RESUMEN
In patients presenting for an evaluation of pregnancy in the first trimester, transvaginal ultrasound is the modality of choice for establishing the presence of an intrauterine pregnancy; evaluating pregnancy viability, gestational age, and multiplicity; detecting pregnancy-related complications; and diagnosing ectopic pregnancy. In this pictorial review article, the sonographic appearance of a normal intrauterine gestation and the most common complications of pregnancy in the first trimester in the acute setting are discussed.
RESUMEN
Computed tomography (CT) is an indispensable part of diagnostic imaging and contributes significantly to patient care. With increasing use of CT, there have been growing concerns regarding risks from radiation exposure. This has prompted efforts to introduce measures to optimize the radiation dose used in CT imaging. The Dose Index Registry (DIR) was launched by the American College of Radiology (ACR) in 2011. It provides a national database of radiation dose indices for various CT examinations performed at participating institutions. It affords an opportunity for institutions to compare and tailor their CT protocols against existing national averages. In this article, we review the history, mechanism, and major elements of the DIR. We also briefly discuss similar radiation dose registries in other countries.
Asunto(s)
Guías de Práctica Clínica como Asunto , Dosis de Radiación , Sistema de Registros/estadística & datos numéricos , Sociedades Médicas , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Humanos , Estados UnidosRESUMEN
Recent studies have supported the use of low-dose computed tomography (LDCT) of the chest as a screening tool for lung cancer. Several professional organizations have now included LDCT screening in high-risk populations in their guidelines. The United States Preventive Services Task Force has added LDCT to its lung cancer-screening guidelines as of December 2013. Recently, the Centers for Medicare and Medicaid Services acknowledged that the evidence for LDCT lung cancer screening is adequate, provided that eligibility criteria are met. As widespread use of LDCT is anticipated, the radiation dose associated with LDCT needs to be optimized. The American College of Radiology-Society of Thoracic Radiology collaboration and the National Comprehensive Cancer Care Network recently provided some guidelines for LDCT utilization for lung cancer screening. There are several scanning and image reconstruction techniques that can be used for reducing radiation dose in LDCT lung cancer screening. This review article presents protocols and guidelines for use of LDCT in lung cancer screening and describes our early experience in implementing LDCT at our institution.
Asunto(s)
Detección Precoz del Cáncer/métodos , Neoplasias Pulmonares/diagnóstico por imagen , Tamizaje Masivo/métodos , Guías de Práctica Clínica como Asunto , Dosis de Radiación , Radiografía Torácica/métodos , Tomografía Computarizada por Rayos X/métodos , Humanos , Neoplasias Pulmonares/epidemiología , Estados Unidos/epidemiologíaRESUMEN
In the initial installment of this 3-part article, we reviewed the role and logistics of the American College of Radiology (ACR) Dose Index Registry (DIR). In this second installment, we review the essential components of ACR DIR and describe how users can interpret their biannual dose reports by benchmarking them against regional or national levels. Understanding these reports can help participating institutions to identify specific protocols or practices that may benefit from changes in order to minimize patient dose while maintaining diagnostic quality examinations.
