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Medical imaging instrumentation design and construction is based on radiation sources and radiation detectors/sensors. This review focuses on the detectors and sensors of medical imaging systems. These systems are subdivided into various categories depending on their structure, the type of radiation they capture, how the radiation is measured, how the images are formed, and the medical goals they serve. Related to medical goals, detectors fall into two major areas: (i) anatomical imaging, which mainly concerns the techniques of diagnostic radiology, and (ii) functional-molecular imaging, which mainly concerns nuclear medicine. An important parameter in the evaluation of the detectors is the combination of the quality of the diagnostic result they offer and the burden of the patient with radiation dose. The latter has to be minimized; thus, the input signal (radiation photon flux) must be kept at low levels. For this reason, the detective quantum efficiency (DQE), expressing signal-to-noise ratio transfer through an imaging system, is of primary importance. In diagnostic radiology, image quality is better than in nuclear medicine; however, in most cases, the dose is higher. On the other hand, nuclear medicine focuses on the detection of functional findings and not on the accurate spatial determination of anatomical data. Detectors are integrated into projection or tomographic imaging systems and are based on the use of scintillators with optical sensors, photoconductors, or semiconductors. Analysis and modeling of such systems can be performed employing theoretical models developed in the framework of cascaded linear systems analysis (LCSA), as well as within the signal detection theory (SDT) and information theory. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to find the entrance skin dose (ESD) for diagnostic radiation qualities RQRs, RQAs and RQTs given in IAEA technical report series No. 457 using direct and indirect methods of measurement. Measurements were done for 5 × 5, 10 × 10, 15 × 15, 20 × 20 and 25 × 25 cm2 field sizes and 70, 80, 90 and 100 cm source to surface distance (SSD) using shadow-free diagnostic (SFD) chamber and water phantom having dimension 30 × 30 × 30 cm3. ESD direct measurements were done by placing SFD chamber on the surface of water phantom, while in the case of indirect measurements, air kerma values were obtained. Results: ESD values for different selected radiation qualities RQR2, RQR5, RQR8, RQR10, RQA2, RQA5, RQA8, RQA10, RQT8, RQT9 and RQT10 were found to be in the range of 0.0045–5.11 mGy per examination. Conclusions: Results obtained were found to be comparable with ESD values published in the literature. The obtained results in this research would help in establishing the national diagnostic reference levels (DRLs) which would help in the optimization of diagnostic imaging procedures. It would also help the radiographers to optimize field sizes and SSDs in order to reduce dose to the patients thereby ensuring good radiological practices, and this would reduce the stochastic risk to the patients caused by the ionizing radiations. [ABSTRACT FROM AUTHOR]

Introduction. Diagnosis and treatment of lesional pathology of the thyroid are important problems in Russia and worldwide. Currently, fine-needle aspiration (FNA) is the main technique of differential diagnosis of benign and malignant tumors of the thyroid. In 2023, clinical guidelines of the European Thyroid Association (ETA) on thyroid lesion treatment were published noting possible minimally invasive treatment of benign and malignant tumors of the thyroid requiring repeat cytologic verification. Despite the proven effectiveness of FNA, its informativity and specificity vary between 60 and 100 %. Additionally, this method is associated with high risk of false negative and false positive results. Therefore, there is a need to improve FNA and minimize its disadvantages.Aim. To evaluate the capabilities of vacuum FNA of small lesions using multiparameter ultrasound in diagnosis of thyroid cancer.Materials and methods. At the scientific and practical problem laboratory Diagnostic Studies and Minimally Invasive Technologies of the Smolensk State Medical University, a device for vacuum FNA was developed. Between 2023 and 2024, patients with thyroid lesions of size

Abstract Background The aim of this study was to find the entrance skin dose (ESD) for diagnostic radiation qualities RQRs, RQAs and RQTs given in IAEA technical report series No. 457 using direct and indirect methods of measurement. Measurements were done for 5 × 5, 10 × 10, 15 × 15, 20 × 20 and 25 × 25 cm2 field sizes and 70, 80, 90 and 100 cm source to surface distance (SSD) using shadow-free diagnostic (SFD) chamber and water phantom having dimension 30 × 30 × 30 cm3. ESD direct measurements were done by placing SFD chamber on the surface of water phantom, while in the case of indirect measurements, air kerma values were obtained. Results ESD values for different selected radiation qualities RQR2, RQR5, RQR8, RQR10, RQA2, RQA5, RQA8, RQA10, RQT8, RQT9 and RQT10 were found to be in the range of 0.0045–5.11 mGy per examination. Conclusions Results obtained were found to be comparable with ESD values published in the literature. The obtained results in this research would help in establishing the national diagnostic reference levels (DRLs) which would help in the optimization of diagnostic imaging procedures. It would also help the radiographers to optimize field sizes and SSDs in order to reduce dose to the patients thereby ensuring good radiological practices, and this would reduce the stochastic risk to the patients caused by the ionizing radiations.

