Posts Tagged ‘Radiology’

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Fairview Southdale Hospital in Edina installs Toshiba’s 16-channel Titan 1.5T system

Fairview Southdale Hospital in Edina installs Toshiba’s 16-channel Titan 1.5T system

Fairview Southdale Hospital in Edina, Minn., improved its advanced imaging capabilities and patient comfort by installing the first 16-channel Vantage TitanTM 1.5T scalable system from Toshiba America Medical Systems, Inc. Fairview will use the system for all general MR exams, as well as breast and cardiac imaging, and expand its capabilities by offering prostate imaging to patients.

“Toshiba’s 16-channel Titan 1.5T will enable us to offer more services to our patients and explore new ways of imaging,” said Judy Sager, director, Radiology, Fairview Health Services. “For instance, we plan to utilize the system to visualize CSF bulk flow without contrast to improve diagnoses of CSF disorders non-invasively.”

The 16-channel Titan 1.5T offers patient-friendly features, including a 71 cm bore and feet first exams to reduce claustrophobia. Toshiba’s exclusive Pianissimo™ noise-reduction technology, advanced non-contrast imaging, integrated coils and intuitive M-Power user interface make the system easier to use for the clinician and more comfortable for the patient.

“The 1.5T MR series offers hospitals like Fairview the option to invest in a scalable MR system that meets their clinical needs today, with the opportunity to easily upgrade as their needs change in the future,” said Stuart Clarkson, director, MR Business Unit, Toshiba. “Titan 1.5T improves comfort and compliance, resulting in faster exams and improved patient satisfaction.”

Fairview also utilizes a Toshiba AquilionTM ONE dynamic volume CT and an earlier version of the Vantage Titan 1.5T MR.

Source : http://www.news-medical.net/news/20121203/Fairview-Southdale-Hospital-in-Edina-installs-Toshibas-16-channel-Titan-15T-system.aspx

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Philips Healthcare, UH to showcase latest medical technology at Cleveland Medical Mart

Philips Healthcare, UH to showcase latest medical technology at Cleveland Medical Mart

University Hospitals (UH) and Philips Healthcare are among a group of global leaders in healthcare to showcase the latest medical technology at the new Cleveland Medical Mart & Convention Center. The two organizations will collaborate to highlight innovative imaging technology in use and in development by Philips and other Ohio biomedical companies.

Scheduled to open in July 2013, the $465 million Cleveland Medical Mart & Convention Center is a one million-square-foot campus located in the heart of downtown Cleveland. The space occupied by UH and Philips will anchor the building’s third floor, which is dedicated to “clinical spaces.”

The showcase at the Cleveland Medical Mart is an outgrowth of the Philips Healthcare Global Advanced Imaging Innovation Center, a collaboration between Philips and UH, along with Case Western Reserve University, which brings together scientists and physicians to test and evaluate new imaging technologies. Through the $38.5 million Center, established in 2010, the latest Philips Healthcare imaging equipment is brought to UH Case Medical Center for development, validation of clinical efficacy and product release.

“The Medical Mart showcase will further establish Cleveland as an international hub for imaging technology by highlighting the latest equipment that we have co-developed with Philips right here in Northeast Ohio,” said Thomas F. Zenty III, CEO of University Hospitals. “The synergy between our organizations has created a pipeline to move innovative technologies more quickly into patient care.

We look forward to showcasing the important work that has come out of the Philips Healthcare Global Advanced Imaging Innovation Center to the Cleveland Medical Mart’s visitors, while enhancing the rich heritage and distinctive capability of Northeast Ohio healthcare.”

The Department of Radiology at UH Case Medical Center and Case Western Reserve University, led by Pablo Ros, MD, Professor and Chairman, is home to a number of the nation’s leaders in radiology who partner with Philips, which has one of its North American largest manufacturing headquarters in Cleveland. The announcement comes in conjunction with the Radiological Society of North America annual meeting in Chicago, where Philips will display some of the equipment that will be in the Cleveland Medical Mart showcase.

“We are very excited to join the Cleveland Medical Mart with our partners at the nationally renowned University Hospitals Case Medical Center,” said Dominic Smith, Vice President, Global Computed Tomography at Philips. “Our company aspires to assist clinicians by providing breakthrough imaging technologies that today are not yet possible. The Philips Healthcare Global Advanced Imaging Innovation Center has helped us realize these objectives and in the process, help improve the healthcare of patients in Ohio and throughout the world.”

The four-story Cleveland Medical Mart will serve health and health care innovation, education, and commerce through state-of-the-art spaces, programs, and virtual offerings while building on and enhancing the rich heritage and distinctive capability of Northeast Ohio healthcare. Visitors will come to see state-of-the-art medical technologies in use, without having to go into the care or research setting itself.

“Congratulations to both University Hospitals Case Medical Center and Philips Healthcare for being the first Medical Mart collaborative partnership between a commercial enterprise and a leading healthcare provider,” said Cuyahoga County Executive Ed FitzGerald. “This is yet another positive and visible step forward for the Cleveland Medical Mart project.”

source : http://www.news-medical.net/news/20121127/Philips-Healthcare-UH-to-showcase-latest-medical-technology-at-Cleveland-Medical-Mart.aspx

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Screening for Osteoporosis…During a Mammography?

