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To assess the value of the administration of positive rectal contrast at CT in patients referred for suspected diverticular disease (DD) of the colon. 460 patients (253 male, 207 female; median age 62 years; interquartile range 24) with clinical suspicion of DD of the colon were included in this retrospective IRB-approved study. CT was performed with i. v. contrast only (n = 328, group M1), i. v. + positive rectal contrast (n = 82, group M2), neither i. v. nor rectal contrast (n = 32, group S1), or positive rectal contrast only (n = 19, group S2). Two readers in consensus evaluated all CT datasets concerning diagnosis of DD (yes/no) and categorized findings (classification of diverticular disease (CDD)). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values for the diagnosis of DD were calculated for all groups, using either clinical follow-up (n = 335) or intraoperative findings (n = 125) as the reference standard. In patients undergoing surgery, radiological staging of DD was correlated with the histopathology (weighted Cohen-k). 224 patients (48.7 %) were diagnosed with DD. The sensitivity, specificity, PPV, and NPV were as follows. Group M1 / M2: 92 %/92 %, 97 %/94 %, 96 %/96 %, 94 %/89 %, respectively; group S1 / S2: 94 %/86 %, 93 %/80 %, 94 %/92 %, 93 %/67 %, respectively. Radiological staging and histopathology correlated substantially in all groups (k = 0.748-0.861). Abdominal CT had a high sensitivity and specificity for the diagnosis of DD. Disease staging correlated well with the findings at surgery. Additional positive rectal contrast administration did not have a significant advantage and may therefore be omitted in patients with suspected DD.· CT has a high sensitivity and specificity for diagnosis of DD.. · CT staging using the CDD algorithm correlates very well with surgery.. · Positive rectal contrast administration does not improve diagnosis and radiological staging..· Meyer S, Schmidbauer M, Wacker FK et al. To Fill or Not to Fill? - Value of the Administration of Positive Rectal Contrast for CT Evaluation of Diverticular Disease of the Colon. Fortschr Röntgenstr 2021; 193: 804 - 812.ZIEL: Evaluation der rektalen Gabe positiven KM im Rahmen der CT bei Patienten mit klinischem Verdacht auf Divertikelkrankheit des Dickdarms (DD). 460 Patienten (253 Männer, 207 Frauen; medianes Alter 62 Jahre; Interquartilsabstand 24) mit klinischem Verdacht auf DD wurden in diese retrospektive, durch die Ethikkommission genehmigte Studie eingeschlossen. Die CT wurde nur mit i. v. KM (n = 328, Gruppe M1), i. v. und positivem rektalem KM (n = 82, Gruppe M2), weder i. v. noch positivem rektalem KM (n = 32, Gruppe S1) oder nur positivem rektalem KM (n = 18, Gruppe S2) durchgeführt. Die CT-Untersuchungen wurden von 2 Radiologen gemeinsam im Hinblick auf die Diagnose DD (ja/nein) evaluiert und, falls zutreffend, basierend auf der Klassifikation der Divertikelkrankheit (CDD) kategorisiert. Als Referenzstandard dienten der klinische Verlauf (n = 335) sowie der operative/histologische Befund (n = 125). Sensitivität, Spezifität, positiver (PPV) und negativer prädiktiver Wert (NPV) wurden für alle Gruppe berechnet. Im Fall einer Operation wurde das CT-Stadium mit dem histopathologischen Ergebnis korreliert (gewichtete Cohen-k). Bei 224 Patienten (48,7 %) wurde eine DD diagnostiziert. Sensitivität, Spezifität, PPV und NPV für die CT waren wie folgt: Gruppe M1 / M2: 92 %/92 %, 97 %/94 %, 96 %/96 %, 94 %/89 %; Gruppe S1 / S2: 94 %/86 %, 93 %/80 %, 94 %/92 %, 93 %/67 %. Das CT-Stadium korrelierte in allen Gruppen sehr gut mit dem histopathologischen Befund (k = 0,748–0,861). Die CT hat eine hohe Sensitivität und Spezifität für die Diagnose einer Divertikelkrankheit des Dickdarms. Das radiologische Krankheitsstadium korrelierte sehr gut mit dem intraoperativen Befund. Die ergänzende rektale Applikation von positivem KM hat jedoch in der vorliegenden Studie keinen signifikanten Vorteil gezeigt, sodass im Rahmen der klinischen Routine auf diese verzichtet werden kann.· Die CT hat eine hohe Sensitivität/Spezifität für die Diagnose DD.. · Das CT-Stadium (CDD Algorithmus) korreliert sehr gut mit dem operativen Befund.. · Die Gabe von positivem rektalen KM verbessert weder Diagnose noch Stadieneinteilung..

