Multidisciplinary Tumor Boards: An Opportunity for Radiologists to Demonstrate Value

Rewinding the Clock: Preparing the Next Generation of Radiology Residents for Oral Boards

The replacement of the ABR in-person oral examination with the DR certifying examination affected approximately 15,000 radiologists, spanning from 2013 to 2027. This decision was motivated by better aligning with the timing of other American Board of Medical Specialty (ABMS) members, more closely reflecting real-world practice of radiology and narrowing training geared towards the trainee's subspecialty preference. However, in retrospect, this change may have subtracted from the quality and value of diagnostic radiology training as a whole with the de-emphasis on competence in general radiology, communication skills, and cognitive reasoning. In this paper, the authors lay out a blueprint necessary in order to rewind the clock of how diagnostic radiology programs can prepare their trainees for the new DR oral examination. Such a change will require substantial redactions affecting all designations, including radiology faculty, education teams, departmental leadership, academic institutions, ACGME, and ABR. The authors believe that implementing these modifications will not only effectively equip radiology candidates for the new DR oral examination but will also augment the significance of radiologists as indispensable members of multidisciplinary teams. The authors also outline the challenges that could emerge from these changes and speculate on the anticipated role of AI in future oral board examinations.

The role of the radiologist in the prostate cancer multidisciplinary conference

The broad range of disease aggressiveness together with imperfect screening, diagnostic, and treatment options in prostate cancer (PCa) makes medical decision-making complex. The primary goal of a multidisciplinary conference is to improve patient outcomes by combining evidence-based data and expert opinion to discuss optimal management, including for those patients with challenging presentations. The primary purpose of the genitourinary imaging specialist in the prostate cancer multidisciplinary conference is to use imaging findings to reduce uncertainty by answering clinical questions. In this review, we discuss the role and the opportunities for an imaging specialist to add value in the care of men with prostate cancer discussed at multidisciplinary conferences.

Reducing Barriers and Strategies to Improve Appropriate Screening Mammogram Attendance in Women 75 Years and Older

Although breast cancer death rates have persistently declined over the last 3 decades, older women have not experienced the same degree in mortality reduction as younger women despite having more favorable breast cancer phenotypes. This occurrence can be partially attributed to less robust mammographic screening in older women, the propensity to undertreat with advancing age, and the presence of underlying comorbidities. With recent revisions to breast cancer screening guidelines, there has been a constructive shift toward more agreement in the need for routine mammographic screening to commence at age 40. Unfortunately, this shift in agreement has not occurred for cutoff guidelines, wherein the recommendations are blurred and open to interpretation. With increasing life expectancy and an aging population who is healthier now than any other time in history, it is important to revisit mammographic screening with advanced age and understand why older women who should undergo screening are not being screened as well as offer suggestions on how to improve screening mammogram attendance in this population.

Practical Strategies to Retain Radiologists

Since the great resignation associated with the coronavirus disease 2019 pandemic, radiology practices are now challenged with maintaining adequate radiology staffing requirements to cope with increasing clinical workload requirements. The authors describe practical strategies for radiology practice leaders to retain radiologists in the current challenging job market, while mitigating their burnout.

Factors Contributing to Disproportionate Burnout in Women Breast Imaging Radiologists: A Review

Physician burnout continues to increase in prevalence and disproportionately affects women physicians. Breast imaging is a woman-dominated subspeciality, and therefore, worsening burnout among women physicians may have significant repercussions on the future of the breast imaging profession. Systemic and organizational factors have been shown to be the greatest contributors to burnout beyond individual factors. Based on the Mayo Model, we review the evidence regarding the 7 major organizational contributors to physician burnout and their potential disproportionate impacts on women breast radiologists. The major organizational factors discussed are work-life integration, control and flexibility, workload and job demands, efficiency and resources, finding meaning in work, social support and community at work, and organizational culture and values. We also propose potential strategies for institutions and practices to mitigate burnout in women breast imaging radiologists. Many of these strategies could also benefit men breast imaging radiologists, who are at risk for burnout as well.

What is the Value of Radiology Input During a Multidisciplinary Orthopaedic Oncology Conference?

BACKGROUND

Multidisciplinary orthopaedic oncology conferences are important in developing the treatment plan for patients with suspected orthopaedic bone and soft tissue tumors, involving physicians from several services. Past studies have shown the clinical value of these conferences; however, the impact of radiology input on the management plan and time cost for radiology to staff these conferences has not been fully studied.

