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Reviewed By Allergy, Immunology & Inflammation Assembly

Submitted by

Jarrod Bruce M.D.

Pulmonary, Allergy, Critical Care and Sleep Medicine

The Ohio State University Medical Center

Columbus, Ohio

Joanna Williams M.D.

Clinical Assistant Professor

Department of Pathology

Nitin Bhatt M.D.

Assistant Professor of Clinical Internal Medicine

Maria Lucarelli M.D.

Associate Professor of Clinical Internal Medicine

Submit your comments to the author(s).

A 61 year old female presented to an outside hospital with increasing shortness of breath and cough. She complained of a non-productive cough for approximately six weeks.  She denied hemoptysis but complained of a low grade fever. Over this time she became progressively more short of breath. At the time of presentation she was able to only walk one hundred meters before she had to stop due to dyspnea.

Her past medical history included obesity, gastroesophageal reflux disease (GERD), peripheral vascular disease, hypertension, and type II diabetes. Family history was negative for lung cancer or chronic obstructive pulmonary disease (COPD). Her medications included aspirin, metoprolol, lisinopril, insulin glargine and esomeprazole. She denied any previous tobacco, alcohol or intravenous drug use. She was currently disabled due to chronic lower back pain.

Physical Exam

She presented to an outside hospital emergency department and was found to have an abnormal chest x-ray. Posterior-anterior (PA) and lateral films were provided ( Figures 1 and 2 ).

Figure 1

Figure 1. Posterior-anterior chest x-ray demonstrating left sided consolidation without volume loss.

Figure 2

Figure 2. Lateral view on chest x-ray demonstrating left upper lobe consolidation.

Subsequently the patient underwent computed tomography (CT) of the chest with pulmonary angiography. Two cuts are provided below ( Figures 3 and 4 ).

Figure 3

Figure 3. Computed tomography image of the chest demonstrating consolidation of the left upper lobe.

Figure 4

Figure 4. Computed tomography image of the chest demonstrating left upper lobe (LUL) consolidation with endobronchial lesion in LUL bronchus.

The patient was admitted to the outside hospital and underwent bronchoscopy for evaluation of left upper lobe (LUL) and lingular collapse. She was electively intubated for the procedure and bronchoscopy revealed an endobronchial lesion in the LUL. The patient was transferred on mechanical ventilation to a tertiary care center for further evaluation of suspected endobronchial malignancy. Repeat bronchoscopy was performed with results as shown in Video 1 .

Bronchoscopy revealed a foreign body in the left upper lobe bronchus. Using cryotherapy, the foreign body was successfully removed and eventually identified as a popcorn kernel ( Figure 5 ).

Figure 5

Figure 5. Foreign body identified as popcorn kernel.

C. Clinically, aspirated foreign bodies may commonly be confused with endobronchial malignancies based on the similar radiographic findings and initial gross appearances. Surrounding granulation tissue and secretions can obscure the margins making it difficult to correctly identify the nature of the obstructing lesion.

Foreign body aspiration is detailed extensively in children but less frequently in adults. The significance of the problem in adults is not minimal. In 2004, choking remained the fourth leading cause of unintentional injury or death in the United States and 4,100 deaths (1.4 deaths per 100,000 population) from unintentional ingestion or inhalation of food or other objects resulting in airway obstruction were reported[1]. The incidence rate in adults increases with age beginning in the sixth decade (2.6 deaths per 100,000 population aged 65-75 y) and rises rapidly after age 70 years (13.6 deaths per 100,000 population older than 75 y). Café coronary syndrome has been defined as the aspiration of a foreign body leading to immediate asphyxiation and death[2]. The incidence has been described at 0.66 per 100000. Since the angles made by the mainstem bronchi with the trachea are identical until 15 years of age foreign bodies are found on either side with equal frequency in children. After age 15 the right mainstem bronchus has a more acute angle off the trachea and foreign bodies are more commonly encountered here. Predisposing factors that have been described in previous reviews include primary neurologic disorders that result in impaired cough and swallowing, poor dentition, trauma, and sedative use[3]. Less common but still pertinent factors described are cultural practices such as not using eating utensils.

With further questioning, this patient remembered an incident of choking while eating popcorn lying on her couch approximately two months prior to presentation. 

B. Infrequently (less than 50% of the time) - In his review, Lan divided patients into clinical categories of acute or chronic aspirated foreign bodies[4]. In acute aspiration, patients can present immediately with a discrete choking episode and respiratory symptoms of dyspnea, coughing, localized wheezing, or absent breath sounds. Penetration syndrome is the presence of intractable cough and choking with or without vomiting that occurs at the time of the event[5]. This has been reported to occur upward of 49% in cases of foreign body aspiration. For patients identified as having chronic aspiration, a discrete episode of choking was not often recalled[4]. In Lan’s review, the duration of foreign body presence in the lung was approximately 25 months. Clinical characteristics associated with chronic foreign body aspiration were refractory asthma symptoms with localized wheezing, delayed resolution of pneumonia with appropriate treatment or recurrent pneumonias. Clinical sequelae in the chronic group included bronchiectasis, hemoptysis or bronchial stricture.