BACKGROUND Patients with head and neck squamous cell carcinoma (HNSCC) often acquire an impaired nutritional status resulting in compromised outcomes. Perioperative immunonutrition may have a positive effect on outcomes after elective surgery. METHODS Short-term outcomes before and after implementation of preoperative immunonutrition were retrospectively assessed. Regression models adjusted for outcome predictors were used to compare the length of stay (LOS) in the hospital, local infections, and general complications. RESULTS Four hundred eleven patients were included (control group = 209 and the intervention group = 202). With immunonutrition, hospital LOS was significantly lower (median 6 vs 8 days; adjusted mean difference of -5.65 days; P

Purpose Aim of our study was to evaluate the motivation of medical students in their final year of medical school to choose radiology for further specialization by means of a Germany-wide survey. Materials and Methods The survey was performed during the 2015/16 semester among German medical students in their four months radiology elective during the final year. Invitations for the study were distributed by the Student Secretariats of each university. The survey was web-based with EvaSys 7.0 software. Questions on radiology contents during medical studies and “practical year” were part of the survey. Plans for residency and possible advantages and disadvantages of radiology as medical specialty were inquired. Descriptive statistics and group comparisons were used as analysis methods. Results 89 students participated in the survey at the beginning and 60 students at the end of the practical year. Of these 39 students could be identified who answered both questionnaires. Most students were satisfied with their final year radiology elective (mean 1.8 on a range from 1 to 5). Nevertheless, they criticized mentoring during routine work (mean 2.1) and a lack of educational courses (mean 2.1). Most students (83 %) were uncertain about their residency choice at the beginning of their “practical year” and about one fifth changed their plans. From the students’ point of view main advantages of radiology included contact with many other clinical disciplines (87 %) and the working conditions (68 %). The reduced patient contact (42 %), the large amount of work at a computer (43 %), and the dependency on referring physicians (42 %) were regarded as the main disadvantages. The students regarded the way radiology is taught during the studies as not practical enough. With regard to radiology the majority of students (63 %) felt poorly prepared for their future work. Conclusion The “practical year” is important regarding the choice of future specialization. There was a high degree of satisfaction with the “practical year” in radiology. The mentoring during routine work and a lack of educational courses was mildly criticized. These factors provide room for improvement to foster students’ interest in radiology. Key Points Citation Format

To assess the value of oral effervescent powder (EP) for evaluation of esophageal distension, and for detection and staging of esophageal cancer with contrast-enhanced CT.84 patients without esophageal pathology and 52 patients with histological confirmed diagnosis of esophageal cancer were included in this prospective IRB-approved study. Half of the patients in both groups received EP prior to CT. Esophageal distension was assessed by planimetry of the inner (IA) and outer area (OA). Two blinded readers evaluated the datasets separately with regard to diagnosis of esophageal cancer (yes/no) and staging (T0-T4), if applicable. Distension results were compared (t-Test). In patients with cancer sensitivity, specificity, NPV and PPV were calculated. CT staging results were compared to histopathology (Cohen-k).IA and IA/OA were significantly larger after EP as compared to the group without EP (p0.05). Sensitivity, specificity, NPV and PPV for cancer detection cancer were as follows: 78%/78%, 98%/98%, 95%/95%, 87%/87% with EP; 60%/68%, 98%/98%, 94%/94%, 80%/83% without EP. Staging with EP was good (k=0.84/0.67) and moderate without EP (k=0.58/0.59).Administration of EP prior to CT results in good distension of the esophagus, and improves detection and staging of esophageal cancer, as compared to control studies without EP.

Evaluation and analysis of the integrative course "Radiological Anatomy" established since 2007 at the Medical School Hannover (MHH) in comparison with conventional education.Anatomy and radiology are usually taught separately with a considerable time lag. Interdisciplinary teaching of these associated subjects seems logical for several reasons. Therefore, the integrative course "Radiological Anatomy" was established in the second year of medical education, combining these two closely related subjects. This interdisciplinary course was retrospectively evaluated by consideration of a student questionnaire and staff observations. The advantages and disadvantages of integrative teaching in medical education are discussed.The course ratings were excellent (median 1; mean 1.3 on a scale of 1 to 6). This is significantly (p0.001) better than the average of all evaluated courses in the respective term (grade 2.8). The course improved the anatomical comprehension (90 %) and the students stated that the topics were relevant for their future medical education (90 %). Furthermore, interest in the subject's anatomy and radiology increased during the course (88 %). According to the students' suggestions the course was enhanced by a visitation in the Department of Radiology and the additional topic central nervous system.Integrative teaching of anatomy and radiology was well received by the students. Both, anatomical and radiological comprehension and the motivation to learn were improved. However, it should be considered, that the amount of work and time required by the teaching staff is considerably increased compared to traditional teaching.