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  1. 1. Health Sciences Library Radiology Current Awareness Bulletin Date: February 2008 This bulletin includes references from the following sources: Aunt Minnie; Blackwells Journals; Bloglines; Ovid journals; TDNet. If you know someone else who would like to receive a copy of this bulletin then please contact us at the details shown below. To request any of the articles listed, please complete and sign an inter-library loan form in the Health Sciences Library, to comply with Copyright regulations. Athens: Please ensure you have your Athens username and password details to hand as they will be necessary to access some of the full-text articles listed. If you have not yet registered with Athens, as an East Cheshire NHS Trust employee you may self-register online at: Hyperlinks: Many of the articles contain hyperlinks which should lead to the chosen articles. In some cases a single click will be sufficient, but occasionally you may need to Ctrl and Click to activate the link. If the hyperlinks are broken or fail to work, then please contact us. Copyright: Copied material(s) is for the purpose of non-commercial research or private study and relates to a single paper copy which will not be copied (by any means) to any other person. Disclaimer: Every effort has been made to ensure that the information provided is accurate, up- to-date and complete. However articles may contain errors. No responsibility can be accepted for any action taken on the basis of this information. Sue Taylor Library Services Manager: Ext: 3923 Jan Read Library Services Trainer: Ext: 3923 Health Sciences Library Education and Training Centre West Park
  2. 2. Macclesfield Cheshire SK10 3BL NEW BOOKS IN THE LIBRARY None this month WEBSITES [Ctrl + click for links] From Biomed Central 29 January 2008 BioMed Central bolsters radiology image collection BioMed Central has partnered with the American Roentgen Ray Society to add more journals and images to GoldMiner(tm), the ARRS radiology search engine. BioMed Central, the open access publisher of peer-reviewed biomedical research has contributed over 170 journals, adding over 4,200 images to the GoldMiner(tm) collection. The collection now numbers over 170,000 images and over 225 journals. "GoldMiner(tm) speeds your search for radiology images by quickly matching search criteria with peer-reviewed content available on the Web," said Charles E. Kahn, Jr., MD, a creator of GoldMiner(tm). "By limiting results to images from respected, peer-reviewed journals, you won't spend a lot of time sifting through thousands of unrelated images or images from unknown sources. You can save more time by filtering by imaging modality, patient age and gender," said Dr. Kahn. "BioMed Central is very happy to be partnering with the ARRS to expand their radiology image search tool with the indexing of thousands of openly licensed images from our journals," said Matthew Cockerill, publisher of BioMed Central. "We are always keen to encourage creative use of the open access articles which we publish and GoldMiner(tm) is a great example of this," he said. From Bloglines 22/1/08 National PACS steering group disbanded A shake-up in national governance arrangements for PACS across England has been signalled by Connecting for Health (CfH). From Health Management Specialist Library Report into the effects of CT scanning asymptomatic people The Committee on Medical Effects of Radiation in the Environment [COMARE] has published its 12th Report: The impact of personally initiated X-ray computed tomography scanning for the health assessment of asymptomatic individuals including recommendations into the regulation of such tests and consideration of whether or not they are effective in a public health context. COMARE press release From Aunt Minnie 9/1/08 Multislice CT detects coronary disease in men and women NEW YORK (Reuters Health) - Multislice computed tomography (MSCT) coronary angiography appears highly effective in diagnosing obstructive coronary artery disease in both men and women, Dutch researchers report in the January issue of Heart. To investigate, Dr. Jereon Bax, of Leiden University Medical Center, and colleagues studied 50 men and 50 women with known and suspected coronary artery disease who underwent 64-slice MSCT.
  3. 3. 21/1/08 Trauma radiologists overhaul abdominal CT contrast protocols Radiologists routinely administer both an oral barium suspension and IV contrast for evaluating suspected appendicitis, diverticulitis, and small-bowel obstruction (SBO). Would studies work as well without oral contrast? And what about oral iodine? Can it replace barium in abdominal applications other than virtual colonoscopy? Two research groups recently explored these issues. 21/1/08 Ultrasound quality strongly affects ovarian cancer management NEW YORK (Reuters Health) - Improving the quality of pre-operative ultrasound can reduce the number of unnecessary staging procedures performed to confirm ovarian cancer and can also shorten the hospital stay, according to a report in the January 21st online issue of The Lancet Oncology. 23/1/08 Groups advocate less radiation for kids Thirteen radiology-related organizations are urging healthcare practitioners to significantly reduce the amount of radiation administered to children during imaging scans. 25/1/08 Cochrane Review studies mammo discomfort In a review of studies conducted to evaluate ways to reduce mammography exam discomfort, women's imaging vendor Hologic's MammoPad breast cushions were found to reduce pain, according to the Cochrane Collaboration of Oxford, U.K. 29/1/08 DMIST: Women under 50 with dense breasts benefit from FFDM Full-field digital mammography (FFDM) performs significantly better than film-screen in one particular subgroup of women, according to researchers of the Digital Mammographic Imaging Screening Trial (DMIST). They examined the DMIST data for 10 subgroups of women, and found that women younger than 50 with dense breasts benefited the most from FFDM. 31/1/08 False positives a concern with FDG-PET/CT for head, neck tumors FDG-PET/CT is worthwhile for assessing patients with occult head and neck primary tumors, but false positives remain a shortcoming of the hybrid technology, according to a British study. The results show that FDG-PET/CT cannot replace examination under anesthesia and biopsies for assessing occult head and neck primary tumors. 4/2/08 Dark-field x-ray measures scatter radiation for better image quality A new technique for producing images could offer a way to create higher-quality images using conventional digital radiography equipment, according to Swiss researchers. The technique, called dark-field x-ray, is based on radiation scattered from a target rather than the traditional method of using radiation absorbed by the target. The researchers discussed their implementation of dark-field imaging in a paper published in Nature Materials. 5/2/08 Ultrasound shows promise as a screening tool for wrist pain More than 2.2 million people in the U.S. turn up at their doctor's office with complaints of wrist pain, but ordering up costly MRI and MR arthrography exams -- or radiation-laden CT arthrography -- is not always feasible. Orthopedic specialists from Tucson's University of Arizona have proposed ultrasound-based exams as a screening tool for wrist ligaments. 12/2/08 The use of computer-aided detection (CAD) software for digital radiography (DR) images is a relatively new application, but the combination could prove useful if DR is to develop a role in lung screening. One possible fly in the ointment, however, is the impact of various DR postprocessing techniques on CAD functionality. DR data can be manipulated, massaged, and processed in various ways, any one of which could affect CAD's ability to detect suspicious lung nodules.
