101
|
Isambert A, Le Du D, Valéro M, Guilhem MT, Rousse C, Dieudonné A, Blanchard V, Pierrat N, Salvat C. Medical physics personnel for medical imaging: requirements, conditions of involvement and staffing levels-French recommendations. RADIATION PROTECTION DOSIMETRY 2015; 164:130-133. [PMID: 25323441 DOI: 10.1093/rpd/ncu312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics.
Collapse
|
102
|
Karabulut N. Requirements for manuscript submission: what every author needs to know and comply with to facilitate the review process. Diagn Interv Radiol 2015; 21:93-5. [PMID: 25751887 PMCID: PMC4463320 DOI: 10.5152/dir.2015.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
103
|
Leggett T. Competency-based education: a brief overview. Radiol Technol 2015; 86:445-448. [PMID: 25835408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
104
|
Strigari L, Caivano R, Avanzo M, Cremonesi M, Arrichiello C, Bianchi C, Botta F, Califano G, Ciscognetti N, D'Alessio D, D'Ambrosio L, D'Andrea M, Falco D, Guerriero F, Guerrisi M, Mola D, Pressello MC, Sarnelli A, Spiazzi L, Terlizzi A, Benassi M, Pedicini P. Twenty years of radiobiology in clinical practice: the Italian contribution. TUMORI JOURNAL 2015; 100:625-35. [PMID: 25688496 DOI: 10.1700/1778.19266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS AND BACKGROUND To present the Italian state-of-the-art contribution to radiobiology of external beam radiotherapy, brachytherapy, and radionuclide radiotherapy. METHODS AND STUDY DESIGN A survey of the literature was carried out, using PubMed, by some independent researchers of the Italian group of radiobiology. Each paper was reviewed by researchers of centers not comprising its authors. The survey was limited to papers in English published over the last 20 years, written by Italian investigators or in Italian institutions, excluding review articles. RESULTS A total of 135 papers have been published in journals with an impact factor, with an increase in the number of published papers over time, for external beam radiotherapy rather than radionuclide radiotherapy. The quantity and quality of the papers researched constitutes a proof of the enduring interest in clinical radiobiology among Italian investigators. CONCLUSIONS The survey could be useful to individuate expert partners for an Italian network on clinical radiobiology, addressing future collaborative investigations.
Collapse
|
105
|
Powell DK, Silberzweig JE. State of structured reporting in radiology, a survey. Acad Radiol 2015; 22:226-33. [PMID: 25442793 DOI: 10.1016/j.acra.2014.08.014] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 08/05/2014] [Accepted: 08/06/2014] [Indexed: 01/06/2023]
Abstract
RATIONALE AND OBJECTIVES To survey North American radiologists on current practices in structured reporting and language. MATERIALS AND METHODS An e-mail invitation was sent to the Association of University Radiologists membership (comprising 910 members) to participate in an online survey that addressed development, use, and experience of structured reporting, language, and imaging classification or reporting systems and personal dictation styles. RESULTS Of the 910 members e-mailed, 265 (29.1%) responded, 90.6% of whom were from academic teaching hospitals. There were no significant differences in responses based on group size or region of practice. Of all the respondents, 51.3% come from groups that developed structured reporting for at least half of their reports and only 10.9% for none. A significantly fewer 13% of respondents used rigid unmodifiable structures or checklists rather than adaptable outlines; 59.5% respondents report being satisfied or very satisfied with their structured reports, whereas a significantly fewer 13% report being dissatisfied or very dissatisfied. Structured reports were reportedly significantly more likely to be required, appreciated, and to decrease errors in departments using many structured reports compared to groups with less widespread use. CONCLUSIONS Most academic radiology departments are using or experimenting with structured reports. Although radiologist satisfaction with standardization is significant, there are strong opinions about their limitations and value. Our survey suggests that North American radiologists are invested in exploring structured reporting and will hopefully inform future study on how we define a standard report and how much we can centralize this process.