A 48-year-old female with a background history of alcoholic liver cirrhosis and noninsulin-dependent diabetes presented to our institution with emphysematous pyelonephritis of the right kidney diagnosed on CT. Both urine and blood culture grew multidrug-resistant Escherichia coli. The patient developed severe thrombocytopenia, hyponatremia, confusion as well as septic shock. Preoperative right renal arterial embolization was performed, followed by immediate primary nephrectomy. This article reports the first documented case of preoperative angioembolization to prevent severe intraoperative hemorrhage and vascular complications in severe emphysematous pyelonephritis.

A 26-year-old male with Behçet's disease (BD) presented with recurrent oral and genital ulcers, bilateral pneumonia, and a left lower pulmonary artery aneurysm. Endovascular coil embolization was initially performed, followed by treatment with prednisone, colchicine, and azathioprine. Despite treatment, disease progression occurred, requiring additional embolization, intravenous pulse methylprednisolone, and cyclophosphamide. Ultimately, a combination of medical and endovascular interventions resolved the pulmonary arterial aneurysms. This case highlights BD's systemic inflammatory nature and vascular complications like pulmonary artery aneurysms. It emphasizes the importance of early detection and individualized, multidisciplinary care for such complications.

Mycobacterium szulgai (MS) is a species of non-tuberculous mycobacterium (NTM), which very rarely is identified as the causative pathogen of pulmonary infections. Due to its rarity, there are limitations in the existing literature regarding the diagnosis, investigation and treatment of MS pulmonary infection. Our case report provides further information regarding the clinical, microbiological and radiological findings associated with MS pulmonary infection with suggestions provided on its long term management. [ABSTRACT FROM AUTHOR]

The advent of Deep Learning (DL) has significantly propelled the field of diagnostic radiology forward by enhancing image analysis and interpretation. The introduction of the Transformer architecture, followed by the development of Large Language Models (LLMs), has further revolutionized this domain. LLMs now possess the potential to automate and refine the radiology workflow, extending from report generation to assistance in diagnostics and patient care. The integration of multimodal technology with LLMs could potentially leapfrog these applications to unprecedented levels. However, LLMs come with unresolved challenges such as information hallucinations and biases, which can affect clinical reliability. Despite these issues, the legislative and guideline frameworks have yet to catch up with technological advancements. Radiologists must acquire a thorough understanding of these technologies to leverage LLMs' potential to the fullest while maintaining medical safety and ethics. This review aims to aid in that endeavor. [ABSTRACT FROM AUTHOR]

Simple Summary: Orbital and ocular adnexal lymphoma (OAL) refers to a type of cancer affecting the eye and its surrounding structures. It typically originates from lymphoid tissue and can manifest with different variants, including the non-Hodgkin subtype. While prognosis is generally favorable, this relies on different factors, including early detection, prompt treatment, and cancer subtype. This observational study on diagnostic and prognostic factors in OAL aims to provide significant information about the relationship between imaging and disease outcomes. We conclude that by analyzing radiological features such as subtype, fluorodeoxyglucose avidity, and bone marrow involvement, researchers can identify potential prognostic indicators, ultimately helping clinicians in predicting disease progression, refining diagnostic protocols, and improving patient outcomes. Orbital and ocular adnexal lymphoma (OAL) affects the orbit and the surrounding structures and can arise as several subtypes with variable prognoses. We performed an observational study on the relationship between OAL subtype, diagnostic features, and prognosis to offer valuable insights into imaging techniques, such as Positron Emission Tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with Computed Tomography (18F-FDG PET-CT), in predicting outcomes. With this aim, we retrospectively reviewed 99 patients with OALs, recording demographics, cancer subtype, location and treatment, 18FDG avidity, and bone marrow positivity. We divided patients into Group 1 (those presenting with extranodal marginal zone lymphoma—EMZL) and Group 2, including all other subtypes. The primary outcome was long-term cancer-specific survival (CSS) based on key predictors, performed through Kaplan–Meier curves and the log-rank test, with a p < 0.05 significance threshold. The mean patient age was 67 years (57–75.5). The most frequent histopathologic subtypes were EMZL lymphoma in 69 patients (69.7%), small lymphocytic lymphoma (11.1%) and diffuse-large B-cell lymphoma (10.1%). Patients of Group 1 showed a better prognosis (CSS = 80%) compared to those of Group 2 (CSS = 60%) (p = 0.01). In patients with high-grade lymphoma, the occurrence of 18FDG avidity (p = 0.003) and bone marrow positivity (p = 0.005) were related to a worse prognosis. In our group, EMZL was the most prominent subtype of OALs and exhibited the best prognosis, low 18FDG avidity, and bone marrow negativity. By observing specific patterns in radiological findings, it is possible to increase our understanding of disease progression, treatment response, and the overall prognosis in OAL patients. [ABSTRACT FROM AUTHOR]