Screening for Osteoporosis…During a Mammography?

Screening for Osteoporosis…During a Mammography?

Digital X-ray radiogrammetry of hand or wrist radiographs can predict hip fracture risk—a study in 5,420 women and 2,837 men

M. L. Wilczek1, 6 , J. Kälvesten2, 3, J. Algulin2, O. Beiki4, 5 and T. B. Brismar1

(1)

Karolinska Institutet, Department for Clinical Science, Intervention and Technology, Division of Radiology, Karolinska University Hospital, Stockholm, Sweden

(2)

Sectra Imtec AB, Linköping, Sweden

(3)

Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden

(4)

Department of Medicine Solna, Unit of Clinical Epidemiology, Karolinska Institutet, Stockholm, Sweden

(5)

Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran

(6)

Frejgatan 34, 113 26 Stockholm, Sweden

M. L. Wilczek

Email: michael.wilczek@gmail.com

Received: 18 August 2012Revised: 28 September 2012Accepted: 15 October 2012Published online: 16 November 2012

Abstract

Objectives

To assess whether digital X-ray radiogrammetry (DXR) analysis of standard clinical hand or wrist radiographs obtained at emergency hospitals can predict hip fracture risk.

Methods

A total of 45,538 radiographs depicting the left hand were gathered from three emergency hospitals in Stockholm, Sweden. Radiographs with insufficiently included metacarpal bone, fractures in measurement regions, foreign material or unacceptable positioning were manually excluded. A total of 18,824 radiographs from 15,072 patients were analysed with DXR, yielding a calculated BMD equivalent (DXR-BMD). Patients were matched with the national death and inpatient registers. Inclusion criteria were age ? 40 years, no prior hip fracture and observation time > 7 days. Hip fractures were identified via ICD-10 codes. Age-adjusted hazard ratio per standard deviation (HR/SD) was calculated using Cox regression.

Results

8,257 patients (65.6 % female, 34.4 % male) met the inclusion criteria. One hundred twenty-two patients suffered a hip fracture after their radiograph. The fracture group had a significantly lower DXR-BMD than the non-fracture group when adjusted for age. The HR/SD for hip fracture was 2.52 and 2.08 in women and men respectively. The area under the curve was 0.89 in women and 0.84 in men.

Conclusions

DXR analysis of wrist and hand radiographs obtained at emergency hospitals predicts hip fracture risk in women and men.

Key Points

• Digital X-ray radiogrammetry of emergency hand/wrist radiographs predicts hip fracture risk.

• Digital X-ray radiogrammetry (DXR) predicts hip fracture risk in both women and men.

• Osteoporosis can potentially be identified in patients with suspected wrist fractures.

• DXR can potentially be used for selective osteoporosis screening.

Keywords

Osteoporosis Hip fracture Digital X-ray radiogrammetry Cohort BMD

Abbreviations and acronyms

DXR

Digital X-ray radiogrammetry

QCT

Quantitative computed tomography

DXA

Dual-energy X-ray absorptiometry

BMD

Bone mineral density

T-score

Standard deviations above or below the mean for a healthy young adult of the same sex and ethnicity as the patient

Z-score

The number of standard deviations above or below the mean for the patient’s age, sex and ethnicity

HR

Hazard ratio

SD

Standard deviation

ROC

Receiver-operating characteristic

AUC

Area under the curve

ICD-10

International Statistical Classification of Diseases and Related Health Problems, 10th Revision

Institution from which the work originated

Karolinska Institutet Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology, Stockholm, Sweden

Introduction

According to epidemiological studies, about one third of women over 50 years of age will experience a fragility fracture [1, 2]. The number of fractures can be reduced by adequate measures, such as lifestyle adaptations [3–6] and pharmaceutical interventions [7–10]. To be cost effective and avoid unnecessary and potentially harmful pharmaceutical treatment, it is imperative that those at risk are properly identified and targeted.

Previous studies have shown a correlation between bone mineral density (BMD) and the risk of fracture [11–15]. Consequently, BMD measurement has a prominent position in fracture risk assessment and diagnosis of osteoporosis. Dual-energy X-ray absorptiometry (DXA) of the hip or spine is considered the gold standard [12, 15, 16]. Unfortunately, most patients with a high risk of osteoporosis are not scanned by DXA, even when the clinician suspects osteoporosis. This is due to the relatively high costs [17, 18] and low availability of equipment [19–22].

Digital X-ray radiogrammetry (DXR) is a peripheral measurement method based on a combination of an average geometrical measure of the cortical thickness of metacarpals II-IV and structural analysis of cortical bone porosity [23, 24]. The analysis is based on a standard radiograph of the hand (Fig. 1) and gives a computed BMD equivalent measurement. This makes DXR an interesting and potentially cost-effective candidate for the evaluation of osteoporosis-related fracture risk.

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Fig. 1

Wrist radiographs used for DXR analysis of patients with varying DXR T-scores. Measurement regions are indicated over metacarpals II-IV. Patient 1: a 50-year-old woman. DXR T-score 1.18. DXR-BMD 0.64 g/cm2. Patient 2: a 48-year-old woman. DXR T-score -1.90. DXR-BMD 0.49 g/cm2. Patient 3: a 75-year-old woman. DXR T-score -3.70. DXR-BMD 0.41 g/cm2

The objective of this study was to assess whether DXR analysis can predict hip fracture risk by using standard clinical hand or wrist radiographs obtained at emergency hospitals.

