Computed tomographic colonography: comparison of two workstations.

PURPOSE: To compare two commercially available computed tomography (CT) colonography systems with respect to interobserver variability, the influence of level of expertise, and the gradual reduction of reviewing time for each system. MATERIAL AND METHODS: Two residents and two radiologists using Siemens CTAPP Colography software and Viatronix V3D-Colon software reviewed supine and prone CT acquisitions from 24 patients in a primary 3D endoluminal view. The observers graded each case with respect to technical quality and diagnostic value, assessed the presence of pathology, and indicated the time spent on the viewing. RESULTS: Significant differences were found in technical quality (P < 0.001) and diagnostic value (P<0.001) depending on which system was used, with higher scores for the Viatronix software. The agreement between specialists tended to be higher than that between residents (kappa=0.63 (0.30-0.95) vs. kappa=0.51 (0.21-0.81)), and the residents gave significantly (P < 0.001) higher scores of technical quality. However, the level of expertise had no significant impact on the assessments. We noted extensive variability in pathological lesions found by the different observers. The number of findings did not differ between workstations, but the viewers tended to report larger polyp sizes with the Viatronix software. The time needed for viewing decreased significantly from the first to the last examination viewed by each observer. CONCLUSION: Both the evaluated systems present trustworthy images of the human colon, but in a primary 3D setting the Viatronix software is favored owing to the user-friendly interface, higher experienced technical quality, and better diagnostic value.

Restenosis and occlusion after carotid surgery assessed by duplex scanning and digital subtraction angiography.

In a study of 140 patients operated upon with 143 carotid endarterectomies (mean follow-up time 5.2 +/- 2.3 years, range 1 month - 9.3 years), vessel morphology was examined with duplex scanning in 113 patients and with digital subtraction angiography (DSA) in 82 patients. The operative mortality was 1.4%; persisting stroke morbidity 3.6% and the combined operative mortality/morbidity 5%. During the follow-up time a further 20 patients (14.5%) died, 13 had new strokes and 14 new TIAs. By life table analysis, the annual rate of stroke including the operative period was 2.7% (1.7% on the operated side and 1.0% on the non-operated side). Fourteen new occlusions (12%) of the operated carotid artery was found and restenosis (greater than 50%) in 13 patients (11.2%). Progression of the atherosclerotic disease in the contralateral non-operated carotid artery was found in 41 patients (37%) including 3 new occlusions. Agreement DSA/duplex was 88% on the operated side and 92% on the non-operated side. New strokes or TIAs on the operated side were more common in patients with occlusions or restenosis (p less than 0.05), whereas no symptoms were referable to occlusions on the non-operated side. Risk factor analysis revealed an increased risk of atherosclerotic progression on the non-operated side in smokers and those with two or more risk factors. The risk of restenosis in the operated carotid artery was higher in females (p less than 0.025).

Striking regression of advanced prostatic carcinoma induced by cyproterone acetate (Androcur). A case report.

An 80-year-old man with advanced adenocarcinoma of the prostate received cyproterone acetate, 200 mg orally per day as sole treatment. Striking regression of the tumour was demonstrated by ultrasonograms and excretory urograms. Serum concentrations of acid phosphatases, gonadotrophins, and testosterone decreased significantly. No significant cardiovascular side effects occurred.