4区医学

Radiologe Pub Date : 2022-05-01 Epub Date: 2022-02-22 DOI: 10.1007/s00117-022-00967-y

Hanns-Christian Breit, Jan Vosshenrich, Michael Bach, Elmar M Merkle

{"title":"[New clinical applications for low-field magnetic resonance imaging : Technical and physical aspects].","authors":"Hanns-Christian Breit, Jan Vosshenrich, Michael Bach, Elmar M Merkle","doi":"10.1007/s00117-022-00967-y","DOIUrl":"https://doi.org/10.1007/s00117-022-00967-y","url":null,"abstract":"Background: Low-field magnetic resonance imaging (MRI) is experiencing a renaissance due to technical innovations. The new-generation devices offer new applications for imaging and a possible solution to increasing cost pressures in the healthcare system.Objectives: Effects of field strength on technique, physics, image acquisition, and diagnostic quality of examinations are presented.Methods: Important basic physical parameters for image acquisition and quality are summarized. Initial clinical experience with a new 0.55 T low-field scanner is presented.Results: Field strengths that are lower than the currently used 1.5 T and 3 T field strengths are characterized by an expected lower signal-to-noise ratio in image acquisition. Whether this is a diagnostic limitation needs to be evaluated in studies, as there are several options to offset this perceived drawback, including increasing measurement time or artificial intelligence (AI) postprocessing techniques. In addition, it is necessary to meticulously investigate whether low-field systems allow diagnostically adequate image quality to be achieved in different body regions and different disease entities. Initial studies in our clinic are promising and show, for example, diagnostic quality without relevant loss of time for examinations of the lumbar spine. Advantages of low-field MRI include reduced susceptibility artifacts when imaging the lungs and in patients with metallic implants.Conclusion: Low-field scanners offer a variety of new fields of application with field strength-related advantages. In most other clinical examination fields, at least diagnostic quality can be expected.","PeriodicalId":54513,"journal":{"name":"Radiologe","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9061674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39943202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

[Economic aspects of low-field magnetic resonance imaging : Acquisition, installation, and maintenance costs of 0.55 T systems]. [低场磁共振成像的经济方面:0.55 T系统的购置、安装和维护成本]。

4区医学

Radiologe Pub Date : 2022-05-01 DOI: 10.1007/s00117-022-00986-9

Jan Vosshenrich, Hanns-Christian Breit, Michael Bach, Elmar M Merkle

{"title":"[Economic aspects of low-field magnetic resonance imaging : Acquisition, installation, and maintenance costs of 0.55 T systems].","authors":"Jan Vosshenrich, Hanns-Christian Breit, Michael Bach, Elmar M Merkle","doi":"10.1007/s00117-022-00986-9","DOIUrl":"https://doi.org/10.1007/s00117-022-00986-9","url":null,"abstract":"Background: Low-field magnetic resonance imaging (MRI) scanners offer an opportunity for cost reduction in the healthcare system. This is due to lower manufacturing costs and reduced construction requirements for installation and operation.Objectives: To discuss potential cost reductions in acquisition, installation, and maintenance by using new low-field MRI systems.Methods: We provide an overview of key cost drivers and an evaluation of the potential savings of a recent generation 0.55T low-field MRI compared to conventional 1.5T and 3T MRI systems in routine clinical practice.Results: In terms of purchase price, the savings potential of a 0.55T MRI compared to a 1.5T MRI system is about 40-50%. The 25% lower weight of the system reduces the transportation costs incurred, and the smaller size of the unit allows for installation by a remotely controlled mobile robotic system without opening the exterior façade, if the operating site is at ground level. Together with the lack of need to install a quench pipe, this reduces the total cost of installation by up to 70%. The maintenance cost of a 0.55T MRI is approximately 45% less than that of a 1.5T unit with a comparable service contract. Further cost reductions result from the smaller room size and potentially lower energy consumption for examinations and cooling.Conclusion: The use of lower field strength MRI systems offers enormous economic and environmental potential for both hospitals and practice operators, as well as for the healthcare system as a whole.","PeriodicalId":54513,"journal":{"name":"Radiologe","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9061693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

[Car accident with severe abdominal wall injury]. 【严重腹壁损伤的车祸】。

4区医学

Radiologe Pub Date : 2022-05-01 Epub Date: 2022-03-22 DOI: 10.1007/s00117-022-00994-9

C Kloth, L Linderich, N Sollmann, A Beck, A Formentini, R Alberts, M Schultheiss, M Beer, D Vogele

