[Imaging of non-traumatic spinal diseases in children]. / Bildgebung nichttraumatischer erkrankungen der kindlichen wirbelsäule.

Pain is also the main symptom of spinal diseases in children. The younger the child, the more frequently organic causes are to be found, whereas in adolescents functional dorsalgia and lumbalgia are ubiquitous. Apart from the neonatal period, where ultrasound is used as the primary method for investigation of closed spinal dysraphia, radiography is still considered to be the first choice examination, which nevertheless should only be carried out after a thorough anamnesis and clinical examination. For targeted follow-up and especially exclusion of neoplasms, MRI is the method of choice in most cases. Computed tomography (CT) plays an important role preoperatively and postoperatively in corrective spine surgery and together with scintigraphy in the diagnostics of spondylolysis and some tumors such as osteoid osteoma. Important is the care of children with hereditary spinal malformations, especially dysraphias where the entire CNS may be affected as with the common association of myelomeningocele and Chiari II malformation with hydrocephalus and hydromyalia.

[Referral guidelines in diagnostic imaging]. / Uberweisungsleitlinien in der bildgebenden Diagnostik.

This article describes the causes and motivations for the introduction of referral guidelines for diagnostic radiology. Guidelines are not intended to serve as directives, but as a concept for good practice and as a basis for discussion and communication between prescribers and practitioners of radiological examinations. Although not all questions about the most effective way of implementation have been solved, it has been shown that referral guidelines serve as a means of avoiding unnecessary x-ray examinations and therefore represent an important tool within a comprehensive concept of radiation protection.

[Radiofrequency-thermoablation in malignant liver disease]. / Radiofrequenz-Thermoablation maligner Raumforderungen der Leber.

The clinical application of radiofrequency tumor ablation in primary liver tumors and metastatic liver disease is rapidly growing because this technique has proven to be simple, safe, and effective in first clinical studies. Most of the patients with malignant liver disease are not candidates for surgical resection due to localisation or comorbidity, so radiofrequency therapy offers a good alternative for inoperable patients. With this method, high frequency alternating current is delivered to tissue via a needle electrode, the produced heat leads to coagulation necrosis. The largest focus of necrosis that can be induced with the currently available systems is approximately 4 - 5 cm with a single application. The radiofrequency needle is usually placed with US or CT guidance. For follow up examinations CT and MRI can be used, they proved to be equally accurate in the assessment of treatment response.

[Teleconsultation 2001--report of the Teleconsultation Study Circle of the Austrian Roentgen Society (ORG)]. / Telekonsultation 2001--Bericht des Arbeitskreises Telekonsultation der Osterreichischen Röntgengesellschaft (ORG).

In 1997, the working group "Teleconsultation" of the Austrian Roentgen Society (ORG) has performed a first survey about the status of teleradiological applications in Austria. Now, in 2001, a second survey was performed in order to adapt the ORG's approach in this field to the most actual needs. Most of the 38 teleradiological projects in Austria already working or shortly before inauguration are aiming at an improvement of the medical service in favour of our patients (expert consultation, image transfer to doctors requesting radiological examinations, clinical case discussion). However, a small but not unimportant fraction of teleradiology projects in Austria (11%) is performed for replacement of radiologists on duty, therefore for reasons mainly directed to minimising costs for the hospital administration. Other purposes of teleradiology projects, like quality assurance and medical education have even lost their small importance the 1997 survey already has shown. This paper discusses the professional implications from the results of the 2001 survey and the legal framework for the application of telecommunication in diagnostic radiology. The most important goal of all professional activities in radiology is the well-being of our patients, based on the immediacy of the medical profession in accordance with the "physician law".

[Digital radiology]. / Digitale Radiologie.

Digital radiology is the integration of established and new digital imaging modalities into a system which enables the filmless communication of radiological information. It is becoming an indispensable tool in daily medical practice, and yields improved, faster medical communication, reduces the patient's dose and saves 307 307 archivation costs. Some knowledge of the inherent features of digital images and some open-mindedness for a change in viewing and workflow habits is necessary to make full profit of these possibilities. This paper describes digital radiography and the aspects of radiological networking based on 5 years experience with one of the very first filmless radiology departments worldwide.

Conventional film-screen versus computed storage phosphor radiography. Simulated miliary lung disease in an anthropomorphic phantom.

RATIONALE AND OBJECTIVES: In this experimental study, the authors examined whether laser printed hardcopies from digital storage phosphor radiographs yield diagnostic performance equal to conventional film-screen radiographs in the detection of simulated miliary disease, using a standardized object. METHODS: A commercially available anthropomorphic chest phantom was used for radiographic evaluation. Miliary disease was simulated by superimposing one to four sheets of millet seeds on the lungs, resembling a miliary disease pattern with varying degrees of detectability. An observer study (receiver-operating characteristic) with eight radiologists was conducted to compare the reader performance using hardcopies of computed storage phosphor radiography versus the conventional film-screen system, optimized for chest x-rays. The digitally generated images were presented as a double-image hardcopy, with a conventionally adopted version and an edge enhanced image version. RESULTS: When analyzed separately, one out of the eight observers performed slightly better using the conventional films. When treated as a group, analysis of the areas under the receiver-operating characteristic curves demonstrated no significant difference in reader performance for each of the systems under investigation (t = 0.286). The Wilcoxon test could not prove a statistical difference. CONCLUSION: Storage phosphor technology is a method that yields equal diagnostic performance as conventional film in evaluating miliary disease of the chest.

[Findings of digital intensive or bed lung radiographs at the monitor vs. hard copy: a clinical ROC study]. / Befundung von digitalen Intensiv- bzw. Bettlungenaufnahmen am Monitor vs. Hardcopy: eine klinische ROC-Studie.

45 bedside chest examinations acquired with storage phosphorus radiography, were displayed on a viewing box as single-format hard copies and at a high-performance digital reporting console. 6 observers performed an ROC study. For the pathologies under question, significantly better results were shown in monitor reporting due to pneumonic infiltration whereas no significant differences were found for pulmonary or mediastinal masses, or for pneumothoraces.