E Eisenhuber

Krankenhaus Göttlicher Heiland, Wien, Vienna, Austria

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Publications (48)152.74 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: The finding of subsolid pulmonary nodules poses a frequent problem in the daily routine of the radiologist. The biological behavior of such subsolid lesions differs significantly from solid nodules. The risk of malignancy is significantly higher in subsolid nodules as compared to solid or purely ground glass opacities or nodules. The recommendations regarding the diagnostic management of subsolid nodules have been adapted according to the tendency of growth and the risk of malignancy. A benign etiology is also seen quite often in subsolid lesions and in this case they will show a reduction of size or disappear completely by the follow-up examination. Therefore, in many cases a short-term follow-up examination is primarily recommended. As the findings will often show no changes for a long period of time, further annual follow-up examinations over a longer, not yet specified period of time are recommended. Subsolid lesions that grow in size and/or show an increase in density or develop a solid part within a ground glass lesion should remain as suspected malignancies until proven otherwise.
    Der Radiologe 05/2014; · 0.47 Impact Factor
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    ABSTRACT: PURPOSE: The aim of this study was to survey the current CT protocols used by members of the European Society of Thoracic Imaging (ESTI) to evaluate patients with interstitial lung diseases (ILD). METHODS: A questionnaire was e-mailed to 173 ESTI members. The survey focussed on CT acquisition and reconstruction techniques. In particular, questions referred to the use of discontinuous HRCT or volume CT protocols, the acquisition of additional acquisitions in expiration or in the prone position, and methods of radiation dose reduction and on reconstruction algorithms. RESULTS: The overall response rate was 37 %. Eighty-five percent of the respondents used either volume CT alone or in combination with discontinuous HRCT. Forty-five percent of the respondents adapt their CT protocols to the patient's weight and/or age. Expiratory CT or CT in the prone position was performed by 58 % and 59 % of the respondents, respectively. The number of reconstructed series ranged from two to eight. CONCLUSION: Our survey showed that radiologists with a special interest and experience in chest radiology use a variety of CT protocols for the evaluation of ILD. There is a clear preference for volumetric scans and a strong tendency to use the 3D information. KEY POINTS: • Experienced thoracic radiologists use various CT protocols for evaluating interstitial lung diseases. • Most workers prefer volumetric CT acquisitions, making use of the 3D information • More attention to reducing the radiation dose appears to be needed.
    European Radiology 12/2012; · 3.55 Impact Factor
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    ABSTRACT: The bedside chest x-ray (CXR) is an indispensible diagnostic tool for monitoring seriously ill patients in the intensive care unit. The CXR often reveals abnormalities that may not be detected clinically. In addition, bedside CXRs are an irreplaceable tool with which to detect the malposition of tubes and lines and to identify associated complications. Although the image quality is often limited, bedside CXRs still provide valuable diagnostic information. The interpretation of the bedside CXRs is often challenging, and requires extensive radiologic experience to avoid misinterpretation of the wide spectrum of pleural and pulmonary disease. The clinical information is of substantial value for the interpretation of the frequently nonspecific findings.
    Respiratory care 03/2012; 57(3):427-43. · 2.03 Impact Factor
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    ABSTRACT: The aim of this retrospective study was to compare the diagnostic accuracy, the frequency of complications, the duration of the interventions and the radiation doses of CT fluoroscopy (CTF) guided biopsies of lung lesions with those of multislice CT (MS-CT) biopsy mode-guided biopsies. Data and images from 124 consecutive patients undergoing CTF-guided lung biopsy (group A) and 132 MS-CT-biopsy mode-guided lung biopsy (group B) were reviewed. CTF-guided biopsies were performed on a Siemens Emotion 6 CT scanner with intermittent or continuous CT-fluoroscopy, MS-CT biopsy mode-guided biopsies were performed on a Siemens Emotion 16 CT scanner. All biopsies were performed with a coaxial needle technique. The two groups (A vs. B) did not differ significantly regarding sensitivity (95.5% vs. 95.9%), specificity (96.7% vs. 95.5%), negative predictive value (87.9% vs. 84%) or positive predictive value (98.8% vs. 98.9%). Pneumothorax was observed in 30.0% and 32.5% of the patients, respectively. Chest tube placement was necessary in 4% (group A) and 13% (group B) of the patients. The duration of the intervention was significantly longer in group A (median 37 min vs. 32 min, p=0.04). The mean CT dose index (CTDI) was 422 in group A and 36.3 in group B (p<0.001). Compared to CTF-guided biopsies, chest biopsies using the MS-CT biopsy mode show dramatically lower CTDI levels. Although the diagnostic yield of the procedures do not differ significantly, biopsies using the MS-CT-biopsy mode have a three-fold higher rate of chest tube placement.
