Categorization and evaluation of online teaching files in radiology by representative members of ... more Categorization and evaluation of online teaching files in radiology by representative members of the target group to make the specific search for adequate programs more effective. A representative team of board qualified radiologists, residents and medical students performed a basic search for radiology teaching files on the Internet using search machines, international mailing lists and link lists to collections of national and international radiological societies and departments. The programs were categorized by language, modality, target group and special features, such as qualification for CME-accreditation. For final evaluation and ranking of the detected files, a questionnaire was developed to assess completeness, image quality, page loading time, layout, orientation, interactivity, annotation and maintenance. The results were stored in an Access database on a web server. A query form in HTML format, including the parameters described above, was made accessible to the online user. A search machine for radiological teaching files (RadList/Entity-link List) was made available online ( www.tnt-radiology.de/radlist and www.tnt-radiology.de/entitylinklist ). A submitted request calls a cgi script that searches the database for the appropriate sites according to the individual search parameters selected by the user. The list of matching URLs is returned to the user as HTML page. Evaluating the single sites by applying the criteria listed above contributed to the quality assurance of the radiological teaching resources on the Internet. Adapting a new Internet interface to the particular needs of the user allows a more effective access to specific radiological teaching files online. RadList/Entity-link List ( www.tnt-radiology.de/radlist and www.tnt-radiology.de/entitylinklist ) is conducive to quality improvement and benefits users as well as authors of radiological teaching files on the Internet.
To investigate the tolerance of MR examinations in children and adolescents performed in a 1.5 Te... more To investigate the tolerance of MR examinations in children and adolescents performed in a 1.5 Tesla MR scanner with an expanded bore diameter. 163 patients, ages 4 to 25, underwent MR examinations in a 1.5 Tesla MR scanner with an open design (MAGNETOM Espree, Siemens, Erlangen, Germany), characterized by a compact length of 125 cm and an expanded 70 cm bore diameter. MR imaging of the brain was carried out in most cases (78.5 %), followed by examinations of the spinal canal (9.8 %), the extremities (9.2 %) and the neck (2.5 %). The patients were divided into four age groups and the success rate, motion artifacts and diagnostic quality of the MR examinations were assessed using a 3-grade scale. In 119 of 163 patients (73.0 %), MR examination was possible without any motion artifacts. With respect to the different age groups, 41.7 % of the 4 - 7-year-old children, 67.6 % of the 8 - 10-year-old children, 84.1 % of the 11 - 16-year-old children and 95.8 % of the patients older than 17 showed tolerance grade I without motion artifacts and excellent diagnostic image quality. In 39 of 163 children (23.9 %), the MR images showed moderate motion artifacts but had sufficient diagnostic quality. With regard to the different age groups, 52.8 % of the 4 - 7-year-old children, 26.5 % of the 8 - 10-year-old children, 15.9 % of the 11 - 16-year-old children and none of the patients older than 17 showed tolerance grade II with moderate motion artifacts and sufficient diagnostic image quality. In only 4 of 124 children < 10 years old and 1 child > 10 years old, the MR examination was not feasible and had to be repeated under sedation. Pediatric MR imaging using a 1.5 Tesla MR scanner with an open design can be conducted in children and adolescents with excellent acceptance. The failure rate of 3.0 % of cases for pediatric MR imaging is comparable to that of a conventional low-field open MR scanner.
To create radiology-related interdisciplinary programs for the undergraduate education in terms o... more To create radiology-related interdisciplinary programs for the undergraduate education in terms of the new "Approbation Regulation". Medical students developed in collaboration with radiologists and clinical partners virtual, radiology-related interdisciplinary training courses for different fields. Students and teachers evaluated the acceptance of the programs' structure and content as well as the possibility to replace the radiologist partly during interdisciplinary lessons. Six target group oriented virtual, radiology-related interdisciplinary training courses were developed which will relieve the implementation of the new AR's demands for more interdisciplinary education in small groups and the dreaded shortage of personnel. By the use of web- and CDRom-based interdisciplinary course models different fields of medicine and diagnostic radiology can be bridged in the sense of the new AR's demands as well as manpower in radiology can be saved.
