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Zarei F, Khatamizadeh N, Zeinali-Rafsanjani B. Assessment of the Adherence of Radiologists in Reporting the Ovarian Cysts to the 2010 Society of Radiologists in Ultrasound Guidelines. J Med Ultrasound 2023; 31:107-111. [PMID: 37576420 PMCID: PMC10413409 DOI: 10.4103/jmu.jmu_137_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 12/20/2021] [Accepted: 05/03/2022] [Indexed: 08/15/2023] Open
Abstract
Background The objective of this study was to determine the adherence of radiologists to the guideline of the Society of Radiologists in Ultrasound (SRU)-2010 for the follow-up of ovarian cysts in patients during 2015-2016. Methods The patients' data, referring for transvaginal and pelvic ultrasonography, suffering from ovarian cyst were assessed in terms of menopause status, cyst size, and type, as well as follow-ups recommended by radiologist to assess the adherence of reports to SRU-2010. Results Three hundred and sixty-four sonography reports were investigated. Seventy-seven percent of the reports had adhered to SRU-2010, 9.9% and 9.1% had under/overmanagement, and 4.1% was incomplete. 94.2% and 5.8% of cases were in pre/postmenopause status, respectively. The highest adherence belonged to cysts in size <1 cm, 1-3 cm, 5-7 cm. The highest adherence, over/undermanagement, and incomplete reports belonged to corpus luteum, hemorrhagic, dermoid cysts, and nodules without flow. The adherence of sonography reports to SRU-2010 for accidental ovarian cysts was 76.9%. Conclusion The tendency for overmanagement of simple cysts in premenopausal women and the tendency for undermanagement in simple cysts and in postmenopausal women were higher, respectively. It is expected that more training of the guideline to radiologists will lead to the reduction of unnecessary follow-up, which in turn leads to reduced patient's anxiety and cost of treatment.
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Affiliation(s)
- Fariba Zarei
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Banafsheh Zeinali-Rafsanjani
- Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Crable EL, Feeney T, Harvey J, Grim V, Drainoni ML, Walkey AJ, Steiling K, Drake FT. Management Strategies to Promote Follow-Up Care for Incidental Findings: A Scoping Review. J Am Coll Radiol 2021; 18:566-579. [DOI: 10.1016/j.jacr.2020.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/28/2020] [Accepted: 11/13/2020] [Indexed: 12/19/2022]
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Size threshold for follow-up of postmenopausal adnexal cysts: 1 cm versus 3 cm. Abdom Radiol (NY) 2020; 45:3213-3217. [PMID: 31396641 DOI: 10.1007/s00261-019-02176-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To assess 3 cm size threshold for follow-up of simple cysts in postmenopausal women. MATERIALS AND METHODS Radiology information system was retrospectively queried for "US pelvis complete" over 8 years in women > 50 years, with keywords ovarian cyst, adnexal cyst, ovarian mass, cystic mass, cystic neoplasm, ovarian neoplasm, and ovarian mass. Premenopausal women were excluded. Cysts, were classified as ≤ 1 cm, 1-3 cm, 3-5 cm, and ≥ 7 cm. Largest cysts on each ovary was recorded. EMR and imaging archives were reviewed for assessing size, stability duration, and surgical records. Descriptive statistics and confidence interval were performed. RESULTS 4388 patients met the initial search criteria. 919 cysts in 896 women (age: 50-91 years, mean: 61.5 years) were identified. We found 162 cysts ≤ 1 cm, 352 1-3 cm, 296 3-7 cm , and 51 ≥ 7 cm cysts. 127 patients with 1-3 cm cysts had no follow-up. Final analysis of 225 1-3 cm cysts included 203 ovarian and 22 paraovarian cysts (average size = 1.95 cm (1.1-3.0 cm)). 103 ovarian cysts had less than 2 years, and 100 cysts had more than 2 years follow-up. All except one ovarian cyst were stable for the entire duration of their follow-up (Mean duration of follow-up 5.4 years) (0.3%, 95% CI 0.0-0.05). 40 cysts resolved. One simple cyst increased in size (followed over 3.25 years) without suspicious imaging features and benign on surgery. CONCLUSION 1-3 cm cysts represented the most common size range (> 40%) in postmenopausal women, majority of which are stable over follow-up with benign outcome. 3 cm size threshold is appropriate for simple cyst follow-up in postmenopausal women.