    European journal of radiology 07/2011; 81(5):1029-33. · 2.65 Impact Factor
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    ABSTRACT: Liver lesions are frequently detected in the CT staging of lung cancer patients and may require further investigation. The aim of our study was to assess the value of an ultrasound (US) examination of the liver in addition to routine CT staging. In this retrospective study we included 174 consecutive patients with lung cancer who underwent US of the liver in addition to contrast-enhanced CT of the thorax and upper abdomen. The reports of the examinations were evaluated for the presence of liver lesions. Based on CT and US standard criteria, liver lesions were grouped into unequivocal cysts, hemangiomas, metastases and undefined lesions. With CT, liver lesions were detected in 56 / 174 patients (32 %). These included 24 cysts in 11 patients, 2 hemangiomas in 2 patients and 18 patients with liver metastases. In 31 patients, 66 small (< 1.5 cm) hypodense lesions were detected, which could not be further defined by CT. Using US, 21 of these 66 liver lesions were confirmed as benign (cysts, hemangiomas), and two lesions were diagnosed as metastases. In 2 patients US revealed metastases that were not visible on the CT scans. The study demonstrates that a complementary US of the liver in patients with lung cancer may reveal information relevant for treatment. Therefore, liver US may play an important role in the staging of lung cancer. When equivocal small liver lesions are detected with CT, a complementary US examination may help to diagnose these lesions or detect metastases not visible on the single-phase staging CT of the liver.
    Ultraschall in der Medizin 10/2009; 30(6):551-7. · 4.12 Impact Factor
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    ABSTRACT: Small subpleural pulmonary lesions are difficult to biopsy. While the direct, short needle path has been reported to have a lower rate of pneumothorax, the indirect path provides a higher diagnostic yield. Therefore, we tried to optimize the needle pathway and minimize the iatrogenic pneumothorax risk by evaluating a CT fluoroscopy guided direct approach to biopsy subpleural lesions. Between 01/2005 and 01/2007, CT fluoroscopy guided core biopsies were performed in 24 patients. Using our technique, the tip of the guide needle remains outside the visceral pleura (17 G coaxial guide needle, 18 G Biopsy-gun, 15 or 22 mm needle path). The position of the lesion relative to the needle tip can be optimized using CT fluoroscopy by adjusting the breathing position of the patient. The Biopty gun is fired with the needle tip still outside the pleural space. Cytological smears are analyzed by a cytopathologist on-site, and biopsies are repeated as indicated with the coaxial needle still outside the pleura. Median nodule size was 1.6 cm (0.7-2.3 cm). A definitive diagnosis was obtained in 22 patients by histology and/or cytology. In one patient, only necrotic material could be obtained. In another patient, the intervention had to be aborted as the dyspnoic patient could not follow breathing instructions. An asymptomatic pneumothorax was present in seven patients; chest tube placement was not required. The presented biopsy approach has a high diagnostic yield and is especially advantageous for biopsies of small subpleural lesions in the lower lobes.
    European journal of radiology 09/2009; 77(1):164-6. · 2.65 Impact Factor
  • Ultraschall in Der Medizin - ULTRASCHALL MED. 01/2009; 30(06):551-557.
