Forensic age estimation based on magnetic resonance imaging of third molars: converting 2D staging into 3D staging

Background: Established methods to stage development of third molars for forensic age estimation are based on the evaluation of radiographs, which show a 2D projection. It has not been investigated whether these methods require any adjustments in order to apply them to stage third molars on magnetic resonance imaging (MRI), which shows 3D information.

Aim: To prospectively study root stage assessment of third molars in age estimation using 3 Tesla MRI and to compare this with panoramic radiographs, in order to provide considerations for converting 2D staging into 3D staging and to determine the decisive root.

Subjects and methods: All third molars were evaluated in 52 healthy participants aged 14–26 years using MRI in three planes. Three staging methods were investigated by two observers. In sixteen of the participants, MRI findings were compared with findings on panoramic radiographs.

Results: Decisive roots were palatal in upper third molars and distal in lower third molars. Fifty-seven per cent of upper third molars were not assessable on the radiograph, while 96.9% were on MRI. Upper third molars were more difficult to evaluate on radiographs than on MRI (p?p?=?.375). Inter- and intra-observer agreement for evaluation was higher in MRI than in radiographs. In both imaging techniques lower third molars showed greater inter- and intra-observer agreement compared to upper third molars. MR images in the sagittal plane proved to be essential for staging.

Conclusion: In age estimation, 3T MRI of third molars could be valuable. Some considerations are, however, necessary to transfer known staging methods to this 3D technique.     

Volume and Coverage of Secondary Imaging Interpretation Under Medicare, 2003 to 2016

PurposeThe aim of this study was to assess changing Medicare volumes of, and coverage for, secondary interpretations of diagnostic imaging examinations stratified by modality and body region service families.MethodsMedicare Physician/Supplier Procedure Summary Master Files for 2003 to 2016 were obtained. Aggregate Part B fee-for-service claims frequency and payment data were isolated for noninvasive diagnostic imaging and stratified by service family. Using published Medicare payment rules, secondary interpretations were identified as studies billed using both modifiers 26 and 77. Billed and denied services volumes were calculated and compared across modality and body region service families.ResultsSeven service families showed a compound annual growth rate from 2003 to 2016 of >20% (an additional 12 service families, >10% growth). For select high-volume service families (chest radiography and fluoroscopy [R&F], brain MRI, and abdominal and pelvic CT), relative growth in billed secondary interpretation services exceeded that for primary interpretations. In 2016, body region and modality service families with the most billed secondary interpretations were chest R&F (674,124), abdominal and pelvic R&F (65,566), brain CT (45,642), extremity R&F (34,560), abdominal and pelvic CT (14,269), and chest CT (10,914). All service families had secondary interpretation denial rates <25% in 2016 (15 service families, <10%).ConclusionsAmong Medicare beneficiaries, the frequency of billed secondary interpretation services for diagnostic imaging services increased from 2003 to 2016 across a broad range of modalities and body regions, often dramatically. Payment denial rates were consistently low across service families. As CMS continues to seek input on appropriate coverage for these services, these findings suggest increasing clinical demand for and payer acceptance of these value-added radiologist services.     

Interprofessional working in diagnostic radiography

This paper considers interprofessional working within one diagnostic imaging department.The literature is still divided about the long-term impact of interprofessional learning in pre-registration health and social care education, and its impact on the quality of care provided. When reading the literature about interprofessional working the main topics considered by other authors are team working, communication between professionals, stereotyping and tribalism.The results presented are from an ethnographic study in one department with participant observation and semi-structured interviews.The three main aspects discussed in this paper are; tribalism and culture within the diagnostic radiography profession, communication between different professional groups, and a lack of understanding of the roles of other professional groups.It was evident from the results of this study that tribalism and culture, and a lack of understanding were significant barriers to interprofessional working.It was felt by the authors that pre-registration and post-registration interprofessional education could be significant in changing the culture of the NHS in the future as more professionals learn from and about one another.     

牙弓形态对牙科全景X射线摄影的影响研究

分析研究牙科全景X射线摄影原理,以及牙弓形态对全景摄影的影响,提出优化设计的主要指导原则,提高其图像质量。分析全球人群的牙弓形态特征参数,对特定的全景摄影运动轨迹进行优化。牙科全景X射线摄影成像效果有诸多影响因素,断层曲线的设计对设备成像会产生决定性影响,尤其是对尖牙部分。优化断层曲线设计可缩小水平垂直放大倍率变化范围,减少几何失真和牙齿重叠。     

Roentgen and Gastrophotographic Features of Intraluminal Gastric Mycosis

The roentgen and gastrophotographic appearances associated with intraluminal gastric mycosis are described and discussed. To the best of our knowledge, gastrophotographs of this disorder have not been published earlier, but seem to be highly characteristic. In this newly detected disease, as in others, gastrophotography proved to be an extremely valuable complement to roentgen examination.     

计算机乳腺摄影与常规乳腺摄影的比较研究

目的探讨计算机(CR)乳腺摄影的图像质量和对乳腺病灶的检测能力。方法对在该院检查的在临床上诊断为疑似乳腺癌的30例患者同时进行常规乳腺摄影和CR乳腺摄影,对二者摄影图像质量与病灶检测能力进行比较。结果 CR乳腺摄影的图像质量及对乳腺病灶的检测能力均优于常规乳腺摄影。结论 CR乳腺摄影因其具有大的曝光宽容度和后处理功能,可获得高质量的图像,从而提高了诊断符合率。     

Risk Stratification and Radiologic Evaluation of Central Venous Port Malfunction

BackgroundAppropriate indications for radiologic evaluation of central venous ports are not fully understood. We aimed to quantitatively assess the utility of clinical history and imaging in the evaluation of malfunctioning central venous ports.MethodsClinical history, plain radiographs, and line injections intended to evaluate central venous port malfunction in 153 consecutive cases over a nearly 4-year period were retrospectively reviewed by 2 radiologists. Radiographs and line injections were separately categorized as normal or abnormal, and a consensus was reached on the final imaging diagnosis. The likelihood of a port-related abnormality necessitating immediate intervention was determined for all represented combinations of clinical history, radiographic findings, and line injection results.ResultsA radiologic diagnosis was made in 96.1% of cases; 19.7% of these diagnoses were classified as critical, requiring prompt intervention. Very low risk histories had a 0.0% incidence of critical port abnormalities in our cohort, regardless of imaging findings. Low risk histories had a 10.5% incidence of a critical abnormality and were best evaluated either by line injection, either directly or following an abnormal chest radiograph. Intermediate and high risk histories were associated with a 30.5% and 61.1% incidence of critical port abnormalities, respectively, and were best evaluated by line injection without preceding chest radiograph.ConclusionsThere are several scenarios in which imaging does not meaningfully affect management of malfunctioning central venous ports. Recognizing these inefficiencies may allow for more appropriate and cost-effective use of radiographs and line injections to evaluate the cause of port malfunction.