1
|
Kwee RM, Toxopeus R, Kwee TC. Publication pressure in medical imaging. Eur J Radiol 2024; 174:111404. [PMID: 38442475 DOI: 10.1016/j.ejrad.2024.111404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 03/07/2024]
Abstract
PURPOSE To investigate the degree of perceived publication pressure in medical imaging. METHOD Corresponding authors who published an article in one of the top 12 general radiology journals were invited to complete a survey about publication pressure. The revised Publication Pressure Questionnaire (PPQr) was used. Higher PPQr scores (5-point Likert scale) indicate a more negative view towards the various domains of publication pressure. RESULTS 203 corresponding authors participated. Median PPQr scores in the domains "publication stress", "publication attitude", and "publication resources" were 3.33, 3.50, and 3.67, respectively. Age 25-34 years (β coefficient 0.366, P = 0.047), female gender (β coefficient 0.293, P = 0.020), and 5-10 years of research experience (β coefficient 0.370, P = 0.033) were associated with a higher level of perceived publication stress, whereas age ≥ 65 years was negatively associated with perceived publication stress (β coefficient -0.846, P < 0.001). Age 55-64 years and age > 65 years were associated with a more positive view towards the publication climate (β coefficients -0.391 and -0.663, P = 0.018 and P = 0.002, respectively). Age 45-54 years was associated with a perception of fewer factors available to alleviate publication pressure (β coefficient 0.301, P = 0.014), whereas age 25-34 years was associated with a perception of more factors available to alleviate publication pressure (β coefficient -0.352, P = 0.012). CONCLUSION Perceived publication pressure among medical imaging researchers appears to be appreciable and is associated with several (academic) demographics.
Collapse
Affiliation(s)
- Robert M Kwee
- Department of Radiology, Zuyderland Medical Center, Heerlen/Sittard/Geleen, the Netherlands.
| | - Romy Toxopeus
- Medical Imaging Center, Department of Radiology, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Thomas C Kwee
- Medical Imaging Center, Department of Radiology, University Medical Center Groningen, University of Groningen, the Netherlands
| |
Collapse
|
2
|
Qian W, Curtain BMM, Deshwal A, Chetrit S. Massive appendiceal mucinous neoplasm diagnosed after abdominal trauma: Pitfalls in imaging and diagnosis. Radiol Case Rep 2024; 19:1956-1959. [PMID: 38434782 PMCID: PMC10909596 DOI: 10.1016/j.radcr.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 03/05/2024] Open
Abstract
Low grade appendiceal mucinous neoplasm (LAMN) is a rare tumor presenting typically with symptoms of acute appendicitis. A 33-year-old gentleman presented with abdominal fullness and discomfort secondary to abdominal trauma obtained during boxing training. Investigations with magnetic resonance imaging (MRI), ultrasound, and colonoscopy revealed a large cystic lesion in the ascending colon mesentery with unclear continuation with the appendix. There were no obvious features of malignancy. Laparoscopy revealed a large, firm mass connected to the appendix with enlarged lymph nodes, and the patient underwent radical resection with a right hemicolectomy. Histopathology revealed complete excision of LAMN with no lymphatic involvement. Post traumatic intra-abdominal cystic lesions pose a diagnostic challenge, and neoplastic lesions cannot be ruled out with imaging alone, even with benign appearances. Careful surgical excision and histopathological diagnosis is the only definitive method of ruling-out malignancy.
Collapse
Affiliation(s)
- Wanyang Qian
- Department of Surgery, St John of God Subiaco Hospital, Subiaco, WA, USA
| | | | - Avinash Deshwal
- Department of Radiology, Fiona Stanley Hospital, Murdoch, WA, USA
| | - Stephanie Chetrit
- Department of Surgery, St John of God Subiaco Hospital, Subiaco, WA, USA
| |
Collapse
|
3
|
du Preez L, Flaherty F, Elkabbani R. Dual ectopy: Unique appearance of ectopic thyroid. Radiol Case Rep 2024; 19:1801-1805. [PMID: 38390425 PMCID: PMC10883775 DOI: 10.1016/j.radcr.2024.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/13/2024] [Accepted: 01/20/2024] [Indexed: 02/24/2024] Open
Abstract
A 67-year-old female underwent a computed tomography angiogram (CTA) of the head in the setting of acute, short-term memory loss. Two lobulated hyperattenuating lesions were incidentally discovered at the base of the tongue and the hyoid bone. Upon further investigation in the outpatient setting including further imaging and ultrasound-guided biopsy, the lesions were confirmed to be ectopic thyroid tissue with dual ectopy. Heterotopic tissue, especially when arising at separate sites, can be concerning for a broad differential diagnosis including malignancy, and further evaluation is certainly recommended. When evaluating possible heterotopic tissue, one must always keep in mind the expected embryologic development of the organ in question. Further, in cases where biopsy is less favorable, consideration of the heterotopic tissue's expected physiology is equally important. With these 2 facts in mind, midline hyperattenuating, enhancing lesions in the neck must always be considered to be a possible developmental anomaly of the thyroid, even when there are multiple lesions.
Collapse
Affiliation(s)
- Liam du Preez
- Norwalk Hospital Diagnostic Radiology Residency, 34 Maple St Norwalk, CT 06850 USA
| | - Francis Flaherty
- Norwalk Hospital Diagnostic Radiology Residency, 34 Maple St Norwalk, CT 06850 USA
| | - Ragaa Elkabbani
- Danbury Hospital Clinical Pathology Residency, 24 Hospital Ave Danbury, CT 068102 USA
| |
Collapse
|
4
|
Jabal MS, Hamouda N, Ibrahim MK, Kobeissi H, Ghozy S, Shehata MA, Bilgin C, Brinjikji W, Kallmes DF. Impact analysis of primary and secondary research in radiology journals. Clin Imaging 2024; 108:110089. [PMID: 38430717 DOI: 10.1016/j.clinimag.2024.110089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/04/2023] [Revised: 01/14/2024] [Accepted: 01/17/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Primary and secondary studies are considered the two major research categories. In this study, we examined the scientific and social media impact of primary and secondary publication types in papers published radiological journals during 2010-2020. MATERIALS AND METHODS PubMed publication type tags were used to filter original articles and systematic review and meta-analysis (SR/MA) articles. Clarivate Web of Science was utilized to obtain a list of all radiology journals from the category "Radiology, Nuclear Medicine and Imaging" in Science Citation Index Expanded (SCIE). Automated approach was developed for programmatic extraction of bibliometric and Altmetric yearly citations of each included article using Dimensions API and Altmetric API with Python. Statistical analysis was performed to compare the citation rates between primary and secondary research articles. RESULTS A total of 96,684 published articles from 2010 to 2020 were identified and their meta-data collected. The mean 2-year citation count following publication year was 5.8 for primary research and 10.2 for SR/MA articles (p < 0.001). Between 2010 and 2020, the mean number of citations per SR/MA article was 51.3 compared to 30.5 per primary research article (p < 0.001). Mean Altmetric score was 8.2 in SR/MA compared to 3.7 for primary research articles (p < 0.001). CONCLUSION Secondary research studies have been increasing in impact in both academia and social media compared to primary research. Our results highlight the importance and impact of systematic reviews and meta-analysis articles as a scientifically influential study type in radiology.
Collapse
Affiliation(s)
| | - Noha Hamouda
- Department of Radiology, Alexandria University, Alexandria, Egypt
| | | | | | - Sherief Ghozy
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Cem Bilgin
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | |
Collapse
|
5
|
Marcus E, Teuwen J. Artificial intelligence and explanation: How, why, and when to explain black boxes. Eur J Radiol 2024; 173:111393. [PMID: 38417186 DOI: 10.1016/j.ejrad.2024.111393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/10/2024] [Accepted: 02/22/2024] [Indexed: 03/01/2024]
Abstract
Artificial intelligence (AI) is infiltrating nearly all fields of science by storm. One notorious property that AI algorithms bring is their so-called black box character. In particular, they are said to be inherently unexplainable algorithms. Of course, such characteristics would pose a problem for the medical world, including radiology. The patient journey is filled with explanations along the way, from diagnoses to treatment, follow-up, and more. If we were to replace part of these steps with non-explanatory algorithms, we could lose grip on vital aspects such as finding mistakes, patient trust, and even the creation of new knowledge. In this article, we argue that, even for the darkest of black boxes, there is hope of understanding them. In particular, we compare the situation of understanding black box models to that of understanding the laws of nature in physics. In the case of physics, we are given a 'black box' law of nature, about which there is no upfront explanation. However, as current physical theories show, we can learn plenty about them. During this discussion, we present the process by which we make such explanations and the human role therein, keeping a solid focus on radiological AI situations. We will outline the AI developers' roles in this process, but also the critical role fulfilled by the practitioners, the radiologists, in providing a healthy system of continuous improvement of AI models. Furthermore, we explore the role of the explainable AI (XAI) research program in the broader context we describe.
Collapse
Affiliation(s)
- Eric Marcus
- AI for Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands.
| | - Jonas Teuwen
- AI for Oncology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands
| |
Collapse
|
6
|
Faghani S, Gamble C, Erickson BJ. Uncover This Tech Term: Uncertainty Quantification for Deep Learning. Korean J Radiol 2024; 25:395-398. [PMID: 38528697 DOI: 10.3348/kjr.2024.0108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 03/27/2024] Open
Affiliation(s)
- Shahriar Faghani
- Artificial Intelligence Laboratory, Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Cooper Gamble
- Artificial Intelligence Laboratory, Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Bradley J Erickson
- Artificial Intelligence Laboratory, Department of Radiology, Mayo Clinic, Rochester, MN, USA.
| |
Collapse
|
7
|
Alzghoul H, Kadri F, Ismail MF, Youssef R, Shamaileh M, Al-Assi AR, Adzhieva L, Alzghoul B. Paraneoplastic NMDA encephalitis, a case report and an extensive review of available literature. Radiol Case Rep 2024; 19:1371-1385. [PMID: 38288050 PMCID: PMC10823033 DOI: 10.1016/j.radcr.2023.11.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/31/2024] Open
Abstract
Anti-N-methyl-D-aspartate receptor (NMDAr) encephalitis is a prevalent autoimmune condition marked by diverse neuropsychiatric symptoms, primarily impacting young females. The exact mechanisms underlying the development of NMDAr encephalitis have not been fully elucidated. Nonetheless, studies have demonstrated that auto-antibodies targeting the NR1-NR2 subunits of the NMDAr can trigger receptor dysfunction within the central nervous system, thus giving rise to the associated symptoms. Notably, an association exists between NMDAr encephalitis and an underlying neoplastic condition, with approximately 38% of cases exhibiting this paraneoplastic relationship with ovarian teratomas being the most commonly associated malignancy. While the association between NMDAr encephalitis and renal cell carcinoma (RCC) is exceedingly rare. This case report presents the clinical scenario of a 20-year-old female patient diagnosed with NMDAr encephalitis in conjunction with RCC discovered incidentally on a CT abdomen and pelvis performed to rule out an ovarian teratoma. The presented case underscores the importance of adopting a multidisciplinary approach in the diagnosis and treatment of NMDAr encephalitis, particularly when it is linked to an underlying malignancy. Furthermore, it emphasizes the significance of expanding our understanding of the molecular pathogenesis of NMDAr encephalitis to enhance patient care and optimize clinical outcomes. Additionally, a comprehensive review of the existing literature is included, summarizing all reported malignancies associated with NMDAr encephalitis.
