Diagnostic imaging in developing countries: considerations for improvement.
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Biomedical subjects
Publications and source records attributed to V Volodin.
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Twelve countries participated in the WHO intercomparison for which transmission CAP (College of American Pathologists) brain and CAP liver phantoms and emission London liver phantoms were used. A total of 157 imaging devices were tested. Overall results from the phantoms revealed a wide range of targets detected. For the CAP-phantoms target detectability dropped below 50% for target sizes less than 9 mm and below 60% for target contrast less than 0.84:1. On average one false positive and six false negative results were reported using CAP-brain phantoms and one false positive and one false negative result using CAP-liver phantoms. For the London liver phantoms containing the tissue equivalent rubber abdominal simulation the target of 1 cm was never visualised. Two targets in this phantom (2 cm and 2.5 cm) were correctly identified in 34% of studies and one of these targets in 52% of studies. Equivocal and false positive results were reported in 42%. The WHO inter-comparison demonstrated the need to establish new, or to improve the existing, quality control programmes.
Thyroid disease is common in developing countries and its management is based on the measurement of thyroid function and the investigation of thyroid masses. This report discusses techniques and outlines a strategy for the measurement of thyroid function using radioimmunoassays of thyroid-related hormones in the blood. It makes proposals for the evaluation of thyroid morphology using echography, pertechnetate imaging and fine needle biopsy. Note is taken of the difficulties facing laboratories in developing countries and the International Atomic Energy Agency is concerned with the practical assessment of these recommendations and of any alternative proposals in this field.
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