D. - The initial tests to obtain are AP and lateral neck films, inspiratory and expiratory PA chest films and a lateral chest film. Lateral neck views may show swelling or infraglottic opacity[5]. Many of the x-ray findings are dependent upon the length of time that the foreign body has been present and the properties of the foreign body itself. Radiopaque materials such as metal or teeth are easily identified. Organic materials including bones may not be easily seen. Bones from cod, haddock and salmon are radioapaque while trout, mackerel, and herring bones are radiolucent[6]. Some foreign bodies may have a physiologic ball and valve effect on the expiratory film, resulting in hyperinflation during expiration on the affected side[7]. In chronic foreign body aspiration atelectasis is more often seen. Recurrent pneumonias with volume loss are a common presentation of chronic foreign body aspiration[4]. The diagnostic accuracy, sensitivity, and specificity of foreign body detection on chest x-rays was 67%, 68%, and 67%, respectively in one series 34 pediatric cases[8]. Chest computed tomography (CT) in the evaluation of foreign body in adults has been described in the literature but there are no large series that have provided the sensitivity or specificity of CT. CT scans offer the additional ability to detect the foreign body in the lumen of the tracheobronchial tree[9]. Sensitivity may be increased with the use of higher resolution CT scans. Typical findings include hyperlucency, lobar consolidation, bronchiectasis and atelectasis.

B. With regards to removal of the foreign body both flexible bronchoscopy and rigid bronchoscopy can be utilized. In one case series 90% of tracheobronchial foreign bodies were able to be removed using flexible bronchoscopy and 97% using the combination of the two procedures[10]. Cryotherapy can be useful in the removal of soft material as was the case here. Other tools that can be utilized with the flexible bronchoscope include forceps and basket retrieval devices. The nature of the foreign body is important to the clinical presentation and its subsequent removal. The foreign body reaction within the airway tends to be much stronger with vegetative materials than non-vegetative[11]. After becoming lodged vegetable material may swell over hours or days, worsening the obstruction. Oily nuts such as peanuts have been shown to induce significant congestion and edema due to the free fatty acid released from decomposition of the nut itself. Inert objects such as bone or metal often do not cause significant airway obstruction but tend to be sharper and can lend to bleeding on removal.

After the foreign body removal bronchoalveolar lavage (BAL) from the LUL stained positive for a beaded gram positive bacilli that was modified Ziehl-Neelson acid fast stain negative. Poor growth was noted in aerobic culture but granules were seen on examination of the biopsy material.

C. Actinomyces is classically defined by the aforementioned staining characteristics and lack of growth on aerobic media[12]. Culturing material from foreign bodies requires special care. Laboratory personnel should be alerted of the possibility of aerobic and anaerobic organisms along with the possible need for the use of special culture media. Cultures should be allowed to grow for extended periods due to the relatively slow growth of these organisms. The cultures should also be kept after initial identification of more common airway organisms in an attempt to visualize fastidious organisms.

The three members of the genera actinomycetes are Actinomyces, Nocardia and Streptomycoses. The Actinomyces species are nonspore forming anaerobic prokaryotic bacteria. The presence of gram positive bacilli with beaded, branched morphology are suggestive of actinomycoses. It will typically stain acid fast negative. Sulphur granules have classically been associated with these organisms. Risk factors include alcoholism and poor dentition with weaker evidence suggesting immunosuppression as a risk factor[12]. Clinically this is often confused with a malignancy due to its slow growing characteristics. It is often associated with malignancy as it tends to colonize dead tissue which may be seen with necrotic endobronchial malignancies. Diagnosis should include a combination of positive culture, demonstration of sulphur granules in purulent matter from infected tissue, correlation with the clinical and radiological features, and the response to antibiotic treatment.  Actinomyces has been associated with foreign body aspiration in a previous case report[13]. Treatment consists of high dose intravenous penicillin for 2-6 weeks and then oral therapy for 6 to 12 months.

Differentiating amongst the members of the genera can be difficult as all have been associated with human disease. Nocardia species is identified as an aerobic, gram positive rod that stains partially acid fast[14]. This organism rarely forms granules and can be treated with trimethoprim/sulfamethoxazole. Streptomyces species typically cause mycetomas. They will often appear as an aerobic, gram positive rod. Acid fast staining is negative and these organisms often will produce granules. Treatment is also with trimethoprim /sulfamethoxazole.