QUESTIONS/PURPOSES

(1) Does radiology input at multidisciplinary conference help guide clinical management and improve clinician confidence? (2) What is the time cost of radiology input for a multidisciplinary conference?

METHODS

This prospective study was conducted from October 2020 to March 2022 at a tertiary academic center with a sarcoma center. A single data questionnaire for each patient was sent to one of three treating orthopaedic oncologists with 41, 19, and 5 years of experience after radiology discussion at a weekly multidisciplinary conference. A data questionnaire was completed by the treating orthopaedic oncologist for 48% (322 of 672) of patients, which refers to the proportion of those three oncologists' patients for which survey data were captured. A musculoskeletal radiology fellow and musculoskeletal fellowship-trained radiology attending physician provided radiology input at each multidisciplinary conference. The clinical plan (leave alone, follow-up imaging, follow-up clinically, recommend different imaging test, core needle biopsy, surgical excision or biopsy or fixation, or other) and change in clinical confidence before and after radiology input were documented. A second weekly data questionnaire was sent to the radiology fellow to estimate the time cost of radiology input for the multidisciplinary conference.

RESULTS

In 29% (93 of 322) of patients, there was a change in the clinical plan after radiology input. Biopsy was canceled in 30% (24 of 80) of patients for whom biopsy was initially planned, and surgical excision was canceled in 24% (17 of 72) of patients in whom surgical excision was initially planned. In 21% (68 of 322) of patients, there were unreported imaging findings that affected clinical management; 13% (43 of 322) of patients had a missed finding, and 8% (25 of 322) of patients had imaging findings that were interpreted incorrectly. For confidence in the final treatment plan, 78% (251 of 322) of patients had an increase in clinical confidence by their treating orthopaedic oncologist after the multidisciplinary conference. Radiology fellows and attendings spent a mean of 4.2 and 1.5 hours, respectively, reviewing and presenting at a multidisciplinary conference each week. The annual combined prorated time cost for the radiology attending and fellow was estimated at USD 24,310 based on national median salary data for attendings and internal salary data for fellows.

CONCLUSION

In a study taken at one tertiary-care oncology program, input from radiology attendings and fellows in the setting of a multidisciplinary conference helped to guide the final treatment plan, reduce procedures, and improve clinician confidence in the final treatment plan, at an annual time cost of USD 24,310.

CLINICAL RELEVANCE

Multidisciplinary orthopaedic oncology conferences can lead to changes in management plans, and the time cost to the radiologists should be budgeted for by the radiology department or parent institution.

Exploring Radiologists' Burnout in the COVID-19 Era: A Narrative Review

Since its beginning in March 2020, the COVID-19 pandemic has claimed an exceptionally high number of victims and brought significant disruption to the personal and professional lives of millions of people worldwide. Among medical specialists, radiologists have found themselves at the forefront of the crisis due to the pivotal role of imaging in the diagnostic and interventional management of COVID-19 pneumonia and its complications. Because of the disruptive changes related to the COVID-19 outbreak, a proportion of radiologists have faced burnout to several degrees, resulting in detrimental effects on their working activities and overall wellbeing. This paper aims to provide an overview of the literature exploring the issue of radiologists' burnout in the COVID-19 era.

Attitudes and perceptions of radiologists towards online (virtual) oncologic multidisciplinary team meetings during the COVID-19 pandemic-a survey of the European Society of Oncologic Imaging (ESOI)

OBJECTIVES

To explore radiologists' opinions regarding the shift from in-person oncologic multidisciplinary team meetings (MDTMs) to online MDTMs. To assess the perceived impact of online MDTMs, and to evaluate clinical and technical aspects of online meetings.

METHODS

An online questionnaire including 24 questions was e-mailed to all European Society of Oncologic Imaging (ESOI) members. Questions targeted the structure and efficacy of online MDTMs, including benefits and limitations.

RESULTS

A total of 204 radiologists responded to the survey. Responses were evaluated using descriptive statistical analysis. The majority (157/204; 77%) reported a shift to online MDTMs at the start of the pandemic. For the most part, this transition had a positive effect on maintaining and improving attendance. The majority of participants reported that online MDTMs provide the same clinical standard as in-person meetings, and that interdisciplinary discussion and review of imaging data were not hindered. Seventy three of 204 (35.8%) participants favour reverting to in-person MDTs, once safe to do so, while 7/204 (3.4%) prefer a continuation of online MDTMs. The majority (124/204, 60.8%) prefer a combination of physical and online MDTMs.

