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Majcher KB, Kontulainen SA, Leswick DA, Dolovich AT, Johnston JD. Magnetic resonance imaging based finite element modelling of the proximal femur: a short-term in vivo precision study. Sci Rep 2024; 14:7029. [PMID: 38528237 DOI: 10.1038/s41598-024-57768-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/21/2024] [Indexed: 03/27/2024] Open
Abstract
Proximal femoral fractures are a serious life-threatening injury with high morbidity and mortality. Magnetic resonance (MR) imaging has potential to non-invasively assess proximal femoral bone strength in vivo through usage of finite element (FE) modelling (a technique referred to as MR-FE). To precisely assess bone strength, knowledge of measurement error associated with different MR-FE outcomes is needed. The objective of this study was to characterize the short-term in vivo precision errors of MR-FE outcomes (e.g., stress, strain, failure loads) of the proximal femur for fall and stance loading configurations using 13 participants (5 males and 8 females; median age: 27 years, range: 21-68), each scanned 3 times. MR-FE models were generated, and mean von Mises stress and strain as well as principal stress and strain were calculated for 3 regions of interest. Similarly, we calculated the failure loads to cause 5% of contiguous elements to fail according to the von Mises yield, Brittle Coulomb-Mohr, normal principal, and Hoffman stress and strain criteria. Precision (root-mean squared coefficient of variation) of the MR-FE outcomes ranged from 3.3% to 11.8% for stress and strain-based mechanical outcomes, and 5.8% to 9.0% for failure loads. These results provide evidence that MR-FE outcomes are a promising non-invasive technique for monitoring femoral strength in vivo.
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Affiliation(s)
- Kadin B Majcher
- Department of Mechanical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - Saija A Kontulainen
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N 0W6, Canada.
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada.
| | - David A Leswick
- Department of Medical Imaging, University of Saskatchewan, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Allan T Dolovich
- Department of Mechanical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada
| | - James D Johnston
- Department of Mechanical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada.
- Division of Biomedical Engineering, University of Saskatchewan, 57 Campus Drive, Saskatoon, SK, S7N 5A9, Canada.
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Hayes E, Leswick DA, Obaid H, Sauder DA. Four-Corner Arthrodesis with a Dorsal Locking PEEK Plate: A Retrospective Case Series. J Wrist Surg 2023; 12:225-231. [PMID: 37223382 PMCID: PMC10202573 DOI: 10.1055/s-0042-1757448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/17/2022] [Indexed: 10/17/2022]
Abstract
Background Four-corner arthrodesis (4CA) can be performed with a variety of methods. To our knowledge, fewer than 125 cases of 4CA with a locking polyether ether ketone (PEEK) plate have been reported, necessitating further study. Purpose The purpose of this study was to evaluate the radiographic union rate and clinical outcomes in a series of patients who received 4CA with a locking PEEK plate. Methods We re-examined 39 wrists in 37 patients at a mean follow-up of 50 months (median: 52 months, range: 6-128). Patients completed the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), Patient-Rated Wrist Evaluation (PRWE), and participated in measurements of grip strength and range of motion. Anteroposterior, lateral, and oblique radiographs of the operative wrist were examined for union, screw breakage and/or loosening, and lunate change. Results The mean QuickDASH score was 24.4 and the mean PRWE score was 26.5. Mean grip strength was 29.2 kg or 84% of the nonoperative hand. Mean flexion, extension, radial deviation, and ulnar deviation were : 37.2, 28.9, 14.1, and 17.4 degrees, respectively. Eighty-seven percent of wrists achieved union; 8% had nonunion; and5% had indeterminate union. There were seven cases of screw breakage and seven cases of screw loosening (as defined by lucency or bony resorption surrounding screws). Twenty-three percent of wrists required reoperation (four total wrist arthrodesis and five reoperations for other reasons). Conclusion 4CA with a locking PEEK plate has clinical and radiographic outcomes similar to other methods. We observed a high rate of hardware complications. It is unclear whether this implant offers a clear advantage over other methods of fixation used in 4CA. Type of Study/Level of Evidence Level IV, therapeutic study.
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Affiliation(s)
- Emmitt Hayes
- Division of Orthopedic Surgery, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
| | - David A. Leswick
- Department of Medical Imaging, Saskatchewan Health Authority, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Haron Obaid
- Department of Medical Imaging, Saskatchewan Health Authority, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David A. Sauder
- Division of Orthopedic Surgery, Royal University Hospital, University of Saskatchewan College of Medicine, Saskatoon, Saskatchewan, Canada
- Saskatoon Orthopedic and Sports Medicine Center, Saskatoon, Saskatchewan, Canada
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3
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Rattee J, Sims L, Leswick DA, Obaid H. Correlation between superior humeral head migration and proximal long head of biceps tendon pathology in patients with and without rotator cuff tears using magnetic resonance imaging and radiography. JSES Int 2022; 6:809-814. [PMID: 36081706 PMCID: PMC9446281 DOI: 10.1016/j.jseint.2022.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Matuszczak M, Melendez S, Leswick DA. Presentation at the Canadian Association of Radiologists Annual General Meeting Is Associated With Higher Likelihood of Publication of Canadian Radiology Resident Research Day Presentations. Can Assoc Radiol J 2022; 73:478-485. [PMID: 35042397 DOI: 10.1177/08465371211067159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Determine how many radiology resident research day projects are presented at the Canadian Association of Radiologists Annual Scientific Meeting (CAR ASM) and if presentation at the CAR ASM is associated with increased rates of publication. Methods: A database of radiology resident presentations from 2012 to 2017 research days at seven Canadian radiology programs was utilized. Each presenting resident was searched for in 2011-2019 CAR ASM books of abstracts to identify all CAR ASM presentations both related to and separate from their research day projects. These presentations were matched with resident research day presentations and their publication status. Descriptive statistical analysis and calculation of relative risk (RR) between publication of research day projects and presentation at CAR was performed. Results: 208 residents presented 288 projects at internal research days. 93 of the 208 residents had a total of 195 presentations at CAR (mean .94 +/- 1.91 SD). 36 of the 288 (13%) research day projects were presented at a CAR ASM, of which 18/36 (50%) were published. 83 of the 252 (32%) research day projects not presented at CAR were published. CAR ASM presentation of a research day project was associated with an increased rate of publication (RR 1.537 P=.0396). There was no significant association between research day project publication and unrelated CAR ASM presentations (P=.275). Most research day projects both presented at CAR ASM and published (56%) were in the Canadian Association of Radiologists Journal. Conclusion: CAR ASM presentation of research day projects is associated with an increased rate of publication.