Though being inferior to magnetic resonance imaging, computed tomography (CT) of the brain is the... more Though being inferior to magnetic resonance imaging, computed tomography (CT) of the brain is the most frequently applied imaging modality in the diagnostic workup of acute cerebral Ischaemia. We report on a case of a comatose 53-year-old man who was brought to the emergency room after cardiopulmonary resuscitation. The CT of the brain showed a diffuse brain oedema with an explicit hypodense demarcation of all deep nuclei.
PURPOSE To evaluate the diagnostic value of whole body diffusion weighted MR imaging (WB-DWI) and... more PURPOSE To evaluate the diagnostic value of whole body diffusion weighted MR imaging (WB-DWI) and T2 weighted MR imaging in comparison to positron emission tomography-CT (PET-CT) in metastasis evaluation METHOD AND MATERIALS 16 consecutive patients with suspected metastases from malignant tumors (NHL (n=4), gastric carcinoma (n=2), bronchial carcinoma (n=6), colon carcinoma (n=2), breast carcinoma (n=2) were examined with WB-MRI on an automatic moving table with a 1.5 T scanner (Avanto, Siemens Medical Solutions) using a five step scan in the coronal plane. T2 STIR, T1 FSE and SE-EPI sequences (b=0, 400, 800) with parallel acquisition technique were performed without i.v. Gd-administration. PET-CT images were obtained 45 minutes after 18F-FDG injection. PET-CT images were used as standard of reference. WB-MRI and the PET-CT findings were evaluated and compared as to the detection of metastases. Lesions were confirmed by follow-up over 6 months or biopsy. RESULTS 1. PET-CT scan showe...
PURPOSE Evaluate image quality of spiral-CT exams with a dual source CT system using a high pitch... more PURPOSE Evaluate image quality of spiral-CT exams with a dual source CT system using a high pitch mode in free breathing non-sedated children METHOD AND MATERIALS 63 consecutive children (age range 1-18 years, mean age: 5,7 years) who were referred to chest or abdomen CT were scanned with a dual source CT system with a high-pitch spiral mode protocol. Patient were not intubated and not sedated. Image quality was rated by two experienced radiologists on a three point quality scale in consensus; special focus was on motion artefacts of lung parenchyma, aortic root and anterior chest/abdominal wall (0: non-diagnostic, 1: acceptable, 2: excellent image quality). RESULTS All examinations were technically successful and overall image quality score was 2,0. CONCLUSION Spiral chest/abdomen CT with high-pitch on a dual source system seems to be feasible for pediatric patients without sedation in free breathing and delivers excellent image quality. CLINICAL RELEVANCE/APPLICATION Pediatric pat...
PURPOSE To asses the value of 18F-FDG PET in patients with suspected vasculitis and vascular sten... more PURPOSE To asses the value of 18F-FDG PET in patients with suspected vasculitis and vascular stent graft infection in comparison to CT and MR METHOD AND MATERIALS A retrospective database search with the logical keyword combination [“vasculitis” or “takayasu” or “arteritis” or “graft infection”] regarding imaging diagnosis revealed a total of 13 patients who were referred from January 2006 to April 2010 to Positron Emission Tomography in our institution. All patients were examined on a hybrid PET-CT system. In addition to 18F-FDG PET scan additional non contrast enhanced low dose CT scans (n=6) or non contrast enhanced diagnostic CT scans (n=2) or a Magnetic Resonance Angiography (n=6) was performed if vasculitis was suspected, whereas a contrast enhanced diagnostic CT scan was performed in addition if "fever of unknown origin" was the referring diagnose (n=5). Diagnose of vasculitis or vascular stent graft/prothesis infection was based on the detection of high accumulatio...