Materials and methods

This cohort study includes data from 1 January 2000 to 31 December 2008. The data were retrieved in 2009 and 2010. The ethical committee in Stockholm approved the study.

Radiograph selection

Database queries based on examination codes were used to extract all left hand and wrist radiographs from the digital archives of three major emergency hospitals in the Stockholm region. Clinical indications for left hand or wrist radiographs included suspicion of fracture, luxation, foreign body or arthritis.

A total of 45,538 radiographs were extracted from the digital archives. All measurements and radiographs were manually reviewed by two of the investigators, who were blinded to all clinical information, and assessed according to suitability for further DXR analysis. Inclusion criteria were radiographs of the left hand or wrist depicting sufficient metacarpal bone for DXR analysis. Exclusion criteria were fractures in the measurement regions, foreign material such as fixation pins and plaster, or unacceptable positioning of the metacarpals. In all, 18,824 examinations from 15,072 patients were considered suitable for DXR analysis. In patients with repeated examinations, only the chronologically first evaluable examination was used. The image and patient selection process is illustrated in a flow chart (Fig. 2).

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Fig. 2

Flow chart of how radiographs and patients were selected (gray = inclusion, red = exclusion)

Patient selection

All patients whose radiographs were included for DXR analysis were identified in the National Patient Register provided by the National Board of Health and Welfare. Patients who subsequently had a hip fracture were identified via ICD-10 codes (S72.0, S72.1, S72.2). Inclusion criteria were age >40 years, no hip fracture prior to acquisition of the radiograph and observation time >7 days. To minimise the risk of erroneous registrations, only those coded for both diagnosis and adequate intervention (either upper femur fracture surgery or hip replacement, i.e. ICD-10 surgical codes NFJ and NFB) were registered as hip fracture. In order not to exclude patients with a hip fracture who were too critically ill for surgery, patients who died within 3 days after a registered fracture were also included. Date of fracture diagnosis, date of death or study end date (31 December 2008) was used as censoring time. The National Cause of Death Register provided date of death.

Digital X-ray radiogrammetry and BMD

Digital X-ray radiogrammetry (DXR) (Onescreen, Sectra Imtec AB, Linköping, Sweden) is a development of the traditional technique of radiogrammetry. On a standard projection radiograph, measurement regions are automatically placed around the narrowest parts of metacarpals II-IV. A BMD equivalent measurement (DXR-BMD) is then computed. The calculation is defined as DXR-BMD = cxVPAx(1-p) where c is a density constant empirically determined so that DXR-BMD on average is equal to the mid-distal forearm region of the Hologic QDR-2000 densitometer (Hologic, Bedford, MA, USA), VPA is cortical bone volume per area and p is porosity. When comparing an individual’s DXR-BMD to the mean DXR-BMD of a young, healthy, normal reference population, a DXR T-score can be derived. When compared to a healthy reference population of the same age, a DXR Z-score is obtained.

Any digital or CR radiography equipment that is applicable for acquiring hand X-ray images can be used to acquire images for DXR-BMD analysis. The DXR analysis process is automated and operator independent. However, there are some requirements about positioning and exposure settings, e.g., when acquiring radiographs intended for DXR analysis. Some requirements are generic (posterior-anterior X-ray image of one hand, palm flat to detector table/image plate surface, focus centred on metacarpal III) and some are specific per modality type and model (image postprocessing settings, focus distance, exposure settings, location on detector).

The DXR technology has been described in more detail previously [23, 24], and normative reference tables have been published [25, 26].

Statistical analysis

Group comparisons were made using Student’s t-test for continuous normally distributed data. Receiver-operator characteristics (ROC) were plotted (Fig. 3) to evaluate the predictive value of the DXR T-score to assess fracture risk. In these graphs the sensitivity of a parameter, in this case DXR T-score, to predict future fractures is plotted as a function of the proportion of false positives (1-specificity). To compensate for age-related fracture risk that is not related to DXR-BMD (e.g. the increased tendency to fall), the ROCs were adjusted for age. To enable comparison among different studies, the area under the plotted age-adjusted ROC curve, the AUC and the age-adjusted hazard ratio per standard deviation change in DXR T-score (HR/SD) were calculated. The HR/SD was calculated using Cox regression and the risk of sustaining a hip fracture at DXR T-scores >-1 was defined as risk = 1. SAS® 9.2 (SAS Institute, Cary, NC) was used for the statistical analysis.

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Fig. 3

a Age-adjusted ROC curve for women. b Age-adjusted ROC curve for men

A new study from Karolinska Institutet in Sweden shows, that a technique for measuring bone density called digital X-ray radiogrammetry (or DXR) used on standard hand radiographs can help to identify patients with a higher risk of hip fracture. The researchers believe that DXR, which is fully comparable with other, more costly methods, can be used preventively to identify people in the risk zone for osteoporosis – a disease estimated to effect some 200 million women worldwide.