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Affiliation(s)
- Martin Matuszczak
- Department of Medical Imaging, College of Medicine, Department of Medical Imaging, RinggoldID:%207235University of Saskatchewan, Saskatoon, SK, Canada
| | - Sarah Melendez
- Department of Medical Imaging, College of Medicine, Department of Medical Imaging, RinggoldID:%207235University of Saskatchewan, Saskatoon, SK, Canada
| | - David A Leswick
- Department of Medical Imaging, College of Medicine, Department of Medical Imaging, RinggoldID:%207235University of Saskatchewan, Saskatoon, SK, Canada
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Naqvi SR, Beavis RC, Mondal P, Bryce R, Leswick DA. Incidence Rates of Surgery After Knee MRI: Association According to Referring Physician Type and Patient's Age and Sex. Orthop J Sports Med 2021; 9:23259671211052560. [PMID: 34790833 PMCID: PMC8591651 DOI: 10.1177/23259671211052560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022] Open
Abstract
Background The utility of magnetic resonance imaging (MRI) in the primary care setting is uncertain, with a perception that there is less likelihood for surgery after MRI ordered by general practitioners (GPs) when compared with orthopaedic surgeons and sports medicine physicians. Additionally, the influence of patient age and sex on subsequent surgical intervention is currently unknown. Purpose/Hypothesis The purpose of this study was to compare surgical incidence after MRI referrals by orthopaedic surgeons, GPs, and sports medicine physicians, including a subset analysis for GP patients based on type of approval given by the radiologist. The authors also wanted to explore the association of age and sex on subsequent surgical intervention. They hypothesized that surgical incidence after MRI ordered by orthopaedic surgeons and sports medicine physicians would be higher than after MRI ordered by GPs. Study Design Cohort study; Level of evidence, 3. Methods Knee MRI referrals by the 3 physician cohorts during May to December 2017 were assessed. For GP patients, the types of approval or recommendation from a radiologist were categorized. Subsequent surgical intervention status was then compared among referral groups up to 2 years after MRI. Associations of age and sex with surgical occurrence were also assessed. Chi-square test, analysis of variance, and univariate/multivariable logistic regression were used for statistical analysis. Results Overall, 407 referrals were evaluated (GP, n = 173; orthopaedic, n = 176; sports medicine, n = 58). Surgical incidence was not significantly higher for orthopaedic and sports medicine than GP referrals at 3 months (10%, 3%, and 6%, respectively; P = .23), 6 months (20%, 17%, and 15%; P = .49), and 2 years (30%, 35%, and 24%; P = .25). Surgical incidence for GP patients was higher after discussion with a radiologist or when evaluating specific pathology on prior imaging versus less defined reasons (30.4% vs 15.7%, respectively; P = .03). Surgical incidence was lower for older patients (11% vs 31% for >60 years vs all other age groups combined; P = .002), and women were less likely to undergo surgery than men (22% vs 35%, respectively; P = .008). Conclusion Surgical incidence after MRI was likely appropriately lower for older patients. Lower incidence for female patients is of uncertain cause and warrants further study.
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Affiliation(s)
- Syed R Naqvi
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - R Cole Beavis
- Division of Orthopedics, Department of Surgery, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Prosanta Mondal
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Rhonda Bryce
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David A Leswick
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Obaid H, Pike S, Lutz I, Buchko J, Leswick DA. Proximal femoral epiphyseal spurs and their association with acetabular labral tears on MRI in symptomatic patients. Skeletal Radiol 2021; 50:1567-1573. [PMID: 33410966 DOI: 10.1007/s00256-020-03686-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 11/21/2020] [Accepted: 11/29/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Femoral epiphyseal spurs are developmental projections that form at the edge of the physis. Although considered incidental, their association with acetabular labral tears has never been examined. Our aim was to assess the prevalence of femoral epiphyseal spurs in symptomatic patients with mechanical hip pain and explore if they are associated with labral tears on MRI. MATERIALS AND METHODS Hip MRI scans performed on a Siemens 3 T MRI using femoroacetabular impingement protocol were retrospectively reviewed. All patients were referred by orthopaedic surgeons for mechanical hip pain. Two musculoskeletal radiologists blinded to initial reports evaluated MRI images for the presence of an epiphyseal spur and acetabular labral changes. A consensus was achieved on all cases by the two readers. The association between epiphyseal spurs and labral changes was assessed using Fisher's exact test. RESULTS A total of 115 patients (178 hip MRI scans) were reviewed; the mean age was 28.8 years (SD 7.1). There were 52 females (45.2%) and 63 males (54.8%). There were 115 hips with labral tears (64.6%). Fourteen hips (7.8%) in ten patients (8.7%) demonstrated epiphyseal spurs and all of them showed labral tears (100%). There was statistically significant association between epiphyseal spurs and labral tears on MRI (p value = 0.0024). CONCLUSION Femoral epiphyseal spurs were observed in 8.7% of our defined patient population, and all patients with epiphyseal spurs demonstrated labral tears. Epiphyseal spurs should be documented on imaging reports due to their potential association with labral tears. Future research is needed to further delineate and guide management of these entities.
