38 injected intravenously,doses ranged between 15-20mCi. Whole body delayed bone scan imaging was done 2-4 hours post injection. Results: *skeletal metastases,the commonest clinical indication for radionuclide bone scan. * 95% of patients were females with preponderance of left breast cancer. * Larger numbers of men are for metastatic prostate cancer. * affected age group is the productive age range of Nigerians (41-50) Conclusion: No effective cancer management can be achieved without Nuclear Imaging. Ability to use this imaging modality for specific anatomical cancer screening will go a long way in contributing positively in cancer prevention/management. 12.4. Multimodality imaging in the medical radiation sciences Presenter: Robert Miner, The Michener Institute CE Author: Robert Miner Introduction: New multimodality imaging technologies are significantly impacting diagnostic imaging and the current practice of medical radiation professionals. All imaging modalities have their own strengths and weaknesses: radiography, CT and MRI are excellent at imaging anatomy while nuclear medicine (PET and SPECT) image physiology and molecular response. Hybridized complementary modalities allow increased diagnostic accuracy and improved workflow. Methods: Conventional and future imaging technologies and topics relevant to the medical radiation sciences are compared and contrasted: Image fusion, SPECT/CT, PET/CT, PET/MRI, optical, Compton and neutron activated SPECT (nSPECT) imaging. Results: The merging of anatomical and physiological modalities has marked a shift in diagnostic imaging. The integration of different modalities is now the norm. Possible future clinical imaging modalities such as optical, Compton and nSPECT are either in pre-clinical use or in development offer unique advantages. 13. PEDIATRIC IMAGING 13.1. Guidelines for skeletal surveys in Suspected Child Abuse Presenter: Bo Mussmann, Department of Radiology, Odense University Hospital, Odense, Denmark Author: Bo Mussmann Introduction: Child abuse imaging differs from general musculoskeletal imaging in the demands for low noise. The consequences of misdiagnosis are serious. The images are directly involved in legal processes and the child and the family faces major consequences if the images are not adequate. If head trauma or fractures are overlooked, or if the radiological diagnosis is uncertain, abused children may be sent home with violent parents or caregivers. If no abuse has taken place, and the certainty of the diagnosis is questionable, it may result in prolonged hospitalization of an innocent family. In Southern Denmark approximately 40 children pr. year are examined in four different radiology departments. Until the autumn of 2012 different projections and imaging techniques were used for the skeletal surveys. This proposed difficulties, because all images are subject to second opinion statements. In many cases supplement images or a complete reexamination of the child were needed in order to state a second opinion, resulting in unnecessary excess radiation dose. Methods: A literature review was performed and the results were discussed at an initial meeting at Odense University Hospital. A follow-up meeting was arranged in Sept. 2013. The meeting focused on follow-up skeletal surveys in children < 2 years of age Results: Images are acquired at low noise levels. Speed class 100 against normally 200 - 400 is sufficient, demanding higher radiation dose compared to common pediatric examinations. For children < 2 years, images are acquired systematically and consequently. If a follow-up skeletal survey is needed, images of the spine, head and pelvis are not repeated. No cases of unnecessary supplement images or reexaminations have occurred since autumn 2012 indicating successful implementation of the guidelines 13.2. Improving neonatal chest radiography: an evaluation of image acquisition techniques, dose and technical quality Presenter: Maryann Hardy, University of Bradford, UK Authors: Maryann Hardy, Beverly Snaith Introduction: Neonatal radiography is unique in terms of vulnerability of patient group to radiation exposure and distinctive anatomical appearances. While internationally agreed standards for neonatal chest radiography dose and image quality assessment criteria exist, these are not readily transferrable to radiographic image acquisition practice and variation in recommended practice is evident within internationally acclaimed radiographic technique textbooks. While previous studies have considered dose and collimation within neonatal radiography, no published research has considered the technical quality of neonatal chest radiographs (i.e. lordosis, rotation, inspiration) or the prevalence of suboptimal image acquisition approaches, radiographer knowledge of neonatal anatomical proportions or their anxieties re: working with this patient group in specialized neonatal ward environments. This study forms the initial phase of a progressive programme of research that will explore these issues. The findings of this phase of the study will provide a baseline evaluation of practice quality from which the learning needs of radiographers can be determined and intervention developed. The outcome of the programme of work, of which this proposed study forms the fundamental phase, will be international standards on neonatal chest radiographic image acquisition technique and technical quality assessment and promotion of the professional knowledge and responsibility of radiographers for image acquisition quality in this vulnerable patient group. Methods: Phase 1: A retrospective evaluation of neonatal chest radiography quality and dose Results: Analysis of results is ongoing. A descriptive analysis of image acquisition quality will be undertaken to identify differences and commonalities in radiographic practice. Dose range at each Trust will be statistically summarised and compared with national and local DRLs where available. The findings of this study will provide baseline data to support revision of national and international neonatal radiography standards. 13.3. Every Picture Tells a Story Presenter: Anne Connell, Mater Children's Hospital, Brisbane Qld, Australia Author: Anne Connell Introduction: This story began with a single AP view of a knee which demonstrated Harris Lines ( or Growth Arrest Lines). These lines result from a temporary slowdown of normal longitudinal growth rates during a period of injury or illness. Research into the cause of these lines made a very interesting case study which I would like to share with you, and discuss how after multiple surgical examinations the resultant outcome was amazing. The history included SUFE(Slipped Upper Femoral Epiphysis), AVN( A vascular necrosis) osteotomy and long leg imaging. Methods: This is a case study based presentation therefore the examinations discussed will be briefly mentioned. Results: This is a case study presentation which will explain the treatment and will conclude with an excellent outcome. 13.4. The importance of verbal interaction between child and radiographer during radiographic procedure Presenter: Berit Björkman, School of Health Sciences, Jönköping University, Sweden Authors: Björkman, B., Golsäter, M., Simeonsson, R., Enskär, K. Introduction: The verbal interaction between the child and radiographer during a radiographic examination is an unexplored, but important area of clinical practice. The aim of this study was to investigate the nature and distribution of that interaction between child and radiographer and the extent to which it varied as a function of the child’s age. Methods: The study had a quantitative approach. The verbal interaction between child and radiographer during 32 examinations was analyzed using the Roter Interaction Analysis System (RIAS). Results: The results revealed that 80% of the verbal interaction was carried out by the radiographer either to the child or to an escorting parent, while 17% was carried out by the child and 3% by the parent. More utterances containing social emotional exchange were used to involve
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