Conclusion The patient was treated with IV penicillin and transitioned to oral therapy. At time of follow up she had radiographic resolution of her LUL collapse. Her cough had disappeared and she was back to her functional baseline.

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Case Studies on X-ray Imaging, MRI and Nuclear Imaging

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Cite this chapter

x ray case studies

  • Shuvra Sarker 5 ,
  • Angona Biswas 5 ,
  • Nasim Md Abdullah Al 5 ,
  • Md Shahin Ali 6 ,
  • Sai Puppala 7 &
  • Sajedul Talukder 7  

59 Accesses

The field of medical imaging is an essential aspect of the medical sciences, involving various forms of radiation to capture images of the internal tissues and organs of the body. These images provide vital information for clinical diagnosis, and in this chapter, we will explore the use of X-ray, MRI, and nuclear imaging in detecting severe illnesses. However, manual evaluation and storage of these images can be a challenging and time-consuming process. To address this issue, artificial intelligence (AI)-based techniques, particularly deep learning (DL), have become increasingly popular for systematic feature extraction and classification from imaging modalities, thereby aiding doctors in making rapid and accurate diagnoses. In this review study, we will focus on how AI-based approaches, particularly the use of Convolutional Neural Networks (CNN), can assist in disease detection through medical imaging technology. CNN is a commonly used approach for image analysis due to its ability to extract features from raw input images, and as such, will be the primary area of discussion in this study. Therefore, we have considered CNN as our discussion area in this study to diagnose ailments using medical imaging technology.

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Arsanjani, R., Dey, D., Khachatryan, T., Shalev, A., Hayes, S.W., Fish, M., Nakanishi, R., Germano, G., Berman, D.S., Slomka, P.: Prediction of revascularization after myocardial perfusion SPECT by machine learning in a large population. J. Nucl. Cardiol. 22 , 877–884 (2015)

Berkaya, S.K., Sivrikoz, I.A., Gunal, S.: Classification models for SPECT myocardial perfusion imaging. Comput. Biol. Med. 123 , 103893 (2020)

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Sarker, S., Biswas, A., Al, N.M.A., Ali, M.S., Puppala, S., Talukder, S. (2023). Case Studies on X-ray Imaging, MRI and Nuclear Imaging. In: Zheng, B., Andrei, S., Sarker, M.K., Gupta, K.D. (eds) Data Driven Approaches on Medical Imaging. Springer, Cham. https://doi.org/10.1007/978-3-031-47772-0_10

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Radiopaedia.org

Skull fracture - linear

Citation, doi, disclosures and case data.

At the time the case was submitted for publication Dalia Ibrahim had no recorded disclosures.

Presentation

Head trauma.

Patient Data

Long linear branching (inverted y shape) left parietal fracture. It ends perpendicular on the lambdoid suture.

Left parietal linear branching (inverted y shape) fracture which ends perpendicular on the lambdoid and the squamosal sutures.

No underlying intra-cerebral, epidural or subdural hemorrhage.

Case Discussion

Linear skull fracture are usually more radiolucent than calvarial sutures with straightness and lack of serration along its edges.

1 article features images from this case

  • Skull fractures (summary)

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Chest X-ray: A case study based tutorial

28 short case studies with questions.

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Free open access medical education, 6 clinical radiology practice cases.

Screen Shot 2016-04-01 at 11.38.44 AM.png

We present 6 practice x-ray cases from Junior Medical Officer teaching at Westmead hospital.  When interpreting films pattern recognition is developed quickly over time but always stick with your solid system so as to  not miss things .  FOAMed images from LITFL.

Lecture Handout Notes – CLICK HERE

Thanks for Dr Andrew Baker for the opportunity to present.

RSS icon

  • Where is the Nasogastric Tube?
  • Where should it be?

NGT.png

Answer – Look for the “ tip ” 10cm below the Lower Oesophageal Sphincter :

Case1.png

Are you happy to feed the patient without repositioning?

Case 1.png

No. Not in this case!

This patient developed an aspiration pneumonitis after enteral feeding into the lung…

  • A normally healthy 33 year old man is brought to your Emergency Department with acute shortness of breath after developing chest pain during a run at the park.
  • On arrival in hospital, he is pale and sweaty. He was found to be tachycardic and hypotensive.  A CXR was taken immediately after a procedure was performed to stabilise his condition.

Case2.png

Can you describe his Chest X-ray?

  • Chest X-ray showing a pneumothorax
  • A thoracotomy needle in the left chest
  • No evidence tension pneumothorax (deviated heart, mediastinum, trachea)

Can you write down a systematic approach to interpreting a Chest X-ray?