CONCLUSIONS

Online MDTMs are a viable alternative to in-person meetings enabling continued timely high-quality provision of care with maintained coordination between specialties. They were accepted by the majority of surveyed radiologists who also favoured their continuation after the pandemic, preferably in combination with in-person meetings. An awareness of communication issues particular to online meetings is important. Training, improved software, and availability of support are essential to overcome technical and IT difficulties reported by participants.

KEY POINTS

• Majority of surveyed radiologists reported shift from in-person to online oncologic MDT meetings during the COVID-19 pandemic. • The shift to online MDTMs was feasible and generally accepted by the radiologists surveyed with the majority reporting that online MDTMs provide the same clinical standard as in-person meetings. • Most would favour the return to in-person MDTMs but would also accept the continued use of online MDTMs following the end of the current pandemic.

Pyramidal Decision Support Framework Leverages Subspecialty Expertise across Enterprise to Achieve Superior Cancer Outcomes and Personalized, Precision Care Plans

The complexity of cancer care requires integrated and continuous support to deliver appropriate care. An expert network with complementary expertise and the capability of multidisciplinary care is an integral part of contemporary oncology care. Appropriate infrastructure is necessary to empower this network to deliver personalized precision care to their patients. Providing decision support as cancer care becomes exponentially more complex with new diagnostic and therapeutic choices remains challenging. City of Hope has developed a Pyramidal Decision Support Framework to address these challenges, which were exacerbated by the COVID pandemic, health plan restrictions, and growing geographic site diversity. Optimizing efficient and targeted decision support backed by multidisciplinary cancer expertise can improve individual patient treatment plans to achieve improved care and survival wherever patients are treated.

Relationship Building as a Strategy for Managing Referring Clinicians

The strength of a radiology practice depends on the strong relationships radiologists develop with referring clinicians. Solid relationships with referring clinicians can contribute to a satisfying work environment, and ultimately excellent patient care. There are several different ways that a radiologist can help improve relationships with clinicians. As a start, this includes a radiologist strengthening one's emotional intelligence. Also, identifying the personality traits of others is key to successful interactions. Conflicts in the workplace are inevitable, and effective negotiation is helpful in building relationships with clinicians. Interacting with the referring clinicians is also key to a successful relationship. This includes all in-person communication, participating in tumor boards, community outreach events, and social functions outside of work. This article presents several tips to improve and manage relationships with referring clinicians.

How to choose an abdominal imaging fellowship

Radiologists in training draw from their early experiences in residency when choosing a fellowship. Once they have decided on an abdominal imaging fellowship, applicants must learn to navigate the interview process. During this challenging time, applicants explore the difference in clinical curricula and rotations, meet potential mentors and clinical faculty, consider potential academic interests and projects, and choose what location they would like to train for one year after residency. When in training, fellows undergo the challenge of finding employment while learning new skills and refining their abilities to become a well-rounded radiologist and clinician. This article summarizes key points potential applicants should consider when deciding on an abdominal imaging fellowship, how to prepare for the interview season, and how to plan their fellowship year before fellows take the next step to becoming attendings.

Restructuring of a Hospital Radiology Department: Subspecialization Between Man, Machine, and Multidisciplinary Board

BACKGROUND

 Radiology, like almost no other discipline, is faced with a rapid increase in information and technology. This and the growing demands regarding referring medicine, quality requirements, and personnel efficiency increasingly require subspecialization in terms of content. There is already an established move towards radiological subspecialization in the Anglo-American region. In this review article, the content and possibilities of restructuring a hospital radiology department are presented in order to support acceptance in German-speaking countries.

METHOD

 Based on the current literature, the aspects of subspecialized radiology as well as its necessity, advantages, and disadvantages are discussed and the challenges to hospital management with respect to strategic implementation in the individual phases are presented based on the example of a university radiology department. The viewpoints also take into account the education regulations and integrate a modern learning concept.

RESULTS AND CONCLUSION

 Modern restructuring of hospital radiology departments is faced with increasing demands on a traditionally technically organized radiology department with regard to the complexity of referring medicine, subspecialization pressure (including in certified boards), and staff efficiency. The restructuring of a radiology department must be aligned with the clinical requirements and discussed in the overall concept of radiology including its environment.