Collapse
Affiliation(s)
- Hamza Alzghoul
- University of Central Florida College of Medicine, Graduate Medical Education, Orlando, FL, USA
| | - Ferdous Kadri
- Division of Pulmonary and Critical Care Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Mohamed F. Ismail
- University of Central Florida College of Medicine, Graduate Medical Education, Orlando, FL, USA
| | - Robeer Youssef
- Jordan University of Science and Technology College of Medicine, Irbid, Jordan
| | | | | | | | - Bashar Alzghoul
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Gainesville, FL, USA
| |
Collapse
|
8
|
Loftus JR, Kadom N, Baran TM, Hans K, Waldman D, Wandtke B. Impact of Early Direct Patient Notification on Follow-Up Completion for Nonurgent Actionable Incidental Radiologic Findings. J Am Coll Radiol 2024; 21:558-566. [PMID: 37820835 DOI: 10.1016/j.jacr.2023.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 05/29/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 10/13/2023]
Abstract
PURPOSE The aim of this study was to evaluate whether early direct patient notification in addition to an existing multistage recommendation-tracking system (Backstop) increases follow-up completion rates for actionable incidental findings (AIFs). Patient attitudes toward early notification were also assessed. METHODS This prospective, randomized controlled trial recruited patients with AIFs requiring follow-up being enrolled into the Backstop system. Patients were randomized into four groups: those receiving additional early direct notification in a mailed letter (group 1, similar to Pennsylvania Act 112), by phone (group 2), or in an electronic portal message (group 3) and a control group (group 4) without additional notifications added to the existing Backstop system. Differences in follow-up completion rates among these groups were determined using χ2 tests. Patients were surveyed on binary yes/no and Likert-type scale questions, and descriptive statistics are reported. RESULTS Data from 2,548 randomized patients were analyzed for the study, including 593 patients notified by letter, 637 notified by phone, 701 notified by portal, and 617 control patients. Group 3 demonstrated the lowest rate of follow-up completion within 1 month of the follow-up due date at 36.4%, compared with 58.7% for group 1, 60.4% for group 2, and 53.2% for group 4 (P < .0001 for all). Group 2 was the only group to have a significantly higher completion rate than group 4 (P = .014). Patients responded positively regarding early notification and preferred electronic portal communication. CONCLUSIONS Early direct notification had a mixed impact on follow-up completion rates on the basis of communication modality but was positively received by patients and may have health care benefits when implemented within a recommendation-tracking system.
Collapse
Affiliation(s)
- James Ryan Loftus
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York.
| | - Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory Healthcare, Atlanta, Georgia; Chair, ACR Metrics Committee; Interim Medical Director for Radiology Quality, Emory Healthcare, Atlanta, Georgia
| | - Timothy M Baran
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York
| | - Kristen Hans
- Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York
| | - David Waldman
- Chief Medical IT Development Officer and Associate Vice President, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York
| | - Ben Wandtke
- Vice Chair of Quality and Safety, Department of Imaging Sciences, University of Rochester Medical Center, Rochester, New York
| |
Collapse
|
9
|
Kahraman A, Dirilenoğlu F, Güzeliş İ, Çetinoğlu K. Intraoperative pathologic diagnosis of central nervous system lymphomas: A comparison of frozen and permanent section diagnoses, and the significance of preoperative imaging. Ann Diagn Pathol 2024; 69:152246. [PMID: 38113550 DOI: 10.1016/j.anndiagpath.2023.152246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/01/2023] [Revised: 12/09/2023] [Accepted: 12/10/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Central nervous system (CNS) lymphomas, either primary or secondary in origin, are rare malignant tumors affecting the brain, spinal cord, or leptomeninges. Diagnosis of CNS lymphomas is complicated by their diverse clinical presentations, radiological features, and histopathological characteristics. Although frozen section (FS) analysis is commonly employed for various CNS tumors, its role and accuracy in CNS lymphoma diagnosis are less explored. In this study, we conducted a comparative analysis to assess the impact of knowledge of preoperative imaging on enhancing the accuracy of FS diagnosis in CNS lymphomas. METHODS Data collection involved a retrospective review of CNS lymphoma patients from January 2009 to August 2021. Patients who underwent intraoperative consultation were included, excluding those with prior cortisone treatment. The dataset incorporated patient demographics, classification as primary or secondary lymphoma, radiological preliminary diagnoses, FS diagnosis, and permanent section diagnosis. We employed various archived materials, including FSs, touch imprint slides, crush cytology slides, H&E-stained sections, and immunohistochemical stains, and re-evaluated all slides for diagnostic validation. RESULTS Our study included 25 patients, of whom 60 % were female and had a mean age of 56.5 years. Preoperative radiology data were available for 80 % of cases, with preliminary diagnoses commonly including lymphoma and/or metastasis. Intraoperative consultation results indicated lymphoma in 18 (72 %) patients, with discordance observed in 28 % of cases when compared to permanent section diagnoses. Most permanent section diagnoses were diffuse large B-cell lymphomas (92 %), with the remainder being T-cell non-Hodgkin lymphoma (4 %) and follicular lymphoma (4 %). Intraoperative misdiagnoses were significantly associated with the absence of knowledge of preoperative imaging. CONCLUSION Our study demonstrates the reliability of FS diagnosis for CNS lymphomas during surgery, with a favorable complete concordance rate of 72 % when compared to permanent diagnoses. Importantly, lack of knowledge of preoperative imaging significantly impaired diagnostic accuracy in FS, emphasizing the need for close collaboration between pathologists and radiologists.
Collapse
Affiliation(s)
- Aslı Kahraman
- Department of Pathology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Türkiye
| | - Fikret Dirilenoğlu
- Department of Pathology, Faculty of Medicine, Near East University, Nicosia, Cyprus.
| | - İsmail Güzeliş
- Department of Pathology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Türkiye
| | - Kenan Çetinoğlu
- Department of Radiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Türkiye
| |
Collapse
|
10
|
Zhang Y, Li Q, Shi Z, Li Q, Dai X, Pan C, Ma Y, Yan R, Fei D, Xie J. A novel growth-friendly system alleviates pulmonary dysplasia in early-onset scoliosis combined with thoracic insufficiency syndrome: Radiological, pathological, and transcriptomic assessments. Heliyon 2024; 10:e27887. [PMID: 38509966 PMCID: PMC10951595 DOI: 10.1016/j.heliyon.2024.e27887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024] Open
Abstract
Background The posterior procedure utilizing growth-friendly techniques is the golden standard for patients with early-onset scoliosis combined with thoracic insufficiency syndrome (EOS + TIS). Pulmonary hypoplasia is the main cause of dying prematurely in the EOS + TIS. This study assessed the therapeutic impact of a novel growth-friendly system on the pulmonary development of piglet's EOS + TIS model. Methods The animal procedure period lasts 12 weeks, of which the construction of the EOS + TIS was performed at 0-8 weeks, and implantation of a novel growth-friendly system was applied at 8-12 weeks. During the animal procedure, X-rays and CT were performed to observe scoliosis, thorax, and lungs. After 12 weeks, pathological changes in lung tissue were assessed using HE and IHC staining. RNA-seq characterized novel growth-friendly system-associated differentially expressed genes (DEGs) and validated using RT-qPCR, western blotting, and IHC. Results Implantation of the novel growth-friendly system increased body weight, body length, and total lung volume, as well as decreased the coronal and sagittal Cobb angles for the EOS + TIS model. It also ameliorated EOS + TIS-induced thickening of the alveolar wall, increased alveolar spaces, and decreased alveolar number and diameter. In lung tissue, a total of 790 novel growth-friendly system-associated DEGs were identified, and they were mainly involved in the regulation of immune, inflammatory, calcium transport, and vascular development. Among these DEGs, BDKRB1, THBS1, DUSP1, IDO1, and SPINK5 were hub genes, and their differential expression was consistent with RNA-seq results in lung tissues. Conclusion The novel growth-friendly system has mitigated scoliosis and pulmonary hypoplasia in the EOS + TIS model. We further elucidate the molecular mechanisms underlying the amelioration of pulmonary hypoplasia.
Collapse
Affiliation(s)
- Ying Zhang
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Quan Li
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Zhiyue Shi
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Qitang Li
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Xinfei Dai
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Cheng Pan
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Yujian Ma
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Rongshuang Yan
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Derui Fei
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| | - Jingming Xie
- Department of Orthopaedics, the Second Affiliated Hospital of Kunming Medical University, China
| |
Collapse
|
11
|
Olivares-Antúnez Y, Dávila-Zablah YJ, Vázquez-Ávila JR, Gómez-Macías GS, Mireles-Aguilar MT, Garza-Montemayor ML. Ductal carcinoma in situ within a fibroadenoma: A case report and review of literature. World J Radiol 2024; 16:58-68. [DOI: 10.4329/wjr.v16.i3.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/27/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND Fibroadenoma (FA) is the most common tumor found in young women, although it can occur in any age group. Ductal carcinoma in situ (DCIS) that is confined in a FA is rare; it is most frequently reported as an incidental finding.
CASE SUMMARY We report a case of DCIS within a FA in a 46-year-old female without cancer-related personal and family histories. The patient was diagnosed with a breast conglomerate of nodules and was followed for 1 year. In the current control image study, we found suspicious microcalcification, as a new finding, within one of the nodules. Consequently, a core biopsy of the tumor, which appeared hypoechoic, oval, and circumscribed, was performed. The pathological diagnosis was ductal carcinoma in situ within a fibroepithelial lesion. The patient underwent breast-conserving surgery and received radiotherapy as well as endocrine therapy (tamoxifen).
CONCLUSION We recommend a multidisciplinary approach for adequate treatment and follow-up.
Collapse
Affiliation(s)
- Yazmin Olivares-Antúnez
- Department of Diagnostic Breast Imaging Center, Hospital Zambrano Hellion, Tecnológico de Monterrey, Nuevo León 66260, Mexico
| | - Yesika Janett Dávila-Zablah
- Department of Diagnostic Breast Imaging Center, Hospital Zambrano Hellion, Tecnológico de Monterrey, Nuevo León 66260, Mexico
| | - José Raúl Vázquez-Ávila
- Department of Patology Service, Hospital San José, Tecnológico de Monterrey, Nuevo León 64710, Mexico
| | - Gabriela Sofía Gómez-Macías
- Department of Patology Service, Hospital San José, Tecnológico de Monterrey, Nuevo León 64710, Mexico
- Department of Faculty of Medicine, Hospital Universitario de la UANL, Nuevo León 64710, Mexico
| | - María Teresa Mireles-Aguilar
- Department of Breast Surgery Center, Hospital Zambrano Hellion, Tecnológico de Monterrey, Nuevo León 66260, Mexico
| | | |
Collapse
|
12
|
Whitesell RT, Burnett AM, Johnston SK, Sheafor DH. Pre-hospital emergency medicine: a spectrum of imaging findings. Emerg Radiol 2024:10.1007/s10140-024-02223-3. [PMID: 38528277 DOI: 10.1007/s10140-024-02223-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 03/14/2024] [Indexed: 03/27/2024]
Abstract
The goal of emergency medical services (EMS) is to provide urgent medical care and stabilization prior to patient transport to a healthcare facility for definitive treatment. The number and variety of interventions performed in the field by EMS providers continues to grow as early management of severe injuries and critical illness in the pre-hospital setting has been shown to improve patient outcomes. The sequela of many field interventions, including those associated with airway management, emergent vascular access, cardiopulmonary resuscitation (CPR), patient immobilization, and hemorrhage control may be appreciated on emergency department admission imaging. Attention to these imaging findings is important for the emergency radiologist, who may be the first to identify a malpositioned device or an iatrogenic complication arising from pre-hospital treatment. Recognition of these findings may allow for earlier corrective action to be taken in the acute care setting. This review describes common EMS interventions and their imaging findings.