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Rezaii PG, Fredericks N, Lincoln CM, Hom J, Willis M, Burleson J, Haines GR, Chatfield M, Boothroyd D, Ding VY, Bello JA, McGinty GB, Smith CD, Yucel EK, Hillman B, Thorwarth WT, Wintermark M. Assessment of the Radiology Support, Communication and Alignment Network to Reduce Medical Imaging Overutilization: A Multipractice Cohort Study. J Am Coll Radiol 2020; 17:597-605. [PMID: 32371000 DOI: 10.1016/j.jacr.2020.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/31/2020] [Accepted: 02/18/2020] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to determine whether participation in Radiology Support, Communication and Alignment Network (R-SCAN) results in a reduction of inappropriate imaging in a wide range of real-world clinical environments. METHODS This quality improvement study used imaging data from 27 US academic and private practices that completed R-SCAN projects between January 25, 2015, and August 8, 2018. Each project consisted of baseline, educational (intervention), and posteducational phases. Baseline and posteducational imaging cases were rated as high, medium, or low value on the basis of validated ACR Appropriateness Criteria®. Four cohorts were generated: a comprehensive cohort that included all eligible practices and three topic-specific cohorts that included practices that completed projects of specific Choosing Wisely topics (pulmonary embolism, adnexal cyst, and low back pain). Changes in the proportion of high-value cases after R-SCAN intervention were assessed for each cohort using generalized estimating equation logistic regression, and changes in the number of low-value cases were analyzed using Poisson regression. RESULTS Use of R-SCAN in the comprehensive cohort resulted in a greater proportion of high-value imaging cases (from 57% to 79%; odds ratio, 2.69; 95% confidence interval, 1.50-4.86; P = .001) and 345 fewer low-value cases after intervention (incidence rate ratio, 0.45; 95% confidence interval, 0.29-0.70; P < .001). Similar changes in proportion of high-value cases and number of low-value cases were found for the pulmonary embolism, adnexal cyst, and low back pain cohorts. CONCLUSIONS R-SCAN participation was associated with a reduced likelihood of inappropriate imaging and is thus a promising tool to enhance the quality of patient care and promote wise use of health care resources.
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Affiliation(s)
- Paymon G Rezaii
- Department of Radiology, Neuroradiology Division, Stanford University, Stanford, California
| | | | | | - Jason Hom
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Marc Willis
- Department of Radiology and Orthopedics, Baylor College of Medicine, Houston, Texas
| | | | | | | | - Derek Boothroyd
- Department of Medicine, Quantitative Sciences Unit, Stanford University, Stanford, California
| | - Victoria Y Ding
- Department of Medicine, Quantitative Sciences Unit, Stanford University, Stanford, California
| | - Jacqueline A Bello
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, New York, New York
| | | | - Cynthia Daisy Smith
- Medical Education Division, American College of Physicians, Philadelphia, Pennsylvania
| | - E Kent Yucel
- Department of Radiology, Tufts Medical Center, Boston, Massachusetts
| | - Bruce Hillman
- Department of Radiology, University of Virginia, Charlottesville, Virginia
| | | | - Max Wintermark
- Department of Radiology, Neuroradiology Division, Stanford University, Stanford, California.
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Kohli M, Alkasab T, Wang K, Heilbrun ME, Flanders AE, Dreyer K, Kahn CE. Bending the Artificial Intelligence Curve for Radiology: Informatics Tools From ACR and RSNA. J Am Coll Radiol 2019; 16:1464-1470. [DOI: 10.1016/j.jacr.2019.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 01/22/2023]
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Maturen KE, Blaty AD, Wasnik AP, Patel-Lippmann K, Robbins JB, Barroilhet L, Huffman LB, Sadowski EA. Risk Stratification of Adnexal Cysts and Cystic Masses: Clinical Performance of Society of Radiologists in Ultrasound Guidelines. Radiology 2017; 285:650-659. [DOI: 10.1148/radiol.2017161625] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Bobbin MD, Ip IK, Sahni VA, Shinagare AB, Khorasani R. Focal Cystic Pancreatic Lesion Follow-up Recommendations After Publication of ACR White Paper on Managing Incidental Findings. J Am Coll Radiol 2017; 14:757-764. [DOI: 10.1016/j.jacr.2017.01.044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 01/24/2017] [Accepted: 01/30/2017] [Indexed: 12/18/2022]
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Kim DC, Bennett GL, Somberg M, Campbell N, Gaing B, Recht MP, Doshi AM. A Multidisciplinary Approach to Improving Appropriate Follow-Up Imaging of Ovarian Cysts: A Quality Improvement Initiative. J Am Coll Radiol 2016; 13:535-41. [DOI: 10.1016/j.jacr.2016.01.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 01/03/2016] [Accepted: 01/25/2016] [Indexed: 10/22/2022]
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