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Affiliation(s)
- Haron Obaid
- Department of Medical Imaging, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada.
| | - Samuel Pike
- Department of Medical Imaging, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
| | - Ian Lutz
- Division of Orthopedic Surgery, Department of Surgery, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan, Canada
| | - Jordan Buchko
- Division of Orthopedic Surgery, Department of Surgery, University of Saskatchewan, Pasqua Hospital, Regina, Saskatchewan, Canada
| | - David A Leswick
- Department of Medical Imaging, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK, S7N 0W8, Canada
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Huynh J, Horne D, Bryce R, Leswick DA. Is Call Karma Real? Resident After-Hours On-Call Imaging at the University of Saskatchewan: An Assessment of Call Volumes Including Inter-Resident Variability. Can Assoc Radiol J 2021; 73:38-48. [PMID: 34227429 DOI: 10.1177/08465371211026310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Quantify resident caseload during call and determine if there are consistent differences in call volumes for individuals or resident subgroups. METHODS Accession codes for after-hours computed tomography (CT) cases dictated by residents between July 1, 2012 and January 9, 2017 were reviewed. Case volumes by patient visits and body regions scanned were determined and categorized according to time period, year, and individual resident. Mean shift Relative Value Units (RVUs) were calculated by year. Descriptive statistics, linear mixed modeling, and linear regression determined mean values, differences between residents, associations between independent variables and outcomes, and changes over time. Consistent differences between residents were assessed as a measure of good or bad luck / karma on call. RESULTS During this time there were 23,032 patients and 30,766 anatomic regions scanned during 1,652 call shifts among 32 residents. Over the whole period, there were on average 10.6 patients and 14.3 body regions scanned on weekday shifts and 22.3 patients and 29.4 body regions scanned during weekend shifts. Annually, the mean number of patients, body regions, and RVUs scanned per shift increased by an average of 0.2 (1%), 0.4 (2%), and 1.2 (5%) (all p < 0.05) respectively in regression models. There was variability in call experiences, but only 1 resident had a disproportionate number of higher volume calls and fewer lower volume shifts than expected. CONCLUSIONS Annual increases in scan volumes were modest. Although residents' experiences varied, little of this was attributable to consistent personal differences, including luck or call karma.
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Affiliation(s)
- James Huynh
- Department of Medical Imaging, University of Calgary, Foothills Hospital, Calgary, Alberta, Canada
| | - David Horne
- Department of Medical Imaging, University of Saskatchewan and Saskatchewan Health Authority, Saskatoon City Hospital, Saskatoon, Saskatchewan, Canada
| | - Rhonda Bryce
- Clinical Research Support Unit, College of Medicine, Health Sciences Building, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David A Leswick
- Department of Medical Imaging, University of Saskatchewan and Saskatchewan Health Authority, Royal University Hospital, Saskatoon, Saskatchewan, Canada
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Jo P, Leswick DA, Allen LA. Teenage Female with Knee Pain and Instability. Mcgill J Med 2020. [DOI: 10.26443/mjm.v13i2.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Congenital dislocation of the knee, result- ing from an absence of the cruciate ligaments, is a condition affecting 0.017 per 1000 live births (1). Although very rare, it has drawn the attention of or- thopaedic surgeons and radiologists because it is associated with other congential anomalies. This paper presents abnormalities that are isolated to the knee and without evidence of associated syndrome. The absent anterior cruciate ligament (ACL) is associated with a hypoplastic posterior cruciate ligament (PCL), a shallow femoral notch, and hypoplastic tibial spines seen with radiographic and magnetic resonance imaging. The objective of this article is to review the clinical presentation and imaging fndings associated with congenitally absent ACL.
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Abstract
OBJECTIVE Twenty-one previous studies have shown a mean presentation to publication conversion rates at radiology conferences of 26%. There have been no prior studies on publication of medical imaging residency research presentations. Our objective was to determine how many medical imaging resident research projects presented at internal program research days across Canada go on to publication. METHODS A list of unique medical imaging resident research presentations given at program research days during the 2012-2013 to 2016-2017 academic years was generated via e-mail contact of programs or review of publicly available data on program websites. Unique resident presentations were identified and publications associated with these presentations were sought via database and Internet searching. The number of publications, publishing journals, and time to publication was determined. RESULTS Data from 32 research days at 7 programs were assessed. A total of 287 resident presentations were identified. Of these 287 presentations, 99 had associated publications (34% presentation to publication conversation rate), with variation in presentation numbers and publication conversion rates between schools. These 99 presentations were associated with a total of 118 publications in a total of 57 different journals. Time from presentation to publication was calculable for 109 of the 118 articles. Fifteen (14%) were published before research day and 94 (86%) were published after research day with a mean time to publication of 12.3 ± 13.6 months for all articles. CONCLUSIONS Thirty-four percent of resident research presentations at Canadian medical imaging program research days go on to publication.
