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One-stop prostate imaging: multiparametric-MRI followed by TRUS-guided biopsy
S8
Abstract / Clinical Radiology 70 (2015) S1eS9
provided by a general on call team. The pathology is different to that seen in an adult population and the need to minimise radiation dose dictates different imaging strategies. In acknowledgement of this, we have put together a compilation of eight common paediatric presentations, how they present and how to tackle them. Methods and materials: In discussion with paediatric radiologists and trainees, a list was devised of common paediatric pathologies encountered out of hours. The presentation, diagnosis and treatment of each condition was discussed with radiologists and surgeons to ensure accuracy. Images were obtained from the local picture archive and communication system (PACS) archive to illustrate each case and local guidelines were consulted when specific protocols were implied. Results: The eight conditions selected were intussusception, malrotation, pyloric stenosis, appendicitis, torsion, hydrocephalus, pleural effusion and trauma. We describe the classic presentation and age group for each condition, how to obtain and interpret diagnostic images and give key practical points to aid the registrar or general radiologist in dealing with these cases. Conclusion: Paediatric emergencies are rare and cause anxiety for many radiology trainees and non-paediatric radiology consultants. We hope to have provided a practical guide to dealing with common presentations. Accuracy of ultrasound in the detection of renal scarring in paediatric patients presenting with urinary tract infection
(VR) software. Additionally to determine if improvements could be made by introducing an updated version of current VR software in combination with re-education of reporters in its use. Methods and materials: All reports generated over four nonconsecutive days were analysed for errors which were categorised based on modality and type of error. Subsequently an updated version of the voice recognition software was introduced in combination with education following the initial audit results. Once the new software was introduced a re-audit was performed after three months. Reports were analysed over three non-consecutive days and categorised with the same methodology used in the initial audit. Results: In the initial audit 687 reports were retrospectively analysed with 127 containing errors (18.4%). In the subsequent re-audit 408 reports were analysed with 13 containing errors (3.2%). The re-audit demonstrated statistically significant reduction in errors (p < 0.05). Conclusion: The initial audit demonstrated a significant error rate in VR dictated reports but the combination of updated VR software and radiologist training on its use led to a statistically significant improvement in report transcription accuracy throughout the department.
One-stop prostate imaging: multiparametric-MRI followed by TRUSguided biopsy Authors: Nirav Patel, Amy Lecomte, Shantanu Kar, Bilal Khalil
Authors: Reena Aggarwal, Rachael Holmes, A. Rickett
Purpose: Urinary tract infection (UTI) is common in childhood with renal scarring documented in up to 15% after a first UTI. This has significant long-term complications including hypertension and renal failure and therefore it is important that we detect these changes early to prevent this. It is widely accepted that dimercaptosuccinic acid (DMSA) scintigraphy is the most sensitive method to detect renal scarring, however there is variable evidence for the role of ultrasound. The aim of this study is to assess the accuracy of ultrasound to detect renal scarring using DMSA scan as gold standard. Methods and materials: A retrospective radiology information system (RIS) search was performed to identify paediatric patients presenting with UTI who underwent DMSA scan over a sevenmonth period. Imaging findings were compared to that of the preceding ultrasound. Results: The study reviewed 128 patients. Ultrasound correlated with DMSA in 99 patients. Forty-three patients (34%) had renal scarring on DMSA, however, only 16 of these (37%) were detected on preceding ultrasound. Of the 110 patients with normal ultrasound, the DMSA scan showed renal scarring in 27 (25%). The sensitivity, specificity, positive and negative predictive values are 37%, 98%, 89% and 75% respectively. Conclusion: This study suggests only a small percentage of renal scars are detected by ultrasound and therefore this should be used in conjunction with DMSA scintigraphy when imaging for this purpose.
Education and improved software, can it improve voice recognition errors in radiology reports?
Purpose: The current role of prostate cancer imaging is to provide biopsy guidance and staging. Previously, magnetic resonance imaging (MRI) was used to pre-assess patients for radical therapy. Recently, multiparametric MRI (MP-MRI) has helped transform the diagnostic pathway through an improved yield in detecting and characterising cancer and is used prior to biopsy in many centres. At our centre, we have recently provided a one-stop same day service of MP-MRI to transrectal ultrasound (TRUS) for preselected patients. We investigate whether this service leads to a reduced time to management outcome. Methods and materials: Three groups of 20 consecutive patients were identified: TRUS biopsy followed by staging MRI, MP-MRI after TRUS biopsy and the one-stop MP-MRI/TRUS biopsy patients. Date of referral to management outcome decision date was recorded from multi-disciplinary teams (MDT) and clinic letters. Results: The mean days of referral to outcome is 75.0, 66.2 and 30.1 days for the TRUS biopsy followed by staging MRI, MP-MRI after TRUS biopsy and one-stop MP-MRI/TRUS biopsy respectively, with the latter group showing less variability. Conclusion: A one-stop prostate imaging service in pre-selected patients allows localised staging prior to biopsy, identifies suspicious areas for a targeted biopsy, avoids the pitfalls of post biopsy artefact in MRI interpretation, expedites the MDT process and enhances patient experience. Pictorial essay of thyroid nodules using the British Thyroid Association Ultrasound classification with radio pathological correlation Authors: Pauline Rajan, Christopher Barber, Evdokia Arkoumani
Authors: Pavan S. Najran, Nick Watson, Vishal Bhalla
Purpose: The purpose of this audit was to identify the number of errors in radiological reports generated using voice recognition
Purpose: Ultrasound operators have a varying range of experience and identifying thyroid nodules that would need sampling can sometimes be difficult.
