Radiologie (Heidelberg, Germany)最新文献

{"title":"[Strangulation].","authors":"K Yen, A Tsaklakidis, H P Schlemmer","doi":"10.1007/s00117-024-01372-3","DOIUrl":"10.1007/s00117-024-01372-3","url":null,"abstract":"<p><strong>Clinical problem: </strong>Detection of manual strangulation, choking and hanging, as well as the intensity of these actions, helps to clarify the course of events, to enforce the state's right to prosecute and ultimately to protect against further attacks. However, this is complicated by the scarcity of externally visible findings.</p><p><strong>Standard procedure to date: </strong>The forensic examination of the head and neck after strangulation is carried out by means of external inspection to detect injuries and congestion above the strangulation level. Lesions below the surface of the skin, in particular of the subcutaneous fat tissue, the muscles or the laryngeal structures, usually escape the external inspection.</p><p><strong>Forensic radiology as an important component: </strong>Imaging techniques allow internal injuries to be recorded and objectified, which can be of considerable added value in the collection of evidence. Since criminal proceedings must meet the highest standards of security, high demands are placed on imaging and diagnosis.</p><p><strong>Assessment: </strong>Imaging techniques are suitable for detecting and objectifying internal injuries after a person has survived strangulation. However, their excellent reconstruction and visualization capabilities also make them a valuable addition to postmortem examinations.</p><p><strong>Recommendations for practice: </strong>After reported and survived strangulation, choking or hanging, magnetic resonance imaging (MRI) of the soft tissues of the neck should be performed as soon as possible, and if cerebral damage is suspected, the skull should also be examined. If the event was not survived, whole-body computed tomography (CT) is now standard practice at many forensic medicine institutes.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"861-867"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Between clinical and forensic imaging : Differences, similarities and legal framework].","authors":"Gina Maria Bruch, Benno Schäffer, Bastian O Sabel","doi":"10.1007/s00117-024-01361-6","DOIUrl":"10.1007/s00117-024-01361-6","url":null,"abstract":"<p><p>Clinical imaging uses a variety of medical imaging techniques to diagnose and monitor diseases, injuries and other health conditions. These include X‑ray images, computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound. These procedures are used to make accurate diagnoses and plan the best possible treatment for patients. Forensic imaging, in contrast, is used in both living and deceased persons in the context of criminal investigations. Postmortem forensic imaging techniques, such as postmortem CT (PMCT) and postmortem CT angiography (PMCTA), include some of the same procedures used in clinical imaging. An important difference between clinical and forensic imaging is the purpose and context in which the imaging studies are used. In addition, radiological procedures, such as angiography, need to be adapted and modified in the post-mortem setting. From a legal perspective clinical and forensic imaging must strictly adhere to privacy and procedural guidelines. Forensic images often need to be admissible as evidence in court, which places specific requirements on the quality, authenticity and documentation of images. In the case of living individuals, there must be a valid indication and consent from the patient. Consent must also fundamentally be obtained for post-mortem examinations, e.g. from the public prosecutor's office.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"830-836"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of myeloma-associated osteolytic bone lesions with energy-integrating and photon-counting detector CT.","authors":"Martin Grözinger, Markus Wennmann, Stefan Sawall, Eckhard Wehrse, Sam Sedaghat, Christian Neelsen, Fabian Bauer, Hartmut Goldschmidt, Vivienn Weru, Christian H Ziener, Annette Kopp-Schneider, Heinz-Peter Schlemmer, Lukas T Rotkopf","doi":"10.1007/s00117-024-01344-7","DOIUrl":"10.1007/s00117-024-01344-7","url":null,"abstract":"<p><strong>Background: </strong>A recent innovation in computed tomography (CT) imaging has been the introduction of photon-counting detector CT (PCD-CT) systems, which are able to register the number and the energy level of incoming x‑ray photons and have smaller detector elements compared with conventional CT scanners that operate with energy-integrating detectors (EID-CT).