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Affiliation(s)
- Sarah Melendez
- Department of Medical Imaging, 3158University of Alberta, University of Alberta Hospital, Edmonton, Alberta, Canada
| | - David A Leswick
- Department of Medical Imaging, 7235University of Saskatchewan and Saskatchewan Health Authority, Royal University Hospital, Saskatoon, Saskatchewan, Canada
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Accorsi F, Lalonde A, Leswick DA. Endoclip Magnetic Resonance Imaging Screening: A Local Practice Review. Can Assoc Radiol J 2018; 69:162-168. [PMID: 29706253 DOI: 10.1016/j.carj.2017.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 09/17/2017] [Accepted: 12/07/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Not all endoscopically placed clips (endoclips) are magnetic resonance imaging (MRI) compatible. At many institutions, endoclip screening is part of the pre-MRI screening process. Our objective is to determine the contribution of each step of this endoclip screening protocol in determining a patient's endoclip status at our institution. METHODS A retrospective review of patients' endoscopic histories on general MRI screening forms for patients scanned during a 40-day period was performed to assess the percentage of patients that require endoclip screening at our institution. Following this, a prospective evaluation of 614 patients' endoclip screening determined the percentage of these patients ultimately exposed to each step in the protocol (exposure), and the percentage of patients whose endoclip status was determined with reasonable certainty by each step (determination). RESULTS Exposure and determination values for each step were calculated as follows (exposure, determination): verbal interview (100%, 86%), review of past available imaging (14%, 36%), review of endoscopy report (9%, 57%), and new abdominal radiograph (4%, 96%), or CT (0.2%, 100%) for evaluation of potential endoclips. Only 1 patient did not receive MRI because of screening (in situ gastrointestinal endoclip identified). CONCLUSIONS Verbal interview is invaluable to endoclip screening, clearing 86% of patients with minimal monetary and time investment. Conversely, the limited availability of endoscopy reports and relevant past imaging somewhat restricts the determination rates of these. New imaging (radiograph or computed tomography) is required <5% of the time, and although costly and associated with patient irradiation, has excellent determination rates (above 96%) when needed.
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Affiliation(s)
- Fabio Accorsi
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Alain Lalonde
- Department of Medical Imaging, Saskatoon Health Region and University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David A Leswick
- College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Medical Imaging, Saskatoon Health Region and University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Irving B, Leswick DA, Fladeland D, Lim HJ, Bryce R. Knowing the Enemy: Health Care Provider Knowledge of Computed Tomography Radiation Dose and Associated Risks. J Med Imaging Radiat Sci 2016; 47:243-250. [PMID: 31047289 DOI: 10.1016/j.jmir.2016.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 04/25/2016] [Accepted: 05/09/2016] [Indexed: 10/24/2022]
Abstract
BACKGROUND There is ionizing radiation and associated risk from many medical imaging examinations, especially computed tomography (CT). Unfortunately, health care providers often have limited knowledge regarding radiation dose levels and potential risk. RESEARCH OBJECTIVES To assess knowledge of dose levels and risk among referring physicians, imaging technologists, and radiologists in Saskatoon, Saskatchewan, and to identify potential differences between and within those groups. MATERIALS AND METHODS A survey was designed and administered to health care professionals. RESULTS A total of 308 of 328 surveys were completed (91% response rate). Overall 73% of physicians, 97% of radiologists, and 76% of technologists correctly believed that there is a risk for cancer from an abdomen-pelvic CT scan. Although only 18% of physicians, 28% of radiologists, and 22% of technologists selected the most appropriate estimate of abdominal-pelvic CT dose in terms of chest x-ray equivalents, this is similar to other reported studies. Physicians and technologists who use CT were more likely to select the correct dose than those who do not. Most respondents (91% of physicians, 100% of radiologists, and 100% of technologists) felt that pregnant patients should always be informed about radiation dose as a risk. Although frequency of discussing risk decreased with increasing patient age, technologists were more likely to discuss risk at any age. A total of 93% of respondents expressed interest in receiving dose feedback from medical imaging procedures. CONCLUSIONS Radiologists and technologists generally showed better knowledge than referring physicians. Among physicians and technologists, knowledge was better in those who use CT than those who do not.