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    ABSTRACT: A wide variety of artifacts can be seen in clinical MR imaging. This review describes the most important and most prevalent of them, including magnetic susceptibility artifacts and motion artifacts, aliasing, chemical-shift, zipper, zebra, central point, and truncation artifacts. Although the elimination of some artifacts may require a service engineer, the radiologist and MR technologist have the responsibility to recognize MR imaging problems. This review shows the typical MR appearance of the described artifacts, explains their physical basis, and shows the way to solve them in daily practice.
    European Radiology 06/2007; 17(5):1242-55. · 3.55 Impact Factor
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    ABSTRACT: The radiologic knowledge of tuberculosis-associated lung disease is an essential tool in the clinical diagnosis of tuberculosis. Chest radiography is the primary imaging method, but the importance of CT is still increasing, as CT is more sensitive in the detection of cavitation, of hilar and mediastinal lymphadenopathie, of endobronchial spread and of complications in the course of the disease. In addition, CT has been proven as a valuable technique in the assessment of tuberculosis activity, especially in patients where M. tuberculosis has not been detected in the sputum or in patients with multidrug-resistant tuberculosis. Depending on the immune status of the patient, the morphologic spectrum of tuberculosis is quite variable. Early diagnosis of tuberculosis is essential to prevent further spread of the disease.
    Der Radiologe 06/2007; 47(5):393-400. · 0.47 Impact Factor
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    ABSTRACT: beyond the pure morphological visual representation, MR imaging offers the possibility to quantify parameters in the healthy, as well as, in pathologic lung parenchyma. Gas exchange is the primary function of the lung and the transport of oxygen plays a key role in pulmonary physiology and pathophysiology. The purpose of this review is to present a short overview of the relaxation mechanisms of the lung and the current technical concepts of T1 mapping and methods of oxygen enhanced MR imaging. molecular oxygen has weak paramagnetic properties so that an increase in oxygen concentration results in shortening of the T1 relaxation time and thus to an increase of the signal intensity in T1 weighted images. A possible way to gain deeper insights into the relaxation mechanisms of the lung is the calculation of parameter Maps. T1 Maps based on a snapshot FLASH sequence obtained during the inhalation of various oxygen concentrations provide data for the creation of the so-called oxygen transfer function (OTF), assigning a measurement for local oxygen transfer. T1 weighted single shot TSE sequences also permit expression of the signal changing effects associated with the inhalation of pure oxygen. the average of the mean T1 values over the entire lung in inspiration amounts to 1199 +/- 117 milliseconds, the average of the mean T1 values in expiration was 1333 +/- 167 milliseconds. T1 Maps of patients with emphysema and lung fibrosis show fundamentally different behavior patterns. Oxygen enhanced MRT is able to demonstrate reduced diffusion capacity and diminished oxygen transport in patients with emphysema and cystic fibrosis. results published in literature indicate that T1 mapping and oxygen enhanced MR imaging are promising new methods in functional imaging of the lung and when evaluated in conjunction with the pure morphological images can provide additional valuable information.
    International Journal of Biomedical Imaging 02/2007; 2007:23624.
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    ABSTRACT: Das Kennen und Erkennen charakteristischer Tuberkulose-assoziierter Lungenvernderungen stellt einen Grundpfeiler in der Diagnostik der Tuberkulose dar. Neben dem Thoraxrntgen spielt die Computertomographie bei der Lungentuberkulose eine zunehmend wichtigere Rolle, da sie wesentlich sensitiver beim Nachweis von Kavernen, einer hilren und mediastinalen Lymphadenopathie, von Streuherden und Komplikationen der Tuberkulose ist. Die Computertomographie erlaubt die Beurteilung einer Aktivitt speziell bei negativem Nachweis der Mykobakterien im Sputum und bei multiresistenter Tuberkulose. Die Tuberkulose kann in Abhngigkeit von der Immunlage des Patienten ein sehr unterschiedliches Erscheinungsbild haben. Die frhzeitige Diagnose und Therapie sind entscheidend, um eine weitere Ausbreitung zu verhindern. The radiologic knowledge of tuberculosis-associated lung disease is an essential tool in the clinical diagnosis of tuberculosis. Chest radiography is the primary imaging method, but the importance of CT is still increasing, as CT is more sensitive in the detection of cavitation, of hilar and mediastinal lymphadenopathie, of endobronchial spread and of complications in the course of the disease. In addition, CT has been proven as a valuable technique in the assessment of tuberculosis activity, especially in patients where M. tuberculosis has not been detected in the sputum or in patients with multidrug-resistant tuberculosis. Depending on the immune status of the patient, the morphologic spectrum of tuberculosis is quite variable. Early diagnosis of tuberculosis is essential to prevent further spread of the disease.