PURPOSE Creation of an internet resource of cases for interactive education and training in nucle... more PURPOSE Creation of an internet resource of cases for interactive education and training in nuclear medicine, with assessment tools and a focus on hybrid modalities including PET/CT and SPECT/CT, using international resources of the internet. METHOD AND MATERIALS Case reports are selected for educational value as part of the daily reporting routine and saved in a teaching database. This database is structured by modality, pathological entity and into three levels of difficulty. The cases are presented as multiple choice questions with one or more images, essential clinical information and several answers, if requested under time pressure. In addition to in-house cases, teaching cases published elsewhere were added with permission of the authors. Hyperlinks take the learner to answers and explanations on the originating sites as well as on other sites with essential information according to the cases. A survey among the different user groups was conducted in order to obtain feedback ...
LEARNING OBJECTIVES 1) Define Vasculitis. 2) Review classifications. 3) Discuss symptoms. ABSTRAC... more LEARNING OBJECTIVES 1) Define Vasculitis. 2) Review classifications. 3) Discuss symptoms. ABSTRACT Vasculitis is defined as the inflammation of the blood vessel wall. The term ‘‘vasculitis’’ describes a group of multisystemic disorders characterized by inflammation and necrosis of the blood vessel wall. Vasculitides can cause pathologic changes. The extent and clinical course of disease depends on the size and location of the affected vessel and characteristics of the lesion. Vasculitis may primarily involve large vessels (eg, giant cell arteritis, Takayasu arteritis), medium-sized vessels (eg, polyarteritis nodosa, Kawasaki disease, primary granulomatous central nervous system vasculitis), or small vessels (eg, Wegener granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis, Henoch-Schönlein syndrome, systemic lupus erythematosus, rheumatoid vasculitis, Behçet syndrome). Radiologic findings in various types of vasculitis often overlap considerably and therefore have limite...
PURPOSE To investigate accuracy of Dual Energy Cardiac-CT in pediatric Thalassaemia patients in c... more PURPOSE To investigate accuracy of Dual Energy Cardiac-CT in pediatric Thalassaemia patients in correlation with T2*w Cardiac MR imaging and Serum Ferritin levels METHOD AND MATERIALS 19 patients with clinical history of Thalassaemia underwent multiecho GRE Cardiac MRI with 1,5 T MR scanner and Dual Energy CT with a Dual Source CT scanner for detection and quantification of iron load of the myocardium. T2* values (MRI) and HU values (CT with 80kV and 140 kV) were obtained and correlated, additionally those values were correlated with mean Serum Ferritin values obtained within the last 12 months. RESULTS 1. T2*w Cardiac MRI measurements as well as Dual Energy Cardiac-CT evaluation could be technically performed in all patients. 2. T2* values showed strong negative correlation with Dual Energy CT HU values (rs=-0,741; p<0,0001) 3. No significant correlation between mean serum Ferritin values and T2* values, Dual Energy CT HU values respectively, were found (MR: rs=0,403; p=0,121 - ...
BACKGROUND High noise/sound levels of gradients during MRI scans are the worst feature of this te... more BACKGROUND High noise/sound levels of gradients during MRI scans are the worst feature of this technique of which patients complain most. A new scanning technique called SilentMR reduces noise levels at the gradient level without reducing the power of gradients used during scan. EVALUATION SilentMR (GE Healthcare, Milwaukee/WI) was performed in 32 patients referred to brain MRI with 12 channel head coil on a 3T system (Discovery 750w, GE Healthcare). Ethical committee waiver as well as written informed consent from each patient was obtained. Patients completed written survey regarding previous experience with subjective level of sound during MRI on a 6-point scale (0=no noise, 5=extreme sound/not bearable) before the exam. SilentMR (T1w, T2w or PDw 3D-Sequence) was performed in sagittal plane, 1 mm slice thickness, 256x256 matrix, field of view 25,6x25,6 cm. Patients completed another survey regarding subjective experience of SilentMR noise level after exam and were asked to report ...
BACKGROUND: Long-term results of both surgery and observation for patients with focal nodular hyp... more BACKGROUND: Long-term results of both surgery and observation for patients with focal nodular hyperplasia (FNH) in a large single-center experience do not exist. Accordingly, the aim of this study was to compare long-term outcomes in patients with FNH who underwent either elective hepatectomy or observation alone.