Collapse
|
106
|
Grady AT, Sosa JA, Tanpitukpongse TP, Choudhury KR, Gupta RT, Hoang JK. Radiology reports for incidental thyroid nodules on CT and MRI: high variability across subspecialties. AJNR Am J Neuroradiol 2015; 36:397-402. [PMID: 25147197 DOI: 10.3174/ajnr.a4089] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Variability in radiologists' reporting styles and recommendations for incidental thyroid nodules can lead to confusion among clinicians and may contribute to inconsistent patient care. Our aim was to describe reporting practices of radiologists for incidental thyroid nodules seen on CT and MR imaging and to determine factors that influence reporting styles. MATERIALS AND METHODS This is a retrospective study of patients with incidental thyroid nodules reported on CT and MR imaging between January and December 2011, identified by text search for "thyroid nodule" in all CT and MR imaging reports. The studies included CT and MR imaging scans of the neck, spine, and chest. Radiology reports were divided into those that mentioned the incidental thyroid nodules only in the "Findings" section versus those that reported the incidental thyroid nodules in the "Impression" section as well, because this latter reporting style gives more emphasis to the finding. Univariate and multivariate analyses were performed to identify radiologist, patient, and nodule characteristics that influenced reporting styles. RESULTS Three hundred seventy-five patients met the criterion of having incidental thyroid nodules. One hundred thirty-eight (37%) patients had incidental thyroid nodules reported in the "Impression" section. On multivariate analysis, only radiologists' divisions and nodule size were associated with reporting in "Impression." Chest radiologists and neuroradiologists were more likely to report incidental thyroid nodules in the "Impression" section than their abdominal imaging colleagues, and larger incidental thyroid nodules were more likely to be reported in "Impression" (P ≤ .03). Seventy-three percent of patients with incidental thyroid nodules of ≥20 mm were reported in the "Impression" section, but higher variability in reporting was seen for incidental thyroid nodules measuring 10-14 mm and 15-19 mm, which were reported in "Impression" for 61% and 50% of patients, respectively. CONCLUSIONS Reporting practices for incidental thyroid nodules detected on CT and MR imaging are predominantly influenced by nodule size and the radiologist's subspecialty. Reporting was highly variable for nodules measuring 10-19 mm; this finding can be partially attributed to different reporting styles among radiology subspecialty divisions. The variability demonstrated in this study further underscores the need to develop CT and MR imaging practice guidelines with the goal of standardizing reporting of incidental thyroid nodules and thereby potentially improving the consistency and quality of patient care.
Collapse
|
107
|
Applegate KE, Brent RL, Sutlief SG. Radiation protection in medicine (program area committee 4) session Q&A. HEALTH PHYSICS 2015; 108:275-276. [PMID: 25551508 DOI: 10.1097/hp.0000000000000244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
108
|
Diagnostic radiology. CLINICAL PRIVILEGE WHITE PAPER 2015:1-14. [PMID: 26767210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
109
|
Wu FZ, Wu MT. 2014 SCCT guidelines for the interpretation and reporting of coronary CT angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr 2015; 9:e3. [PMID: 25708015 DOI: 10.1016/j.jcct.2015.01.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 01/01/2015] [Indexed: 02/03/2023]
|
110
|
Endovascular surgical neuroradiology. CLINICAL PRIVILEGE WHITE PAPER 2015:1-13. [PMID: 25890987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
111
|
Becker GJ. Understanding and applying the principles of contemporary medical professionalism: illustration of a suggested approach, part 2. J Am Coll Radiol 2014; 12:12-4. [PMID: 25444064 DOI: 10.1016/j.jacr.2014.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 09/02/2014] [Indexed: 11/15/2022]
Abstract
In recent years, formal professionalism education, training, and assessment have been introduced to medical schools and accredited residency training programs. Current constructs of medical professionalism characterize it as a multidimensional competency rather than a trait. Medical professionalism is a belief system for organizing and delivering care, in which group members (medical professionals) promise patients and the public that they will self-regulate (ie, ensure that medical professionals live up to standards of competence and ethical values). Physicians who are good professionals have lapses in professionalism. Responses to professional lapses should focus on remediation. Failure of groups of professionals to enforce the standards and values can convey to patients and the public a lack of trustworthiness and thereby undermine the foundation of professionalism, the social contract. The Physician Charter sets forth the 3 fundamental principles and 10 commitments that offer guidance in some of the most challenging situations. One example is illustrated herein and is continued from Part 1 of this two-part series.
