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Safe time interval for screening estimated glomerular filtration rate prior to gadolinium-enhanced MRI scan

Dear Editor, Magnetic resonance imaging (MRI) contrast media are commonly used in medical imaging and are usually gadolinium-based contrast agents (GBCAs). They can be divided...

The Lancet Commission on diagnostics: What it means for Singapore

Effective healthcare systems depend on a functioning healthcare value chain—defined as a care cascade comprising screening, diagnosis, treatment and follow-up. The tremendous heterogeneity and...

Reduction in Retake Rates and Radiation Dosage Through Computed Radiography

New computed radiography imaging systems are slowly gaining a foothold in radiological departments worldwide. By computed radiography we mean a digital imaging system which...

Computed Tomographic and Magnetic Resonance Imaging Findings in Paranasal Sinus Involvement in Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma (NPC) is an aggressive infiltrative neoplasm. Spread into the paranasal sinuses is often seen but the frequency is documented in only a...

Book Review

This book is a collection of 30 case studies, which were published in the Singapore Medical Journal from 1994 to 1997. They include interesting...

Bone Mineral Density—Correlation between Quantitative Ultrasound Characteristics and Dual Energy X-ray Absorptiometry

Osteoporosis is well documented to be a significant determinant of the risk of fracture and its assessment in vivo has been based on various...

A Review of the Role of Magnetic Resonance Imaging in the Evaluation of Shoulder Impingement Syndrome and Rotator Cuff Tendon Tears

In the evaluation of chronic shoulder pain and dysfunction clinically suspected to be due to shoulder impingement syndrome and rotator cuff tendon tears, magnetic...

Portable Chest Radiography: Comparison of High-resolution Digital Displays with Laser Printed Digital Film

In most institutions, about 10% to 25% of imaging examinations are recorded digitally (e.g. digital subtraction angiography, computed tomography, magnetic resonance imaging and ultrasound)....

Percutaneous Needle Aspiration in the Treatment of Hepatic Abscess: Factors Influencing Patients’ Outcome

Liver abscess traditionally has been treated by open surgical drainage, mortality rates being as high as 80% to 100% if left untreated. However, with...

Contrast-Enhanced Magnetic Resonance Imaging of the Internal Auditory Canals and Posterior Fossa

Contrast-enhanced magnetic resonance imaging (MRI) is now the gold-standard examination for the exclusion of acoustic schwannomas or other posterior fossa tumours. We retrospectively reviewed...

Imaging of Thoracic Manifestations of Scleroderma

Systemic sclerosis (SScl) is a generalised disease of the connective tissue characterised by fibrosis and vascular changes affecting the skin, lungs, gastrointestinal tract, kidneys,...

Overview of Imaging in Rheumatologic Diseases

Since the discovery of X-rays over a century ago, radiology has played a pivotal role in rheumatology and diseases of the joints. The innovations...

Magnetic Resonance Imaging of Brain Metastases: Magnetisation Transfer or Triple Dose Gadolinium?

Accurate detection of brain metastases is an important part of tumour staging. Magnetic resonance (MR) imaging is well accepted as a sensitive tool in...

Radiological Placement of 211 Central Venous Catheters: Outcome and Complications

Long-term central venous access is an important part of modern medical practice, especially in the haematology and oncology units. Central venous (CV) catheters are...

Tissue Microangiography Using a Simplified Barium Sulphate Cadaver Injection Technique

The understanding of blood supply is the cornerstone of successful tissue transfer in reconstructive surgery. This understanding has been derived largely from cadaveric dissections,...

Radionuclide Studies of Articular Cartilage in the Early Diagnosis of Arthritis in the Rabbit

Osteoarthritis is a common joint disease that involves destruction of articular cartilage. Magnetic resonance imaging (MRI) provides a sensitive imaging modality for the diagnosis...

Retroperitoneal Castleman’s Disease in the Perinephric Space—Imaging Appearance: A Case Report and a Review of the Literature

Castleman’s disease (CD) was first proposed by Castleman in 1954. It is usually found in the mediastinum, but other sites have been described. This article...