Artificial intelligence (AI) has emerged as a transformative paradigm, promising revolutionary advancements in animal healthcare. Leveraging AI's unparalleled capacity for rapid data analysis significantly enhances diagnostic precision and speed, thereby facilitating informed decision-making by veterinarians. Predictive medicine powered by AI not only anticipates disease outbreaks but also enables tracking zoonotic diseases and predicting individual health risks for animals. AI helps to generate personalized treatment plans by analyzing genetic, environmental, and historical data. Remote monitoring and telemedicine, empowered by AI, overcome geographical constraints and offer continuous care, enabling veterinarians to track vital signs and intervene promptly. However, as AI becomes integral to veterinary practice, ethical considerations surrounding data privacy, transparency, and responsible AI use are crucial. This review explores the scope of AI in enhancing research and drug development, highlighting its ability to improve the discovery process and contribute to novel therapeutic interventions. It emphasizes the necessity of maintaining a delicate balance between AI-driven automation and the expertise of veterinary professionals. As the veterinary community moves toward embracing the transformative potential of AI, this comprehensive examination provides valuable insights into the current scenario. It discusses the challenges, opportunities, implications, and ethical considerations that shape the future of AI in veterinary science. [ABSTRACT FROM AUTHOR]

Abnormal uterine bleeding (AUB) poses a multifaceted challenge in women's health, necessitating an integrated approach that addresses its diverse etiologies and clinical presentations. The International Federation of Gynecology and Obstetrics PALM-COEIN classification system provides a systematic approach to the diagnosis of AUB in non-pregnant women, based on clinical and imaging-based categorization of causes into structural (Polyps, Adenomyosis, Leiomyomas and Malignancy; PALM), and non-structural causes (Coagulopathies, Ovulatory disorders, primary Endometrial disorders, Iatrogenic and Not otherwise classified; COEIN). On the other hand, placental disorders, uterine rupture, ectopic pregnancy and retained products of conceptions are the main causes of uterine bleeding during pregnancy and in the peripartum period. Ultrasound is usually the first-line imaging technique for the differential diagnosis of causes of AUB. Computed Tomography may be useful if ultrasound findings are unclear, especially in emergency settings. Magnetic resonance imaging, when indicated, is an excellent second-line diagnostic tool for a better non-invasive characterization of the underlying cause of AUB. This pictorial review aims to illustrate the main causes of AUB from the point of view of diagnostic imaging and to show not-so-common cases that can be treated by means of interventional radiology. [ABSTRACT FROM AUTHOR]

AbstractPrenatal exposure to environmental factors may play an important role in the aetiopathogenesis of autism spectrum disorder (ASD). We aim to investigate the potential effects of low-dose x-rays from dental diagnostic x-rays on neurodevelopment and molecular mechanisms associated with ASD in developing zebrafish embryos. Zebrafish embryos were divided into four groups and exposed using a dental x-ray unit: control, 0.08, 0.15 and 0.30 seconds, which are exemplary exposure settings for periapical imaging. These exposure times were measured as 7.17, 23.17 and 63.83 mSv using optical stimulated luminescence dosimeters. At the end of 72 hours post-fertilization, locomotor activity, oxidant-antioxidant status, and acetylcholine esterase (AChE) activity were analyzed. Expression of genes related to apoptosis (bax, bcl2a, p53), neurogenesis (α1-tubulin, syn2a, neurog1, elavl3) and ASD (eif4eb, adsl2a, shank3) was determined by RT-PCR. Even at reduced doses, developmental toxicity was observed in three groups as evidenced by pericardial edema, yolk sac edema and scoliosis. Deleterious effects of dental x-rays on neurogenesis through impaired locomotor activity, oxidative stress, apoptosis and alterations in genes associated with neurogenesis and ASD progression were more pronounced in the 0.30s exposure group. Based on these results we suggest that the associations between ASD and low-dose ionizing radiation need a closer look. [ABSTRACT FROM AUTHOR]

