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Kocak B, Borgheresi A, Ponsiglione A, Andreychenko AE, Cavallo AU, Stanzione A, Doniselli FM, Vernuccio F, Triantafyllou M, Cannella R, Trotta R, Ghezzo S, Akinci D'Antonoli T, Cuocolo R. Explanation and Elaboration with Examples for CLEAR (CLEAR-E3): an EuSoMII Radiomics Auditing Group Initiative. Eur Radiol Exp 2024; 8:72. [PMID: 38740707 DOI: 10.1186/s41747-024-00471-z] [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: 03/18/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024] Open
Abstract
Overall quality of radiomics research has been reported as low in literature, which constitutes a major challenge to improve. Consistent, transparent, and accurate reporting is critical, which can be accomplished with systematic use of reporting guidelines. The CheckList for EvaluAtion of Radiomics research (CLEAR) was previously developed to assist authors in reporting their radiomic research and to assist reviewers in their evaluation. To take full advantage of CLEAR, further explanation and elaboration of each item, as well as literature examples, may be useful. The main goal of this work, Explanation and Elaboration with Examples for CLEAR (CLEAR-E3), is to improve CLEAR's usability and dissemination. In this international collaborative effort, members of the European Society of Medical Imaging Informatics-Radiomics Auditing Group searched radiomics literature to identify representative reporting examples for each CLEAR item. At least two examples, demonstrating optimal reporting, were presented for each item. All examples were selected from open-access articles, allowing users to easily consult the corresponding full-text articles. In addition to these, each CLEAR item's explanation was further expanded and elaborated. For easier access, the resulting document is available at https://radiomic.github.io/CLEAR-E3/ . As a complementary effort to CLEAR, we anticipate that this initiative will assist authors in reporting their radiomics research with greater ease and transparency, as well as editors and reviewers in reviewing manuscripts.Relevance statement Along with the original CLEAR checklist, CLEAR-E3 is expected to provide a more in-depth understanding of the CLEAR items, as well as concrete examples for reporting and evaluating radiomic research.Key points• As a complementary effort to CLEAR, this international collaborative effort aims to assist authors in reporting their radiomics research, as well as editors and reviewers in reviewing radiomics manuscripts.• Based on positive examples from the literature selected by the EuSoMII Radiomics Auditing Group, each CLEAR item explanation was further elaborated in CLEAR-E3.• The resulting explanation and elaboration document with examples can be accessed at https://radiomic.github.io/CLEAR-E3/ .
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Affiliation(s)
- Burak Kocak
- Department of Radiology, University of Health Sciences, Basaksehir Cam and Sakura City Hospital, Basaksehir, Istanbul, Turkey.
| | - Alessandra Borgheresi
- Department of Clinical, Special and Dental Sciences, University Politecnica delle Marche, Ancona, Italy
- Department of Radiology, University Hospital "Azienda Ospedaliero Universitaria delle Marche", Via Conca 71, 60126, Ancona, Italy
| | - Andrea Ponsiglione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Anna E Andreychenko
- Laboratory for Digital Public Health Technologies, ITMO University, St. Petersburg, Russian Federation
| | - Armando Ugo Cavallo
- Division of Radiology, Istituto Dermopatico dell'Immacolata (IDI) IRCCS, Rome, Italy
| | - Arnaldo Stanzione
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Fabio M Doniselli
- Neuroradiology Unit, Fondazione Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milano, Italy
| | - Federica Vernuccio
- Section of Radiology, Department of Biomedicine, Neuroscience and Advanced Diagnosis (Bi.N.D), University of Palermo, 90127, Palermo, Italy
| | - Matthaios Triantafyllou
- Department of Medical Imaging, University Hospital of Heraklion, 71110, Crete, Voutes, Greece
| | - Roberto Cannella
- Section of Radiology - Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
| | - Romina Trotta
- Department of Radiology - Fatima Hospital, Seville, Spain
| | | | - Tugba Akinci D'Antonoli
- Institute of Radiology and Nuclear Medicine, Cantonal Hospital Baselland, Liestal, Switzerland
| | - Renato Cuocolo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Italy
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2
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Pfeifer CM. Maintaining Subjectivity While Reducing Bias in the New Oral Certifying Examination. Acad Radiol 2024; 31:2192. [PMID: 38448328 DOI: 10.1016/j.acra.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 02/13/2024] [Accepted: 02/13/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Cory M Pfeifer
- Phoenix Children's, Department of Radiology, 1919 E Thomas Rd, Phoenix, Arizona 85016, USA.
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3
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Moore QT. Radiologic Technologists' Perceived Reasons for Inappropriate Imaging. Radiol Technol 2022; 93:532-543. [PMID: 35790302] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/25/2021] [Indexed: 06/15/2023]
Abstract
PURPOSE To examine whether radiologic technologists' perceptions of imaging appropriateness differed based on their primary imaging modality, work shift, shift length, and primary practice type. METHODS A national, cross-sectional study was conducted in the fourth quarter of 2019 using a simple, randomized sample of American Society of Radiologic Technologists (ASRT) members. Study participants were employed in health care settings in radiography, computed tomography (CT), mammography, or radiology leadership. Seven potential reasons for inappropriate imaging procedures (ie, patient expectations, provide patient with a feeling of being taken seriously, lack of time, expectations from relatives, compensation for insufficient clinical examination, normal findings would reassure the patient, and fear of lawsuits) were evaluated for relationships with their primary imaging modality, work shift, shift length, and primary practice type. RESULTS Disparities in perceived reasons affecting imaging appropriateness were found. Providing the patient with a feeling of being taken seriously was related to primary practice type (P = .022). Lack of time was related to primary imaging modality (P = .005) and primary practice type (P = .006). Expectations from relatives was related to primary imaging modality (P = .016) and primary practice type (P = .027). Compensation for insufficient clinical examination was related to primary imaging modality (P < .001), shift length (P = .011), work shift (P = .002), and primary practice type (P < .001). Fear of lawsuits was related to primary imaging modality (P = .001)) and work shift (P = .002). DISCUSSION The study reveals that radiologic technologists' perceptions of patient-centered factors and defensive medicine-related factors differ among imaging modalities, shift types, and practice settings. However, more research is required to determine why radiologic technologists perceive these reasons to be present, investigate whether providers feel similarly, and determine perceptual alignment with evidence-based guidelines. CONCLUSION The findings suggest that attention should focus on the appropriateness of CT imaging procedures performed in hospitals during night shifts.
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Affiliation(s)
- Quentin T Moore
- Quentin T Moore, PhD, R.T.(R)(T)(QM), is director of imaging sciences and associate professor for Mercy College of Ohio
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Davidson EM, Poon MTC, Casey A, Grivas A, Duma D, Dong H, Suárez-Paniagua V, Grover C, Tobin R, Whalley H, Wu H, Alex B, Whiteley W. The reporting quality of natural language processing studies: systematic review of studies of radiology reports. BMC Med Imaging 2021; 21:142. [PMID: 34600486 PMCID: PMC8487512 DOI: 10.1186/s12880-021-00671-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 09/20/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Automated language analysis of radiology reports using natural language processing (NLP) can provide valuable information on patients' health and disease. With its rapid development, NLP studies should have transparent methodology to allow comparison of approaches and reproducibility. This systematic review aims to summarise the characteristics and reporting quality of studies applying NLP to radiology reports. METHODS We searched Google Scholar for studies published in English that applied NLP to radiology reports of any imaging modality between January 2015 and October 2019. At least two reviewers independently performed screening and completed data extraction. We specified 15 criteria relating to data source, datasets, ground truth, outcomes, and reproducibility for quality assessment. The primary NLP performance measures were precision, recall and F1 score. RESULTS Of the 4,836 records retrieved, we included 164 studies that used NLP on radiology reports. The commonest clinical applications of NLP were disease information or classification (28%) and diagnostic surveillance (27.4%). Most studies used English radiology reports (86%). Reports from mixed imaging modalities were used in 28% of the studies. Oncology (24%) was the most frequent disease area. Most studies had dataset size > 200 (85.4%) but the proportion of studies that described their annotated, training, validation, and test set were 67.1%, 63.4%, 45.7%, and 67.7% respectively. About half of the studies reported precision (48.8%) and recall (53.7%). Few studies reported external validation performed (10.8%), data availability (8.5%) and code availability (9.1%). There was no pattern of performance associated with the overall reporting quality. CONCLUSIONS There is a range of potential clinical applications for NLP of radiology reports in health services and research. However, we found suboptimal reporting quality that precludes comparison, reproducibility, and replication. Our results support the need for development of reporting standards specific to clinical NLP studies.