  4. 4. Chinese researchers address this issue in an article we're featuring this week in our Digital X-Ray Community. The investigators used a commercially available CAD application to analyze DR images processed with three different types of image postprocessing techniques. They found that CAD's performance varied widely based on the type of image processing used, with statistically significant variations in nodule detection and false-positive rates. Learn more by clicking here, or visit the community at 13/2/08 Study finds that CAD does improve mammography's sensitivity A new study published this week found that computer-aided detection improves the sensitivity of mammography screening with only a small boost in the patient recall rate. The research offers a rebuttal to last year's New England Journal of Medicine study that found that CAD actually reduced the accuracy of breast screening centers that used it. Click here to read the rest of the article. 14/2/08 A new study published this week has reignited the debate over the use of computer- aided detection (CAD) software for mammography screening. The new research finds that CAD has a beneficial role in breast screening, contradicting the results of last year's controversial study in the New England Journal of Medicine. In the new study, U.S. researchers analyzed their experience with CAD in more than 230,000 patients over four years, according to an article in our Women's Imaging Digital Community by staff writer Kate Madden Yee. The methodology specifically addressed a number of the perceived shortcomings in the earlier NEJM study that CAD proponents believe reduced the accuracy for sites using CAD. The new study found that sites using CAD turned in results that were superior compared to those of a single reader, and comparable to double reading by two radiologists. What's more, CAD's recall rate didn't exceed that of double reading. The question is, what impact will the study have on recent efforts by insurance payors to restrict CAD reimbursement? So far, CAD advocates have successfully beaten back most of the proposed cuts -- this week's study should give them another weapon in their arsenal. Get the rest of the details by clicking here. 21/2/08 Medical imaging has become a crucial tool in managing acute stroke patients. Technologies like CT and MRI have developed indispensable roles in determining the course of treatment during the "golden hour," when at-risk brain tissue can be saved by the accurate administration of therapy. But imaging's role in stroke diagnosis and treatment is still evolving, and that's the subject of a new series on stroke imaging we're featuring this week in our CT Digital Community by staff writer Eric Barnes. In part I of the series, we examine the role of imaging in identifying brain tissue that can be salvaged through early and effective treatment. Part of the problem is that, despite recent advancements, medical imaging is still limited to simplistic representations of brain physiology. Even some of the terms imaging specialists use to describe at-risk brain tissue -- such as the term "penumbra" -- aren't completely accurate. Learn more about the current state of the art in stroke imaging by clicking here. We'll be running part II of this series in our next CT Insider newsletter, so make sure you're signed up to get it. To register as a CT Insider (or for any of our other Insider newsletters), just click on the "Newsletters" link at the top of any AuntMinnie Web page when you're logged in. The link will take you to a page where you can manage your AuntMinnie newsletters just by checking the boxes beside each one.
  5. 5. JOURNAL ARTICLES AVAILABLE FROM THE HEALTH SCIENCES LIBRARY AMERICAN JOURNAL OF ROENTGENOLOGY 2007 ; VOL 190 ; PART 2 Article Title: The Image Gently Campaign : Working Together to Change Practice Author(s): Goske , M . J . ; Applegate , K . E . ; Boylan , J . Page: 273-274 Article Title: CMS 2008 Rulemaking Focuses on Curbing Self - Referred Imaging Author(s): Greeson , T . W . ; Zimmerman , H . M . Page: 275-279 Article Title: Dual - Phase CT of Autoimmune Pancreatitis : A Multireader Study Author(s): Takahashi , N . ; Fletcher , J . G . ; Fidler , J . L . ; Hough , D . M . ; Kawashima , A ; Chari , S . T . Page: 280-286 Article Title: MR Enterography of Small - Bowel Lymphoma : Potential for Suggestion of Histologic Subtype and the Presence of Underlying Celiac Disease Author(s): Lohan , D . G . ; Alhajeri , A . N . ; Cronin , C . G . ; Roche , C . J . ; Murphy , J . M Page: 287-293 Article Title: Gas Bubble Motion Artifact in MDCT Author(s): Liu , F . ; Cuevas , C . ; Moss , A . A . ; Kolokythas , O . ; Dubinsky , T . J . ; Kinahan , P . E . Page: 294-299 Article Title: Transient Homogeneously Enhancing Hepatic Masses : Can Size Predict Benignity ? Author(s): Hughes - Cassidy , F ; Wong , J . ; Aguirre , D . Page: 300-307 Article Title: Automated Threshold - Based 3D Segmentation Versus Short - Axis Planimetry for Assessment of Global Left Ventricular Function with Dual - Source MDCT Author(s): Juergens , K . U . ; Seifarth , H . ; Range , R . Page: 308-314 Article Title: Radiation Dose , Image Quality , Stenosis Measurement , and CT Densitometry Using ECG - Triggered Coronary 64 - MDCT Angiography : A Phantom Study Author(s): Horiguchi , J . ; Kiguchi , M . ; Fujioka , C . Page: 315-320 Article Title: Repeatability Limits for Measurement of Coronary Artery Calcified Plaque with Cardiac CT in the Multi - Ethnic Study of Atherosclerosis Author(s): Chung , H . ; McClelland , R . L . ; Katz , R . ; Carr , J . J . ; Budoff , M . J Page: 321 Article Title: Routine Pelvic and Lower Extremity CT Venography in Patients Undergoing CT Pulmonary Angiography Author(s): Hunsaker , A . R . ; Zou , K . H . ; Poh , A . C . Page: 322-326 Article Title: Dynamic Oxygen - Enhanced MRI Versus Quantitative CT : Pulmonary Functional Loss Assessment and Clinical Stage Classification of Smoking - Related COPD Author(s): Ohno , Y . ; Koyama , H . ; Nogami , M . Page: 327 Article Title: Prediction of Perceptible Artifacts in JPEG 2000 - Compressed Chest CT Images Using Mathematical and Perceptual Quality Metrics Author(s): Kim , B . ; Lee , K H . ; Kim , K . J . Page: 328-334
