teleconsult

Teleradiology

Designing and delivering teleradiology services which meet your specific requirements is our forte. Our Board Certified radiologists offer preliminary, final and subspecialty reports 24/7/365. Turnaround times are set to match your needs. Our technical support center provides state of the art PACS/RIS and communication technology, which securely integrates with your current Information Systems.

Telepathology

Teleconsult pathologists offer services ranging from remote reporting of cyto- and histological cases, to lab design and quality assurance programs. We support the most basic lab set ups with second opinions and on-line consultations, and connect more advanced labs to our web based telepathology platform for routine reporting of diverse cases.

Telemicrobiology

Our telemicrobiology services are offered by Dutch and UK Board Certified clinical microbiologists with sub-specialties in the fields of general microbiology, bacteriology, virology, parasitology, mycology, molecular diagnostics and epidemiology. Our clinical microbiologists are mainly active in clinical hospital settings, keeping them closely connected and in tune with daily clinical situations and challenges. This creates affinity with remote cases and ensures the up-to-date knowledge our customers require.

Locum Placement

Our recruitment division recruits certified radiologists, pathologists and micro biologists for part time and full time positions. In our 15 year history we successfully recruited and placed medical specialists in over 60 hospitals and clinics across the globe

Screening & Trials

From its worldwide network of Board Certified medical specialists, TeleConsult creates subspecialty teams for specific screening and clinical trial assignments. In 2012 TeleConsult’s dedicated breast radiologists were selected by the Dutch Breast Cancer Screening program to interpret its screening mammography studies.

We are hiring

We recruit, select and place sub-specialty, EU educated and certified radiologists, pathologists and microbiologists for short and long term positions. Our reputation has been built on a foundation of providing highly skilled doctors and the following core values: Professionalism, Value for money, Quality, Reliability and Integrity. Interested in joining our team? Register now!

Specialist care at your fingertips

Whether you are a hospital  department, diagnostic center or laboratory, Teleconsult doctors and IT experts bring optimal efficiency to your  workflow. A thorough analysis of your current situation, needs and requirements results in a balanced work flow management plan.

Teleconsult does not have any volume requirement and you are in full control to decide when to outsource studies to a Teleconsult doctor. To find out how your clinic or department will benefit from working with Teleconsult Europe, please contact us.

  • INCREASE YOUR SUBSPECIALTY OFFERINGS

  • Balance on- and off site tasks

  • INCREASE PRODUCTIVITY AND PROFITABILITY

  • MAXIMUM USE OF RADIOLOGY AND LABORATORY EQUIPMENT

  • 24/7/365 AVAILABILITY OF EXPERTISE

About Teleconsult

Founded in 2007 by Dutch radiologists, TeleConsult Europe (TCE) offers radiology services to hospitals, clinics, diagnostic centers, laboratories, medical services companies and the Dutch Government.

TCE’s mission is to provide its customers with tailored telemedicine solutions. Since its inception, TCE carefully listened to wishes and needs of its clients. This resulted in an array of interchangeable services providing radiology and pathology departments with high quality, cost efficient, flexible on- and off-site solutions.

Today TCE’s solutions consist of a combination of an on-site physician workforce, teleradiology, telepathology, and IT services. Our Western Board certified radiologists and pathologists perform reading services for a broad array of institutions varying from a 24/7 emergency reading service for hospitals and clinics, to screening services for the famous Dutch Breast Cancer Screening Program.

The primary objective of our highly trained physicians and staff is to enable our clients to provide optimal patient care and diagnostic services by placing quality and value first. Our synergetic modules provide tailored services to hospitals, clinics and imaging centers at any location on the globe. Whether you need an on-site physician, reports through telemedicine or a combination of both, we help you to realize an optimal and cost efficient workflow.

Study shows area undamaged by stroke remains so, regardless of time stroke is left untreated

Radiological imaging is being used more often to evaluate stroke diagnosis and outcomes, with penumbra, or tissue that is at risk of progressing to dead tissue but is still salvageable if blood flow is returned, as a potential target for therapy.

However, there have been few studies about what happens to the penumbra without treatment to restore blood flow through the blocked arteries, known as reperfusion treatment.