KEY POINTS

  · The tremendous expansion of knowledge requires a content-based subspecialization of modern radiology as a cross-sectional discipline.. · Proactive radiology meets the increasing demands of its clinical partners and offers great potential for improving quality and efficiency.. · The restructuring of a hospital radiology department requires well-planned strategic management taking into account all involved processes, resources, and personnel qualifications..

CITATION FORMAT

· Henkelmann J, Ehrengut C, Denecke T. Restructuring of a Hospital Radiology Department: Subspecialization Between Man, Machine, and Multidisciplinary Board. Fortschr Röntgenstr 2021; DOI: 10.1055/a-1545-4713.

Role of Key Guidelines in an Era of Precision Oncology: A Primer for the Radiologist

OBJECTIVE. The purpose of this article is to familiarize radiologists with the evidence-based imaging guidelines of major oncologic societies and organizations and to discuss approaches to effective implementation of the most recent guidelines in daily radiology practice. CONCLUSION. In an era of precision oncology, radiologists in practice and radiologists in training are key stakeholders in multidisciplinary care, and their awareness and understanding of society guidelines is critically important.

Patient Diversity in Breast Imaging: Barriers and Potential Solutions

Recent reports have highlighted disparities in breast cancer care related to patient diversity. Breast radiologists represent the face of breast imaging and are key players in advocating for patients to reduce these disparities. Diversity-related barriers for breast imaging patients, as they journey from screening to survivorship, include impediments to access and quality of care, gaps in communication, and lack of knowledge in both providers and patients. Potential strategies for overcoming these specific barriers include "culturally tailored" nurse navigators, mobile mammography, improved communication, patient and provider education, and breast radiologist involvement in advocacy efforts promoting diversity. As current trends in recommendations and guidelines for breast imaging include more numerous and advanced imaging modalities, it is important to acknowledge and address diversity-related disparities.

The radiologist empowerment through virtual multidisciplinary tumor boards: The commitment of oncologic care during COVID-19 pandemic

•

Implementing a virtual tumor board program should represent a feasible goal for every health-care provider pursuing clinical excellence.

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Even in time of COVID-19, the multidisciplinary commitment to oncologic care should remain imperative, as cancer may not forgive delays.

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Working daily with advanced computer technologies, radiologists should lead virtual multidisciplinary tumor boards by present key images.

Involvement of radiologists in oncologic multidisciplinary team meetings: an international survey by the European Society of Oncologic Imaging

Objectives

Multidisciplinary tumour boards (MTBs) play an increasingly important role in managing cancer patients from diagnosis to treatment. However, many problems arise around the organisation of MTBs, both in terms of organisation-administration and time management. In this context, the European Society of Oncologic Imaging (ESOI) conducted a survey among its members, aimed at assessing the quality and amount of involvement of radiologists in MTBs, their role in it and related issues.

Methods

All members were invited to fill in a questionnaire consisting of 15 questions with both open and multiple-choice answers. Simple descriptive analyses and graphs were performed.

Results

A total of 292 ESOI members in full standing for the year 2018 joined the survey. Most respondents (89%) declared to attend MT-Bs, but only 114 respondents (43.9%) review over 70% of exams prior to MTB meetings, mainly due to lack of time due to a busy schedule for imaging and reporting (46.6%). Perceived benefits (i.e. surgical and histological feedback (86.9%), improved knowledge of cancer treatment (82.7%) and better interaction between radiologists and referring clinicians for discussing rare cases (56.9%)) and issues (i.e. attending MTB meetings during regular working hours (71.9%) and lack of accreditation with continuing medical education (CME) (85%)) are reported.

Conclusions

Despite the value and benefits of radiologists’ participation in MTBs, issues like improper preparation due to a busy schedule and no counterpart in CME accreditation require efforts to improve the role of radiologists for a better patient care.

Key Points

• Most radiologists attend multidisciplinary tumour boards, but less than half of them review images in advance, mostly due to time constraints.

• Feedback about radiological diagnoses, improved knowledge of cancer treatment and interaction with referring clinicians are perceived as major benefits.

• Concerns were expressed about scheduling multidisciplinary tumour boards during regular working hours and lack of accreditation with continuing medical education.

