Chest X-ray (CXR) teaching files

Chest radiology is one of the most interesting and challenging parts of Radiology. In particular CXR interpretation.

A useful link which is intended as a self-tutorial for residents and medical students to learn to interpret chest radiographs with confidence. Technique, normal anatomy and common pathology are presented. Quizzes are provided for practice and self-assessment.

Check out-

Introduction to Chest Radiology

University of Virginia

Medical Litigation issues and Mammography

Screening mammography, public perceptions, and medical liability.

Mavroforou A, Mavrophoros D, Michalodimitrakis E

Department of Forensic Sciences, University of Crete Medical School, 40 Daliani Street, 71306 Heraklion, Crete, Greece.

To outline the most common sources of raising malpractice claims in screening mammography and to discuss the related medical litigation issues in the light of the evidence-based medicine.

The most common cause of malpractice is the delayed diagnosis of breast cancer. The plaintiff must establish that the radiologist was negligent and the delay in diagnosis caused injury to the patient. Literature shows that mammography does not always detect breast cancer, and even skilled radiologists may periodically miss malignant lesions. Also, delay in diagnosis does not always affect treatment and prognosis.

Over-promotion of screening mammography has made disproportionately difficult for a defendant radiologist to prevail in a malpractice lawsuit.

Thus, screening mammography is at stake, although it saves lives. The public and legal system should be educated about biological processes, medical practice, and the limitations of screening mammography.

Full article at-
Eur J Radiol 2005 Nov 28; [Epub ahead of print]

Med School Curriculum

Well I have always believed that the medical school curriculum should be made more apt for a general physician and then let him specialize later on and thereby reducing probably a year of time in his undergraduation. Nowadays at least in India specialization is a must. Sometimes I wonder as a practising radiologist now... Why did I study Biochemistry, DNA Polymerases, etc in my med school......

Excellent thoughts here-
http://medrants.com/archives/2005/12/06/further-thoughts-on-doctoring/

Virtual Bronchoscopy

Virtual Bronchoscopy: Accuracy and Usefulness—An Overview
W. De Wever MD, , J. Bogaert MD, PhD and J.A. Verschakelen MD, PhD Department of Radiology, University Hospitals Gasthuisberg, Leuven, Belgium.

Multidetector CT generated virtual bronchoscopy (VB) represents one of the most recent developments in three-dimensional (3D) visualization techniques which allows a 3D evaluation of the airways down to the sixth- to seventh-generation. In comparison with real bronchoscopy, VB has some advantages: it is a non-invasive procedure that can visualize areas inaccessible to the flexible bronchoscope. Virtual bronchoscopy is able to evaluate bronchial stenosis and obstruction caused by both endoluminal pathology (tumor, mucus, foreign bodies) and external compression (anatomical structures, tumor, lymph nodes), can be helpful in the preoperative planning of stent placement and can be used to evaluate surgical sutures after lung transplantations, lobectomy or pneumectomy. In children, in some indications, VB can replace fiber optical bronchoscopy (FB) when this technique is considered too invasive. Finally, VB can also be used to evaluate anatomical malformations and bronchial variants. Virtual bronchoscopy is accurate but its accuracy is not 100% because false-positives and false-negatives occur. Virtual bronchoscopy contributes to a better understanding of tracheo-bronchial pathology. Fiber optical bronchoscopy will, without doubt, remain the golden standard but it can be expected that in the near future, the technique of VB will find a place in the daily routine.

Full article in-

Seminars in Ultrasound, CT, and MRI Volume 26, Issue 5 , October 2005, Pages 364-373

doi:10.1053/j.sult.2005.07.005

Imaging in Oncology-New horizons

PET/CT in oncology—a major advance
K. Wechalekar, B. Sharma and G. Cook

The concept of hardware fusion between positron emission tomography (PET) and computed tomography (CT) has only been introduced commercially in the last 4 years. The advantages of this combined technique over PET alone have become obvious. There is increasing evidence to suggest that PET/CT adds complementary information in staging, re-staging and follow-up in oncology patients, leading to changes in management plans. The present paper is a review of the strengths, weaknesses, current evidence and future directions of this technique.

Keywords: 18F-fluorodeoxyglucose; Positron emission tomography/computed tomography (PET/CT); Oncology

Full article at-

Clinical Radiology Volume 60, Issue 11, November 2005, Pages 1143-1155

Residents are learners FIRST..

Well here is something which is close to my heart, i have always felt that learning should be the top priorty for a resident and his working hours should be adjusted according to this.

Same is reflected in a new Compact Between Resident Physicians and Their Teachers, which articulates the principles underlying the education of U.S. residents, was announced by the AAMC (Association of American Medical Colleges) in November-2005.

The AAMC initiated the development of the compact to re-focus attention on the primary goal of U.S. residency training-physician education-following the ACGME's imposition of restrictions on resident duty hours in 2003. The compact, which will be sent to all residency programs directors and their institutional sponsors this month, articulates the three core tenets of graduate medical education:

• Residents are, first and foremost, learners
• Residents must learn in clinical settings that embody the highest standards of medical practice and patient safety
• Residents' well being must be a high priority.

Read the full text here-

Medical Education is Core Focus of Landmark Compact for Residents and Faculty

As expected Doctors say sonography should be done by sonographers not actors!

DOC'S FURY ON TOM'S TOT SCANS
DOCTORS have warned Tom Cruise to stop carrying out ultrasound scans on his pregnant fiancee Katie Holmes...

Full Article on-
mirror.co.uk