Torkel Brismar Photo: Anders Svensson

Each year, approximately 1.7 million hip fractures occur worldwide (about 18,000 only in Sweden), mainly in elderly people and women with osteoporosis. A hip fracture can be particularly serious for the elderly; it often entails lengthy rehabilitation and leaves many patients unable to lead an independent life. Moreover, between 10 and 20 per cent of sufferers die from complications. Apart from the human suffering they cause, hip fractures are also very costly to the healthcare services in the amount of care they demand.

“If we can identify people with osteoporosis and treat them with drugs, we can reduce the risk of hip fracture,” says principal investigator, Associate Professor Torkel Brismar of Karolinska Institutet’s Department of Clinical Sciences, Intervention and Technology. “Our research shows that DXR is a technique that lends itself well to this, maybe at general health check-ups, or screenings, for example, or when people seek treatment for a suspected hand or wrist fracture.”

For the present study, which is published in the scientific journal European Radiology, the researchers analysed digital hand X-rays taken at three hospitals in Stockholm between 2000 and 2008. Their databank included pictures from over 8,000 men and women aged forty years and up. They used DXR to assess bone density in the hand, and by searching in the National Board of Health and Welfare fracture registry they were able to study the link between bone density in the hand and the risk of hip fracture.

Analysis of the sub-group of 122 patients who had suffered a post-X-ray hip fracture showed that they had significantly lower bone density than those who had not had a hip fracture, a result that held up also when adjusted for age. The DXR technique uses a normal X-ray of the hand to analyse the thickness and texture (i.e. small variations in density) of the metacarpal bones. The analysis is automatic and includes around 1,000 measurements. The standard method of measuring bone density is currently DXA (dual-energy X-ray absorptiometry).

In this study, the researchers showed that DXR is at least as effective as DXA, which means that the former might one day be an important feature of osteoporosis examinations as part of a general screening. Several pilot projects are underway in several counties to ascertain whether DXR screening of bone density is a useful way of preventing hip fractures.

The study was financed with ALF funds (provided through the agreement on medical training and research) and also a grant from the Stockholm County Council. The material was analysed free of charge by DXR-software developer Sectra, which also employs two of the study’s co-authors.

Approximately 1.7 million hips are fractured each year, most often due to progressive bone demineralization from osteoporosis. While there is a lot of cool technology aimed at fixing hip fractures, it would be even better if we could find ways to prevent the fractures in the first place.

Researchers at the Karolinska Institute in Sweden have found a relatively easy technique that may be used to screen for those at risk for hip fractures. In a paper published last week in European Radiology the scientists describe how they analyzed 18,824 left-hand radiographs from over 8,000 patients using digital X-ray radiogrammetry (DXR). They correlated measurements of bone cortex porosity and thickness with whether the patients suffered a hip fracture following the X-ray. According to the Karolinska press release:

Analysis of the sub-group of 122 patients who had suffered a post-X-ray hip fracture showed that they had significantly lower bone density than those who had not had a hip fracture, a result that held up also when adjusted for age. The DXR technique uses a normal X-ray of the hand to analyse the thickness and texture (i.e. small variations in density) of the metacarpal bones. The analysis is automatic and includes around 1,000 measurements. The standard method of measuring bone density is currently DXA (dual-energy X-ray absorptiometry).

In this study, the researchers showed that DXR is at least as effective as DXA, which means that the former might one day be an important feature of osteoporosis examinations as part of a general screening. Several pilot projects are underway in several counties to ascertain whether DXR screening of bone density is a useful way of preventing hip fractures.

Two of the study authors are employees of Sectra, a medical imaging company specializing in orthopedics and rheumatology. One of their medical experts is quoted in the press release speaking about the potential of combining DXR-based osteoporosis screening with mammographies given the similar equipment used (men would presumably be screened under different circumstances) :

Sectra OneScreen can easily be combined with mammograms by taking a hand X-ray at the same time as breast images using the same radiology equipment. The extra examination takes less than 30 seconds…”If all mammograms were combined with osteoporosis screenings, a portion of the hip fractures occurring every year could be prevented, which would reduce personal suffering and generate major cost savings for the healthcare sector.”

Medgadget interviewed lead study author, Michael Wilczek, of the Karolinska Institute about the team’s findings:

Shiv Gaglani, Medgadget: How is hip fracture risk currently assessed?

Michael Wilczek Screening for Osteoporosis…During a Mammography? (Interview)Michael Wilczek: Hip fracture risk is currently assessed with risk assessment instruments, FRAX being the most commonly used, which are based on a combination of hereditary and clinical risk factors. Ideally such a risk assessment tool is also combined with a dual-energy x-ray absorptiometry (DXA) scan, which provides a measurement of bone density. A DXA scan is required to diagnose osteoporosis.

Medgadget: Can you discuss the pros and cons of DXR as compared with DXA?

Wilczek: DXR has several advantages compared to DXA. It is fast, each examination takes about 1-2 minutes whereas a DXA scan normally takes between 15-20 minutes. DXR only requires standard x-ray equipment that can take plain radiographs and an internet connection in order to function. DXA is more complicated and requires specific devices and certified staff that can operate them. Thus DXR has the potential to be widely available and reach areas without current access to DXA. Another theoretical benefit is the high reproducibility of DXR that has been shown in previous studies.

Medgadget: Do you have a sense of potential screening recommendations using DXR? For example, Sectra mentioned that DXR could be combined with mammography screening.

