Extrarenal retroperitoneal angiomyolipoma mimicking metastatic melanoma: CT and FDG PET correlation.

A 38-year-old man with melanoma of the right flank underwent a staging 18F-fluoro-2-deoxyglucose (FDG) PET/CT scan, which demonstrated a hypermetabolic extrarenal mass in the left retroperitoneal space, concerning for metastatic melanoma. However, surgical pathology demonstrated an angiomyolipoma (AML). Although AMLs can rarely occur in an extrarenal location, extrarenal retroperitoneal AMLs are exceptional. AMLs have variable imaging appearances on multiple imaging modalities, including FDG PET, and can confound accurate diagnosis when in an extrarenal location. This case demonstrates the only known FDG PET description of an extrarenal retroperitoneal AML and highlights the challenge in accurate diagnosis based on FDG PET findings.

White Paper Report of the 2010 RAD-AID Conference on International Radiology for Developing Countries: identifying sustainable strategies for imaging services in the developing world.

The 2010 RAD-AID Conference on International Radiology for Developing Countries was a multidisciplinary meeting to discuss data, experiences, and models pertaining to radiology in the developing world, where widespread shortages of imaging services reduce health care quality. The theme of this year's conference was sustainability, with a focus on establishing and maintaining imaging services in resource-limited regions. Conference presenters and participants identified 4 important components of sustainability: (1) sustainable financing models for radiology development, (2) integration of radiology and public health, (3) sustainable clinical models and technology solutions for resource-limited regions, and (4) education and training of both developing and developed world health care personnel.

Global health training in radiology residency programs.

RATIONALE AND OBJECTIVES: To measure perceptions of radiology residents regarding the imaging needs of the developing world and the potential role of an organized global health imaging curriculum during residency training. MATERIALS AND METHODS: An electronic survey was created and then distributed to residents in accredited US radiology residency. RESULTS: Two hundred ninety-four residents responded to the survey. A majority (61%) planned to pursue future international medical aid work, even though a similar proportion (59%) believed that they would be ill-prepared with their current training to pursue this career goal. The vast majority (91%) of respondents stated that their residency program offers no opportunities to participate in global health imaging experiences. Most surveyed residents felt that an organized global health imaging curriculum would improve understanding of basic disease processes (87%) and cost-conscious care (82%), prepare residents for lifelong involvement in global health (80%), and increase interpretative skills in basic radiology modalities (73%). If such a curriculum were available, most (62%) of surveyed residents stated that they would be likely or very likely to participate. Many (58%) believed the availability of such a program would have influenced their choice of residency program; a similar proportion of residents (75%) believed that the availability of a global health imaging curriculum would increase recruitment to the field of radiology. CONCLUSION: Many radiology residents are motivated to acquire global health imaging experience, with most survey respondents planning to participate in global health initiatives. These data demonstrate an imbalance between the level of resident interest and the availability of global health imaging opportunities, and support the need for discussion on how to implement global health imaging training within radiology residency programs.

Esophageal actinomycosis: a case report and review of radiographic findings.

Esophageal Actinomycosis is a rare disease with only two previous reports in the Radiology literature. We present a 27 year-old African American male with a past medical history of a renal transplant for renal disease secondary to lupus who presented with odynophagia. The computed tomography and barium swallow findings are presented as well as a differential diagnosis of infectious esophageal diseases.

MDCT and radiography of wrist fractures: radiographic sensitivity and fracture patterns.

OBJECTIVE: The purpose of our study was to determine which wrist fractures are not prospectively diagnosed at radiography using CT as a gold standard and to identify specific fracture patterns. MATERIALS AND METHODS: Through a search of radiology records from January 1 to December 31, 2005, 103 consecutive patients were identified as having radiographic and CT examinations of the wrist. After excluding incomplete or nondiagnostic examinations and those with a greater than 6-week interval between imaging studies, the final study group consisted of 61 wrist examinations in 60 patients. Two musculoskeletal radiologists and one emergency radiologist blindly reviewed CT examinations, and each bone (scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, hamate, metacarpals, distal radius, distal ulna) was categorized as normal or fractured, with agreement reached by consensus. Each prospective radiographic report was categorized as either normal or fracture/equivocal for each osseous structure. Results were compared using the chi-square and Fisher's exact tests. RESULTS: In the proximal carpal row, lunate and triquetrum fractures were often radiographically occult (0% and 20%, respectively, detected at radiography); whereas in the distal carpal row, trapezoid, capitate, and hamate fractures were often occult (0%, 0%, and 40% detected at radiography, respectively). Hamate fractures were significantly associated with metacarpal fractures, and distal radius fractures were associated with scaphoid and ulna fractures. CONCLUSION: Thirty percent of wrist fractures were not prospectively diagnosed on radiography, suggesting that CT should be considered after a negative radiographic finding if clinically warranted. The location of a dorsal scaphoid avulsion fracture emphasizes the need for specific radiographic views or cross-sectional imaging for diagnosis.

Reducing liposome size with ultrasound: bimodal size distributions.

Sonication is a simple method for reducing the size of liposomes. We report the size distributions of liposomes as a function of sonication time using three different techniques. Liposomes, mildly sonicated for just 30 sec, had bimodal distributions when surface-weighted with modes at about 140 and 750 nm. With extended sonication, the size distribution remains bimodal but the average diameter of each population decreases and the smaller population becomes more numerous. Independent measurements of liposome size using Dynamic Light Scattering (DLS), transmission electron microscopy (TEM), and the nystatin/ergosterol fusion assay all gave consistent results. The bimodal distribution (even when number-weighted) differs from the Weibull distribution commonly observed for liposomes sonicated at high powers over long periods of time and suggests that a different mechanism may be involved in mild sonication. The observations are consistent with the following mechanism for decreasing liposome size. During ultrasonic irradiation, cavitation, caused by oscillating microbubbles, produces shear fields. Large liposomes that enter these fields form long tube-like appendages that can pinch-off into smaller liposomes. This proposed mechanism is consistent with colloidal theory and the observed behavior of liposomes in shear fields.