MyMedR

Radiology and disease patterns in Malaysia

Wastie ML

Trop Geogr Med, 1975 Mar;27(1):17-24.

The organisation of the radiological services in Malaysia is described and those diseases in which radiology plays an important part in diagnosis are discussed. As radiology embraces all specialities a pattern of diseases emerges which is different from that seen in the West. The control of infectious diseases, the general improvement in health care and the more sophisticated radiological investigations now available mean that in future radiology will play a much more important part in diagnosis and management of patients.

Matched MeSH terms: Radiology*

Fulltext The comparative accuracy of ultrasound and mammography in the detection of breast cancer

Tan KP, Mohamad Azlan Z, Rumaisa MP, Siti Aisyah Murni MR, Radhika S, Nurismah MI, et al.

Med J Malaysia, 2014 Apr;69(2):79-85.

PMID: 25241817 MyJurnal

AIM: This study was performed to determine the accuracy of ultrasound (USG) as compared to mammography (MMG) in detecting breast cancer.

METHODS: This was a review of patients who had breast imaging and biopsy during an 18-month period. Details of patients who underwent breast biopsy were obtained from the department biopsy record books and imaging request forms. Details of breast imaging findings and histology of lesions biopsied were obtained from the hospital Integrated Radiology Information System (IRIS). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of USG and MMG were calculated with histology as the gold standard.

RESULTS: A total of 326 breast lesions were biopsied. Histology results revealed the presence of 74 breast cancers and 252 benign lesions. USG had a sensitivity of 82%, specificity of 84%, PPV = 60%, NPV = 94% and an accuracy of 84%. MMG had a sensitivity of 49%, specificity of 89%, PPV = 53%, NPV = 88% and an accuracy of 81%. A total of 161 lesions which were imaged with both modalities were analyzed to determine the significance in the differences in sensitivity and specificity between USG and MMG. Sensitivity of USG (75%) was significantly higher than sensitivity of MMG (44%) (X(2)1=6.905, p=0.014). Specificity of MMG (91%) was significantly higher than specificity of USG (79%) (X(2)1=27.114, p<0.001). Compared with MMG, the sensitivity of USG was 50% (95% CI 10%-90%) higher in women aged less than 50 years (X(2)1=0.000, p=1.000) and 27% (95% CI 19%-36%) higher in women aged 50 years and above (X(2)1=5.866, p=0.015). Compared with MMG, the sensitivity of USG was 40% (95% CI 10%-70%) higher in women with dense breasts (X(2)1=0.234, p=0.628) and 27% (95% CI 9%-46%) higher in women with non-dense breasts (X(2)1=4.585, p=0.032).

CONCLUSION: Accuracy of USG was higher compared with MMG. USG was more sensitive than MMG regardless of age group. However, MMG was more specific in those aged 50 years and older. USG was more sensitive and MMG was more specific regardless of breast density. In this study, 20% of breast cancers detected were occult on MMG and seen only on USG.

Matched MeSH terms: Radiology Information Systems

Fulltext Diagnosis and management of ruptured hepatoma: single center experience over 10 years

Letchumanan VP, Lim KF, Mohamad AB

Med J Malaysia, 2013 Oct;68(5):405-9.

PMID: 24632870 MyJurnal

INTRODUCTION: Spontaneous rupture is a dramatic presentation of HCC and it carries high mortality rate. To study the outcomes of ruptured HCC patients managed at a tertiary referral centre in Malaysia.
METHODS: A retrospective review of all ruptured HCC patients managed as inpatient at the Department of Hepatobiliary Surgery, Hospital Selayang between January 2001 and December 2010. Data was retrieved from the hospital electronic medical records, Powerchart (Cerner Corporation Inc., USA) and supplemented with registry from Interventional Radiology record of chemoembolization and registry from hepatobiliary operative surgery records.
RESULTS: There were 22 patients admitted with confirmed diagnosis of ruptured HCC over 10 years period. The common clinical findings on presentation were abdominal pain and presence of shock (36.4%). The mortality rate was 81.8% with only four patients noted to be alive during the follow up. One year overall survival for ER and DR are 40.0% and 72.7% respectively and the median survival in patients treated with DR was 433.3 days whereas it was 212.5 days in ER group.
CONCLUSIONS: This study supports the clinical practice of TAE should be the first line treatment followed by staged surgery in suitable candidates with ruptured HCC.