  6. 6. Article Title: Radiation Dose Reduction in Chest CT : A Review Author(s): Kubo , T . ; Lin , P J . P . ; Stiller , W . Page: 335-343 Article Title: Effect of Patient Size on Radiation Dose for Abdominal MDCT with Automatic Tube Current Modulation : Phantom Study Author(s): Schindera , S . T . ; Nelson , R . C . ; Toth , T . L . Page: 344 Article Title: Two - Step Postmortem Angiography with a Modified Heart - Lung Machine : Preliminary Results Author(s): Grabherr , S . ; Gygax , E . ; Sollberger , B . Page: 345-351 Article Title: MDCT Analysis of Projectile Injury in Forensic Investigation Author(s): Harcke , H . T . ; Levy , A . D . ; Getz , J . M . ; Robinson , S . R . Page: 352 Article Title: Accuracy of Retrograde Ileostomy Radiographic Examination for Detecting Small - Bowel Abnormalities Author(s): Kessler , J . M . ; Levine , M . S . ; Rubesin , S . E . ; Rombeau , J . L . ; Laufer , I Page: 353-360 Article Title: Noncathartic CT Colonography with Stool Tagging : Performance With and Without Electronic Stool Subtraction Author(s): Johnson , C . D . ; Manduca , A . ; Fletcher , J . G . Page: 361-366 Article Title: Imaging Findings in Roux - en - O and Other Misconstructions : Rare but Serious Complications of Roux - en - Y Gastric Bypass Surgery Author(s): Mitchell , M . T . ; Gasparaitis , A . E . ; Alverdy , J . C . Page: 367-373 Article Title: Critical Analysis of the Performance of Double - Contrast Barium Enema for Detecting Colorectal Polyps > or = 6 mm in the Era of CT Colonography Author(s): Sosna , J . ; Sella , T . ; Sy , O . Page: 374-385 Article Title: Asymptomatic Pneumatosis at CT Colonography : A Benign Self - Limited Imaging Finding Distinct from Perforation Author(s): Pickhardt , P . J . ; Kim , D . H . ; Taylor , A . J . Page: 386 Article Title: MR Defecography : Prospective Comparison of Two Rectal Enema Compositions Author(s): Solopova , A . E . ; Hetzer , F . H . ; Marincek , B . ; Weishaupt , D . Page: 387 Article Title: Nonobstructing Renal Stones on Unenhanced CT : A Real Cause for Renal Colic ? Author(s): Furlan , A . ; Federle , M . P . ; Yealy , D . M . ; Averch , T . D . ; Pealer , K Page: 388 Article Title: 3 - T Contrast - Enhanced MR Angiography in Evaluation of Suspected Intracranial Aneurysm : Comparison with MDCT Angiography Author(s): Nael , K . ; Villablanca , J . P . ; Mossaz , L . Page: 389-395 Article Title: Original Research . Preoperative Evaluation of Bile Duct Cancer : MRI Combined with MR Cholangiopancreatography Versus MDCT with Direct Cholangiography . Author(s): Park , H . S . ; Lee , J . M . ; Choi , J . Y . Page: 396-405 Article Title: Pictorial Essay . CT of Serous Cystadenoma of the Pancreas and Mimicking Masses Author(s): Kim , H . J . ; Lee , D . H . ;Ko , Y . T . ;Lim , J . W . ;Kim , H . C . ;Kim , K . W
  7. 7. Page: 406-412 Article Title: Original Research . Percutaneous Imaging - Guided Solid Organ Core Needle Biopsy : Coaxial Versus Noncoaxial Method Author(s): Hatfield , M . K . ; Beres , R . A . ; Sane , S . S . ; Zaleski , G . X . Page: 413-417 Article Title: Original Research . Radiofrequency Ablation of Liver Adjacent to Body of Gallbladder : Histopathologic Changes of Gallbladder Wall in a Pig Model . Author(s): Lee , J . W . ; Rhim , H . ; Jeon , Y . H . Page: 418-425 Article Title: Technical Innovation Adjustment of Laparoscopic Banding Device with the Aid of an Angiographic Compression Device Author(s): Tan , C . K . F . ; Walker , G . D . Page: 426 Article Title: Technical Innovation Cutting Balloon Treatment for Recurrent Benign Bronchial Strictures . Author(s): Shin , J . H . ; Song , H . Y . ; Kim , J . H . Page: 426 Article Title: Technical Innovation PET of Hypoxia and Perfusion with ^ 6 ^ 2Cu - ATSM and ^ 6 ^ 2Cu - PTSM Using a ^ 6 ^ 2Zn / ^ 6 ^ 2Cu Generator . Author(s): Wong , T . Z . ; Lacy , J . L . ; Petry , N . A . Page: 427-432 Article Title: Original Research . In Vivo Proton Spectroscopy of Giant Cell Tumor of the Bone Author(s): Sah , P . L . ; Sharma , R . ; Kandpal , H . Page: 433 Article Title: Pictorial Essay . Simple Changes to 1 . 5 - T MRI Abdomen and Pelvis Protocols to Optimize Results at 3 T Author(s): Cornfeld , D . ; Weinreb , J . Page: 434 Article Title: Clinical Observations . MRI Features of Posterior Capitellar Impaction Injuries Author(s): Rosenberg , Z . S . ;Blutreich , S . I . ;Schweitzer , M . E . ;Zember , J .S et al Page: 435-441 Article Title: Original Research . Popliteomeniscal Fascicles : Anatomic Considerations Using MR Arthrography in Cadavers Author(s): Peduto , A . J . ; Nguyen , A . ; Trudell , D . J . ; Resnick , D . L . Page: 442-448 Article Title: Review . The Posterolateral Corner of the Knee Author(s): Vinson , E . N . ; Major , N . M . ; Helms , C . A . Page: 449-458 Article Title: Original Research . Diagnostic Accuracy and Reading Time to Detect Intracranial Aneursyms on MR Angiography Using a Computer - Aided Diagnosis System . Author(s): Kakeda , S . ; Korogi , Y . ; Arimura , H . Page: 459-465 Article Title: Original Research . Suppression of Myocardial ^ 1 ^ 8F - FDG Uptake by Preparing Patients with a High - Fat , Low - Carbohydrate Diet Author(s): Williams , G . ; Kolodny , ; G . M . Page: 466 Article Title: Original Research . Prospective Evaluation of Image Quality with Use of a Patient Image Gallery for Dose Reduction in Pediatric 16 - MDCT Author(s): Honnef , D . ; Wildberger , J . E . ; Haras , G . Page: 467-475 Article Title: Original Research . Role of Sonography in the Detection of Contralateral Metachronous Breast Cancer in an Asian Population