Collapse
Affiliation(s)
- Ryan T Whitesell
- Division of Emergency Radiology, Midwest Radiology, 2355 Highway 36 West, Roseville, MN, USA.
| | - Aaron M Burnett
- Department of Emergency Medicine, Regions Hospital, 640 Jackson St, St. Paul, MN, USA
| | - Sean K Johnston
- Division of Emergency Radiology, Midwest Radiology, 2355 Highway 36 West, Roseville, MN, USA
| | - Douglas H Sheafor
- Division of Emergency Radiology, Midwest Radiology, 2355 Highway 36 West, Roseville, MN, USA
| |
Collapse
|
13
|
Tallada AK, Ahmed J, Sujir N, Shenoy N, Pawar SM, Muralidharan A, Mallya S. Accessory lingual mental foramen: A case report of a rare anatomic variation. Oral Radiol 2024:10.1007/s11282-024-00747-5. [PMID: 38523181 DOI: 10.1007/s11282-024-00747-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024]
Abstract
INTRODUCTION The mandibular nerve and the mental foramen have occasionally shown variations in its anatomy. This report aims to present a case of lingual mental foramen recognised on three-dimensional cone beam computed tomographic imaging (CBCT). CASE REPORT Routine Orthopantomogram (OPG) and CBCT images were evaluated to assess the status of impact third molars in a 31-year-old female who had visited the dental clinics in our institution. The OPG image failed to reveal any anatomic variation in the position of the mental foramen. On tracing the course of the mandibular canal in CBCT images, two foramina were traced at the region of premolar. One opened towards the buccal cortical plate at the normal position of the mental foramen and an accessory lingual mental foramen had an opening on the lingual cortical bone at the same level as the mental foramen. CONCLUSION Understanding variations of the mental foramen is extremely essential in dentistry to carry out successful anaesthetic or surgical interventions and to avoid complications such as nerve damage or excessive bleeding.
Collapse
Affiliation(s)
- Arjun Kumar Tallada
- Oral Medicine and Maxillofacial Radiology Specialist, Olive's Dental World, Hyderbad, 500033, Telangana, India
| | - Junaid Ahmed
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Nanditha Sujir
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| | - Nandita Shenoy
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Shubham M Pawar
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Archana Muralidharan
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Sanjay Mallya
- Section of Oral and Maxillofacial Radiology, School of Dentistry, University of California, Los Angeles, CA, USA
| |
Collapse
|
14
|
Ola M, Yousra G, Abdelkader SH, Meriem F, Mohamed J, Firdaous T. Trigeminal neuralgia revealing an epidermoid cyst impinging on the Vth cranial nerve: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241241416. [PMID: 38524382 PMCID: PMC10960973 DOI: 10.1177/2050313x241241416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
Intracranial epidermoid cysts, also referred to as intracranial primary cholesteatomas, are uncommon, benign tumors characterized by slow, linear growth patterns akin to normal epidermal tissue. They typically become symptomatic around age 43, with a slight female predominance, and are most frequently located in the cerebellopontine angle. This summary presents the case of a 62-year-old woman suffering from paroxysmal excruciating pain of the right hemiface, indicative of trigeminal neuralgia, linked to an intracranial epidermoid cyst in the cerebellopontine angle. Radiological assessment, through magnetic resonance imaging, was instrumental in identifying the cyst. Total surgery resection is the most effective treatment, but it can be challenging due to tumor adherence to important neurovascular structures, therefore responsible for an incomplete removal of the proliferative capsule causing a higher risk of recurrence. The case also raises questions about treatment options, as the patient opted against surgical intervention. Managing intracranial epidermoid cysts requires a careful weighing of potential benefits against associated risks.
Collapse
Affiliation(s)
- Messaoud Ola
- Neuroradiology Department of the Specialty Hospital Rabat, Rabat, Morocco
| | - Guelzim Yousra
- Neuroradiology Department of the Specialty Hospital Rabat, Rabat, Morocco
| | | | - Fikri Meriem
- Neuroradiology Department of the Specialty Hospital Rabat, Rabat, Morocco
| | - Jiddane Mohamed
- Neuroradiology Department of the Specialty Hospital Rabat, Rabat, Morocco
| | - Touarsa Firdaous
- Neuroradiology Department of the Specialty Hospital Rabat, Rabat, Morocco
| |
Collapse
|
15
|
Siwatch S, Bagga R, Singh T, Khastgir G. Pyomyoma after caesarean section: a rare entity. BMJ Case Rep 2024; 17:e257190. [PMID: 38521514 DOI: 10.1136/bcr-2023-257190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 03/25/2024] Open
Abstract
Pyomyoma, a rare complication of a myoma undergoing infarction and subsequent infection, may be a diagnostic challenge in patients with unexplained puerperal fever. A woman in her 30s presented with fever and foul-smelling discharge per vaginum, 6 months after her first caesarean section (CS). She underwent an elective CS for symptomatic placenta praevia at 34 weeks of gestation. Intra-operatively, post-partum haemorrhage was managed with uterotonics and blood transfusions. However, 2 weeks later, she developed a high-grade fever that was non-responsive to parenteral antibiotics. She continued to have intermittent episodes of high-grade fever, which were treated on an outpatient basis. Six months later, she developed purulent vaginal discharge, which grew Escherichia coli on bacterial culture. She received intravenous antibiotics and blood. Radiology confirmed the presence of a large fibroid with a focal capsular breach and peripherally enhanced collection extending to the endometrial cavity. The patient subsequently underwent a myomectomy. Intra-operatively, a large fundal myoma with endometrial breach and purulent discharge in the fibroid and endometrial cavity was noted. She sustained the procedure well and recovered uneventfully.
Collapse
Affiliation(s)
- Sujata Siwatch
- Obstetrics & Gynaecology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Rashmi Bagga
- Obstetrics & Gynaecology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Tulika Singh
- Radiodiagnosis & Imaging, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| | - Gaurav Khastgir
- Obstetrics & Gynaecology, Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
| |
Collapse
|
16
|
Postle RD, Ahmad G, Forster BB. Extensor carpi ulnaris (ECU) tenosynovitis. Br J Sports Med 2024; 58:401-402. [PMID: 38050013 DOI: 10.1136/bjsports-2023-107479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/20/2023] [Indexed: 12/06/2023]
Affiliation(s)
- Ryan D Postle
- Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Gulraiz Ahmad
- Radiology Department, Manchester University NHS Foundation Trust, Manchester, UK
| | - Bruce B Forster
- Department of Radiology, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| |
Collapse
|
17
|
Abdelnabi M, Sanchez S, Chaisrimaneepan N, Mittal N. Allopurinol desensitisation protocol for chronic untreated tophaceous gout. BMJ Case Rep 2024; 17:e259930. [PMID: 38514160 DOI: 10.1136/bcr-2024-259930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Affiliation(s)
- Mahmoud Abdelnabi
- Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Sebastian Sanchez
- Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | | | - Neha Mittal
- Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| |
Collapse
|
18
|
Munhoz EA, Xavier CRG, Salles RP, Capelozza ALA, Bodanezi AV. Convenient model of hard tissue simulation for dental radiographic research and instruction. World J Methodol 2024; 14:88850. [DOI: 10.5662/wjm.v14.i1.88850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/20/2023] [Accepted: 01/19/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The authors describe a technique for building an alternative jawbone phantom using dental gypsum and rice for research and dental radiology instruction.
AIM To investigate the potential of an alternative phantom to simulate the trabecular bone aspect of the human maxilla in periapical radiographs.
METHODS Half-maxillary phantoms built from gypsum-ground rice were exposed to X-rays, and the resulting images (experimental group) were compared to standardized radiographic images produced from dry human maxillary bone (control group) (n = 7). The images were blindly assessed according to strict criteria by three examiners for the usual trabecular aspects of the surrounding bone, and significant differences between groups and in assessment reliability were compared using Fisher’s exact and kappa tests (α = 0.05).
RESULTS The differences in the trabecular aspects between groups were not statistically significant. In addition, interobserver agreement among observers was 0.43 and 0.51 for the control and experimental groups, respectively, whereas intraobserver agreement was 0.71 and 0.73, respectively.
CONCLUSION The tested phantom seemed to demonstrate potential for trabecular bone image simulation on maxillary periapical radiographs.
Collapse
Affiliation(s)
- Etiene Andrade Munhoz
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Claudio Roberto Gaiao Xavier
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Roberto Ponce Salles
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Ana Lúcia Alvares Capelozza
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Augusto Vanni Bodanezi
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| |
Collapse
|
19
|
Brix MAK, Järvinen J, Bode MK, Nevalainen M, Nikki M, Niinimäki J, Lammentausta E. Financial impact of incorporating deep learning reconstruction into magnetic resonance imaging routine. Eur J Radiol 2024; 175:111434. [PMID: 38520806 DOI: 10.1016/j.ejrad.2024.111434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE Artificial intelligence and deep learning solutions are increasingly utilized in healthcare and radiology. The number of studies addressing their enhancement of productivity and monetary impact is, however, still limited. Our hospital has faced a need to enhance MRI scanner throughput, and we investigate the utility of new commercial deep learning reconstruction (DLR) algorithm for this purpose. In this work, a multidisciplinary team evaluated the impact of the widespread deployment of a new commercial deep learning reconstruction (DLR) algorithm for our magnetic resonance imaging scanner fleet. METHODS Our analysis centers on the DLR algorithm's effects on patient throughput and investment costs, contrasting these with alternative strategies for capacity expansion-namely, acquiring additional MRI scanners and increasing device utilization on weekends. We provide a framework for assessing the financial implications of new technologies in a trial phase, aiding in informed decision-making for healthcare investments. RESULTS We demonstrate substantial reductions in total operating costs compared to other capacity-enhancing methods. Specifically, the cost of adopting the deep learning technology for our entire scanner fleet is only 11 % compared to procuring an additional scanner and 20 % compared to the weekend utilization costs of existing devices. CONCLUSIONS Procuring DLR for our existing five-scanner fleet allows us to sustain our current MRI service levels without the need for an additional scanner, thereby achieving considerable cost savings. These reductions highlight the efficiency and economic viability of DLR in optimizing MRI service delivery.
