When performing a cost utility analysis, utilizing an ultrasound as the initial imaging test for rotator cuff tear, along with pre-operative MRI to identify alternative and concurrent diagnoses, can be a very effective hybrid imaging strategy, according to research being presented at the 2011 American Roentgen Ray Society's annual meeting.
The study, performed at Duke University Medical Center in Durham, NC and Rush University Medical Center in Chicago, IL, utilized three evaluation techniques: the use of ultrasound alone, MRI alone, and a hybrid strategy of ultrasound for all patients followed by MRI for those patients who required surgery.
"Several meta-analyses in the literature have found that ultrasound and MRI have similar accuracies for the evaluation of rotator cuff tears. Ultrasound is a cheaper imaging modality, yet MRI is much more frequently used for rotator cuff evaluation," said Robert Lee Suber, MD, lead author of the study. "The reasons for the preference of MRI may be related to the possibility of identifying alternative and/or concurrent diagnoses with MRI as well as surgeon preference for anatomic imaging prior to surgery," said Suber.
"One of the imaging strategies we studied was an initial screening test with ultrasound. All those patients who required surgery or failed conservative treatment would then have an MRI. We found this to more cost effective than everyone undergoing MRI as the initial evaluation," he said.
"There are cutoff values for accuracy of ultrasound and/or MRI where this combined imaging strategy is no longer cost effective over MRI alone. Additionally, as the prevalence (pre-test probability) for rotator cuff tear increases, this combined imaging strategy decreases in cost savings over MRI alone," said Suber.
"Our research shows that in populations with a lower pre-test probability of rotator cuff tear (e.g. patients seeing family practice physicians as opposed to a shoulder specialist surgeon) it may be more cost effective to initially to obtain an ultrasound. Then if the patient needs to have surgery, they can get an MRI," he said.
This abstract is being presented in conjunction with the 2011 American Roentgen Ray Society's annual meeting.
Keri Sperry | EurekAlert!
Penn first in world to treat patient with new radiation technology
22.09.2017 | University of Pennsylvania School of Medicine
Skin patch dissolves 'love handles' in mice
18.09.2017 | Columbia University Medical Center
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
22.09.2017 | Life Sciences
22.09.2017 | Medical Engineering
22.09.2017 | Physics and Astronomy