Categorization and evaluation of online teaching files in radiology by representative members of ... more Categorization and evaluation of online teaching files in radiology by representative members of the target group to make the specific search for adequate programs more effective. A representative team of board qualified radiologists, residents and medical students performed a basic search for radiology teaching files on the Internet using search machines, international mailing lists and link lists to collections of national and international radiological societies and departments. The programs were categorized by language, modality, target group and special features, such as qualification for CME-accreditation. For final evaluation and ranking of the detected files, a questionnaire was developed to assess completeness, image quality, page loading time, layout, orientation, interactivity, annotation and maintenance. The results were stored in an Access database on a web server. A query form in HTML format, including the parameters described above, was made accessible to the online user. A search machine for radiological teaching files (RadList/Entity-link List) was made available online ( www.tnt-radiology.de/radlist and www.tnt-radiology.de/entitylinklist ). A submitted request calls a cgi script that searches the database for the appropriate sites according to the individual search parameters selected by the user. The list of matching URLs is returned to the user as HTML page. Evaluating the single sites by applying the criteria listed above contributed to the quality assurance of the radiological teaching resources on the Internet. Adapting a new Internet interface to the particular needs of the user allows a more effective access to specific radiological teaching files online. RadList/Entity-link List ( www.tnt-radiology.de/radlist and www.tnt-radiology.de/entitylinklist ) is conducive to quality improvement and benefits users as well as authors of radiological teaching files on the Internet.
To investigate the tolerance of MR examinations in children and adolescents performed in a 1.5 Te... more To investigate the tolerance of MR examinations in children and adolescents performed in a 1.5 Tesla MR scanner with an expanded bore diameter. 163 patients, ages 4 to 25, underwent MR examinations in a 1.5 Tesla MR scanner with an open design (MAGNETOM Espree, Siemens, Erlangen, Germany), characterized by a compact length of 125 cm and an expanded 70 cm bore diameter. MR imaging of the brain was carried out in most cases (78.5 %), followed by examinations of the spinal canal (9.8 %), the extremities (9.2 %) and the neck (2.5 %). The patients were divided into four age groups and the success rate, motion artifacts and diagnostic quality of the MR examinations were assessed using a 3-grade scale. In 119 of 163 patients (73.0 %), MR examination was possible without any motion artifacts. With respect to the different age groups, 41.7 % of the 4 - 7-year-old children, 67.6 % of the 8 - 10-year-old children, 84.1 % of the 11 - 16-year-old children and 95.8 % of the patients older than 17 showed tolerance grade I without motion artifacts and excellent diagnostic image quality. In 39 of 163 children (23.9 %), the MR images showed moderate motion artifacts but had sufficient diagnostic quality. With regard to the different age groups, 52.8 % of the 4 - 7-year-old children, 26.5 % of the 8 - 10-year-old children, 15.9 % of the 11 - 16-year-old children and none of the patients older than 17 showed tolerance grade II with moderate motion artifacts and sufficient diagnostic image quality. In only 4 of 124 children &lt; 10 years old and 1 child &gt; 10 years old, the MR examination was not feasible and had to be repeated under sedation. Pediatric MR imaging using a 1.5 Tesla MR scanner with an open design can be conducted in children and adolescents with excellent acceptance. The failure rate of 3.0 % of cases for pediatric MR imaging is comparable to that of a conventional low-field open MR scanner.
To create radiology-related interdisciplinary programs for the undergraduate education in terms o... more To create radiology-related interdisciplinary programs for the undergraduate education in terms of the new &quot;Approbation Regulation&quot;. Medical students developed in collaboration with radiologists and clinical partners virtual, radiology-related interdisciplinary training courses for different fields. Students and teachers evaluated the acceptance of the programs&#39; structure and content as well as the possibility to replace the radiologist partly during interdisciplinary lessons. Six target group oriented virtual, radiology-related interdisciplinary training courses were developed which will relieve the implementation of the new AR&#39;s demands for more interdisciplinary education in small groups and the dreaded shortage of personnel. By the use of web- and CDRom-based interdisciplinary course models different fields of medicine and diagnostic radiology can be bridged in the sense of the new AR&#39;s demands as well as manpower in radiology can be saved.