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Affiliation(s)
- Emma M Davidson
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Little France, Edinburgh, EH16 4TJ, Scotland, UK.
| | - Michael T C Poon
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Brain Tumour Centre of Excellence, Cancer Research UK Edinburgh Centre, University of Edinburgh, Edinburgh, Scotland, UK
| | - Arlene Casey
- School of Literatures, Languages and Cultures (LLC), University of Edinburgh, Edinburgh, Scotland, UK
| | - Andreas Grivas
- School of Literatures, Languages and Cultures (LLC), University of Edinburgh, Edinburgh, Scotland, UK
| | - Daniel Duma
- School of Literatures, Languages and Cultures (LLC), University of Edinburgh, Edinburgh, Scotland, UK
| | - Hang Dong
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Health Data Research UK, London, UK
| | - Víctor Suárez-Paniagua
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
- Health Data Research UK, London, UK
| | - Claire Grover
- Institute for Language, Cognition and Computation, School of Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Richard Tobin
- Institute for Language, Cognition and Computation, School of Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Heather Whalley
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Little France, Edinburgh, EH16 4TJ, Scotland, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Honghan Wu
- Health Data Research UK, London, UK
- Institute of Health Informatics, University College London, London, UK
| | - Beatrice Alex
- School of Literatures, Languages and Cultures (LLC), University of Edinburgh, Edinburgh, Scotland, UK
- Edinburgh Futures Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - William Whiteley
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor's Building, Little France, Edinburgh, EH16 4TJ, Scotland, UK
- Health Data Research UK, London, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
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5
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Francone M, Aquaro GD, Barison A, Castelletti S, de Cobelli F, de Lazzari M, Esposito A, Focardi M, di Renzi P, Indolfi C, Lanzillo C, Lovato L, Maestrini V, Mercuro G, Natale L, Mantini C, Polizzi G, Rabbat M, Secchi F, Secinaro A, di Cesare E, Pontone G. Appropriate use criteria for cardiovascular MRI: SIC - SIRM position paper Part 2 (myocarditis, pericardial disease, cardiomyopathies and valvular heart disease). J Cardiovasc Med (Hagerstown) 2021; 22:515-529. [PMID: 34076599 DOI: 10.2459/jcm.0000000000001170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cardiovascular magnetic resonance (CMR) has emerged as an accurate diagnostic technique for the evaluation of patients with cardiac disease in the majority of clinical settings, thanks to an established additional diagnostic and prognostic value. This document has been developed by a joined group of experts of the Italian Society of Cardiology (SIC) and Italian Society of Radiology (SIRM) to provide a summary about the current state of technology and clinical applications of CMR, to improve the clinical diagnostic pathways and to promote its inclusion in clinical practice. The writing committee consisted of members and experts of both societies in order to develop a more integrated approach in the field of cardiac imaging. This section 2 will cover myocarditis, pericardial disease, cardiomyopathies and valvular heart disease.
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Affiliation(s)
- Marco Francone
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan
| | | | | | - Silvia Castelletti
- Istituto Auxologico Italiano IRCCS, Center for the Cardiac Arrhythmias of Genetic Origin
| | - Francesco de Cobelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan
| | - Manuel de Lazzari
- Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Italy
| | - Antonio Esposito
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan
| | - Marta Focardi
- Department of Cardiology, Azienda Ospedaliera Universitaria Senese, Siena
| | - Paolo di Renzi
- U.O.C. Radiologia, Ospedale 'San Giovanni Calibita' Fatebenefratelli - Isola Tiberina - Rome
| | - Ciro Indolfi
- Division of Cardiology, University Magna Graecia, Italy and Mediterranea Cardiocentro, Naples
| | | | - Luigi Lovato
- Cardiovascular Radiology Unit, Department of Imaging S.Orsola-Malpighi University Hospital, Bologna
| | - Viviana Maestrini
- Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari
| | - Luigi Natale
- Department of Diagnostic Imaging, Oncological Radiotherapy, and Hematology - Diagnostic Imaging Area
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Universita ' Cattolica del Sacro Cuore, Rome
| | - Cesare Mantini
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University, Chieti
| | - Gesualdo Polizzi
- Unit of Radiodiagnostics II, University Hospital 'Policlinico-Vittorio Emanuele', Catania, Italy
| | - Mark Rabbat
- Loyola University of Chicago, Chicago
- Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Francesco Secchi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan
- Unit of Radiology, IRCCS Policlinico San Donato, San Donato Milanese
| | - Aurelio Secinaro
- Advanced Cardiovascular Imaging Unit, Department of Imaging, Bambino Gesù Children's Hospital, Rome
| | - Ernesto di Cesare
- Department of Life, Healt and Enviromental Sciences, University of L'Aquila, L'Aquila
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6
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Dick J, Darras KE, Lexa FJ, Denton E, Ehara S, Galloway H, Jankharia B, Kassing P, Kumamaru KK, Mildenberger P, Morozov S, Pyatigorskaya N, Song B, Sosna J, van Buchem M, Forster BB. An International Survey of Quality and Safety Programs in Radiology. Can Assoc Radiol J 2021; 72:135-141. [PMID: 32066249 DOI: 10.1177/0846537119899195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/05/2023] Open
Abstract
PURPOSE The aim of this study was to determine the status of radiology quality improvement programs in a variety of selected nations worldwide. METHODS A survey was developed by select members of the International Economics Committee of the American College of Radiology on quality programs and was distributed to committee members. Members responded on behalf of their country. The 51-question survey asked about 12 different quality initiatives which were grouped into 4 themes: departments, users, equipment, and outcomes. Respondents reported whether a designated type of quality initiative was used in their country and answered subsequent questions further characterizing it. RESULTS The response rate was 100% and represented Australia, Canada, China, England, France, Germany, India, Israel, Japan, the Netherlands, Russia, and the United States. The most frequently reported quality initiatives were imaging appropriateness (91.7%) and disease registries (91.7%), followed by key performance indicators (83.3%) and morbidity and mortality rounds (83.3%). Peer review, equipment accreditation, radiation dose monitoring, and structured reporting were reported by 75.0% of respondents, followed by 58.3% of respondents for quality audits and critical incident reporting. The least frequently reported initiatives included Lean/Kaizen exercises and physician performance assessments, implemented by 25.0% of respondents. CONCLUSION There is considerable diversity in the quality programs used throughout the world, despite some influence by national and international organizations, from whom further guidance could increase uniformity and optimize patient care in radiology.
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Affiliation(s)
- Jeremy Dick
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Kathryn E Darras
- University of British Columbia, Vancouver, British Columbia, Canada
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Frank J Lexa
- Department of Medical Imaging, 12216University of Arizona College of Medicine, Tucson, AZ, USA
- The Radiology Leadership Institute and Commission on Leadership and Practice Development, 72672American College of Radiology, Tucson, AZ, USA
| | - Erika Denton
- Norfolk & Norwich University Hospital, Norwich, Norfolk, United Kingdom
| | - Shigeru Ehara
- Department of Radiology, Tohoku Medical and Pharmaceutical University, Sendai, Tohoku, Japan
| | | | | | - Pam Kassing
- 72672American College of Radiology, Reston, VA, USA
| | | | - Peter Mildenberger
- Department of Radiology, 9182University Medical Center Mainz, Mainz, Germany
| | | | - Nadya Pyatigorskaya
- Department of Neuroradiology, 27063Sorbonne University, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Bin Song
- West China Hospital, 12530Sichuan University, Chengdu, Sichuan, China
| | - Jacob Sosna
- Department of Radiology, 58884Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Marcus van Buchem
- Department of Radiology, 4501Leiden University Medical Center, Leiden, the Netherlands
| | - Bruce B Forster
- University of British Columbia, Vancouver, British Columbia, Canada
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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7
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Chen KJ, Dedhia PH, Imbus JR, Schneider DF. Thyroid Ultrasound Reports: Will the Thyroid Imaging, Reporting, and Data System Improve Natural Language Processing Capture of Critical Thyroid Nodule Features? J Surg Res 2020; 256:557-563. [PMID: 32799005 PMCID: PMC8102071 DOI: 10.1016/j.jss.2020.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 03/03/2020] [Revised: 06/29/2020] [Accepted: 07/11/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Critical thyroid nodule features are contained in unstructured ultrasound (US) reports. The Thyroid Imaging, Reporting, and Data System (TI-RADS) uses five key features to risk stratify nodules and recommend appropriate intervention. This study aims to analyze the quality of US reporting and the potential benefit of Natural Language Processing (NLP) systems in efficiently capturing TI-RADS features from text reports. MATERIALS AND METHOD This retrospective study used free-text thyroid US reports from an academic center (A) and community hospital (B). Physicians created "gold standard" annotations by manually extracting TI-RADS features and clinical recommendations from reports to determine how often they were included. Similar annotations were created using an automated NLP system and compared with the gold standard. RESULTS Two hundred eighty-two reports contained 409 nodules at least 1-cm in maximum diameter. The gold standard identified three nodules (0.7%) which contained enough information to calculate a complete TI-RADS score. Shape was described most often (92.7% of nodules), whereas margins were described least often (11%). A median number of two TI-RADS features are reported per nodule. The NLP system was significantly less accurate than the gold standard in capturing echogenicity (27.5%) and margins (58.9%). One hundred eight nodule reports (26.4%) included clinical management recommendations, which were included more often at site A than B (33.9 versus 17%, P < 0.05). CONCLUSIONS These results suggest a gap between current US reporting styles and those needed to implement TI-RADS and achieve NLP accuracy. Synoptic reporting should prompt more complete thyroid US reporting, improved recommendations for intervention, and better NLP performance.