Wilczek: Our previous study results suggest that DXR can be used for a selective screening, e.g. for patients seeking the emergency department. We hypothesize that DXR can also be used for general screening, for example in conjunction with mammography. This is something that we are currently investigating. The method’s ability to estimate hip fracture risk in a general population needs to be studied as do the health economical aspects of osteoporosis screening with DXR. We expect to have those answers in a couple of years.

Source : http://link.springer.com/article/10.1007/s00330-012-2706-9/fulltext.html

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Siemens introduces ACUSON Freestyle ultrasound system with wireless transducers at RSNA 2012

Siemens introduces ACUSON Freestyle ultrasound system with wireless transducers at RSNA 2012

At the 98th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA), November 25-30 in Chicago, Siemens Healthcare (Booth #831, East Building/Lakeside Center at McCormick Place, Hall D) is introducing the ACUSON Freestyle™ ultrasound system that features wireless transducers, eliminating the impediment of cables in ultrasound imaging. To enable this pioneering technology, the system brings to the market a large number of innovations, including acoustics, system architecture, radio design, miniaturization, and image processing. The ACUSON Freestyle system will expand ultrasound’s use in interventional and therapeutic applications, where the technology provides numerous workflow and image quality advantages. The development of wireless ultrasound is in line with the objectives of the Healthcare Sector’s global initiative Agenda 2013 – specifically in the areas of innovation and accessibility.

“Siemens Healthcare is the first company to introduce an ultrasound system that enables physicians to work with cable-free transducers”

Transducer cables have always been a cumbersome necessity in ultrasound imaging. Not only are they an impediment to fast and ergonomic examination procedures, but they also present an infection control risk in sterile interventional settings, even when they are covered in sterile sheaths. “Siemens Healthcare is the first company to introduce an ultrasound system that enables physicians to work with cable-free transducers,” says Jeffrey Bundy, CEO of the Siemens Healthcare Ultrasound business unit. “The ACUSON Freestyle system facilitates the use of advanced ultrasound technology into clinical fields requiring a sterile environment, such as interventional radiology, anesthesiology, critical care, cath lab, or emergency care.” Wireless transducers can also expand ultrasound into new and emerging applications such as administering nerve blocks, enhancing vascular access, and improving target localization through ultrasound guidance during therapeutic interventions and biopsies.

For image acquisition and processing, the ACUSON Freestyle system employs advanced synthetic aperture imaging technology, an integration of proprietary hardware and software that was specifically developed for the wireless signal transmission of full-resolution digital image data at very high data rates. Focusing on each pixel in the image, this method produces excellent image quality throughout the field of view. This design reduces the transducer’s power requirements, increasing battery life. Wireless real-time ultrasound data transmission is further enabled through the proprietary development of a novel ultra-wideband radio technology, which, operating at a high frequency of 7.8 Gigahertz, is not susceptible to interference with other electronic equipment.

Three wireless transducers are available for the ACUSON Freestyle system, covering a range of general imaging, vascular, and high-frequency applications such as musculoskeletal and nerve imaging. The user can operate the transducers up to three meters away from the system, which includes an ergonomic interface that enables remote control of scanning parameters from within the sterile field. The ACUSON Freestyle system has a 38-centimeter, high-resolution LED display. The system console can be mounted easily on a lightweight cart and also operates on battery power.

The products mentioned here are not commercially available in all countries. Due to regulatory reasons the future availability in any country cannot be guaranteed. Further details are available from the local Siemens organizations.

Launched by Siemens Healthcare Sector in November 2011, Agenda 2013 is a two-year global initiative to further strengthen the Healthcare Sector’s innovative power and competitiveness. Specific measures will be implemented in four fields of action: Innovation, Competitiveness, Regional Footprint, and People Development.

Source : http://www.news-medical.net/news/20121126/Siemens-introduces-ACUSON-Freestyle-ultrasound-system-with-wireless-transducers-at-RSNA-2012.aspx

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X-Ray Viewing Box Desk

X-Ray Viewing Box Desk

X-Ray Viewing Box Desk

This is my desk I made from an old wall mounted x-ray viewer. I bought some wall brackets and mounted it perpendicular to the wall and now I use it to do trace work and over lays for graphic and interior design.

If you’re looking for a sturdy desk with a futuristic vibe, this workspace crafted from an X-ray illuminator fits the bill.

Drew Wright, a graphic designer returning to school to study interior design, converted an old wall mounted X-ray illuminator into a desk with the addition of some sturdy brackets. The desk is both a really neat element in the room and a functional workspace—he uses it to do trace work and overlays for his designs.

The X-Ray Desk

If you have a workspace of your own to show off, throw the pictures on your Flickr account and add it to the Lifehacker Workspace Show and Tell Pool. Include some details about your setup and why it works for you, and you just might see it featured on the front page of Lifehacker.

The X-ray Office [Deskography]

This one’s not for me, but I really dig the colors and the clean, glossy workspace. I can’t imagine it would be easy for someone who spends all day on their keyboard like me, but for someone who spends more time with drawing implements in their hands and needs a little open space to trace or sketch, it looks like it works great.

I can also see the benefit of vertical displays as opposed to horizontal ones: it’s not my style, but I could see myself using the top display to monitor apps that I like to keep open but don’t interact with regularly, like my e-mail client and other apps that I’d like to glance at now and again.