Though being inferior to magnetic resonance imaging, computed tomography (CT) of the brain is the... more Though being inferior to magnetic resonance imaging, computed tomography (CT) of the brain is the most frequently applied imaging modality in the diagnostic workup of acute cerebral Ischaemia. We report on a case of a comatose 53-year-old man who was brought to the emergency room after cardiopulmonary resuscitation. The CT of the brain showed a diffuse brain oedema with an explicit hypodense demarcation of all deep nuclei.
PURPOSE To evaluate the diagnostic value of whole body diffusion weighted MR imaging (WB-DWI) and... more PURPOSE To evaluate the diagnostic value of whole body diffusion weighted MR imaging (WB-DWI) and T2 weighted MR imaging in comparison to positron emission tomography-CT (PET-CT) in metastasis evaluation METHOD AND MATERIALS 16 consecutive patients with suspected metastases from malignant tumors (NHL (n=4), gastric carcinoma (n=2), bronchial carcinoma (n=6), colon carcinoma (n=2), breast carcinoma (n=2) were examined with WB-MRI on an automatic moving table with a 1.5 T scanner (Avanto, Siemens Medical Solutions) using a five step scan in the coronal plane. T2 STIR, T1 FSE and SE-EPI sequences (b=0, 400, 800) with parallel acquisition technique were performed without i.v. Gd-administration. PET-CT images were obtained 45 minutes after 18F-FDG injection. PET-CT images were used as standard of reference. WB-MRI and the PET-CT findings were evaluated and compared as to the detection of metastases. Lesions were confirmed by follow-up over 6 months or biopsy. RESULTS 1. PET-CT scan showe...
PURPOSE Evaluate image quality of spiral-CT exams with a dual source CT system using a high pitch... more PURPOSE Evaluate image quality of spiral-CT exams with a dual source CT system using a high pitch mode in free breathing non-sedated children METHOD AND MATERIALS 63 consecutive children (age range 1-18 years, mean age: 5,7 years) who were referred to chest or abdomen CT were scanned with a dual source CT system with a high-pitch spiral mode protocol. Patient were not intubated and not sedated. Image quality was rated by two experienced radiologists on a three point quality scale in consensus; special focus was on motion artefacts of lung parenchyma, aortic root and anterior chest/abdominal wall (0: non-diagnostic, 1: acceptable, 2: excellent image quality). RESULTS All examinations were technically successful and overall image quality score was 2,0. CONCLUSION Spiral chest/abdomen CT with high-pitch on a dual source system seems to be feasible for pediatric patients without sedation in free breathing and delivers excellent image quality. CLINICAL RELEVANCE/APPLICATION Pediatric pat...
PURPOSE To asses the value of 18F-FDG PET in patients with suspected vasculitis and vascular sten... more PURPOSE To asses the value of 18F-FDG PET in patients with suspected vasculitis and vascular stent graft infection in comparison to CT and MR METHOD AND MATERIALS A retrospective database search with the logical keyword combination [“vasculitis” or “takayasu” or “arteritis” or “graft infection”] regarding imaging diagnosis revealed a total of 13 patients who were referred from January 2006 to April 2010 to Positron Emission Tomography in our institution. All patients were examined on a hybrid PET-CT system. In addition to 18F-FDG PET scan additional non contrast enhanced low dose CT scans (n=6) or non contrast enhanced diagnostic CT scans (n=2) or a Magnetic Resonance Angiography (n=6) was performed if vasculitis was suspected, whereas a contrast enhanced diagnostic CT scan was performed in addition if "fever of unknown origin" was the referring diagnose (n=5). Diagnose of vasculitis or vascular stent graft/prothesis infection was based on the detection of high accumulatio...