</p><p><strong>Objectives: </strong>The study aimed to evaluate the potential benefits of a novel, non-CE certified PCD-CT in detecting myeloma-associated osteolytic bone lesions (OL) compared with a state-of-the-art EID-CT.</p><p><strong>Materials and methods: </strong>Nine patients with multiple myeloma stage III (according to Durie and Salmon) underwent magnetic resonance imaging (MRI), EID-CT, and PCD-CT of the lower lumbar spine and pelvis. The PCD-CT and EID-CT images of all myeloma lesions that were visible in clinical MRI scans were reviewed by three radiologists for corresponding OL. Additionally, the visualization of destructions to cancellous or cortical bone, and trabecular structures, was compared between PCD-CT and EID-CT.</p><p><strong>Results: </strong>Readers detected 21% more OL in PCD-CT than in EID-CT images (138 vs. 109; p < 0.0001). The sensitivity advantage of PCD-CT in lesion detection increased with decreasing lesion size. The visualization quality of cancellous and cortical destructions as well as of trabecular structures was rated higher by all three readers in PCD-CT images (mean image quality improvements for PCD-CT over EID-CT were +0.45 for cancellous and +0.13 for cortical destructions).</p><p><strong>Conclusions: </strong>For myeloma-associated OL, PCD-CT demonstrated significantly higher sensitivity, especially with small size. Visualization of bone tissue and lesions was considered significantly better in PCD-CT than in EID-CT. This implies that PCD-CT scanners could potentially be used in the early detection of myeloma-associated bone lesions.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141636063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between symptomatic status and aneurysm wall enhancement characteristics of single unruptured intracranial aneurysm.","authors":"Zi Chen, Wei Zhang, Fang-Li Li, Wen-Biao Lu","doi":"10.1007/s00117-024-01305-0","DOIUrl":"10.1007/s00117-024-01305-0","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to analyze the aneurysm wall enhancement (AWE) characteristics of a single unruptured intracranial aneurysm (UIA) and observe the relationship between the symptoms of a single UIA and the aneurysm wall.</p><p><strong>Methods: </strong>In our hospital, 85 patients diagnosed with a single UIA using computed tomography angiography (CTA) were retrospectively analyzed. The patients were divided into symptomatic and asymptomatic groups, including 46 asymptomatic and 39 symptomatic aneurysms. High-resolution magnetic resonance imaging of the vascular wall (HR-MR-VWI) was utilized to ascertain the presence, degree, and extent of AWE and thick-wall enhancement. In addition to AWE characteristics, morphological parameters of aneurysms, such as maximal size, shape, height, neck width, aspect ratio (AR), and size ratio (SR), were scanned using CTA. The differences in the parameters of a single UIA between the two groups were compared. An investigation explored the correlation between the symptom status of a single UIA and AWE.</p><p><strong>Results: </strong>We observed a correlation between symptom status and maximal size, height, and neck width for a single UIA, the presence or absence of AWE, and the levels and boundaries of AWE and thick-wall reinforcement. This study found that the AWE range was independently correlated with symptom status in the multivariate regression analysis.</p><p><strong>Conclusion: </strong>A larger AWE range was an independent risk factor for the onset of symptoms in a single UIA.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"86-92"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheal computed tomography radiomics model for prediction of the Omicron variant of severe acute respiratory syndrome coronavirus 2.","authors":"Xu Fang, Feng Shi, Fang Liu, Ying Wei, Jing Li, Jiaojiao Wu, Tiegong Wang, Jianping Lu, Chengwei Shao, Yun Bian","doi":"10.1007/s00117-024-01275-3","DOIUrl":"10.1007/s00117-024-01275-3","url":null,"abstract":"<p><strong>Objectives: </strong>The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly contagious, fast-spreading, and insidious. Most patients present with normal findings on lung computed tomography (CT). The current study aimed to develop and validate a tracheal CT radiomics model to predict Omicron variant infection.