  • D emographics (Name, Time Taken)
  • –(Quality = Rotation/Adequacy/Penetration)
  • A irway (Trachea)
  • Mediastinum (>7cm)
  • Hilum (Left Should be Higher than Right)
  • Lungs (Lung Fields, Fissures)
  • C irculation
  • E verything Else
  • Step Back – Consider ‘Overall Appearance’ (‘gestalt’ comes in here)

What are your treatment options?

Resuscitation Phase

Screen Shot 2016-04-01 at 12.14.33 PM

(1) Is there is evidence of tension pneumothorax?

  • IV, O2, Monitor
  • Decompress the pneunothorax with needle +/- aspiration technique
  • Follow the A-G assessment
  • Call for help

A-G assessment

General  Manangement

(2) Are there minimal symptoms?

  • If small (3cm or less at hilum) –  observe (oxygen may increase absorption)
  • follow BTS guideline
  • consider a chest drain if >3cm

(3) The patient is not improving after chest drain for several days – what should I do?

  • Get a CT scan to reveal a possible underlying cause for the pneumothorax
  • Involve a Cardiothoracic surgeon in the care (may need surgical intervention)

Approaches to Pneumothorax for reference:

Pneumothorax Emergency Medicine.png

  • A 60 year old car driver presents following a head on collision with a bus at 60Kph.
  • BP 130/90mmHg
  • Respiratory Rate 24/min
  • Oxygen Saturations 98% (on 6L oxygen)

Case3.png

Describe and interpret her X-ray

  • Widened Mediastinum
  • Clavicle Fracture
  • Rib Fractures
  • ?Right Haemopneumothorax

monitor.JPG

Outline your management options

  • Care of the Trauma patient is delivered by a Team with good communication amount members.  Ultrasound would help you differentiate the chest injuries further in skilled hands
  • Start treating the patient with the mantra IV / O2 / Monitor with resuscitation trolley at the bedside
  • If shocked (as the picture above would indicate) activate your local transfusion protocols in liaison with haematology
  • If Aortic Injury  is a concern caution with over resuscitation
  • Chest drain (intercostal catheter insertion) of the correct side – re-expansion of the lung may help tamponade bleeding

If Aortic Injury:

Management of Aortic Injuries

  • Thoracotomy for haemothorax – if on going bleeding or massive initial blood loss
  • Disposition – admission to ICU
  • A 65 year old woman presents to your hospital with gradually increasing breathlessness over the preceding 2 days.
  • It is about 10 days since her last chemotherapy (cisplatin).
  • Respiratory rate 30/min
  • Oxygen Saturations 91% (on 6L Oxygen)
  • Temperature 36.8 degrees

Case 4.png

What does her Chest X-ray show?

  • Large left pleural effusion
  • Multiple discrete lung parenchymal lesions typical of metastatic lung disease
  • ? Mastectomy
  • No Obvious boney mets

Write down 6 differentials in the acutely short of breath patient with malignancy

  • Sepsis with metabolic acidosis (in view of recent chemotherapy)
  • Pericardial Effuson
  • SVC Obstruction
  • Pleural Effusion(s)
  • Lymphangitis

What are the causes of a Pleural Effusion?

  • Transudates – Congestive Heart Failure, Liver Failure, Renal Failure, Nephrotic syndrome, Hypoalbuminaemia, Enteropathy and Dialysis
  • Exudates – Lung Ca, TB, Infections (Bacterial), RA, Pancreatitis, Sub-phrenic Abscess, ‘Meig’s’ Syndrome, Dressler’s Syndrome, SLE, Lymphoma, Hypothyroid, PE, Mesothelioma, Yellow Nail Syndrome and Vasculitis

What is Light’s Criteria?

  • The ratio of pleural fluid protein to serum protein is greater than 0.5
  • The ratio of pleural fluid LDH and serum LDH is greater than 0.6
  • Pleural fluid LDH is greater than 0.6 times the normal upper limit for serum. (i.e 0.6 of 200)

A 50 year old regular Emergency Department presenter with a history ETOH excess presents with a few weeks of feeling tired and coughing up small amounts of blood. He has a past history of pancreatitis and appendicectomy

case5

What does the X-ray show?

Answer – X-ray showing a ‘cavitating’ lesion in right chest with soft tissue densities in lower zone.

List your differential diagnosis

  • Acute Infective causes – such as TB, Fungi, Aspiration
  • Malignancy (Primary and Secondary)
  • Other bacterial infections Staphylococcus / Klebsiella
  • Wegner’s ( recent name change of this disease due to a Nazi doctor who described it )
  • Severe Fibrosis
  • PICC lines are occasionally required for venous access IV administration of medication nutrition.
  • You are called to the ward for a patient who has just had a PICC line placed.