Matched MeSH terms: Radiology, Interventional

Fulltext Computed Tomography (CT) of Blunt Abdominal Trauma: The Frequency of Incidental Findings, how it was Documented in Radiology Report and the Implication of These Findings to Acute Trauma Care

Radhiana H, Siti Kamariah CM, Mohd Nazli K, Azian AA

Med J Malaysia, 2014 Feb;69(1):46-8.

PMID: 24814633 MyJurnal

The wide use of computed tomography (CT) scanning for patients with blunt abdominal trauma can reveal incidental findings that vary in their importance. We evaluated these findings, how it was reported by radiologists and its implication on the trauma care. In 30 out of 154 patients, 32 incidental findings were discovered (19.5%). Out of these 32 findings, only 3 cases (9.4%) were considered significant and required immediate attention from the managing team. In all these 3 cases, the findings were described in the body of the report and highlighted in the conclusion section at the end of the radiology report. However, similar reporting style was used in only 58.4% of cases with moderate clinical concern and 23.5% of cases with little clinical concern. In 41.2% of cases with little concern, the incidental findings were not mentioned in the radiology report. In conclusion, incidental findings in CT scan performed for blunt abdominal trauma were common but many were clinically insignificant. There is little consistency in radiology reporting of these findings especially those with moderate and little clinical concern.

Matched MeSH terms: Radiology

Fulltext Quality assurance in mammography: College of Radiology Survey in Malaysia

Ho EL, Ng KH, Wong JH, Wang HB

Med J Malaysia, 2006 Jun;61(2):204-8.

PMID: 16898312

Malaysia's mammography QA practice was surveyed based on the Malaysian Ministry of Health and the American College of Radiology (ACR) requirements. Data on mammography unit, processor, image receptor, exposure factors, mean glandular dose (MGD), sensitometry, image quality and viewbox luminance were obtained. Mean developer temperature and cycle time were 34.1 +/- 1.8degreesC and 107.7 +/- 33.2 seconds. Mean base+fog level, speed index and contrast index were 0.20+/-0.01, 1.20+/-0.01 and 1.33+/-0.26 respectively. Eighty-six percent of the fifty centres passed the image quality test while 12.5% complied with ACR recommended viewbox luminance. Average MGD was 1.0+/-0.4 mGy. Malaysia is on the right track for QA but with room for total quality improvement.

Matched MeSH terms: Radiology/statistics & numerical data*

Fulltext Turn-around-time of radiographs in a neonatal intensive care unit

Rohana J, Boo NY, Yong SC, Ong LC

Med J Malaysia, 2005 Aug;60(3):338-44.

PMID: 16379189 MyJurnal

A quality assurance study was carried out prospectively in two phases at the Neonatal Intensive Care Unit (NICU) of Hospital Universiti Kebangsaan Malaysia. The objectives of the study were to determine the turn-around-time (TAT) of radiographs requested for infants undergoing intensive care treatment in the NICU and the effects of a standard operating procedure introduced based on initial findings of first phase of the study on subsequent TAT. The TAT was defined as the time taken for the radiograph to be ready for viewing after the attending doctor had requested for it to be done on an infant. During phase one of the study, none of the requested radiographs was ready to be viewed by the doctors within the standard TAT of 45 minutes. The problems identified were ward staffs delay in sending request forms to the radiology department, radiographers' delay in shooting and processing the films, and delay by NICU porter in collecting the processed films. Based on these findings, a standard operating procedure (SOP) was drawn up jointly by the staff of NICU and Department of Radiology. During phase two of the study conducted at one month after implementation of the SOP, there was a reduction of TAT by 50%. However, only 3 (4.3%) of the radiographs achieved the standard TAT. The main problems identified during phase two were delay in sending request forms and in collecting processed radiographs by the porter system. The dismal TAT of radiographs in NICU was related primarily to human behaviour. Besides continuous staff education, replacement of the porter system with electronic system may improve the TAT.
Keywords: Turn-around time, radiographs, neonatal intensive care unit, standard operating procedure, Kuala Lumpur

Matched MeSH terms: Radiology Department, Hospital/organization & administration*; Radiology Department, Hospital/standards*

Fulltext Comparative study of plain-film radiographs of maxillary sinuses between radiologists and clinicians

Krishnan G

Med J Malaysia, 1992 Sep;47(3):190-3.

