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Introduction The aim of this study was to establish institutional diagnostic reference levels (DRLs) by summarising doses collected across the five computed tomography (CT) system in our institution. Methods CT dose data of 15940 patients were collected retrospectively from May 2015 to October 2015 in five institutional scanners. The mean, 75th percentile and 90th percentile of the dose spread were calculated according to anatomic region. The common CT examinations such as head, chest, combined abdomen/pelvis (A/P), and combined chest/abdomen/pelvis (C/A/P) were reviewed. Distribution of CT dose index (CTDIvol), dose‐length product (DLP) and effective dose (ED) were extracted from the data for single‐phasic and multiphasic examinations. Results The institutional DRL for our CT units were established as mean (50th percentile) of CTDIvol (mGy), DLP (mGy.cm) and ED (mSv) for single and multiphasic studies using the dose‐tracking software. In single phasic examination, Head: (49.0 mGy), (978.0 mGy.cm), (2.4 mSv) respectively; Chest: (6.0 mGy), (254.0 mGy.cm), (4.9 mSv) respectively; CT A/P (10.0 mGy), (514.0 mGy.cm), (8.9 mSv) respectively; CT C/A/P (10.0 mGy), (674.0 mGy.cm), (11.8 mSv) respectively. In multiphasic studies: Head (45.0 mGy), (1822.0 mGy.cm), (5.0 mSv) respectively; Chest (8.0 mGy), (577.0 mGy.cm), (10.0 mSv) respectively; CT A/P: (10.0 mGy), (1153.0 mGy.cm), (20.2 mSv) respectively; CT C/A/P: (11.0 mGy), (1090.0 mGy.cm), (19.2 mSv) respectively. Conclusions The reported metrics offer a variety of information that institutions can use for quality improvement activities. The variations in dose between scanners suggest a large potential for optimisation of radiation dose.

Purpose To investigate whether providing sonographic (US)/MRI fusion images will enhance the ability of medical students and radiology residents to identify MSK anatomy on sonograms alone. Methods Medical students (n = 31) and radiology residents (n = 23) were each randomly divided into two groups: Group A and Group B. Subjects in Group A were shown 10 MSK sonograms with arrows pointing to a specific anatomic structure or anatomic region. Subjects in Group B were shown the exact same 10 annotated sonograms as Group A as well as an additional fusion image consisting of an MRI of the same anatomy in the same plane fused with the sonogram without arrows. Sonograms and MRI were obtained from adult patients who consented to have their images used. The anatomic regions included the shoulder, hip, and pelvis. Both groups were given the same 10-question multiple choice examination to identify the anatomic structure that the arrow was marking on the sonogram. The transducer's location was given for every question. One minute was allowed to answer each question. The Wilcoxon rank sum test was used to assess if there was a difference between Group A and Group B in both the medical student and the radiology resident cohorts. Results Medical students: subjects in Group A (n = 16) gave the correct answers in 33.8% of the cases (54/160). Subjects in Group B (n = 15) gave correct answers in 26.0% of the cases (39/150) (p value

Background Occupational health hazards associated with fluoroscopic-based procedures are well known, including a high prevalence of orthopedic problems, and those related to radiation exposure, particularly cancer and cataracts. This article reports the “first-in-man” clinical experience with a novel radiation protection system designed to eliminate radiation exposure to operators and thereby obviate the need for orthopedically burdensome leaded aprons. The Trinity Radiation Protection System consists of a combination of fixed shields, radiation drapes, and interconnecting flexible radiation resistant materials creating a complete radiation protection environment for the operators, yet maintaining full and unimpeded contact with the patient and total control of all operational elements of the catheterization equipment. Methods and Results This report constitutes an analysis of 19 nonrandomized cases in which operator radiation exposure data were collected (Trinity Radiation Protection System n = 10 cases versus standard shielding alone n = 9). In all cases performed with the Trinity System, there was neither any measurable significant radiation exposure in any anatomic region nor for the total case, whereas operators performing cases with standard shielding were exposed to radiation in all regions of their bodies (total per case exposure differences P < 0.0001). Conclusion The novel radiation protection system described is the first to provide a complete radiation barrier that eliminates radiation exposure to operators, thereby obviating the need for orthopedically burdensome leaded aprons. This approach to radiation protection has promise to enhance the safety and occupational health of medical personnel in the catheterization laboratory. © 2012 Wiley Periodicals, Inc.

Objective: The epitympanum is an anatomic region of great surgical importance, yet its dimensions have gone largely unstudied since Bezold in the 1800s. We investigated the radiologic dimensions of the epitympanum, compared these dimensions with those determined at anatomic dissection by Bezold, and compared them to mastoid pneumatization.Method: Of 41 clinically normal human crania, the 5 with the smallest mastoid pneumatization areas and the 5 with the largest areas were imaged by high-resolution computed tomography, both direct axial and direct coronal. The two authors measured the heights, breadths, and lengths independently.Results: Wide ranges were found for epitympanum heights (5.0-10.0 mm), breadths (6.0-7.0 mm). and (lengths 9.5-12.5 mm), and for mastoid sizes. The range of heights was wider than Bezold reports, but the range of breadths was tighter. Bilateral symmetry was found for mastoid pneumatization.Conclusion: Epitympanic heights and breadths were generally consistent with the report by Be...

Computed tomography (CT) is a sensitive, noninvasive radiographic technique which can produce detailed cross-sectional images of any anatomic region. The amount and accuracy of the information it provides far exceeds that produced by conventional radiographic techniques. The chemosurgeon can find CT scanning invaluable in his preoperative evaluation of patients with large, invasive head and neck tumors of cutaneous origin.

Elective excisions of the forehead are relatively easy to plan because of the prominence of horizontal skin folds and vertical glabellar furrows. However, the variety of defects in that region which result from Mohs micro-graphic surgery for cutaneous tumors frequently present reconstructive challenges. Principles applicable to this anatomic region and illustrative cases are presented and discussed.