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Eibschutz L, Lu MY, Abbassi MT, Gholamrezanezhad A. Artificial intelligence in the detection of non-biological materials. Emerg Radiol 2024; 31:391-403. [PMID: 38530436 DOI: 10.1007/s10140-024-02222-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 03/14/2024] [Indexed: 03/28/2024]
Abstract
Artificial Intelligence (AI) has emerged as a transformative force within medical imaging, making significant strides within emergency radiology. Presently, there is a strong reliance on radiologists to accurately diagnose and characterize foreign bodies in a timely fashion, a task that can be readily augmented with AI tools. This article will first explore the most common clinical scenarios involving foreign bodies, such as retained surgical instruments, open and penetrating injuries, catheter and tube malposition, and foreign body ingestion and aspiration. By initially exploring the existing imaging techniques employed for diagnosing these conditions, the potential role of AI in detecting non-biological materials can be better elucidated. Yet, the heterogeneous nature of foreign bodies and limited data availability complicates the development of computer-aided detection models. Despite these challenges, integrating AI can potentially decrease radiologist workload, enhance diagnostic accuracy, and improve patient outcomes.
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Affiliation(s)
- Liesl Eibschutz
- Department of Radiology Division of Emergency Radiology, Keck School of Medicine, University of Southern California (USC), 1500 San Pablo Street, Los Angeles, CA, 90033, USA
| | - Max Yang Lu
- Department of Radiology Division of Emergency Radiology, Keck School of Medicine, University of Southern California (USC), 1500 San Pablo Street, Los Angeles, CA, 90033, USA
| | - Mashya T Abbassi
- Department of Radiology Division of Emergency Radiology, Keck School of Medicine, University of Southern California (USC), 1500 San Pablo Street, Los Angeles, CA, 90033, USA
| | - Ali Gholamrezanezhad
- Department of Radiology Division of Emergency Radiology, Keck School of Medicine, University of Southern California (USC), 1500 San Pablo Street, Los Angeles, CA, 90033, USA.
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Challapalli JV, Yoon JH, Ward RC. Breast Cryoablation, From the AJR "How We Do It" Special Series. AJR Am J Roentgenol 2024. [PMID: 38630088 DOI: 10.2214/ajr.24.31025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Breast cryoablation is a minimally invasive image-guided percutaneous procedure to treat fibroadenomas and early-stage breast cancer utilizing liquid nitrogen or argon gas to create extremely cold temperatures that devitalize targeted tissue. Although more long term data are needed, this outpatient procedure is well tolerated and carries minimal risks, including non-target thermal injury that can be mitigated by careful planning and proper technique. Building a sustainable breast cryoablation service in a radiology practice poses several practical considerations, such as training proceduralists, purchasing equipment, recruiting patients, and understanding the revenue cycle. This article describes aspects of the radiologist's role in this procedure, including implementation of a breast ablation program, patient selection, technical details related to intervention, and expected postprocedural outcomes.
