Diagnostic imaging for hepatocellular carcinoma

Hepatocellular carcinoma (HCC) occurs mostly in individuals with cirrhosis, which is why the guidelines of the most important scientific societies indicate that these patients are included in surveillance programs through the repetition of an ultrasound examination every 6 months. The aim is to achieve early identification of the neoplasia in order to increase the possibility of curative therapies (liver transplantation, surgery or local ablative therapies) and to increase patient survival. HCC nodules arising in cirrhotic livers show characteristic angiographic behavior that can be evaluated with dynamic multidetector computed tomography and dynamic magnetic resonance imaging (MRI). However, the use of these techniques in real life is often hindered by the lack of uniform terminology in reporting and in the interpretation of the exams reflected in the impossibility of comparing examinations performed in different centers and/or at different times. Liver Imaging Reporting and Data System® was created to standardize reporting and data collection of computed tomography and MRI for HCC. In some cases HCC arises in patients with healthy livers and, although there is evidence that angiographic behavior is not different from cirrhotic patients in this clinical situation, the guidelines still indicate the execution of a biopsy. Frequent use of palliative therapeutic techniques such as transarterial chemoembolization, transarterial radioembolization or administration of antiangiogenic drugs (sorafenib) poses problems of interpretation of the therapeutic response with repercussions on the subsequent choices that have been attempted to resolve with the use of stringent criteria such as Modified Response Evaluation Criteria In Solid Tumors

Diagnostic imaging of the canine stifle

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Treatment Patterns in Patients with Diagnostic Imaging for Low Back Pain: A Retrospective Observational Study

Purpose: Low back pain (LBP) is one of the most frequent reasons for medical consultations. Literature suggests a large evidence-performance gap, especially regarding pain management. Therefore, the monitoring of treatment patterns is important to ensure high quality of treatment. This study aimed to describe treatment patterns specific to patients with diagnostic imaging of the spine for LBP. Patients and Methods: The study was retrospective observational and based on health claims data from 2015 to 2019 provided by a Swiss health insurance company covering around 12% of the population. Patients, ≥ 18 years of age, with diagnostic imaging of the spine were included and observed 12 months before and after imaging. Patients with back surgery or comorbidities associated with the use of pain medications were excluded. Results: In total, 60,822 patients (mean age: 53.5 y, 56.1% female) were included and 85% received at least one pain medication. Of these, non-steroidal anti-inflammatory drugs, paracetamol, or opioids were prescribed in 88.6%, 70.7%, and 40.3% of patients, respectively. Strong opioids were used in 17% of patients given opioids. Patients with combinations of diagnostic imaging methods had the highest odds of receiving pain medication prescriptions (1.81, 95% CI: 1.66, 1.96, P < 0.001). Prescribed defined daily doses corresponded to short-term therapies. Conclusion: Although the majority of patients received non-opioid short-term therapies, we found a substantial use of opioids, and in particular, a relative high usage of strong opioids. Our results highlighted the importance of both patient and healthcare provider awareness regarding the prudent treatment of LBP. Keywords: low back pain medication, radiology, diagnostic imaging, NSAIDs, opioids, non-pharmacologic therapie

The U.S. Health System in Perspective: A Comparison of Twelve Industrialized Nations

Compares the U.S. health system to those of twelve OECD countries based on measures of spending; physician supply and visits; utilization, supply, and prices of drugs and diagnostic imaging; and performance. Examines the causes of high U.S. spending

Film vs. digital - A Simulation of diagnostic imaging systems in healthcare

Today, healthcare providers are faced with the decision of how to perform diagnostic imaging services with respect to continuing with traditional film-based imaging techniques or converting to digital imaging technology. This research focuses on the multifactor operational aspects of the diagnostic imaging system, and evaluates the effect that film or digital based imaging have on operational performance, productivity, and quality of patient care. That is, the time the patient spends in the system, the number of diagnostic imaging procedures performed per week and machine utilization. The goal of this research is to provide a quantitative analysis of film-based versus digital diagnostic imaging systems from an operational perspective in order to aid healthcare providers in their decisions with regard to diagnostic imaging technology. This involves using simulation to design an operationally efficient digital diagnostic imaging system, performing a quantitative comparison of film-based and the most efficient digital diagnostic imaging system, and conducting a case study of the Diagnostic Imaging Department at F.F. Thompson Hospital in Canandaigua, New York to validate experiments and to aid the hospital in reorganizing workflow as they switch from film to digital imaging. Based on the results of these experiments and case study, healthcare providers will be better able to decide upon an appropriate diagnostic imaging technology and system configuration that will attain high performance in terms of productivity and the quality of care provided to their patients