specified depth layer, and it can perform fast imaging detection of the mutually occluded target structures and improve the recognition of the occluded targets, which has a good application prospect.
Introduction: Periodontal disease affects more than half of the population in Colombia and is estimated to be one of the leading causes of oral morbidity. Diagnostic aids that allow the evaluation of its extension and severity are of importance since this will provide reliable tools to quantify the severity of the problem. Objective: To determine the inter-examiner agreement for the detection of radiographic findings in patients with localized chronic periodontitis using conventional periapical radiography. Methods: Study of diagnostic tests including patients with localized chronic periodontitis, the tooth with the worst clinical insertion level and a single conventional radiograph per dental organ using parallelism technique. The radiographic evaluations were performed by two independent and blinded evaluators for the findings: lamina dura, bone defects and type of defect. The agreement obtained was estimated through Cohen’s Kappa. Results: A total of 125 radiographs were taken. The mean age was 38.8 ± 9.9, and 61.6% were women. Concordance for lamina dura was 0.08 (95% CI: -0.04–0.21), bone defects 1.00 (95% CI: 1.00–1.00); type of defect present 0.31 (95% CI: 0.29–0.38). Conclusions: Concordance was evaluated as null, almost perfect and acceptable for the findings lamina dura, presence of bone defects and type of defect respectively. For some findings and given the importance of the diagnostic and therapeutic processes, more accurate evaluations are needed which would result in a higher degree of agreement.
In Costa Rica, there is no explicit recommendation from the competent authorities for the use of a specific phantom, so experts must explore what suppliers offer, among which the Normi Mam Digital phantom from PTW stands out. This article presents the results of the dosimetry and image quality control applied to the Normi Mam Digital phantom to validate it as equipment that complies with the recommendations of the Human Health Series No. 17. The results obtained were satisfactory, proving that the equipment complies with the tolerances recommended by international health bodies.
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