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Biomedical subjects

C Pistitsch

Publications and source records attributed to C Pistitsch.

9 recordsLinked to original sources
PubMed1999

Usefulness of morphological characteristics for the differentiation of benign from malignant solitary pulmonary lesions using HRCT.

The aim of this study was to analyze different characteristics on high-resolution computed tomography (HRCT) that help differentiate benign solitary pulmonary lesions (BSPLs) from malignant solitary pulmonary lesions (MSPLs). High-resolution computed tomography was performed on 104 consecutive patients with SPLs. The whole lesion was examined with a slice thickness of 1 mm and a 12-cm field of view. All lesions were surgically excised within 24 h of the CT examination. Satellite nodules, cavitations, and necrosis were found only in MSPLs. Useful characteristics for the differentiation of BSPLs from MSPLs were the presence of spicules (p < 0.00005), spicules extending to the visceral pleura (p < 0.0005), the vessel sign (p < 0.0005), pleural retraction (p < 0.001), circumscribed pleural thickening (p < 0.001), the bronchus sign (p < 0.005), the presence of ground-glass attenuation adjacent to the SPL (p < 0.01), the density of the lesion (p < 0.05), and the length of spicules (p < 0.05). Using the significant characteristics p < 0.01 for the identification of MSPLs, a sensitivity of 91.4 % and a specificity of 56.5 % (accuracy of 83.7 %) was found. A precise morphological assessment of the periphery of the pulmonary lesion is necessary. The HRCT technique is useful in differentiation of BSPLs from MSPLs. However, metastases strongly resembled benign lesions in terms of size and edge type, and chronic inflammatory pseudotumors as a group mimic MSPLs.

Biopsy, Needle↗
PubMed1999

Functional requirements for a HIS-RIS-PACS-interface design, including integration of "old" modalities.

Radiology, Information Systems (RIS) and Picture Archiving Systems (PACS), have the potential for immense rationalization of operations in radiology and hence for the improvement of health care, as well as the return of investments. These systems must, however, be carefully designed such that they support routine work rather than being an additional burden to radiology staff. Analyses show that comprehensive communication of patient demographic and clinical data between RIS, PACS and Hospital Information Systems (HIS) are necessary prerequisites to achieve cost effectiveness. Based on analyses of radiology operations in a large university primary care hospital, functional requirements and data structures for designing HIS/RIS/PACS interfaces are presented. These concern communication of past examinations, associated written reports and images, appointment scheduling, requests of new examinations, digitizing old analog X-ray films, access from RIS/PACS to other clinical data, and transfer of new radiology reports and relevant images. Consistency of all redundant data stored in the three systems is essential. A pragmatic, safe and inexpensive method of electronically integrating "old" modalities not fully "PACS capable" in the HIS/RIS/PACS world is presented.

Germany↗
PubMed1998

A comparison of digital luminescence mammography and conventional film - screen system: preliminary results of clinical evaluation.

The objective of this study was to determine if digital luminescence mammography can be used as a diagnostic tool. We investigated twenty-two patients with mammographically suspicious findings using a conventional film-screen system and a digital phosphor storage plate in order to compare these two techniques. Four radiologists experienced in mammography reviewed each pair of images. Our results indicate that detectability of microcalcifications and solid masses with digital systems is superior to conventional film-screen mammography due to the increased contrast enhancement associated with digital systems. We did, however, find that characterization of morphological details is inferior with the digital system, presumably due to reduced spatial resolution. In addition, we found no statistically significant difference in the differentiation of benign from malignant lesions with both techniques. The accuracy of mammographic diagnosis was investigated in a receiver operating characteristic study and similar values were found with both techniques. Our results indicate that digital mammography will become an acceptable diagnostic tool although improvement, especially in spatial resolution, is desirable.

Aged↗
PubMed1998

[A comparison of the monitor and alternator findings of digital thoracic images with the aid of a computer-supported procedure].

