Assessing the image quality of brain magnetic resonance images taken with 1.5T and 3T scanners

Magnetic resonance imaging (MRI) is the ideal modality for brain imaging, as high quality anatomical detail is provided while having a higher sensitivity and specificity over other imaging modalities such as Computed Tomography (CT) (Isalm & Munir, 2019; Khan et al., 2019). MRI does not make use of ionising radiation, but acquires images in multiple planes without repositioning the patient through the generation of powerful electromagnetic fields, and radiofrequency pulses. Depending on the gradient and the number of radiofrequency pulses set, different MRI sequences are created. An MRI sequence is a series of radio-frequency pulses used to obtain a signal from the patient to produce an image of the examined area with a particular appearance (weighting) (Liang et al., 2021). [Excerpt]peer-reviewe

The initial implementation of the sentinel lymph node biopsy (SLNB) for breast cancer management in Malta

Over the past two decades, the sentinel lymph node biopsy (SLNB) based on sentinel node (SN) being the first lymph node that harbors metastases, revolutionized breast cancer management. SLNB presents much less morbidity when compared to radical axillary lymph node dissection (ALND) where all nodes are dissected irrespective of their metas-tatic involvement. The purpose of this study was to evaluate the effectiveness of SLNB by investigating whether the histological characteristics of the SNs identified using scintigraphy are predictive of the histological characteristics of the ALN basin. Methods: Fifty-five female breast cancer patients underwent lymphoscintigraphy and SLNB followed by ALND. The histological status of the SN/s was correlated to the histological status of the ALNs to determine whether the SN accurately stages the ALNs in breast cancer. Results: During surgery, SNs were successfully isolated in 52 out of 55 cases (94.5%) (range, 0 to 9). No SNs were identified in 3 cases (5.5%). Results demonstrate a significant association (p = 0.05) between the metastatic status of SNs and the corresponding ALNs in 42 out of 52 patients (80.8%), but with a high false-negative rate (FNR) of 37.5%. Conclusion: The findings of this study show that the sen-tinel node concept provides the benefits of SLNB in the majority of instances. However, further work is required in re-ducing the FNR. Once the effectiveness of SLNB as a staging technique is locally established, the need of ALND in SN-negative patients would be limited, thus improving the quality of life of Maltese breast cancer patients.peer-reviewe

Ischaemic heart disease risk scores and their applications : a systematic review

Numerous diagnostic strategies can be used on patients suspected of suffering from coronary artery disease (CAD), also referred to as ischaemic heart disease (IHD). Coronary angiography is currently still considered as the gold standard for diagnosing arterial plaques causing obstructive IHD, yet coronary angiography is invasive and costly, and may still not be able to demonstrate non-atheromatous CAD, which, although rare, may still occur in the younger age group. Since the overall risk of IHD is made up of a number of multiple risk factors several risk assessment tools may be used to try and estimate the risk of this pathology within the different age groups.peer-reviewe

The role of radiographers in nuclear medicine; the link between patient and technology

Recently, Slart and de Geus‑Oei published an editorial entitled: A new colleague in nuclear medicine, the clinical technologist: quo vadis? [1]. The authors describe how the new healthcare profession, clinical technologists, contributes to the field of nuclear medicine with a position between the physicist and the physician in the healthcare sector in the Netherlands. Furthermore, the editorial emphasizes how the clinical technologist plays a role in developing molecular imaging, dosimetry, and radionuclide therapy in a multidisciplinary environment.info:eu-repo/semantics/publishedVersio

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially