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Kirsch J, Wu CC, Bolen MA, Henry TS, Rajiah PS, Brown RKJ, Galizia MS, Lee E, Rajesh F, Raptis CA, Rybicki FJ, Sams CM, Verde F, Villines TC, Wolf SJ, Yu J, Donnelly EF, Abbara S. ACR Appropriateness Criteria® Suspected Pulmonary Embolism: 2022 Update. J Am Coll Radiol 2022; 19:S488-S501. [PMID: 36436972 DOI: 10.1016/j.jacr.2022.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/27/2022]
Abstract
Pulmonary embolism (PE) remains a common and important clinical condition that cannot be accurately diagnosed on the basis of signs, symptoms, and history alone. The diagnosis of PE has been facilitated by technical advancements and multidetector CT pulmonary angiography, which is the major diagnostic modality currently used. Ventilation and perfusion scans remain largely accurate and useful in certain settings. MR angiography can be useful in some clinical scenarios and lower-extremity ultrasound can substitute by demonstrating deep vein thrombosis; however, if negative, further studies to exclude PE are indicated. In all cases, correlation with the clinical status, particularly with risk factors, improves not only the accuracy of diagnostic imaging but also overall utilization. Other diagnostic tests have limited roles. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer-reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances in which peer-reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
| | - Carol C Wu
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Travis S Henry
- Panel Chair, Division Chief of Cardiothoracic Imaging, Duke University, Durham, North Carolina; Co-Director, ACR Education Center HRCT Course; Chair
| | | | - Richard K J Brown
- Vice Chair of Clinical Operations, Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah; Commission on Nuclear Medicine and Molecular Imaging
| | | | - Elizabeth Lee
- University of Michigan Health System, Ann Arbor, Michigan; Director M1Radiology Education University of Michigan Medical School; Associated Program Director Diagnostic Radiology Michigan Medicine; Director of Residency Education Cardiothoracic Division Michigan
| | - Fnu Rajesh
- MetroHealth Medical Center, Cleveland, Ohio; Primary care physician
| | | | | | | | - Franco Verde
- Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Todd C Villines
- University of Virginia Health System, Charlottesville, Virginia; Society of Cardiovascular Computed Tomography
| | - Stephen J Wolf
- Denver Health, Denver, Colorado; American College of Emergency Physicians; Director of Service for Emergency Medicine, Denver Health Medical Center, Denver Colorado; Co-Chair, American College of Emergency Physicians Clinical Policies Committee
| | - Jeannie Yu
- Deputy Chief of Medicine, VA Medical Center, University of California-Irvine, Irvine, California; Society for Cardiovascular Magnetic Resonance
| | - Edwin F Donnelly
- Specialty Chair, Ohio State University Wexner Medical Center, Columbus, Ohio; Ohio State University Medical Center: Chief of Thoracic Radiology, Interim Vice Chair of Academic Affairs, Department of Radiology
| | - Suhny Abbara
- Specialty Chair, UT Southwestern Medical Center, Dallas, Texas
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Abstract
Panoramic radiography, particularly in the pediatric population, is rarely addressed in the radiology literature. The authors provide an in-depth discussion of how these images are acquired, what artifacts can be visualized, and how to mitigate these artifacts. Dental anatomy, as well as relevant osseous and soft-tissue anatomy visible on a panoramic image, are reviewed. The appearance of the normal pediatric panoramic radiograph, with an emphasis on the dental follicle, is discussed, as well as how to differentiate this normal structure from underlying pathologic conditions. The most commonly encountered pathologic conditions of carious disease and trauma are emphasized. A systematic approach to diagnosing mass lesions and their appropriate work-up, including multimodality imaging examples of relevant pathologic conditions, is also provided. Finally, congenital anomalies, including some of the more commonly encountered dysplasias, are reviewed. The authors provide a concise review of the relevant information needed to confidently interpret a pediatric panoramic radiograph. The online slide presentation from the RSNA Annual Meeting is available for this article. ©RSNA, 2021.
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Affiliation(s)
- Cassandra M Sams
- From the Department of Diagnostic Imaging (C.M.S., E.W.D., D.W.S., R.S.A.) and Department of Dentistry, Samuels Sinclair Dental Center (G.J.D.), Warren Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, 593 Eddy St, Providence, RI 02903
| | - Eric W Dietsche
- From the Department of Diagnostic Imaging (C.M.S., E.W.D., D.W.S., R.S.A.) and Department of Dentistry, Samuels Sinclair Dental Center (G.J.D.), Warren Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, 593 Eddy St, Providence, RI 02903
| | - David W Swenson
- From the Department of Diagnostic Imaging (C.M.S., E.W.D., D.W.S., R.S.A.) and Department of Dentistry, Samuels Sinclair Dental Center (G.J.D.), Warren Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, 593 Eddy St, Providence, RI 02903
| | - George J DuPont
- From the Department of Diagnostic Imaging (C.M.S., E.W.D., D.W.S., R.S.A.) and Department of Dentistry, Samuels Sinclair Dental Center (G.J.D.), Warren Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, 593 Eddy St, Providence, RI 02903
| | - Rama S Ayyala
- From the Department of Diagnostic Imaging (C.M.S., E.W.D., D.W.S., R.S.A.) and Department of Dentistry, Samuels Sinclair Dental Center (G.J.D.), Warren Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, 593 Eddy St, Providence, RI 02903
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Sams CM, Dietsche EW, Swenson DW, DuPont GJ, Ayyala RS. Pediatric Panoramic Radiography: Techniques, Artifacts, and Interpretation. Radiographics 2021. [DOI: 10.1148/rg.2021200112.pres] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wadood Z, Sams CM. Imaging of the Pediatric Acute Abdomen. Semin Roentgenol 2020; 55:373-384. [PMID: 33220784 DOI: 10.1053/j.ro.2020.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Zara Wadood
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI
| | - Cassandra M Sams
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Rhode Island Hospital/Hasbro Children's Hospital, Providence, RI.
