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Diagnostics
Special Issues
Emergency Radiology: Challenges and New Trends
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Emergency Radiology: Challenges and New Trends

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 5135

Special Issue Editor

Dr. Francesco Macrì

E-Mail Website
Guest Editor
1. Department of Emergency and Trauma Radiology, Geneva University Hospital, Geneva, Switzerland
2. Department of Radiology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
Interests: emergency radiology; forensic radiology; CT; MRI; dual-energy CT; radiation dose optimization; workflow optimization

Special Issue Information

Dear Colleagues,

Emergency radiology is a relatively new subspecialty that has thrived in the last decade, due to the development of cross-sectional imaging and, in particular, CT imaging. Most universities and community hospitals strive to have a dedicated emergency radiology department, as the variety of urgent clinical situations require specialized radiology training to offer the best care and ensure the quality of emergency medicine as a whole.

To offer the best care, multiple imaging modalities at our disposal must be correctly chosen based on the clinical indications. Artificial intelligence-aided diagnostic tools have proven to be helpful, and it is crucial to understand their potential for routine use.

Another form of emergency radiology that has accrued value in the post-pandemic era is emergency teleradiology. To guarantee a fast and proper response to critically injured patients, it is paramount to implement workflow optimization methods.

The purpose of this Special Issue is to showcase the new advances in the field of emergency radiology and to demonstrate how to maximize our current knowledge to provide the best patient care.

Dr. Francesco Macrì
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • CT in trauma
  • errors in emergent case interpretations
  • artificial intelligence
  • workflow
  • teleradiology

Published Papers (4 papers)

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Research

Jump to: Review

10 pages, 235 KiB  
Article
Chest X-rays and Lung Ultrasound Are Not Interchangeable in Intensive Care Practice
by Stefan Schmidt, Nico Behnke and Jana-Katharina Dieks
Diagnostics 2024, 14(1), 82; https://doi.org/10.3390/diagnostics14010082 - 29 Dec 2023
Viewed by 744
Abstract
Purpose: Data comparing lung ultrasound (LUS) and chest X-rays (CXRs) have increased over the past years. However, there still is a lack of knowledge as to how these modalities compare with one another in the critical care setting, and several factors, including artificial [...] Read more.
Purpose: Data comparing lung ultrasound (LUS) and chest X-rays (CXRs) have increased over the past years. However, there still is a lack of knowledge as to how these modalities compare with one another in the critical care setting, and several factors, including artificial study conditions, limit the generalizability of most published studies. Our study aimed to analyze the performance of LUS in comparison with CXRs in real-world critical care practice. Materials and Methods: This study presents new data from the prospective FASP-ICU trial. A total of 209 corresponding datasets of LUS and CXR results from 111 consecutive surgical ICU patients were subanalyzed, and categorial findings were compared. Statistical analysis was performed on the rates of agreement between the different imaging modalities. Results: A total of 1162 lung abnormalities were detected by LUS in ICU patients compared with 1228 detected by CXR, a non-significant difference (p = 0.276; 95% CI −0.886 to 0.254). However, the agreement rates varied between the observed abnormalities: the rate of agreement for the presence of interstitial syndrome ranged from 0 to 15%, consolidation from 0 to 56%, basal atelectasis from 33.9 to 49.34%, pleural effusion from 40.65 to 50%, and compression atelectasis from 14.29 to 19.3%. The rate of agreement was 0% for pneumothorax and 20.95% for hypervolemia. Conclusions: LUS does not detect more lung abnormalities in real-world critical care practice than CXRs, although a higher sensitivity of LUS has been reported in previous studies. Overall, low agreement rates between LUS and CXRs suggest that these diagnostic techniques are not equivalent but instead are complementary and should be used alongside each other. Full article
(This article belongs to the Special Issue Emergency Radiology: Challenges and New Trends)
13 pages, 2679 KiB  
Article
Determining the Optimal Energy Level of Virtual Monoenergetic Images in Dual-Source CT for Diagnosis of Bowel Obstruction and Colitis
by Loris Lahuna, Joël Greffier, Jean Goupil, Julien Frandon, Maxime Pastor, Fabien De Oliveira, Jean Paul Beregi and Djamel Dabli
Diagnostics 2023, 13(23), 3491; https://doi.org/10.3390/diagnostics13233491 - 21 Nov 2023
Viewed by 884
Abstract
Images from 64 patients undergoing an enhanced abdominal-pelvis scan at portal phase in dual-energy CT mode for the diagnosis of colitis or bowel obstruction were retrospectively analyzed. Acquisitions were performed on a third-generation dual-source CT (DSCT) 100/Sn150 kVp. Mixed images were generated, as [...] Read more.
Images from 64 patients undergoing an enhanced abdominal-pelvis scan at portal phase in dual-energy CT mode for the diagnosis of colitis or bowel obstruction were retrospectively analyzed. Acquisitions were performed on a third-generation dual-source CT (DSCT) 100/Sn150 kVp. Mixed images were generated, as well as virtual monoenergetic images (VMIs) at 40/50/60/70 keV. Objective image quality was assessed on VMIs and mixed images by measuring contrast, noise and contrast-to-noise ratio (CNR). Noise, smoothing and overall image quality were subjectively analyzed by two radiologists using Likert scales. For both patient groups, the noise decreased significantly according to the energy level from 40 to 60 keV by −47.2 ± 24.0% for bowel obstruction and −50.4 ± 18.2% for colitis. It was similar between 60 and 70 keV (p = 0.475 and 0.059, respectively). Noise values were significantly higher in VMIs than in mixed images, except for 70 keV (p = 0.53 and 0.071, respectively). Similar results were observed for contrast values, with a decrease between 40 and 70 keV of −56.3 ± 7.9% for bowel obstruction −56.2 ± 10.9% for colitis. The maximum CNR value was found at 60 keV compared to other energy levels and mixed images, but there was no significant difference with the other energy levels apart from 70 keV (−9.7 ± 9.8%) for bowel obstruction and 40 keV (−6.6 ± 8.2%) and 70 keV (−5.8 ± 9.2%) for colitis. The VMIs at 60 keV presented higher scores for all criteria for bowel obstruction and colitis, with no significant difference in smoothing score compared to mixed images (p = 0.119 and p = 0.888, respectively). Full article
(This article belongs to the Special Issue Emergency Radiology: Challenges and New Trends)
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Review