Evaluation of Technetium-99m Ciprofloxacin (Infecton) in the Imaging of Infection

Over the past 10 years we have used various radiopharmaceuticals (RPCs) for imaging of inflammation and infection. These include gallium-67 citrate and the technetium-99m...

Magnetic Resonance Arthrography of the Labral-Ligamentous Complex of the Shoulder: An Update

Shoulder instability is a frequently encountered clinical problem in young active people following injury, particularly in athletes. The labral-ligamentous complex is increasingly recognised as...

Limited Magnetic Resonance Imaging (MRI) and the Occult Hip Fracture

Worldwide, in the past decade, the application of magnetic resonance imaging (MRI) has increased tremendously in the management of musculoskeletal trauma. Not least is...

Technetium-99m Methoxyisobutylisonitrile Imaging in the Follow-up of Differentiated Thyroid Carcinoma

Differentiated thyroid carcinoma (DTC) is not an uncommon tumour in Thailand.1 A high percentage of 10-year survival results in long-term follow-up. I-131 total-body scan...

Embolisation of a Renal Artery Pseudoaneurysm in a Patient with Renal Malrotation and Chronic Aortic Dissection

A 40-year-old Chinese male presented with severe right loin pain. He had a history of chronic abdominal aortic dissection of unknown aetiology. He was...

Single Centre Review of Radiologically-guided Percutaneous Nephrostomies: A Report of 273 Procedures

Percutaneous nephrostomy (PCN) is a well-established technique in the armamentarium of an interventional radiologist when dealing with urinary obstruction. It provides temporary relief in...

To Establish the Normal Bone Mineral Density Reference Database for the Singapore Male

Bone mineral densitometry was developed as a means to quantify the bone mineral content of the skeleton accurately and has been used in the...

Percutaneous Vertebroplasty in the Management of Osteoporotic Vertebral Compression Fractures: Initial Experience

With the general increase in life expectancy in the local population, the incidence of osteoporosis is anticipated to rise as well. Even with screening...

Differentiation of Malignant Vertebral Collapse from Osteoporotic and Other Benign Causes Using Magnetic Resonance Imaging

An elderly patient presenting with backache and vertebral collapse on plain X-ray is a common clinical scenario and a diagnostic challenge. It is difficult...

Imaging-guided Bone Biopsy

Biopsy may be performed at surgery (open biopsy) or percutaneously (closed biopsy). Percutaneous bone biopsies are usually performed under imaging guidance using a variety...

Carcinoma of the Cervix: Role of MR Imaging

In females with cancer, cervical carcinoma is second to breast cancer in both incidence and mortality worldwide. About 465,000 new cases are diagnosed each...

Intracerebral Schwannoma—A Rare Cause of Epilepsy

Schwannomas are extra-axial neoplasms derived from the nerve sheath of peripheral or cranial nerves. They represent approximately 8% of all intracranial tumours, arising predominantly...

Radiographic Features of a Case of Severe Acute Respiratory Syndrome with Fatal Outcome

Severe acute respiratory syndrome (SARS) is an atypical pneumonia that was first reported in early 2003. Reports of outbreaks of cases rapidly appeared in...

Clinical Applications of MR Cholangiopancreatography

Magnetic resonance cholangiopancreatography (MRCP) has attracted a lot of interest from clinicians because it is a non-invasive method of obtaining a cholangiographic image without...

Imaging of Paediatric Mediastinal Masses

A review of mediastinal masses in children, emphasising imaging features, is important for several reasons. Firstly, the mediastinum is the most common location for...

Clinical Positron Emission Tomography Imaging—Current Applications

Like other radionuclide techniques, positron emission tomography (PET) is based on the tracer principle – a small amount of labelled ligand is used to...

MR Imaging and MR Spectroscopy of Adenocarcinoma of the Prostate

Prostate cancer is usually suspected due to an abnormal digital rectal examination, elevated serum prostate specific antigen (PSA) level or both. The diagnosis of...

Imaging of Congenital Middle Ear Deafness

When a child or young adult with morphologically normal external ears and no previous history of ear discharge or trauma presents with conductive hearing...