Collapse
|
112
|
Morin RL. Utility of medical data registries. J Am Coll Radiol 2014; 11:1191. [PMID: 25444071 DOI: 10.1016/j.jacr.2014.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 09/02/2014] [Indexed: 11/27/2022]
|
113
|
Lee KA. Breast Imaging Reporting and Data System category 3 for magnetic resonance imaging. Top Magn Reson Imaging 2014; 23:337-344. [PMID: 25463408 DOI: 10.1097/rmr.0000000000000037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Breast Imaging Reporting and Data System (BI-RADS) category 3 signifies a probably benign finding and should be reserved for those findings that have a less than 2% risk of malignancy. There are limited data defining the use of this category in magnetic resonance imaging (MRI) and the imaging features of probably benign lesions are not well defined. Most recent studies have shown that the frequency of use of BI-RADS 3 is comparable with that reported in mammography and ultrasound and that the rate of malignancy is within the targeted range. Several findings, once assessed as BI-RADS 3, are now known to represent benign entities, such as variations of background parenchymal enhancement and intramammary lymph nodes. A subset of masses, foci, and nonmass enhancement can appropriately be assigned BI-RADS 3 on baseline MRI. The BI-RADS 3 is most appropriately used for round, dot-like foci, which are unique and separate from background parenchymal enhancement and for oval masses with circumscribed margins and homogeneous enhancement, such as those typically seen in incidental fibroadenomas. The BI-RADS 3 may also be appropriate for a focal or regional distribution of nonmass enhancement without suspicious features.
Collapse
|
114
|
AIUM Practice Guideline for Documentation of an Ultrasound Examination. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:2219-2224. [PMID: 25425385 DOI: 10.7863/ultra.33.12.2219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
115
|
Gustafson GS, Nguyen PL, Assimos DG, D'Amico AV, Gottschalk AR, Hsu ICJ, Lloyd S, Mclaughlin PW, Merrick GS, Showalter TN, Taira AV, Vapiwala N, Yamada Y, Davis BJ. ACR appropriateness Criteria® Postradical prostatectomy irradiation in prostate cancer. ONCOLOGY (WILLISTON PARK, N.Y.) 2014; 28:1125-1136. [PMID: 25510812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purpose of this article is to present an updated set of American College of Radiology consensus guidelines formed from an expert panel on the appropriate use of radiation therapy in postprostatectomy prostate cancer. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Recent and relevant literature reviewed by the panel led to establishment of criteria for appropriate use of radiation therapy in postprostatectomy prostate cancer. The discussion includes treatment technique, appropriate dose, field design, and the role of prostate-specific antigen (PSA). Ratings and commentary of the panel on multiple treatment parameters were used to reach consensus. Patients with high-risk pathologic features benefit from postprostatectomy radiation therapy.
