Radiology

To establish the level of observer variation for the current ATS/ERS/JRS/ALAT criteria for a diagnosis of usual interstitial pneumonia (UIP) on CT among a large group of thoracic radiologists of varying levels of experience. 112 observers (96 of whom were thoracic radiologists) categorised CTs of 150 consecutive patients with fibrotic lung disease using the ATS/ERS/JRS/ALAT CT criteria for a UIP pattern (3 categories-UIP, possibly UIP and inconsistent with UIP). The presence of honeycombing, traction bronchiectasis and emphysema was also scored using a 3-point scale (definitely present, possibly present, absent). Observer agreement for the UIP categorisation and for the 3 CT patterns in the entire observer group and in subgroups stratified by observer experience, were evaluated. Interobserver agreement across the diagnosis category scores among the 112 observers was moderate, ranging from 0.48 (IQR 0.18) for general radiologists to 0.52 (IQR 0.20) for thoracic radiologists of 10-20 ...

Background and Aim: As ageing advances, the human brain undergoes many gross and histopathological changes with regression of the brain tissue leading to the enlargement of the ventricles. Knowledge of morphometric and size of normal ventricular system of brain is important to understand these changes. Methods: For the present perspective study, computerized tomography (CT) for 152 patients (Males-89 and Females-63) were studied for the measurements of fourth ventricle, third ventricle and lateral ventricle and it was statistically analyzed. Results: The anteroposterior extent of the body of the lateral ventricles on the right side was 74.89 + 9.86 mm and 70.06 + 8.83 mm in the males and females and on the left side was 74.89 + 9.89 mm and 69.56 + 11.42 mm in the males and females; the length of the frontal horns on the right side was 28.53 + 3.88 mm and 26.16 + 4.21 mm in the males and females and on the left side was 28.53 + 3.88mm and 26.17 + 4.237 mm in the males and females respectively. The width and height of the fourth ventricle were 12.54 + 1.90 mm and 9.66 + 2.12 in the males and 11.60 + 2.099 mm and 9.70 + 2.219 in the females respectively. The width of the third ventricle was 5.70 + 1.54 mm and 5.40 + 1.68 mm in the males and females respectively. Conclusion: The present study has defined the morphometric measurements of the lateral ventricles, third ventricle, and fourth ventricle of the brain which has clinical correlations in diagnosis and for further line of treatment.

Introduction: This study investigated the impact of different protocols on radiation dose and image quality for obese patients undergoing abdominal CT examinations. Methods: Five abdominal/pelvis CT protocols employed across three scanners from a single manufacturer in a single centre used a variety of parameters (kV: 100/120, reference mAs: 150/190/218/250/300, image reconstruction: filtered back projection (FBP)/iterative (IR)). The routine protocol employed 300 reference mAs and 120 kV. Data sets resulting from obese patient examinations (n ¼ 42) were assessed for image quality using visual grading analysis by three experienced radiologists. Objective assessment (noise, signal/contrast-noise ratios) and radiation dose was compared to determine optimal protocols for prospective testing on a further sample of patients (n ¼ 47) for scanners using FBP and IR techniques. Results: Compared to the routine protocol, mean radiation dose was reduced by 60% when using 100 kV and SAFIRE technique strength 3 (p ¼ 0.001). Reduction of up to 30% in radiation dose was noted for the FBP protocol: 120 kV and 190 reference mAs (p ¼ 0.008). Subjective and objective image quality for both protocols were comparable to that of the routine protocol (p > 0.05). An overall improvement in image quality with increasing strength of SAFIRE was noted. Upon clinical implementation of the optimal dose protocols, local radiology consensus deemed image quality to be acceptable for the participating obese patient cohort. Conclusion: Radiation dose for obese patients can be optimised whilst maintaining image quality. Where iterative reconstruction is available relatively low kV and quality reference mAs are also viable for imaging obese patients at 30e60% lower radiation doses.

This paper presents a comparison of the overpressures and pressure gradients obtained in turbulent premixed flames of liquified petroleum gas (LPG), compressed natural gas (CNG), and hydrogen propagating past solid obstacles. The fuel-air mixture is initially at rest and is ignited at the base of a vented chamber. For each fuel a total of eighteen configurations are studied here with various permutations of three baffles plates and an obstacle with a square cross section providing a blockage ratio of either 0.24 or 0.5. High speed laser induced fluorescence from OH (LIF-OH) imaging is also performed at a repetition rate of 5kHz providing new measurements of the evolution of the flame front along the middle section of the chamber. It is found that for all fuels the peak pressure as well as the rate change of pressure increases not only with increasing blockage ratio induced by the increasing blockage ratio, but also with decreasing separation between successive baffles. The peak pressure and its rate of change in hydrogen flames are over an order of magnitude higher than those obtained in LPG and CNG fuels. High speed images of LIF-OH show that the degree of wrinkling and contortion in the flame front also increases significantly with increasing blockages. It is evident from the LIF-OH images that the flame front relaminarises as the separation between successive obstacles increase hence explaining the pressure decrease with increasing separation.

Objectives: The primary purpose of this study was to assess and report the perceived negative impact of long duty hours on education and personal well-being among medical trainees in the diagnostic radiology residency training program in Saudi Arabia. Methods: This cross-sectional study used a questionnaire (sent by email) with eight indicators related to the education and well-being of radiology residents in Saudi Arabia during the academic year 2019–2020. Participants were given a five-point Likert response format for each indicator. The relative importance index (RII) was calculated to rank the different indicators. Results: Our of 337 residents, 116 diagnostic radiology trainees completed the survey, with a response rate of 34.4%. A total of 102 (87.9%) indicated their preference for 16-hour shifts instead of the currently implemented 24-hour duty system. Using the RII, three items related to the post-duty day ranked at the top of the list. The negative impact on sleep rhythm du...

The aim of this study was to compare the effectiveness of percutaneous needle aspiration (PNA) and percutaneous catheter drainage (PCD) in the management of liver abscess. Electronic searches (Cochrane Library, MEDLINE, EMBASE, SCIE) were conducted to identify randomized controlled trials (RCTs) comparing PNA and PCD. A meta-analysis was subsequently performed. A total of five RCTs covering 306 patients were included. The meta-analysis showed that outcomes in patients treated with PCD were superior to those in patients treated with PNA in terms of success rate [relative risk (RR): 0.81, 95% confidence interval (CI) 0.66-0.99; P = 0.04], clinical improvement [standardized mean difference (SMD): -0.73, 95% CI 0.36-1.11; P = 0.0001] and days to achieve a 50% reduction in abscess cavity size (SMD: -1.08, 95% CI 0.64-1.53; P < 0.00001). No significant differences were found in duration of hospitalization (mean difference: -0.17, 95% CI -2.10 to 1.75; P = 0.86) or procedure-related com...