Collapse
Affiliation(s)
- Mikael A K Brix
- Research Unit of Health Sciences and Technology, University of Oulu, Aapistie 5A, Oulu FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, Oulu FI-90220, Finland.
| | - Jyri Järvinen
- Research Unit of Health Sciences and Technology, University of Oulu, Aapistie 5A, Oulu FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, Oulu FI-90220, Finland
| | - Michaela K Bode
- Research Unit of Health Sciences and Technology, University of Oulu, Aapistie 5A, Oulu FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, Oulu FI-90220, Finland
| | - Mika Nevalainen
- Research Unit of Health Sciences and Technology, University of Oulu, Aapistie 5A, Oulu FI-90220, Finland; Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, Oulu FI-90220, Finland
| | - Marko Nikki
- Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, Oulu FI-90220, Finland
| | - Jaakko Niinimäki
- Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, Oulu FI-90220, Finland
| | - Eveliina Lammentausta
- Department of Diagnostic Radiology, Oulu University Hospital, Kajaanintie 50, Oulu FI-90220, Finland
| |
Collapse
|
20
|
vanSonnenberg E, Mueller PR, Towbin R, Silverman SG, Berliner L, D'Agostino HB. Transitioning from interventional radiology: ideas for the inevitable. Abdom Radiol (NY) 2024:10.1007/s00261-024-04234-7. [PMID: 38502212 DOI: 10.1007/s00261-024-04234-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Interventional Radiology (IR) is a highly rewarding specialty, both for its salutary effects for patients, as will as the satisfaction it provides for the operating radiologists. Nonetheless, arduous work and long hours have led to numerous reports of burnout amongst interventional radiologists (IRs). MATERIALS AND METHODS Six long-term academic radiologists in leadership positions briefly chronicle their becoming IRs, their type of transitioning from IR, and the pros and cons of those respective transitions. RESULTS The specific transitions include reduced time in IR, switching to diagnostic radiology, becoming involved in medical school education, ceasing IR leadership, and retirement. Pros and cons of the various transition strategies are highlighted. CONCLUSION As the taxing work and long hours are so ubiquitous for IRs, and as burnout is so common, transitioning from IR is highly likely eventually for IRs. The varied transition experiences highlighted in this report hopefully will be helpful for current and aspiring IRs.
Collapse
Affiliation(s)
- Eric vanSonnenberg
- Departments of Radiology and Student Affairs, University of Arizona College of Medicine Phoenix, HSEB Building, C536, 435 North 5th Street, Phoenix, AZ, 85004, USA.
| | - Peter R Mueller
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Richard Towbin
- Department of Radiology, University of Arizona College of Medicine Phoenix, Phoenix, USA
| | - Stuart G Silverman
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Leonard Berliner
- Department of Radiology, Staten Island University Hospital, Northwell Health, Staten Island, USA
| | | |
Collapse
|
21
|
Sobota JKB, Kienapfel H, Werner M, Vogt DM. Intraosseous myolipoma of the calcaneus. BMJ Case Rep 2024; 17:e259743. [PMID: 38508597 PMCID: PMC10952934 DOI: 10.1136/bcr-2024-259743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 03/22/2024] Open
Abstract
A man in his 40s presented with an incidental finding of an osteolytic bone lesion. He sustained an ankle injury while inline skating, fracturing his lateral malleolus. Besides the fracture, radiographic imaging on the day of the injury incidentally revealed a well-defined solitary osteolytic lesion with a sclerotic rim within the right calcaneus. MRI showed an intraosseous, fat-containing lesion with focal contrast enhancement, assessed as an intraosseous lipoma with central necrosis. In the pathological analysis of a sample of the lesion an intraosseous myolipoma of the calcaneus was found-an unexpected and extraordinary finding. To prevent pathological fracturing, curettage and bone grafting were performed using autologous iliac crest bone in combination with allogenous bone chips.
Collapse
Affiliation(s)
- Jana Kerstin Betty Sobota
- Zentrum für Operative Medizin Klinik und Poliklinik für Unfallchirurgie und Orthopädie, UKE, Hamburg, Hamburg, Germany
| | | | - Mathias Werner
- Vivantes Hospital in Friedrichshain Landsberger Allee, Berlin, Berlin, Germany
| | - Dominik Maximilian Vogt
- Klinik für Orthopädie und Unfallchirurgie, Universitatsklinikum Schleswig Holstein - Campus Lubeck, Lübeck, Germany
| |
Collapse
|
22
|
Marzocchi G, Damiani Ferretti M, Mengoli M, Lovato L. Non-traumatic fat necrosis of the buttock: MRI findings of an unusual entity. BMJ Case Rep 2024; 17:e258530. [PMID: 38508600 PMCID: PMC10952900 DOI: 10.1136/bcr-2023-258530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Affiliation(s)
- Guido Marzocchi
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Margherita Damiani Ferretti
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Mengoli
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luigi Lovato
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| |
Collapse
|
23
|
Batheja A, Lalwani N. A National Survey Evaluating Burnout and Wellness During Radiology Residency. Acad Radiol 2024:S1076-6332(24)00137-5. [PMID: 38508933 DOI: 10.1016/j.acra.2024.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/22/2024]
Abstract
RATIONALE AND OBJECTIVES Burnout is a serious problem during medical residency and can contribute to poorer resident and patient health. A thorough understanding of factors associated with burnout can provide insight into supporting resident well-being. The purpose of this study is to assess the prevalence of burnout and ascertain its associated factors among radiology residents in the U.S. MATERIALS AND METHODS This cross-sectional study involved sending an anonymous survey to radiology program directors, coordinators, and residents across the U.S. Data regarding demographics, burnout levels, and burnout-associated factors were collected in the month of August 2023. Multivariable linear regression models evaluated the association of demographic and burnout-associated variables with burnout scores in the dimensions of Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Chi-square analyses with Bonferroni correction and Kruskal-Wallis analyses were used to assess associations between program types and burnout as well as between program type and program effectiveness in managing burnout. Resident suggestions on addressing burnout were qualitatively assessed. RESULTS 147 radiology residents responded to the survey. Emotional Exhaustion was positively associated with seeking social support (p = .03) and negatively associated with perceived program effectiveness in addressing burnout (p < .001). Respondents who identified as male experienced greater Depersonalization (p = .02). Increased frequency of physical activity was associated with higher Personal Accomplishment scores (p = .04). The most common resident suggestions related to Work Burden, Program Support, and Protected Wellness Time. CONCLUSION Radiology programs should consider designing interventions addressing burnout, such as enhancing avenues for feedback and tailoring resident training based on individual preferences for remote work. Understanding the unique challenges faced by radiology residents is essential to tackle burnout and improve wellness.
Collapse
Affiliation(s)
- Aashish Batheja
- Department of Radiology, Virginia Commonwealth University School of Medicine, 1200 East Broad Street, Box 980470, Richmond, Virginia 23298, USA
| | - Neeraj Lalwani
- Department of Radiology, Virginia Commonwealth University School of Medicine, 1200 East Broad Street, Box 980470, Richmond, Virginia 23298, USA.
| |
Collapse
|
24
|
Marzocchi G, Casavola M, Pinelli G, Lovato L. Enhanced myometrial vascularity as a cause of heavy bleeding: the emergency radiologist's point of view. BMJ Case Rep 2024; 17:e255088. [PMID: 38499352 PMCID: PMC10952933 DOI: 10.1136/bcr-2023-255088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024] Open
Affiliation(s)
- Guido Marzocchi
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Mario Casavola
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Gianluigi Pinelli
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luigi Lovato
- Pediatric and Adult CardioThoracic and Vascular, Oncohematologic and Emergency Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| |
Collapse
|
25
|
Kotter E, Pinto Dos Santos D. [Ethics and artificial intelligence]. Radiologie (Heidelb) 2024:10.1007/s00117-024-01286-0. [PMID: 38499692 DOI: 10.1007/s00117-024-01286-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 03/20/2024]
Abstract
The introduction of artificial intelligence (AI) into radiology promises to enhance efficiency and improve diagnostic accuracy, yet it also raises manifold ethical questions. These include data protection issues, the future role of radiologists, liability when using AI systems, and the avoidance of bias. To prevent data bias, the datasets need to be compiled carefully and to be representative of the target population. Accordingly, the upcoming European Union AI act sets particularly high requirements for the datasets used in training medical AI systems. Cognitive bias occurs when radiologists place too much trust in the results provided by AI systems (overreliance). So far, diagnostic AI systems are used almost exclusively as "second look" systems. If diagnostic AI systems are to be used in the future as "first look" systems or even as autonomous AI systems in order to enhance efficiency in radiology, the question of liability needs to be addressed, comparable to liability for autonomous driving. Such use of AI would also significantly change the role of radiologists.
Collapse
Affiliation(s)
- Elmar Kotter
- Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Freiburg, Hugstetterstr. 55, 79106, Freiburg, Deutschland.
| | - Daniel Pinto Dos Santos
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsklinik Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Deutschland.
| |
Collapse
|
26
|
Lindner C, Riquelme R, San Martín R, Quezada F, Valenzuela J, Maureira JP, Einersen M. Improving the radiological diagnosis of hepatic artery thrombosis after liver transplantation: Current approaches and future challenges. World J Transplant 2024; 14:88938. [DOI: 10.5500/wjt.v14.i1.88938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/03/2023] [Accepted: 12/29/2023] [Indexed: 03/15/2024] Open
Abstract
Hepatic artery thrombosis (HAT) is a devastating vascular complication following liver transplantation, requiring prompt diagnosis and rapid revascularization treatment to prevent graft loss. At present, imaging modalities such as ultrasound, computed tomography, and magnetic resonance play crucial roles in diagnosing HAT. Although imaging techniques have improved sensitivity and specificity for HAT diagnosis, they have limitations that hinder the timely diagnosis of this complication. In this sense, the emergence of artificial intelligence (AI) presents a transformative opportunity to address these diagnostic limitations. The development of machine learning algorithms and deep neural networks has demonstrated the potential to enhance the precision diagnosis of liver transplant complications, enabling quicker and more accurate detection of HAT. This article examines the current landscape of imaging diagnostic techniques for HAT and explores the emerging role of AI in addressing future challenges in the diagnosis of HAT after liver transplant.
Collapse
Affiliation(s)
- Cristian Lindner
- Department of Radiology, Faculty of Medicine, University of Concepción, Concepción 4030000, Chile
- Department of Radiology, Hospital Clínico Regional Guillermo Grant Benavente, Concepción 4030000, Chile
| | - Raúl Riquelme
- Department of Radiology, Faculty of Medicine, University of Concepción, Concepción 4030000, Chile
- Department of Radiology, Hospital Clínico Regional Guillermo Grant Benavente, Concepción 4030000, Chile
| | - Rodrigo San Martín
- Department of Radiology, Faculty of Medicine, University of Concepción, Concepción 4030000, Chile
- Department of Radiology, Hospital Clínico Regional Guillermo Grant Benavente, Concepción 4030000, Chile
| | - Frank Quezada
- Department of Radiology, Faculty of Medicine, University of Concepción, Concepción 4030000, Chile
- Department of Radiology, Hospital Clínico Regional Guillermo Grant Benavente, Concepción 4030000, Chile
| | - Jorge Valenzuela
- Department of Radiology, Faculty of Medicine, University of Concepción, Concepción 4030000, Chile
- Department of Radiology, Hospital Clínico Regional Guillermo Grant Benavente, Concepción 4030000, Chile
| | - Juan P Maureira
- Department of Statistics, Catholic University of Maule, Talca 3460000, Chile
| | - Martín Einersen
- Department of Radiology, Faculty of Medicine, University of Concepción, Concepción 4030000, Chile
- Neurovascular Unit, Department of Radiology, Hospital Clínico Regional Guillermo Grant Benavente, Concepción 4030000, Chile
| |
Collapse
|
27
|
Ganapathy A, Mohakud S, Rout S, Joy P, Alagappan A, Manokaran A. A radio-anatomical study of median arcuate ligament syndrome: unveiling the morphology and morphometry of median arcuate ligament, celiac trunk, and superior mesenteric artery. Abdom Radiol (NY) 2024:10.1007/s00261-024-04231-w. [PMID: 38494467 DOI: 10.1007/s00261-024-04231-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 03/19/2024]
Abstract
PURPOSE In the context of medical literature, a significant lacuna exists in understanding median arcuate ligament syndrome (MALS). While clinical aspects are well documented, literature lacks a robust exploration of the anatomical relationship between the celiac trunk and the median arcuate ligament (MAL). METHODS Morphometric parameters, including the vertebral level of MAL origin, MAL thickness, celiac trunk (CeT) origin level, diameter, and distances between CeT/Superior Mesenteric Artery (SMA) and the MAL center were observed on 250 CT angiograms. Cadavers (n = 11) were dissected to examine the same parameters and histo-morphological examination of MAL tissue was done. RESULTS Radiological findings established average MAL thickness of 7.79 ± 2.58 mm. The celiac trunk typically originated at T12. The average distance between the celiac trunk and the MAL center was 1.32 ± 2.04 mm. The angle of the celiac trunk to the abdominal aorta was primarily obtuse. The average celiac trunk diameter was 5.53 ± 1.33 mm. Histological examinations revealed a diverse MAL composition, indicating variable mechanical properties. CONCLUSION This study provides comprehensive morphometric data on the anatomical relationship between the MAL and the celiac trunk. In contrast to available literature which says the average MAL thickness of > 4 mm is an indicator of increased thickness, we observed much higher average thickness in the studied population. The findings contribute to a better understanding of normal anatomical variations which can serve as reference values for accurate radiological diagnosis of MALS. The histological examination revealed the heterogeneous nature of the MAL tissue composition, suggesting variable mechanical properties and functions in different regions.
Collapse
Affiliation(s)
- Arthi Ganapathy
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India.
| | - Sudipta Mohakud
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sipra Rout
- Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Praisy Joy
- Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Alamelu Alagappan
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Aarthi Manokaran
- Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, India
| |
Collapse
|
28
|
Arun Kumar D, Aiyappan SK. Imaging findings of granulosa cell tumour of right ovary with rupture and torsion presenting as acute abdomen. BMJ Case Rep 2024; 17:e259517. [PMID: 38490713 PMCID: PMC10946348 DOI: 10.1136/bcr-2023-259517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Affiliation(s)
- Deepthi Arun Kumar
- Radiodiagnosis, SRM Medical college hospital and research centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| | - Senthil Kumar Aiyappan
- Radiodiagnosis, SRM Medical college hospital and research centre, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India
| |
Collapse
|
29
|
Chigullapalli S, Malani SK, Nalawade D, Musuku MR. Aorto-atrial tunnel arising from sinus of Valsalva aneurysm in a young female. BMJ Case Rep 2024; 17:e259254. [PMID: 38490706 PMCID: PMC10946376 DOI: 10.1136/bcr-2023-259254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 03/17/2024] Open
Abstract
A young female patient presented with complaints of breathlessness and palpitations since 2 years. On clinical examination, there was a loud continuous murmur at the right sternal border.Transthoracic echocardiography and colour Doppler showed a tunnel-like structure originating from the aneurysmal right coronary sinus and opening into the right atrium with left to right shunt. Coronary angiography revealed a large tunnel beginning in right coronary sinus and terminating in the right atrium and right coronary artery (RCA) was seen originating from the tunnel. Cardiac catheterisation revealed normal pulmonary artery pressure. CT and 3D-reconstructed images delineated the extracardiac course of the tunnel.Various treatment modalities including percutaneous transcatheter approach and surgical treatment were taken into consideration, but because of the close proximity of RCA from the tunnel opening, surgical closure was preferred.
Collapse
Affiliation(s)
- Sridevi Chigullapalli
- Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India
| | - Susheel Kumar Malani
- Cardiology, Dr D Y Patil Medical College Hospital and Research Centre, Pune, Maharashtra, India
| | - Digvijay Nalawade
- Cardiology, Dr D Y Patil Vidyapeeth University Dr D Y Patil Medical College Hospital and Research Centre, Pune, India
| | | |
Collapse
|
30
|
Danis HE, Keenan C, Schaber J, Grasso SL. Primary hepatic Castleman disease. BMJ Case Rep 2024; 17:e256819. [PMID: 38479827 PMCID: PMC10941136 DOI: 10.1136/bcr-2023-256819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 03/18/2024] Open
Abstract
Castleman disease (CD) is a rare, benign lymphoproliferative disorder with characteristic histopathological features, but variable aetiology, presentation, treatment and prognosis. It is broadly classified based on its location and histopathological features, with unicentric hyaline vascular disease presenting most commonly. We present a case of primary, unicentric hepatic CD that was incidentally found on imaging and managed with laparoscopic resection.
Collapse
Affiliation(s)
| | - Corey Keenan
- General Surgery, William Beaumont Army Medical Center, Ft. Bliss, Texas, USA
| | - John Schaber
- Pathology, William Beaumont Army Medical Center, El Paso, Texas, USA
| | - Samuel L Grasso
- General Surgery, William Beaumont Army Medical Center, Ft. Bliss, Texas, USA
| |
Collapse
|
31
|
Tsurumaki N, Suzuki M, Izumi S, Hojo M. Rupture of a bronchial artery pseudoaneurysm after radiotherapy. BMJ Case Rep 2024; 17:e259825. [PMID: 38471708 DOI: 10.1136/bcr-2024-259825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Affiliation(s)
- Nozomu Tsurumaki
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Manabu Suzuki
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Shinyu Izumi
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Masayuki Hojo
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| |
Collapse
|
32
|
Neitzel E, Grewal S, Kaur M, Sitton Z, Kang P, van Sonnenberg E. Academic radiology department subspeciality organization & fellowship offerings: A hodgepodge. Curr Probl Diagn Radiol 2024:S0363-0188(24)00055-0. [PMID: 38503598 DOI: 10.1067/j.cpradiol.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION As opportunities for radiologists to subspecialize have increased, many avenues to organize Radiology department subspecialties exist. This study seeks to determine how academic U.S. Radiology departments structure themselves with respect to subspecialty divisions/sections, as there are no current standards for how Radiology departments are subdivided. Additionally, the extent of Radiology fellowships offered are assessed. The websites of academic U.S. Radiology departments, a highly influential source of information, were analyzed to perform this study. MATERIALS & METHODS Radiology department websites of all allopathic U.S. medical schools (n = 148) were assessed for the following: presence/absence of Radiology department subdivisions, division/section labels, number of divisions/sections, division/section titles, presence/absence of Radiology fellowships, number of fellowships, and fellowships titles. RESULTS 114/148 (77 %) medical schools had Radiology department websites. According to their respective websites, 66/114 (58 %) academic Radiology departments had subspecialty divisions/sections, whereas 48/114 (42 %) had no divisions/sections listed. Of the departments that had divisions/sections, the median number of divisions/sections per department was nine, and ranged from two to 14. Fellowships were offered at 82/114 (72 %) academic Radiology departments that had websites, and the median number was six, ranging from one to 13. CONCLUSION There is marked heterogeneity of departmental organization across Radiology departments nationwide, likely due to the lack of current standards for how Radiology departments are subdivided into divisions/sections. Of the 77 % of medical schools that have Radiology department websites, only 58 % of departments listed divisions/sections, and 72 % posted fellowship offerings.
Collapse
Affiliation(s)
- Easton Neitzel
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA.
| | - Shivraj Grewal
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Manroop Kaur
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Zachary Sitton
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | - Paul Kang
- University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA
| | | |
Collapse
|
33
|
Kadom N, Peterson RB. Streaming Success: Harnessing Social Media for Dynamic Radiology Education. Curr Probl Diagn Radiol 2024:S0363-0188(24)00051-3. [PMID: 38508977 DOI: 10.1067/j.cpradiol.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/07/2024] [Indexed: 03/22/2024]
Abstract
Social media are increasingly used as tools in radiologists education. This article describes features that aid with the selection of SM platforms, and how to emulate educator roles in the digital world. In addition, we summarize best practices regarding curating and delivering stellar content, building a SM brand, and rules of professionalism when using SM in radiology education.
Collapse
Affiliation(s)
- Nadja Kadom
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA; Department of Radiology, Children's Healthcare of Atlanta- Egleston Campus, Atlanta, GA, USA.
| | - Ryan B Peterson
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| |
Collapse
|
34
|
Wang M, Luo X, Xiao X, Zhang L, Wang Q, Wang S, Wang X, Xue H, Zhang L, Chen Y, Lei J, Štupnik T, Scarci M, Fiorelli A, Laisaar T, Fruscio R, Elkhayat H, Novoa NM, Davoli F, Waseda R, Estill J, Norris SL, Riley DS, Tian J. CARE- radiology statement explanation and elaboration: reporting guideline for radiological case reports. BMJ Evid Based Med 2024:bmjebm-2023-112695. [PMID: 38458654 DOI: 10.1136/bmjebm-2023-112695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Accepted: 02/12/2024] [Indexed: 03/10/2024]
Abstract
Despite the increasing number of radiological case reports, the majority lack a standardised methodology of writing and reporting. We therefore develop a reporting guideline for radiological case reports based on the CAse REport (CARE) statement. We established a multidisciplinary group of experts, comprising 40 radiologists, methodologists, journal editors and researchers, to develop a reporting guideline for radiological case reports according to the methodology recommended by the Enhancing the QUAlity and Transparency Of health Research network. The Delphi panel was requested to evaluate the significance of a list of elements for potential inclusion in a guideline for reporting mediation analyses. By reviewing the reporting guidelines and through discussion, we initially drafted 46 potential items. Following a Delphi survey and discussion, the final CARE-radiology checklist is comprised of 38 items in 16 domains. CARE-radiology is a comprehensive reporting guideline for radiological case reports developed using a rigorous methodology. We hope that compliance with CARE-radiology will help in the future to improve the completeness and quality of case reports in radiology.
Collapse
Affiliation(s)
- Mengshu Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Xufei Luo
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Xiaojuan Xiao
- Department of Radiology, The Eighth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Shenzhen, China
| | - Linlin Zhang
- Editorial Office of Chinese Journal of Radiology, Beijing, China
| | - Qi Wang
- Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
| | - Shiyu Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Huadan Xue
- Department of Radiology, Translational Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Longjiang Zhang
- Department of Radiology, Jinling Hospital, Medical School of Nanjing University, General Hospital of Eastern Theater Command, Nanjing, China
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- World Health Organization Collaboration Center for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Junqiang Lei
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
- Intelligent Imaging Medical Engineering Research Center of Gansu Province, Lanzhou, China
- Accurate Image Collaborative Innovation International Science and Technology Cooperation Base of Gansu Province, Lanzhou, China
| | - Tomaž Štupnik
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Marco Scarci
- Department of Cardiothoracic Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Tanel Laisaar
- Department of Thoracic Surgery and Lung Transplantation, Lung Clinic, Tartu University Hospital, Tartu, Estonia
- Lung Clinic, Institute of Clinical Medicine, Medical Faculty, University of Tartu, Tartu, Estonia
| | - Robert Fruscio
- Clinic of Obstetrics and Gynecology, University of Milan-Bicocca, IRCCS San Gerardo, Monza, Italy
| | - Hussein Elkhayat
- Cardiothoracic Surgery Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Nuria M Novoa
- Thoracic Surgery, Puerta de Hierro University Hospital-Majadahonda, Madrid, Spain
- Biomedical Institute of Salamanca, Salamanca, Spain
| | - Fabio Davoli
- General & Thoracic Surgery Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Ryuichi Waseda
- Department of General Thoracic, Breast and Pediatric Surgery, Fukuoka University, Fukuoka, Japan
| | - Janne Estill
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Susan L Norris
- Oregon Health & Science University, Portland, Oregon, USA
| | - David S Riley
- University of New Mexico Medical School, Santa Fe, New Mexico, USA
| | - Jinhui Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou, China
| |
Collapse
|
35
|
Sylvester R, Singh G, Haque A. The uncommon preoperative diagnosis of a De Garengeot hernia and its more novel laparoscopic treatment. BMJ Case Rep 2024; 17:e251938. [PMID: 38453231 PMCID: PMC10921507 DOI: 10.1136/bcr-2022-251938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 03/09/2024] Open
Abstract
This case report involves an elderly woman who presented with a 3-day history of a tender groin swelling on her right side. Her admission bloods were fairly unremarkable, but a preoperative ultrasound impressively confirmed a femoral hernia containing the appendix (De Garengeot hernia) and she underwent emergency laparoscopic hernioplasty with a prosthetic mesh and appendicectomy. The procedure found an incarcerated hernia with a strangulated tip of the appendix that unexpectedly separated upon gentle manipulation and histopathology revealed appendiceal inflammation. There were no complications with the patient's recovery and she was discharged 2 days after surgery.