Collapse
|
116
|
Grandl S, Ingrisch M, Hellerhoff K. [Therapy monitoring of neoadjuvant therapy with MRI. RECIST and functional imaging]. Radiologe 2014; 54:233-40. [PMID: 24585048 DOI: 10.1007/s00117-013-2576-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
CLINICAL/METHODICAL ISSUE Neoadjuvant chemotherapy is increasingly being applied in patients with operable breast cancer. Thus, an early prediction of response to neoadjuvant chemotherapy is of high relevance. STANDARD RADIOLOGICAL METHODS The interobserver variability of clinical examination, mammography and ultrasonography in the assessment of response to neoadjuvant chemotherapy is high. METHODICAL INNOVATIONS Magnetic resonance imaging (MRI) allows the assessment of functional parameters in addition to changes in tumor size and morphology. PERFORMANCE A reliable therapy response monitoring aims at optimizing individualized patient care. ACHIEVEMENTS This paper summarizes current guidelines for the assessment of response to neoadjuvant chemotherapy in breast cancer according to the response evaluation criteria in solid tumors (RECIST). Furthermore, the technical principles of MRI-based therapy monitoring are described and an overview of the clinical studies that have assessed the feasibility of functional MRI in response to treatment evaluation is given. PRACTICAL RECOMMENDATIONS The technology of functional MRI offers promising results concerning therapy response monitoring. However, the level of evidence is not sufficiently evaluated for the technologies of functional MRI presented here.
Collapse
|
117
|
Lee CI, Ichikawa L, Rochelle MC, Kerlikowske K, Miglioretti DL, Sprague BL, DeMartini WB, Wernli KJ, Joe BN, Yankaskas BC, Lehman CD. Breast MRI BI-RADS assessments and abnormal interpretation rates by clinical indication in US community practices. Acad Radiol 2014; 21:1370-6. [PMID: 25126973 PMCID: PMC4194166 DOI: 10.1016/j.acra.2014.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Revised: 05/31/2014] [Accepted: 06/09/2014] [Indexed: 01/19/2023]
Abstract
RATIONALE AND OBJECTIVES As breast magnetic resonance imaging (MRI) use grows, benchmark performance parameters are needed for auditing and quality assurance purposes. We describe the variation in breast MRI abnormal interpretation rates (AIRs) by clinical indication among a large sample of US community practices. MATERIALS AND METHODS We analyzed data from 41 facilities across five Breast Cancer Surveillance Consortium imaging registries. Each registry obtained institutional review board approval for this Health Insurance Portability and Accountability Act compliant analysis. We included 11,654 breast MRI examinations conducted in 2005-2010 among women aged 18-79 years. We categorized clinical indications as 1) screening, 2) extent of disease, 3) diagnostic (eg, breast symptoms), and 4) other (eg, short-interval follow-up). We characterized assessments as positive (ie, Breast Imaging Reporting and Data System [BI-RADS] 0, 4, and 5) or negative (ie, BI-RADS 1, 2, and 6) and provide results with BI-RADS 3 categorized as positive and negative. We tested for differences in AIRs across clinical indications both unadjusted and adjusted for patient characteristics and registry and assessed for changes in AIRs by year within each clinical indication. RESULTS When categorizing BI-RADS 3 as positive, AIRs were 21.0% (95% confidence interval [CI], 19.8-22.3) for screening, 31.7% (95% CI, 29.6-33.8) for extent of disease, 29.7% (95% CI, 28.3-31.1) for diagnostic, and 27.4% (95% CI, 25.0-29.8) for other indications (P < .0001). When categorizing BI-RADS 3 as negative, AIRs were 10.5% (95% CI, 9.5-11.4) for screening, 21.8% (95% CI, 19.9-23.6) for extent of disease, 17.7% (95% CI, 16.5-18.8) for diagnostic, and 13.3% (95% CI, 11.6-15.2) for other indications (P < .0001). The significant differences in AIRs by indication persisted even after adjusting for patient characteristics and registry (P < .0001). In addition, for most indications, there were no significant changes in AIRs over time. CONCLUSIONS Breast MRI AIRs differ significantly by clinical indication. Practices should stratify breast MRI examinations by indication for quality assurance and auditing purposes.
