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The utility of CT imaging in the diagnosis and management of patients presenting with acute abdominal pain is confirmed, but is limited in a minority of cases where poor negative interobserver agreement exists. Good communication to the reporting radiologist of the relevant patient history and clinical question becomes important.

ABSTRACT. The aim of this study was to identify the effect of the installation of Premium View post-processing software on our mammographic reporting performance, in particular the effects on our recall rate, biopsy rate and cancer detection rate. The case notes and imaging of all patients discussed at the weekly indeterminate imaging multidisciplinary team meeting were reviewed retrospectively before, immediately after and at a delayed interval following the installation of Premium View post-processing software. Factors recorded included the mammographic abnormality, further investigations and final histology. The indeterminate mammogram rate increased significantly from a baseline of 5.7% (before Premium View) to 8.7% in the time period immediately after the installation of Premium View (p50.002). The stereotactic biopsy rate also increased from 0.8% to 2.4% (p50.001), with a significant increase in the overall cancer detection rate from 3.4% to 4.4% (p50.02). In the follow-up period several months after the installation of Premium View, the indeterminate mammogram rate returned to a level similar to that before Premium View (6%; p50.7). The stereotactic biopsy rate remained significantly higher at 1.6% (p50.07), as did the overall cancer detection rate of 5.0% (p50.003). In conclusion, the use of Premium View may lead to higher cancer detection rates, at the expense of an initial increase in recall rate. Although prospective studies are suggested, this result is of interest in light of the proposed installation of digital mammography across the NHS Breast Screening Programme. Image quality is of paramount importance in mammography, and it has long been recognised that full-field digital mammography (FFDM) has many potential advantages over conventional screen-film mammography (SFM) [1][2][3][4][5]. A number of large studies have fully evaluated the diagnostic performance of this technology, notably the Digital Mammographic Imaging Screening Trial (DMIST), which showed the overall diagnostic accuracy of digital and film mammography as a means of screening for breast cancer to be similar, but digital mammography as more accurate in women under the age of 50 years, women with radiographically dense breasts and pre-or peri-menopausal women [5]. Several other studies have also looked at the use of digital mammography in screening, supporting the fact that FFDM is at least equal to SFM; the effect on recall rate, however, has varied. The Oslo I study comprised 3683 women aged 50-60 years and found no significant difference in cancer detection rates [3]. Direct side-byside cancer conspicuity was equal; however, the recall rate for FFDM was slightly higher (4.6% vs 3.5%). Another paired screening study by Lewin et al [6] involving 6736 paired screen-film and digital mammography examinations performed in 4489 women again found no significant difference in cancer detection rates between the two modalities. In this study, however, the recall rate for FFDM was significantly lower than for SFM (11.8% vs 14.9%; p,0.001). M...

This case study presents the case of a patient self‐injecting Vaseline into the penile skin to increase the size of the penis. The history of this procedure, complications and management options are presented.