ABSTRACT
Radiology is a key enabler of clinical activity and has been shown to be highly cost effective. Demand and activity have increased over time, with demand for computed tomography (CT), magnetic resource imaging (MRI) and ultrasound (US) growing faster than population growth. Complexity has also increased over time. Resources in the public sector have not kept up with demand, exacerbated by the COVID-19 pandemic. A reliance on an overseas trained workforce has resulted in critical shortages. Waiting times for CT, MRI and US across Aotearoa New Zealand remain well below targets and have not improved over 10 years. Robust links between clinical activity and radiology resourcing are needed to address the deficits and thereby maintain clinical safety.
Subject(s)
COVID-19 , Radiology , Humans , Pandemics , New Zealand/epidemiology , WorkforceABSTRACT
INTRODUCTION: To report a series of patients with osteoid osteoma treated by radiofrequency ablation in whom no complications or recurrences occurred. METHODS: Over a 13-year period, 32 consecutive patients with osteoid osteoma were treated by radiofrequency ablation in an Australasian teaching centre. RESULTS: All patients had resolution of symptoms with no complication or recurrence. CONCLUSIONS: This series is further evidence for the use of radiofrequency ablation as the primary treatment for osteoid osteoma.
Subject(s)
Osteoma, Osteoid/surgery , Radiofrequency Ablation/methods , Adolescent , Child , Child, Preschool , Female , Humans , Male , New Zealand , Osteoma, Osteoid/diagnostic imaging , Tomography, X-Ray Computed , Treatment Outcome , Young AdultABSTRACT
INTRODUCTION: Diffuse idiopathic skeletal hyperostosis (DISH) is a musculoskeletal disorder in which ligaments and entheses slowly become ossified, leading to decreased mobility and pain. The prevalence is variably reported as between 3% and 25% of the population over 50. In Australasia, the prevalence and severity of DISH has long been thought by radiologists to be high in certain populations, particularly among Pacific Islanders. The purpose of this study is to investigate the prevalence and severity of DISH in a Pacific Islander community. METHODS: Chest radiographs in 459 individuals were retrospectively reviewed to assess for the presence of features consistent with DISH, as per the Resnick Criteria. Each radiograph was also assessed for the number of vertebral bodies involved. The clinical records of these patients were accessed to obtain the patient's ethnicity. RESULTS: The prevalence of DISH in our group overall was 138/459 (30%) with a prevalence of 42/96 (44%) in the Pacific Islanders. The difference compared to the Europeans in the group is highly significant (P < 0.0001). CONCLUSIONS: This study verifies the high prevalence of DISH in Pacific Islanders.
Subject(s)
Hyperostosis, Diffuse Idiopathic Skeletal/diagnostic imaging , Hyperostosis, Diffuse Idiopathic Skeletal/ethnology , Native Hawaiian or Other Pacific Islander , Aged , Female , Humans , Male , Middle Aged , New Zealand/epidemiology , Prevalence , Retrospective StudiesABSTRACT
INTRODUCTION: Ductal carcinoma in situ (DCIS) of the breast is commonly treated surgically. The intent of this study was to evaluate whether preoperative MRI could add to mammography in predicting the extent of the disease. METHODS: A series of patients with DCIS attending our surgical clinic for preoperative assessment were offered MRI as part of a prospective study. The extent of the disease indicated by mammography and MRI was compared with histopathology after definitive treatment. The null hypothesis was that MRI does not add to mammography in accurately predicting disease extent. RESULTS: Fifty patients make up the basis of this report. Mammography was concordant with the pathology in 31/50. MRI and mammography combined were concordant in 43/50. This is a statistically significant difference (P = 0.01, Fisher's exact test). Upstaging to mastectomy by MRI was correct in 7/8 patients, but downstaging was correct in only 2/4. CONCLUSIONS: The null hypothesis is rejected. MRI does add to mammography in accurately predicting the extent of DCIS. Upstaging by MRI is usually reliable.
Subject(s)
Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging , Carcinoma, Intraductal, Noninfiltrating/pathology , Magnetic Resonance Imaging/methods , Ultrasonography, Mammary/methods , Adult , Aged , Female , Humans , Middle Aged , Multimodal Imaging/methods , Neoplasm Staging , Observer Variation , Preoperative Care , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
RATIONALE AND OBJECTIVES: To evaluate the prevalence of physiologic pineal calcification, estimate observer variability, and examine the association with choroid plexus calcification. MATERIALS AND METHODS: A retrospective review of hard copy head computed tomography films of 242 patients age younger than 16 years by two independent observers. RESULTS: Physiologic pineal calcification was present in 20% of the whole group, in 39% of those 8-14 years age, in 8% of those younger than 10 years age, and in 1% of those younger than age 6 years. Observer agreement was very good (kappa = 0.72). Choroid plexus calcification was present in 16% and was four times as common in those with pineal calcification (38% versus 10%, P = .005), with very good observer agreement (kappa = 0.74). CONCLUSION: Physiologic pineal calcification is more common in children than previously reported, mostly because of improving computed tomography technology. There is an association with choroid plexus calcification.