The Radiologist's Role in a Breast Multidisciplinary Tumor Board

Breast multidisciplinary tumor boards (MTBs) play an important role in determining treatment. This article serves as a guide for the radiologist participating in a breast MTB, as the information presented at MTB can significantly influence treatment plans and dictate future steps for further patient work-up. Multidisciplinary tumor board preparation involves a careful review of the patient's history while gathering all relevant imaging studies, and reinterpreting them when appropriate. Presented images should be carefully selected, annotated, and displayed clearly before providing final recommendations for localization and incompletely assessed findings. Anatomic staging factors from the AJCC Breast Cancer Staging System, such as tumor size and degree of suspected skin involvement, should be described. In addition, there are many other types of information that the treatment specialists want to know. The surgeon is interested in anatomic information that will help them decide whether breast conservation therapy is feasible or if local structures, such as the nipple, can be spared. The radiation oncologist may need to know whether accelerated partial breast irradiation is feasible or if postmastectomy radiation therapy is indicated. The medical oncologist is looking for factors that may provide an indication for neoadjuvant therapy and ensuring there is a reliable follow-up method for evaluating the response to treatment, such as comparative MRI. Additionally, all specialists need to know the extent of suspected nodal involvement. By clearly and comprehensively presenting this information to the rest of the MTB team, the radiologist provides a vital contribution that guides treatment and ensures adherence to clinical guidelines.

The future of pathology is digital

Information, archives, and intelligent artificial systems are part of everyday life in modern medicine. They already support medical staff by mapping their workflows with shared availability of cases' referral information, as needed for example, by the pathologist, and this support will be increased in the future even more. In radiology, established standards define information models, data transmission mechanisms, and workflows. Other disciplines, such as pathology, cardiology, and radiation therapy, now define further demands in addition to these established standards. Pathology may have the highest technical demands on the systems, with very complex workflows, and the digitization of slides generating enormous amounts of data up to Gigabytes per biopsy. This requires enormous amounts of data to be generated per biopsy, up to the gigabyte range. Digital pathology allows a change from classical histopathological diagnosis with microscopes and glass slides to virtual microscopy on the computer, with multiple tools using artificial intelligence and machine learning to support pathologists in their future work.

Role of Breast Imaging Radiologists as Advocates for Screening Mammography

The objective of this article is to outline opportunities for breast imaging radiologists to advocate for screening mammography. Despite breast cancer being the second most common cancer in women and screening mammography's ability to reduce mortality from this disease, there remains suboptimal utilization in the community. The different guidelines for screening presented by respected organizations has created confusion for patients and referring clinicians and the eventual underutilization of screening mammography. As experts in the value of early detection, breast radiologists are well suited to take on the role of screening advocates. Using specific action steps and examples, we create a template for a radiologist to utilize in the promotion of screening among the breast imaging team, clinicians, administrators, and the community at large. By deliberately filling the role of screening mammography advocate, one can satisfy the mandate for radiologists to bring increased value to the health care team while contributing to community health and patient satisfaction.

Finding Inspiration for the Next Generation of Breast Radiologists

Challenges currently facing breast radiologists, including controversial screening mammography guidelines, radiologist burnout, and the perceived threat posed by artificial intelligence could deter potential candidates from pursuing a career in radiology. However, breast radiologists play a fulfilling role by decreasing the effect of breast cancer through both early detection and direct interaction with patients and interdisciplinary clinical colleagues. While perception is that artificial intelligence will threaten the need for radiologists, it is more likely that it will improve image interpretation and efficiency in workflow, thereby further improving patient care. Trainees can be engaged in breast imaging through interactive teaching methods and by role modeling clinical and image interpretation skills.

Difficulties and possibilities in communication between referring clinicians and radiologists: perspective of clinicians

Purpose

To investigate modes and quality of interprofessional communication between clinicians and radiologists, and to identify difficulties and possibilities in this context, as experienced by referring clinicians.

Patients and methods

Focus group interviews with 22 clinicians from different specialties were carried out. The leading question was: "How do you experience communication, verbal and nonverbal, between referring clinicians and radiologists?" Content analysis was used for interpretation of data.

Results

Overall, referring clinicians expressed satisfaction with their interprofessional communication with radiologists, and digital access to image data was highly appreciated. However, increased reliance on digital communication has led to reduced face-to-face contacts between clinicians and radiologists. This seems to constitute a potential threat to bilateral feedback, joint educational opportunities, and interprofessional development. Cumbersome medical information software systems, time constraints, shortage of staff, reliance on teleradiology, and lack of uniform format of radiology reports were mentioned as problematic. Further implementation of structured reporting was considered beneficial.

