IMG-01. DWI RATIO OF HISTOLOGICAL MOLECULAR SUBTYPES OF PAEDIATRIC MEDULLOBLASTOMAS

AIM To evaluate if diffusion weighted imaging (DWI) ratio on MRI is able to distinguish between the histological molecular subtypes of paediatric medulloblastomas. MATERIALS AND METHODS From 2002 to 2017, 38 cases of medulloblastoma with preoperative MRI available had histological subtyping performed with NanoString nCounter technology. The medulloblastomas were classified into 4 subtypes. There were 3 Sonic Hedgehog (SHH), 9 Wingless (WNT), 12 Group 3 and 14 Group 4 subtypes. Single operator manually outlined solid non-haemorrhagic component of the tumour on DWI images with largest axial tumour cross sectional diameter, correlating with the other MRI images (T1 pre and post contrast, SWI/GRE, FLAIR) to identify areas of haemorrhage. The same operator also drew region of interest to identify normal cerebellar tissue on the same axial images on which the tumour was outlined. All MRI images were obtained from the department’s Radiological Information System Picture Archiving and Communicating System (RIS PACS). DWI ratio for each case was obtained by dividing the values obtained from tumour by normal cerebellar tissue seen on the same axial image. RESULTS DWI ratio of all medullloblastomas is 1.34 +/- 0.18. DWI ratio of SHH subtype is 1.43 +/- 0.07. DWI ratio of WNT subtype is 1.40 +/- 0.07. DWI ratio of Group 3 subtype is 1.31 +/- 0.25. DWI ratio of Group 4 subtype is 1.30 +/- 0.17. There is no significant statistical differences in the DWI ratio between the various subtypes. CONCLUSION DWI ratio of medulloblastoma is unable to distinguish between the 4 medulloblastoma subtypes.

Temporal evaluation of computed tomographic scans at a Level 1 trauma department in a central South African hospital

Background: Time is a precious commodity, especially in the trauma setting, which requires continuous evaluation to ensure streamlined service delivery, quality patient care and employee efficiency.Objectives: The present study analyses the authors’ institution’s multi-detector computed tomography (MDCT) scan process as part of the imaging turnaround time of trauma patients. It is intended to serve as a baseline for the institution, to offer a comparison with institutions worldwide and to improve service delivery.Method: Relevant categorical data were collected from the trauma patient register and radiological information system (RIS) from 01 February 2013 to 31 January 2014. A population of 1107 trauma patients who received a MDCT scan was included in the study. Temporal data were analysed as a continuum with reference to triage priority, time of day, type of CT scan and admission status. Results: The median trauma arrival to MDCT scan time (TTS) and reporting turnaround time (RTAT) were 69 (39–126) and 86 (53–146) minutes respectively. TTS was subdivided into the time when the patient arrived at trauma to the radiology referral (TTRef) and submission of the radiology request, to the arrival at the MDCT (RefTS) location. TTRef was statistically significantly longer than RefTS (p < 0.0001). RTAT was subdivided into the arrival at the MDCT to the start of the radiology report (STR) and time taken to complete the report (RT). STR was statistically significantly longer than RT (p < 0.0001). Conclusion: The time to scan (TTS) was comparable to, but unfortunately the report turnaround time (RTAT) lagged behind, the findings of some first-world institutions.

Management of image information

Medical imaging has become a major investigation tool during the last few years, due to availability of several digitalised imaging modalities (Computed Tomography, Magnetic Resonance, etc.). Interest has grown in medical image management by appropriate information systems. These processing tools defined PACS - systems of acquisition, storage, transmission and communication - must be integrated on the one hand with the RIS - radiological information system (patient, appointment procedure) - and on the other hand with the HIS - hospital information system - to offer sufficient advantages to justify their installation.