Data management solution for large-volume computed tomography in an existing picture archiving and communication system (PACS).

Multidetector row computed tomography (MDCT) creates massive amounts of data, which can overload a picture archiving and communication system (PACS). To solve this problem, we designed a new data storage and image interpretation system in an existing PACS. Two MDCT image datasets, a thick- and a thin-section dataset, and a single-detector CT thick-section dataset were reconstructed. The thin-section dataset was archived in existing PACS disk space reserved for temporary storage, and the system overwrote the source data to preserve available disk space. The thick-section datasets were archived permanently. Multiplanar reformation (MPR) images were reconstructed from the stored thin-section datasets on the PACS workstation. In regular interpretations by eight radiologists during the same week, the volume of images and the times taken for interpretation of thick-section images with (246 CT examinations) or without (170 CT examinations) thin-section images were recorded, and the diagnostic usefulness of the thin-section images was evaluated. Thin-section datasets and MPR images were used in 79% and 18% of cases, respectively. The radiologists' assessments of this system were useful, though the volume of images and times taken to archive, retrieve, and interpret thick-section images together with thin-section images were significantly greater than the times taken without thin-section images. The limitations were compensated for by the usefulness of thin-section images. This data storage and image interpretation system improves the storage and availability of the thin-section datasets of MDCT and can prevent overloading problems in an existing PACS for the moment.

Buccal mucosal cancer patient who failed to recover taste acuity after partial oral cavity irradiation.

PURPOSE: We report a patient who suffered from prolonged loss of taste acuity after partial oral cavity irradiation. METHODS: The electric taste threshold (ETT) of each point in the oral cavity was measured with an electric gustometer to evaluate quantitative local taste acuity. A subjective total taste acuity (STTA) scale was used to evaluate subjective total taste acuity. CASE: A 61-year-old male patient with right buccal mucosal cancer underwent radiation therapy more than 11 years ago, and has suffered from loss of taste acuity since then. He received electron beam irradiation to part of the oral cavity and right upper neck, mainly the right buccal mucosa near the retromolar trigone and a metastatic right submandibular node. He did not receive irradiation to the anterior portion of the tongue or left side of the posterior portion of the tongue. His ETT scores for each point were equal to or greater than 26, and his STTA score was grade 3. CONCLUSION: The present case implies that radiation damage to part of the oral cavity can cause the loss of subjective total taste acuity.

CT Findings in Pediatric Novel Influenza A (H1N1)-Associated Pneumonia.

OBJECTIVE: To explore CT findings in pediatric novel influenza A (H1N1)-associated pneumonia METHODS: We examined the CT findings in a series of six children with influenza H1N1-associated pneumonia. FINDINGS: In this series of cases, the predominant CT patterns were consolidations surrounded by ground glass opacities (GGOs) as well as isolated GGOs in all patients. Atelectasis was present in the right upper lobe (n=2) in three cases and pneumomediastinum in two. CONCLUSION: In this series of cases, there may be no imaging differences between pediatric and reported adult influenza H1N1 cases and other viral pneumonia cases even with CT. Pneumomediastinum and atelectasis, especially in the right upper lobe, may frequently present in influenza H1N1-associated pneumonia as well as in other pediatric respiratory diseases.

Adverse allergic reaction to 131I MIBG.

No adverse allergic reactions to iodine-131-metaiodobenzylguanidine ((131)I MIBG) at a diagnostic dose have been reported in the English literature. This report of a skin eruption in a 35-year-old man after an intravenous injection of (131)I MIBG strongly suggests an adverse allergic reaction, and is the first to address such a side effect of (131)I MIBG at a diagnostic dose. Erythematous maculopapular eruptions, some of which were contiguous, were seen in a symmetric disposition on the patient's chest walls, elbows, neck and face 18 h after the (131)I MIBG injection. Antiallergic treatment resolved the lesions completely. There were no possible causes of the exanthema other than the (131)I MIBG injection. Urticaria related to the (131)I MIBG injection and caused by type I allergic reaction was suspected, and these findings point to the possible risk of a hitherto unreported allergic skin reaction to (131)I MIBG. We would like to draw the attention of nuclear physicians to this possible drawback of (131)I MIBG.