MR Imaging of the Fetal Brain and Spine: A Maturing Technology

The introduction of a new diagnostic test into a clinical arena goes through a number of stages. The first stage is technical development. This article...

Imaging of Acquired Immunodeficiency Syndrome (AIDS)

The pandemic of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a global healthcare problem and HIV infection is the most common cause of...

The Singapore National Breast Screening Programme: Principles and Implementation

In January 2002, the first population-based national mammographic breast screening programme in Asia, the Singapore National Breast Screening Programme (BreastScreen Singapore), was launched. The...

Brachiocephalic-Superior Vena Cava Metallic Stenting in Malignant Superior Vena Cava Obstruction

A large majority of superior vena cava (SVC) syndrome is caused by malignancy (74% to 95%). This can either be due to direct SVC...

Pilot Study Using Technetium-99m Pertechnetate Sequential Radionuclide-Sialography to Assess Salivary Gland Function in Nasopharyngeal Cancer Patients on Radiation Therapy

Nasopharyngeal carcinoma (NPC) is an epithelial malignancy occurring worldwide with particularly high frequencies in the Far East. The incidence is highest in Hong Kong...

Breath-hold Fast Recovery Fast Spin Echo versus Conventional Non-Breath-hold Fast Spin Echo T2-Weighted MR Imaging of Focal Liver Lesions

T2-weighted magnetic resonance (MR) imaging is an important sequence for characterisation of focal liver lesion. Accurate characterisation of benign lesions, such as haemangioma or...

Diffusion-weighted MR Imaging in Intracranial Infections

Diffusion-weighted magnetic resonance (MR) imaging (DWMRI) is becoming essential to the assessment of acute cerebral infarction and has also been applied to distinguish cerebral...

Preoperative High Resolution CT and MR Imaging in Cochlear Implantation

Candidates for cochlear implantation undergo a thorough audiological and medical assessment. The audiological assessment is done to ensure that these candidates who have bilateral...

Non-consensual Double Reading in the Singapore Breast Screening Project: Benefits and Limitations

Double reading of mammogram is not the standard practice in the United Kingdom National Health Service Breast Screening Programme (NHSBSP). Rather, single reading of...

Breast Cancer in Women Under 40 Years: Preoperative Detection by Mammography

The incidence of breast cancer peaks between the ages of 45 and 55 years. Approximately 7% of breast cancers occur below 40 years of...

The Past Decade of Diagnostic Radiology in Singapore: How Much Progress Have We Really Made?

It has been 10 years since the first ever issue of Annals dedicated to “Radiology” was published in Volume 22 No. 5 September 1993....

Colorectal Hepatic Metastases: Role of Radiofrequency Ablation

Colorectal cancer is the second most common cancer in Singapore, accounting for 15.9% of all cancers registered with the Singapore Cancer Registry in the...

Computed Tomographic Appearance of Colorectal Hepatic Metastases

It is important to recognise the computed tomography (CT) appearance of hepatic metastases from colorectal primaries, as resection in a selected group may offer...

Current Status in Imaging of Colorectal Liver Metastases

Colorectal cancer is a common primary that metastasizes to the liver. About 20% of patients with colorectal cancer will have detectable metastases at the...

Routine Abdominal and Pelvic Ultrasound Examinations: An Audit Comparing Radiographers and Radiologists

Since its introduction into clinical practice in the early 1970s, ultrasound (US) has become firmly established as an extremely valuable imaging modality and widely...

Clinical Utility of Selective Intra-arterial Calcium-stimulated Hepatic Venous Sampling in Regionalisation of Insulinomas—The Singapore Experience

Insulinomas are small tumours with dimensions that seldom exceed 2.0 cm in diameter. Preoperative non-invasive localisation using trans-abdominal ultrasound and conventional computed tomography (CT)...

Reflections of a Septuagenarian – Radiology: Past, Present and Future

Before I commence, I would like to thank the Singapore Radiological Society and the Chapter of Radiologists of the Academy of Medicine for inviting...