Now that almost any modern hospital’s radiology department has gone completely digital, there must be thousands of obsolete X-ray viewing boxes hanging around. Drew Wright , a graphic designer, makes some creative use of one of these oldies. He used an old wall mounted x-ray viewer and mounted it perpendicular to the wall, and now it functions as a desk. He uses it for trace work and overlays for graphic and interior design. Using it for any other purposes would probably not be recommended by your ophthalmologist, even if radiologists have been staring at these boxes full-time for many decades.

source : http://lifehacker.com/5744902/the-x+ray-desk

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BRIGHTs bind to biomarkers of disease and light up to reveal their location

BRIGHTs bind to biomarkers of disease and light up to reveal their location

Called BRIGHTs, the tiny probes described in the online issue of Advanced Materials on Nov. 15, bind to biomarkers of disease and, when swept by an infrared laser, light up to reveal their location.

Tiny as they are, the probes are exquisitely engineered objects: gold nanoparticles covered with molecules called Raman reporters, in turn covered by a thin shell of gold that spontaneously forms a dodecahedron.

The Raman reporters are molecules whose jiggling atoms respond to a probe laser by scattering light at characteristic wavelengths.

The shell and core create an electromagnetic hotspot in the gap between them that boosts the reporters’ emission by a factor of nearly a trillion.

BRIGHTs shine about 1.7 x 1011 more brightly than isolated Raman reporters and about 20 times more intensely than the next-closest competitor probe, says Srikanth Singamaneni, PhD, assistant professor of mechanical engineering and materials science in the School of Engineering & Applied Science at Washington University in St. Louis.

Goosing the signal from Raman reporters

Singamaneni and his postdoctoral research associate Naveen Gandra, PhD, tried several different probe designs before settling on BRIGHTS.

Singamaneni’s lab has worked for years with Raman spectroscopy, a spectroscopic technique that is used to study the vibrational modes (bending and stretching) of molecules. Laser light interacts with these modes and the molecule then emits light at higher or lower wavelengths that are characteristic of the molecule,

Spontaneous Raman scattering, as this phenomenon is called, is by nature very weak, but 30 years ago scientists accidently stumbled on the fact that it is much stronger if the molecules are adsorbed on roughened metallic surfaces. Then they discovered that molecules attached to metallic nanoparticles shine even brighter than those attached to rough surfaces.

The intensity boost from surface-enhanced Raman scattering, or SERS, is potentially huge. “It’s well-known that if you sandwich Raman reporters between two plasmonic materials, such as gold or silver, you are going to see dramatic Raman enhancement,” Singamaneni says.

Originally his team tried to create intense electromagnetic hot spots by sticking smaller particles onto a larger central particle, creating core-satellite assemblies that look like daisies.

“But we realized these assemblies are not ideal for bioimaging,” he says, “because the particles were held together by weak electrostatic interactions and the assemblies were going to come apart in the body.”

Next they tried using something called Click chemistry to make stronger covalent bonds between the satellites and the core.

“We had some success with those assemblies,” Singamaneni says, “but in the meantime we had started to wonder if we couldn’t make an electromagnetic hot spot within a single nanoparticle rather than among particles.

“It occurred to us that if we put Raman reporters between the core and shell of a single particle could we create an internal hotspot.”

That idea worked like a charm.

A rainbow of probes carefully dispensing drugs?

The next step, says Singamaneni, is to test BRIGHTS in vivo in the lab of Sam Achilefu, PhD, professor of radiology in the School of Medicine.

But he’s already thinking of ways to get even more out of the design.

Since different Raman reporter molecules respond at different wavelengths, Singamaneni says, it should be possible to design BRIGHTS targeted to different biomolecules that also have different Raman reporters and then monitor them all simultaneously with the same light probe.

And he and Gandra would like to combine BRIGHTS with a drug container of some kind, so that the containers could be tracked in the body and the drug and released only when it reached the target tissue, thus avoiding many of the side effects patients dread.

Source : http://www.news-medical.net/news/20121121/BRIGHTs-bind-to-biomarkers-of-disease-and-light-up-to-reveal-their-location.aspx

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Sectra OneScreen can effectively identify people at high risk for osteoporosis

Sectra OneScreen can effectively identify people at high risk for osteoporosis

A research team at the Karolinska Institute in Stockholm has conducted a study that shows how Sectra’s online service, Sectra OneScreen, provides an efficient and inexpensive method for early identification of people in the “at-risk group” for osteoporosis. Sectra OneScreen can be combined with routine mammography examinations. The study, published in European Radiology, shows that Sectra OneScreen is fully comparable with other more expensive methods currently in use to predict hip fractures caused by osteoporosis, a disease affecting one in two women.

Sectra OneScreen can easily be combined with mammograms by taking a hand X-ray at the same time as breast images using the same radiology equipment. The extra examination takes less than 30 seconds. With this study, researchers have shown that the technique is equivalent to DXA, the golden standard for predicting hip fractures.