Collapse
Affiliation(s)
| | - Gautam Singh
- Frimley Health NHS Foundation Trust, Frimley, UK
| | - Ali Haque
- Frimley Health NHS Foundation Trust, Frimley, UK
| |
Collapse
|
36
|
Gillis T, Low G, Wilson MP. Cushing's syndrome diagnosed incidentally on CT imaging. BMJ Case Rep 2024; 17:e258830. [PMID: 38453225 PMCID: PMC10921431 DOI: 10.1136/bcr-2023-258830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Indexed: 03/09/2024] Open
Abstract
In this case report, we describe an uncommon presentation of Cushing's syndrome in a patient in their 60s who presented to the emergency department with left-sided chest pain. The initial workup for the patient was unremarkable except for an elevated blood pressure and elevated fasting plasma glucose. A CT scan of the chest, abdomen and pelvis was performed, demonstrating a splenic artery thrombus with multiple splenic infarcts, in addition to a combination of macronodular adrenal hyperplasia, bilateral gynecomastia, centripetal fat distribution and suspected mild bone demineralisation. Adrenocorticotropic hormone-independent macronodular adrenal hyperplasia, a rare aetiology responsible for Cushing's syndrome, was raised as a potential unifying diagnosis for the patient's hypercoagulable status, which was subsequently confirmed on an endocrinological investigation. The case report underscores the importance of communicating clinically relevant details to the imaging specialist in combination with considering a broad differential, including endocrine disorders, when evaluating an undifferentiated patient with atypical imaging findings.
Collapse
Affiliation(s)
- Timber Gillis
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Gavin Low
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Mitchell P Wilson
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
37
|
Ajmera P, Nischal N, Ariyaratne S, Botchu B, Bhamidipaty KDP, Iyengar KP, Ajmera SR, Jenko N, Botchu R. Validity of ChatGPT-generated musculoskeletal images. Skeletal Radiol 2024:10.1007/s00256-024-04638-y. [PMID: 38438538 DOI: 10.1007/s00256-024-04638-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/23/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE In the evolving landscape of medical research and radiology, effective communication of intricate ideas is imperative, with visualizations playing a crucial role. This study explores the transformative potential of ChatGPT4, a powerful Large Language Model (LLM), in automating the creation of schematics and figures for radiology research papers, specifically focusing on its implications for musculoskeletal studies. MATERIALS AND METHODS Deploying ChatGPT4, the study aimed to assess the model's ability to generate anatomical images of six large joints-shoulder, elbow, wrist, hip, knee, and ankle. Four variations of a text prompt were utilized, to generate a coronal illustration with annotations for each joint. Evaluation parameters included anatomical correctness, correctness of annotations, aesthetic nature of illustrations, usability of figures in research papers, and cost-effectiveness. Four panellists performed the assessment using a 5-point Likert Scale. RESULTS Overall analysis of the 24 illustrations encompassing the six joints of interest (4 of each) revealed significant limitations in ChatGPT4's performance. The anatomical design ranged from poor to good, all of the illustrations received a below-average rating for annotation, with the majority assessed as poor. All of them ranked below average for usability in research papers. There was good agreement between raters across all domains (ICC = 0.61). CONCLUSION While LLMs like ChatGPT4 present promising prospects for rapid figure generation, their current capabilities fall short of meeting the rigorous standards demanded by musculoskeletal radiology research. Future developments should focus on iterative refinement processes to enhance the realism of LLM-generated musculoskeletal schematics.
Collapse
Affiliation(s)
- P Ajmera
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - N Nischal
- Department of Radiology, Holy Family Hospital, New Delhi, India
| | - S Ariyaratne
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | | | | | - K P Iyengar
- Department of Orthopedics, Southport and Ormskirk Hospital, Mersey and West Lancashire NHS Trust, Southport, UK
| | - S R Ajmera
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - N Jenko
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK
| | - R Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Bristol Road South, Northfield, Birmingham, UK.
| |
Collapse
|
38
|
Lee S, Kim YY, Shin J, Roh YH, Choi JY, Chernyak V, Sirlin CB. Liver Imaging Reporting and Data System version 2018 category 5 for diagnosing hepatocellular carcinoma: an updated meta-analysis. Eur Radiol 2024; 34:1502-1514. [PMID: 37656177 DOI: 10.1007/s00330-023-10134-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/17/2022] [Revised: 05/24/2023] [Accepted: 07/07/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVE We performed an updated meta-analysis to determine the diagnostic performance of Liver Imaging Reporting and Data System (LI-RADS, LR) 5 category for hepatocellular carcinoma (HCC) using LI-RADS version 2018 (v2018), and to evaluate differences by imaging modalities and type of MRI contrast material. METHODS The MEDLINE and Embase databases were searched for studies reporting the performance of LR-5 using v2018 for diagnosing HCC. A bivariate random-effects model was used to calculate the pooled per-observation sensitivity and specificity. Subgroup analysis was performed based on imaging modalities and type of MRI contrast material. RESULTS Forty-eight studies qualified for the meta-analysis, comprising 9031 patients, 10,547 observations, and 7216 HCCs. The pooled per-observation sensitivity and specificity of LR-5 for diagnosing HCC were 66% (95% CI, 61-70%) and 91% (95% CI, 89-93%), respectively. In the subgroup analysis, MRI with extracellular agent (ECA-MRI) showed significantly higher pooled sensitivity (77% [95% CI, 70-82%]) than CT (66% [95% CI, 58-73%]; p = 0.023) or MRI with gadoxetate (Gx-MRI) (65% [95% CI, 60-70%]; p = 0.001), but there was no significant difference between ECA-MRI and MRI with gadobenate (gadobenate-MRI) (73% [95% CI, 61-82%]; p = 0.495). Pooled specificities were 88% (95% CI, 80-93%) for CT, 92% (95% CI, 86-95%) for ECA-MRI, 93% (95% CI, 91-95%) for Gx-MRI, and 91% (95% CI, 84-95%) for gadobenate-MRI without significant differences (p = 0.084-0.803). CONCLUSIONS LI-RADS v2018 LR-5 provides high specificity for HCC diagnosis regardless of modality or contrast material, while ECA-MRI showed higher sensitivity than CT or Gx-MRI. CLINICAL RELEVANCE STATEMENT Refinement of the criteria for improving sensitivity while maintaining high specificity of LR-5 for HCC diagnosis may be an essential future direction. KEY POINTS • The pooled per-observation sensitivity and specificity of LR-5 for diagnosing HCC using LI-RADSv2018 were 66% and 91%, respectively. • ECA-MRI showed higher sensitivity than CT (77% vs 66%, p = 0.023) or Gx-MRI (77% vs 65%, p = 0.001). • LI-RADS v2018 LR-5 provides high specificity (88-93%) for HCC diagnosis regardless of modality or contrast material type.
Collapse
Affiliation(s)
- Sunyoung Lee
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Yeun-Yoon Kim
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jaeseung Shin
- Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yun Ho Roh
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin-Young Choi
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Victoria Chernyak
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Claude B Sirlin
- Liver Imaging Group, Department of Radiology, University of California San Diego, San Diego, CA, USA
| |
Collapse
|
39
|
Ralhan T, Padda I, Sethi Y, Karroum P, Fabian D, Hashmi R, Elmeligy M, Piccione G, Sharp R, Fulton M. Unusual case of bullous emphysema with superimposed pneumonia. Radiol Case Rep 2024; 19:844-849. [PMID: 38188954 PMCID: PMC10770481 DOI: 10.1016/j.radcr.2023.10.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 01/09/2024] Open
Abstract
Bullous emphysema is a chronic obstructive pulmonary disease (COPD) that results from chronic inflammation of the lung parenchyma leading to alveolar destruction. Etiology includes tobacco smoking and alpha-1 antitrypsin deficiency. In this article, we present a rare case of bullous emphysema in a nonsmoker with no genetic predisposition or social risk factors presenting with productive cough, fatigue, and shortness of breath. The patient was diagnosed with bullous emphysema with superimposed pneumonia based on clinical and radiological findings. The patients acute complaints were treated successfully with antibiotics, supplemental oxygen, systemic steroids, and, nebulizer treatments. With this case report the authors highlight an unusual presentation of pneumonia in a patient with underlying bullous emphysema. Environmental exposure is often overlooked and the outcomes cannot be turned to favor without a comprehensive approach in patient management from history and physical to deciding the right treatment and follow-up protocols.
Collapse
Affiliation(s)
- Tushar Ralhan
- School of Medicine, St. George's University, True Blue, Grenada
| | - Inderbir Padda
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Yashendra Sethi
- Department of Internal Medicine, Government Doon Medical College, Dehradun, India
| | - Paul Karroum
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Daniel Fabian
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Razi Hashmi
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Mohamed Elmeligy
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - GianPaulo Piccione
- Department of Internal Medicine, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Richard Sharp
- Department of Radiology, Richmond University Medical Center/Mount Sinai, Staten Island, NY, USA
| | - Matthew Fulton
- Department of Emergency Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| |
Collapse
|
40
|
Jalloul M, Derbew HM, Miranda-Schaeubinger M, De Leon Benedetti L, Mekete Y, Jr Carbajal JA, Doherty M, Noor A, Dako F, Otero HJ. Case competition sessions: a global education and academic engagement tool. Pediatr Radiol 2024; 54:385-391. [PMID: 37535093 DOI: 10.1007/s00247-023-05723-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Radiology virtual teaching sessions utilize live video conferencing to promote collaborative learning and engagement by discussing radiology cases. Because of its convenience and flexibility, this mode of education has gained popularity, particularly after the corona virus disease 2019 pandemic. OBJECTIVE We describe our experience in organizing a series of "Global Health Imaging Case Competitions" for trainees in low- and middle-income countries (LMICs). These competitions provide the trainees with an opportunity to present unique radiology cases, network with radiologists, learn about various radiology topics, win prizes and potentially publish their case reports in a peer-reviewed journal. MATERIALS AND METHODS Planning and execution of the competition involves several steps. First, trainees are invited to participate and submit abstracts discussing unique cases. The organizing committee grades these abstracts; the authors of the 20 abstracts with the highest scores are asked to submit a video presentation of their cases to be presented during the live webinar. During this webinar, presentations are displayed and graded to select winners. Additionally, the audience votes to choose a participant as the people's favorite. We have completed four cycles (Africa, Latin America and the Caribbean, Africa and the Middle East and Asia) and will continue in the same order of rotation. RESULTS Attendance totalled 2,510 participants from 50 countries. Pediatric cases represented the majority of cases among finalists. Feedback was positive; 26 out of 29 (90%) participants surveyed indicated that the webinar was "very good" to "excellent" with well-organized and challenging cases. Diversity of participating countries was noted. Limitations included technology barriers such as internet connectivity. CONCLUSION This innovative approach emphasizing audience participation engaged trainees from LMICs and fostered locoregional collegiality and mentoring.
