Who's the boss? Reversing the hierarchy

According to the author, radiology managers can improve staff morale, increase commitment to patient care and decrease their workloads by "reversing the hierarchy" and empowering their staff. Despite what some managers may think, she says, employees can make good decisions and stay committed if they are given authority, encouragement and trust. She also describes some of the steps managers can take to reverse the hierarchy at their organizations.     

Do we really need to thank the Beatles for the financing of the development of the computed tomography scanner?

It is commonly believed that the revenues from the selling of the Beatles' records by Electric and Musical Industries (EMI) allowed the company to develop the computed tomography (CT) scanner. Some went to define this as the Beatles' gift to medicine. However, significant controversies and discrepancies arise from analysis of this statement, making its correctness doubtful. The details of financing required for the CT development and the part of EMI in financial input have never been publicly announced. This work analyzes the financial contributions to the CT development and investigates if the revenues received from the sales of the Beatles' records were used for the creation of the CT scanner. Timeline of the development of the EMI CT scanner and the financial inputs of EMI and British Department of Health and Social Security (DHSS) were assessed. Without salary expenses to Godfrey Hounsfield and his team, the development of the CT scanner cost EMI approximately ￡100,000. The British DHSS's expenses were ￡606,000. Hence, the financial contribution of DHSS into the development of the CT scanner was significantly bigger than that of EMI. Accordingly, British tax payers and officials of British DHSS are to be thanked for the CT scanner. The Beatles' input into the world's culture is valuable and does not require decoration by nonexistent connection to the development of CT. A positive aspect to this misconception is that it keeps in public memory the name of the company that developed the CT scanner.     

Impact of the COVID-19 pandemic on the activity of the Radiological Emergency Department: the experience of the Maggiore della Carità Hospital in Novara

Emergency Radiology - During the first peak of the COVID-19 pandemic, the activity of Emergency Departments worldwide changed dramatically, focusing on diagnosis and care of the Sars-Cov-2...     

Does the digital signature of the DICOM standard meet the requirements of German law?

The DICOM standard offers the possibilities to generate electronic signatures, valid according to German laws. This enhances the reliability of the correlation between image and patient data. However, only so called qualified electronic signatures--conveniently issued by an accredited supplier--are permissible and not rejectable as evidence in German jurisdiction and are completely equivalent to the handwritten signatures. These qualified electronic signatures can be executed only by individuals, whereas the former are not applicable to technical apparatus like image generating modalities. In consequence, a modality is able to provide its pictures with a "common or advanced signature" solely. This limits the use of the digital signature of the DICOM standard for further applications, e.g. the verifiability within the teleradiology.     

MRI of the kidney—state of the art

Ultrasound and computed tomography (CT) are modalities of first choice in renal imaging. Until now, magnetic resonance imaging (MRI) has mainly been used as a problem-solving technique. MRI has the advantage of superior soft-tissue contrast, which provides a powerful tool in the detection and characterization of renal lesions. The MRI features of common and less common renal lesions are discussed as well as the evaluation of the spread of malignant lesions and preoperative assessment. MR urography technique and applications are discussed as well as the role of MRI in the evaluation of potential kidney donors. Furthermore the advances in functional MRI of the kidney are highlighted.     

Can the intra-abdominal hypertension be the cause of poly-organic insufficiency during the destructive pancreatitis?

The results of measurement and dynamics of intra-abdominal pressure obtained in 129 patients with acute destructive pancreatitis are presented. It was revealed that in 78% cases the pancreatonecrosis is accompanied by increase in intra-abdominal pressure (IAP); the intra-abdominal hypertension have developed in 9,3% patients. The prolonged intra-abdominal hypertension in the patients with progressive pancreatonecrosis requires the performance of laparotomy, which contributes to decrease in intra-abdominal pressure. The dependence between IAP value and dissemination of pancreatogenic inflammatory process in abdominal cavity and retroperitoneal space as well as between IAP level and condition gravity according to APACHE II scale was revealed.     

Monitoring of the medical radiological exposures of the population of the Emilia–Romagna Region

PURPOSE: The Italian Decree of Law 187/2000 provides for many fulfilments relevant to justification and optimisation of medical exposures that can complicate the daily work of radiology departments if considered as mere legal requirements. On the contrary, this law should be regarded as a good opportunity to analyse and optimise working practices. To this end, the Emilia- Romagna Region carried out an initial assessment of medical exposures to its population in 2001 followed by a second survey taking into account new dosimetric evaluations. This paper illustrates the results of this second survey and analyses the most significant parameters in comparison with similar studies reported in the literature. MATERIALS AND METHODS: We first determined the examinations to be considered: 12 easily identifiable examinations divided into macroaggregates were selected for conventional radiography and computed tomography (CT). Hospitals of the Emilia-Romagna Region were directly asked to provide the number of examinations performed subdivided by type and grouped by nomenclature code, some technical parameters related to both examination protocol and equipment and the value of dose quantities as measured by local medical physicists. RESULTS: Study of distribution of the entrance skin dose for different examinations in single hospitals showed no systematic differences in kilovoltage settings versus dose whereas the number of examinations tended to be inversely proportional to dose. These trends could be explained by the fact that in hospitals where many examinations of the same type are performed, operators, equipment and procedures are well integrated, leading to a level of specialisation that allows efficient interaction in order to deliver an "optimal dose". Analysis of the "entrance skin dosemax"/"entrance skin dosemin" ratios for various projections and comparison with literature data seem to show that a "scale factor" has a fundamental role in the variability of entrance skin dose values amongst hospitals and that "chest" examinations are the most critical, with the greatest differences in entrance skin doses. CONCLUSIONS: The evaluations performed in this study show that this type of analysis heavily relies not only on the cooperation of all professionals responsible for patient radiation protection but also on the experience gained during previous surveys because data collection is a very critical process that can invalidate, if not carefully performed, all subsequent processing.     

Questions of the handsurgeon to the radiologist—a survey on the most common lesions in the hand and the implications of diagnostic tools on their therapy

By the rapid development of imaging techniques, a significant gap developed between the knowledge of the radiologists and that of the hand surgeons on specific indications of the different technical possibilities. The problems to be solved by both specialties together are analyzed. Examples of the most common lesions in the hand like trauma, reflex sympathetic dystrophy, congenital malformation, infection, tumour, rheumatoid and other degenerative processes, nerve compression syndromes etc., are given, and the implications of diagnostic tools on their therapy are discussed.     

Gorham–Stout disease: the experience of the Rizzoli Institute and review of the literature

Gorham–Stout disease (also known as “disappearing bone disease”) was first described by Jackson in 1838, but was properly defined by Gorham and Stout in a series of 24 patients in 1954–1955. It is a rare disease of unknown etiology (about 200 cases reported in the literature) characterized by spontaneous progressive resorption of bone without malignant proliferation of vascular structures. The diagnosis is one of exclusion and it is based on combined histological, radiological, and clinical features. Benign vascular proliferation with fatty bone marrow and thinning of bony trabeculae is a typical histological feature. Standard radiographs of disappearing bone disease show progressive bony resorption with adjacent soft tissue involvement. Most cases of Gorham–Stout disease resolve spontaneously, but prognosis remains unpredictable. This study reports 13 cases of Gorham–Stout disease treated in our institution from 1968 to 2008. The aim of the work was to review our series and the literature on this rare disease, as well as to evaluate whether or not an optimal treatment can be identified and recommended.