Imaging Findings in Acute Neck Infection due to Pyriform Sinus Fistula

Pyriform sinus fistula is a developmental abnormality of the 3rd or 4th branchial pouch. It usually presents in childhood as acute inflammatory swelling of...

Audit of Diagnostic and Interventional Craniocervical Catheter Angiographic Procedures at the Singapore General Hospital

Catheter angiography has long been considered the diagnostic standard by which the accuracy of other vascular imaging modalities are compared, given its superior contrast...

Breast Ultrasound in Women With Familial Risk of Breast Cancer

Mammography is the modality of choice to screen for breast cancer in asymptomatic women. However, it is known that about 10% to 12% of...

Coronary Artery Disease: Comprehensive Evaluation by Cardiovascular Magnetic Resonance Imaging

Coronary artery disease (CAD) is a major health problem worldwide. With advances in CAD intervention and improvements in treatment and management of CAD, there...

A Case of Right Loin Pain: Septic Ovarian Vein Thrombosis Due to Campylobacter fetus Bacteraemia

Septic ovarian venous thrombosis is an uncommon entity. Classically, it occurs as a postpartum complication with reported frequency of 1 in 600 to 2000...

Clinical Indications for Positron Emission Tomography (PET) Scanning

The purpose of these guidelines is to provide a broad framework for clinicians considering the use of positron emission tomography (PET) scanning for their...

Semi-Quantitative Measurements of Normal Organs With Variable Metabolic Activity on FDG PET Imaging

Positron emission tomography (PET) has a proven clinical role in oncology, cardiology and neurology that primarily uses 2-deoxy-2--fluoro-deoxyglucose (FDG). FDG is an analogue of...

Clinical Applications of Positron Emission Tomography in Cardiology: A Review

Ischaemic heart disease associated with depressed left ventricular function is a common clinical management dilemma. There is overwhelming evidence that such patients have a...

The Role of FDG-PET in the Management of Non-small Cell Lung Carcinoma

Carcinoma of the lung is the leading cause of cancer death in both men and women and is the second most common malignancy in...

Clinical PET Imaging – An Asian Perspective

Positron emission tomography (PET) is distinct from other imaging modalities in its ability to probe the physiology and biochemistry of normal and abnormal tissues....

PET Tracers and Radiochemistry

Positron emission tomography (PET) has become a powerful scientific and clinical tool for probing biochemical processes in the human body. This is due, in...

Physical Principles and Technology of Clinical PET Imaging

The past few years have seen the transition of positron emission tomography (PET) from the research domain into mainstream clinical applications for oncology. The...

Positron Emission Tomography – A Vital Component of Molecular Imaging

Contemporary medical imaging is progressing towards quantification of tissue function in addition to merely providing anatomical information, as illustrated by the rising use of...

Use of D-dimer and Lower Extremity Doppler Ultrasound Results to Obviate the Need for Computerised Tomographic Pulmonary Angiography

The diagnosis of pulmonary embolism (PE) can be a challenging problem. It depends on clinical suspicion and the interpretation of a combination of clinical...

Image-guided Radiofrequency Ablation of Liver Malignancies: Experience at Singapore General Hospital

Radiofrequency (RF) ablation for the treatment of focal liver malignancies is a relatively new image-guided procedure that is gaining increasing acceptance in the radiologic...

Building Collaboration in Cardiac Imaging

Publicity about new developments in medical technology is not at all unusual. But the degree with which multi-slice computed tomography (MSCT) for coronary artery...

3rd FY Khoo Memorial Lecture – Education, Professionalism, Outsourcing and the Future of Radiology

Radiology is undergoing unprecedented changes. Not only is the technology evolving rapidly, providing images of breathtaking anatomical clarity, but functional information has also become...

Singapore National Medical Image Resource Centre (SN.MIRC): A World Wide Web Resource for Radiology Education

Radiological images are critical for diagnosis, teaching and research. In radiology education, learners must be exposed to large amounts of visual information, and assimilation...

Teleradiology in Singapore – Taking Stock and Looking Ahead

Teleradiology is the electronic transmission of radiologic images from one location to another for the purposes of interpretation and/or consultation. The current interest in...