PMID: 1491644

Maxillary sinuses plain film radiographs of 59 patients were reviewed and reported by both clinicians or Radiologists at the University Hospital, Kuala Lumpur. There was agreement in 52 reports of the plain film radiographs however there was partial differences in about seven cases. This gave an impression that the ENT specialist and the Radiologist were both capable of reporting plain film radiographs of maxillary sinuses, even though the radiologist has no opportunity of doing detail clinical examination of the patient.

Matched MeSH terms: Radiology*

Radiology in Malaya in the 1920s

Wastie ML

Med J Malaysia, 1994 Sep;49(3):199-204.

PMID: 7845265

Matched MeSH terms: Radiology/history*

Medical audit. A method of assessing hospital efficiency

Dugdale AE

Med J Aust, 1970 Dec 5;2(23):1087-91.

PMID: 5491085

Matched MeSH terms: Radiology/manpower

Fulltext Embolisation of a bronchial artery of anomalous origin in massive haemoptysis

Md Ralib AR, Han NT, Hin HS, Muda AS

Malays J Med Sci, 2010 Jul;17(3):55-60.

PMID: 22135550 MyJurnal

Massive haemoptysis is the most dreaded of all respiratory emergencies. Bronchial artery embolisation is known to be a safe and effective procedure in massive haemoptysis. Bronchial artery of anomalous origin presents a diagnostic challenge to interventional radiologists searching for the source of haemorrhage. Here, we report a case of massive haemoptysis secondary to a lung carcinoma with the bronchial artery originating directly from the right subclavian artery. This artery was not evident during the initial flush thoracic aortogram. The anomalous-origin bronchial artery was then embolised using 15% diluted glue with good results. An anomalous-origin bronchial artery should be suspected if the source of haemorrhage is not visualised in the normally expected bronchial artery location.

Matched MeSH terms: Radiology, Interventional

Fulltext The vanishing veins: difficult venous access in a patient requiring translumbar, transhepatic, and transcollateral central catheter insertion

Yaacob Y, Zakaria R, Mohammad Z, Ralib AR, Muda AS

Malays J Med Sci, 2011 Oct;18(4):98-102.

PMID: 22589680

Central venous catheter placement is indicated in patients requiring long-term therapy. With repeated venous catheterisations, conventional venous access sites can be exhausted. This case illustrates the expanding role of radiology in managing difficult venous access. We present a case of translumbar, transhepatic, and transcollateral placement of central catheter in a woman with a difficult venous access problem who required lifelong parenteral nutrition secondary to short bowel syndrome. This case highlights the technical aspects of interventional radiology in vascular access management.

Matched MeSH terms: Radiology, Interventional

Fulltext Evaluation of X-Ray Beam Quality Based on Measurements and Estimations Using SpekCalc and Ipem78 Models

Chen SC, Jong WL, Harun AZ

Malays J Med Sci, 2012 Jul;19(3):22-8.

PMID: 23610546 MyJurnal

Different computational methods have been used for the prediction of X-ray spectra and beam quality in diagnostic radiology. The purpose of this study was to compare X-ray beam qualities based on half-value layers (HVLs) determined through measurements and computational model estimations.

Matched MeSH terms: Radiology

Fulltext Image-guided chemoport insertion by interventional radiologists: A single-center experience on periprocedural complications

Yaacob Y, Nguyen DV, Mohamed Z, Ralib AR, Zakaria R, Muda S

Indian J Radiol Imaging, 2013 Apr;23(2):121-5.

PMID: 24082475 DOI: 10.4103/0971-3026.116543

To report our early experience in image-guided chemoport insertions by interventional radiologists.

Matched MeSH terms: Radiology, Interventional

In the eyes of the beholder: what we see is not what we get

Abdullah BJ, Ng KH

Br J Radiol, 2001 Aug;74(884):675-6.

PMID: 11511489

Matched MeSH terms: Radiology/standards*

Fulltext Consensus survey on pre-procedural safety practices in radiological examinations: a multicenter study in seven Asian regions

Lee YH, Quek ST, Khong PL, Lee CS, Wu JS, Zhang L, et al.

Br J Radiol, 2020 Sep;93(1113):20200082.

PMID: 32584595 DOI: 10.1259/bjr.20200082

OBJECTIVE: To understand the status of pre-procedural safety practices in radiological examinations at radiology residency training institutions in various Asian regions.