Collapse
|
118
|
AIUM practice guideline for the performance of the focused assessment with sonography for trauma (FAST) examination. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2014; 33:2047-2056. [PMID: 25336497 DOI: 10.7863/ultra.33.11.2047] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
119
|
Brink JA. Clinical decision-making tools for exam selection, reporting and dose tracking. Pediatr Radiol 2014; 44 Suppl 3:418-21. [PMID: 25304698 DOI: 10.1007/s00247-014-3015-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 03/10/2014] [Accepted: 04/24/2014] [Indexed: 12/21/2022]
Abstract
Although many efforts have been made to reduce the radiation dose associated with individual medical imaging examinations to "as low as reasonably achievable," efforts to ensure such examinations are performed only when medically indicated and appropriate are equally if not more important. Variations in the use of ionizing radiation for medical imaging are concerning, regardless of whether they occur on a local, regional or national basis. Such variations among practices can be reduced with the use of decision support tools at the time of order entry. These tools help reduce radiation exposure among practices through the appropriate use of medical imaging. Similarly, adoption of best practices among imaging facilities can be promoted through tracking the radiation exposure among imaging patients. Practices can benchmark their aggregate radiation exposures for medical imaging through the use of dose index registries. However several variables must be considered when contemplating individual patient dose tracking. The specific dose measures and the variation among them introduced by variations in body habitus must be understood. Moreover the uncertainties in risk estimation from dose metrics related to age, gender and life expectancy must also be taken into account.
Collapse
|
120
|
Jari I, Ursaru M, Gheorghe L, Naum AG, Negru D. Computerized calculation of breast density: our experience from Arcadia Medical Imaging Center. REVISTA MEDICO-CHIRURGICALA A SOCIETATII DE MEDICI SI NATURALISTI DIN IASI 2014; 118:979-985. [PMID: 25581957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
THE AIM OF THIS STUDY To implement a spatial fuzzy C-means algorithm for image segmentation and breast tissue density quantification and compare it with BI-RADS breast density classes determined by radiologists. MATERIAL AND METHODS The analysis was based on 206 mammograms performed in 111 women with various breast abnormalities. Digitized mammographic films were independently double read by radiologists certified in breast diagnosis, followed by consensus with arbitration agreement (radiological ground truth). Reporting was done using the BI-RADS mammography lexicon. Using an algorithm based on a combination of spatial fuzzy C-means clustering and binary thresholding, percent mammographic density was computed in digitized mammograms. The BI-RADS breast density readings were compared with percent breast density measurements determined by computer algorithm. RESULTS The algorithm was found to match the BI-RADS density classification in 90% of the cases, with an excellent agreement (kappa = 0.88) between the radiological ground truth versus the algorithm breast tissue density estimates. CONCLUSIONS Our study proposed an algorithm that can be applied both to digitized and digital mammograms, which proved to be effective in breast density estimates. The method can accurately determine the percentage density removing the human observer variability. The proposed method showed an excellent agreement with radiological ground truth.
Collapse
|
121
|
Dykes TM, Bhargavan-Chatfield M, Dyer RB. Intravenous contrast extravasation during CT: a national data registry and practice quality improvement initiative. J Am Coll Radiol 2014; 12:183-91. [PMID: 25245788 DOI: 10.1016/j.jacr.2014.07.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/11/2014] [Indexed: 11/17/2022]
Abstract
PURPOSE Establish 3 performance benchmarks for intravenous contrast extravasation during CT examinations: extravasation frequency, distribution of extravasation volumes, and severity of injury. Evaluate the effectiveness of implementing practice quality improvement (PQI) methodology in improving performance for these 3 benchmarks. METHODS The Society of Abdominal Radiology and ACR developed a registry collecting data for contrast extravasation events. The project includes a PQI initiative allowing for process improvement. RESULTS As of December 2013, a total of 58 radiology practices have participated in this project, and 32 practices have completed the 2-cycle PQI. There were a total of 454,497 contrast-enhanced CT exams and 1,085 extravasation events. The average extravasation rate is 0.24%. The median extravasation rate is 0.21%. Most extravasations (82.9%) were between 10 mL and 99 mL. The majority of injuries, 94.6%, are mild in severity, with 4.7% having moderate and 0.8% having severe injuries. Data from practices that completed the PQI process showed a change in the average extravasation rate from 0.28% in the first 6 months to 0.23% in the second 6 months, and the median extravasation rate dropped from 0.25% to 0.16%, neither statistically significant. The distribution of extravasation volumes and the severity of injury did not change between the first and second measurement periods. CONCLUSIONS National performance benchmarks for contrast extravasation rate, distribution of volumes of extravasate, and distribution of severity of injury are established through this multi-institutional practice registry. The application of PQI failed to have a statistically significant positive impact on any of the 3 benchmarks.