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Affiliation(s)
- Breanne Irving
- Department of Academic Family Medicine, University of Saskatchewan, Swift Current, Saskatchewan, Canada.
| | - David A Leswick
- Department of Radiology, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Derek Fladeland
- Department of Radiology, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Hyun Ja Lim
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Rhonda Bryce
- Department of Community Health & Epidemiology, Clinical Research Support Unit, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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12
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Taylor-Gjevre RM, Mitchell A, Street M, Leswick DA, Stewart SA, Obaid H. The role of radiology in the quantification of digital ulnar deviation in rheumatoid arthritis patients. J Med Imaging Radiat Oncol 2016; 60:323-8. [DOI: 10.1111/1754-9485.12454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 02/26/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Regina M Taylor-Gjevre
- Division of Rheumatology; Department of Medicine; Royal University Hospital; University of Saskatchewan; Saskatoon Saskatchewan Canada
| | - Allison Mitchell
- Psychiatry Department; College of Medicine; Royal University Hospital; University of Saskatchewan Saskatoon Canada
| | - Michelle Street
- Occupational Therapist; Royal University Hospital; Saskatoon Saskatchewan Canada
| | - David A Leswick
- Department of Diagnostic Imaging; Royal University Hospital; University of Saskatchewan; Saskatoon Saskatchewan Canada
| | - Samuel Alan Stewart
- Division of Medical Informatics; Faculty of Medicine; Dalhousie University; Canada
| | - Haron Obaid
- Department of Diagnostic Imaging; Royal University Hospital; University of Saskatchewan; Saskatoon Saskatchewan Canada
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Kawalilak CE, Johnston JD, Olszynski WP, Leswick DA, Kontulainen SA. Comparison of short-term in vivo precision of bone density and microarchitecture at the distal radius and tibia between postmenopausal women and young adults. J Clin Densitom 2014; 17:510-7. [PMID: 24206866 DOI: 10.1016/j.jocd.2013.09.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 08/31/2013] [Accepted: 09/11/2013] [Indexed: 10/26/2022]
Abstract
The purpose was to assess whether precision of bone properties derived via the use of high-resolution peripheral quantitative computed tomography (HR-pQCT) differs between postmenopausal women and young adults. Using HR-pQCT, we scanned the distal radius and tibia at 2 time points in 34 postmenopausal women (74 ± 7 years) and 30 young adults (mean age ± SD: 27 ± 9 years). Standard protocols were used to acquire bone area, density, and microarchitectural properties. We calculated coefficients of variation (CV; percentage CV and percentage CV of the root mean square) and 95% limits of agreement (95% LOA) to assess precision errors. The 95% LOA is the magnitude of individual change needed to be observed to ensure that a real change has occurred. Multiple Mann-Whitney U-tests (with the use of Bonferroni correction for multiple comparisons) were used to compare percentage CV between the 2 groups. Significance was set to p < 0.004. All standard outcome variables were not significantly different between the groups. The 95% LOA confirmed that the measurement bias between the groups did not differ. These results suggest that short-term precision errors in HR-pQCT-derived bone outcomes are similar between postmenopausal women and young adults.
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Affiliation(s)
- Chantal E Kawalilak
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - James D Johnston
- Department of Mechanical Engineering, College of Engineering, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Wojciech P Olszynski
- Osteoporosis Centre, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David A Leswick
- Department of Medical Imaging, College of Medicine, University of Saskatchewan and Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
| | - Saija A Kontulainen
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Abstract
OBJECTIVES To systematically evaluate the accuracy of text descriptions and labeling of radiologic images published in the Canadian Journal of Emergency Medicine (CJEM). Error detection by radiologists and emergency physicians and the clinical significance and educational value of these errors were assessed. Errors were also correlated with radiologist involvement in publication and imaging modality. METHODS Thirty-three issues of CJEM were examined from January 2003 to May 2008. Electronic copies of all radiologic images published were obtained with their caption and description from the text. Identifying information was removed to present images in an anonymous fashion. Images were presented to two radiologists who, working in consensus, critically appraised each image and accompanying text. Images were then presented to two emergency department physicians who, working in consensus, critically appraised each image and accompanying text. All images with errors detected by either radiology or emergency physicians were then discussed to determine if errors would have affected clinical management or educational value. The emergency physicians also identified "underlabeled" images where it was felt that further labeling would enhance their educational value. RESULTS Forty-five articles with 82 images were obtained. At least one error was observed in 18 (40%) articles and 20 (24%) images. Two errors were present in three images, resulting in 23 errors. Of the 23 errors, 17 were image description errors and 6 were labeling errors. Five errors were detected by both radiology and emergency physicians, whereas 15 were detected only by radiologists and 3 were detected only by emergency physicians. Of these errors, 12 (52%) were rated as potentially affecting both clinical management and educational value, 5 (22%) as only affecting educational value, and 6 (26%) as nonsignificant. Radiologists were involved in six articles, including 12 images that contained no errors. There was no official radiologist involvement in 39 articles, including 70 images, 18 (26%) of which contained errors. In addition, 26 images were identified by emergency physicians as potentially benefiting from enhanced labeling to improve educational value. CONCLUSIONS Radiologic images published in the CJEM are generally of high quality; however, 23 errors were found in 82 images, 18 (78%) of which were rated as potentially affecting clinical management, educational value, or both. Radiologist involvement in the publication process may be of assistance as no errors were seen in articles that included radiologists as authors.