PURPOSE: To compare softcopy and hardcopy reading of chest radiographs a software tool was designed for creating lesions with clearly defined size, location and contrast. METHOD: An ROC study was performed using a set of chest radiographs with 300 simulated small nodules and linear details displayed on film and on a 1 K monitor. Six observers participated in the study. ROC curves were generated on the basis of 7200 decisions. RESULTS: There was no significant difference in observer performance overall (AUC = Area under curve). Monitor: 0.84 +/- 0.08 vs. AUC, Film: 0.84 +/- 0.08). Slight, but not statistical significant differences were found in the detection of low-contrast lung nodules and of linear lung details. CONCLUSION: Soft-copy reading using a high quality 1 K CRT display provides the same accuracy for the detection of subtle computer-simulated lesions as hardcopy reading. A software tool could be used for assigning optimal characteristics of CRT- and hardcopy displays using clearly defined lesions as a gold standard.

Computer Simulation↗
PubMed1998

[The filmless hospital--a legal challenge].

PURPOSE: This article concerns the legal aspects of digital archiving of radiological images, in particular with regard to the resolution passed by the 37th Committee meeting of the Federal Board of "RöV" (x-ray ordinance). Concepts of filmless hospitals must therefore be tested for compliance with all present legal requirements. MATERIAL AND METHODS: The literature concerning the legal aspects of digital medical archiving of x-ray documents is reviewed. The concept of a digital archive was compared with these aspects and tested for compliance with the respective legal rules. RESULTS: There are no legal obstacles to realizing our concept of a filmless hospital. However, there are no civil court rulings on record, since there have not been any legal proceedings to date. CONCLUSIONS: There are no legal objections to a complete digital archiving in a hospital in the absence of any court rulings to the contrary.

Confidentiality↗
PubMed1998

[Magnetic resonance tomography in plasmacytoma: ranking of various sequences in diffuse and focal infiltration patterns].

PURPOSE: The aim of this study was to compare various pulse-sequences employing the spine array coil while considering the different infiltration patterns in multiple myeloma, in order to develop a fast and cost effective screening method. MATERIALS AND METHODS: In a prospective study, 50 patients with histologically proven multiple myeloma were examined with the following standardised sequences: T1-weighted SE, T2-weighted FSE, opposed phase GRE, FSE STIR, T1-weighted SE post gadopentate dimeglumine without and with fat saturation. The images were evaluated in a ROC analysis by three radiologists in consensus with a 5-grade scale separatively for diffuse and focal involvement. The gold standard was bone marrow histology in cases of diffuse infiltration and the combination of all sequences with the staging system according to Durie and Salmon. RESULTS: For focal bone marrow involvement the area under curve was greatest for FSE STIR sequences, in cases of diffuse infiltration the area under curve was superior for unenhanced T1-w SE-Sequenz images. The sensitivity can be increased by contrast material application and signal intensity measurements. A combined focal and diffuse infiltration and a "salt and pepper" pattern can be diagnosed with the combination of T1-w SE-Sequenz and FSE STIR sequences. CONCLUSION: With T1-weighted SE-Sequenz sequences pre- and post-contrast and FSE STIR all therapeutical relevant infiltration patterns of plasmocytoma can be identified and bone marrow screening of the spine can be carried out with an acquisition time of 5.58 minutes.

Adult↗
PubMed1996

[Digital radiography. Cost-benefit analysis].

Due to its high dynamic range and contrast discernibility, digital radiography offers substantial advantages compared with conventional film-screen systems. Moreover, further advantages can be assumed for radiation protection. Digital radiography also allows conventional image data to be included in PACS (Picture Archiving Communication System). These well-known advantages are faced with legal questions which are not yet settled. Cost effectiveness in using systems of digital radiography and PACS are also under discussion. By means of examining economic efficiency and cost analysis of digital radiography systems, economic effectiveness was assessed. This was also compared with conventional alternatives. As a result, it may be assumed that amortization is reached in three to four years. Based on lower costs for films, digital systems are more cost effective than conventional systems after this period.

Cost-Benefit Analysis↗