Review of radiological screening programmes for breast, lung and pancreatic malignancy.

The premise of medical screening is to identify clinically occult disease, facilitating intervention at an early stage with the intention of improving prognosis. Identifying solid organ malignancy before nodal or distal metastases have occurred unanimously offers the best chance of successful radical treatment, thus there is clearly a potential significant mortality benefit for successful oncological screening programmes. However, the negative consequences of screening have to be considered, particularly the impact of intervening in asymptomatic populations. Diagnostic radiology has an invaluable ability to non-invasively detect disease and has developed an essential role in several oncological screening programmes with new programmes emerging. These include the established mammography screening programme for breast carcinoma, the emerging CT screening programme for lung carcinoma and a new proposed radiological screening programme for pancreatic carcinoma. Results from published randomized controlled trials analysing the benefits of radiological screening have been convoluted and conflicting. Cancer screening remains a widely contested topic and it is a challenge for both radiologist and clinician to assess the risks and benefits at both a population and individual patient level. In this article, we discuss radiological screening and analyse the current literature on these programmes, with evaluation of recently published studies and ongoing trials.

Computed tomography in congenital heart disease: how generic principles can be applied to create bespoke protocols in the Fontan circuit.

Cardiac computed tomography (CCT) has become an invaluable cross-sectional imaging modality in congenital heart disease (CHD) patients. However, altered anatomical connections and cardiovascular physiology makes CHD arguably the most challenging area in CCT imaging, which remains a complimentary modality to cardiac magnetic resonance and echocardiography. A bespoke CT protocol is often required to achieve a diagnostic examination; this can be achieved through careful consideration of the basic principles of image acquisition and contrast administration. This article reviews these principles and demonstrates how they can be applied to CCT in CHD using the Fontan circulation as an example.

Characteristics and trends in publication of scientific papers presented at the European Congress of Radiology: a comparison between 2000 and 2010.

OBJECTIVE: To determine journal publication rates of scientific papers presented orally at the European Congress of Radiology (ECR) 2010, with comparison of country data to ECR 2000. METHODS: All oral presentations from ECR 2010 were evaluated for publication between 2010 and 2014 using the MEDLINE database. Countries, collaborations, subspecialties, modalities and study design were ranked by publication percentage. Chi-square tests were used to compare publication percentages for each category of variables. Hazard ratios (HR) were calculated for each country relative to the host nation, Austria. ECR 2010 country statistics were compared with analogous data from ECR 2000. RESULTS: In total, 360/840 abstracts were subsequently published (43 %). The author's country of origin (p = 0.02), subspecialty (p = 0.02) and study design (p = 0.001) were significantly associated with subsequent publication. Switzerland, the Netherlands, France and Germany were among the top six countries by publication percentage in 2000 and 2010. In 2010, Switzerland had the highest publication rate (62 %) and HR in comparison to Austria (HR 2.62 [1.31-5.25], p = 0.01). Three Asian nations increased relative publication rates over the 10-year period. CONCLUSION: Several European nations consistently convert relatively high percentages of oral abstracts at ECR into publications, and the influence of Asian countries is increasing. MAIN MESSAGES: • Certain European nations consistently publish high percentages of orally presented abstracts at ECR. • The influence of several Asian countries on ECR is increasing. • Country, subspecialty and study design are significantly associated with journal publication. • Authors collaborating internationally have the highest publication rates and mean impact factors. • Among all modalities, PET-CT, MRI and CT have the highest publication percentages.

Development of a plain radiograph requesting algorithm for patients presenting with acute abdominal pain.

Radiologists at a large teaching hospital felt that plain radiograph imaging was being performed inappropriately for patients admitted with acute abdominal pain. They felt requests were either not indicated or CT was a more appropriate first line radiological investigation in certain circumstances.An audit was performed looking at plain radiograph imaging requests for emergency admissions under general surgery, using Royal College of Radiologists (RCR) guidelines as the standard. The audit revealed that only 80% of plain radiograph requests met RCR guidelines. It also showed that 33% of acute admissions undergoing plain radiograph imaging proceeded to CT within forty-eight hours. These findings lead to the development of a plain radiograph algorithm. This aimed to improve plain radiograph imaging requests and to increase the use of CT as an earlier or first line radiological investigation where appropriate.Outcome of discussion at local and regional clinical governance meetings was that earlier CT would be useful in specific circumstances. The algorithm provides a framework for appropriately expediting CT in patients presenting with acute abdominal pain where bowel obstruction or perforation was suspected. However, consultant surgeons felt that in patients presenting with acute abdominal pain, the plain abdominal radiograph often demonstrates findings associated with specific diagnoses not specifically indicated by RCR guidelines. If RCR guidelines for plain radiograph imaging are broadened, radiological interpretation would examine for a broader range of findings and, when combined with other clinical information, diagnoses can be made, thus avoiding the need for further imaging or explorative surgery.