CXR ( http://www.rtexam.com ) is shown:

Case 6.png

Are you happy with the position of the PICC line?

  • Chest X-ray showing tip of PICC line in the Superior Vena Cava (SVC) – so in this case we are happy with the position
  • Malposition of the tip is common (superior (IJ), across (subclavian), or twisted around). In one study about 8% of PICC lines were badly positioned on initial assessment post insertion
  • Feeding / medications should not be commenced unless a good position is identified on the CXR

(1) Image 1 – Click Here

(2) Image 2 – Click Here

(3) Image 3 – Click Here

(4) Image 4 – Click Here

(5) Image 5 – Click Here

(6) Image 6 – Click Here

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2 thoughts on “ 6 clinical radiology practice cases ”.

Great post! I recommend attributing/citing sources from which figures are obtained. This serves several purposes and allows readers to contact primary authors should a change or typo exist. Thanks for the #FOAMed.

Thanks . If you click on each item it should take you there but we ll add a fuller reference section at end. This was really an intern flipped classroom more than anything else…

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Breakthrough: X-ray of a single atom captured for the first time

I n a remarkable feat, a team of scientists has taken the world's first X-ray signature of just one atom. This stunning achievement could revolutionize the way scientists detect materials .

The research team was led by Saw Wai Hla , Professor of Physics at Ohio University and scientist at Argonne National Laboratory .

Atoms and the evolution of X-ray technology

Since its discovery by Roentgen in 1895, X-rays have been used in various applications, from medical examinations to security screenings in airports. Even NASA's Mars rover, Curiosity , is equipped with an X-ray device to examine the materials composition of rocks on Mars.

Over the years, advancements in synchrotron X-ray sources and new instruments have greatly reduced the quantity of materials required for X-ray detection.

However, until now, the smallest amount one could X-ray a sample was in attogram, which is about 10,000 atoms or more. This limitation was due to the extremely weak X-ray signal produced by an atom, making it undetectable by conventional X-ray detectors.

Realizing a long-standing dream

According to Hla, it has been a long-standing dream of scientists to X-ray just one atom, which is now being realized by his research team.

"Atoms can be routinely imaged with scanning probe microscopes, but without X-rays one cannot tell what they are made of. We can now detect exactly the type of a particular atom, one atom-at-a-time, and can simultaneously measure its chemical state," explained Hla, who is also the director of the Nanoscale and Quantum Phenomena Institute at Ohio University .

"Once we are able to do that, we can trace the materials down to the ultimate limit of just one atom. This will have a great impact on environmental and medical sciences and maybe even find a cure that can have a huge impact for humankind. This discovery will transform the world," Hla continued.

How to x-ray a single atom

The research team used a purpose-built synchrotron X-ray instrument at the XTIP beamline of Advanced Photon Source and the Center for Nanoscale Materials at Argonne National Laboratory. They chose an iron atom and a terbium atom, both inserted in respective molecular hosts, for demonstration.

To detect the X-ray signal of one atom, the team supplemented conventional detectors in X-rays with a specialized detector made of a sharp metal tip positioned at extreme proximity to the sample to collect X-ray excited electrons. This is a technique known as synchrotron X-ray scanning tunneling microscopy or SX-STM.

"The technique used, and concept proven in this study, broke new ground in X-ray science and nanoscale studies," said Tolulope Michael Ajayi, the first author of the paper and a Ph.D. student working on this project as part of his thesis.

"More so, using X-rays to detect and characterize individual atoms could revolutionize research and give birth to new technologies in areas such as quantum information and the detection of trace elements in environmental and medical research, to name a few. This achievement also opens the road for advanced materials science instrumentation," Ajayi concluded.

Decade of collaboration ends with success

Hla has been involved in the development of an SX-STM instrument and its measurement methods for the last 12 years, together with Volker Rose, a scientist at the Advanced Photon Source at Argonne National Laboratory.

"I have been able to successfully supervise four OHIO graduate students for their Ph.D. theses related to SX-STM method development over a 12-year period. We have come a long way to achieve the detection of a single atom X-ray signature," Hla said.

Investigating environmental effects on rare-Earth atoms

In addition to achieving the X-ray signature of one atom, the team's key goal was to use this technique to investigate the environmental effect on a single rare-earth atom.

"We have detected the chemical states of individual atoms as well," Hla explained. "By comparing the chemical states of an iron atom and a terbium atom inside respective molecular hosts, we find that the terbium atom, a rare-earth metal , is rather isolated and does not change its chemical state while the iron atom strongly interacts with its surrounding."

Rare-earth materials are extremely important in creating and advancing technology, and are used in everyday devices such as cell phones, computers, and televisions.