  8. 8. Author(s): Kim , M . J . ; Kim , E . K . ; Kwak , J . Y . Page: 476-480 Article Title: Original Research . Diffusion - Weighted Single - Shot Echo - Planar Imaging with Parallel Technique in Assessment of Endometrial Cancer . Author(s): Shen , S . H . ; Chiou , Y . Y . ; Wang , J . H . Page: 481-488 Article Title: Original Research . 3 - T MRI in the Preoperative Evaluation of Depth of Myometrial Infiltration in Endometrial Cancer . Author(s): Torricelli , P . ; Ferraresi , S . ; Fiocchi , F . Page: 489-495 Article Title: Original Research . Correlation of Whole - Breast Vascularity with Ipsilateral Breast Cancers Using Contrast - Enhanced MDCT Author(s): Kang , D . K . ; Kim , E . J . ; Kim , H . S . ; Sun , J . S . ; Jung , Y . S . Page: 496-504 Article Title: Original Research . Proton MR Spectroscopy in Normal Breasts Between Pre - and Postmenopausal Women : A Preliminary Study Author(s): Wang , J . ; Torng , P . L . ; Liu , T . P . ; Chen , K . L . ; Shih , T . T . F Page: 505-510 Article Title: Original Research . Lesion and Patient Characteristics Associated with Malignancy After a Probably Benign Finding on Community Practice Mammography Author(s): Lehman , C . D . ; Rutter , C . M . ; Eby , P . R . ; White , E . et al Page: 511-515 Article Title: Original Research . Screening - Detected and Symptomatic Ductal Carcinoma in Situ : Differences in the Sonographic and Pathologic Features . Author(s): Shin , H . J . ; Kim , H . H . ; Kim , S . M . ; Kwon , G . Y . ; Gong , G . et al Page: 516-525 Article Title: Original Research . Physician Workload in Mammography Author(s): Smith - Bindman , R ; Miglioretti , D . L . ; Rosenberg , R . Page: 526-532 BRITISH JOURNAL OF NURSING VOL 15 NUMB 15 2006 Aug 10-Sep 13 p.825-7 Ward nurses' knowledge of computed tomography scanning Majeed-M, Nayeemuddin-M, Christie-M. Walsgrave Hospital University Hospitals of Coventry and Warwickshire NHS Trust Patients benefit from and are reassured by advance information on procedures that they are to undergo. Ward nurses should have adequate knowledge of radiological investigations to ensure proper patient preparation and good interdepartmental communication to avoid delays and cancellations. This study was conducted to assess the ward nurses' knowledge of the process of computed tomography (CT) scanning. One hundred and twenty qualified nurses were asked to complete a questionnaire regarding CT scanning. The findings revealed a suboptimal level of awareness about the process. This is probably due to lack of formal teaching for nurses on the wards in regards the different radiological procedures and patient preparation. There is a strong case for better educational talks on rapidly changing radiological techniques for ward staff to ensure high-quality patient care. NEW ENGLAND JOURNAL OF MEDICINE 21 Feb 2008 CORRESPONDENCE Computed Tomography and Radiation Exposure
  9. 9. Incidental Findings on Brain MRI Visualizing Out-of-Body Experience in the Brain JOURNAL ARTICLES AVAILABLE TO YOU IN FULL TEXT – [Ctrl + click to open link] Athens password required – contact Library if you do not have one BMC MEDICAL IMAGING 2008, 8:5 (29 February 2008) Abdominal ultrasonography in HIV/AIDS patients in Southwestern Nigeria Obajimi MO, Atalabi MO, Ogbole GI, Adeniji-Sofoluwe AT, Agunloye AM, Adekanmi AJ et al [Abstract] [Provisional PDF] 2008, 8:4 (29 February 2008) Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping McGoron AJ, Capille M, Georgiou MF, Sanchez P, Solano J, Gonzalez-Brito M, Kuluz JW [Abstract] [Provisional PDF] LARYNGOSCOPE Web link to this journal 118(3):501-505, March 2008. 3 Tesla Delayed Contrast Magnetic Resonance Imaging Evaluation of Meniere's Disease Carfrae, Matthew J. ; Holtzman, Adrian ; Eames, Fred ; Parnes, Steven M. ; Lupinetti, Allison Abstract Objective: To determine whether 3 Tesla (T) magnetic resonance imaging (MRI) with delayed contrast imaging has sufficient anatomic resolution to image the intracochlear fluid spaces (i.e., the scala tympani, scala media, and scala vestibuli) of the inner ear and identify endolymphatic hydrops in vivo. Study Design: Four normal subjects underwent 3T MRI scanning after the administration of gadodiamide intravenous (IV) contrast. MRI region of interest signal intensity was used to determine the diffusion of gadodiamide into the perilymphatic fluid spaces over time. Seven subjects with unilateral Meniere's disease underwent 3T MRI 4 hours after administration of gadodiamide IV contrast agent. Results: All four normal subjects demonstrated perilymphatic enhancement by 4 hours postinjection. Loss of definition of the membranous cochlea was noted in five of the seven subjects with Meniere's disease. Precise definition of the scala media could not be achieved with this imaging protocol. Conclusion: Delayed contrast imaging of the inner ear with 3T MRI revealed in vivo changes of the membranous labyrinth consistent with unilateral Meniere's disease. NEUROLOGY Web link to this journal 70(7):512-520, February 12, 2008 MRI patterns of atrophy associated with progression to AD in amnestic mild cognitive impairment SYMBOL Whitwell, J L.; Shiung, M M.; Przybelski, S A.; Weigand, S D.; Knopman, D S.; Boeve, B F. et al Abstract
  10. 10. Objective: To compare the patterns of gray matter loss in subjects with amnestic mild cognitive impairment (aMCI) who progress to Alzheimer disease (AD) within a fixed clinical follow-up time vs those who remain stable. Methods: Twenty-one subjects with aMCI were identified from the Mayo Clinic Alzheimer's research program who remained clinically stable for their entire observed clinical course (aMCI- S), where the minimum required follow-up time from MRI to last follow-up assessment was 3 years. These subjects were age- and gender-matched to 42 aMCI subjects who progressed to AD within 18 months of the MRI (aMCI-P). Each subject was then age- and gender-matched to a control subject. Voxel-based morphometry (VBM) was used to assess patterns of gray matter atrophy in the aMCI-P and aMCI-S groups compared to the control group, and compared to each other. Results: The aMCI-P group showed bilateral loss affecting the medial and inferior temporal lobe, temporoparietal association neocortex, and frontal lobes, compared to controls. The aMCI-S group showed no regions of gray matter loss when compared to controls. When the aMCI-P and aMCI-S groups were compared directly, the aMCI-P group showed greater loss in the medial and inferior temporal lobes, the temporoparietal neocortex, posterior cingulate, precuneus, anterior cingulate, and frontal lobes than the aMCI-S group. Conclusions: The regions of loss observed in subjects with amnestic mild cognitive impairment (aMCI) who progressed to Alzheimer disease (AD) within 18 months of the MRI are typical of subjects with AD. The