32 (CT) demonstrates more accurate tumor extent and supplying territories of the cannulated vessels than digital subtraction angiography (DSA). We demonstrate a case of inoperable recurrent breast cancer receiving four sessions of TACE with drug-eluting microspheres (DEMs) using combination of angiography and intraarterial CT angiogram with angio-CT system. Methods: A 44-year-old woman with recurrent breast cancer received 4 sessions of DEM-TACE from April 2013 to November 2013. Hepasphere was impregnated with chemoagents. TACE was performed with angioagram and corresponding CT angiogram using Angio-CT system. Results: The tumor bulk was supplied by the branches of internal mammary, thoracoacromial and lateral thoracic arteries. Tumor volume decreased during the first 3 sessions and disease progression occurred after the 3rd TACE. Superselective angiogram and corresponding CT angiogram clearly demonstrate the feeding arteries and their supplying territories. Precise evaluation of supplying territories with CT before delivering the chemoagents ensures the coverage and reduces the risk of nontarget embolization 9.7. NIS (Neurointervention system): Developing an image file and database for Neurointervention Presenter: Ok-Kyun Lim, Asan medical center, South Korea Authors: OK-Kyun Lim, Ben Joonyeon Park, Eun-Hye Kim, Seon Moon Hwang Introduction: According to increasing of the interest of general health in the people and improving of the diagnostic instrument, the number of medical examination such as X-ray, CT, MR, Ultrasound and angiography have increased for several decades continuously. Increasing of the number of diagnostic cases naturally has been led to encourage of the amount of the interventional treatment cases. Consequently, we could obtain a deepseated knowledge of the procedure from the cases. In these circumstances, it is important that how to manage the amount of the data which are derived from a series of the examination and medical treatment. We already realized that complex clinical information in cerebral angiointervention unit requires effective management of statistical analysis for the classification of diagnosis and intervention including follow-up data from the interventional treatment. Since 2002, we’ve used an application of Microsoft Access(Microsoft, WA, USA) program for the management of patient’s data in cerebral angiointervention unit. Microsoft Access program has been effective in the management of patient’s data in cerebral angiointervention unit for nearly ten years. However, our access program hasn’t enough field or storage space to save the images which can be the source of education, presentation, teaching file, or research. It was too difficult to handle the images which stored in the Access program and to search multiple patients as quickly. In 2000, Tran et al. reported that they succeeded in creating an inexpensive electronic database of digital radiographic teaching images using commercially available software. Methods: In order to develop the new database system linked PACS, firstly we searched our database programs which have been using in our daily work. There were many kinds of database system such as EMR, PACS, OCS, MS Access, Excel. Results: We developed a new database system, NIS(Neurointervention system). We could easily connect NIS while using the PACS system and we could input the patient’s images as well as information related patient’s diseases. The NIS consisted of two parts. One part performed a database to save text type of data linked schedule of department of neuroangiointervention unit in our hospital. Another part performed a database to save image and text type of data. 9.8. When Radiographers participate in EndoVascular Aneurysm Repair Presenter: Henrik Mogensen, Odense University Hospital, Denmark Authors: Radiographer Henrik Mogensen and Radiographer Jette Skjellerup Jensen Introduction: Department of Radiology, Odense University Hospital (OUH) was first in Denmark to offer endovascular treatment of a ruptured Abdominal Aorta Aneurysm (rAAA). The treatment was introduced in October 2012 and has been available as a round-the-clock service ever since, as the only place in Denmark. The procedure is interdisciplinary and is highly dependent on teamwork between the vascular surgeons, the anaesthetic team and the radiologic team in which radiographers are important contributors. The radiographer’s role is to contribute with expertise, knowledge and having total responsibility for handling the x-ray equipment during the entire procedure as well as preparing and handling the stent graft. A cost benefit analysis has shown that this treatment is more expensive than traditional surgery (approx 2.700 EUR), primarily due to the higher price of the stent graft. In this analysis only the cost of the actual treatment is considered. The benefits for the patient such as lower mortality rate, less pain and faster recreation etc. are not valued. Methods: The procedure is performed in local anaesthesia where the radiologist places the stent graft fluoroscopy guided in the abdominal aorta to exclude the aneurysm thus avoiding general anaesthesia and open surgery. Results: So far 38 patients have undergone treatment for rAAA using this method, resulting in a better outcome for the patient with a mortality rate of 7% versus 30-35% when traditional open surgery in full anaesthesia is performed. Participating in this procedure requires highly skilled and experienced radiographers. If complications occur during the procedure, it is of utmost importance with an experienced team who has a vast knowledge of materials allowing for other possibilities to be explored. 10. MANAGEMENT 10.1. Optimizing patient care in radiology through team-working: a case study from the United Kingdom Presenter: Nick Woznitza, Homerton University Hospital & Canterbury Christ Church University, UK Authors: N Woznitza, K Piper, S Rowe & C West Introduction: Improving patient care should be the primary focus of all healthcare providers, regardless of country, setting or department; radiology is no exception. Roles within radiology have evolved and professional boundaries blurred; assistant practitioners contribute to image acquisition and advanced and consultant radiographers undertake tasks historically performed by medical professionals. Team working and appropriate use of skill mix has been highlighted as a way of managing ever increasing imaging workloads. In the United Kingdom, trained radiographers have developed their roles to include tasks traditionally performed radiologists, including definitive clinical reporting and interventional procedures. The aim of this study was to demonstrate how a radiology department within an acute district general hospital optimizes imaging services to improve access for patients and support for referrers through a strong emphasis on team-working. Methods: Data about service delivery was analyzed across three consecutive years and interrogated by modality, referral source and reporting practitioner to determine how workload had evolved. Feedback from referring clinicians was sought. Conclusions: Overall trend was for increased activity (13%) with significant reductions (p50% of x-ray and ultrasound examinations. Novel services and patient pathway redesigns were implemented with high clinician satisfaction. Radiologists and radiographers, working together, can deliver an effective service. Innovation, staff development and redesigned patient pathways have produced significant improvements. 10.2. Patient Classification System in the work of a Radiographer Presenter: Virva Seiko-Vänttinen, Medical Imaging Centre of South West Finland Authors: Luotolinna-Lybeck Helena and Seiko-Vänttinen Virva Introduction: Patient classification is needed to measure and to make visible the workload of radiographers. Nurse leaders and managers need it to plan the radiographer resources properly and flexibly. In today’s economical situation it is very important to have all your resources in most effective use. Patient classification is coming true for all patients and examinations in the medical imaging centre of Southwest Finland. In Turku we have developed a patient classification system which is suitable for patients in the radiological department. This classification system has its roots in the Oulu Patient Classification system. Radiological Patient Classification system is a way to measure how much each patient in a radiological examination in different health condition needs radiographer resources. We evaluate patient’s ability to move, to get dressed, need of advice, stage of health, the examination type needed and planning of the examination. Evaluation takes few seconds. All these numbers are
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