Through this discovery, scientists can now identify not only the type of element but its chemical state as well, allowing them to better manipulate atoms inside different materials hosts to meet ever-changing needs in various fields.

Connecting synchrotron X-rays with quantum tunneling

Moreover, the research team has also developed a new method called "X-ray excited resonance tunneling or X-ERT" that allows them to detect how orbitals of a single molecule orient on a material surface using synchrotron X-rays.

"This achievement connects synchrotron X-rays with quantum tunneling process to detect X-ray signature of an individual atom and opens many exciting research directions including the research on quantum and spin (magnetic) properties of just one atom using synchrotron X-rays," Hla excitedly concluded.

Atoms, x-rays and future technology

In summary, the incredible feat of capturing the first-ever X-ray signature of a single atom marks a significant milestone in the field of X-ray science and nanoscale studies .

This achievement, made possible by the dedicated efforts of a collaborative research team led by Professor Saw Wai Hla, opens up a world of possibilities for scientific research and technological advancements.

By pushing the boundaries of what was previously thought to be undetectable, this innovative technique has the potential to revolutionize various fields, from environmental and medical sciences to quantum information and advanced materials science instrumentation.

As scientists continue to explore the capabilities of this powerful tool, they pave the way for discoveries that could have a profound impact on our understanding of the world at the atomic level and beyond.

The full study was published in the journal Nature .

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Breakthrough: X-ray of a single atom captured for the first time

How the XRISM spacecraft can study the X-ray universe with only 36 pixels

"That may sound impossible, but it’s actually true."

A cyclinder shaped silver gold and green spacecraft against a black background with golden square to its right

A new X-ray space telescope is broadening our understanding of the universe with just three dozen pixels — really putting smartphones with as many as 12 million to 48 million pixels to shame!

The Japan Aerospace Exploration Agency (JAXA) and NASA spacecraft known as the X-ray Imaging and Spectroscopy Mission (XRISM; pronounced "crism") launched in Sept. 2023. Its mission is to study the universe in " soft X-rays ," referring to electromagnetic radiation with energies around 5,000 times greater than that of visible light. The way XRISM works has to do with an instrument called "Resolve."

The really stunning thing about Resolve is it allows XRISM to widen humanity's celestial understanding with a fraction of the pixels used by the screen of the original Nintendo Gameboy, released in 1989. With Resolve in hand, the ultimate aim of the XRISM mission is to allow scientists to discover more about some of the hottest regions of the cosmos , as well as some of the largest structures in the universe and the feeding supermassive black holes that sit in the active hearts of many galaxies. 

Related: Hubble Space Telescope pauses science due to gyroscope issue

"That may sound impossible, but it’s actually true," Richard Kelley, the U.S. principal investigator for XRISM at NASA's Goddard Space Flight Center  in Greenbelt, Maryland, said in a statement . "The Resolve instrument gives us a deeper look at the makeup and motion of X-ray-emitting objects using technology invented and refined at Goddard over the past several decades."

A space mission with plenty of Resolve

To be fair, it might be inappropriate to compare Resolve to a smartphone camera. 

The 6-by-6-pixel microcalorimeter array, which measures just 0.2 inches by 0.2 inches (0.5 centimeters by 0.5 centimeters), makes Resolve way more than a camera.

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"Its detector takes the temperature of each X-ray that strikes it," Brian Williams, NASA's XRISM project scientist, explained in a statement. "We call Resolve a microcalorimeter spectrometer because each of its 36 pixels is measuring tiny amounts of heat delivered by each incoming X-ray, allowing us to see the chemical fingerprints of elements making up the sources in unprecedented detail."

a blue, purple and reddish-orange supernova remnant shines against the blackness of space

To produce a spectrum of X-ray sources between 400 and 12,000 electron volts, the entire Resolve detection has to be kept extremely cold at a temperature of minus 459.58 degrees Fahrenheit (minus 273.1 degrees Celsius). That is a fraction of a degree warmer than absolute zero , the theoretical temperature at which all atomic movement would cease.

—  Voyager 2: An iconic spacecraft that's still exploring 45 years on

—  NASA's Voyager 1 spacecraft finally phones home after 5 months of no contact

—  JAXA, NASA reveal 1st images from XRISM X-ray space telescope

Resolve is so precise that it can detect a target celestial object's motion, giving astronomers a 3D view of that target. For galaxies, this means the motions of hotter gas glowing at higher energies can be distinguished from that of colder gas. 

These X-ray maps should allow scientists to track the motion of matter blasted out by stars dying explosive supernova deaths — a pretty big deal for a little device with just 36 pixels.

Join our Space Forums to keep talking space on the latest missions, night sky and more! And if you have a news tip, correction or comment, let us know at: [email protected].

