An Investigation of Exposure to the Eyes and Thyroid of Personnel Near to Patient in Abdominal Radiography: A Phantom Study

Abdominal radiography is beneficial in a variety of clinical situations. Prior to the introduction of multiplanar imaging, it was considered as the main examination for gastrointestinal pathology. However, the radiation dose received is considered high since it is equivalent to the dose of at least 75 chest radiographs. Personnel including staff or relatives may be required to assist patients in many conditions, increasing unnecessary radiation and the likelihood of radiation-induced cancer. The purpose of this study was to determine the radiation dose received by personnel when eyes and thyroid are exposed during abdominal radiography. The Rando and body phantoms were used to represent personnel and patients in this experimental approach. The dose was measured as entrance surface dose (ESD) by using TLD-100, which was positioned at the Rando phantom's eyes and thyroid. The study included a total of twenty exposures, five times at each of four distinct sites. The mean doses (eyes/thyroid in mGy) were (0.083/0.081), (0.090/0.087), (0.093/0.092), and (0.092/0.089), respectively, at locations 1, 2, 3, and 4. The results indicated that there was no correlation between organ and location affecting ESD measurement (p=0.960). There was no significant difference in dose between the two organs (p=0.355), with the mean difference in the eyes being 0.002 more than in the thyroid. The proximity of the eyes to the tube source contributed for the increased dose observed at the eyes. Though ESD was substantial for location pairings 1 vs. 3 (p=0.001) and 1 vs. 4 (p=0.015) owing to the anode-cathode phenomena. In conclusion, personnel should avoid the tube source and cathode region, since they give a greater dose of radiation, particularly when the personnel are closest to the patient and does not have eyes or thyroid protection.

Evaluation of Supratentorial Brain Neoplasms - A Cross Sectional Study from a Tertiary Care Hospital, Surendranagar, Gujarat

BACKGROUND Brain tumours represents 1.7 % of all cancers and contributes 1.8 % of all cancer deaths. Of all the brain tumours, 80 % are supratentorial.1 Magnetic resonance imaging (MRI) is an important modality, having higher sensitivity for detecting intracranial pathology. Multiplanar imaging is possible with MRI which helps in detection, localization and characterization of the lesion. MRI examination has helped in early diagnosis, accurate localization of the tumour, with prompt initiation of appropriate medical or surgical therapy. Recent advances like magnetic resonance (MR) spectroscopy, MR fluoroscopy with stereotactic guided biopsy have revolutionized the role of MRI in study of intracranial tumours. METHODS A cross sectional study of 75 patients was done by Siemens Essenza 1.5T MRI from June 2018 to June 2020 using dedicated head coil. RESULTS In our study, most of the patients were between 31 - 60 years of age (39 % of all patients) with the largest group between 31 - 40 years (20 % of all patients). Out of 75 cases of supratentorial neoplasms, 47 (72 %) were intra-axial lesions, 15 (23 %) were extra-axial lesions and 3 (5 %) were intra ventricular lesions. In this study, 69 % of the lesions were solitary and 31 % were multiple. Most of patients (89 %) showed some enhancement, most common being heterogeneous/inhomogeneous enhancement. Commonest type of supratentorial neoplasms were metastases comprising 29 % of this study. CONCLUSIONS Magnetic resonance imaging is an important modality, having higher sensitivity for detecting intracranial pathology. Multiplanar imaging is possible with MRI which helps in early detection, localization and characterization of the lesion. Metastasis is the most common supratentorial tumour in this study followed by meningioma. Intra-axial tumours are more common than extra-axial tumours in this study. KEYWORDS MRI, Metastasis, Glioma, Meningioma

Radiological Parameters Review for Choanal Atresia

(1) Background: The study aims to identify which imaging parameters are necessary for a new correct surgical approach in the study of choanal atresia, and which anatomical findings are essential for correct planning of endoscopic treatment in choanal atresia. (2) Methods: In this retrospective study, 19 patients with choanal atresia had high-resolution multiplanar imaging (14 cases aged ≤1 year and 5 cases aged 1 to 3 years) and 35 patients in the control group similarly distributed by age. Fourteen variables, the most relevant from a surgical point of view, were selected and measured. A comparison was made between the averages of the study group and the different control groups, either directly observed or selected from the literature, using Pearson’s correlation. (3) Results: In 14 out of 26 cases, the differences were statistically significant. There was a correlation between the structures assessed, such as choanal height, rostrum height, and age. (4) Conclusions: Thanks to volumetric reformatting, this work identified and provided the clinician with useful information that helped choose the correct surgical approach. Furthermore, it focused on which imaging parameters are necessary to improve the planning of the surgical correction of choanal atresia.

Observation of Retropharyngeal Fluid Collection in 2 COVID-19 Positive Patients

Our understanding of the novel coronavirus, COVID-19, is growing; yet, there remains much we do not understand, and unique presentations are abundant. One potential presentation is retropharyngeal edema, defined as fluid in the retropharyngeal space. Multiplanar imaging with computed tomography or magnetic resonance imaging is ideal for characterizing and diagnosing these fluid collections rapidly as possible life-threatening complications may develop (eg, airway obstruction and mediastinitis). Here, we discuss the presentation, imaging identification, treatment, and recovery of retropharyngeal fluid collection in 2 COVID-19 cases. The significance of this article is to suggest conservative management as a viable treatment option for retropharyngeal fluid collection, as opposed to incision and drainage, in the setting of COVID-19.

Assessment of lateral hindfoot impingement with weightbearing multiplanar imaging in a flatfoot

Background Estimation of the lateral hindfoot impingement in the standing position in conventional radiography can be difficult due to superimposition of different bones. Patients with flat feet frequently suffer from pain around the lateral malleolus and sinus tarsi caused by osseous impingement in the lateral hindfoot. Weightbearing multiplanar images (tomosynthesis) yield tomographic images and can be taken while full weightbearing. Purpose To assess the availability of tomosynthesis to determine hindfoot lateral impingement. Material and Methods A total of 14 feet (in 13 patients) with acquired flatfoot deformity and lateral hindfoot pain were included (mean age 64 years; age range 55–80 years). All patients underwent tomosynthesis, radiography, and computed tomography (CT) (non-weightbearing). Talofibular, calcaneofibular, and talocalcaneal impingement were determined. To compare the number of impingements or to determine the area between each image, statistical evaluations were analyzed using the Mann–Whitney U-test ( P < 0.05). Results On tomosynthesis, we clearly found talofibular impingement in three feet, calcaneofibular impingement in seven feet, and talocalcaneal impingement in 11 feet. Therefore, we could identify most impingements as “positive” compared to those on normal radiographs and CT images. The number of impingements in the calcaneofibular and talocalcaneal regions was significantly higher using tomosynthesis than when using CT ( P < 0.05). Conclusion Tomosynthesis imaging makes it easier to obtain CT-like images in a short period of time, in a free position, including while standing, and provides useful information to assess lateral pain in patients with flatfoot deformity.