lack of gray matter loss in subjects with aMCI who remained clinically stable for their entire observed clinical course is consistent with the notion that patterns of atrophy on MRI at baseline map well onto the subsequent clinical course. SPINE Web link for this journal 33(4):E109-E115, February 15, 2008 Surgical Results in Hidden Lumbar Spinal Stenosis Detected by Axial Loaded Computed Tomography and Magnetic Resonance Imaging: An Outcome Study Willen, Jan ; Wessberg, Per J. ; Danielsson, Barbro Abstract Study Design. An outcome study of patients with neurogenic claudication and/or sciatica with hidden stenosis, detected only by axial loading of the lumbar spine (ACE) but not at the traditional unloaded examination (psoas relaxed position) during computed tomography (CT) myelography or magnetic resonance imaging (MRI), followed up after surgery. Objective. To estimate the clinical effect of decompression with or without fusion in patients with hidden stenosis in the lumbar spine. Summary of Background Data. A number of patients with neurogenic claudicatio with or without sciatica do not have corresponding imaging abnormalities. Axial loaded CT and MRI have disclosed hidden stenosis in certain cases. The surgical effect in patients with hidden stenosis has never been described. Methods and Materials. Axial loading of the lumbar spine during CT and MRI was performed in 250 patients with neurogenic claudication and sciatica. All fulfilled the inclusion criteria for ACE, i.e., suspected but not verified spinal stenosis in 1 to 3 levels. In 125 patients (50%), a significant narrowing of the spinal canal occurred. Out of these 125 patients, 101 had a clear stenosis besides the stenosis only detected at ACE. In 24 patients, a hidden stenosis was detected in 1 to 3 levels only at the ACE. These patients were observed for 1 to 6 years after decompression with or without fusion regarding subjective improvement of leg and back pains, walking capacity, satisfaction, and health related quality of life.
  11. 11. Results. At follow-up, 76% of the patients had leg pain less than 25/100 on a VAS scale and 62% had back pain less than 25/100. Ninety-six percent were improved or much improved regarding leg and back pains The ability to walk increased significantly after surgery. Walking capacity to more than 500 m increased from 4% to 87%. Twenty-two patients were subjectively satisfied with the surgical results. The ODI score, the SF-36 and the EQ-5D score corresponded well to the above mentioned improvements at follow-up. Conclusion. According to this study, the results of surgery in hidden lumbar stenosis only detected by axial compression in extension during CT or MRI, are convincing and comparable with the results of surgical treatment for stenoses diagnosed by unloaded examinations. STROKE Web link to this journal Publish Ahead of Print, published online before print, 31 January 2008 Antidepressant Treatment and Worsening White Matter on Serial Cranial Magnetic Resonance Imaging in the Elderly: The Cardiovascular Health Study Steffens, David C. ; Chung, Hyoju ; Krishnan, K Ranga R. ; Longstreth, W T. Jr et al Abstract Background and Purpose-: In some studies, late life depression is associated with white matter lesions on MRI. The effect of different classes of antidepressants on progression of white matter lesions is unknown. Selective serotonergic reuptake inhibitors (SSRIs) may decrease platelet aggregation. We hypothesized that Cardiovascular Health Study participants taking SSRIs would less often have worsening white matter on serial MRI than participants not on antidepressants. Methods-: Among 1826 participants who were not using an antidepressant at initial MRI scan, we examined the association of worsening in white matter grade from initial to follow-up MRI scans, 5 years apart on average, and antidepressant use between the scans. Logistic regression models were used, controlling for a variety of potential confounding variables. Results-: Use of any antidepressant during the period of study was associated with worsening white matter. In a multivariable model, risk was slightly increased, not reduced, with use of serotonergic agents (OR 1.36, 95% CI 0.87 to 2.12) and was significantly increased with the use of tricyclic antidepressants (OR 1.77, 95% CI 1.07 to 2.94). Conclusions-: The association between worsening white matter and use of tricyclic antidepressants was an unexpected finding that may relate to indications for use other than depression or to side effects such as hypotension. Protection against worsening was not seen with use of serotonergic agents. Publish Ahead of Print, published online before print, 7 February 2008 Linking MRI Hyperintensities With Patterns of Neuropsychological Impairment: Evidence for a Threshold Effect Libon, David J. ; Price, Catherine C. ; Giovannetti, Tania ; Swenson, Rodney ; Bettcher, Brianne Magouirk ; Heilman, Kenneth M. ; Pennisi, Alfio Abstract Background and Purpose-: Leukoaraiosis (LA) might interrupt intra- and interhemispheric communication and thus induce cognitive impairments and dementia. It remains unclear, however, if there is a volume threshold of LA that is needed before either the signs of dementia and/or a specific pattern of neuropsychological impairment become manifest. Roman et al has suggested that 25% of white matter may need to be involved before white matter alterations influence the clinical signs associated with dementia. The purpose of this study is to ascertain the threshold of MRI-LA as measured with a visual rating scale needed to induce specific patterns of
