Apparent diffusion coefficient value of diffusion-weighted imaging for differential diagnosis of ductal carcinoma in situ and infiltrating ductal carcinoma.

PURPOSE: The present meta-analysis investigated the clinical value of apparent diffusion coefficient (ADC) values in diffusion-weighted imaging (DWI) for differential diagnosis of ductal carcinoma in situ (DCIS) and infiltrating ductal carcinoma (IDC). MATERIALS AND METHODS: Electronic databases searches were employed to identify relevant scientific literature, and the search results were screened to selected high-quality studies for this meta-analysis. Methodological quality of the enrolled studies was evaluated by quality evaluation of diagnostic accuracy studies (QUADAS). Summary odds ratios (ORs) and its corresponding 95% confidence interval (95% CI) were calculated for DCIS versus IDC category of ADC value using Z test. RESULTS: Our meta-analysis contained a combined total of 1,097 subjects (928 patients with IDC and 169 patients with DCIS) from 9 relevant high-quality cohort studies. Pooled ORs demonstrated that ADC value in IDC patients was significantly lower than DCIS patients. Subgroup analysis stratified by ethnicity indicated a higher ADC value in DCIS patients compared to IDC, in Asian population, but not in Caucasians. Magnetic resonance imaging (MRI) machine type-stratified analysis revealed that the ADC value of DWI obtained from both non- General Electric Company (GE) 1.5T and GE 1.5T machines were highly reliable in the differential diagnosis of DCIS and IDC. CONCLUSION: Our meta-analysis provides evidence that ADC values in DWI accurately conveys the differences in tumor architecture between IDC and DCIS, which has high clinical value in differentiatal diagnosis of IDC and DCIS. This may lead to improved BC prediction and treatment.

Clinic application of Epub of medical imaging film in CT workflow.

OBJECTIVE: To investigate the clinical effects of the Epub of medical imaging film (EMIF) in CT workflow. METHODS: All experiments were approved by the ethics committee of the local district. An EMIF application is fully implemented in PACS according to the DICOM 3.0 standard. For a statistical comparison in the effects of the EMIF in CT workflow, consecutive 50,000 CT hardcopy film prints have been randomly selected before and after the EMIF application in PACS, respectively. The role of the EMIF in the application of hardcopy films, the clinic practice, the integrality of the quality control data archived in PACS/RIS and so on is investigated. RESULTS: For consecutive 50,000 CT hardcopy films before vs. after the EMIF application respectively, the counts of wasted films are 21 vs. 14 sheets due to the hardware problem, 28 vs. 0 sheets owing to operation errors, and 24 vs. 0 sheets caused by serious defects in image layout. Reissuing films for lost films and other special needs is 60 vs. 55 sheets. The average reissuing film time for each case is 16.97±6.14 vs. 4.36±1.26 min (t=5.94, p<0.01). The EMIF application has offered more convenience for medical viewing and reviewing, and has enhanced the integrality of the quality control data archived in PACS/RIS (χ2=320.835, P<0.01). CONCLUSION: EMIF application in clinical healthcare can help enhance the function of PACS/RIS, and improve the quality and efficiency in CT routine work.

The role of key image notes in CT imaging study interpretation.

The objective of the study was to investigate the clinical effects of CT key image notes (KIN) in the interpretation of a CT image study. All experiments were approved by the ethics committee of the local district. Six experienced radiologists were equally divided into routine reporting (RR) group and KIN reporting (KIN) group. CT scans of each 100 consecutive cases before and after using KIN technique were randomly selected, and the reports were made by group RR and KIN, respectively. All the reports were again reviewed 3 months later by both groups. All the results with using or not using KIN were interpreted and reinterpreted after 3 months by six clinicians, who were experienced in picture archiving and communication system (PACS) applications and were equally divided into the clinical routine report group and the clinical KIN report group, respectively. The results were statistically analyzed; the time used in making a report, the re-reading time 3 months later, and the consistency of imaging interpretation were determined and compared between groups. After using KIN technique, the time used in making a report was significantly increased (8.77 ± 5.27 vs. 10.53 ± 5.71 min, P < 0.05), the re-reading time was decreased (5.23 ± 2.54 vs. 4.99 ± 1.70 min, P < 0.05), the clinical interpretation and reinterpretation time after 3 months were decreased, and the consistency of the interpretation, reinterpretation between different doctors in different time was markedly improved (P < 0.01). CT report with KIN technique in PACS can significantly improve the consistency of the interpretation and efficiency in routine clinical work.