Rofo-fortschritte Auf Dem Gebiet Der Rontgenstrahlen Und Der Bildgebenden Verfahren最新文献

The randomized controlled, multicenter TOSYMA study showed a superiority of the combination of digital breast tomosynthesis and synthetic mammography (DBT+SM) over digital mammography (DM) in the detection rate of invasive breast cancer at stage UICC I. In this subanalysis, we compared the mammographic tumor signs of UICC I stage breast cancers detected in each study arm and stratified according to histological grade.This subanalysis included 49,462 women in the DBT+SM arm and 49,669 women in the DM arm after 1:1 randomization from July 2018 to December 2020. The mammographic abnormalities documented at the consensus conference were collected for breast cancers in stage UICC I based on various tumor signs (such as masses, microcalcifications, architectural distortions, or their combinations). The detection rates (per 10,000 screened women) were calculated with differentiation of grade 1 and grade 2 or 3 cancers.Grade 1 cancers were detected using DBT+SM in 6.5/10,000 screened women only by masses (+1.5/10,000 versus DM), in 2.4/10,000 (+1.6/10,000) by architectural distortions, and in 1.2/10,000 (+0.8/10,000) by microcalcifications. Combinations of tumor signs were present in 7.9/10,000 (+6.1/10,000) screened women. Grade 2 or 3 cancers were detected by DBT+SM in 13.7/10,000 by masses (+2.6/10,000 versus DM), in 4.9/10,000 by microcalcifications (+2.3/10,000), and in 3.6/10,000 by architectural distortions (+2.0/10,000). Combinations were present in 10.1/10,000 (+6.3/10,000) screened women.In DBT+SM screening, the detection rate of UICC I breast cancers is higher compared to DM: both, individual tumor signs and their combinations contribute to this finding. The detection rate of UICC I grade 2 or 3 cancers is higher in DBT+SM screening than in DM screening mainly due to the combination of tumor signs. · DBT+SM detects more grade 2 or 3-UICC I breast cancers than DM.. · This increase in detection rate results mainly from a combination of tumor signs.. · Nearly half of the increase relates to individual signs: masses, microcalcifications, and architectural distortions.. · Weigel S, Hense HW, Weyer-Elberich V et al. Radiological Tumor Signs of Breast Cancer in UICC Stage I: Subanalysis of the Randomized Controlled Trial TOSYMA. Rofo 2026; 198: 85-92.

We investigated the energy savings in our radiology department by changing the manner of operation of MRI scanners.Since October 2022, two of our MRIs were consistently shut down overnight and on weekends instead of being left in prepared-to-scan mode. Also, an energy-saving mode was activated for one of the scanners. Previously, the scanners were only shut down on some days, and no energy-saving mode was active. We determined the energy savings by measuring the power consumption in the section of the building where the two MRI scanners are housed and comparing it with previous values.By shutting down both MRIs at night, the building section's power consumption could be reduced by 7.04 kW, and by activating the energy-saving mode by an additional 2.15 kW. Through these measures, annual energy savings of up to 25000 kWh were achieved. This corresponds to a cost reduction of approx. EUR 4200, as well as a reduction in CO₂ emissions of about 10t. According to our measurements, a hospital that has previously left its MRIs ready for scanning at all times would save up to 20000 kWh per year per scanner, which corresponds to approx. EUR 3300 in cost savings and a reduction in CO₂ emissions of approx. 8t. In addition, there was no noticeable impact on the quality of patient care.Energy-saving measures in radiology departments can be implemented effectively and with little effort by changing the manner of operation of MRI scanners. · Shutting down MRIs outside of routine operating hours reduces power consumption. · Activating an energy-saving mode further reduces consumption. · Implementing these measures is simple and has no identifiable disadvantages. · Thurner J, Fellner C, Stroszczynski C et al. Energy Savings Potential for MRI Scanners in Routine Clinical Practice. Rofo 2026; 198: 77-83.