  12. 12. neuropsychological impairment associated with dementia. Methods-: One hundred fifteen patients with dementia received a comprehensive neuropsychological examination and the severity of MRI-LA was measured using a 40-point LA scale. Results-: Patients were categorized into low (mean LA=4.21+/-2.92; 3.22%-17.82%), moderate (mean LA=12.58+/-2.54; 25.01%-37.80%), and severe (mean LA=22.36+/-4.04; 45.80%-66.00%) LA groups. Patients in the mild LA group obtained markedly lower scores on tests of episodic memory compared with working memory, a neuropsychological profile often associated with Alzheimer disease. Patients with moderate LA displayed equal impairment on neuropsychological tests. Patients in the severe LA group obtained significantly lower scores on tests of working memory as compared with episodic memory. Conclusions-: These data provide evidence that a threshold of moderate MRI-LA as measured with a visual rating scale is associated with greater and/or equal impairment on tests of working memory versus episodic memory and provides a benchmark to assess the effect of MRI-LA on the clinical presentation of dementia. Publish Ahead of Print, published online before print, 7 February 2008 Gray Matter Atrophy in Patients With Ischemic Stroke With Cognitive Impairment. Stebbins, Glenn T.; Nyenhuis, David L. ;Wang, Changsheng ; Cox, Jennifer L. ; Freels, Sally et al Abstract Background and Purpose-: Patients with ischemic stroke are at risk for developing vascular cognitive impairment ranging from mild impairments to dementia. MRI findings of infarction, white matter hyperintensities, and global cerebral atrophy have been implicated in the development of vascular cognitive impairment. The present study investigated regional gray matter volume differences between patients with ischemic stroke with no cognitive impairment and those with impairment in at least one domain of cognitive function. Methods-: Ninety-one patients with ischemic stroke participated. Detailed neuropsychological testing was used to characterize cognitive functioning in 7 domains: orientation, attention, working memory, language, visuospatial ability, psychomotor speed, and memory. High-resolution T1- weighted 3-dimensional fast-spoiled gradient recalled structural MRIs were processed using optimized voxel-based morphometry techniques while controlling for lesions. Whole brain voxelwise regional differences in gray matter volume were assessed between patients with stroke with no impaired cognitive domains and patients with stroke with at least one impaired cognitive domain. Logistic regression models were used to assess the contribution of demographic variables, stroke-related variables, and voxel-based morphometry results to classification of cognitive impairment group membership. Results-: Fifty-one patients had no impairments in any cognitive domain and 40 patients were impaired in at least one cognitive domain. Logistic regression identified significant contributions to cognitive impairment groups for demographic variables, stroke-related variables, and cognitive domain performance. Voxel-based morphology results demonstrated significant gray matter volume reductions in patients with stroke with one or more cognitive domain impairment compared with patients with stroke without cognitive impairment that was seen mostly in the thalamus with smaller reductions found in the cingulate gyrus and frontal, temporal, parietal, and occipital lobes. These reductions were present after controlling for group differences in age, education, stroke volume, and laterality of stroke. The addition of voxel-based morphometry- derived thalamic volume significantly improved a logistic regression model predicting cognitive impairment group membership when added to demographic variables, stroke-related variables, and cognitive domain performance. Conclusions-: These results suggest a central role for the thalamus and lesser roles for other cortical regions in the development of cognitive impairment after ischemic stroke. Indeed,
  13. 13. consideration of thalamic volumes adds significant information to the classification of cognitive impaired versus nonimpaired groups beyond information provided by demographic, stroke- related, and cognitive performance measures. JOURNAL ARTICLES NOT AVAILABLE TO YOU IN FULL TEXT AUSTRALASIAN RADIOLOGY Volume 51, Bonus Issue, December 2007 HEAD AND NECK Myoepithelioma and malignant myoepithelioma arising from the salivary gland: computed tomography and magnetic resonance findings Y Monzen, N Fukushima and T Fukuhara pages B169–B172 Ossifying pleomorphic adenoma of the parotid gland: A case report and review H Kato, M Kanematsu, K Ando, K Mizuta, Y Ito, Y Hirose and H Hoshi pages B173–B175 Cemento-ossifying fibroma of mandible AG Hombal, KK Hegde and VN Narvekar pages B176–B179 Rare presentation of thyroglossal duct cyst after radiation therapy to the neck A Srinivasan, M Hayes, D Chepeha and SK Mukherji pages B180–B182 Cervical chordoma presenting as retropharyngeal mass and dysphonia: Case report and literature review N Singh, M Soo, M De Cruz, L Gomes, F Maclean and G Dandie pages B183–B188 Invasive sinus aspergillosis with perineural spread in an immunocompetent patient S Subramanian, H Kandpal, R Sharma, N Pushkar, S Sen, S Gamanagatti and S Vashist pages B189–B192 Oesophageal and tracheal perforation in thyroid B-cell lymphoma JL Jaremko, B Rawat and S Naik pages B193–B195 Lemierre’s syndrome revisited: case report and imaging findings O Chiu, SH Erbay and RA Bhadelia pages B196–B198
  14. 14. Imaging features of endolymphatic sac tumours: case report with review of literature M Kang, N Khandelwal, P Singh, S Choudhary and KK Mukherjee pages B199–B201 Myxoma of the masticator space MR Gandhi, YM Tang and B Panizza pages B202–B204 PAEDIATRIC Dorsal dermal sinus with intramedullary abscess formation JR Shah,V Joshi and D Patkar pages B205–B209 Paradoxical cerebral arterial gas embolism: Computed tomography findings SB Ghatge, VL Bhatgadde, AM Nagar, AA Raut and RS Narlawar pages B210–B213 Anterior urethral value: An uncommon cause of urethral obstruction SMA Hassam and K Tew pages B214–B216 A child with respiratory distress having unilateral obstructive emphysema and contralateral opaque hemithorax on chest radiograph: Role of multi-detector computerized tomography with multi-planar reconstruction and virtual bronchoscopy J Debnath, NK Jain, KM Adhikari, SK Shelley, A Vaidya and RA George pages B217–B220 Brain MRI features of merosin-negative congenital muscular dystrophy JK Ibrahim Abdulla, S Vattoth, AA Al Tawari, T Pandey and S Abubacker pages B221–B223 Patent urachus in a neonate: Findings at micturating cystourethregram PJ Depree and CKF Wong pages B224–B226 Magnetic resonance imaging of a case of monomelic macrodystrophia lipomatosa AK Pandey pages B227–B230 CHEST Candida prosthetic valve endocarditis: the complementary role of multidetector