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Affiliation(s)
- Kallie J Chen
- Division of Endocrine Surgery at University of Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, Wisconsin.
| | - Priya H Dedhia
- Division of Endocrine Surgery at University of Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, Wisconsin
| | - Joseph R Imbus
- Division of Endocrine Surgery at University of Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, Wisconsin
| | - David F Schneider
- Division of Endocrine Surgery at University of Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, Wisconsin
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8
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Dudiak KM, Maturen KE, Akin EA, Bell M, Bhosale PR, Kang SK, Kilcoyne A, Lakhman Y, Nicola R, Pandharipande PV, Paspulati R, Reinhold C, Ricci S, Shinagare AB, Vargas HA, Whitcomb BP, Glanc P. ACR Appropriateness Criteria® Gestational Trophoblastic Disease. J Am Coll Radiol 2020; 16:S348-S363. [PMID: 31685103 DOI: 10.1016/j.jacr.2019.05.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 11/30/2022]
Abstract
Gestational trophoblastic disease (GTD), a rare complication of pregnancy, includes both benign and malignant forms, the latter collectively referred to as gestational trophoblastic neoplasia (GTN). When metastatic, the lungs are the most common site of initial spread. Beta-human chorionic gonadotropin, elaborated to some extent by all forms of GTD, is useful in facilitating disease detection, diagnosis, monitoring treatment response, and follow-up. Imaging evaluation depends on whether GTD manifests in one of its benign forms or whether it has progressed to GTN. Transabdominal and transvaginal ultrasound with duplex Doppler evaluation of the pelvis are usually appropriate diagnostic procedures in either of these circumstances, and in posttreatment surveillance. The appropriateness of more extensive imaging remains dependent on a diagnosis of GTN and on other factors. The use of imaging to assess complications, typically hemorrhagic, should be guided by the location of clinical signs and symptoms. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | | | - Esma A Akin
- George Washington University Hospital, Washington, District of Columbia
| | - Maria Bell
- Sanford Health, Sioux Falls, South Dakota, American College of Obstetricians and Gynecologists
| | | | - Stella K Kang
- New York University Medical Center, New York, New York
| | | | - Yulia Lakhman
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Refky Nicola
- State University of New York Upstate Medical University, Syracuse, New York
| | | | | | | | - Stephanie Ricci
- Cleveland Clinic, Cleveland, Ohio, American College of Obstetricians and Gynecologists
| | - Atul B Shinagare
- Brigham & Women's Hospital Dana-Farber Cancer Institute, Boston, Massachusetts
| | | | - Bradford P Whitcomb
- University of Connecticut, Farmington, Connecticut, Society of Gynecologic Oncology
| | - Phyllis Glanc
- Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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9
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Abstract
The major goal of the radiology report is to deliver timely, accurate, and actionable information to the patient care team and the patient. Structured reporting offers multiple advantages over traditional free-text reporting, including reduction in diagnostic error, comprehensiveness, adherence to national consensus guidelines, revenue capture, data collection, and research. Various technological innovations enhance integration of structured reporting into everyday clinical practice. This review discusses the benefits of innovations in radiology reporting to the clinical decision process, the patient experience, the cost of imaging, and the overall contributions to the health of the population. Future directions, including the use of artificial intelligence, are reviewed.
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Affiliation(s)
| | - Victoria Chernyak
- Department of Radiology, Montefiore Medical Center, Bronx, New York.
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10
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Güneyli S, Atçeken Z, Doğan H, Altınmakas E, Atasoy KÇ. Radiological approach to COVID-19 pneumonia with an emphasis on chest CT. Diagn Interv Radiol 2020; 26:323-332. [PMID: 32352917 PMCID: PMC7360081 DOI: 10.5152/dir.2020.20260] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has recently become a worldwide outbreak with several millions of people infected and more than 160.000 deaths. A fast and accurate diagnosis in this outbreak is critical to isolate and treat patients. Radiology plays an important role in the diagnosis and management of the patients. Among various imaging modalities, chest CT has received attention with its higher sensitivity and specificity rates. Shortcomings of the real-time reverse transcriptase-polymerase chain reaction test, including inappropriate sample collection and analysis methods, initial false negative results, and limited availability has led to widespread use of chest CT in the diagnostic algorithm. This review summarizes the role of radiology in COVID-19 pneumonia, diagnostic accuracy of imaging, and chest CT findings of the disease.
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Affiliation(s)
- Serkan Güneyli
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
| | - Zeynep Atçeken
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
| | - Hakan Doğan
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
| | - Emre Altınmakas
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
| | - Kayhan Çetin Atasoy
- From the Department of Radiology (S.G. ), Koc University School of Medicine, Istanbul, Turkey
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11
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Li T, Jiang Z, Lu M, Zou S, Wu M, Wei T, Wang L, Li J, Hu Z, Cheng X, Liao J. Computer-aided diagnosis system of thyroid nodules ultrasonography: Diagnostic performance difference between computer-aided diagnosis and 111 radiologists. Medicine (Baltimore) 2020; 99:e20634. [PMID: 32502044 PMCID: PMC7306365 DOI: 10.1097/md.0000000000020634] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
To evaluate the diagnostic efficiency of computer-aided diagnosis (CAD) system and 111 radiologists with different experience in identifying benign and malignant thyroid nodules, and to summarize the ultrasound features that may affect the diagnostic of CAD and radiologists.Fifty thyroid nodules and 111 radiologists were enrolled in this study. All the 50 nodules were diagnosed by the 111 radiologists and the CAD system simultaneously. The diagnostic performance of the CAD system, senior and junior radiologists with the maximum accuracy were calculated and compared. Interobserver agreement for different ultrasound characteristics between the CAD and senior radiologist were analyzed.CAD system showed a higher specificity than junior radiologist (87.5% vs 70.4%, P = .03), and a lower sensitivity than the senior radiologist and junior radiologist but the statistics were not significant (76.9% vs 86.9%, P > .5; 76.9% vs 82.6%, P > .5). The CAD system and senior radiologist got larger AUC than junior radiologist but the differences were not statistically significant (0.82 vs 0.76, respectively; P = .5). The interobserver agreement for the US characteristics between the CAD system and senior radiologist were: substantial agreement for hypoechoic and taller than wide (kappa value = 0.66, 0.78), and moderate agreement for irregular margin and micro-calcifications (kappa value = 0.52, 0.42).The CAD system achieved equal diagnostic accuracy to the senior radiologists and higher accuracy than the junior radiologists. The interobserver agreements in the US features between the CAD system and senior radiologist were substantial agreement for hypoechoic and taller than wide; moderate agreement for irregular margin and micro-calcifications. The location of a thyroid nodule and the feature of macrocalcification with wide acoustic shadow may influence the analysis of the CAD system.
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Affiliation(s)
- Tingting Li
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Zirui Jiang
- Electrical and computer Engineering, University of Wisconsin Madison, Madison, Wisconsin
| | - Man Lu
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shibin Zou
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Minggang Wu
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting Wei
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lu Wang
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Juan Li
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ziyue Hu
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xueqing Cheng
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Jifen Liao
- Ultrasound Medical Center, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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12
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Hafeez M, Sattar A. Contributions and Challenges of Radiology in the Era of COVID-19 Pandemic. J Coll Physicians Surg Pak 2020; 30:84-85. [PMID: 32723466 DOI: 10.29271/jcpsp.2020.supp1.s84] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Mahnoor Hafeez
- Dow Institute of Radiology, Dow University of Health Sciences (DUHS), Karachi, Pakistan
| | - Amjad Sattar
- Dow Institute of Radiology, Dow University of Health Sciences (DUHS), Karachi, Pakistan
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13
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Naidoo J, Reuss JE, Suresh K, Feller-Kopman D, Forde PM, Mehta Steinke S, Rock C, Johnson DB, Nishino M, Brahmer JR. Immune-related (IR)-pneumonitis during the COVID-19 pandemic: multidisciplinary recommendations for diagnosis and management. J Immunother Cancer 2020; 8:e000984. [PMID: 32554619 PMCID: PMC7316105 DOI: 10.1136/jitc-2020-000984] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2020] [Indexed: 01/08/2023] Open
Abstract
Immune-related (IR)-pneumonitis is a rare and potentially fatal toxicity of anti-PD(L)1 immunotherapy. Expert guidelines for the diagnosis and management of IR-pneumonitis include multidisciplinary input from medical oncology, pulmonary medicine, infectious disease, and radiology specialists. Severe acute respiratory syndrome coronavirus 2 is a recently recognized respiratory virus that is responsible for causing the COVID-19 global pandemic. Symptoms and imaging findings from IR-pneumonitis and COVID-19 pneumonia can be similar, and early COVID-19 viral testing may yield false negative results, complicating the diagnosis and management of both entities. Herein, we present a set of multidisciplinary consensus recommendations for the diagnosis and management of IR-pneumonitis in the setting of COVID-19 including: (1) isolation procedures, (2) recommended imaging and interpretation, (3) adaptations to invasive testing, (4) adaptations to the management of IR-pneumonitis, (5) immunosuppression for steroid-refractory IR-pneumonitis, and (6) management of suspected concurrent IR-pneumonitis and COVID-19 infection. There is an emerging need for the adaptation of expert guidelines for IR-pneumonitis in the setting of the global COVID-19 pandemic. We propose a multidisciplinary consensus on this topic, in this position paper.
