Evaluation of a prospective adverse event reporting system in interventional radiology.

AIM: To assess the performance of a prospective adverse event (AE) reporting system. MATERIALS AND METHODS: Four hundred and seventy-one consecutive arterial procedures were performed in 465 patients (median age, 65 years; interquartile range, 54-77; 276 men) over 2 years by four interventional radiologists at a single centre where clinical follow-up was not performed routinely by interventional radiology (IR). AEs were reported prospectively using a radiology information system or in interventional radiologists' electronic records and combined in a departmental listing of adverse events (DLAE). A retrospective medical record review was performed to identify a reference standard list of AEs for this observational cohort study. AEs were graded according to the Society of Interventional Radiology AE classification system. Descriptive statistics were calculated for the performance of the DLAE. A model comparing the rate of reporting of AEs with and without integration of clinical follow-up was tested for significance. RESULTS: Thirty-eight of the 471 (8%) IR procedures had an AE according to the reference standard. The DLAE identified 20/38 (53%) of AEs (K=0.67 [good agreement], 95% confidence interval [CI] agreement=0.53-0.81; p=0.0001; sensitivity 52.6% [95% CI, 36-69%], specificity 100% [95% CI, 99-100%], positive predictive value [PPV] 100%, negative predictive value [NPV] 96 [95% CI, 94.5-97%], accuracy 96% [95% CI, 94-97%]). The performance of the AE reporting system will improve with integration of clinical follow-up (p=0.0015). CONCLUSION: A prospective AE reporting system without clinical integration will not detect all procedure complications.

PET imaging of subclinical seizure associated with intracranial cavernous malformations.

We present the case of a subclinical seizure identified during positron emission tomography with 18-fluorodeoxyglucose in a patient with cavernous malformations.

The use of ultrasonography and digital mammography in women under 40 years with symptomatic breast cancer: a 7-year Irish experience.

BACKGROUND: Breast cancer in women under 40 years of age is rare and typically presents symptomatically. The optimal imaging modality for this patient group is controversial. Most women undergo ultrasonography with/without mammography. Young women typically have dense breasts, which can obscure the features of malignancy on film mammography, however, initial studies have suggested that digital mammography may have a more accurate diagnostic performance in younger women. Ultrasound generally performs well in this age group, although it is poor at detecting carcinoma in situ (DCIS). AIMS: To evaluate the comparative diagnostic performance of ultrasonography and digital mammography in the initial diagnostic evaluation of women under 40 years of age with symptomatic breast cancer. METHODS: Retrospective review of all women under the age of 40 years managed at our symptomatic breast cancer unit from January 2009 to December 2015. RESULTS: There were 120 patients that met the inclusion criteria for this study. The sensitivity of ultrasonography and digital mammography for breast cancer in this patient group was 95.8 and 87.5 %, respectively. The patients with a false negative mammographic examination were more likely to have dense breasts (p < 0.01). Five patients had a false negative ultrasonographic examination, withal of whom were diagnosed with DCIS detected by mammography. CONCLUSION: This study demonstrates the superior sensitivity of ultrasound for breast cancer in women under the age of 40 years, however, the results show that digital mammography has an important complimentary role in the comprehensive assessment of these patients, particularly in the diagnosis of DCIS.

Minimally Invasive Diagnosis of Secondary Intracranial Lymphoma.

Diffuse large B cell lymphomas (DLBCL) are an aggressive group of non-Hodgkin lymphoid malignancies which have diverse presentation and can have high mortality. Central nervous system relapse is rare but has poor survival. We present the diagnosis of primary mandibular DLBCL and a unique minimally invasive diagnosis of secondary intracranial recurrence. This case highlights the manifold radiological contributions to the diagnosis and management of lymphoma.

Oncogenic transformation and the reductions of insulin secretion and proliferative calcium dependence during repeated passage of pancreatic islet cells in vitro.

Islet cells were isolated from 2 fetal bovine pancreas glands and cultivated in vitro. During the course of repeated passage in vitro, the B-cells in these cultures retained the ability to synthesize insulin, but rapidly lost the ability to secrete it. The cells also became progressively more able to proliferate in calcium-deficient medium which did not support the proliferation of cells from primary cultures. The reductions of insulin secretion and proliferative calcium dependence were accompanied by the acquisition of the ability to produce tumors in nude mice.