  15. 15. computed tomography and transoesophageal echocardiography in preoperative evaluation E Ghersin, J Lessick, Y Agmon, A Engel, A Kophit and Z Adler pages B231–B234 Barium aspiration showing crazy-paving appearance on high-resolution computed tomography S Akata, J Park, H Shindo, M Yoshimura, D Kakizaki and K Abe pages B235–B237 Tracheal bronchus misdiagnosed as tuberculosis Nivene Saad, Merle Wigeson and Troy Stapleton pages B238–B241 Bag of worms B McGuinness, MC Soh, S Kumar and J Donald pages B242–B245 Thoracic splenosis: Diagnosis of a case based on history and computerized tomography findings S McKeen and F Dharsono pages B246–B249 Strangulated stomach within a paraoesophageal hernia: A rare complication of laparoscopic Nissen fundoplication J Robertson and E Avjioglu pages B250–B252 Multidetector spiral CT venography in the diagnosis of upper extremity deep venous thrombosis R Sabharwal, D Boshell and P Vladica pages B253–B256 Double superior vena cava with a persistent left superior vena cava: an incidental finding during peripherally inserted central catheter placement NK Shyamkumar and R Brown pages B257–B259 Intramural haematoma of the oesophagus presenting as an unusual complication of endotracheal intubation AY Wang, RD Riordan, N Yang and C-y Hiew pages B260–B264
  16. 16. Pseudomesotheliomatous adenocarcinoma of the lung with synchronous gastric and esophageal cancer K Kaira, N Sunaga, N Yanagitani, T Hisada, T Ishizuka and M Mori pages B265–B267 GYNAECOLOGY AND OBSTETRICS Disseminated peritoneal leiomyomatosis: magnetic resonance imaging and differential diagnosis MK Demir pages B268–B271 Endometriosis of the inguinal region: Magnetic resonance imaging (MRI) findings RS Low, AO Jones, M Houang, L Newland, AL Morey and T Chan-Ling pages B272–B275 Magnetic resonance imaging of pregnancy in suspected uterine anomaly MH Pui pages B276–B280 Meat balls: a pathognomonic ultrasound and computed tomography finding in mature cystic teratoma S Mahomedy, MR Bayat and M Seedat pages B281–B283 Transmigrated intrauterine device discovered 17 years after its insertion T Bartalena, E Pascali, MF Rinaldi, R Marasco, F Bassi, C Alboni and G Gavelli pages B284–B286 HEPATOPANCREATOBILIARY Solid pseudopapillary tumor of the pancreas with portal vein compression presenting as portal hypertension H Kandpal, R Sharma, CJ Das, P Sahni, AK Das and Z Neyaz pages B287–B291 Portal vein thrombosis with unusual hepatic enhancement pattern: Diagnosis using 64- slice multidetector computed tomography and 3 Tesla magnetic resonance imaging J Salanitri pages B292–B295 Herniation of the gall bladder through the abdominal wall M Pijpers, EJ Hazebroek, PPLO Coene, H Beerman and D Vroegindeweij pages B296–B298
  17. 17. Fluoromethylcholine PET in recurrent multifocal hepatoma NP Lenzo, J Anderson, A Campbell, L Morandeau and TR De Grado pages B299–B302 Aberrant right hepatic duct presenting as empyema of the gall bladder B Pottakkat and SS Sikora pages B303–B305 Celiomesenteric trunk: Two variants of a rare anomaly JM Petscavage and P Maldjian pages B306–B309 Multiple hepatic hemangiomas with fluid-fluid levels J Lee, HK Lim, and YH Jeon pages B310–B312 INTERVENTIONAL Intramural haematoma of the thoracic aorta: Rupture and endoluminal exclusion AJ Spencer and TM Buckenham pages B313–B315 Management of iatrogenic porto-biliary fistula following biliary stent IM Chaitowitz, R Heng and KW Bell pages B316–B318 Iatrogenic stenosis following suture-mediated closure device J Tam, M Given, P Lutjen, K Thomson and S Lyon pages B319–B323 Percutaneous intracorporeal lithotripsy of biliary calculi JK Hoang, AF Little and A Clarke pages B324–B327 Direct percutaneous portocaval shunt creation for haematemesis: Case Report M Pianta, N Tran, M Given and SM Lyon pages B328–B330 Emergent treatment of an Iatrogenic arterial injury at femoral puncture site With Symbiot® self-expanding PTFE-covered coronary stent-graft A Arat, B Turkbey, BE Cil, M Canyigit and S Cekirge pages B331–B333
  18. 18. Percutaneous biliary internal decompression in a patient with simultaneous malignant biliary and duodenal obstruction and surgically modified anatomy MS Gulati, T Sabharwal, R Dourado and A Adam1 pages B334–B336 Emergency embolization of multiple splenic artery pseudoaneurysms associated with portal hypertension complicating cystic fibrosis T Geoghegan, G McAuley, A Snow and WC Torreggiani pages B337–B339 Basilar artery aneurysm treated with coil embolization via persistent primitive hypoglossal artery JR Bapuraj, V Ojili, N Khandelwal, AKP Shanbhogue and SK Gupta pages B340–B343 Combined treatment of ablative therapy with percutaneous radiofrequency and cementoplasty of a symptomatic metastatic lesion of the acetabulum G Carrafiello, D Laganà, C Recaldini, M Mangini, A Giorgianni, S Cuffari, G Dionigi, F D’Angelo and C Fugazzola pages B344–B348 BRITISH JOURNAL OF RADIOLOGY VOL 81 PART 962 2008 Article Title: Summary of meeting on ``Radiobiological modelling in treatment planning' at the BIR on 12 December 2006 Author(s): Fowler , J . F Page: 89-90 Article Title: Pelvic phased - array MR imaging of anal carcinoma before and after chemoradiation Author(s): Koh , D . M . ; Dzik - Jurasz , A . ;O Neill , B . ; Tait , D . ;Husband , J . E et al Page: 91-98 Article Title: Three - dimensional CT angiography of the pancreatic artery in 16 - channel multislice CT : value of scanning with submillimetre collimation Author(s): Ishigaki , S . ; Itoh , S . ; Suzuki , K . ; Satake , H . ; Ota , T . ; Ikeda , M .et al Page: 99-106 Article Title: Percutaneous needle biopsy of lung nodules under CT fluoroscopic guidance with use of the ``I - I device' Author(s): Yoshimatsu , R . ; Yamagami , T .; Kato , T . Hirota , T . ;Matsumoto , T et al Page: 107-112 Article Title: Haemodynamic parameters of the hepatic artery and vein can detect liver metastases : assessment using contrast - enhanced ultrasound Author(s): Zhou , J . H . ; Li , A . H . ; Cao , L . H . ; Jiang , H . H . ; Liu , L . Z . et al Page: 113-119 Article Title: Measurement of pharmacokinetic parameters in histologically graded invasive breast tumours using dynamic contrast - enhanced MRI Author(s): Radjenovic , A . ; Dall , B . J . ; Ridgway , J . P . ; Smith , M . A . Page: 120-128