    Der Radiologe 01/2007; 47(5):393-400. · 0.47 Impact Factor
  • Int. J. Biomedical Imaging. 01/2007; 2007.
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    ABSTRACT: We sought to evaluate the performance of dual-readout and single-readout computed radiography compared with direct radiography for detecting subtle lung abnormalities with a standard and a low-dose technique. Posteroanterior radiographs of an anthropomorphic chest phantom were obtained with a single-readout storage phosphor radiography system (CRS, pixel size 200 microm), a dual-readout storage phosphor radiography system (CRD, pixel size 100 microm), and a direct detector (DR, pixel size 143 microm) at dose levels of 400 and 800 speed. Ten templates were superimposed to project 4 types of lesions over low- and high-attenuation areas, simulating nodules, micronodules, lines, and patchy opacities. Six radiologists evaluated 60 hard-copy images for the presence or absence of lesions. Statistical significance of differences was evaluated using receiver operating characteristic analysis and analysis of variance. For both low- and high-attenuation areas, CRD (Az = 0.85 and 0.66) was superior to CRS (Az = 0.75 and 0.58) for overall performance and all lesion subtypes (P < 0.05). DR (Az = 0.87 and 0.67) performed slightly better than CRD, being significant only for the detection of micronodules. Acquisition dose significantly affected only the detection of lines and micronodules, whereas the detection of nodules and patchy opacities was not significantly different with reduced exposure, regardless of the system used. The dual-readout CR system significantly outperformed the single-readout CR and almost equaled the performance of DR. Dose reduction was more critical for small-sized lesions (micronodules, lines) than for nodular or patchy opacifications and affected mainly the lesions in high attenuation areas.
    Investigative Radiology 06/2005; 40(5):249-56. · 5.46 Impact Factor
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    ABSTRACT: The aim of our study was to assess the availability of videofluoroscopy to examine patients with swallowing disorders in Austria. A questionnaire was sent to the department heads of the radiology departments of all hospitals (n=143) and to all non-hospital-based radiologic practices (n=226) throughout Austria. The survey focused on the availability of videofluoroscopic swallowing studies and on the studies performed in patients with deglutition disorders. The questionnaire was completed and returned by 134 of 143 radiology departments (94%) and 65 of 226 non-hospital-based radiologists (29%). Videofluoroscopic swallowing studies were performed in 38 of 134 radiology departments (28%) and in 21 of 65 practices (32%). The method is available in all nine Austrian states (100%) and 27 of 99 districts (27%). The number of examinations performed in different states ranged from 0.7 to 19 studies/10,000 population per year. The number of videofluoroscopic examinations per department or practice in the year 2001 ranged between 5 and 690 (median, 100 examinations). To 85% of videofluoroscopy units patients were referred from otorhinolaryngology/phoniatrics-logopedics, to 69% of videofluoroscopy units referrals were also from internal medicine, from neurology in 54%, and from pediatrics in 20%. Despite the widespread availability of videofluoroscopy throughout Austria, its use still varies largely between different states. The data show that in general there is a wide-spread demand for videofluoroscopic swallowing studies.
