Current Status of Contrast Computed Tomography Examination for Diagnosing Acute Pulmonary Thromboembolism.

The purpose of this study was to identify instances of unnecessary contrast-enhanced computed tomography (CT) scans performed at the time of diagnosis in patients with pulmonary thromboembolism at the emergency department of Saiseikai Kumamoto Hospital in Kumamoto Prefecture, Japan, between April 1, 2015, and March 31, 2020. The decision criteria for unnecessary contrast-enhanced CT scans included a Wells score of low or moderate risk, a D-dimer level <1.0 µg/mL, and no shock symptoms, or a negative finding for pulmonary thromboembolism. Consequently, 27 patients were considered to have undergone unnecessary contrast-enhanced CT scans. This equated to approximately 15.6% of the study population.

[Construction and Analysis of a Digital Mammography Database: Analysis of Breast Compression Pressures at Four Facilities].

We analyzed the compression pressures in 2772 mammography images of 807 patients acquired by digital mammography equipment at four facilities. The analysis included the average compression pressure at all facilities, difference in compression pressure at each facility, differences between the pressures used by radiological technologists in the same facility, and difference attributed to the breast structure. We also analyzed the effects of the compression pressure on the breast thickness and mean glandular dose (MGD) at each facility. The median values of the compression pressure and breast thickness for the 2772 images at all facilities were 86.5 N and 43 mm, respectively. The compression pressures differed among the institutions. The maximum difference in the median pressures among the four facilities was 38.6 N, while the difference in the breast thickness was 6 mm. The radiological technologists working at the same facility used almost the same compression pressure. However, differences between the compression pressures used by different radiological technologists were observed. The compression pressure in a dense breast was smaller than that in a non-dense breast. The difference in the compression pressure affected the breast thickness and MGD. The results of this analysis could be utilized for an optimal imaging in future digital mammography.

[Image examination of malignant tumors in lungs observed on the basis of cost analysis using diagnosis procedure combination data].

Recently, the environment of medical treatment in our country has become more strict. The purpose of this study is to find changes in the implementation of diagnostic imaging from the point of view of cost analysis, through the use of diagnosis procedure combination (DPC) data. The patient data has been extracted from the DPC data. We compared patients (n=693) in terms of their daily income, cost, and image examination cost ratio for malignant tumors in lungs. The results of this study indicated the ratio of the image examination cost of 040040xx99100x was 25.2% in the old grading sheet. The ratio of the image examination cost increased 42.4% in the new grading sheet. The implementation of diagnostic imaging was able to be made visible simply by analyzing the cost. We found one of the methodologies that connected the improvement of that standard treatment with the examination of each DPC.