Clinical value of prostate health index as an indicator for recommending magnetic resonance imaging in patients with gray-zone prostate-specific antigen level.

PURPOSE: To evaluate the usefulness of prostate health index (PHI) as an indicator for recommending magnetic resonance imaging (MRI) in patients with prostate-specific antigen (PSA) gray zone level < 10 ng/mL. METHODS: 443 patients who underwent prostate biopsy (PB) after serum PHI test and MRI between April 2019 and December 2022 were enrolled. For patients with visible lesion on MRI with Prostate Imaging Reporting and Data System Score (PI-RADS) ≥ 3, MRI-targeted PB was performed in addition to systematic 12-core PB. RESULTS: The optimal cutoff value of PHI for predicting PI-RADS ≥ 3 lesions was 39.6, which was significantly associated with overall prostate cancer (OR 3.07, p = 0.018) and clinically significant prostate cancer (csPCa) (OR 4.15, p = 0.006) at MRI-targeted PB cores. When MRI was restricted to patients with PHI ≥ 39.6 alone, 28.7% of unnecessary MRI could be saved at the cost of missing 13.6% of csPCa. When omitting MRI for patients with PHI < 39.6 and PSAD < 0.12 ng/mL2, unnecessary MRI could be reduced by 20.1% with the risk of missing 6.2% of csPCa. With addition of systematic PB, 21.0% of patients with negative MRI-targeted PB were diagnosed as csPCa. CONCLUSIONS: For patients in PSA gray zone, PHI of 39.6 might be an indicator for MRI and further MRI-targeted PB in additional to PSAD of 0.12 ng/mL2, reducing 20.1% of unnecessary MRI with the minimal risk of missing 6.2% of csPCa. To maximize csPCa detection, combining both MRI-targeted and systematic PB should be also considered.

Development and impact of radio-frequency identification-based workflow management in health promotion center: using interrupted time-series analysis.

Radio-frequency identification (RFID) technology is being used increasingly for its efficiency and safety. The goal of this study is to evaluate the RFID technology within a hospital information system (HIS) for better workflow management in a health promotion center. We developed an RFID (433 mHz) real-time tracking system to monitor patients at the room level. Then we implemented an automatic workflow management by integrating RFID system with HIS. If a patient has finished one examination, the next step is determined automatically by previous number of examined patients and duration in each examination room. We performed interrupted time-series analysis of the mean waiting time for patients in a health promotion center compared with a control group of outpatients in the hospital's radiology department before and after the implementation of an RFID-based system. After implementation of the RFID system, the mean waiting time of patients in the health promotion center decreased significantly (from 5.4 to 4.3 min, 20% decrease) compared with the control group (from 3.8 to 3.5 min, 8% decrease). The RFID system integrated with HIS increases workflow efficiency by shortening the mean waiting time during the workflow process and provides valuable real-time data for physicians and staff regarding workflow efficiency.

Quantitative assessment of fetal bowel echogenicity: comparison of harmonic, compound, and fundamental sonographic images.

PURPOSE: The aims of this study were to assess normal fetal bowel echogenicity quantitatively and to compare the levels of bowel echogenicity observed with the use of 3 different sonographic image-processing techniques-harmonic plus compound imaging, harmonic imaging alone, and fundamental imaging-and 2 different broadband transducers. METHODS: Women with normal singleton second-trimester fetuses underwent sonographic scanning with both a 2-5-MHz and a 4-7-MHz transducer. The use of the 3 imaging techniques and the 2 transducers resulted in 6 types of images: 2-5-HC (harmonic plus compound images), 2-5-H (harmonic images), and 2-5-F (fundamental images), and 4-7-HC, 4-7-H, and 4-7-F images. The relative echogenicities (brightness) of the fetal bowel and iliac bone were measured, and bowel echogenicity ratios (bowel echogenicity/iliac bone echogenicity x 100) were calculated using graphics software. The resulting data were analyzed to evaluate differences in echogenicity ratios between the 6 types of images. RESULTS: We examined 37 fetuses during the study period. The bowel echogenicity ratios were highest on the images obtained with harmonic and compound-imaging techniques (2-5-HC, 84.7 +/- 23.4%; 4-7-HC, 98.5 +/- 36.4%). The bowel echogenicity ratio for the 2-5-HC images was significantly higher than those for the 2-5-H and the 2-5-F images (p < 0.01 and p < 0.001, respectively), and those for the 4-7-HC and 4-7-H images were higher than that for the 4-7-F images (p < 0.01 for both comparisons). CONCLUSIONS: A sonographic finding of echogenic fetal bowel should be interpreted cautiously because the use of special image-processing techniques can artificially enhance the apparent level of echogenicity of the bowel. We recommend rescanning without the use of those techniques if the fetal bowel appears to have an increased level of echogenicity.