Collapse
Affiliation(s)
- Mohammad Jalloul
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Hermon Miliard Derbew
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
- College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Yadel Mekete
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Jesus A Jr Carbajal
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Megan Doherty
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | - Abass Noor
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Hospital of the University of Pennsylvania, Philadelphia, USA
| | - Farouk Dako
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Hospital of the University of Pennsylvania, Philadelphia, USA
| | - Hansel J Otero
- Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
- Hospital of the University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
41
|
Miranda-Schaeubinger M, Derbew HM, Andronikou S, Jalloul M, Otero HJ. Global pediatric radiology education: responding to training-level specific needs. Pediatr Radiol 2024; 54:381-384. [PMID: 37610649 DOI: 10.1007/s00247-023-05747-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023]
Abstract
Pediatric radiology education for pediatric and radiology trainees and practicing professionals must be adapted to the target audience. In efforts to narrow the gaps in global pediatric radiology education, the Children's Hospital of Philadelphia's radiology department's Global Outreach and Education Program has designed specific interventions and curricula according to different levels of training and desired expertise. Our initiatives include an online "Introduction to Pediatric Imaging" lecture series for pediatrics residents in Botswana, Ethiopia and Vietnam; access to a learning management system (Outreach RADIAL) for radiology residents; case-based review sessions for pediatric radiology fellows; and in-person seminars for professionals from Eastern Europe and Africa. Here, we highlight our global education efforts to encourage other departments to take a similar systematic approach to outreach activities.
Collapse
Affiliation(s)
- Monica Miranda-Schaeubinger
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | - Hermon Miliard Derbew
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Savvas Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Mohammad Jalloul
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Hansel J Otero
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| |
Collapse
|
42
|
Achangwa NR, Nierobisch N, Ludovichetti R, Negrão de Figueiredo G, Kupka M, De Vere-Tyndall A, Frauenfelder T, Kulcsar Z, Hainc N. Sustainable reduction of phone-call interruptions by 35% in a medical imaging department using an automatic voicemail and custom call redirection system. Curr Probl Diagn Radiol 2024; 53:246-251. [PMID: 38290903 DOI: 10.1067/j.cpradiol.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/02/2023] [Revised: 12/07/2023] [Accepted: 01/16/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Have you ever been in the trenches of a complicated study only to be interrupted by a not-so urgent phone-call? We were, repeatedly- unfortunately. PURPOSE To increase productivity of radiologists by quantifying the main source of interruptions (phone-calls) to the workflow of radiologists, and too assess the implemented solution. MATERIALS AND METHODS To filter calls to the radiology consultant on duty, we introduced an automatic voicemail and custom call redirection system. Thus, instead of directly speaking with radiology consultants, clinicians were to first categorize their request and dial accordingly: 1. Inpatient requests, 2. Outpatient requests, 3. Directly speak with the consultant radiologist. Inpatient requests (1) and outpatient requests (2) were forwarded to MRI technologists or clerks, respectively. Calls were monitored in 15-minute increments continuously for an entire year (March 2022 until and including March 2023). Subsequently, both the frequency and category of requests were assessed. RESULTS 4803 calls were recorded in total: 3122 (65 %) were forwarded to a radiologist on duty. 870 (18.11 %) concerned inpatients, 274 (5.70 %) outpatients, 430 (8.95 %) dialed the wrong number, 107 (2.23 %) made no decision. Throughout the entire year the percentage of successfully avoided interruptions was relatively stable and fluctuated between low to high 30 % range (Mean per month 35 %, Median per month 34.45 %). CONCLUSIONS This is the first analysis of phone-call interruptions to consultant radiologists in an imaging department for 12 continuous months. More than 35 % of requests did not require the input of a specialist trained radiologist. Hence, installing an automated voicemail and custom call redirection system is a sustainable and simple solution to reduce phone-call interruptions by on average 35 % in radiology departments. This solution was well accepted by referring clinicians. The installation required a one-time investment of only 2h and did not cost any money.
Collapse
Affiliation(s)
- Ngwe Rawlings Achangwa
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland.
| | - Nathalie Nierobisch
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Riccardo Ludovichetti
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Giovanna Negrão de Figueiredo
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Michael Kupka
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Anthony De Vere-Tyndall
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Thomas Frauenfelder
- Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, University of Zurich, Switzerland
| | - Zsolt Kulcsar
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| | - Nicolin Hainc
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
| |
Collapse
|
43
|
Tonks A, Jimenez Y, Gray F, Ekpo E. A stake in the game: Can radiographer image interpretation improve X-ray quality? A scoping review. Radiography (Lond) 2024; 30:641-650. [PMID: 38340575 DOI: 10.1016/j.radi.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/07/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Image quality is an important factor in imaging optimisation and diagnosis. Many determinants of image quality are controlled by the radiographer; therefore, radiographer-led strategies may be key to improving X-ray image quality. This review examines the literature on radiographer-led diagnostic evaluation to establish its potential to improve X-ray image quality. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews and the Joanna Briggs Institute Manual for Evidence Synthesis Scoping Review were used to review studies relevant to the impact of radiographer-led diagnostic evaluation on image quality. CINHAL, Embase, Scopus, Web of Science and Medline databases were searched for relevant articles. Search terms synonymous with radiographer, commenting, and image quality were used and studies that examined any type of radiographer-led image interpretation and its relationship to image quality in X-ray based modalities were reviewed. RESULTS Fourteen studies that met the inclusion criteria were reviewed. All the studies reviewed unanimously reported a positive association between radiographer image interpretation and image quality in X-ray based modalities. Five emerging themes were identified to be responsible for the improvement in image quality: increased understanding of image quality requirements, improved technical skills, enhanced ability to utilise supplementary imaging and repeats, collaborative upskilling of colleagues, and a complementary interaction between diagnostic and radiographic skills that serves to enhance image quality. CONCLUSIONS The findings demonstrate that radiographer image interpretation is a useful strategy to optimise the quality of X-ray examinations. IMPLICATIONS FOR PRACTICE The findings highlight a new avenue to improve X-ray quality in the clinical environment and support evidence-based uptake of preliminary image evaluation systems. These findings also support the integration of radiographer commenting alongside technical image quality in teaching curricula.
Collapse
Affiliation(s)
- A Tonks
- Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Susan Wakil Health Building, Western Ave, Camperdown, NSW, 2050, Australia.
| | - Y Jimenez
- Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Susan Wakil Health Building, Western Ave, Camperdown, NSW, 2050, Australia
| | - F Gray
- Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Susan Wakil Health Building, Western Ave, Camperdown, NSW, 2050, Australia
| | - E Ekpo
- Medical Image Optimisation and Perception Group, Discipline of Medical Imaging Science, Susan Wakil Health Building, Western Ave, Camperdown, NSW, 2050, Australia
| |
Collapse
|
44
|
Poletto MC, Thomazi E, Zorzi JE, Gamba TO, Perottoni CA. Development of an open project rectangular collimator for use with intraoral dental X-ray unit. Radiol Phys Technol 2024; 17:315-321. [PMID: 38265510 DOI: 10.1007/s12194-023-00772-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/29/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024]
Abstract
In this work, an open beam-limiting device, consisting of a rectangular collimator to be coupled to an intraoral dental X-ray device, was made using recycled lead sheets as a radiation-absorbing element. The collimator was designed for 3D printing, and using Spektr 3.0 software, the number of lead sheets needed to absorb excess radiation was calculated. The rectangular collimator reduced the radiation dose to patients by 65% when using four layers of recycled lead sheets (saturating with a 70% reduction in radiation dose at the limit of eight or more sheets of lead). The rectangular collimator does not negatively impact the quality of the radiological image, is available as an open design for 3D printing, and can be built with materials that are easily accessible to the dentist, facilitating its use in clinical practice and reducing the patient's exposure to ionizing radiation.
Collapse
Affiliation(s)
- Marina C Poletto
- Graduate Program in Health Sciences (PPGCS), University of Caxias do Sul (UCS), Francisco Getúlio Vargas, 1130, Caxias do Sul, RS, 95070-560, Brazil
| | - Eduardo Thomazi
- Federal Institute of Education, Science and Technology of Rio Grande do Sul (IFRS), Campus Caxias do Sul, Avelino Antônio de Souza, 1730, Caxias do Sul, RS, 95043-700, Brazil.
| | - Janete E Zorzi
- Graduate Program in Health Sciences (PPGCS), University of Caxias do Sul (UCS), Francisco Getúlio Vargas, 1130, Caxias do Sul, RS, 95070-560, Brazil
| | - Thiago O Gamba
- Graduate Program in Health Sciences (PPGCS), University of Caxias do Sul (UCS), Francisco Getúlio Vargas, 1130, Caxias do Sul, RS, 95070-560, Brazil
- Surgery and Orthopedics Department, Dental School, Federal University of Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Cláudio A Perottoni
- Graduate Program in Health Sciences (PPGCS), University of Caxias do Sul (UCS), Francisco Getúlio Vargas, 1130, Caxias do Sul, RS, 95070-560, Brazil
| |
Collapse
|
45
|
Doddi S, Tirumani SH. Hospital payment systems and physician reimbursement: A primer for radiology residents. Curr Probl Diagn Radiol 2024; 53:171-174. [PMID: 37891082 DOI: 10.1067/j.cpradiol.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/04/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
Prior to practicing independently, radiology trainees spend considerable time and energy to learn and understand the practice of radiology. However, upon graduation trainees are often deficient in understanding the business of hospitals and the structure of reimbursement. Specifically, the workflow of relative value units (RVUs) and its impact on practice of radiology after completing training. In this manuscript, we provide a resource for trainees to understand the workflow of physician reimbursement. This article includes information on the mixed model healthcare structure of the United States and two government programs that influence reimbursement: Diagnosis-Related Groups (DRG) and Hospital Value-Based Purchasing (HVBP) programs. Furthermore, we explain the method by which the Center of Medicare and Medicate Service's (CMS) reimburses physicians via the Medicare Physician Fee Schedule (MPFS) using the Resource Based Relative Value Scale. Understanding the structure of these payments along with the challenges and current landscape of radiology reimbursement will help new radiologists prior to seeking employment where reimbursements are integral to contract expectations.