</p><p><strong>Materials and methods: </strong>In this retrospective study, a radiomics model was developed based on a training set consisting of 157 patients with an Omicron variant infection and 239 healthy controls between 1 January and 30 April 2022. A set of morphological expansions, with dilations of 1, 3, 5, 7, and 9 voxels, was applied to the trachea, and radiomic features were extracted from different dilation voxels of the trachea. Logistic regression (LR), support vector machines (SVM), and random forests (RF) were developed and evaluated; the models were validated on 67 patients with the Omicron variant and on 103 healthy controls between 1 May and 30 July 2022.</p><p><strong>Results: </strong>Logistic regression with 12 radiomic features extracted from the tracheal wall with dilation of 5 voxels achieved the highest classification performance compared with the other models. The LR model achieved an area under the curve of 0.993 (95% confidence interval [CI]: 0.987-0.998) in the training set and 0.989 (95% CI: 0.979-0.999) in the validation set. Sensitivity, specificity, and accuracy of the model for the training set were 0.994, 0.946, and 0.965, respectively, whereas those for the validation set were 0.970, 0.952, and 0.959, respectively.</p><p><strong>Conclusion: </strong>The tracheal CT radiomics model reliably identified the Omicron variant of SARS-CoV‑2, and may help in clinical decision-making in future, especially in cases of normal lung CT findings.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"66-75"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CBCT-based three-dimensional dual-phase vascular image fusion: a novel technique for interventional real-time TIPS guidance.","authors":"Huibin Shi, Zhiquan Zhuang, Suming Zhang, Wenyi Li, Wen Zhang, Zihan Zhang, Minjie Yang, Jiaze Yu, Xin Zhou, Shiyao Chen, Jian Wang, Jianjun Luo, Jingqin Ma, Zhiping Yan","doi":"10.1007/s00117-024-01265-5","DOIUrl":"10.1007/s00117-024-01265-5","url":null,"abstract":"<p><strong>Background: </strong>Due to the invisibility of the portal vein (PV), how to puncture the PV accurately and safely in transjugular intrahepatic portosystemic shunt (TIPS) creation remains a challenge of the procedure.</p><p><strong>Objectives: </strong>We aimed to provide the first evaluation of the safety, feasibility, and efficiency of cone beam computed tomography (CBCT)-based three-dimensional (3D) dual-phase vascular image fusion for interventional real-time guided PV puncture during TIPS procedures.</p><p><strong>Materials and methods: </strong>From January 2021 to May 2021, 13 patients undergoing TIPS were prospectively enrolled in this study. Images of the hepatic artery (HA) and PV in 3D were acquired and overlaid on interventional fluoroscopy images in a dual-phase display mode for real-time PV puncture guidance. The number of PV puncture attempts, puncture time, overlaid image accuracy, dose area product, fluoroscopy time, and interventional complications were recorded.</p><p><strong>Results: </strong>Portal vein puncture guided by CBCT-based 3D dual-phase vascular image fusion was successfully performed on 92.3% (12/13) patients. The mean number of PV puncture attempts was 1.8 ± 0.7 (1-3). The mean puncture time and fluoroscopy time was 3.5 ± 1.2 (2-6) min and 25.1 ± 9.4 (15-45) min, respectively. The mean dose area product was 39.49 ± 7.88 (28.81-52.87) mGym². The error between the reference position of the fusion image and the interventional PV angiography image was less than 0.5 cm. No interventional complication was observed.</p><p><strong>Conclusion: </strong>Our results show that 3D dual-phase vascular image fusion might be a safe and feasible technique for interventional real-time guided PV puncture during TIPS. This novel technique might help to reduce the number of PV puncture attempts and the puncture time as well as lower the risks of interventional complications.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"60-65"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139914172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing verifiable oncological imaging by quality assurance and optimization (i‑Violin) : Protocol for a European multicenter study.","authors":"Tobias Jorg, Moritz C Halfmann, Lukas Müller, Fabian Stoehr, Peter Mildenberger, Monika Hierath, Graciano Paulo, Joana Santos, John Damilakis, Ivana Kralik, Boris Brkljacic, Danijel Cvetko, Dimitrij Kuhleji, Hilde Bosmans, Dimitar Petrov, Shane Foley, Paula Toroi, Jonathan P McNulty, Christoph Hoeschen","doi":"10.1007/s00117-024-01389-8","DOIUrl":"10.1007/s00117-024-01389-8","url":null,"abstract":"<p><strong>Background: </strong>Advanced imaging techniques play a pivotal role in oncology. A large variety of computed tomography (CT) scanners, scan protocols, and acquisition techniques have led to a wide range in image quality and radiation exposure. This study aims at implementing verifiable oncological imaging by quality assurance and optimization (i-Violin) through harmonizing image quality and radiation dose across Europe.