A study led by Achala Vagal, MD, associate professor at the University of Cincinnati (UC) College of Medicine and a UC Health radiologist, looked at a group of untreated acute stroke patients and found that there was no evidence of time dependence on damage outcomes for the penumbra but rather an association with collateral flow - or rerouting of blood through clear vessels.

These findings are being presented at the American Society of Neuroradiology's annual meeting May 25 in Washington, DC.

Vagal says their sample size was small - only 110 patients - so larger studies are needed to examine how treatment may differ in a stroke with a delayed or unknown onset time.

"Using a large, multicenter stroke registry, we analyzed all untreated acute stroke patients who received baseline CT angiogram, an X-ray that uses a dye and camera (fluoroscopy) to take pictures of the blood flow in an artery, and CT perfusion, to show which areas of the brain were getting blood, within 24 hours of the onset of stroke, and follow-up CT angiogram or MR angiogram within 48 hours," she says. "Baseline CT angiogram results were reviewed for artery blockages and rerouting of blood flow, and follow-up imaging was reviewed to determine if blood flow was restored."

Vagal adds that CT perfusion was used to determine baseline numbers for the penumbra and that dead tissue was measured on follow up CT and MR imaging.

Results showed that there was no significant correlation between salvaged penumbra and time; however, there was a correlation between salvaged penumbra and the amount of collateral blood flow, meaning the blood flow that was rerouted.

"Larger studies are needed to understand the natural history of penumbra that could lead to future trials and have treatment implications particularly in delayed or unknown onset time," she says.

This research was funded by a National Institutes of Health Center for Clinical and Translational Science and Training (CCTST) KL2 Research Scholar Mentored Career Development Award. Vagal's mentoring team for this scholar award included Pooja Khatri, UC Department of Neurology, Max Wintermark, MD, University of Stanford, and Thomas Tomsick, MD, UC Department of Radiology.



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Chemo, radiation, surgery combo boosts survival for pancreatic cancer patients

In roughly one-third of pancreatic cancer patients, tumors have grown around the pancreas to encompass critical blood vessels. Conventional wisdom has long held that surgery to remove the tumors is rarely an option, and life expectancies are usually measured in months. Mayo Clinic, teaming oncologists, gastrointestinal and vascular surgeons and others, is finding that many of these patients actually are candidates for surgery. Mayo has been fine-tuning a protocol to treat them, and in two studies, found survival now stretching into years.

The findings were presented at the Pancreas Club and Society for Surgery of the Alimentary Tract annual meetings in San Diego.

"We're definitely seeing a revolution," says Mark Truty, M.D., a gastrointestinal surgical oncologist at Mayo Clinic in Rochester, Minn., who is first author of one abstract and senior author of the other. "A lot of this has to do with better chemotherapy drugs and use of what we call multimodal therapy: chemotherapy, radiation and then an aggressive operation. Now we can potentially offer these therapies to patients who previously were told they had no options."

About 50,000 people are diagnosed with pancreatic cancer each year in the U.S. Historically, only about 7 percent of pancreatic cancer patients have lived at least five years after diagnosis.

Because the cancer tends to spread before symptoms appear, it is found early enough to make surgery a clear-cut option in only about 15 percent of patients. In about half of patients, the cancer has spread throughout the body by the time it is diagnosed, ruling out surgery.

In one-third of patients, cancer hasn't spread through the body, but has grown around veins and arteries in and around the pancreas. For decades, surgery was considered too risky and ineffective to be performed in most of those patients. The Mayo studies chronicle a transformation in treatment for these patients.

In the study presented at the Society for Surgery of the Alimentary Tract annual meeting, researchers analyzed surgical outcomes for the past 25 years among such stage 3 patients who had surgery requiring removal and reconstruction of arteries. They found that most of the operations on this group were performed in the past five years, since the advent of improved chemotherapy and radiation.

Although these surgeries carry more risk than operations not requiring removal and reconstruction of arteries, there appeared to be a significant long-term survival advantage in patients treated with chemotherapy and radiation followed by such aggressive operations. Those who had surgery without chemotherapy or radiation first didn't do well long-term, while patients who had chemotherapy and/or radiation before surgery did significantly better long-term, the researchers found. Looking at short-term outcomes, they discovered that complication rates have decreased over time.