METHODS: A questionnaire based on the Joint Commission International Accreditation Standards was electronically sent to 3 institutions each in 10 geographical regions across 9 Asian countries. Questions addressing 45 practices were divided into 3 categories. A five-tier scale with numerical scores was used to evaluate safety practices in each institution. Responses obtained from three institutions in the United States were used to validate the execution rate of each surveyed safety practice.

RESULTS: The institutional response rate was 70.0% (7 Asian regions, 21 institutions). 44 practices (all those surveyed except for the application of wrist tags for identifying patients with fall risks) were validated using the US participants. Overall, the Asian participants reached a consensus on 89% of the safety practices. Comparatively, most Asian participants did not routinely perform three pre-procedural practices in the examination appropriateness topic.

CONCLUSION: Based on the responses from 21 participating Asian institutions, most routinely perform standard practices during radiological examinations except when it comes to examination appropriateness. This study can provide direction for safety policymakers scrutinizing and improving regional standards of care.

ADVANCES IN KNOWLEDGE: This is the first multicenter survey study to elucidate pre-procedural safety practices in radiological examinations in seven Asian regions.

Matched MeSH terms: Radiology/education

A comparative study of X-ray pelvimetry and CT pelvimetry

Raman S, Samuel D, Suresh K

Aust N Z J Obstet Gynaecol, 1991 Aug;31(3):217-20.

PMID: 1804081

In this study 24 patients who had conventional erect lateral X-ray pelvimetry had a CT pelvimetry done after delivery to complete the pelvimetry views. The erect lateral pelvimetry was read independently by a Consultant Radiologist, Consultant Obstetrician and a Medical Officer training in Obstetrics and Gynaecology. Using CT pelvimetry as the 'gold standard' (as the error of measurement was known with the machine used) the 3 readings were compared. There was no statistical difference in the values suggesting that X-ray pelvimetry is comparable to CT pelvimetry. However CT pelvimetry is preferred, if available, because of the lower dose of radiation involved, more comfort for the patient and shorter time in performing the procedure. Measurements done are easily read directly from the CT console.

Matched MeSH terms: Radiology

Fulltext X-rays in Singapore. II. Section 1, 1901-1914

Khoo FY

Singapore Med J, 1972 Feb;13(1):65-73.

PMID: 4555689

Matched MeSH terms: Radiology/history*

Diagnostic radiology in the tropics: technical considerations

Ng KH, McLean ID

Semin Musculoskelet Radiol, 2011 Nov;15(5):441-5.

PMID: 22081279 DOI: 10.1055/s-0031-1293490

An estimated two thirds of the world's population is currently without access to diagnostic radiology services, and most of them live in resource-limited tropical regions with harsh environments. Most patients are diagnosed and treated in poorly equipped government-funded hospitals and clinics that have insufficiently trained staff and are barely operational. Any available imaging equipment is likely to be functioning suboptimally and be poorly maintained. The root of the problem is usually a lack of know-how and a quality culture, combined with insufficient basic equipment and infrastructure. Radiological imaging is an essential aspect of primary care and used in the critical diagnosis and management of trauma, tuberculosis, pneumonia, acquired immunodeficiency syndrome, cancer, and other respiratory and abdominal diseases. Considerations such as quality management and infrastructure, personnel, equipment, and radiation protection and safety are important to ensure the proper functioning and rational use of a diagnostic radiology facility in the tropics.

Matched MeSH terms: Radiology/education; Radiology/instrumentation; Radiology/manpower; Radiology/standards*

Malaysian adventure

Riemenschneider PA

Radiology, 1992 Mar;182(3):749-51.

PMID: 1535889

The author recently spent 4 months at the University of Malaya in Kuala Lumpur, Malaysia, as a visiting professor of radiology. In this report he describes his experiences in the country and at the hospital and medical school, which is one of only three in Malaysia. Each day, the author worked one-on-one with a different resident, supervising either procedures or image interpretation. Additional activities included conferences, grand rounds, and medical student teaching. Because of the mixed ethnicity of the population, the incidence and variety of pathologic conditions that were encountered clinically provided an unparalleled educational experience. The author encourages anyone with available time to consider a sabbatical such as this; it is a rewarding personal and professional experience.

Matched MeSH terms: Radiology/education*

Scenes from the past: sun-dried X rays

Joazlina ZY, Wastie ML

Radiographics, 2005 Mar-Apr;25(2):549.

PMID: 15798071

Matched MeSH terms: Radiology/history*; Radiology/methods

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