    European Journal of Radiology 02/2005; 53(1):120-4. · 2.51 Impact Factor
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    ABSTRACT: Surgically or conservatively treated brain abscesses may resolve, or pus may re-accumulate, requiring further intervention or treatment change. We hypothesized that diffusion-weighted (DW) imaging is useful in depicting features of abscesses related to therapeutic success or failure. Conventional contrast-enhanced T1- and T2-weighted imaging and DW imaging were performed in seven patients (aged 30-69 years) with proved pyogenic brain abscesses. The center of the abscess was qualitatively and quantitatively analyzed at initial and follow-up imaging in all patients. We correlated the signal intensity on trace DW images and the apparent diffusion coefficients (ADCs) with the clinical and laboratory data, particularly with respect to treatment failure and repeat therapy. Surgical drainage was performed in six patients; one patient was treated with only antibiotics. All abscess cavities initially had high signal intensity (restricted diffusion) on DW images, with a mean ADC value of 0.52 x 10 (-3)mm (2)/s. Low signal intensity at DW imaging with high ADC were seen on follow-up images in the patient receiving medication and in four patients in whom the abscesses were drained; this correlated with a good therapeutic response. Two patients underwent drainage; their second follow-up DW images showed areas of high signal intensity and low ADC values suggesting re-accumulation of pus. Increased C-reactive protein level and WBC count correlated well with DW image findings. DW imaging was superior to conventional MR imaging in evaluating the success or failure of abscess therapy. Restricted diffusion in a drained abscess corresponded to pus.
    American Journal of Neuroradiology 10/2004; 25(8):1310-7. · 3.17 Impact Factor
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    ABSTRACT: Many studies have suggested that Hounsfield measurements on unenhanced CT can reliably differentiate adrenal adenomas from nonadenomas using a scanner-independent threshold level. The purpose of this study was to determine whether establishment of a scanner-independent threshold for differentiation of adenomas from nonadenomas is technically feasible. Surgically resected adrenal tumor specimens (total, seven; adenomas, three; nonadenomas, four; size range, 17-76 mm), were placed in an anthropomorphic phantom. Lesion specimens were scanned with one MDCT and two single-detector scanners. Scanning protocols for all three scanners included variations in kilovoltage (140, 120, and 80 [Somatom Plus 4, Somatom VolumeZoom] or 100 [Tomoscan AV] kVp) and slice thickness. Hounsfield measurements were performed on exactly matched slices using regions of interest of a constant size. The difference in lesion Hounsfield measurements among scanning protocols with 140, 120, and 100/80 kVp was up to 6.2 H for the adenoma group and up to 3.8 H for the nonadenoma group. The comparison of the Tomoscan AV and the Somatom Plus 4 scanners showed a mean difference of 2.6 H at 120 kVp and of 4.6 H at 140 kVp. The differences between the Tomoscan AV and Somatom VolumeZoom scanners were 1.7 and 3.6 H for 120 and 140 kVp, respectively. Between the two Somatom scanners, the divergence was 2.9 and 3.3 H for the two kilovoltage settings. Differentiation between adenomas and nonadenomas was better at lower kilovoltage. Slice thickness did not affect the CT density measurements significantly. Significant differences in CT density measurements of adrenal tumors may occur when different CT scanners or imaging protocols are used. The dependence of measurements on scanner type and scanning technique makes the recommendation of a universal, scanner- and protocol-independent threshold problematic.
    American Journal of Roentgenology 04/2004; 182(3):671-5. · 2.90 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate how ambient light and interactive adjustment of density and contrast affect the detection of catheter fragments when interpreting bedside chest radiographs on soft-copy displays. A total of 131 catheter fragments were superimposed over 10 bedside chest radiographs obtained with storage phosphor technology. Images were displayed on a clinical intensive care unit viewing station (color cathode-ray tube monitor, 21 inch [53 cm], 1280 x 1024 matrix) and were independently evaluated by five radiologists. The number of catheter fragments per image varied between 12 and 14, with an approximately equal distribution in high- and low-absorption areas. Detectability of catheter fragments was assessed under subdued and bright ambient light conditions with and without interactive adjustment of window width and level. Under subdued light, the detection rate of catheter fragments was significantly higher than under bright light (51.8% vs 56.6%, p < 0.05). Interactive window setting adjustment significantly increased the detection rate from 52.5% to 60.8% (p < 0.05) under subdued light and from 47.9% to 55.6% (p < 0.05) under bright light. With adjustment of window settings, the difference between the detection rates under subdued light (60.8%) and under bright light (55.6%) did not reach statistical significance. Detection of catheters on soft-copy display is significantly decreased by bright ambient light, an effect that can be largely compensated for by means of interactive adjustment of window settings.