Collapse
|
122
|
Farshad-Amacker NA, Nguyen TD, Farshad M, Andreisek G, Min K, Frauenfelder T. Semiautomatic superimposition improves radiological assessment of curve flexibility in scoliosis. Eur Radiol 2014; 25:860-4. [PMID: 25231133 DOI: 10.1007/s00330-014-3433-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 08/20/2014] [Accepted: 09/03/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Assessment of scoliotic curve flexibility and stiffness is essential for planning surgical treatment in adolescent idiopathic scoliosis (AIS). Measurement of curve flexibility is currently insufficiently precise. The purpose of this study was to introduce and validate a novel method of superimposing radiographs for more reliable measurement of curve flexibility. MATERIAL AND METHODS Two independent radiologists measured Cobb angles separately on standard anterior-posterior (AP) (n = 48) and supine bending radiographs (n = 48), in patients with AIS, who were randomly included from a surgical database. The same readers repeated the measurements after the bending radiographs were semi-automatically superimposed on the AP radiographs by fusing the caudad end vertebra. Curve flexibility was calculated. Inter-reader agreement between the two independent readers was calculated using interclass correlation coefficient (ICC). RESULTS A moderate inter-reader agreement was achieved in the upper curve (ICC = 0.57) and a good agreement in the lower curve (ICC = 0.72) with the standard method of assessing curve flexibility. With the use of the semiautomatic superimposition, however, almost perfect agreement was achieved for both the upper and the lower curves flexibilities (ICC = 0.93 and 0.97, respectively). CONCLUSION The introduced semi-automatic superimposition technique for measurement of scoliotic curve flexibility in AIS is more precise and reliable than the current standard method.
Collapse
|
123
|
Brusin JH. Reducing errors in radiology. Radiol Technol 2014; 86:61-82. [PMID: 25224086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Medical errors, even those that are relatively minor, can have serious consequences, such as misdiagnosis and longer and costlier hospital stays. Reducing errors requires all members of the health care clinical and administrative team to commit to the effort, and effective risk management addresses system-wide causes of errors. Errors often result from poor communication, inadequate training, chronic fatigue, and entrenched workplace hierarchies. Error reduction strategies support high-quality patient care, even in the most stressful and complex situations.
Collapse
|
124
|
Plana JC, Galderisi M, Barac A, Ewer MS, Ky B, Scherrer-Crosbie M, Ganame J, Sebag IA, Agler DA, Badano LP, Banchs J, Cardinale D, Carver J, Cerqueira M, DeCara JM, Edvardsen T, Flamm SD, Force T, Griffin BP, Jerusalem G, Liu JE, Magalhães A, Marwick T, Sanchez LY, Sicari R, Villarraga HR, Lancellotti P. Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: a report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr 2014; 27:911-39. [PMID: 25172399 DOI: 10.1016/j.echo.2014.07.012] [Citation(s) in RCA: 864] [Impact Index Per Article: 86.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
125
|
Poelhuis DJ. Accreditation resources: help is available. Radiol Technol 2014; 86:87-89. [PMID: 25224087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|