“If we can identify people with osteoporosis and treat them with drugs, we can reduce the risk of hip fracture. Our research shows that DXR (the patented technology on which Sectra OneScreen is based) is a technique that lends itself well to this, maybe at general health check-ups, or screenings, for example, or when people seek treatment for a suspected hand or wrist fracture,” says Associate Professor Torkel Brismar, who led the study at the Department of Clinical Sciences, Intervention and Technology, in an earlier press release from the Karolinska Institute.

Around 300,000 hip fractures occur in Europe and 600,000 in the US every year. Mainly women over 50 are affected by osteoporosis. A hip fracture has serious consequences for people and quality of life is impaired for many individuals. About 10-15% of people die within one year as a result of their fractures. In addition to their own personal suffering, these patients often have a major need for care. Treating osteoporosis with medication can reduce the risk of hip fracture.

“If all mammograms were combined with osteoporosis screenings, a portion of the hip fractures occurring every year could be prevented, which would reduce personal suffering and generate major cost savings for the healthcare sector,” says Fredrik Agholme, Medical expert at Sectra.

Source : http://www.news-medical.net/news/20121121/Sectra-OneScreen-can-effectively-identify-people-at-high-risk-for-osteoporosis.aspx

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Addition of tomosynthesis to standard mammogram increases breast screening accuracy

Addition of tomosynthesis to standard mammogram increases breast screening accuracy

The addition of three-dimensional breast imaging-a technology called tomosynthesis-to standard digital mammography significantly increases radiologists’ diagnostic accuracy while reducing false positive recall rates, according to the results of a multi-center study published in Radiology.

“This is the first major advance in breast imaging and breast cancer screening since the development of breast MRI,” said lead researcher Elizabeth A. Rafferty, M.D., director of Breast Imaging at the Avon Comprehensive Breast Center at Massachusetts General Hospital in Boston. “The beauty of tomosynthesis is that it addresses two major concerns with screening mammography: missed cancers and false positive rates.”

According to the National Cancer Institute, there is convincing evidence that screening mammography reduces breast cancer mortality in women between the ages of 40 and 74. However, as many as 30 percent of breast cancers are not detected by mammography and an additional eight to 10 percent of women who undergo a screening mammogram are recalled for further testing when no cancer is present (called a false positive result).

Unlike a screening digital mammogram, which involves two X-ray images of each breast, breast tomosynthesis captures multiple, low-dose images from different angles around the breast. The images are then used to produce a three-dimensional reconstruction of the breast. Both digital mammography and breast tomosynthesis, which was approved by the United States Food and Drug Administration (FDA) in February of 2011, can be performed on the same mammography equipment in rapid succession.

Dr. Rafferty’s study involved 1,192 women recruited from five sites, of whom 997, including 780 screening cases and 217 women who needed pre-biopsy breast imaging, had complete data sets. Each of the women underwent a standard digital mammogram followed by breast tomosynthesis. The total radiation dose for the combined procedure was less than 3 milligray, which is the FDA limit for a single mammogram.

Drawing from the eligible cases, the researchers then conducted two reader studies involving 312 and 310 cases, respectively. Twelve radiologists participated in the first reader study; 15 radiologists in the second. A total of 48 cancers were included in the first reader study; 51 cancers in the second.

Compared to digital mammography alone, the use of both standard mammogram and tomosynthesis resulted in increased diagnostic accuracy for all 27 radiologists. Additionally, the diagnostic sensitivity of the combined exam – or the rate at which cancer present in the breast was correctly identified – increased by 10.7 percent for radiologists in Reader Study 1 and 16 percent for radiologists in Reader Study 2.

“Almost all of the gains in diagnostic sensitivity with the combined modality were attributable to the improved detection and characterization of invasive cancers, which are the cancers we are most concerned about because of their potential to metastasize,” Dr. Rafferty said.

With the addition of breast tomosynthesis to standard digital mammography, false positive recall rates also significantly decreased for all 27 of the radiologists. Absolute recall rate reductions of 38.6 percent and 17.1 percent were seen in Reader Studies 1 and 2, respectively.

“In the clinical setting, we would expect that type of reduction in recall rate to translate into a substantial number of unnecessary diagnostic tests being avoided,” Dr. Rafferty said.

Source : http://www.news-medical.net/news/20121120/Addition-of-tomosynthesis-to-standard-mammogram-increases-breast-screening-accuracy.aspx

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Primordial deploys new RealTime system at NYU Langone

Primordial deploys new RealTime system at NYU Langone

Primordial, a leading vendor of workflow applications for the medical imaging market, announced today the first two deployments of Primordial RealTime™ — a real-time Electronic Whiteboard and Operational Tracking Platform — at NYU Langone Medical Center in New York and Mission Hospital in Asheville, NC.

At both NYU and Mission, RealTime is providing advanced tracking of patients, exams, rooms, procedures, laboratory results, and departmental operations customized to the unique workflow requirements of ED, MR, CT, Interventional, and other areas.

The genesis of RealTime stems from the need of imaging departments to move beyond the traditional “greaseboards” and paper workflows which are highly inefficient due to manual data entry, and lack of widespread visibility into patient, room, exam, and provider status. RealTime addresses these issues by providing information-rich, customizable electronic whiteboards that are visible anywhere.

“Mission Hospital identified the need to develop an interactive electronic communications and patient tracking board as a core need moving forward,” said John Campbell, Mission Hospital’s Chief Imaging Informatics Officer. “RealTime enabled us to design a customized informatics system that would allow more immediate access to our patients’ progress in various stages of their procedures and include vital information for their quality of care.