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Chatterson LC, Leswick DA, Fladeland DA, Hunt MM, Webster S, Lim H. Fetal shielding combined with state of the art CT dose reduction strategies during maternal chest CT. Eur J Radiol 2014; 83:1199-1204. [PMID: 24838282 DOI: 10.1016/j.ejrad.2014.04.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 04/14/2014] [Accepted: 04/15/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE Custom bismuth-antimony shields were previously shown to reduce fetal dose by 53% on an 8DR (detector row) CT scanner without dynamic adaptive section collimation (DASC), automatic tube current modulation (ATCM) or adaptive statistical iterative reconstruction (ASiR). The purpose of this study is to compare the effective maternal and average fetal organ dose reduction both with and without bismuth-antimony shields on a 64DR CT scanner using DASC, ATCM and ASiR during maternal CTPA. MATERIALS AND METHODS A phantom with gravid prosthesis and a bismuth-antimony shield were used. Thermoluminescent dosimeters (TLDs) measured fetal radiation dose. The average fetal organ dose and effective maternal dose were determined using 100 kVp, scanning from the lung apices to the diaphragm utilizing DASC, ATCM and ASiR on a 64DR CT scanner with and without shielding in the first and third trimester. Isolated assessment of DASC was done via comparing a new 8DR scan without DASC to a similar scan on the 64DR with DASC. RESULTS Average third trimester unshielded fetal dose was reduced from 0.22 mGy ± 0.02 on the 8DR to 0.13 mGy ± 0.03 with the conservative 64DR protocol that included 30% ASiR, DASC and ATCM (42% reduction, P<0.01). Use of a shield further reduced average third trimester fetal dose to 0.04 mGy ± 0.01 (69% reduction, P<0.01). The average fetal organ dose reduction attributable to DASC alone was modest (6% reduction from 0.17 mGy ± 0.02 to 0.16 mGy ± 0.02, P=0.014). First trimester fetal organ dose on the 8DR protocol was 0.07 mGy ± 0.03. This was reduced to 0.05 mGy ± 0.03 on the 64DR protocol without shielding (30% reduction, P=0.009). Shields further reduced this dose to below accurately detectable levels. Effective maternal dose was reduced from 4.0 mSv on the 8DR to 2.5 mSv on the 64DR scanner using the conservative protocol (38% dose reduction). CONCLUSION ASiR, ATCM and DASC combined significantly reduce effective maternal and fetal organ dose during CTPA. Shields continue to be an effective means of fetal dose reduction.
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Affiliation(s)
| | - David A Leswick
- Department of Diagnostic Imaging, University of Saskatchewan, Canada
| | - Derek A Fladeland
- Department of Diagnostic Imaging, University of Saskatchewan, Canada
| | - Megan M Hunt
- Saskatchewan Ministry of Labour Relations and Workplace Safety, Canada
| | - Stephen Webster
- Saskatchewan Ministry of Labour Relations and Workplace Safety, Canada
| | - Hyun Lim
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Canada
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16
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Khan N, Shepel M, Leswick DA, Obaid H. Increasing lateral tibial slope: is there an association with articular cartilage changes in the knee? Skeletal Radiol 2014; 43:437-41. [PMID: 24414035 DOI: 10.1007/s00256-013-1800-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 12/04/2013] [Accepted: 12/11/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE The geometry of the lateral tibial slope (LTS) plays an important role in the overall biomechanics of the knee. Through this study, we aim to assess the impact of LTS on cartilage degeneration in the knee. MATERIALS AND METHODS A retrospective analysis of 93 knee MRI scans (1.5 T or 3 T) for patients aged 20-45 years with no history of trauma or knee surgery, and absence of internal derangement. The LTS was calculated using the circle method. Chondropathy was graded from 0 (normal) to 3 (severe). Linear regression analysis was used for statistical analysis (p < 0.05). RESULTS In our cohort of patients, a statistically significant association was seen between increasing LTS and worsening cartilage degenerative changes in the medial patellar articular surface and the lateral tibial articular surface (p < 0.05). There was no statistically significant association between increasing LTS and worsening chondropathy of the lateral patellar, medial trochlea, lateral trochlea, medial femoral, lateral femoral, and medial tibial articular surfaces. CONCLUSIONS Our results show a statistically significant association between increasing LTS and worsening cartilage degenerative changes in the medial patella and the lateral tibial plateau. We speculate that increased LTS may result in increased femoral glide over the lateral tibial plateau with subsequent increased external rotation of the femur predisposing to patellofemoral articular changes. Future arthroscopic studies are needed to further confirm our findings.
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Affiliation(s)
- Nasir Khan
- Department of Medical Imaging, Royal University Hospital, and College of Medicine, University of Saskatchewan, 103 Hospital Drive, Saskatoon, Saskatchewan, S7N 0W8, Canada,
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17
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Johnston JD, Liao L, Dolovich AT, Leswick DA, Kontulainen SA. Magnetic resonance imaging of bone and muscle traits at the hip: an in vivo precision study. J Musculoskelet Neuronal Interact 2014; 14:104-110. [PMID: 24583545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To determine the in vivo precision of MRI-based measures of bone and muscle traits at the hip. METHODS Left proximal femoral neck and shaft of 14 participants (5M:9 F; age:21-68) were scanned 3 times using a 1.5 T MRI. Commercial and custom image processing methods were used to derive bone geometry and strength traits at the proximal femoral neck and shaft along with muscle area of various muscle groups at the shaft site. For precision, root mean square coefficients of variation (CV%rms) and standard deviations (SDrms) were calculated. RESULTS At the femoral neck, CV%rms for area-based bone measures ranged between 1.7-5.0%; CV%rms for cortical thickness varied from 4.7 to 5.6%; and CV%rms for bending, torsional and buckling-based strength indices ranged between 4.6-7.1%. At the femoral shaft, CV%rms for bone area ranged between 1.2-3.0%; CV%rms for cortical thickness varied from 1.7 to 2.0%; and CV%rms for bending and buckling-based strength indices ranged between 1.4-3.1%. For muscle area, CV%rms ranged between 1.3-4.5%. CONCLUSIONS MRI-based measures of bone and muscle traits at the proximal femoral neck and shaft demonstrated in vivo precision errors <7.1%. MRI is a promising 3D technique for monitoring changes in bone and muscle at the clinically important hip.