Introduction: The use of diagnostic imaging services is increasing worldwide. This has important impacts on healthcare resource allocation and potential risks to the population. This study aimed to quantify trends in medical imaging in Australia over the past two decades. Methods: Data were extracted from the Australian Medicare Benefits Schedule (MBS) between 2000 and 2021. Simple linear regression analyses were performed to assess changes in absolute utilisation and utilisation rate per 100,000 population of total imaging services as well as by each imaging modality. Logistic regression analysis was performed to assess changes in total imaging services as a proportion of total Medicare services over time. Chi‐squared test was used to assess for change in modality composition of imaging services. Results: There were 436,255,500 imaging studies performed between 2000 and 2021. The absolute utilisation of total imaging services increased annually by an average of 864,404 (95% CI: 808,235–920,573, p < 0.001). For each consecutive year, the proportion of total Medicare services attributed to total imaging services increased by 0.01% (95% CI: 0.01–0.01, p < 0.01). There was also a statistically significant increase in the utilisation rates of imaging services per 100,000 population for each imaging modality. The number of imaging services per radiologist increased on average by 74 (95% CI: 26–122, p < 0.05) annually. Conclusion: The utilisation of diagnostic imaging services has increased in Australia between 2000 and 2021, outpacing the population growth, total healthcare services, and the radiologist workforce. [ABSTRACT FROM AUTHOR]

Pulmonary artery sling is an incomplete vascular ring, where the left pulmonary artery originates from the right pulmonary artery, leading to airway constriction. A tracheal bronchus is an anatomical variation in which an extra bronchus originates from the trachea, frequently resulting in respiratory symptoms or complications. We report a 6-week-old female patient with a pulmonary artery sling coursing around the distal trachea and a concurrent tracheal bronchus.

Accidental ingestion of fish bones can potentially lead to serious complications like perforation of the alimentary tract and the formation of abscesses in adjacent organs. Prompt and accurate diagnosis of the etiology of hepatic abscesses is critical to prevent clinical deterioration and poor outcomes. Notably, fish bones can be subtle in imaging studies and erroneously interpreted as calcifications, vessels, or artifacts potentially delaying diagnosis and management. Further complicating medical management, fish bones can be seeded with oral microflora which may not be effectively targeted by empiric antibiotics. Patients presenting with an occult hepatic abscess often have repeated visits to the emergency department with vague symptomology and abdominal pain without recollection of any precipitating events. In this case report, a multidisciplinary approach, including a high index of suspicion applied to CT imaging, was vital in identifying a foreign body within an abscess localized between the greater curvature of the stomach and left liver lobe. The foreign body, mimicking an intraperitoneal calcification, was a fish bone that had transmigrated through the stomach wall into the liver lobe. Once identified, definitive treatment included laparoscopic drainage of the abscess, extraction of the foreign body, and coverage with broad-spectrum antibiotics.

Medical imaging instrumentation design and construction is based on radiation sources and radiation detectors/sensors. This review focuses on the detectors and sensors of medical imaging systems. These systems are subdivided into various categories depending on their structure, the type of radiation they capture, how the radiation is measured, how the images are formed, and the medical goals they serve. Related to medical goals, detectors fall into two major areas: (i) anatomical imaging, which mainly concerns the techniques of diagnostic radiology, and (ii) functional-molecular imaging, which mainly concerns nuclear medicine. An important parameter in the evaluation of the detectors is the combination of the quality of the diagnostic result they offer and the burden of the patient with radiation dose. The latter has to be minimized; thus, the input signal (radiation photon flux) must be kept at low levels. For this reason, the detective quantum efficiency (DQE), expressing signal-to-noise ratio transfer through an imaging system, is of primary importance. In diagnostic radiology, image quality is better than in nuclear medicine; however, in most cases, the dose is higher. On the other hand, nuclear medicine focuses on the detection of functional findings and not on the accurate spatial determination of anatomical data. Detectors are integrated into projection or tomographic imaging systems and are based on the use of scintillators with optical sensors, photoconductors, or semiconductors. Analysis and modeling of such systems can be performed employing theoretical models developed in the framework of cascaded linear systems analysis (LCSA), as well as within the signal detection theory (SDT) and information theory.