Radiographic Features of SARS in Paediatric Patients: A Review of Cases in Singapore

Severe acute respiratory syndrome (SARS) is a newly emerged atypical pneumonia caused by the SARS-associated coronavirus (SARS-CoV). It is easily transmitted via droplet infection...

A Case of Cystic Schwannoma of the Lesser Sac

Schwannoma or neurilemmoma (NL) is a well-defined, usually benign, tumour arising from the nerve sheath (Schwann cell). It may present as a solitary mass...

Magnetic Resonance Imaging of Sports Injuries of the Knee

Sports-related knee injuries are common, with contact sports and sports involving twisting movements being the most frequent causes. Sports injuries may affect any of...

Local Experience of Endorectal Magnetic Resonance Imaging of Prostate with Correlation to Radical Prostatectomy Specimens

Prostate cancer ranks among the top 10 cancers in Singapore. The incidence of prostate cancer has risen by 5% to 118% in most Asian...

Medical Misadventure: Barium Extravasation in Colorectal Cancer

Double contrast barium enema (DCBE) is a safe and accurate diagnostic procedure for colorectal cancer. It is often the next diagnostic test after incomplete...

Durian Seed Masquerading as Gallstone Ileus on Computed Tomography

Bezoars and gallstones are unusual causes of small bowel obstruction, with well-described imaging features on CT. We present a case of intestinal obstruction caused...

A Survey of Local Preclinical and Clinical Medical Students’ Attitudes towards Radiology

Radiology is not a popular specialty for undergraduate student electives or postgraduate training amongst students from a local undergraduate medical school which is based...

Primary Epithelioid Angiosarcoma of the Lung Presenting as Left-sided Shoulder Pain

Primary angiosarcoma of the lung is a rare, often difficult to diagnose disorder with non-specific respiratory manifestations. Angiosarcoma involving the lung is usually a...

Macronodular Tuberculosis: Imaging Resemblance of Cholangiocarcinoma

The ability of multiphasic computed tomography (CT) and magnetic resonance (MR) studies in the diagnosis of liver tumours such as hepatocellular carcinoma and cholangiocarcinoma...

Central Clot Score at Computed Tomography as a Predictor of 30-day Mortality after Acute Pulmonary Embolism

Multi-detector Computed Tomography (MDCT) pulmonary angiography is currently the method of choice for the detection of acute pulmonary embolism (PE), because of its convenience,...

Periarticular FDG Uptake on PET/CT in Malignant Melanoma—Metastatic or Misleading?

A 74-year-old male with newly diagnosed melanoma of the right mastoid region, underwent resection of the lesion followed by F-18 fluoro-deoxyglucose (FDG) positron emission tomography/computed...

Ultrasound-Guided Thyroid Fine Needle Aspiration Biopsy—The Way Forward

I read with great interest the recent article published in the Annals of Academy of Medicine Singapore entitled, ‘Surgeon-Performed Ultrasound-Guided Fine Needle Aspiration Cytology...

Relationships between Prostatic Volume and Intravesical Prostatic Protrusion on Transabdominal Ultrasound and Benign Prostatic Obstruction in Patients with Lower Urinary Tract Symptoms

Benign prostatic hyperplasia (BPH) is one of the commonest diseases of ageing men. It can be associated with bothersome lower urinary tract symptoms (LUTS)...

Are Pregnant Women Adequately Equipped for Autonomy in Pregnancy Screening?

The concept of first trimester screening (FTS) to evaluate the risk of fetal aneuploidies was first introduced in 1997 by Orlandi et al. The...

A Follow-up Longitudinal Survey on a Cohort of Undergraduate Medical Students’ Attitudes towards Radiology

As a follow-up to an earlier study comparing the attitudes of first year undergraduate medical students following the introduction of a new radiology curriculum...

Transthyretin amyloid cardiomyopathy: The emerging role of cardiac amyloid imaging

Transthyretin amyloidosis (or ATTR amyloidosis) is an under-recognised multisystemic disorder, arising from misfolding of transthyretin proteins into insoluble amyloid fibrils. As amyloid fibrils deposit...