PURPOSE Creation of an internet resource of cases for interactive education and training in nucle... more PURPOSE Creation of an internet resource of cases for interactive education and training in nuclear medicine, with assessment tools and a focus on hybrid modalities including PET/CT and SPECT/CT, using international resources of the internet. METHOD AND MATERIALS Case reports are selected for educational value as part of the daily reporting routine and saved in a teaching database. This database is structured by modality, pathological entity and into three levels of difficulty. The cases are presented as multiple choice questions with one or more images, essential clinical information and several answers, if requested under time pressure. In addition to in-house cases, teaching cases published elsewhere were added with permission of the authors. Hyperlinks take the learner to answers and explanations on the originating sites as well as on other sites with essential information according to the cases. A survey among the different user groups was conducted in order to obtain feedback ...
LEARNING OBJECTIVES 1) Define Vasculitis. 2) Review classifications. 3) Discuss symptoms. ABSTRAC... more LEARNING OBJECTIVES 1) Define Vasculitis. 2) Review classifications. 3) Discuss symptoms. ABSTRACT Vasculitis is defined as the inflammation of the blood vessel wall. The term ‘‘vasculitis’’ describes a group of multisystemic disorders characterized by inflammation and necrosis of the blood vessel wall. Vasculitides can cause pathologic changes. The extent and clinical course of disease depends on the size and location of the affected vessel and characteristics of the lesion. Vasculitis may primarily involve large vessels (eg, giant cell arteritis, Takayasu arteritis), medium-sized vessels (eg, polyarteritis nodosa, Kawasaki disease, primary granulomatous central nervous system vasculitis), or small vessels (eg, Wegener granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis, Henoch-Schönlein syndrome, systemic lupus erythematosus, rheumatoid vasculitis, Behçet syndrome). Radiologic findings in various types of vasculitis often overlap considerably and therefore have limite...
PURPOSE To investigate accuracy of Dual Energy Cardiac-CT in pediatric Thalassaemia patients in c... more PURPOSE To investigate accuracy of Dual Energy Cardiac-CT in pediatric Thalassaemia patients in correlation with T2*w Cardiac MR imaging and Serum Ferritin levels METHOD AND MATERIALS 19 patients with clinical history of Thalassaemia underwent multiecho GRE Cardiac MRI with 1,5 T MR scanner and Dual Energy CT with a Dual Source CT scanner for detection and quantification of iron load of the myocardium. T2* values (MRI) and HU values (CT with 80kV and 140 kV) were obtained and correlated, additionally those values were correlated with mean Serum Ferritin values obtained within the last 12 months. RESULTS 1. T2*w Cardiac MRI measurements as well as Dual Energy Cardiac-CT evaluation could be technically performed in all patients. 2. T2* values showed strong negative correlation with Dual Energy CT HU values (rs=-0,741; p<0,0001) 3. No significant correlation between mean serum Ferritin values and T2* values, Dual Energy CT HU values respectively, were found (MR: rs=0,403; p=0,121 - ...
BACKGROUND High noise/sound levels of gradients during MRI scans are the worst feature of this te... more BACKGROUND High noise/sound levels of gradients during MRI scans are the worst feature of this technique of which patients complain most. A new scanning technique called SilentMR reduces noise levels at the gradient level without reducing the power of gradients used during scan. EVALUATION SilentMR (GE Healthcare, Milwaukee/WI) was performed in 32 patients referred to brain MRI with 12 channel head coil on a 3T system (Discovery 750w, GE Healthcare). Ethical committee waiver as well as written informed consent from each patient was obtained. Patients completed written survey regarding previous experience with subjective level of sound during MRI on a 6-point scale (0=no noise, 5=extreme sound/not bearable) before the exam. SilentMR (T1w, T2w or PDw 3D-Sequence) was performed in sagittal plane, 1 mm slice thickness, 256x256 matrix, field of view 25,6x25,6 cm. Patients completed another survey regarding subjective experience of SilentMR noise level after exam and were asked to report ...
BACKGROUND: Long-term results of both surgery and observation for patients with focal nodular hyp... more BACKGROUND: Long-term results of both surgery and observation for patients with focal nodular hyperplasia (FNH) in a large single-center experience do not exist. Accordingly, the aim of this study was to compare long-term outcomes in patients with FNH who underwent either elective hepatectomy or observation alone.
Uploads
Papers by Sedat Alibek