</p><p><strong>Methods: </strong>The 2‑year multicenter implementation study outlined here will focus on CT imaging of lung, stomach, and colorectal cancer and include imaging for four radiological indications: diagnosis, radiation therapy planning, staging, and follow-up. Therefore, 480 anonymized CT data sets of patients will be collected by the associated university hospitals and uploaded to a repository. Radiologists will determine key abdominopelvic structures for image quality assessment by consensus and subsequently adapt a previously developed lung CT tool for the objective evaluation of image quality. The quality metrics will be evaluated for their correlation with perceived image quality and the standardized optimization strategy will be disseminated across Europe.</p><p><strong>Results: </strong>The results of the outlined study will be used to obtain European reference data, to build teaching programs for the developed tools, and to create a culture of optimization in oncological CT imaging.</p><p><strong>Conclusion: </strong>The study protocol and rationale for i‑Violin, a European approach for standardization and harmonization of image quality and optimization of CT procedures in oncological imaging, is presented. Future results will be disseminated across all EU member states, and i‑Violin is thus expected to have a sustained impact on CT imaging for cancer patients across Europe.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"160-165"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thickness of the hard palate : A new criterion for the diagnosis of osteoporosis?","authors":"Daniela Kildal, Tobias Riether, Tilmann Blasenbrey, Dritan Turhani, Gerald Antoch, Meinrad Beer, Margrit-Ann Geibel","doi":"10.1007/s00117-024-01318-9","DOIUrl":"10.1007/s00117-024-01318-9","url":null,"abstract":"<p><strong>Background: </strong>We were looking for an osteoporosis screening in computed tomography (CT) exams, simple and without additional examinations. We hypothesized that the criterion of \"decreasing cortical thickness\", may have an influence on the hard palate. Therefore, we investigated whether thickness of the hard palate (HPT) may serve as an indicator of osteoporosis for patients imaged for other reasons.</p><p><strong>Methods: </strong>Patients with dual-energy x-ray absorptiometry (DXA) and CT were identified by a radiology information system (RIS)-based, full-text search. Measurement of thickness of hard palate done in existing CT image by radiologist and dentist and compared with available findings and DXA measurements.</p><p><strong>Results: </strong>We identified a \"test group\": 57 patients with DXA and CT available out of 449 patient population and we selected further 70 patients without bone diseases as \"control groups\". The measurements showed that HPT correlated with age and bone density. The mean HPT was 2.4 mm in normal, 0.9 mm in osteopenia, 0.8 mm in osteoporosis and 5.3 mm in osteopetrosis case. No bone \"healthy\" patient fell below 1 mm. The relationship between bone density and HPT has not been described previously. HPT was highest in the bone-healthy group and decreased with age, osteopenia, and osteoporosis. Osteopetrosis, as a disease with increased bone density showed an increase in HPT.</p><p><strong>Conclusions: </strong>HPT correlates with bone disease. We propose a new criterion for assessment on CT and digital volume tomography (DVT) or cone beam computed tomography (CBCT). A threshold of 1.0 mm when applying a simple measurement of HPT on Head CT or DVT may serve as an indicator for potential osteopenia or osteoporosis as incidental finding without extra imaging further diagnosis and treatment leading to early notice of Osteoporosis.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"109-115"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion tensor imaging: survival analysis prediction in breast cancer patients.","authors":"Devrim Ulaş Urut, Derya Karabulut, Savaş Hereklioglu, Gulşah Özdemir, Berkin Anıl Cicin, Bekir Hacıoglu, Necet Süt, Nermin Tunçbilek","doi":"10.1007/s00117-023-01254-0","DOIUrl":"10.1007/s00117-023-01254-0","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to explore the performance of diffusion-tensor imaging (DTI) and apparent diffusion coefficient (ADC) parameters in evaluating disease-free survival (DFS) and overall survival (OS) in patients with invasive breast cancer.