Robert Lea

Robert Lea is a science journalist in the U.K. whose articles have been published in Physics World, New Scientist, Astronomy Magazine, All About Space, Newsweek and ZME Science. He also writes about science communication for Elsevier and the European Journal of Physics. Rob holds a bachelor of science degree in physics and astronomy from the U.K.’s Open University. Follow him on Twitter @sciencef1rst.

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Astrophysics > High Energy Astrophysical Phenomena

Title: on the detection and characterization of quasiperiodic oscillations in astronomical time series: gamma-ray burst x-ray light curves as a test case.

Abstract: The study of temporal properties of variable sources can elucidate their physical processes. In this context, we present a critical study comparing three approaches to periodic or quasiperiodic behavior: Gaussian process, power spectrum, and wavelet analysis, using celerite, Lomb-Scargle periodograms, and weighted wavelet-Z transforms, respectively. We use 15 Swift-X-ray Telescope light curves of short gamma-ray bursts (sGRBs) as examples. A comprehensive analysis of two sGRB X-ray light curves is performed. The results reveal the importance of artifacts, largely in the form of false quasiperiodic oscillation signals, possibly introduced by preprocessing (such as detrending) or other aspects of the analysis. The exploration described in this paper can be helpful for future studies of variability in GRBs, active galactic nuclei, and other astronomical sources.

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  6. Abdominal X-ray case(Abnormal air) #1 Arabic

COMMENTS

  1. Search

    Cases. By sharing our collective experience through interesting and classic patient cases, we can make a real difference in how people are imaged and diagnosed. Each case belongs to a contributing member and all cases are reviewed by our dedicated editors to ensure they reach quality standards and abide by privacy guidelines. Cases can public ...

  2. A case of progressive dyspnea and abnormal chest x-ray (The Case of

    A 61 year old female presented to an outside hospital with increasing shortness of breath and cough. She complained of a non-productive cough for approximately six weeks. She denied hemoptysis but complained of a low grade fever. Over this time she became progressively more short of breath. At the time of presentation she was able to only walk ...

  3. A case of fatal trauma evaluated using a portable X-ray system at the

    Third, as with traditional X-ray systems, the examiner should be careful about undue radiation exposure in humans. Fourth, the interior of the DH is quite cramped, and a distance of at least 1 m between the subject and the X-ray apparatus is necessary for the examination, so X-ray studies cannot be performed in-flight.

  4. Case Study: 33-Year-Old Female Presents with Chronic SOB and Cough

    Laboratory Studies: Initial work-up from the emergency department revealed pancytopenia with a platelet count of 74,000 per mm3; hemoglobin, 8.3 g per and mild transaminase elevation, AST 90 and ALT 112. Blood cultures were drawn and currently negative for bacterial growth or Gram staining. Chest X-ray. Impression: Mild interstitial pneumonitis

  5. PDF XRAY SCENARIOS

    Welcome to this series of chest radiograph scenarios. Each of these scenarios is based upon a real patient, using their notes and their chest x-rays to test your knowledge. Each scenario focuses on the major, stand-out abnormality on the x-ray. There is a range of difficulty within this set of scenarios. How difficult you find them may depend ...

  6. Clinical Cases • APPLIED RADIOLOGY

    Stay up to date with the latest in Practical Medical Imaging and Management with Applied Radiology.

  7. Improving patient flow in diagnostic imaging: a case report

    This case study aimed to identify options for increasing efficiency, improving adaptive workflow and decreasing wait times during peak hours in DI, and walk-in X-Ray in particular. Although Erie Shores was the target of this case study, other hospitals can benefit from the recommendations provided.

  8. Case report

    Purpose. The purpose of a radiology case report is to describe the patient history, clinical course, and imaging for a notable or unusual case. The case may be intended to aid other practitioners in interpretation, but frequently the oddity, rarity, and non-generalisibility of cases are meant more to amuse or entertain the reader.

  9. Case Studies on X-ray Imaging, MRI and Nuclear Imaging

    2.1 Medical Imaging and Essential Study in Medical Science 2.1.1 Medical Imaging. The history of medical imaging dates back to the discovery of X-rays by Wilhelm Conrad Roentgen in 1895. Since then, the field of medical imaging has evolved rapidly with the development of various imaging modalities, such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and positron ...

  10. Skull fracture

    Ibrahim D, Skull fracture - linear. Case study, Radiopaedia.org (Accessed on 05 May 2024) https://doi.org/10.53347/rID-28686

  11. X-Ray: What It Is, Types, Preparation and Risks

    X-Ray. An X-ray is an imaging study that takes pictures of bones and soft tissues. X-rays use safe amounts of radiation to create these pictures. The images help healthcare providers diagnose a wide range of conditions and plan treatments. Usually, providers use X-rays to evaluate broken bones, dislocated joints and other bone injuries.