Purpose: The International Atomic Energy Agency (IAEA) has developed a harmonized quality control (QC) protocol for performance evaluation and comparison of diagnostic radiology facilities in Africa. This study analyzes QC data on X-ray, computed tomography (CT), mammography and fluoroscopy equipment provided by African countries that applied the established QC protocol for pilot implementation of a regional quality assurance (QA) program. Methods: Total of 108 medical imaging equipment comprising 51 X-ray, 23 CT, 20 mammography and 14 fluoroscopy systems in use at 51 diagnostic radiology centres in 5 African countries were considered. All performance tests were conducted in accordance with the harmonized African protocol, and the data were validated and analyzed using MS Excel 365 through visual summaries, trends and patterns. Results from the analysis were benchmarked against acceptance criteria of the protocol. Results: Results from the performance measurements for X-ray machines include half value layer (HVL), beam perpendicularity, output, timer and kVp accuracies, while CT performance measurements comprised uniformity and accuracy, image noise, dosimetry and laser alignment. Mammography data include collimation accuracy, kV and timer accuracy, radiation output reproducibility and mean glandular dose, and fluoroscopy data cover automatic exposure control (AEC) and resolution. Out-of-tolerance data were conspicuous in some X-ray and CT machines, for which investigation was recommended. Conclusion: The study has produced promising results, showed general performance of the pilot imaging equipment and identified abnormalities that would otherwise not have been detected. A good basis has been set for implementation of the harmonized protocol on a wider scale in Africa. [ABSTRACT FROM AUTHOR]

The human liver exhibits variable characteristics and anatomical information, which is often ambiguous in radiological images. Machine learning can be of great assistance in automatically segmenting the liver in radiological images, which can be further processed for computer-aided diagnosis. Magnetic resonance imaging (MRI) is preferred by clinicians for liver pathology diagnosis over volumetric abdominal computerized tomography (CT) scans, due to their superior representation of soft tissues. The convenience of Hounsfield unit (HoU) based preprocessing in CT scans is not available in MRI, making automatic segmentation challenging for MR images. This study investigates multiple state-of-the-art segmentation networks for liver segmentation from volumetric MRI images. Here, T1-weighted (in-phase) scans are investigated using expert-labeled liver masks from a public dataset of 20 patients (647 MR slices) from the Combined Healthy Abdominal Organ Segmentation grant challenge (CHAOS). The reason for using T1-weighted images is that it demonstrates brighter fat content, thus providing enhanced images for the segmentation task. Twenty-four different state-of-the-art segmentation networks with varying depths of dense, residual, and inception encoder and decoder backbones were investigated for the task. A novel cascaded network is proposed to segment axial liver slices. The proposed framework outperforms existing approaches reported in the literature for the liver segmentation task (on the same test set) with a dice similarity coefficient (DSC) score and intersect over union (IoU) of 95.15 % and 92.10 % , respectively. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the clinical utility of positron emission tomography/magnetic resonance imaging (PET/MRI), especially in comparison with PET/computed tomography (CT), which has been widely used in clinical practice in multiple myeloma. Method: F-18 fluorodeoxyglucose PET/MRI and PET/CT studies were done at baseline and when at least a partial response to treatment was achieved. These were done for newly-diagnosed myeloma patients who have not had more than 1 cycle of anti-myeloma treatment, or for relapsed and/or refractory myeloma patients before the start of next line of therapy. Results: PET/MRI correlated significantly with PET/CT, in terms of number of lesions detected, standardised uptake value (SUVmean and SUVmax, both at baseline and post-treatment. PET/MRI and PET/CT correlated with survival at baseline, but not post-treatment. Conclusion: In this study, PET/MRI was more sensitive in detecting early disease and disease resolution posttreatment, compared with PET/CT. However, PET/MRI was less sensitive in detecting lesions in the ribs, clavicle and skull. [ABSTRACT FROM AUTHOR]

Pneumothorax is a medical condition characterized by air in the space between the visceral and parietal pleural surfaces, with spontaneous and traumatic classifications. Spontaneous pneumothorax is further divided into primary and secondary groups based on the presence or absence of clinically apparent underlying lung disease. Here we present a case of a 23-year-old female with no past medical history who presented with chest pain and shortness of breath, ultimately diagnosed with primary spontaneous interlobar pneumothorax. Despite advancements in medical diagnosis techniques, spontaneous interlobar pneumothorax remains a rare presentation of pneumothoraces. Treatment strategies for clinically stable patients with a first episode of primary spontaneous pneumothorax include observation with or without supplemental oxygen, with further intervention only if the pneumothorax fails to improve or worsens.