Collapse
Affiliation(s)
- Sishir Doddi
- University of Toledo College of Medicine, 3000 Arlington Ave Toledo, Toledo, OH 43614, USA.
| | - Sree Harsha Tirumani
- Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| |
Collapse
|
46
|
Karera A, Engel-Hills P, Davidson F. Radiology image interpretation services in a low-resource setting: Medical doctors' experiences and the potential role of radiographers. Radiography (Lond) 2024; 30:560-566. [PMID: 38281318 DOI: 10.1016/j.radi.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/05/2023] [Revised: 01/04/2024] [Accepted: 01/12/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Medical doctors can encounter significant challenges in both the radiology image interpretation service and their ability to interpret images to promote effective patient management. This study aimed to explore the experiences of medical doctors in a low-resource setting regarding the image interpretation service received in state-funded hospitals and the potential role of radiographers. METHODS A qualitative approach with a descriptive phenomenology design was employed. Thirteen medical officers and medical interns, with a maximum of three years of experience, were purposively selected from three state-funded hospitals. Semi-structured interviews were conducted in English, and data analysis followed the conventional content analysis method using Atlas.ti for Windows (version 9). RESULTS Three main themes emerged from the data. The first theme was a poor image interpretation service which highlighted issues such as long turnaround times for image reporting and compromised patient management. The second theme was training and support deficiency which revealed the inadequacy of image interpretation training and the need for additional on-the-job support. The third theme was the inconspicuous radiographer role which showcased the potential opportunities for radiographers to aid in filling the gaps in the image interpretation system. CONCLUSION Medical doctors in this low-resource setting experience significant delays in radiology image interpretation, leading to compromised patient management. Their training in image interpretation is inadequate, and they often lack on-the-job support. Radiographers potentially play a role in image interpretation which may provide solutions to these contextual challenges. IMPLICATIONS FOR PRACTICE There is a need to review and develop a comprehensive image interpretation system that effectively supports medical doctors in image interpretation, possibly involving the collaboration of radiographers.
Collapse
Affiliation(s)
- A Karera
- Department of Medical Imaging and Therapeutic Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.
| | - P Engel-Hills
- Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.
| | - F Davidson
- Department of Medical Imaging and Therapeutic Sciences, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa.
| |
Collapse
|
47
|
Chilanga CC, Lysdahl KB. The radiographers' opinion on assessing radiological referrals. Radiography (Lond) 2024; 30:605-611. [PMID: 38330893 DOI: 10.1016/j.radi.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 11/25/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Radiographers have a fundamental duty to assess radiological referrals and ensure imaging is justified. This study constitutes the third part of a broader research on radiographers' assessment of referrals. The study examines the opinions of radiographers on the matter, as articulated in their own words. METHODS A questionnaire with closed and open-ended questions was designed, validated, and distributed to radiographers following activities organised by the International Society of Radiographers and Radiological Technologists (ISRRT). This third part covers the participants' free-text comments about radiographers' assessment of referrals. Qualitative, inductive content analysis was used to report findings involving three phases: 1) Preparation, 2) Organisation where two authors individually coded and categorised the emerged themes, and 3) Reporting, were the authors compared, reviewed, and defined the meanings of the themes and sub-themes. RESULTS Five main themes Opportunity, Competency, Work environment, Role perception and Significance emerged, shaped as descriptive, normative, and prospective statements. In opportunities the respondents (descriptively) depicted the importance of their position and challenges faced, including lack of adequate clinical information in referrals. Competencies concerned whether they have the required knowledge and skills for the task. In work environment the respondents viewed themselves as partners and collaborators with radiologists and referrers but expressed that unclear regulations could challenge their task. In role perception, the respondents expressed (normatively) that assessing referrals is vital for professional self-esteem and radiographers' responsibility. Significance covers the importance of assessing referrals for different aspects relating to quality of services. CONCLUSION Radiographers expressed high engagement towards tasks of assessing referrals. To support radiographers in this role, it is crucial to establish clear regulations, better organisation of departmental processes and provide adequate training. IMPLICATIONS FOR PRACTICE Radiology departments should actively explore strategies of incorporating the radiographers' resources and core position in the process of assessing referrals, in a consistent and effective manner.
Collapse
Affiliation(s)
- C C Chilanga
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Pb 235, 3603 Kongsberg, Norway.
| | - K B Lysdahl
- Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway (USN), Pb 235, 3603 Kongsberg, Norway
| |
Collapse
|
48
|
De Leon-Benedetti L, Andronikou S, Serai S, Hailu T, Miranda Schaeubinger M, Jalloul M, Dell J, Otero HJ. Learning from experience - Radiology ancillary review of prospective research studies involving imaging. Curr Probl Diagn Radiol 2024; 53:182-184. [PMID: 37891077 DOI: 10.1067/j.cpradiol.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
This report describes the operational process of a big academic children's hospital's Radiology Scientific Review Committee, with a focus on its role in integrating radiology services into pediatric clinical research. We define the step-by-step workflow used to assess research proposals involving imaging and share insights from the past three years of data collection. Trends in modalities, radiologist involvement, and interpretation possibilities are outlined in the data. This systematic methodology provides essential resource allocation concepts and promotes high-quality pediatric clinical research.
Collapse
Affiliation(s)
- Laura De Leon-Benedetti
- Core Radiology Research Group, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Savvas Andronikou
- Core Radiology Research Group, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Suraj Serai
- Core Radiology Research Group, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Tigist Hailu
- Core Radiology Research Group, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Monica Miranda Schaeubinger
- Core Radiology Research Group, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Mohammad Jalloul
- Core Radiology Research Group, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - John Dell
- Core Radiology Research Group, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Hansel J Otero
- Core Radiology Research Group, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
49
|
Doherty G, McLaughlin L, Hughes C, McConnell J, Bond R, McFadden S. A scoping review of educational programmes on artificial intelligence (AI) available to medical imaging staff. Radiography (Lond) 2024; 30:474-482. [PMID: 38217933 DOI: 10.1016/j.radi.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 10/26/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/15/2024]
Abstract
INTRODUCTION Medical imaging is arguably the most technologically advanced field in healthcare, encompassing a range of technologies which continually evolve as computing power and human knowledge expand. Artificial Intelligence (AI) is the next frontier which medical imaging is pioneering. The rapid development and implementation of AI has the potential to revolutionise healthcare, however, to do so, staff must be competent and confident in its application, hence AI readiness is an important precursor to AI adoption. Research to ascertain the best way to deliver this AI-enabled healthcare training is in its infancy. The aim of this scoping review is to compare existing studies which investigate and evaluate the efficacy of AI educational interventions for medical imaging staff. METHODS Following the creation of a search strategy and keyword searches, screening was conducted to determine study eligibility. This consisted of a title and abstract scan, then subsequently a full-text review. Articles were included if they were empirical studies wherein an educational intervention on AI for medical imaging staff was created, delivered, and evaluated. RESULTS Of the initial 1309 records returned, n = 5 (∼0.4 %) of studies met the eligibility criteria of the review. The curricula and delivery in each of the five studies shared similar aims and a 'flipped classroom' delivery was the most utilised method. However, the depth of content covered in the curricula of each varied and measured outcomes differed greatly. CONCLUSION The findings of this review will provide insights into the evaluation of existing AI educational interventions, which will be valuable when planning AI education for healthcare staff. IMPLICATIONS FOR PRACTICE This review highlights the need for standardised and comprehensive AI training programs for imaging staff.
Collapse
Affiliation(s)
- G Doherty
- Ulster University, School of Health Sciences, Faculty of Life and Health Sciences, Shore Road, Newtownabbey, Northern Ireland, United Kingdom.
| | - L McLaughlin
- Ulster University, School of Health Sciences, Faculty of Life and Health Sciences, Shore Road, Newtownabbey, Northern Ireland, United Kingdom
| | - C Hughes
- Ulster University, School of Health Sciences, Faculty of Life and Health Sciences, Shore Road, Newtownabbey, Northern Ireland, United Kingdom
| | - J McConnell
- Leeds Teaching Hospitals NHS Trust, United Kingdom
| | - R Bond
- Ulster University, School of Computing, Faculty of Computing, Engineering and the Built Environment, Shore Road, Newtownabbey, Northern Ireland, United Kingdom
| | - S McFadden
- Ulster University, School of Health Sciences, Faculty of Life and Health Sciences, Shore Road, Newtownabbey, Northern Ireland, United Kingdom
| |
Collapse
|
50
|
Alkojak Almansi A, Sugarova S, Alsanosi A, Almuhawas F, Hofmeyr L, Wagner F, Kedves E, Sriperumbudur K, Dhanasingh A, Kedves A. A novel radiological software prototype for automatically detecting the inner ear and classifying normal from malformed anatomy. Comput Biol Med 2024; 171:108168. [PMID: 38432006 DOI: 10.1016/j.compbiomed.2024.108168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/04/2023] [Revised: 01/29/2024] [Accepted: 02/15/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND To develop an effective radiological software prototype that could read Digital Imaging and Communications in Medicine (DICOM) files, crop the inner ear automatically based on head computed tomography (CT), and classify normal and inner ear malformation (IEM). METHODS A retrospective analysis was conducted on 2053 patients from 3 hospitals. We extracted 1200 inner ear CTs for importing, cropping, and training, testing, and validating an artificial intelligence (AI) model. Automated cropping algorithms based on CTs were developed to precisely isolate the inner ear volume. Additionally, a simple graphical user interface (GUI) was implemented for user interaction. Using cropped CTs as input, a deep learning convolutional neural network (DL CNN) with 5-fold cross-validation was used to classify inner ear anatomy as normal or abnormal. Five specific IEM types (cochlear hypoplasia, ossification, incomplete partition types I and III, and common cavity) were included, with data equally distributed between classes. Both the cropping tool and the AI model were extensively validated. RESULTS The newly developed DICOM viewer/software successfully achieved its objectives: reading CT files, automatically cropping inner ear volumes, and classifying them as normal or malformed. The cropping tool demonstrated an average accuracy of 92.25%. The DL CNN model achieved an area under the curve (AUC) of 0.86 (95% confidence interval: 0.81-0.91). Performance metrics for the AI model were: accuracy (0.812), precision (0.791), recall (0.8), and F1-score (0.766). CONCLUSION This study successfully developed and validated a fully automated workflow for classifying normal versus abnormal inner ear anatomy using a combination of advanced image processing and deep learning techniques. The tool exhibited good diagnostic accuracy, suggesting its potential application in risk stratification. However, it is crucial to emphasize the need for supervision by qualified medical professionals when utilizing this tool for clinical decision-making.
Collapse
Affiliation(s)
- Abdulrahman Alkojak Almansi
- University of Pecs, Faculty of Engineering and Information Technology, Institute of Information and Electrical Technology, Pecs, Hungary
| | - Sima Sugarova
- St. Petersburg ENT and Speech Research Institute, St. Petersburg, Russia
| | - Abdulrahman Alsanosi
- King Saud University, King Abdullah Ear Specialist Center (KAESC), Department of Otolaryngology, Riyadh, Saudi Arabia
| | - Fida Almuhawas
- King Saud University, King Abdullah Ear Specialist Center (KAESC), Department of Otolaryngology, Riyadh, Saudi Arabia
| | - Louis Hofmeyr
- Dr Loius Hofmeyr's workplace to Stellenbosch University Division of Otorhinolaryngology, Stellenbosch, South Africa
| | - Franca Wagner
- University Hospital Bern, University Institute for Diagnostic and Interventional Neuroradiology, Switzerland
| | - Emerencia Kedves
- University of Sopron, Doctoral School of Wood Sciences and Technologies, Sopron, Hungary
| | - Kiran Sriperumbudur
- MED-EL Medical Electronics GmbH., Department of Research and Development, Innsbruck, Austria
| | - Anandhan Dhanasingh
- MED-EL Medical Electronics GmbH., Department of Research and Development, Innsbruck, Austria.
| | - Andras Kedves
- MED-EL Medical Electronics GmbH., Department of Research and Development, Innsbruck, Austria; University of Pecs, Faculty of Engineering and Information Technology, Institute of Information and Electrical Technology, Pecs, Hungary.
| |
Collapse
|