Abstract / Clinical Radiology 70 (2015) S1eS9
provided by a general on call team. The pathology is different to that seen in an adult population and the need to minimise radiation dose dictates different imaging strategies. In acknowledgement of this, we have put together a compilation of eight common paediatric presentations, how they present and how to tackle them. Methods and materials: In discussion with paediatric radiologists and trainees, a list was devised of common paediatric pathologies encountered out of hours. The presentation, diagnosis and treatment of each condition was discussed with radiologists and surgeons to ensure accuracy. Images were obtained from the local picture archive and communication system (PACS) archive to illustrate each case and local guidelines were consulted when specific protocols were implied. Results: The eight conditions selected were intussusception, malrotation, pyloric stenosis, appendicitis, torsion, hydrocephalus, pleural effusion and trauma. We describe the classic presentation and age group for each condition, how to obtain and interpret diagnostic images and give key practical points to aid the registrar or general radiologist in dealing with these cases. Conclusion: Paediatric emergencies are rare and cause anxiety for many radiology trainees and non-paediatric radiology consultants. We hope to have provided a practical guide to dealing with common presentations. Accuracy of ultrasound in the detection of renal scarring in paediatric patients presenting with urinary tract infection
(VR) software. Additionally to determine if improvements could be made by introducing an updated version of current VR software in combination with re-education of reporters in its use. Methods and materials: All reports generated over four nonconsecutive days were analysed for errors which were categorised based on modality and type of error. Subsequently an updated version of the voice recognition software was introduced in combination with education following the initial audit results. Once the new software was introduced a re-audit was performed after three months. Reports were analysed over three non-consecutive days and categorised with the same methodology used in the initial audit. Results: In the initial audit 687 reports were retrospectively analysed with 127 containing errors (18.4%). In the subsequent re-audit 408 reports were analysed with 13 containing errors (3.2%). The re-audit demonstrated statistically significant reduction in errors (p < 0.05). Conclusion: The initial audit demonstrated a significant error rate in VR dictated reports but the combination of updated VR software and radiologist training on its use led to a statistically significant improvement in report transcription accuracy throughout the department.
One-stop prostate imaging: multiparametric-MRI followed by TRUSguided biopsy Authors: Nirav Patel, Amy Lecomte, Shantanu Kar, Bilal Khalil
Authors: Reena Aggarwal, Rachael Holmes, A. Rickett
Purpose: Urinary tract infection (UTI) is common in childhood with renal scarring documented in up to 15% after a first UTI. This has significant long-term complications including hypertension and renal failure and therefore it is important that we detect these changes early to prevent this. It is widely accepted that dimercaptosuccinic acid (DMSA) scintigraphy is the most sensitive method to detect renal scarring, however there is variable evidence for the role of ultrasound. The aim of this study is to assess the accuracy of ultrasound to detect renal scarring using DMSA scan as gold standard. Methods and materials: A retrospective radiology information system (RIS) search was performed to identify paediatric patients presenting with UTI who underwent DMSA scan over a sevenmonth period. Imaging findings were compared to that of the preceding ultrasound. Results: The study reviewed 128 patients. Ultrasound correlated with DMSA in 99 patients. Forty-three patients (34%) had renal scarring on DMSA, however, only 16 of these (37%) were detected on preceding ultrasound. Of the 110 patients with normal ultrasound, the DMSA scan showed renal scarring in 27 (25%). The sensitivity, specificity, positive and negative predictive values are 37%, 98%, 89% and 75% respectively. Conclusion: This study suggests only a small percentage of renal scars are detected by ultrasound and therefore this should be used in conjunction with DMSA scintigraphy when imaging for this purpose.
Education and improved software, can it improve voice recognition errors in radiology reports?
Purpose: The current role of prostate cancer imaging is to provide biopsy guidance and staging. Previously, magnetic resonance imaging (MRI) was used to pre-assess patients for radical therapy. Recently, multiparametric MRI (MP-MRI) has helped transform the diagnostic pathway through an improved yield in detecting and characterising cancer and is used prior to biopsy in many centres. At our centre, we have recently provided a one-stop same day service of MP-MRI to transrectal ultrasound (TRUS) for preselected patients. We investigate whether this service leads to a reduced time to management outcome. Methods and materials: Three groups of 20 consecutive patients were identified: TRUS biopsy followed by staging MRI, MP-MRI after TRUS biopsy and the one-stop MP-MRI/TRUS biopsy patients. Date of referral to management outcome decision date was recorded from multi-disciplinary teams (MDT) and clinic letters. Results: The mean days of referral to outcome is 75.0, 66.2 and 30.1 days for the TRUS biopsy followed by staging MRI, MP-MRI after TRUS biopsy and one-stop MP-MRI/TRUS biopsy respectively, with the latter group showing less variability. Conclusion: A one-stop prostate imaging service in pre-selected patients allows localised staging prior to biopsy, identifies suspicious areas for a targeted biopsy, avoids the pitfalls of post biopsy artefact in MRI interpretation, expedites the MDT process and enhances patient experience. Pictorial essay of thyroid nodules using the British Thyroid Association Ultrasound classification with radio pathological correlation Authors: Pauline Rajan, Christopher Barber, Evdokia Arkoumani
Authors: Pavan S. Najran, Nick Watson, Vishal Bhalla
Purpose: The purpose of this audit was to identify the number of errors in radiological reports generated using voice recognition
Purpose: Ultrasound operators have a varying range of experience and identifying thyroid nodules that would need sampling can sometimes be difficult.