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Affiliation(s)
- Jarushka Naidoo
- Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, Maryland, USA
| | - Joshua E Reuss
- Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, Maryland, USA
| | - Karthik Suresh
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - David Feller-Kopman
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Patrick M Forde
- Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, Maryland, USA
| | - Seema Mehta Steinke
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, Maryland, USA
| | - Clare Rock
- Division of Hospital Epidemiology and Infection Control, Johns Hopkins University, Baltimore, Maryland, USA
| | - Douglas B Johnson
- Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mizuki Nishino
- Radiology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Julie R Brahmer
- Oncology, Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, Maryland, USA
- The Bloomberg-Kimmel Institute for Cancer Immunotherapy, Johns Hopkins University, Baltimore, Maryland, USA
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14
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Kennedy TA, Anderson J. Neuroradiology Fellowship Requirements: Updates in 2019. AJNR Am J Neuroradiol 2020; 41:370-372. [PMID: 32054619 DOI: 10.3174/ajnr.a6450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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15
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Krupinski EA. Optimisation in daily practice - it's more than just radiation dose. J Med Radiat Sci 2020; 67:2-4. [PMID: 32153138 PMCID: PMC7063244 DOI: 10.1002/jmrs.381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
On this editorial, the importance of optimisation of diagnostic imaging and radiation therapy in terms of diagnostic and therapeutic tests and treatments, education and service provision are discussed.
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16
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Parekh VS, Jacobs MA. Multiparametric radiomics methods for breast cancer tissue characterization using radiological imaging. Breast Cancer Res Treat 2020; 180:407-421. [PMID: 32020435 PMCID: PMC7066290 DOI: 10.1007/s10549-020-05533-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 01/11/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE Multiparametric radiological imaging is vital for detection, characterization, and diagnosis of many different diseases. Radiomics provide quantitative metrics from radiological imaging that may infer potential biological meaning of the underlying tissue. However, current methods are limited to regions of interest extracted from a single imaging parameter or modality, which limits the amount of information available within the data. This limitation can directly affect the integration and applicable scope of radiomics into different clinical settings, since single image radiomics are not capable of capturing the true underlying tissue characteristics in the multiparametric radiological imaging space. To that end, we developed a multiparametric imaging radiomic (mpRad) framework for extraction of first and second order radiomic features from multiparametric radiological datasets. METHODS We developed five different radiomic techniques that extract different aspects of the inter-voxel and inter-parametric relationships within the high-dimensional multiparametric magnetic resonance imaging breast datasets. Our patient cohort consisted of 138 breast patients, where, 97 patients had malignant lesions and 41 patients had benign lesions. Sensitivity, specificity, receiver operating characteristic (ROC) and areas under the curve (AUC) analysis were performed to assess diagnostic performance of the mpRad parameters. Statistical significance was set at p < 0.05. RESULTS The mpRad features successfully classified malignant from benign breast lesions with excellent sensitivity and specificity of 82.5% and 80.5%, respectively, with Area Under the receiver operating characteristic Curve (AUC) of 0.87 (0.81-0.93). mpRad provided a 9-28% increase in AUC metrics over single radiomic parameters. CONCLUSIONS We have introduced the mpRad framework that extends radiomic analysis from single images to multiparametric datasets for better characterization of the underlying tissue biology.
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Affiliation(s)
- Vishwa S Parekh
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Department of Computer Science, The Johns Hopkins University, Baltimore, MD, 21208, USA
| | - Michael A Jacobs
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
- Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
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Sollini M, Cozzi L, Ninatti G, Antunovic L, Cavinato L, Chiti A, Kirienko M. PET/CT radiomics in breast cancer: Mind the step. Methods 2020; 188:122-132. [PMID: 31978538 DOI: 10.1016/j.ymeth.2020.01.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/08/2020] [Accepted: 01/14/2020] [Indexed: 12/22/2022] Open
Abstract
The aim of the present review was to assess the current status of positron emission tomography/computed tomography (PET/CT) radiomics research in breast cancer, and in particular to analyze the strengths and weaknesses of the published papers in order to identify challenges and suggest possible solutions and future research directions. Various combinations of the terms "breast", "radiomic", "PET", "radiomics", "texture", and "textural" were used for the literature search, extended until 8 July 2019, within the PubMed/MEDLINE database. Twenty-six articles fulfilling the inclusion/exclusion criteria were retrieved in full text and analyzed. The studies had technical and clinical objectives, including diagnosis, biological characterization (correlation with histology, molecular subtypes and IHC marker expression), prediction of response to neoadjuvant chemotherapy, staging, and outcome prediction. We reviewed and discussed the selected investigations following the radiomics workflow steps related to the clinical, technical, analysis, and reporting issues. Most of the current evidence on the clinical role of PET/CT radiomics in breast cancer is at the feasibility level. Harmonized methods in image acquisition, post-processing and features calculation, predictive models and classifiers trained and validated on sufficiently representative datasets, adherence to consensus guidelines, and transparent reporting will give validity and generalizability to the results.
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Affiliation(s)
- Martina Sollini
- Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy
| | - Luca Cozzi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy; Radiation Oncology, Humanitas Clinical and Research Center - IRCCS, Rozzano (Milan), Italy
| | - Gaia Ninatti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy
| | - Lidija Antunovic
- Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano (Milan), Italy
| | - Lara Cavinato
- Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano (Milan), Italy
| | - Arturo Chiti
- Nuclear Medicine, Humanitas Clinical and Research Center - IRCCS, Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy
| | - Margarita Kirienko
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (Milan), Italy.
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18
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Nana RN, Boadu M, Moyo MN, Gyekye PK, Botwe BO. PRELIMINARY STAFF DOSE ASSESSMENT FOR COMMON FLUOROSCOPY GUIDED PROCEDURES AT KORLE-BU TEACHING HOSPITAL, ACCRA, GHANA. Radiat Prot Dosimetry 2019; 185:351-354. [PMID: 30824922 DOI: 10.1093/rpd/ncz021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 01/23/2019] [Accepted: 02/01/2019] [Indexed: 06/09/2023]
Abstract
Preliminary studies on effective and eye lens doses of six Radiologists, four Cardiologists have been conducted for a period of 3 months. Electronic dosemeters positioned under and over lead apron of staff were used for the dosimetry. The estimated effective dose per month to Cardiologist and Radiologist were 0.01-0.07 mSv and 0.03-0.14 mSv, respectively. The estimated eye lens doses per month to Cardiologists and Radiologists were also 0.15-0.30 mSv and 0.53-3.39 mSv, respectively. The effective doses per month to staff were below the ICRP acceptable limit of 1.67 mSv/month but the upper limit of the range of estimated eye lens dose exceeded the ICRP acceptable limit by a factor of 2. Regular use of protective goggles and consistent eye lens dose monitoring is encouraged at the hospital for dose optimization.
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Affiliation(s)
- R N Nana
- School of Nuclear and Allied Sciences, University of Ghana, PO Box AE 1, Atomic, Accra, Ghana
- Department of Physics, Faculty of Science, University of Douala, PO Box 24157, Douala, Cameroon
| | - M Boadu
- School of Nuclear and Allied Sciences, University of Ghana, PO Box AE 1, Atomic, Accra, Ghana
- Radiological and Medical Science Research Institute, Ghana Atomic Energy Commission, PO Box LG80, Legon, Accra, Ghana
| | - M N Moyo
- Department of Physics, Faculty of Science, University of Douala, PO Box 24157, Douala, Cameroon
- National Radiation Protection Agency (NRPA), PO Box 33732, Yaoundé, Cameroon
| | - P K Gyekye
- Nuclear Regulatory Authority, PO Box AE 50 Atomic Energy, Kwabenya, Accra, Ghana
| | - B O Botwe
- School of Nuclear and Allied Sciences, University of Ghana, PO Box AE 1, Atomic, Accra, Ghana
- Department of Radiography, School of Biomedical & Allied Health Sciences, University of Ghana, PO Box KB 143, Korle-Bu campus, Accra, Ghana
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19
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Mills M. Does the US medical physics community have the optimal certification model for the next decade? J Appl Clin Med Phys 2019; 20:4-5. [PMID: 31774617 PMCID: PMC6909109 DOI: 10.1002/acm2.12781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 11/09/2022] Open
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20
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Abedi A, Tofighi S, Salehi S, Latterman PT, Basques KD, Gholamrezanezhad A. Reason for exam Imaging Reporting and Data System (RI-RADS): A grading system to standardize radiology requisitions. Eur J Radiol 2019; 120:108661. [PMID: 31610322 DOI: 10.1016/j.ejrad.2019.108661] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/11/2019] [Accepted: 08/23/2019] [Indexed: 11/16/2022]
Abstract
Radiologists often encounter imaging requisitions that lack important information needed for accurate diagnostic studies. Reason for exam Imaging Reporting and Data System (RI-RADS) is proposed as a grading system for evaluation of the quality of clinically pertinent information provided in imaging requisitions. Three categories of information are suggested as key indicators of quality: impression, clinical findings, and the diagnostic question. This scheme is intended to improve the quality of imaging requisitions and overall patient care.