</p><p><strong>Material and methods: </strong>A total of 49 women with invasive breast cancer who were diagnosed between 2017 and 2022 were included. All patients underwent breast magnetic resonance imaging (MRI) with DTI and diffusion-weighted imaging (DWI) features, with examiners blinded to the clinical data. Volume anisotropy (VA), fractional anisotropy (FA), and ADC values were measured to assess intratumoral measured heterogeneity. Correlations and differences in diffusion metrics according to OS and DFS status of the cases were analyzed. The discriminative ability of the quantitative findings was assessed by receiver operating characteristic (ROC) curve analyses and validated in the independent cohort.</p><p><strong>Results: </strong>We evaluated patients with metastases (n = 13, 36.5%) and those without metastases (n = 36, 73.5%). Differences in the ADC, FA, and VA values were observed. The results of Cox regression survival analysis for all the patients included in the survival analysis revealed that DTI metrics contributed to the prediction of overall survival (OS) in the emerging models (p < 0.05). Both FA and VA were associated with OS (p = 0.037 and p = 0.038, respectively). However, ADC was not associated with OS (p = 0.177) or DFS (p = 0.252).</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is the first study to assess the prognostic value of DTI-MRI in breast cancer with statistical survival analysis techniques. We believe that DTI measurements can be used as a biomarker for OS analysis in breast cancer given the available data.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"54-59"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139564975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile computed tomography at the Munich Oktoberfest : From idea to implementation.","authors":"W Flatz, P Reidler, P Kampmann, K-G Kanz, J Ricke, J J Bazarian, D Hinzmann, V Bogner-Flatz","doi":"10.1007/s00117-024-01383-0","DOIUrl":"10.1007/s00117-024-01383-0","url":null,"abstract":"<p><strong>Background: </strong>The Munich Oktoberfest, the largest folk festival in the world, attracts around 6.2 million visitors over 16-18 days. Some of the visitors exhibit certain risky behaviors, leading to a significantly increased number of medical emergencies during the festival. During Oktoberfest, the prehospital and clinical emergency services of the city are heavily strained, as one-third more ambulances are needed, and over 7000 patients must be treated on-site each year. Until 2022, there was no option for guideline-compliant radiological assessment on-site for patients with head or facial trauma and suspected serious trauma-related injuries. This required a large number of emergency service admissions to hospitals, mostly for outpatient assessments. To relieve the overburdened medical system, a mobile computed tomography (CT) scanner was set up on the Oktoberfest grounds in 2022 for the first time.</p><p><strong>Methods: </strong>A mobile CT scanner at the Munich Oktoberfest was utilized for diagnosing injuries to the face, cranium, and cervical spine. For an indication of cranial CT, we used a combination of the Canadian CT Head Rule and NEXUS criteria. Despite the complex structural conditions, this integration seamlessly fit into the structured processes of the on-site medical service. Since this deployment was, to our knowledge, the first of its kind globally, we had to develop and implement new clinical concepts and procedures tailored to the unique conditions of a folk festival.</p><p><strong>Results: </strong>We demonstrated that a CT scanner could be effectively integrated into the preclinical processes of a medical service without direct hospital connection. On-site CT diagnostics proved to be a highly effective means of avoiding unnecessary transportation to the hospital. Consequently, a reduction in emergency medical service provision and stabilization of clinical emergency medicine during the Oktoberfest became feasible.</p><p><strong>Conclusion: </strong>From the authors' perspective, establishing a mobile CT scanner at events with high or very high demands on preclinical and clinical emergency medicine is feasible and provides significant relief for the system. The primary goal of stabilizing prehospital and clinical emergency structures, as well as improving the detection and treatment of potentially life-threatening patients on-site, was successfully achieved. Careful integration into the overall process flow is essential.</p>","PeriodicalId":74635,"journal":{"name":"Radiologie (Heidelberg, Germany)","volume":" ","pages":"16-23"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}