Dysphagia is a common issue observed among the elderly, which can arise from various etiologies such as motility disorders and chronic neurologic conditions. Radiologists play a crucial role in diagnosing the cause of dysphagia, as they can identify anatomical abnormalities that may lead to the condition. One such anomaly is the hemiazygos vein, which is the left side equivalent of the azygos vein and can cause dysphagia if it crosses over the esophagus. To our knowledge, there are only 2 other recorded cases of azygos aneurysm/dilation causing esophageal dysphagia. In this context, we present a case report of a 73-year-old female with a 1-month history of weight loss and dysphagia due to a prominent hemiazygos vein. The case highlights the importance of thorough radiological evaluation in identifying the underlying cause of dysphagia and ensuring timely and appropriate treatment.

Patients that incur myocardial disruption from penetrating cardiac injuries have an average 6%-10% expectancy rate of reaching the hospital alive. If prompt recognition on arrival is not immediate, the morbidity and mortality are significantly higher due to the secondary physiologic sequalae of either cardiogenic or hemorrhagic shock. Even after a triumphant arrival at a medical facility, out of that 6%-10%, half of those patients are not expected to survive. The unique significance of the presenting case breaks this tradition, expanding past the paradigms and issuing an exceptional understanding of the protective effects that cardiac surgery can futuristically cause through preformed adhesions. In our case, the cardiac adhesions achieved this by containing a penetrating cardiac injury that had caused complete ventricular disruption.

Primary monophasic synovial sarcoma of the lung is an extremely rare malignant mesenchymal tumor that can develop at any anatomic site. Synovial sarcoma is considered a high grade tumor with a poor prognosis. Metastatic pulmonary sarcoma is much more common. Hence primary lesion elsewhere in the body needs exclusion. No clinical or radiological features are specific for pulmonary sarcoma, often it is confused with bronchogenic carcinoma. Therefore biopsy is needed to establish the diagnosis of this rare tumor. We hereby present two cases of histologically proven primary monophasic synovial sarcoma of lung. The imaging features of this rare disease is reviewed.

Abstract Background QuADRANT was a study funded by the European Commission to evaluate clinical audit uptake and implementation across Europe, with an emphasis on clinical audit as mandated within the BSSD (Basic Safety Standards Directive). AIMS QuADRANT objectives—obtain an overview of European clinical audit activity; identify good practices and resources, barriers and challenges; provide guidance and recommendations going forwards; identify the potential for European Union action on quality and safety in the three core project specialties, radiology, radiotherapy and nuclear medicine. Findings and recommendations QuADRANT identified that developments in national clinical audit infrastructure are required. National professional societies can be pivotal in improving clinical audit implementation, but resource allocation and national prioritisation of clinical audit are needed in many countries. Lack of staff time and expertise are also barriers. Enablers to enhance clinical audit participation are not widely employed. Development of hospital accreditation programmes can facilitate clinical audit uptake. An active and formalised role for patients in clinical audit practice and policy development is recommended. There is persisting variation in European awareness of BSSD clinical audit requirements. Work is needed to improve dissemination of information on the legislative requirements relating to clinical audit in the BSSD and in relation to inspection processes to ensure these include clinical audit and that they encompass all clinics and specialties involved in medical applications using ionising radiation. Conclusion QuADRANT provides an important step towards enhancing clinical audit uptake and implementation across Europe and improving patient safety and outcomes.

Supratentorial glioblastoma is a common primary intracranial tumor in adults. High-grade glioma in cerebellopontine angle (CPA) is rare. We describe a case of adult-type diffuse high-grade glioma of CPA in a 49-year-old female that was managed surgically at our institute. Glioblastoma is an infiltrating type of glioma (WHO grade 4). MRI helped in characterizing the lesion; however, diagnosis was confirmed on histopathology. This report aims at the imaging pattern of primary adult-type diffuse high-grade glioma (WHO grade 4) at cerebellopontine angle.

In female patients, acute pelvic pain can be caused by gynaecological, gastrointestinal, and urinary tract pathologies. Due to the variety of diagnostic possibilities, the correct assessment of these patients may be challenging. The most frequent gynaecological causes of acute pelvic pain in non-pregnant women are pelvic inflammatory disease, ruptured ovarian cysts, ovarian torsion, and degeneration or torsion of uterine leiomyomas. On the other hand, spontaneous abortion, ectopic pregnancy, and placental disorders are the most frequent gynaecological entities to cause acute pelvic pain in pregnant patients. Ultrasound (US) is usually the first-line diagnostic technique because of its sensitivity across most common aetiologies and its lack of radiation exposure. Computed tomography (CT) may be performed if ultrasound findings are equivocal or if a gynaecologic disease is not initially suspected. Magnetic resonance imaging (MRI) is an extremely useful second-line technique for further characterisation after US or CT. This pictorial review aims to review the spectrum of gynaecological entities that may manifest as acute pelvic pain in the emergency department and to describe the imaging findings of these gynaecological conditions obtained with different imaging techniques. [ABSTRACT FROM AUTHOR]