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Affiliation(s)
- Aidin Abedi
- Visiting Research Scholar, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Salar Tofighi
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Sana Salehi
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Paul T Latterman
- Department of Internal Medicine, Olive View-UCLA Medical Center, Los Angeles, CA, USA.
| | - Kyle D Basques
- Department of Radiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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21
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Benitez GB, Fogliatto FS, Cardoso RB, Torres FS, Faccin CS, Dora JM. Systematic Layout Planning of a Radiology Reporting Area to Optimize Radiologists' Performance. J Digit Imaging 2019; 31:193-200. [PMID: 29185102 DOI: 10.1007/s10278-017-0036-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 10/18/2022] Open
Abstract
Optimizing radiologists' performance is a major priority for managers of health services/systems, since the radiologists' reporting activity imposes a severe constraint on radiology productivity. Despite that, methods to optimize radiologists' reporting workplace layout are scarce in the literature. This study was performed in the Radiology Division (RD) of an 850-bed University-based general hospital. The analysis of the reporting workplace layout was carried out using the systematic layout planning (SLP) method, in association with cluster analysis as a complementary tool in early stages of SLP. Radiologists, architects, and hospital managers were the stakeholders consulted for the completion of different stages of the layout planning process. A step-by-step description of the proposed methodology to plan an RD reporting layout is presented. Clusters of radiologists were defined using types of exams reported and their frequency of occurrence as clustering variables. Sectors with high degree of interaction were placed in proximity in the new RD layout, with separation of noisy and quiet areas. Four reporting cells were positioned in the quiet area, grouping radiologists by subspecialty, as follows: cluster 1-abdomen; cluster 2-musculoskeletal; cluster 3-neurological, vascular and head & neck; cluster 4-thoracic and cardiac. The creation of reporting cells has the potential to limit unplanned interruptions and enhance the exchange of knowledge and information within cells, joining radiologists with the same expertise. That should lead to improvements in productivity, allowing managers to more easily monitor radiologists' performance.
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Affiliation(s)
- Guilherme Brittes Benitez
- Industrial Engineering Department, Universidade Federal do Rio Grande do Sul, Avenida Osvaldo Aranha, 99, Porto Alegre, RS, 90035-190, Brazil.
| | - Flavio Sanson Fogliatto
- Industrial Engineering Department, Universidade Federal do Rio Grande do Sul, Avenida Osvaldo Aranha, 99, Porto Alegre, RS, 90035-190, Brazil
| | - Ricardo Bertoglio Cardoso
- Industrial Engineering Department, Universidade Federal do Rio Grande do Sul, Avenida Osvaldo Aranha, 99, Porto Alegre, RS, 90035-190, Brazil
| | | | - Carlo Sasso Faccin
- Radiology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - José Miguel Dora
- Health Operations Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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22
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Hasan A, Visrodia K, Farrell JJ, Gonda TA. Overview and comparison of guidelines for management of pancreatic cystic neoplasms. World J Gastroenterol 2019; 25:4405-4413. [PMID: 31496620 PMCID: PMC6710181 DOI: 10.3748/wjg.v25.i31.4405] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/15/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
Pancreatic cysts are identified at an increasing frequency. Although mucinous cystic neoplasms represent a pre-malignant condition, the majority of these lesions do not progress to cancer. Over the last 10 years several societies have established guidelines for the diagnosis, initial evaluation and surveillance of these lesions. Here we provide an overview of five commonly used guidelines: 2015 American Gastroenterological Association, 2017 International Association of Pancreatology, American College of Gastroenterology 2018, European Study Group and American College of Radiology. We describe the similarities and differences between the methods used to formulate these guidelines, the population they target and their approaches towards initial evaluation and surveillance of cystic lesions.
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Affiliation(s)
- Aws Hasan
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University, New York, NY 10032, United States
| | - Kavel Visrodia
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University, New York, NY 10032, United States
| | - James J Farrell
- Division of Digestive Diseases, Department of Medicine, Yale University, New Haven, CT 06520, United States
| | - Tamas A Gonda
- Division of Digestive and Liver Diseases, Department of Medicine, Columbia University, New York, NY 10032, United States
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Degnan AJ, Ghobadi EH, Hardy P, Krupinski E, Scali EP, Stratchko L, Ulano A, Walker E, Wasnik AP, Auffermann WF. Perceptual and Interpretive Error in Diagnostic Radiology-Causes and Potential Solutions. Acad Radiol 2019; 26:833-845. [PMID: 30559033 DOI: 10.1016/j.acra.2018.11.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 11/19/2018] [Accepted: 11/21/2018] [Indexed: 12/13/2022]
Abstract
Interpretation of increasingly complex imaging studies involves multiple intricate tasks requiring visual evaluation, cognitive processing, and decision-making. At each stage of this process, there are opportunities for error due to human factors including perceptual and ergonomic conditions. Investigation into the root causes of interpretive error in radiology first began over a century ago. In more recent work, there has been increasing recognition of the limits of human image perception and other human factors and greater acknowledgement of the role of the radiologist's environment in increasing the risk of error. This article reviews the state of research on perceptual and interpretive error in radiology. This article focuses on avenues for further error examination, and strategies for mitigating these errors are discussed. The relationship between artificial intelligence and interpretive error is also considered.
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Affiliation(s)
- Andrew J Degnan
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emily H Ghobadi
- Department of Radiology, Northwestern Memorial Hospital, Chicago, Illinois
| | - Peter Hardy
- Department of Radiology, University of Kentucky Medical Center, Lexington, Kentucky
| | - Elizabeth Krupinski
- Department of Radiology & Imaging Sciences, Emory University Hospital, Atlanta, Georgia
| | - Elena P Scali
- Department of Radiology, University of British Columbia, Vancouver, BC Canada
| | - Lindsay Stratchko
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Adam Ulano
- Department of Radiology, University of Vermont Medical Center, The Robert Larner, M.D. College of Medicine at the University of Vermont, Burlington, Vermont
| | - Eric Walker
- Department of Radiology, Penn State Health, Milton S. Hershey Medical Center & Penn State College of Medicine, H066, Hershey, Pennsylvania; Department of Radiology and Nuclear Medicine, Uniformed University of the Health Sciences, Bethesda, Maryland
| | - Ashish P Wasnik
- Department of Radiology, University of Michigan Health System-Michigan Medicine, University Hospital B1D502D, Ann Arbor, Michigan
| | - William F Auffermann
- Department of Radiology and Imaging Sciences, University of Utah School of Medicine, 30 North 1900 East, Rm # 1A71, Salt Lake City, UT 84132, USA.
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Cazzolato MT, Scabora LC, Nesso MR, Milano-Oliveira LF, Costa AF, Kaster DS, Koenigkam-Santos M, Mazzoncini de Azevedo-Marques P, Traina C, Traina AJM. dp-BREATH: Heat maps and probabilistic classification assisting the analysis of abnormal lung regions. Comput Methods Programs Biomed 2019; 173:27-34. [PMID: 31046993 DOI: 10.1016/j.cmpb.2019.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/15/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Identifying abnormalities in chest CT scans is an important and challenging task, demanding time and effort from specialists. Different parts of a single lung image may present both normal and abnormal characteristics. Thus, detecting a single lung as healthy (normal) or not is inaccurate. METHODS In this work we propose dp-BREATH, a method capable of detecting abnormalities in pulmonary tissue regions and directing the specialist's attention to the lung region containing them. It starts by highlighting regions that may indicate pulmonary abnormalities based on the healthy pulmonary tissue behavior using a superpixel-based approach and a heat map visualization. This is achieved by modeling regions of healthy tissue using a statistical model. All regions considered abnormal are modeled and classified according to their probability of containing each of the studied abnormalities. Further, dp-BREATH provides a better recognition of radiological patterns, with the likelihood of a selected lung region to contain abnormalities. RESULTS We validate the statistical model of healthy and abnormal detection using a representative dataset of chest CT scans. The model has shown almost no overlap between healthy and abnormal regions, and the detection of abnormalities presented precision higher than 86%, for all recall values. Additionally, the fitted models describing pulmonary radiological patterns present precision of up to 87%, with a high separation for three of five radiological patterns. CONCLUSIONS dp-BREATH's heat map representation and its list of radiological patterns probabilities provided are intuitive methods to assist physicians during diagnosis.
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Affiliation(s)
- Mirela T Cazzolato
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, SP 13.566-590, Brazil.
| | - Lucas C Scabora
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, SP 13.566-590, Brazil
| | - Marcos R Nesso
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, SP 13.566-590, Brazil
| | | | - Alceu F Costa
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, SP 13.566-590, Brazil
| | - Daniel S Kaster
- Department of Computer Science, University of Londrina, Londrina, PR 86.057-970, Brazil
| | - Marcel Koenigkam-Santos
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP 14049-900, Brazil
| | | | - Caetano Traina
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, SP 13.566-590, Brazil
| | - Agma J M Traina
- Institute of Mathematics and Computer Sciences, University of São Paulo, São Carlos, SP 13.566-590, Brazil.