    American Journal of Roentgenology 11/2003; 181(5):1415-21. · 2.90 Impact Factor
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    ABSTRACT: In patients after chest trauma, imaging plays a key role for both, the primary diagnostic work-up, and the secondary assessment of potential treatment. Despite its well-known limitations, the anteroposterior chest radiograph remains the starting point of the imaging work-up. Adjunctive imaging with computed tomography, that recently is increasingly often performed on multidetector computed tomography units, adds essential information not readily available on the conventional radiograph. This allows better definition of trauma-associated thoracic injuries not only in acute traumatic aortic injury, but also in pulmonary, tracheobronchial, cardiac, diaphragmal, and thoracic skeletal injuries. This article reviews common radiographic findings in patients after chest trauma, shows typical imaging features resulting from thoracic injury, presents imaging algorithms, and recalls to the reader less common but clinically relevant entities encountered in patients after thoracic trauma.
    European Journal of Radiology 11/2003; 48(1):61-70. · 2.51 Impact Factor
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    ABSTRACT: Substantial advances in detector technology characterize digital chest radiography. This article compares the various systems from a radiologist's point of view. Computed radiography (CR) is a well-established system that is robust, has good reproducibility, and is relatively inexpensive. Image quality has been continuously improved in recent years while the physical size of the readout units has been reduced and the throughput increased. CR is the only digital system that can be used for bedside chest radiographs. Improved detector properties and dual reading have made it a dose-efficient system. Although now widely available, a 4K image matrix does not appear to offer a general diagnostic improvement for imaging the chest. New developments with respect to detector composition and readout process can be expected in the future. Direct radiography (DR) is the common name for different technologies that are characterized by a direct readout matrix that covers the whole exposure area. Conversion of x-ray intensity into electric signals can either be direct (selenium-based systems) or indirect (scintillator/photodiode systems). Advantages of DR systems are a high image quality and the potential for dose reduction. The role of selenium radiography (Thoravision) has decreased after the advent of DR systems although this dedicated chest unit offers high image quality at 400 speed acquisition dose. Especially in a PACS environment, CR and DR systems will increasingly substitute for conventional radiography with advantages for CR for bedside chest radiographs and for DR for high-end chest stands.
    Journal of Thoracic Imaging 08/2003; 18(3):124-37. · 1.26 Impact Factor
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    ABSTRACT: To evaluate the performance of the most recent generation of storage phosphor plates for the detection of low-contrast catheter material on bedside chest radiographs. In 10 patients in the intensive care unit, bedside chest radiographs were obtained with a 400-speed conventional screen-film system and with storage phosphor plates with exposure levels comparable to a 200-, 400-, or 800-speed conventional system. The chest radiograph was divided into 20 regions, 60% of which were superimposed with low-contrast catheter fragments. Six observers independently assessed the presence of catheter fragments by using a receiver operating characteristic (ROC) methodology. Detection performance (mean area under the ROC curve [Az]) with the storage phosphor plates was significantly superior to that with the screen-film system (Az = 0.76) at all three dose levels (Az = 0.88, 0.87, and 0.83 for 200-, 400-, and 800-speed doses, respectively; P <.05). Increasing the dose to a 200-speed system did not significantly increase detection performance compared with that with the 400-speed digital radiographs (Az = 0.88 vs 0.87). Dose reduction to 800 speed significantly deteriorated the detection performance (Az = 0.83) compared with that with the 400- and 200-speed digital radiographs, respectively. The most recent generation of storage phosphor plates is superior to a 400-speed screen-film system for the detection of catheter material, even at an exposure level of 800 speed.
    Radiology 05/2003; 227(1):216-21. · 6.34 Impact Factor