引用次数: 0

[Rare soft tissue tumour of the skin of the chest]. [罕见的胸部皮肤软组织肿瘤]。

4区医学

Radiologe Pub Date : 2022-04-01 Epub Date: 2021-10-28 DOI: 10.1007/s00117-021-00927-y

A Ruiu, S Stuppner, M Barillari, B Pedrinolla, C Casalboni, K Eisendle, M Pichler, E Hanspeter, A Cagini, M Tauber, M Maffei, P Orrù, R Polato, E Cretella, F Ferro

引用次数: 0

[Integrated care concepts and multidisciplinary process chains in a radiological context]. [放射学背景下的综合护理概念和多学科流程链]。

4区医学

Radiologe Pub Date : 2022-04-01 Epub Date: 2022-02-24 DOI: 10.1007/s00117-022-00976-x

J Bauer, E Kösel, A G Henkel, C D Spinner, R Kolisch

{"title":"[Integrated care concepts and multidisciplinary process chains in a radiological context].","authors":"J Bauer, E Kösel, A G Henkel, C D Spinner, R Kolisch","doi":"10.1007/s00117-022-00976-x","DOIUrl":"https://doi.org/10.1007/s00117-022-00976-x","url":null,"abstract":"Modern patient-centered and cost-efficient care concepts in hospitals require the mapping of multidisciplinary process chains into clinical pathways. Clinical decision support systems and operations research methods use algorithms to classify patients into homogeneous groups and to model a complete clinical pathway for scheduling individual procedures. An improvement of the economic situation of the care facility can be achieved through improved resource utilization, reduced patient waiting times and a shortening of the length of stay. The interdisciplinary use of centrally stored interoperable information and comprehensive care management via information technology (IT) services lay the foundation for the dissolution of traditional IT system architectures in medicine and the development of flexibly integrable modern system platforms. New IT approaches such as the semantically standardized definition of procedures and resource properties, the use of clinical decision support systems and the use of service-oriented system architectures form the basis for the deep integration of radiology services into comprehensive interdisciplinary care concepts.","PeriodicalId":54513,"journal":{"name":"Radiologe","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39950583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[New MRI guidelines for multiple sclerosis]. [多发性硬化症的新MRI指南]。

4区医学

Radiologe Pub Date : 2022-04-01 Epub Date: 2022-03-22 DOI: 10.1007/s00117-022-00991-y

Wolfgang Reith, Alena Hausmann, Michael Kettner

引用次数: 1

[Cross-sectional diagnostic imaging in the InEK benchmark : An opportunity for radiology]. [InEK基准中的横断面诊断成像:放射学的机会]。

4区医学

Radiologe Pub Date : 2022-04-01 Epub Date: 2022-01-14 DOI: 10.1007/s00117-021-00963-8

V Wienicke, T Denecke, J Henkelmann, R Jacob, Nikolaus von Dercks

{"title":"[Cross-sectional diagnostic imaging in the InEK benchmark : An opportunity for radiology].","authors":"V Wienicke, T Denecke, J Henkelmann, R Jacob, Nikolaus von Dercks","doi":"10.1007/s00117-021-00963-8","DOIUrl":"https://doi.org/10.1007/s00117-021-00963-8","url":null,"abstract":"Background: Based on the lump sum system which is calculated by the InEK (Institut für das Entgeltsystem im Krankenhaus), it is possible to compare one hospital's own performance data with all hospitals in Germany billing according to the Diagnosis-Related Group (DRG). The aim of this article is to investigate exceeding or undercutting of computed tomography (CT) or magnetic resonance imaging (MRI) in comparison to the calculations made by the InEK to reveal potential for improvement.Methods: InEK calculation data for 2021 were used to form comparative ratios for CT and MRI diagnostics at the DRG level. Data from a university hospital was compared at the hospital, departments, DRG and main diagnosis levels.Results: At the hospital level, there were 1025 more MRIs and 371 more CTs compared to InEK. Analysis by department showed, e.g., in neurology, 489 more MRIs and 620 fewer CTs. The benchmark of the DRGs showed in particular that DRG B70B was the driver of deviations in both diagnostic modalities (MRI [Formula: see text] CT [Formula: see text]). The identified deviations can be further analysed at the main diagnosis level.Conclusion: Awareness of above-average use of cross-sectional imaging diagnostics can provide impetus for further development of clinical pathways of a hospital. The methodology of the InEK benchmark is applicable to every hospital and is able to identify processes with potential for improvement. The review of influencing factors as well as the evaluation by clinicians and economists are prerequisite for acceptance and success of the measures generated from the benchmark.","PeriodicalId":54513,"journal":{"name":"Radiologe","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8983549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39820403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