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Assadi M, Velez E, Najafi MH, Gholamrezanezhad A. The need for standardization of nuclear cardiology reporting and data system (NCAD-RADS): Learning from coronary artery disease (CAD), breast imaging (BI), liver imaging (LI), and prostate imaging (PI) RADS. J Nucl Cardiol 2019; 26:660-665. [PMID: 30374849 DOI: 10.1007/s12350-018-01473-2] [Citation(s) in RCA: 5] [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: 07/18/2018] [Accepted: 09/19/2018] [Indexed: 12/19/2022]
Abstract
Newer structured reporting manners, the reporting and data system (RADS), have made vast steps in improving standardized and structured reporting, allowing better communication between radiologists and referring providers. This has been implemented in several fields: breast (BI-RADS), lung (Lung-RADS), liver (LI-RADS), thyroid (TI-RADS), prostate (PI-RADS), and in cardiovascular radiology (CAD-RADS). The field of nuclear cardiology began its efforts of standardization years ago; however, a widespread standardized reporting structure has not yet been adopted. Such an approach in nuclear cardiology, the nuclear cardiology reporting and data system (NCAD-RADS), will assist radiologists and treating clinicians in conveying and understanding reports and determining the appropriate next steps in management. By linking explicit findings to defined recommendations, patients will receive more consistent and appropriate care.
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Affiliation(s)
- Majid Assadi
- The Persian Gulf Nuclear Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Erik Velez
- Department of Diagnostic Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA
| | | | - Ali Gholamrezanezhad
- Department of Diagnostic Radiology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA.
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Chan SS, Francavilla ML, Iyer RS, Rigsby CK, Hernanz-Schulman M. Clinical decision support: practical implementation at two pediatric hospitals. Pediatr Radiol 2019; 49:486-492. [PMID: 30923880 DOI: 10.1007/s00247-018-4322-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/02/2018] [Revised: 08/13/2018] [Accepted: 12/09/2018] [Indexed: 11/26/2022]
Abstract
Clinical decision support has been identified by the United States government as a method to decrease inappropriate imaging exams and promote judicious use of imaging resources. The adoption of this method will be incentivized by requiring appropriate use criteria to qualify for Medicare reimbursement starting in January 2020. While Medicare reimbursement is unlikely to directly impact pediatric imaging because of largely disparate patient populations, insurance providers typically use Medicare to benchmark their reimbursement guidelines. Therefore soon after their adoption these guidelines could become relevant to pediatric imaging. In this article we discuss how pediatric imaging was initially underrepresented in the clinical decision support realm, and how this was addressed by a subcommittee involving both American College of Radiology and Society for Pediatric Radiology members. We also present the experience of implementing clinical decision support software at two standalone pediatric hospitals and summarize the lessons learned from these deployments.
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Affiliation(s)
- Sherwin S Chan
- Department of Radiology, Children's Mercy Hospital, University of Missouri at Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, USA.
| | - Michael L Francavilla
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ramesh S Iyer
- Department of Radiology, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
| | - Cynthia K Rigsby
- Department of Medical Imaging, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Marta Hernanz-Schulman
- Department of Radiology, Vanderbilt University Medical Center, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA
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Jordan JE, Norbash A. A Call to Improve the Visibility and Access of the American College of Radiology Practice Parameters in Neuroradiology: A Powerful Value Stream Enhancer for Both Neuroradiologists and Patients. AJNR Am J Neuroradiol 2019; 40:213-216. [PMID: 30591509 DOI: 10.3174/ajnr.a5923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 10/29/2018] [Indexed: 11/07/2022]
Abstract
Clinical practice guidelines and clinical practice parameters are among the tools that clinicians and radiologists use to inform decision making in the diagnosis and treatment of patients. Radiologists have been urged to objectively establish their value and measurable contributions to patient care. Radiology's contribution to the health care value stream can be established in the development of sound clinical practice guidelines. Neuroradiologists have been quite active in developing clinical guidelines, particularly in collaboration with the American College of Radiology, but there is a need to increase the visibility and accessibility of such documents. Increasing access and visibility can contribute to improved patient outcomes and an improved overall quality of care.
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Affiliation(s)
- J E Jordan
- From the Department of Radiology (J.E.J.), Providence Little Company of Mary Medical Center, Torrance, California
- Department of Radiology (J.E.J.), Stanford University School of Medicine, Stanford, California
| | - A Norbash
- Department of Radiology (A.N.), University of California, San Diego School of Medicine, La Jolla, California
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Abstract
ISSUE Ultrasound is an integral part of imaging diagnostics but, unlike CT or MRI, requires the physician to have advanced technical skills for the implementation and documentation of studies. CURRENT SITUATION Owing to poor remuneration and the large effort required, ultrasound is not a priority at many institutions, and compared to CT, MRI or interventions, little reward is given to those committed to ultrasound. Intense practical teaching is rarely given. As a result, residents have to teach themselves or gain experience during rotations outside radiology. In some cases, they are not educated at all. Only rarely do residents in radiology participate in certified ultrasound courses, compared to other clinical disciplines. ONGOING DEVELOPMENTS: (1) Standardized ultrasound curricula accompanying resident training, training focused on contrast-enhanced ultrasound, ultrasound-guided interventions, vascular ultrasound, and typical radiological applications of ultrasound like image fusion for biopsies or therapeutic interventions; (2) interdisciplinary ultrasound centers; (3) fostering of ultrasound education by the German Radiological Society (DRG) through intensive courses during the annual meeting. ACHIEVEMENTS The above measures will help to increase skill and dexterity of radiologists in ultrasound, to introduce typical radiological applications of ultrasound into a broader field of applications and increase the awareness of these methods, and to strengthen the role of ultrasound in resident training. FUTURE REQUIREMENTS: (1) One senior radiologist in charge of ultrasound in each department; (2) communication of and adherence to examination and documentation standards; (3) demonstration of ultrasound studies during rounds and boards; (4) interdisciplinary centers for ultrasound education.
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Affiliation(s)
- Marc-André Weber
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Rostock, Ernst-Heydemann-Str. 6, 18057, Rostock, Deutschland.
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
| | - Stefan Delorme
- Abteilung Radiologie (E010), Deutsches Krebsforschungszentrum Heidelberg, Heidelberg, Deutschland
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Kawamura S. [14.The Regional Collaboration Support System Promoted by Japanese Organization of Radiotherapy Quality Management]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2019; 75:1470-1476. [PMID: 31866647 DOI: 10.6009/jjrt.2019_jsrt_75.12.1470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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Šegota D, Diklic A, Jurkovic S. IMPLEMENTATION OF QUALITY ASSURANCE PROGRAM IN RADIOGRAPHY-2-YEAR EXPERIENCE OF COLLABORATION WITH PUBLIC HEALTH INSTITUTIONS IN WEST REGION OF CROATIA. Radiat Prot Dosimetry 2018; 182:329-334. [PMID: 30590844 DOI: 10.1093/rpd/ncy069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 04/11/2018] [Indexed: 06/09/2023]
Abstract
Quality Assurance program on using ionizing radiation is mandatory in all EU member states but this is still not implemented in most facilities in Croatia mostly because of a lack of medical physicists in diagnostic radiology. Since public health institutions in Croatia do not employ medical physicists in diagnostic radiology, collaboration between these institutions in west region of Croatia with Clinical Hospital Center Rijeka (CHC) was initiated during the year 2015. Physicists from CHC Rijeka performed periodical Quality Control (QC) tests and were included in optimization process. Results of QC tests during the period of 2 years showed a lot of improvements-equipment is maintained more frequently, some old units were replaced with new ones and all institutions acquired QC equipment so radiographers could perform daily and monthly QC tests. All these activities showed that medical physics support in radiology departments is necessary and can improve clinical practice.
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Affiliation(s)
- Doris Šegota
- Medical Physics Department, Clinical Hospital Centre Rijeka, Krešimirova 42, Rijeka, Croatia
| | - Ana Diklic
- Medical Physics Department, Clinical Hospital Centre Rijeka, Krešimirova 42, Rijeka, Croatia
| | - Slaven Jurkovic
- Medical Physics Department, Clinical Hospital Centre Rijeka, Krešimirova 42, Rijeka, Croatia
- Department of Physics, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, Rijeka, Croatia
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Tang L. [Radiological evaluation of advanced gastric cancer: from image to big data radiomics]. Zhonghua Wei Chang Wai Ke Za Zhi 2018; 21:1106-1112. [PMID: 30370508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Following the increased demand of personalized medicine to precise radiology in advanced gastric cancer, there is particular need for objective and powerful surrogate to help the gastro-radiology to break through the bottleneck of imaging resolution and the defect of subjective diagnosis, which can further improve the efficacy of staging and response evaluation. On the basis of the existing imaging resolution, the radiomics can perform massive data mining through texture analysis and big data, using artificial intelligence deep learning and other algorithms to screen and integrate images and clinical features for modeling and diagnosis, which may further improve the efficacy of staging and response evaluation theoretically. In this paper, we focused on gastro-radiology and radiomics, and reviewed five dimensions progressively: (1) As the first choice for staging and response evaluation, CT application is limited by radiologists' ability to excavate image features and information integration, which needs more powerful image processing method. (2) Radiomics texture analysis can provide massive objective image information that can not be identified by the radiologists' naked eye. It is more detailed and provides quantitative evaluation of the characteristics of tumors better than the radiologists' subjective vision analysis, which can dig potential microscopic information. In the recent two years, the research on the application has been progressing rapidly, covering almost all the solid tumors, and solving the various clinical focuses using entropy, skewness, heterogeneity and other texture analysis indicators. (3) The research progress of radiomics in gastric cancer from the following three directions was summarized: differential diagnosis and biological behavior analysis, staging, and response prediction and evaluation. The current research confirmed the high efficiency of radiomics and texture analysis in differentiating different types, stages and responders of gastric cancer, which can act at least as an important supplement for the subjective evaluation of the radiologists.(4) The congenital defects of radiomics and the current problems on research were summarized, in order to avoid misuse and pitfalls. (5) The radiologists need not to worry about being replaced in the expectation of the future AI radiomics; on the contrary, AI radiomics will be a good assistant. The radiologist should actively take part in the MDT and cooperate with multi-center colleagues to promote the development of large data radiomics in gastric cancer.
