Typical values of z-resolution for different Digital Breast Tomosynthesis systems evaluated in a multicenter study.

PURPOSE: The aim of the present study, conducted by a working group of the Italian Association of Medical Physics (AIFM), was to define typical z-resolution values for different digital breast tomosynthesis (DBT) models to be used as a reference for quality control (QC). Currently, there are no typical values published in internationally agreed QC protocols. METHODS: To characterize the z-resolution of the DBT models, the full width at half maximum (FWHM) of the artifact spread function (ASF), a technical parameter that quantifies the signal intensity of a detail along reconstructed planes, was analyzed. Five different commercial phantoms, CIRS Model 011, CIRS Model 015, Modular DBT phantom, Pixmam 3-D, and Tomophan, were evaluated on reconstructed DBT images and 82 DBT systems (6 vendors, 9 models) in use at 39 centers in Italy were involved. RESULTS: The ASF was found to be dependent on the detail size, the DBT angular acquisition range, the reconstruction algorithm and applied image processing. In particular, a progressively greater signal spread was observed as the detail size increased and the acquisition angle decreased. However, a clear correlation between signal spread and angular range width was not observed due to the different signal reconstruction and image processing strategies implemented in the algorithms developed by the vendors studied. CONCLUSIONS: The analysis led to the identification of typical z-resolution values for different DBT model-phantom configurations that could be used as a reference during a QC program.

[Management of gastrointestinal bleeding in Veneto Region, Italy]. / Gestione delle emorragie digestive nella Regione Veneto.

Gastrointestinal bleeding (GB) is still a common medical emergency and an important cause of morbidity and mortality. There is clear evidence that early endoscopic intervention is effective in reducing mortality, length of stay and surgery procedures utilization in high-risk patients. In the last decades advances in medical practice and in endoscopic technology have influenced the management of GB, but their impact on the incidence and mortality is unclear. The aim of this study was to evaluate retrospectively time trends (2000-2007) in GB hospitalizations and in-hospital mortality, and describe the organization of endoscopic services of Veneto region, Italy. Data were collected from regional database of hospital discharge from 2000 to 2007 and all patients with an ICD 9-CM discharge diagnosis of GB were included. Overall hospitalization and in-hospital mortality rates were respectively 99.3 and 4.5 per 100.000 inh./year, the last being related to older age. Surgery procedures utilization was 5%. Hospitalization and mortality rates decreased significantly over years, probably owing to advances in the acute management of GB, principally represented by endoscopic procedures.

[Acute pancreatitis hospitalization in Veneto Region, Italy]. / Ospedalizzazioni per pancreatite acuta nella Regione Veneto.

The incidence rate of acute pancreatitis (AP) has been reported as having increased during recent decades and associated mortality lies around 10%. This study was undertaken to establish the current AP hospitalization and mortality rates in Veneto Region. A retrospective study of all cases of acute pancreatitis admitted in hospital between 2000 and 2007 was carried out in all Veneto population. Data concerning patients discharged with a diagnosis of acute pancreatitis (ICD 9-CM code: 577.0) were obtained from the Regional data warehouse and analysed on a computer database. Altogether 11,685 discharges for AP were recorded; median age of the patients was 61.6 +/- 20.3 years. The mean annual AP hospitalization rate was 30.6 per 100,000 and in-hospital annual mortality rate (death from all causes) was 1.1 per 100,000 population. Hospitalization and mortality rates were larger in older and increased sharply with age. Hospital admissions for AP rose from 29.3 in 2000 to 32.2 per 100,000 population in 2007 without significative variations in mortality rate probably due to the increase of effectiveness and quality of care. The AP hospitalization rate in Veneto population is comparable to what has been found elsewhere in Italy and AP remains an increasing disease with high mortality.

[Feasibility of week surgery model in general surgery]. / Week surgery in Chirurgia generale: applicabilità del modello.

Progress in medical technology and the research in cost-effectiveness have provided an implementation on new general surgery models. Week Surgery model is a maximum 5 days stay surgical unit which represents an important contribution to surgical therapeutic strategies, allowing an excellent compromise between safety, convenience for the patient and economic savings for health care structures. This model represent an excellent compromise between elective and emergency care and thus allow to improve patients flow across the week, a most efficient bed utilisation and reallocating hospital workloads. With the aim of testing the feasibility of the application of Week Surgery model was carried out a seven-years retrospective study (2000-2006) among Veneto Region public hospitals. Results suggest that week surgery model can be considered a valid and achievable alternative organisation compared to conventional hospitalization: 61% of patient undenrwent elective surgery were discharged in less than 5 days.