Can high-frequency ultrasound predict metastatic lymph nodes in patients with invasive breast cancer?

Aim To determine whether high-frequency ultrasound can predict the presence of metastatic axillary lymph nodes, with a high specificity and positive predictive value, in patients with invasive breast cancer. The clinical aim is to identify patients with axillary disease requiring surgery who would not normally, on clinical grounds, have an axillary dissection, so potentially improving outcome and survival rates. Materials and methods The ipsilateral and contralateral axillae of 42 consecutive patients with invasive breast cancer were scanned prior to treatment using a B-mode frequency of 13 MHz and a Power Doppler frequency of 7 MHz. The presence or absence of an echogenic centre for each lymph node detected was recorded, and measurements were also taken to determine the L/S ratio and the widest and narrowest part of the cortex. Power Doppler was also used to determine vascularity. The contralateral axilla was used as a control for each patient. Results In this study of patients with invasive breast cancer, ipsilateral lymph nodes with a cortical bulge ≥3 mm and/or at least two lymph nodes with absent echogenic centres indicated the presence of metastatic axillary lymph nodes (10 patients). The sensitivity and specificity were 52.6% and 100%, respectively, positive and negative predictive values were 100% and 71.9%, respectively, the P value was 0.001 and the Kappa score was 0.55.\ud Conclusion This would indicate that high-frequency ultrasound can be used to accurately predict metastatic lymph nodes in a proportion of patients with invasive breast cancer, which may alter patient management

Limitations and Management of Static-guided Endodontics Failure

Endodontic treatment in severely calcified canals is always a challenging task because it can result in accidents such as deviations or perforations. Recently, guided endodontics has become an alternative approach for pulp canal calcification, facilitating the location of root canals more predictably through the combined use of cone-beam computed tomographic imaging, oral scanning, and endodontic access guides. Although several reports have shown that guided endodontics is safer, faster and can be performed without an operating microscope and by less experienced operators, the technique has limitations, and iatrogenesis may occur. This article describes the limitations of static-guided endodontics and possible causes of failures. In the present case, not fixing the guide to the bone and inaccuracies generated by manually performing mesh merger software led to root perforation. Endodontic microsurgery was effective in resolving this case and should be considered the treatment of choice when guided endodontics cannot be used safely or when it fails

SPARC 2017 retrospect & prospects : Salford postgraduate annual research conference book of abstracts

Welcome to the Book of Abstracts for the 2017 SPARC conference. This year we not only celebrate the work of our PGRs but also the 50th anniversary of Salford as a University, which makes this year’s conference extra special. Once again we have received a tremendous contribution from our postgraduate research community; with over 130 presenters, the conference truly showcases a vibrant PGR community at Salford. These abstracts provide a taster of the research strengths of their works, and provide delegates with a reference point for networking and initiating critical debate. With such wide-ranging topics being showcased, we encourage you to exploit this great opportunity to engage with researchers working in different subject areas to your own. To meet global challenges, high impact research inevitably requires interdisciplinary collaboration. This is recognised by all major research funders. Therefore engaging with the work of others and forging collaborations across subject areas is an essential skill for the next generation of researchers

The Clinical Nurse Leader as Outcomes Manager: Optimizing Screening Mammography in an Outpatient Breast Center

The Clinical Nurse Leader as Outcomes Manager: Optimizing Screening Mammography in an Outpatient Breast Center Abstract This clinical nurse leader (CNL) practice improvement project was conducted in an outpatient breast center that is part of a community safety-net hospital. The patient population consists of a large proportion of disadvantaged, low income, low English literacy, and high-risk women over 445 years of age. Recent observations and baseline data from the breast center and the mobile mammography van indicated that five to eight radiologic views were taken during a routine mammogram in a subset of screening patients which exceeds the standard set of four views (craniocaudal and mediolateral oblique views). Additional mammographic images can waste resources, expose patients to unnecessary radiation, decrease patient satisfaction, and inhibit efficient workflow. A root cause analysis further revealed there was a lack of consistency in positioning techniques and an opportunity for improvement in technologist education and training. The objectives of this project were to create a long-term teaching and learning plan to help technologists identify their individual learning needs, address challenges related to knowledge and skills, reduce unnecessary film images, and promote optimal screening mammography. An integrated interprofessional training program plan (including one mammography screening case review and feedback session with a breast imaging radiologist) was introduced to the outpatient breast center. Comparative data on the number of routine screening mammographic views were collected and analyzed one week after the training session. A post-meeting evaluation questionnaire was also conducted to collect attendees’ feedback on this activity. Results showed there was a 10% decrease in additional screening mammographic views over a 7-day period post-training. Technologists also experienced high overall satisfaction with this training activity. Consistent and standardized film images are crucial for radiologist interpretation and quality assurance. By teaching enhanced mammography positioning techniques, better images can be achieved by the technologists, as well as increasing the positive predictive value of mammography and ensuring quality for all patients

Computer-aided detection (CAD) tool design for chest pattern recognition training of radiographers

Abstract : The technological advances in radiography, along with the increasing role played by radiographers, require a shift in the training of radiographers at undergraduate level. One of the major shifts has been in the use of technology for learning, teaching and assessment (LTA) which plays an important role in the development of both explicit and implicit knowledge. There has thus been increased interest in the use of technology-enhanced learning, teaching and assessment (TELTA) in radiography education. One of the approaches to the use of TELTA has been the implementation of various virtual tools, including computer-aided detection (CAD) tools. The aim of this exploratory design science research (DSR) study was to design a CAD tool for training student radiographers in chest pattern recognition, followed by the evaluation thereof and exploration of the students experience of the CAD tool. The study employed the DSR methodology which was implemented in five phases: a) awareness of the problem, b) suggestion, c) development, d) evaluation and e) conclusion. The CAD tool (artefact) was designed using Microsoft Visual Studio which operates on the Structured Query Language (SQL) server. The artefact was then evaluated using a combination of quantitative and qualitative approaches. The designed artefact could not be tested for usability with the students as originally intended because of a few technical challenges. The System Usability Scale (SUS) was used to quantitatively evaluate the artefact and revealed that the artefact had an average score of 70.1, exceeding the score of 68 which is generally accepted to indicate that the artefact has good usability. The qualitative evaluation revealed that the artefact was designed adequately while identifying the limitations that prevented the version of the software to be implemented for wider usage. The study only addressed two out of the four objectives that were originally planned for the study. The objectives that were realised were the actual design of the artefact and the evaluation of its usability including its ability to allow timeous communication (and feedback) between the instructor and the students. The two objectives that were planned for exploring how the students experience the artefact and if it enhances their implicit skills, were not realised. In retrospect, the original study plan was over ambitious to have set four objectives to be achieved within a limited period of time.D.Tech. (Radiography