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Affiliation(s)
- J D Johnston
- Department of Mechanical Engineering, College of Engineering
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18
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Chatterson LC, Leswick DA, Fladeland DA, Hunt MM, Webster ST. Lead versus Bismuth-Antimony Shield for Fetal Dose Reduction at Different Gestational Ages at CT Pulmonary Angiography. Radiology 2011; 260:560-7. [DOI: 10.1148/radiol.11101575] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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19
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Jo P, Leswick DA, Allen LA. Teenage female with knee pain and instability. Mcgill J Med 2011; 13:16. [PMID: 22363190 PMCID: PMC3277420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Patricia Jo
- To whom correspondence should be addressed:
Dr. Patricia Jo
University of Sakatchewan, Faculty of Medicine
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20
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Thakur N, Leswick DA. Case of the month #167: flexor hallicus longus tendon tear distal to the master knot of Henry. Can Assoc Radiol J 2011; 62:154-7. [PMID: 21501796 DOI: 10.1016/j.carj.2009.12.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2009] [Revised: 12/04/2009] [Accepted: 12/11/2009] [Indexed: 11/30/2022] Open
Affiliation(s)
- Nathan Thakur
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
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21
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Bird JR, Tynan JR, Dzus AK, Leswick DA. Case of the month #163. Acute lymphoblastic leukaemia. Can Assoc Radiol J 2010; 61:177-8, 180-3. [PMID: 20471536 DOI: 10.1016/j.carj.2009.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jeffery R Bird
- Department of Medical Imaging, University of Western Ontario, London Health Sciences Centre, London, Ontario, Canada
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22
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Leswick DA, Davidson JM, Bock GW, Major PA, Maycher B. Things that go bump in the body: musculoskeletal sports medicine magnetic resonance imaging cases: part 2 of 2. Can Assoc Radiol J 2009; 60:248-62. [PMID: 19931131 DOI: 10.1016/j.carj.2009.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2009] [Revised: 05/01/2009] [Accepted: 05/12/2009] [Indexed: 11/17/2022] Open
Affiliation(s)
- David A Leswick
- Department of Medical Imaging, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
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23
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Theoret CM, Packota GV, Leswick DA. Answer to Case of the Month #153. Can Assoc Radiol J 2009; 60:213-6. [DOI: 10.1016/j.carj.2009.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Christina M. Theoret
- Department of Medical Imaging, Royal University Hospital, Saskatoon, Saskatchewan, Canada
| | - Garnet V. Packota
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David A. Leswick
- Department of Medical Imaging, Royal University Hospital, Saskatoon, Saskatchewan, Canada
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Leswick DA, Davidson JM, Bock GW, Major PA, Maycher B. Things that go bump in the body: musculoskeletal sports medicine magnetic resonance imaging cases: part 1 of 2. Can Assoc Radiol J 2009; 60:238-47. [PMID: 19631497 DOI: 10.1016/j.carj.2009.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2009] [Revised: 05/01/2009] [Accepted: 05/12/2009] [Indexed: 11/19/2022] Open
Affiliation(s)
- David A Leswick
- Department of Medical Imaging, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan, Canada.
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25
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Theoret CM, Packota GV, Leswick DA. Case of the Month #153. Can Assoc Radiol J 2009. [DOI: 10.1016/j.carj.2009.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Christina M. Theoret
- Department of Medical Imaging, Royal University Hospital, Saskatoon, Saskatchewan, Canada
| | - Garnet V. Packota
- College of Dentistry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - David A. Leswick
- Department of Medical Imaging, Royal University Hospital, Saskatoon, Saskatchewan, Canada
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Abstract
The use of computed tomography (CT) is growing, and, consequently, the associated radiation dose to patients is increasing as well. There is also increasing evidence linking the radiation dose within the range of diagnostic CT with a significantly increased risk of malignancy. These two factors combine to make radiation dose from diagnostic CT a public health concern. In order to practise to the best of our abilities and avoid harming patients, the radiation dose from CT must be minimized. Administrators, technologists, radiologists and other physicians are encouraged to work toward this goal through the use of education and a multi-faceted team approach. The objective of this paper is to educate healthcare professionals about the radiation dose from diagnostic CT, including utilization rates, typical examination doses and the risks of this radiation. Our experience in Saskatchewan is discussed. Suggestions regarding CT dose management and optimization are highlighted.
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Affiliation(s)
- David A Leswick
- Department of Radiology, Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan.