“We now have successfully deployed RealTime in six modalities and radiology nursing areas within the department. It has improved the ability for all areas of radiology to see the patient progress throughout the entire patient care cycle. This innovative approach of imaging workflow has resulted in fewer steps in the clinical process thus allowing more time with the patient. We were also able to improve the communication with the patients’ and their families as to their progress through the department.

“What started off initially as a radiology centric project involved into a joint venture between radiology and emergency departments. We were able to reduce the phone calls from the ED by 90% and vastly improve ED-CT throughput. Our next steps are to focus on the waiting rooms and provide patients and their families with information boards tailored for public display.”

Tony Barulic, product manager of RealTime at Primordial, commented: “RealTime’s truly customizable views allow departments to tailor their electronic whiteboards to match existing processes, easing training and adoption. Web-architected design allows visibility from one department to another without the need of phone calls. Tablet and touch-device user interface with drag-and-drop functionality enables RealTime to be as mobile as the hospital’s staff. RealTime provides a whole new approach to managing the daily chaos in radiology departments.”

Source : http://www.news-medical.net/news/20121120/Primordial-deploys-new-RealTime-system-at-NYU-Langone.aspx

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EMUC discusses current and future prospects in imaging for prostate cancer

EMUC discusses current and future prospects in imaging for prostate cancer

At the 4th European Multidisciplinary Meeting on Urological Cancers (EMUC) held this weekend in Barcelona, Spain, specialists from radiology, urology, medical oncology and pathology said that new developments and research are already underway but benefits to patients would take some time due to the need for clinical trials, the high cost of funding research and the ability of cancer experts to efficiently take advantage of new insights and approaches, among other challenges.

“The future of imaging for prostate cancer has already begun,” said radiologist G. Villeirs (BE) in his overview lecture on current and future prospects in imaging for prostate cancer. Villeirs enumerated several technologies that can provide or improve current imaging techniques such as T2 Weighted MRI (Magnetic Resonance Imaging), Diffusion-Weighted Imaging, Dynamic Contrast-Enhanced MRI, Magnetic Resonance (MR) spectroscopy and Multiparametric MRI.

Many of these techniques have been undergoing research tests and refinements, according to Villeirs as he added that it would be a matter of time when the optimal use of these techniques will provide uro-oncological experts the benefits of more accurate, insightful diagnoses.

“In dynamic contrast-enhanced MRI, its most important use is in detection and localisation (of prostate tumours), with an accuracy of up to 90%,” he said.

M. Rubin (USA) spoke on the research developments in biomarkers and noted that diseases like castration resistant prostate cancer (CRPC), for instance, remains a challenge to researchers due to its heterogenous nature. He mentioned that the next generation of PCa biomarkers are urine-based assays (which detects early aggressive PCa), and tissue/CTC-based assays which are employed for prediction and precision medicine.

Urine-based assays include PCA3 (already FDA-approved), TMPRSS2-ERG (in development), other fusions (in development) and SPOP/CHD1 (early discovery), while tissue-based assays include androgen receptor gene (AR), BRCA2 and AURKA. Rubin said that TMPRSS2-ERG which has a specificity of 97% and sensitivity of 96% is commercially available for clinical use in the US and Europe.

The unmet biomarker needs for PCa, according to Rubin, should address the following aims: to distinguish BPH from prostate cancer, to detect the aggressive forms from the indolent cases and to identify the metastatic cancer predictors.

Meanwhile, urologist A. Briganti (IT) gave a comprehensive update on the future of surgery for prostate cancer and his expectations in the coming years. “We need to perform the correct surgery – in the right patient – to decrease the need for secondary therapies,” said Briganti, adding that identifying the right patient for the correct surgery is “…key in optimizing the future of surgery.”

He explained that correctly prescribed surgery will have the higher chance of cure only “…if combined with adjuvant therapy and delivered only to those patients who really deserve it.” He also expects that minimally invasive approaches will change the toxicity profile of more extensive surgical approaches.

“But data are still lacking,” Briganti noted.

M. Van Vulpen (NL) presented the radiation oncologist viewpoint regarding external beam radiotherapy and brachytherapy, while J. De Bono (UK) took up the topic of future medical therapies in prostate cancer.

Van Vulpen also expressed confidence that radiotherapy will remain in the forefront of new developments as he noted several breakthrough developments such as CT-linac (linear accelerator) which is used when prostate movements are problematic for intensity-modulated radiotherapy. He also mentioned computerised tumour detection which can localise tumour and show its aggressiveness.

De Bono gave a thorough overview on medical therapies, stressing that cancer experts should aim to decrease over diagnosis of benign PCa and the over treatment of ‘benign’ disease. De Bono noted that to improve therapeutic options doctors need to cure more high-risk/intermediate disease and improve the outcome from metastatic PCa.

He explained that three elements are important in improving treatment outcomes, namely an improved biological understanding of PCa, developing deliverable biomarkers that can be used for precision medicine, and by developing new drugs through hypotheses testing and are biomarker-driven.

Source : http://www.news-medical.net/news/20121119/EMUC-discusses-current-and-future-prospects-in-imaging-for-prostate-cancer.aspx

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