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Affiliation(s)
| | - Jessica H Yoon
- Department of Diagnostic Imaging, Brown University, Warren Alpert Medical School
| | - Robert C Ward
- Department of Diagnostic Imaging, Brown University, Warren Alpert Medical School
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Trieu N, Ockerman KM, Kerekes D, Han SH, Moser P, Heithaus E, Satteson E, Spiguel LP, Momeni A, Sorice-Virk S. The Incidence of Retained Objects in Intraoperative X-rays for Missing Counts in Plastic Surgery: We Should Do Better. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5419. [PMID: 38025639 PMCID: PMC10653570 DOI: 10.1097/gox.0000000000005419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/28/2023] [Indexed: 12/01/2023]
Abstract
Background In the event of incorrect surgical counts, obtaining X-rays to rule out retained surgical items (RSI) is standard practice. However, these safeguards also carry risk. This study investigates the actual incidence of RSI in plastic reconstructive surgery (PRS) cases as measured on intraoperative X-rays and its associated modifiable risk factors. Methods X-rays with indication of "foreign body" in PRS procedures from 2012 to 2022 were obtained. Reports with "incorrect surgical counts" and associated perioperative records were retrospectively analyzed to determine the incidence of retained surgical items. Results Among 257 X-rays, 21.4% indicated incorrect counts during PRS operations. None were positive for RSIs. The average number of staff present was 12.01. This correlated to an average of 6.98 staff turnovers. The average case lasted 8.42 hours. X-rays prolonged the time under anesthesia by an average of 24.3 minutes. Free flap surgery had 49.1% prevalence of missing counts (lower extremity 25.5%, breast 20%, craniofacial 3.6%), followed by hand (14.5%), breast (10.9%), abdominal reconstruction (10.9%), craniofacial (9.1%), and cosmetic (5.4%). Conclusions Although X-rays for incorrect counts intend to prevent catastrophic sequela of inadvertent RSIs, our results suggest the true incidence of RSI in PRS is negligible. However, intraoperative X-rays have potentially detrimental and pervasive consequences for patients, including increased anesthesia time, radiation exposure, and higher overall cost. Addressing modifiable risk factors to minimize unnecessary intraoperative X-rays is imperative while also considering whether this modality is an effective and appropriate tool in PRS procedures with incorrect surgical counts.
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Affiliation(s)
- Nhan Trieu
- From the University of Florida College of Medicine
| | | | - David Kerekes
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida, Gainesville, Fl
| | | | - Patricia Moser
- Department of Radiology, University of Florida, Gainesville, Fl
| | - Evans Heithaus
- Department of Radiology, University of Florida, Gainesville, Fl
| | - Ellen Satteson
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Florida, Gainesville, Fl
| | - Lisa P. Spiguel
- Division of Surgical Oncology, Department of Surgery, University of Florida, Gainesville, Fl
| | - Arash Momeni
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, Calif
| | - Sarah Sorice-Virk
- Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Palo Alto, Calif
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Endara SA, Dávalos GA, Zamora E E, Redrobán LM, Molina GA. 'Chest gossypiboma after spinal surgery, not so easy to forget'. J Surg Case Rep 2023; 2023:rjad328. [PMID: 37337532 PMCID: PMC10276976 DOI: 10.1093/jscr/rjad328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 05/22/2023] [Indexed: 06/21/2023] Open
Abstract
During any surgical procedure, complications may arise, some of which are fortuitous, whereas others, unfortunately, occur because of errors of the surgical team. Fortunately, most are minor and do not affect the patient's recovery, but others can cause severe morbidity and even mortality. A retained cotton or gauze surgical sponge inadvertently left in the body during an operation is known as a gossypiboma. This dreadful oversight is a marked complication that can cause serious postoperative complications, a severe economic burden on the healthcare system, and many medicolegal implications. We report the case of a 30-year-old male, who suffered a spinal fracture which was repaired through an anterior fixation approach 12 years ago in a local state hospital without complications. Suddenly, he presented with chest pain and cough, and sought medical attention. An 8 × 5 × 8 cm low-density heterogeneous mass was discovered on his chest; after successful surgery, a gossypiboma formed by several gauzes without radiopaque markers was discovered.