In diagnostic imaging, distinguishing chromophobe renal cell carcinomas (chRCCs) from renal oncocytomas (ROs) is challenging, since they both present similar radiological characteristics. Radiomics has the potential to help in the differentiation between chRCCs and ROs by extracting quantitative imaging. This is a preliminary study of the role of radiomic features in the differentiation of chRCCs and ROs using machine learning models. In this retrospective work, 38 subjects were involved: 19 diagnosed with chRCCs and 19 with ROs. The CT nephrographic contrast phase was selected in each case. Three-dimensional segmentations of the lesions were performed and the radiomic features were extracted. To assess the reliability of the features, the intraclass correlation coefficient was calculated from the segmentations performed by three radiologists with different degrees of expertise. The selection of features was based on the criteria of excellent intraclass correlation coefficient (ICC), high correlation, and statistical significance. Three machine learning models were elaborated: support vector machine (SVM), random forest (RF), and logistic regression (LR). From 105 extracted features, 41 presented an excellent ICC and 6 were not highly correlated with each other. Only two features showed significant differences according to histological type and machine learning models were developed with them. LR was the better model, in particular, with an 83% precision. [ABSTRACT FROM AUTHOR]

Introduction: cartilage-forming tumors are the most frequent primary bone tumors. They are characterized by a strange behavior due to their uncertain evolution and they are difficult to diagnose. Osteochondroma or cartilaginous exostosis is one of the most frequent skeletal tumors. It is a tumor typical of young individuals, with a slight predominance in males. It can be solitary or multiple and is part of the hereditary multiple exostosis syndrome. Patient information: it is presented a male patient, 21 years old, who began to present an increase in volume in the right cervical region secondary to a bone tumor of cartilaginous origin. Conclusions: in this case the location of the osteochondroma is rare (right cervical region). There was no genetic family history of the disease, no symptoms, only local volume increase. X-ray studies and computerized axial tomography are particularly useful in the diagnosis of this condition. [ABSTRACT FROM AUTHOR]

Queen's University (Kingston, ON, Canada) adopted a competency-based medical education (CBME) curriculum for Diagnostic Radiology residency training in an accelerated manner in 2017, with the curriculum comprised of four stages of training. This article focuses on the final stage (Transition to Practice), during which assessment methods of the new national curriculum (implemented in July 2022) were piloted. This study aims to highlight the challenges and opportunities associated with the implementation of CBME in Diagnostic Radiology training and specific considerations for programs undergoing this curricular transition. Ethics approval was provided by the affiliated hospital Research Ethics Board. All relevant electronic assessments pertaining to all trainees who had completed the Transition to Practice stage (n = 3) were collated, deidentified, analyzed, and presented in tabulated format. A total of 39 evaluations completed by 13 assessors were assessed, with an average time of 3 minutes and 6 seconds to complete an assessment form. Also, 95% of evaluations were rated as entrustments. However, no residents met the minimum number of required entrustments for all five stage-specific Entrustable Professional Activities. These 39 evaluations included 219 milestone rating scores, with 86% rated as "achieved." Following review by the residency program Competence Committee, all three residents were promoted from the Transition to Practice stage. Challenges in CBME implementation include the number and quality of resident assessments. Strategies for success may include providing clear guidelines and training for both faculty and residents, early identification and intervention, and adopting a holistic evaluation strategy. CBME has the potential to enhance medical education quality by emphasizing learner progress toward competency and providing personalized feedback and support. [ABSTRACT FROM AUTHOR]