  19. 19. Article Title: A morphological index for assessing hip osteoarthritis severity from radiographic images Author(s): Boniatis , I .;Costaridou , L .;Cavouras , D .;Kalatzis , I .Panagiotopoulos , E Page: 129-136 Article Title: Biologically effective dose using reciprocal repair for varying fraction doses and fraction intervals Author(s): Buckle , A . H . ; Lewis , J . Page: 137-142 Article Title: Radiation therapy to non - iatrogenic subcutaneous metastasis in hepatocellular carcinoma : results of a case series Author(s): Huang , Y .- J . ; Tung , W - C . ; Hsu , H .- C . ; Wang , C - Y . ; Huang et al Page: 143-150 Article Title: An investigation of the shielding characteristics of computed radiography cassettes Author(s): Potts , R . ; Baker , K . ; Bridge , L . Page: 151-153 Article Title: Ultrasound - guided thrombin injection of iatrogenic groin pseudoaneurysm : Doppler features and technical tips Author(s): Hanson , J . M . ; Atri , M . ; Power , N . Page: 154-163 Article Title: Cystic neck mass in a young man Author(s): Buckley , O . ; Hamilton , S . Page: 165-167 JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY Volume 52, Issue 1, February 2008 EDITORIALS A message from the Editor-in-Chief, Journal of Medical Imaging and Radiation Oncology (JMIRO) D Ball pages 1–1 Lost in narration: Do we need to improve the quality of breast imaging reporting in Australia? N Houssami L Wylie pages 2–3 RADIOLOGY Pictorial Essay Multidetector CT portal venography in evaluation of portosystemic collateral vessels A Agarwal M Jain pages 4–9 RADIOLOGY Review Article Interventional radiology in the provision and maintenance of long-term central venous
  20. 20. access SM Lyon, M Given NL Marshall pages 10–17 Original Articles Lymph node enlargement in pulmonary arterial hypertension due to chronic thromboembolism CJ Bergin KJ Park pages 18–23 Transrectal ultrasound in detecting prostate cancer compared with serum total prostate-specific antigen levels S Tamsel, R Killi, M Hekimgil, B Altay, S Soydan G Demirpolat pages 24–28 Magnetic resonance findings in women at high risk for developing breast cancer: An Australian feasibility study G Peters, J Anderson, G Longman, J Thomson, D Taylor, M Bennett, E Wylie, J Goldblatt, A Chan C Saunders pages 29–35 Evaluation of chest wall invasion by lung cancer using respiratory dynamic MRI S Akata, N Kajiwara, J Park, M Yoshimura, D Kakizaki, K Abe, T Hirano, T Ohira, M Tsuboi H Kato pages 36–39 Abdominal cerebrospinal fluid pseudocyst: a complication of ventriculoperitoneal shunts in adults F Aparici-Robles R Molina-Fabrega pages 40–43 Magnetic resonance imaging of lipoma and atypical lipomatous tumour/well- differentiated liposarcoma: observer performance using T1-weighted and fluid-sensitive MRI AJ Doyle, AK Pang, MV Miller JG French pages 44–48 Prevalence of significant extracoronary findings on multislice CT coronary angiography examinations and coronary artery calcium scoring examinations YM Law, J Huang, K Chen, FK Cheah T Chua pages 49–56 Follow up of coiled intracranial aneurysms with standard resolution and higher resolution magnetic resonance angiography
  21. 21. S Dupre A Coulthard pages 57–63 Preoperative diagnosis of carcinoma within fibroadenoma on screening mammograms N Borecky M Rickard pages 64–67 Technical Article Saphenous vein peripherally inserted central catheters: Technique, indications and safety issues L Du, K Redmond, S Johnstone, M De Leacy J Harper pages 68–71 RADIATION ONCOLOGY Original Article Medulloblastomas Primitive neuroectodermal tumours in the adult population RI Smee JR Williams pages 72–76 Technical Article Ultrasound-based conformal planning for gynaecological brachytherapy S van Dyk D Bernshaw pages 77–84 Review Article Esthesioneuroblastoma: A case report of diffuse subdural recurrence and review of recently published studies L Capelle H Krawitz pages 85–90 Case Reports Bulky scalp metastasis and superior sagittal sinus thrombosis from a cervical adenocarcinoma: An unusual case A Abhishek, MM Ouseph, P Sharma, V Kamal M Sharma pages 91–94 Unusual behaviour of low-grade chondrosarcoma of bone K Jones, J Pacella, AD Kirby N Pervez pages 95–96 LETTER TO THE EDITOR Bread and butter radiology
  22. 22. R O’Neil, YS Wong pages 97–97 RADIOLOGY MANAGEMENT VOL 30 PART 1 2008 Article Title: Slicetized ! As a result of the growing number of slices ( 16 , 32 , 64 , 256 , and now a 320 multislice CT scanner ! ) , we are encountering an explosion of information Author(s): Lipcamon , J . D Page: 8-9 Article Title: Impending Staffing Shortage . . Again ? A recent study predicted a 26% increase in the number of healthcare jobs this year .Is your facility prepared? Author(s): Edge , R Page: 11-12 Article Title: No , I'm Sorry , You Don't Get Paid for That Either : With a less than delightful start to the year , 2008 brings in sweeping changes for hospital reimbursement Author(s): Mulaik , M . W Page: 13-21 Article Title: Understanding the Revenue Cycle : Coordinated Billing Process Key to Radiology Success Author(s): DeBlock , E Page: 22-27 Article Title: DICOM Questions , Answered Author(s): Oosterwijk , H Page: 33-39 Article Title: Leadership Challenges of a Multigenerational Workforce Author(s): Stockburger , W . T Page: 43-49 Article Title: Moments of Excellence : Whether in the workplace or on the hiking trail , moments of excellence are experienced and should be shared with the team Author(s): Boyd , G Page: 50-51 Article Title: Employee Incentives in the Healthcare Industry Author(s): McKinnies , R . C . ; Collins , S . K . ; Collins , K . S . Page: 52-56 Article Title: Do You Have Differential Advantage ? Differential advantage is what makes a facility unique in the marketplace . It helps create a good business foundation and gets you on the way to marketing and financial success Author(s): Yoder , E Page: 58-58 Article Title: Disaster Drill : If you haven't done so already , start creating a strategic plan now to help your facility out of an unforseen disaster Author(s): Tye , G . A Page: 68-68