[Transarterial chemoembolization of hepatocellular carcinoma]. [经动脉化疗栓塞治疗肝癌]。

4区医学

Radiologe Pub Date : 2022-03-01 Epub Date: 2022-02-16 DOI: 10.1007/s00117-022-00972-1

Peter Huppert

{"title":"[Transarterial chemoembolization of hepatocellular carcinoma].","authors":"Peter Huppert","doi":"10.1007/s00117-022-00972-1","DOIUrl":"https://doi.org/10.1007/s00117-022-00972-1","url":null,"abstract":"Transarterial chemoembolization (TACE) is used as palliative and neoadjuvant treatment for patients with hepatocellular carcinoma (HCC). TACE should be offered as palliative treatment to patients with intermediate stage large or multinodular HCC if no curative treatment option is available by resection or thermoablation and if extrahepatic metastases and tumor infiltration of main portal and systemic veins has been excluded. TACE is possible only in patients with preserved liver function (Child-Pugh A-B, best up to 7 points) and with good performance status (ECOG 0). TACE can be used for bridging and for downstaging prior to liver transplantation with the intention to maintain or reach limited intrahepatic tumor load defined by Milan criteria. TACE should be adapted to the vascularization pattern of the HCC nodules and performed as selective as possible and repetetively if necessary with the goal of complete devascularization of the tumor tissue. Conventional TACE (cytotoxic drugs, iodized oil and embolic particles) and drug-eluting TACE (anthracycline preloaded in microspheres) can be used in a comparable way. During drug-eluting TACE, peripheral concentration of cytotoxic drugs is lower. Using conventional TACE in a palliative setting, survival benefit for patients was 8-11 months compared to best supportive care; however, this requires that all known contraindications and other criteria in terms of tumor and liver disease, respectively, associated with negative prognosis be taken into consideration. Better local response is achieved by drug-eluting TACE; however, no related survival benefit was shown compared to conventional TACE so far. Response to neoadjuvant local treatment is associated with improved prognosis after liver transplantation.","PeriodicalId":54513,"journal":{"name":"Radiologe","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39928384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

[Guideline-based thermal ablation of hepatocellular carcinoma]. [基于指南的肝细胞癌热消融]。

4区医学

Radiologe Pub Date : 2022-03-01 Epub Date: 2022-01-17 DOI: 10.1007/s00117-021-00960-x

Andreas H Mahnken

引用次数: 2

[International comparison of radiological aspects of the new German S3 guideline on hepatocellular carcinoma and intrahepatic cholangiocarcinoma]. [关于肝细胞癌和肝内胆管癌的新德国S3指南放射学方面的国际比较]。

4区医学

Radiologe Pub Date : 2022-03-01 Epub Date: 2022-02-18 DOI: 10.1007/s00117-022-00968-x

Philippe L Pereira, Thomas J Vogl, Thomas Helmberger

{"title":"[International comparison of radiological aspects of the new German S3 guideline on hepatocellular carcinoma and intrahepatic cholangiocarcinoma].","authors":"Philippe L Pereira, Thomas J Vogl, Thomas Helmberger","doi":"10.1007/s00117-022-00968-x","DOIUrl":"https://doi.org/10.1007/s00117-022-00968-x","url":null,"abstract":"The updated German S3 guideline \"Diagnostics and therapy of hepatocellular carcinoma and biliary carcinomas\" covers two tumor entities. The original guideline published in 2013 focusing only on the diagnosis and therapy of hepatocellular carcinoma (HCC) has been expanded to include intrahepatic cholangiocarcinoma. These guidelines were developed within the framework of the guideline program on oncology of the Scientific Medical Society e. V. (AWMF), the German Cancer Society (DKG) and German Cancer Aid Society (DKG) under the auspices of the German Society for Digestive and Metabolic Diseases (DGVS). In addition to updated recommendations regarding histopathology, radiological diagnostics and treatments, the main innovations of the revised guidelines on HCC include a complete revision of the section on the systemic therapeutic approach in advanced stages of the disease. This article presents the significance of the current recommendations for diagnostic and interventional radiology in comparison to other national and international guidelines and should serve to improve the quality of patient care through more widespread dissemination.","PeriodicalId":54513,"journal":{"name":"Radiologe","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39812162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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