Coronary artery disease (CAD) remains one of the leading causes of death in Germany. Since outpatient reimbursement for cardiac computed tomography angiography (CCTA) became available in 2024, non-invasive diagnostics have gained importance. CT-derived fractional flow reserve (FFR-CT) may increase the specificity of CCTA and reduce invasive procedures.In this retrospective analysis, 640 consecutive patients with coronary stenosis >25% were included in outpatient CCTA. Among them, 107 underwent additional FFR-CT. After propensity score matching, two cohorts of 105 patients each were available for comparison. The primary endpoint was the positive predictive value (PPV) for hemodynamically relevant stenoses.Based on propensity score matching, FFR-CT showed a PPV of 88% compared to 73% in the group without FFR-CT. Patients with nonpathological FFR-CT results were mainly managed conservatively, whereas pathological values led to revascularization in more than 70%. In the control group without FFR-CT, invasive coronary angiographies without coronary intervention were significantly more frequent (27%). Correlation between FFR-CT and invasive FFR was strong (r = 0.92; ICC = 0.95).Integration of FFR-CT in outpatient CCTA seems to improve diagnostic accuracy and reduce invasive procedures. It has the potential to combine anatomical and functional information and optimize treatment decisions in stable CAD. · FFR-CT has the potential to increase diagnostic accuracy and reduce invasive coronary angiographies.. · FFR-CT has a higher positive predictive value than CCTA.. · The correlation between FFR-CT and invasive FFR was high.. · In cases of pathological FFR-CT, revascularization was performed in >70% of patients. · Rottländer D, Fischer C, Mohsen Y et al. Value of CT-derived Fractional Flow Reserve in the Context of Outpatient Cardiac CT in Germany: A Propensity Score Matched Analysis. Rofo 2025; DOI 10.1055/a-2760-5485.

According to the text of the Lung Cancer Screening Ordinance on the permissibility of using low-dose computed tomography to screen smokers (LuKrFrühErkV, §7 Quality Assurance, 1), the "radiation protection officer must establish and operate a comprehensive quality assurance system. This must take account of organizational, medical, and technical aspects, in particular [...] 2. the diagnostic image quality of the computed tomography scan, 3. the physical-technical parameters for the acquisition of the computed tomography scan [...]". The German Radiological Society (DRG) considers itself responsible for making recommendations regarding the implementation of such a quality assurance system, in order to provide users with legal certainty and ensure patient safety. The DRG's Physics and Technology Working Group has thus identified the main issues regarding quality assurance for technology, outlined the related challenges, and proposed potential areas for future investigation and resolution (see sections I-V). Existing quality assurance measures for technology must be checked for their suitability with regard to a low-dose screening program and adapted, if necessary. Complex additional constancy tests and the use of special (anthropomorphic) phantoms are not currently considered necessary. The tasks of manufacturers and medical physicists were refined further, and it was recommended that reference centers should be established as soon as possible. · Constancy testing methods for CT are largely sufficient for lung cancer screening.. · Daily air calibration is recommended to ensure consistent image quality.. · Anthropomorphic phantoms are not currently required for quality assurance.. · Manufacturers must provide protocols that meet LuKrFrühErkV requirements.. Eßeling R, Konrad M, Prokesch H et al. Requirements for Physico-Technical Quality Assurance in the Framework of Early Detection of Lung Cancer. Rofo 2026; DOI 10.1055/a-2597-0689.

The well-known "hand with gunshot" X-ray bearing the signature of M.I. Pupin from Columbia College New York is widely recognized in the literature as being the first radiograph acquired with the use of an intensifying screen.Personal research in the New York City daily newspapers from 1896 and at Columbia University allowed us to establish that Pupin took two X-rays of a "hand with gunshot" in a patient on February 15 and 19, 1896. The first X-ray is preserved among the Pupin papers at Columbia University, and the second radiograph was published in an American magazine in March 1896. In 1974, the original radiographic plate of the X-ray performed on February 19 was discovered. In 1930 or shortly before, Pupin signed a contemporary X-ray of a "hand with gunshot", which is incompatible with the historical X-rays. This X-ray was made public in 1931,1965, and 1969, with the false claim that it was the first X-ray acquired using an intensifying screen in 1896.The "hand with gunshot" X-ray signed by Pupin around 1930 is a crude forgery of the X-ray he made on February 19, 1896. This X-ray has since been published many times and has been erroneously taken in good faith for the original. The historical X-rays remained ignored. · This paper establishes that the renowned "hand with gunshot" X-ray signed by M.I. Pupin is a forgery.. · Monville J-F., Dondelinger RF. Rectification: the well-known "hand with gunshot" radiograph signed by M.I. Pupin (1858-1935) and published in 1931 is a forgery. Rofo 2025; DOI 10.1055/a-2742-1763.