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Affiliation(s)
- Santiago A Endara
- Correspondence address. Department of Surgery, Division of Cardiothoracic Surgery, Hospital Metropolitano, Av. Mariana de Jesus Oe7/47 y Conclina, Edificio Diagnostico 2000 tercer piso 3/3, Quito 170129, Ecuador. Tel: +593 99 841 6157; E-mail:
| | - Gerardo A Dávalos
- Department of Surgery, Division of Cardiothoracic Surgery, Hospital Metropolitano, Quito, Ecuador
| | - Elizabeth Zamora E
- Department of Internal Medicine, Division of Radiology, Hospital Metropolitano, Quito, Ecuador
| | - Ligia M Redrobán
- Department of Internal Medicine, Division of Pathology, Hospital Metropolitano, Quito, Ecuador
| | - Gabriel A Molina
- Department of Surgery, Hospital Metropolitano, Quito, Ecuador
- Universidad San Francisco de Quito (USFQ), Quito, Ecuador
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Sayyouh MMH, Sella EC, Shankar PR, Marshall GE, Quint LE, Agarwal PP. Lessons Learned from Peer Learning Conference in Cardiothoracic Radiology. Radiographics 2022; 42:579-593. [PMID: 35148241 DOI: 10.1148/rg.210125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Medical errors may lead to patient harm and may also have a devastating effect on medical providers, who may suffer from guilt and the personal impact of a given error (second victim experience). While it is important to recognize and remedy errors, it should be done in a way that leads to long-standing practice improvement and focuses on systems-level opportunities rather than in a punitive fashion. Traditional peer review systems are score based and have some undesirable attributes. The authors discuss the differences between traditional peer review systems and peer learning approaches and offer practical suggestions for transitioning to peer learning conferences. Peer learning conferences focus on learning opportunities and embrace errors as an opportunity to learn. The authors also discuss various types and sources of errors relevant to the practice of radiology and how discussions in peer learning conferences can lead to widespread system improvement. In the authors' experience, these strategies have resulted in practice improvement not only at a division level in radiology but in a broader multidisciplinary setting as well. The online slide presentation from the RSNA Annual Meeting is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Mohamed M H Sayyouh
- From the Cardiothoracic Imaging Division, Department of Radiology, University of Michigan, Taubman Center B1-132D, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5302 (M.M.H.S., E.C.S., G.E.M., L.E.Q., P.P.A.); and Abdominal Imaging Division and Michigan Radiology Quality Collaborative, Department of Radiology, University of Michigan, Ann Arbor, Mich (P.R.S.)
| | - Edith C Sella
- From the Cardiothoracic Imaging Division, Department of Radiology, University of Michigan, Taubman Center B1-132D, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5302 (M.M.H.S., E.C.S., G.E.M., L.E.Q., P.P.A.); and Abdominal Imaging Division and Michigan Radiology Quality Collaborative, Department of Radiology, University of Michigan, Ann Arbor, Mich (P.R.S.)
| | - Prasad R Shankar
- From the Cardiothoracic Imaging Division, Department of Radiology, University of Michigan, Taubman Center B1-132D, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5302 (M.M.H.S., E.C.S., G.E.M., L.E.Q., P.P.A.); and Abdominal Imaging Division and Michigan Radiology Quality Collaborative, Department of Radiology, University of Michigan, Ann Arbor, Mich (P.R.S.)
| | - Giselle E Marshall
- From the Cardiothoracic Imaging Division, Department of Radiology, University of Michigan, Taubman Center B1-132D, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5302 (M.M.H.S., E.C.S., G.E.M., L.E.Q., P.P.A.); and Abdominal Imaging Division and Michigan Radiology Quality Collaborative, Department of Radiology, University of Michigan, Ann Arbor, Mich (P.R.S.)
| | - Leslie E Quint
- From the Cardiothoracic Imaging Division, Department of Radiology, University of Michigan, Taubman Center B1-132D, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5302 (M.M.H.S., E.C.S., G.E.M., L.E.Q., P.P.A.); and Abdominal Imaging Division and Michigan Radiology Quality Collaborative, Department of Radiology, University of Michigan, Ann Arbor, Mich (P.R.S.)
| | - Prachi P Agarwal
- From the Cardiothoracic Imaging Division, Department of Radiology, University of Michigan, Taubman Center B1-132D, 1500 E Medical Center Dr, Ann Arbor, MI 48109-5302 (M.M.H.S., E.C.S., G.E.M., L.E.Q., P.P.A.); and Abdominal Imaging Division and Michigan Radiology Quality Collaborative, Department of Radiology, University of Michigan, Ann Arbor, Mich (P.R.S.)
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