"All in all, it shows that these patients, who would typically not be offered an operation, can have good short-term and long-term results with the appropriate protocol and treatment sequence," Dr. Truty says.

In the study presented at the Pancreas Club meeting, researchers analyzed modern surgical outcomes for stage 3 patients whose tumors involved blood vessels and who had a specific protocol of chemotherapy, radiation and aggressive surgery.

Eighty patients have now gone through the Mayo protocol with data available for review. The study found that the median survival time after patients complete the protocol is approaching four years, about four times that of patients who do not have surgery. The patients who do even better than that include:

  • Those who receive more chemotherapy before surgery.
  • People who have a particular tumor marker known as CA 19-9 that returns to normal after chemotherapy.

Those whose tumors, when analyzed after removal, are found to have only minimal cancer left.

The study also found that in a majority of patients, CT scans before surgery showed that their tumors didn't shrink after chemotherapy. However, when the tumors were removed, it turned out most of the cancer was dead.

"We're hoping that data from this analysis will now spread to the rest of the country, and now people will have a road map for how to treat these patients and how to choose which patients will benefit from such complex operations," Dr. Truty says. He hopes patients feel a sense of optimism, that there are options.

"Not everyone wants to sign up for these big operations or these long protocols of chemotherapy and radiation. But they have the options available to them to make that educated decision about whether this is something that would benefit them," Dr. Truty says. "We're offering an additional bit of hope for a pretty substantial number of patients who had previously been ignored."



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Combining radiation with immunotherapy showing promise against melanoma

Combining radiation treatments with a new generation of immunotherapies is showing promise as a one-two-punch against melanoma, Loyola Medicine researchers report in the Journal of Radiation Oncology.

Radiation kills cancer cells by damaging their DNA. Immunotherapies work by harnessing a patient's immune system to attack and kill cancer cells. When combined, the two therapies appear to have synergistic effects, according to the article by James S. Welsh, MD and colleagues.

Dr. Welsh is a professor in the department of radiation oncology of Loyola University Chicago Stritch School of Medicine.

Melanoma is one of the most aggressive forms of skin cancer. Among patients with Stage 4 metastatic melanoma, in which the cancer has spread to other organs, one-year survival rates range from just 33 percent to 62 percent. This year in the United States, about 76,000 patients will be diagnosed with melanoma and about 10,000 people are expected to die of the disease, according to the American Cancer Society.

On rare occasions, melanoma patients can spontaneously go into remission. More common are partial spontaneous regressions of melanoma lesions. While scientists aren't certain what causes these effects, evidence points to the immune system mounting an attack on cancer cells.

A key observation that supports the role of the immune system in melanoma is the abscopal effect.This rare phenomenon occurs when a localized treatment such as radiation not only shrinks the targeted tumor but also stimulates the immune system to mount a systemic attack on cancer cells throughout the body. Dr. Welsh saw the abscopal effect firsthand when he gave radiation treatment to a patient who had melanoma that had spread to his liver and bones.The radiation was intended merely to shrink a tumor in the patient's thigh bone, to relieve his pain and reduce the risk of fracture. But three months later, a CT scan found no trace of cancer anywhere.

Many new immunotherapies for melanoma are being tried, some with notable results. One such example is a new generation of "checkpoint inhibitors." These are drugs that, in effect, remove the brakes that normally prevent the immune system from attacking cancer cells.

Radiation increasingly is being used alongside checkpoint inhibitors and other immunotherapies, with encouraging results, Dr. Welsh and colleagues write.

Despite the recent successes of radiation and immunotherapy, not all patients are able to mount an effective immune system response to fight melanoma. So it is important to discover proteins or other biomarkers that can predict whether a patient will respond to immunotherapy. Such biomarkers also could help quantify how well experimental therapies are working, Dr. Welsh and colleagues write.

The review article summarizes the latest research in how radiation can be integrated with immunotherapy in the treatment of melanoma. It is titled "The integration of radiation therapy and immunotherapy in melanoma management."

Article: The integration of radiation therapy and immunotherapy in melanoma management, Kyle Stang, Scott Silva, Alec M. Block, James S. Welsh, Journal of Radiation Oncology, doi: 10.1007/s13566-016-0256-5, published online 6 May 2016.



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