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Ruddell JH, Eltorai AEM, Mark AS, Raman S, Sams CM. What's missing? An analysis of pediatric radiology fellowship website utility and recruitment potential. Pediatr Radiol 2019; 49:723-726. [PMID: 30911780 DOI: 10.1007/s00247-019-04381-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/22/2019] [Accepted: 02/10/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Pediatric radiology fellowship web pages convey practical information and provide an opportunity to impress upon visitors the mission and principles that are core to the program. OBJECTIVE The goal of the study was to assess pediatric radiology fellowship program websites and identify potential areas for improvement because applications and enrollment have been steadily declining since 2013. MATERIALS AND METHODS We evaluated 41 websites of pediatric radiology fellowship programs for 17 criteria. We classified programs by region, size and separate web page status. We compared the met criteria using the Kruskal-Wallis and two-sided t-test, accounting for any unequal variances and distributions. RESULTS Of the websites evaluated, the average content score was 42.3%, meeting only 7.2±2.9 of the 17 criteria. Programs in the Northeast were associated with higher online comprehensiveness (P=0.034), as were programs with a separate website for pediatric radiology (P<0.001). We also noted a higher number of positions offered per year than there were fellows enrolled (2.73±2.3 versus 1.39±2.3; P<0.001). CONCLUSION The future of diverse pediatric radiology fellowship training opportunities is increasingly influenced by the availability and transparency of fellowship program and training attributes online. With an average content score of 42.3% across the examined fellowship websites, it is evident that there is room for improvement in the information provided by the pediatric radiology fellowship programs, particularly with respect to providing alumni information and job dispositions, listing current fellows whom applicants may contact regarding the program, and including realistic call and other work expectations of fellows.
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Affiliation(s)
- Jack H Ruddell
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Adam E M Eltorai
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Andrew S Mark
- Warren Alpert Medical School, Brown University, Providence, RI, USA.,Division of Pediatric Imaging, Department of Diagnostic Imaging, Hasbro Children's Hospital, Rhode Island Medical Imaging, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA
| | - Sasha Raman
- Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Cassandra M Sams
- Warren Alpert Medical School, Brown University, Providence, RI, USA. .,Division of Pediatric Imaging, Department of Diagnostic Imaging, Hasbro Children's Hospital, Rhode Island Medical Imaging, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
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Palatinus JA, Sams CM, Beeston CM, Carroll FA, Argenton AB, Quina FH. Kinney Revisited: An Improved Group Contribution Method for the Prediction of Boiling Points of Acyclic Alkanes. Ind Eng Chem Res 2006. [DOI: 10.1021/ie0604425] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Joseph A. Palatinus
- Department of Chemistry, Davidson College, Davidson, North Carolina 28035, and Instituto de Química, Universidade de São Paulo, CP 26077, São Paulo 05513-970 and Centro de Capacitação e Pesquisa em Meio Ambiente (CEPEMA-USP), Cubatão, Brazil
| | - Cassandra M. Sams
- Department of Chemistry, Davidson College, Davidson, North Carolina 28035, and Instituto de Química, Universidade de São Paulo, CP 26077, São Paulo 05513-970 and Centro de Capacitação e Pesquisa em Meio Ambiente (CEPEMA-USP), Cubatão, Brazil
| | - Christopher M. Beeston
- Department of Chemistry, Davidson College, Davidson, North Carolina 28035, and Instituto de Química, Universidade de São Paulo, CP 26077, São Paulo 05513-970 and Centro de Capacitação e Pesquisa em Meio Ambiente (CEPEMA-USP), Cubatão, Brazil
| | - Felix A. Carroll
- Department of Chemistry, Davidson College, Davidson, North Carolina 28035, and Instituto de Química, Universidade de São Paulo, CP 26077, São Paulo 05513-970 and Centro de Capacitação e Pesquisa em Meio Ambiente (CEPEMA-USP), Cubatão, Brazil
| | - André B. Argenton
- Department of Chemistry, Davidson College, Davidson, North Carolina 28035, and Instituto de Química, Universidade de São Paulo, CP 26077, São Paulo 05513-970 and Centro de Capacitação e Pesquisa em Meio Ambiente (CEPEMA-USP), Cubatão, Brazil
| | - Frank H. Quina
- Department of Chemistry, Davidson College, Davidson, North Carolina 28035, and Instituto de Química, Universidade de São Paulo, CP 26077, São Paulo 05513-970 and Centro de Capacitação e Pesquisa em Meio Ambiente (CEPEMA-USP), Cubatão, Brazil
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