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Purpose: This work aimed to conduct Physics Audit of selected diagnostic X-ray machines in Ghana, with the purpose of serving as a pilot study towards establishing a national need to ensure the safe use of radiation in healthcare. Methods: Analysis of equipment and staffing data and assessment of the X-ray systems' performance were undertaken in the study. Tests performed on the systems include accuracy, reproducibility, and linearity of the X-ray tube potential, Half-Value Layer (HVL), beam alignment and congruence, tube current linearity, and assessment of entrance surface doses. Results: All twenty-seven X-ray machines piloted in the project were within tolerances for half-value layer and congruence tests. While a single X-ray system was out-of-tolerance for beam alignment test, 19% were out-of-tolerance for both kVp accuracy and reproducibility. Contrast and spatial resolution tests on the X-ray machines were within tolerance of ± 10%. Mean entrance surface doses estimated for selected body regions ranged from 1.1 mGy for cervical spine anterior-posterior to 6.7 mGy for lumbar spine lateral. None of the radiology centres was found to engage the services of a Medical Physicists at the time. Conclusions: Analyzed data from the pilot study has presented experiences to guide implementation of the audit project at national level. This is the first of such audit study performed in Ghana and West Africa sub-region. Significance: • The audit aims to make significant contributions for improving radiological safety of patients in the diagnostic X-ray installations in the country. • The study pilots implementation of a national dosimetry audit programme. • Physics audit ensures maintenance of total quality management through quality assurance (QA) and quality control (QC) programmes in the diagnostic X-ray facilities. • The study presents data that can be benchmarked with further physics audit work to be implemented nationally. [ABSTRACT FROM AUTHOR]

The relationship between various factors predisposing to the formation of spondylolisthesis, including degenerative spondylolisthesis, has been analyzed by many authors. However, not all observations are consistent. In this review, we identified factors whose impact on the prevalence of spondylolisthesis was most often mentioned in the literature. These included gender, age, bone mineral density, ethnic origin, and oophorectomy. The results were inclusive in terms of physical activity, pregnancy status, and use of hormone replacement therapy. Associations between diabetes and smoking were very poorly marked. The literature so far has identified a number of factors significantly affecting the incidence of degenerative spondylolisthesis. These include age, gender, body weight, ethnic origin, bone mineral density, and hormonal balance. Radiological parameters, which include iliac crest, pelvic tilt, pelvic incidence, sacral slope, and lumbar lordosis, may also be of great importance for assessing changes in the occurrence and progression. However, the authors do not agree on the real significance of individual factors. The aim of this review was to identify the factors predisposing to the formation of degenerative spondylolisthesis, the importance of which has been suggested in the current literature. The systematization of knowledge in this field can allow a more accurate adjustment of the treatment plan for each patient affected by this condition. [ABSTRACT FROM AUTHOR]

Aims: To determine the major risk factors for unplanned reoperations (UROs) following corrective surgery for adult spinal deformity (ASD) and their interactions, using machine learning-based prediction algorithms and game theory. Methods: Patients who underwent surgery for ASD, with a minimum of two-year follow-up, were retrospectively reviewed. In total, 210 patients were included and randomly allocated into training (70% of the sample size) and test (the remaining 30%) sets to develop the machine learning algorithm. Risk factors were included in the analysis, along with clinical characteristics and parameters acquired through diagnostic radiology. Results: Overall, 152 patients without and 58 with a history of surgical revision following surgery for ASD were observed; the mean age was 68.9 years (SD 8.7) and 66.9 years (SD 6.6), respectively. On implementing a random forest model, the classification of URO events resulted in a balanced accuracy of 86.8%. Among machine learning-extracted risk factors, URO, proximal junction failure (PJF), and postoperative distance from the posterosuperior corner of C7 and the vertical axis from the centroid of C2 (SVA) were significant upon Kaplan-Meier survival analysis. Conclusion: The major risk factors for URO following surgery for ASD, i.e. postoperative SVA and PJF, and their interactions were identified using a machine learning algorithm and game theory. Clinical benefits will depend on patient risk profiles. Cite this article: Bone Joint Res 2023;12(4):245–255.

Abnormal uterine bleeding (AUB) poses a multifaceted challenge in women’s health, necessitating an integrated approach that addresses its diverse etiologies and clinical presentations. The International Federation of Gynecology and Obstetrics PALM-COEIN classification system provides a systematic approach to the diagnosis of AUB in non-pregnant women, based on clinical and imaging-based categorization of causes into structural (Polyps, Adenomyosis, Leiomyomas and Malignancy; PALM), and non-structural causes (Coagulopathies, Ovulatory disorders, primary Endometrial disorders, Iatrogenic and Not otherwise classified; COEIN). On the other hand, placental disorders, uterine rupture, ectopic pregnancy and retained products of conceptions are the main causes of uterine bleeding during pregnancy and in the peripartum period. Ultrasound is usually the first-line imaging technique for the differential diagnosis of causes of AUB. Computed Tomography may be useful if ultrasound findings are unclear, especially in emergency settings. Magnetic resonance imaging, when indicated, is an excellent second-line diagnostic tool for a better non-invasive characterization of the underlying cause of AUB. This pictorial review aims to illustrate the main causes of AUB from the point of view of diagnostic imaging and to show not-so-common cases that can be treated by means of interventional radiology.