Caceres’ Corner Case 150 (Update: Solution)

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Dear Friends,

Dr Pepe and I are very proud to have reached the 150th mark, which happens to be a case that we saw last month (honest!). The radiographs belong to a 68-year-old man, pre-op for cataracts.

What do you see? Check the images below, leave your thoughts for us in the comments section, and come back on Friday for the answer.

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19
Dec 2016
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Dr. Pepe’s Diploma Casebook: Case 100 – A painless approach to interpretation (Chapter 7) – SOLVED!

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Dear Friends,

Today I present the seventh chapter of the Painless Approach to Interpretation, which also happens to be case number 100 of Dr. Pepe’s Diploma Casebook. It makes me very proud to have shared with you one hundred cases and hope they have been useful.

Showing chest radiographs of a 47-year-old woman with mild fever and chest pain.

What do you see? Check the images below, leave me your thoughts in the comments section and come back on Friday for the answer.

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Caceres’ Corner Case 149 (Update: Solution)

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Dear Friends,

Today we are presenting a pre-op PA chest radiograph of a patient with inguinal hernia. What do you see?

Check the image below, leave your thoughts in the comments section and come back on Friday for the answer.

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05
Dec 2016
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IDoR 2016 Cake Competition Winner: the Making Of

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Christina Harter-Felszeghy, co-creator of the amazing winner of our International Day of Radiology cake competition explains the inspiration and production of the winning cake. Don’t miss the photo gallery at the bottom of this post.

My Father, Dr. Scott Harter, is a radiologist and Chief of Radiology Consultants in Little Rock (Arkansas, USA) and I am a confectioner. While researching how Radiology Consultants could celebrate IDoR 2016, Radiology Consultants’ social media manager came across a post about the ESR’s Cake Competition on the International Day of Radiology website. My father and I volunteered to design and bake a cake to share with the group, thinking it would be a wonderful way to celebrate this special day! It turned out to be a truly unique project.

The winning cake (cross section)

The winning cake (cross section)

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Dr. Pepe’s Diploma Casebook: Case 99 – A painless approach to interpretation (Chapter 6) – SOLVED!

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Dear Friends,

We’re moving on to a new chapter of the Painless Approach to Interpretation, and this week I’m showing the routine control radiographs of a 48-year-old woman, surgically treated for carcinoma of the breast ten years ago.
What do you see?

Check the image below, leave your thoughts in the comments section, and come back for the answer on Friday.

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Caceres’ Corner Case 148 (Update: Solution)

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Dear Friends,

Today we are presenting a pre-op chest radiograph of a 70-year-old man with carcinoma of the bladder.
What do you see?

Check the image below, leave your thoughts in the comments section and come back on Friday for the answer.

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21
Nov 2016
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Dr. Pepe’s Diploma Casebook: Case 98 – A painless approach to interpretation (Chapter 5) – SOLVED!

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Dear Friends,

Today we are moving to a new chapter in the Painless Approach to Interpretation, addressing what to do when the chest radiograph does not show an obvious abnormality.

For this purpose I am presenting the PA and lateral radiographs of a 57-year-old man with a chronic cough. What do you see?

Examine the image below, leave your thoughts in the comments section and come back on Friday for the answer.

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IDoR 2016 Cake Competition: VOTE for the winner!

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Over the last few years we have seen more and more people getting into the spirit of the International Day of Radiology (IDoR), holding parties and get-togethers around the world. In the photographs of these celebrations there is often a delicious looking cake, so this year we decided to encourage this as much as possible by launching the IDoR Cake Competition, with a grand prize of free registration for the European Congress of Radiology 2017, along with two nights hotel accommodation.

We received lots of submissions, but below is our jury’s selection of the most original and creative entries. Please vote for your favourite – the cake with the most votes at 12:00 (CET) on November 16 will be our winner!

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Interview: Prof. Boris Brkljačić, professor of radiology and Vice-Dean at the University of Zagreb School of Medicine, Croatia

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This year, the main theme of the International Day of Radiology is breast imaging. To get some insight into the field, we spoke to Prof. Boris Brkljačić, professor of radiology and Vice-Dean at the University of Zagreb School of Medicine, Croatia, and Chairman of the ESR Communications and External Affairs Committee.

European Society of Radiology: Breast imaging is widely known for its role in the detection of breast cancer. Could you please briefly outline the advantages and disadvantages of the various modalities used in this regard?
Boris Brkljačić: Mammography, ultrasound and MRI are three modalities used for the detection of breast cancer. Mammography has been used for many decades, and the introduction of full flat panel digital mammography has enabled image acquisition with a lower radiation dose, and other advantages in image processing and biopsies. Mammography is used widely in breast cancer screening and has been validated through decades of screening. It is also the initial imaging method in women older than 40 and it enables the detection of microcalcifications, the early signs of ductal cancer in situ, and the majority of breast cancers, depending on the radiographic density of the breast. It can also be used to guide biopsy of microcalcifications. The denser the breasts are, the lower the sensitivity of mammography in detecting breast lesions, which is the disadvantage of mammography. The new mammographic method, digital tomosynthesis, improves the detection rate of cancer in dense breasts. Mammography exposes patients to radiation and is therefore not recommended in young women because their breasts are very radiosensitive.

Prof. Boris Brkljačić, Professor of Radiology and Vice-Dean at the University of Zagreb School of Medicine, Croatia, and Chairman of the ESR Communications and External Affairs Committee.

Prof. Boris Brkljačić, Professor of Radiology and Vice-Dean at the University of Zagreb School of Medicine, Croatia, and Chairman of the ESR Communications and External Affairs Committee.

Ultrasound is an imaging method that provides images based on the acoustic properties of tissues. The blood flow in lesions can be analysed by colour Doppler ultrasound, and elasticity of lesions can be analysed and quantified by sonoelastography. The advantage of ultrasound is that it is completely harmless; it does not expose patients to radiation, and is an excellent method for the guidance of biopsies of all sonographically visible lesions. Ultrasound can demonstrate cancers that are not visible in mammographically dense breasts, and is the complementary imaging modality to mammography, both in diagnosis and in screening. Some U.S. states legally oblige physicians to inform women about mammographic density and advise them of additional methods of examination in dense breasts. Among many advantages in ultrasound technology are the automated whole-breast ultrasound systems that have recently been introduced to the market. The disadvantage of ultrasound is that it increases the number of false-positive findings.

Magnetic resonance imaging (MRI) of the breast has gained considerable importance over the last two decades and is used more and more in breast imaging. It is used in high-risk screening, in the detection of occult cancer with positive lymph nodes, and in the evaluation of implants, and it is the best method for detecting the presence of and assessing the distribution and extent of cancer. It can also be used to monitor the success of neoadjuvant chemotherapy, and is an excellent method for looking for residual cancer or recurrence after treatment. MRI is relatively expensive and time consuming, although abbreviated MRI protocols have recently been introduced.

For treatment planning and monitoring it is very important to know the exact type and grade of cancer, and its immunohistochemical profile. Image guided biopsy is crucial in relation to that, and all imaging methods enable precise, image-guided biopsy to obtain an adequate sample from the breast cancer and other breast lesions.
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Caceres’ Corner Case 147 (Update: Solution)

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Dear Friends,

Today we are showing a case in recognition of the International Day of Radiology, which takes place tomorrow.

Below are images of a 35-year-old woman with chest pain and progressive dyspnoea for the last three weeks. Leave your thoughts in the comments section and come back on Friday for the answer.

Most likely diagnosis:

1. Lymphoma
2. Pleural metastases
3. Mesothelioma
4. Any of the above

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07
Nov 2016
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