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12 pages, 6051 KiB  
Review
Initial Imaging of Pregnant Patients in the Trauma Bay—Discussion and Review of Presentations at a Level-1 Trauma Centre
by Roisin MacDermott, Ferco H. Berger, Andrea Phillips, Jason A. Robins, Michael E. O’Keeffe, Rawan Abu Mughli, David B. MacLean, Grace Liu, Heather Heipel, Avery B. Nathens and Sadia Raheez Qamar
Diagnostics 2024, 14(3), 276; https://doi.org/10.3390/diagnostics14030276 - 26 Jan 2024
Viewed by 653
Abstract
Trauma is the leading non-obstetric cause of maternal and fetal mortality and affects an estimated 5–7% of all pregnancies. Pregnant women, thankfully, are a small subset of patients presenting in the trauma bay, but they do have distinctive physiologic and anatomic changes. These [...] Read more.
Trauma is the leading non-obstetric cause of maternal and fetal mortality and affects an estimated 5–7% of all pregnancies. Pregnant women, thankfully, are a small subset of patients presenting in the trauma bay, but they do have distinctive physiologic and anatomic changes. These increase the risk of certain traumatic injuries, and the gravid uterus can both be the primary site of injury and mask other injuries. The primary focus of the initial management of the pregnant trauma patient should be that of maternal stabilization and treatment since it directly affects the fetal outcome. Diagnostic imaging plays a pivotal role in initial traumatic injury assessment and should not deviate from normal routine in the pregnant patient. Radiographs and focused assessment with sonography in the trauma bay will direct the use of contrast-enhanced computed tomography (CT), which remains the cornerstone to evaluate the potential presence of further management-altering injuries. A thorough understanding of its risks and benefits is paramount, especially in the pregnant patient. However, like any other trauma patient, if evaluation for injury with CT is indicated, it should not be denied to a pregnant trauma patient due to fear of radiation exposure. Full article
(This article belongs to the Special Issue Emergency Radiology: Challenges and New Trends)
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15 pages, 19021 KiB  
Review
Acute Colonic Diverticulitis: CT Findings, Classifications, and a Proposal of a Structured Reporting Template
by Francesco Tiralongo, Stefano Di Pietro, Dario Milazzo, Sebastiano Galioto, Davide Giuseppe Castiglione, Corrado Ini’, Pietro Valerio Foti, Cristina Mosconi, Francesco Giurazza, Massimo Venturini, Guido Nicola Zanghi’, Stefano Palmucci and Antonio Basile
Diagnostics 2023, 13(24), 3628; https://doi.org/10.3390/diagnostics13243628 - 08 Dec 2023
Viewed by 2216
Abstract
Acute colonic diverticulitis (ACD) is the most common complication of diverticular disease and represents an abdominal emergency. It includes a variety of conditions, extending from localized diverticular inflammation to fecal peritonitis, hence the importance of an accurate diagnosis. Contrast-enhanced computed tomography (CE-CT) plays [...] Read more.
Acute colonic diverticulitis (ACD) is the most common complication of diverticular disease and represents an abdominal emergency. It includes a variety of conditions, extending from localized diverticular inflammation to fecal peritonitis, hence the importance of an accurate diagnosis. Contrast-enhanced computed tomography (CE-CT) plays a pivotal role in the diagnosis due to its high sensitivity, specificity, accuracy, and interobserver agreement. In fact, CE-CT allows alternative diagnoses to be excluded, the inflamed diverticulum to be localized, and complications to be identified. Imaging findings have been reviewed, dividing them into bowel and extra-intestinal wall findings. Moreover, CE-CT allows staging of the disease; the most used classifications of ACD severity are Hinchey’s modified and WSES classifications. Differential diagnoses include colon carcinoma, epiploic appendagitis, ischemic colitis, appendicitis, infectious enterocolitis, and inflammatory bowel disease. We propose a structured reporting template to standardize the terminology and improve communication between specialists involved in patient care. Full article
(This article belongs to the Special Issue Emergency Radiology: Challenges and New Trends)
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