Privat-docent thesis
English

Geriatric Radiology – Challenges and Opportunities

ContributorsScheffler, Maxorcid
Number of pages114
Handover date2022-02-20
Defense date2022-09-26
Abstract

In the light of an ongoing demographic change in Switzerland, an increasing quantity of radiologic exams is performed in older people. The Trois-Chêne Hospital in Thônex, Switzerland, is a 300-bed hospital dedicated to geriatric patients and disposes since 2014 of a fully equipped radiological platform with computed tomography (CT) and magnetic resonance imaging (MRI) machines, in addition to conventional radiography and ultrasound equipment. A great number of routine exams can now be performed on site without having to transfer patients to the main hospital site of Geneva University Hospitals, about seven kilometers away, thus avoiding stress and costs. Steps have been taken to adapt procedures for performing imaging studies in older patients, considering specific limitations and needs. Following a short review on the coronavirus disease 2019 (COVID-19) pandemic's impact on the imaging site, some of these steps are explained in this work, followed by the presentation of three areas of research the radiological section is involved in. Firstly, as dementing diseases are increasing in older age groups, often of the mixed type of Alzheimer's disease and vascular dementia, the radiological section participated in a radiologic-histopathologic correlation study aiming to gain knowledge about lesser known biomarkers associated with cognitive disorders of vascular origin – cerebral microbleeds and cortical microinfarcts – and two of the studies performed are presented here (articles 1 and 2). Secondly, chronic back pain-associated sciatica is a common condition in older patients, and treatment options include minimally invasive nerve root infiltrations. Sometimes these are performed repeatedly in the same patient, as the effects may wean off after some time, and we optimized procedural steps in the radiological section to perform them under MRI guidance – allowing for high contrast resolution and preferable in situations where radioprotection might be a concern or in patients that are allergic to iodine. Article 3 treats this subject. Thirdly and finally, pneumonia is a common and – even in the pre- COVID-19 era – devastating disease in older patients, and we were interested in the role CT should assume in the diagnostic process, as opposed to conventional radiographs. Two articles we published on a retrospective interventional study on this subject (articles 4 and 5) are presented in this work. The conclusion section finally offers a future outlook on the three treated fields – dementia, minimally invasive pain therapy, and improvement in the diagnosis of pneumonia in older patients - with a short presentation of already planned or envisaged research projects.

Citation (ISO format)
SCHEFFLER, Max. Geriatric Radiology – Challenges and Opportunities. Privat-docent Thesis, 2022. doi: 10.13097/archive-ouverte/unige:164651
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Creation29/09/2022 16:32:00
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Update16/03/2023 08:39:50
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