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Affiliation(s)
- Lei Tang
- Department of Radiology, Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education), Peking University Cancer Hospital and Institute, Beijing 100142, China
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Shi C, Parker BC, Rong Y. Parallel/Opposed Editorial: DMP/residency programs are more sustainable than MPAs for the future of the medical physics profession. J Appl Clin Med Phys 2018; 19:330-334. [PMID: 30117259 PMCID: PMC6123128 DOI: 10.1002/acm2.12439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 07/27/2018] [Accepted: 07/27/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chengyu Shi
- Department of Medical PhysicsMemorial Sloan Kettering Cancer CenterBasking RidgeNJUSA
| | - Brent C. Parker
- Division of Physics and EngineeringDepartment of Radiation OncologyThe University of Texas Medical BranchGalvestonTXUSA
| | - Yi Rong
- Department of Radiation OncologyUniversity of California Davis Comprehensive Cancer CenterSacramentoCAUSA
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Symonds CJ, Seal P, Ghaznavi S, Cheung WY, Paschke R. Thyroid nodule ultrasound reports in routine clinical practice provide insufficient information to estimate risk of malignancy. Endocrine 2018; 61:303-307. [PMID: 29802606 DOI: 10.1007/s12020-018-1634-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 03/22/2018] [Accepted: 05/10/2018] [Indexed: 01/25/2023]
Abstract
PURPOSE Ultrasonographic characteristics of thyroid nodules play an important role in estimating the risk of malignancy (ROM). Guidelines mandate all thyroid nodules be characterized by six key ultrasonographic features to estimate the ROM. Our objective was to evaluate how frequently these characteristics were identified by radiologists and the ensuing utility to estimate ROM. METHODS We retrospectively reviewed 1930 consecutive diagnostic thyroid ultrasound reports from a large community radiology practice. A total of 1339 individual patients were found to have one or more thyroid nodules. Each report was analyzed for six key ultrasonographic features. A utility score (UtS) was calculated (range 0-6) with a single point given for a comment on each feature. RESULTS Of the 1339 patients, 75% of the studies reported more than one nodule (mean number of nodules = 3.4). Mean maximal diameter of the largest nodule per patient = 1.8 cm. The mean UtS was 2.57. Nodule size did not influence the UtS.: Nodule <1 cm (UtS: 2.53), 1-2 cm (UtS: 2.68) and >2 cm (UtS: 2.49). We believe a UtS of four or greater is needed to confidently estimate ROM: we found this in 13.7% of reports. CONCLUSIONS Our retrospective analysis of a large number of consecutive thyroid ultrasound reports in routine clinical practice suggests that the vast majority provide insufficient information to allow the clinician to risk stratify the nodules by estimating the ROM. This could lead to both over-diagnosis and over-treatment of benign/indolent thyroid lesions or under-diagnosis of clinically important thyroid cancers.
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Affiliation(s)
- Christopher John Symonds
- Section of Endocrinology and Metabolism, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Paula Seal
- Department of Diagnostic Imaging, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Sana Ghaznavi
- Section of Endocrinology and Metabolism, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Winson Y Cheung
- Section of Medical Oncology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Ralf Paschke
- Section of Endocrinology and Metabolism, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Abstract
While uncertainty is ubiquitous in medical practice, minimal work to date has been performed to analyze the cause and effect relationship between uncertainty and patient outcomes. In medical imaging practice, uncertainty in the radiology report has been well documented to be a source of clinician dissatisfaction. Before one can effectively create intervention strategies aimed at reducing uncertainty, it must first be better understood through context- and user-specific analysis. One strategy for accomplishing this task is to characterize the source of uncertainty and create user-specific uncertainty profiles which take into account a number of provider-specific variables which may contribute to report uncertainty. The resulting data can in turn be used to create real-time report uncertainty metrics aimed at providing uncertainty analytics at the point of care, for the combined purposes of decision support, improved communication, and enhanced clinical/economic outcomes.
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Affiliation(s)
- Bruce I Reiner
- Maryland VA Healthcare System, 10 North Greene Street, Baltimore, MD, 21201, USA.
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Abstract
OBJECTIVES To determine the appropriateness of medical imaging examinations involving radiation and to estimate the effective radiation dose and costs associated. DESIGN Cross-sectional retrospective study. SETTING Two Spanish public tertiary hospitals. PARTICIPANTS 2022 medical imaging tests were extracted from the radiology information system in February and March of 2014. MRI and ultrasound examinations were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES Five outcomes were set independently by at least two researchers according to four guidelines: (1) appropriate; (2) inappropriate; (3) inappropriate due to repetition, if the timing to carry out next diagnostic tests was incorrect according to guidelines; (4) not adequately justified, if the referral form did not include enough clinical information to allow us to understand the patient's clinical condition; and (5) not included in the guidelines, if the referral could not be matched to a clinical scenario described in the guidelines. We estimated the prevalence of the five categories according to relevant clinical and sociodemographic variables and the effective radiation dose and costs for each category. RESULTS Approximately half of the imaging tests were deemed as appropriate (967, 47.8%) while one-third (634, 31.4%) were considered inappropriate. 19.6% of the effective dose and 25.2% of the cost were associated with inappropriate tests. Women were less likely than men to have an imaging test classified as appropriate (adjusted OR 0.70,95% CI 0.57 to 0.86). Imaging tests requested by general practitioners were less likely to be considered appropriate than those requested by central services (adjusted OR 0.60, 95% CI 0.38 to 0.93). Mammography and CT were more likely to be appropriate than conventional X-rays. CONCLUSION There was a significant frequency of inappropriateness, which resulted in a high percentage of associated effective radiation dose. Percentage of inappropriateness depends on sociodemographic and clinical characteristics such as sex, age, referral physician and medical imaging test.
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Affiliation(s)
| | - Ildefonso Hernandez-Aguado
- Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Barcelona, Spain
- Department of Public Health, History of Science and Gynecology, Miguel Hernández University, Alicante, Spain
| | - María Pastor-Valero
- Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Barcelona, Spain
- Department of Public Health, History of Science and Gynecology, Miguel Hernández University, Alicante, Spain
| | - José Vilar
- Radiology Department, Peset Hospital, Valencia, Spain
| | | | - Blanca Lumbreras
- Centro de Investigacion Biomedica en Red de Epidemiologia y Salud Publica, Barcelona, Spain
- Department of Public Health, History of Science and Gynecology, Miguel Hernández University, Alicante, Spain
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Affiliation(s)
- Colin J Martin
- Honorary clinical senior lecturer, University of Glasgow, Scotland, United Kingdom
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37
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Abstract
Limitations of screening mammography in patients with dense breasts combined with the significant increased risk for breast cancer have made the issue of dense breasts a matter of great concern in recent years, leading to advocacy for policy change and legislation. Dense breast notification legislation requires direct patient notification of mammographic results indicating the presence of dense breast tissue. The aim of this study was to summarize the state of dense breast notification legislation across the country. The general intent of dense breast notification legislation is to increase awareness of dense breasts and encourage patients to discuss the clinical issues with their physicians. It was first enacted in Connecticut in 2009, and since then, 27 other states have passed, rejected, or considered dense breast notification legislation. At the federal level, a bill was introduced in October 2011, but it was not enacted. There are significant differences in the language of the laws from state to state that complicate implementation. Furthermore, legislated recommendations for possible additional testing are often unaccompanied by legal provisions for insurance coverage, which potentially results in unequal access.
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Affiliation(s)
| | - Ruth C Carlos
- Department of Radiology, University of Michigan School of Medicine, Ann Arbor, Michigan; University of Michigan Institute for Healthcare Policy and Innovation, Ann Arbor, Michigan.
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38
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Abstract
Artificial intelligence (AI), especially deep learning, has the potential to fundamentally alter clinical radiology. AI algorithms, which excel in quantifying complex patterns in data, have shown remarkable progress in applications ranging from self-driving cars to speech recognition. The AI application within radiology, known as radiomics, can provide detailed quantifications of the radiographic characteristics of underlying tissues. This information can be used throughout the clinical care path to improve diagnosis and treatment planning, as well as assess treatment response. This tremendous potential for clinical translation has led to a vast increase in the number of research studies being conducted in the field, a number that is expected to rise sharply in the future. Many studies have reported robust and meaningful findings; however, a growing number also suffer from flawed experimental or analytic designs. Such errors could not only result in invalid discoveries, but also may lead others to perpetuate similar flaws in their own work. This perspective article aims to increase awareness of the issue, identify potential reasons why this is happening, and provide a path forward. Clin Cancer Res; 24(3); 532-4. ©2017 AACR.