Conclusion

Deepened face-to-face contacts between clinicians and radiologists were considered prerequisites for mutual understanding, deepened competence and mutual trust; a key factor in interprofessional communication. Clinicians and radiologists should come together in order to secure bilateral feedback and obtain deepened knowledge of the specific needs of subspecialized clinicians.

How to survive and thrive as a new breast imager: what they don't teach in fellowship

PURPOSE

To provide practical tips to assist new breast imagers succeed in their first job after fellowship training.

METHODS

Transitioning from fellowship to a practicing breast radiologist is daunting for the new radiologist. There is a void in the literature addressing this transition. Practical tips are described based on various roles a new breast radiologist must navigate and highlights skills that can help ensure a successful transition and career.

RESULTS

Proficiency in clinical acumen may be assisted by becoming familiar with sentinel works and feedback based on the medical outcome audit. Noninterpretive skills that can assist the transition include communication skills, delegation of tasks, and implementing hanging protocols. Depending on the practice, skills in research, education, administration, teamwork, and community engagement may also assist the successful transition.

CONCLUSION

Practical strategies can assist the new breast radiologist to become proficient at essential skills that will assist the radiologist to survive and thrive in clinical practice.

Impact on Clinical Management of After-Hours Emergent or Urgent Breast Ultrasonography in Patients with Clinically Suspected Breast Abscesses

Newly diagnosed breast abscesses are generally treated as a medical emergency that may necessitate immediate interventional treatment. At our institution, there is no in-house after-hours coverage for breast ultrasonography. We could find no peer-reviewed studies on the cost-effectiveness or clinical management impact of on-call ultrasound technologist coverage for imaging of breast abscesses. The purposes of this study were to determine the incidence of breast abscess in patients with clinical findings highly suggestive of abscess, identify clinical factors associated with breast abscess in such patients, and determine the impact of after-hours emergent or urgent breast ultrasonography on the clinical management of breast abscesses in both outpatients and inpatients. We retrospectively reviewed 100 after-hours breast ultrasound studies performed at our tertiary care center from 2011 to 2015 for evaluation of a suspected breast abscess. Only 26% of our patients with clinically suspected abscess ultimately had a confirmed abscess. Factors associated with breast abscess were a palpable abnormality and a history of breast surgery within the eight weeks before presentation. After-hours diagnosis of an abscess was associated with after-hours clinical intervention. Of the 74 patients in whom after-hours ultrasound imaging showed no evidence of abscess, only three patients underwent after-hours drainage. Our findings support overnight and weekend breast ultrasound coverage in large tertiary care centers.

Implementing a Multidisciplinary Tumor Board in the Community Practice Setting

Multidisciplinary tumor boards are an opportunity for radiologists to demonstrate value to referring clinicians, the hospital, and patients. Multidisciplinary tumor boards are commonly utilized in academic institutions, but may not be readily available in community practice. We discuss strategies academic radiologists may employ to assist in the implementation of a multidisciplinary tumor board in the community practice setting. Summary: Strategies to assist in the implementation of a multidisciplinary tumor board in the community practice setting are described.

Collaborative Branding of Partnered Health Systems in Radiology

In an effort to expand clinical reach and achieve economies of scale, academic radiology practices are strategically expanding into the community by establishing partnerships with existing community health systems. A challenge with this model is to effectively brand the collaboration in a way that underscores the strengths of both partners. In this article, the authors look at the benefits and risks of cobranding and review cobranding strategies for implementation by academic radiology practices considering partnership-based network expansion.

Maximizing Value Through Innovations in Radiologist-Driven Communications in Breast Imaging

OBJECTIVE

The purposes of this article are to provide an overview of current and emerging practices in radiologist communications with both referring physicians and patients across the breast cancer care continuum; to highlight areas in which radiologist-driven communications can improve value in breast cancer screening, diagnosis, and treatment; and describe how the integrative reporting and consultative practices of breast imagers can serve as models of higher-value patient-centered care in other radiology subspecialties.

CONCLUSION

The traditional radiology report will eventually no longer be viewed as the sole consultation by radiologists but instead act as a starting point for more detailed communications between radiologists and both patients and physicians. The value-creating practices of breast imagers can be used as a road map for similar practices across other radiologic specialties, similar to the use of BI-RADS as a road map for structured breast imaging reporting.