Are we aware of radiation: A study about necessity of diagnostic Xray exposure

BACKGROUND Total exposure to ionizing radiation has nearly doubled in the last two decades.This increase is primarily due to increased computed tomography(CT)exposure.Concerns have been raised about the risks associated with patients'exposure to medical imaging radiation,which can increase a person's lifetime risk of developing cancer.Preventing unnecessary examinations becomes critical at this point.To avoid unnecessary examinations,it is necessary to understand the demanding process.AIM To ascertain clinicians'awareness of and reasons for requesting a CT examination.METHODS We developed an online questionnaire that included 20 questions about clinicians'awareness of radiation safety and their reasons for requesting a CT examination,as well as demographic information such as age,gender,and year of medical practice experience.Additionally,we asked participants the number of CT scans requested in a month,the patients'questions and approaches about the imaging method,the effect of the patient's previous imaging history on the current imaging request,whether they believed that they had sufficient information about radiation doses,and whether they requested CT without an indication.We administered the questionnaire to clinicians from a variety of different professions in four different cities.RESULTS A total of 195 clinicians participated.Internal medicine specialists were the most crowded group(38/195,19.5%).Mean age of the population was 33.66±5.92 years.Mean year of experience was 9.01±5.96.Mean number of requested CT scans in a month was 36.88±5.86.Forty-five(23.1%)participants stated that they requested CT scans without clinical indication.The most common reasons for CT scan requests were work load,fear of malpractice,and patient demand/insistence.CONCLUSION CT scan requests are influenced by a variety of factors,both internal and external to the doctors and patients.Raising awareness of radiation safety and reducing fear of malpractice by limiting the number of patients per physician may result in a reduction in unnecessary CT examinations and ionizing radiation exposure.

Antenatal imaging:A pictorial review

Today,in parallel with the use of imaging modalities increases in all fields,the use of imaging methods in pregnant women is increasing.Imaging has become an integral component of routine pregnancy follow-up.Imaging provides parents with an early opportunity to learn about the current situation,including prenatal detection of anomalies or diseases,etiology,prognosis,and the availability of prenatal or postnatal treatments.Various imaging modalities,especially ultrasonography,are frequently used for imaging both maternal and fetal imaging.The goal of this review was to address imaging modalities in terms of usefulness and safety,as well as to provide demonstrative examples for disorders.And this review provides current information on selecting a safe imaging modality to evaluate the pregnant and the fetus,the safety of contrast medium use,and summarizes major pathological situations with demonstrative son-ographic images to assist radiologists and obstetricians in everyday practice.

Imaging of fibroadenoma:Be careful with imaging follow-up

The present letter to the editor is related to the study titled,“Preoperational diagnosis and management of breast ductal carcinoma in situ arising within fibroadenoma:Two case reports.”Fibroadenoma is the most common benign mass lesion in young females.Based on this study showing that malignancy can develop on fibroadenomas,we want to emphasize that careful sonographic follow-up of fibroadenomas should be done and that each lesion should be followed carefully and separately in cases with multiple fibroadenomas.Additionally,we want to emphasize the critical role of sonographic examination in diagnosing fibroadenoma,the importance of correctly defining benign and malignant sonographic findings,and which lesions should be followed up sonographically and which lesions should be evaluated histopathologically.

Type 2 dynamic curves: A diagnostic dilemma

BACKGROUND Magnetic resonance imaging(MRI)with multiparametric dynamic contrast plays a critical role in the assessment of breast lesions.Dynamic curves are a critical parameter in determining the benign or malignant nature of lesions.Dynamic curves of type 1 are known to represent benign masses,while dynamic curves of type 3 are known to identify malignant masses.Type 2 dynamic curves have a sensitivity of 42.6%and specificity of 75%for malignancy detection.AIM To investigate the pathological diagnosis of lesions with type 2 dynamic curves.METHODS We evaluated breast MRI examinations performed between 2020 and 2021 retrospectively and included lesions with type 2 dynamic curves.We included 38 lesions from 33 patients.The lesions were evaluated for their pathological diagnosis and morphological characteristics.RESULTS Twenty-six lesions were malignant,while twelve were benign.The most frequently encountered benign lesion(7/12,58.3%)was sclerosing adenosis,while the most frequently encountered malignant diagnosis was invasive ductal cancer.The presence of a type 2 dynamic curve had a sensitivity of 40.2%and specificity of 73.4%for predicting malignancy.By combining type 2 curves and morphological features,the sensitivity and specificity were increased.CONCLUSION The high rates of malignancy detected histopathologically among patients with type 2 dynamic curves in our study are remarkable.Type 2 dynamic curves can be detected in benign breast masses,especially in sclerosing adenosis cases.Considering morphological features can increase the diagnostic accuracy in cases with type 2 dynamic curves.