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27
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Leswick DA, Hunt MM, Webster ST, Fladeland DA. Thyroid Shields versus z-Axis Automatic Tube Current Modulation for Dose Reduction at Neck CT. Radiology 2008; 249:572-80. [DOI: 10.1148/radiol.2492071430] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Lujan ME, Chizen DR, Peppin AK, Kriegler S, Leswick DA, Bloski TG, Pierson RA. Improving inter-observer variability in the evaluation of ultrasonographic features of polycystic ovaries. Reprod Biol Endocrinol 2008; 6:30. [PMID: 18638401 PMCID: PMC2503984 DOI: 10.1186/1477-7827-6-30] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2008] [Accepted: 07/18/2008] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND We recently reported poor inter-observer agreement in identifying and quantifying individual ultrasonographic features of polycystic ovaries. Our objective was to determine the effect of a training workshop on reducing inter-observer variation in the ultrasonographic evaluation of polycystic ovaries. METHODS Transvaginal ultrasound recordings from thirty women with polycystic ovary syndrome (PCOS) were evaluated by three radiologists and three reproductive endocrinologists both before and after an ultrasound workshop. The following endpoints were assessed: 1) follicle number per ovary (FNPO), 2) follicle number per single cross-section (FNPS), 3) largest follicle diameter, 4) ovarian volume, 5) follicle distribution pattern and 6) presence of a corpus luteum (CL). Lin's concordance correlation coefficients (rho) and kappa statistics for multiple raters (kappa) were used to assess level of inter-observer agreement (>0.80 good, 0.60 - 0.80 moderate/fair, <0.60 poor). RESULTS Following the workshop, inter-observer agreement improved for the evaluation of FNPS (rho = 0.70, delta rho = +0.11), largest follicle diameter (rho = 0.77, delta rho = +0.10), ovarian volume (rho = 0.84, delta rho = +0.12), follicle distribution pattern (kappa = 0.80, delta kappa = +0.21) and presence of a CL (kappa = 0.87, delta kappa = +0.05). No improvement was evident for FNPO (rho = 0.54, delta rho = -0.01). Both radiologists and reproductive endocrinologists demonstrated improvement in scores (p < 0.001). CONCLUSION Reliability in evaluating ultrasonographic features of polycystic ovaries can be significantly improved following participation in a training workshop. If ultrasonographic evidence of polycystic ovaries is to be used as an objective measure in the diagnosis of PCOS, then standardized training modules should be implemented to unify the approach to evaluating polycystic ovarian morphology.
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Affiliation(s)
- Marla E Lujan
- Obstetrics, Gynecology & Reproductive Sciences, University of Saskatchewan, Saskatoon, Canada
| | - Donna R Chizen
- Obstetrics, Gynecology & Reproductive Sciences, University of Saskatchewan, Saskatoon, Canada
| | - Andrew K Peppin
- Radiology & Diagnostic Imaging, University of Alberta, Edmonton, Canada
| | - Stefan Kriegler
- Academic Department of Medical Imaging, University of Saskatchewan, Saskatoon, Canada
| | - David A Leswick
- Academic Department of Medical Imaging, University of Saskatchewan, Saskatoon, Canada
| | - Terri G Bloski
- Obstetrics, Gynecology & Reproductive Sciences, University of Saskatchewan, Saskatoon, Canada
| | - Roger A Pierson
- Obstetrics, Gynecology & Reproductive Sciences, University of Saskatchewan, Saskatoon, Canada
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Chavarria C, Leswick DA, Stoneham GW. Case of the Month #135. Pseudomyxoma peritonei. Can Assoc Radiol J 2008; 59:153-156. [PMID: 18697723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- Cesar Chavarria
- Department of Diagnostic Radiology and Nuclear Medicine, University of Western Ontario, London Health Sciences Centre, London, ON
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30
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Wilson RA, Leswick DA, Fladeland D. Answer to case of the month #122. Orbital capillary hemangioma with magnetic resonance interleaving artifact. Can Assoc Radiol J 2007; 58:239-241. [PMID: 18186436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Affiliation(s)
- Robert A Wilson
- Department of Radiology, Royal University Hospital, University of Saskatchewan, Saskatoon, SK.
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31
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Leswick DA, Robinson CA, Harder SL. Answer to case of the month #112: Progressive multifocal leukoencephalopathy with characteristic magnetic resonance imaging and magnetic resonance spectroscopy findings. Can Assoc Radiol J 2006; 57:249-53. [PMID: 17128894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Affiliation(s)
- David A Leswick
- Department of Medical Imaging, Royal University Hospital, Saskatoon, SK.
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Leswick DA, Szkup P, Stoneham GW. The zero-wall puncture: a novel angiographic puncture technique with substantial benefits. Can Assoc Radiol J 2005; 56:100-2. [PMID: 15957277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Affiliation(s)
- David A Leswick
- Department of Radiology, Royal University Hospital, University of Saskatchewan, Saskatoon, SK.
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Abstract
OBJECTIVE In our department, most high-resolution CT (HRCT) scans of the lungs are performed in conjunction with a standard helical examination to assess the entire chest. This requires scanning the patient twice. The goal of this study was to determine if the radiation dose could be decreased by performing a single combination helical scan of the chest from which both 5-mm standard and 1.25-mm HRCT images could be obtained. CONCLUSION Because the total measured radiation dose is 32% greater from a single combination helical HRCT scan of the chest versus separate standard helical plus axial HRCT scans, helical HRCT is not a clinically advisable technique.
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Affiliation(s)
- David A Leswick
- Department of Radiology, Royal University Hospital, 103 Hospital Dr., Saskatoon, SK S7N 0W8, Canada.
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Leswick DA, Chow V, Stoneham GW. Resident's corner. Answer to case of the month #94. Accessory soleus muscle. Can Assoc Radiol J 2003; 54:313-5. [PMID: 14689808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Affiliation(s)
- David A Leswick
- Department of Radiology, Royal University Hospital, 103 Hospital Dr., Saskatoon SK S7N 0W8.
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