  12. Case Studies on X-Ray Imaging, MRI and Nuclear Imaging

    Case Studies on X-Ray Imaging, MRI and Nuclear Imaging. The field of medical imaging is an essential aspect of the medical sciences, involving various forms of radiation to capture images of the internal tissues and organs of the body. These images provide vital information for clinical diagnosis, and in this chapter, we will explore the use of ...

  13. Case 34-2010

    A 65-year-old woman was admitted to the day-surgery unit of this hospital for release of a trigger finger of the left ring finger. A carpal-tunnel release was performed. After the procedure, the su...

  14. Chest X-ray: A case study based tutorial

    OpenMed rates and lists good resources for learning Medicine. Browse a curriculum to see a selection, or Search (top right) to find more. See Help for more info about the why, what and how of what we are doing here. Level Guide A/B/C = Learner, Practitioner, Expert.

  15. Osgood-Schlatter disease

    Case Discussion. Features on X-ray in 10 years patient with knee pain consistent with Osgood-Schlatter disease , a chronic fatigue injury due to repeated microtrauma at the patellar ligament insertion onto the tibial tuberosity.

  16. 6 Clinical Radiology Practice Cases

    6 Clinical Radiology Practice Cases. April 1, 2016August 23, 2018 by Andrew Coggins. We present 6 practice x-ray cases from Junior Medical Officer teaching at Westmead hospital. When interpreting films pattern recognition is developed quickly over time but always stick with your solid system so as to not miss things . FOAMed images from LITFL.

  17. Case Study: 60-Year-Old Female Presenting With Shortness of Breath

    Case Presentation. The patient is a 60-year-old white female presenting to the emergency department with acute onset shortness of breath. Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago with an acute, chronic ...

  18. X-rays and Mom

    A bedside screen shot of a Carestream DRX mobile X-ray in the ED of the fractured fibula. When I got there my mom was already heavily sedated due to the pain and because the ED staff had already put her ankle back in place. The ED doctor ordered a digital radiograph (DR) of her leg to see the extent of damage.

  19. Case Studies

    Research. North Star Imaging offer a variety of Case Studies of the application of X-Ray and CT in Automotive, Medical Devices, Plastics, and Additive Manufacturing.

  20. Case Studies

    Case Studies. Cotswolds Chiropractic Health Centre chose Wolverson X-Rays Ltd to install a PRS 500 X floor-mounted X-ray system to improve their digital radiography. READ CASE STUDY. Case Studies. Wolverson X-Ray Ltd successfully tendered to install two state-of-the-art X-ray systems for Huddersfield Royal Infirmary. READ CASE STUDY. Case Studies.

  21. Breakthrough: X-ray of a single atom captured for the first time

    "The technique used, and concept proven in this study, broke new ground in X-ray science and nanoscale studies," said Tolulope Michael Ajayi, the first author of the paper and a Ph.D. student ...

  22. Fabella fracture with radiological imaging: A case report

    Fabella fracture may cause knee pain or functional impairment as the previous reports pointed. It is extremely rare, which leads to its high rate of missed diagnosis in clinical and radiography to some extent. We report a case of a 38-year-old female who was struck by an electromobile. The fabella fracture was confirmed on X-ray plain films.

  23. How the XRISM spacecraft can study the X-ray universe with only 36

    The Japan Aerospace Exploration Agency (JAXA) and NASA spacecraft known as the X-ray Imaging and Spectroscopy Mission (XRISM; pronounced "crism") launched in Sept. 2023. Its mission is to study ...

  24. Clinical Radiology Case Presentation: Do's and Don'ts

    Abstract. Clinical case presentation is part of daily routine for doctors to communicate with each other to facilitate learning, and ultimately patient management. Hence, the art of good clinical case presentation is a skill that needs to be mastered. Case presentations are a part of most undergraduate and postgraduate training programs aimed ...

  25. On the Detection and Characterization of Quasiperiodic Oscillations in

    The study of temporal properties of variable sources can elucidate their physical processes. In this context, we present a critical study comparing three approaches to periodic or quasiperiodic behavior: Gaussian process, power spectrum, and wavelet analysis, using celerite, Lomb-Scargle periodograms, and weighted wavelet-Z transforms, respectively. We use 15 Swift-X-ray Telescope light curves ...

  26. [2405.04033] On the Detection and Characterization of Quasiperiodic

    The study of temporal properties of variable sources can elucidate their physical processes. In this context, we present a critical study comparing three approaches to periodic or quasiperiodic behavior: Gaussian process, power spectrum, and wavelet analysis, using celerite, Lomb-Scargle periodograms, and weighted wavelet-Z transforms, respectively. We use 15 Swift-X-ray Telescope light curves ...