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Affiliation(s)
- Hugo J W L Aerts
- Harvard Medical School, Dana-Farber Cancer Institute, and Brigham and Women's Hospital, Boston, Massachusetts.
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Lichstein PM, Wilson SC, Ward WG. Compromise of Radiology Studies From Nonstandardized Viewing Platforms. Orthopedics 2018; 41:e136-e141. [PMID: 29257194 DOI: 10.3928/01477447-20171213-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 11/13/2017] [Indexed: 02/03/2023]
Abstract
There is no standardization of proprietary radiology viewing software platform functions allowing recorded digital radiographic imaging studies on compact discs (CDs) to be viewed in a standardized manner at subsequent institutions. Primary concerns include the following: (1) a large number of image viewing software platforms with a wide variety of features making familiarity with use difficult, (2) an inordinate amount of time required to load imaging data, (3) imaging data may not upload or be viewed with the care center's picture archiving and communication system, (4) navigation through imaging studies is inconsistent and tedious, and (5) image viewing requires additional software downloads. Additionally, images generated from "outside CDs" are frequently of low quality and resolution, eliminating the ability to render a reliable diagnosis. The authors sought to determine the frequency and extent of these functional problems by analyzing a sample of 50 consecutive radiology CDs containing imaging studies referred to a university orthopedic oncology practice. Eighteen different viewing software platforms were encountered. Only 24 (48%) of the CDs met all optimal system criteria. Mean time required to load the studies was 3.4 seconds using the picture archiving and communication system and 37.9 seconds using the proprietary viewing software (P<.001). Fifteen (30%) of the CDs did not upload to the institution's picture archiving and communication system, and 18 (36%) required additional downloads and/or license agreements. Four CDs did not contain Digital Imaging and Communications in Medicine images. Physicians using radiology studies on CDs encounter numerous difficulties in evaluating patients' imaging data because of the plethora of viewing software platforms. These difficulties add time and cost and compromise patient care. [Orthopedics. 2018; 41(1):e136-e141.].
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Ginocchio L, Duszak R, Nicola GN, Rosenkrantz AB. Historic Physician Quality and Reporting System Reporting by Radiologists: A Wake-up Call to Avoid Penalties Under the Medicare Access and CHIP Reauthorization Act (MACRA). J Am Coll Radiol 2017; 15:243-249. [PMID: 29107575 DOI: 10.1016/j.jacr.2017.08.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 07/25/2017] [Revised: 08/16/2017] [Accepted: 08/22/2017] [Indexed: 11/19/2022]
Abstract
PURPOSE The Medicare Access and CHIP Reauthorization Act (MACRA) Quality performance category is the successor to the Physician Quality and Reporting System (PQRS) program and now contributes to physicians' income adjustments based upon performance rates calculated for a minimum of six measures. We assess radiologists' frequency of reporting PQRS measures as a marker of preparedness for MACRA. METHODS Medicare-participating radiologists were randomly searched through the Physician Compare website until identifying 1,000 radiologists who reported at least one PQRS measure. Associations were explored between the number of reported measures and radiologist characteristics. RESULTS For PQRS-reporting radiologists, the number of reported PQRS measures was 1 (25.2%), 2 (27.3%), 3 (18.2%), 4 (19.3%), 5 (8.3%), and 6 (1.7%). The most commonly reported measures were "documenting radiation exposure time for procedures using fluoroscopy" (64.3%) and "accurate measurement of carotid artery narrowing" (56.8%). Reporting at least two measures was significantly (P < .001) more likely for nonacademic (77.3%) versus academic (44.9%) radiologists, generalists (82.7%) versus subspecialists (59.1%), and radiologists in smaller (≤9 members) (84.7%) versus larger (≥100 members) (39.7%) practices. Reporting six measures was significantly (P < .05) more likely for generalists (2.6%) versus subspecialists (0.4%). CONCLUSION Most PQRS-reporting radiologists reported only one or two measures, well below MACRA's requirement of six. Radiologists continuing such reporting levels will likely be disadvantaged in terms of potential payment adjustments under MACRA. Lower reporting rates for academic and subspecialized radiologists, as well as those in larger practices, may relate to such radiologists' reliance on their hospitals or networks for PQRS reporting. Qualified clinical data registries should be embraced to facilitate more robust measure reporting.
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Affiliation(s)
- Luke Ginocchio
- Department of Radiology, NYU Langone Medical Center, New York, New York
| | - Richard Duszak
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
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Covington MF, Rhodes DJ, Pizzitola VJ. Molecular Breast Imaging and the 2016 Update to the ACR Appropriateness Criteria for Breast Cancer Screening. J Am Coll Radiol 2017; 13:1408. [PMID: 27916107 DOI: 10.1016/j.jacr.2016.09.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 09/14/2016] [Accepted: 09/18/2016] [Indexed: 11/19/2022]
Affiliation(s)
- Matthew F Covington
- Department of Radiology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ 85259.
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Wildenberg JC, Chen PH, Scanlon MH, Cook TS. Attending Radiologist Variability and Its Effect on Radiology Resident Discrepancy Rates. Acad Radiol 2017; 24:694-699. [PMID: 28130051 DOI: 10.1016/j.acra.2016.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 04/05/2016] [Revised: 11/23/2016] [Accepted: 12/01/2016] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Discrepancy rates for interpretations produced in a call situation are one metric to evaluate residents during training. Current benchmarks, reported in previous studies, do not consider the effects of practice pattern variability among attending radiologists. This study aims to investigate the impact of attending variability on resident discrepancy rates to determine if the current benchmarks are an accurate measure of resident performance and, if necessary, update discrepancy benchmarks to accurately identify residents performing below expectations. MATERIALS AND METHODS All chest radiographs, musculoskeletal (MSK) radiographs, chest computed tomographies (CTs), abdomen and pelvis CTs, and head CTs interpreted by postgraduate year-3 residents in a call situation over 5 years were reviewed for the presence of a significant discrepancy and composite results compared to prior findings. Simulations of the expected discrepancy distribution for an "average resident" were then performed using Gibbs sampling, and this distribution was compared to the actual resident distribution. RESULTS A strong inverse correlation between resident volume and discrepancy rates was found. There was wide variability among attendings in both overread volume and propensity to issue a discrepancy, although there was no significant correlation. Simulations show that previous benchmarks match well for chest radiographs, abdomen and pelvis CTs, and head CTs but not for MSK radiographs and chest CTs. The simulations also demonstrate a large effect of attending practice patterns on resident discrepancy rates. CONCLUSIONS The large variability in attending practice patterns suggests direct comparison of residents using discrepancy rates is unlikely to reflect true performance. Current benchmarks for chest radiographs, abdomen and pelvis CTs, and head CTs are appropriate and correctly flag residents whose performance may benefit from additional attention, whereas those for MSK radiographs and chest CTs are likely too strict.
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Affiliation(s)
- Joseph C Wildenberg
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104.
| | - Po-Hao Chen
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104
| | - Mary H Scanlon
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104
| | - Tessa S Cook
- Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St., Philadelphia, PA 19104
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Abstract
Besides providing spatial anatomic information on heart valves, real-time three-dimensional echocardiography (3DE) combined with color Doppler has the potential to overcome the limitations of flow quantification inherent to conventional 2D color Doppler methods. Recent studies validated the application of color Doppler 3DE (cD-3DE) for the quantification of regurgitation flow based on the vena contracta area (VCA) and the proximal isovelocity surface area (PISA) methods. Particularly the assessment of VCA by cD-3DE led to a change of paradigm by understanding of the VCA as being strongly asymmetric in the majority of patients and etiologies. This review provides a comprehensive description of the different concepts of cD-3DE-based flow quantification in the setting of different valvular heart diseases and their presentation in recent guidelines.
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Affiliation(s)
- T Buck
- Medizinische Klinik III, Klinik für Kardiologie, Klinikum Westfalen, Am Knappschaftskrankenhaus 1, 44309, Dortmund, Deutschland.
| | - L Bösche
- Medizinische Universitätsklinik II - Kardiologie und Angiologie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland
| | - B Plicht
- Medizinische Klinik III, Klinik für Kardiologie, Klinikum Westfalen, Am Knappschaftskrankenhaus 1, 44309, Dortmund, Deutschland
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Gassenmaier S, Armbruster M, Haasters F, Helfen T, Henzler T, Alibek S, Pförringer D, Sommer WH, Sommer NN. Structured reporting of MRI of the shoulder - improvement of report quality? Eur Radiol 2017; 27:4110-4119. [PMID: 28289942 DOI: 10.1007/s00330-017-4778-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [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: 09/27/2016] [Revised: 02/03/2017] [Accepted: 02/13/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. METHODS Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning. NRs were generated during clinical routine. Corresponding SRs were created using a dedicated template. All 60 reports were evaluated by two experienced orthopaedic shoulder surgeons using a questionnaire that included eight questions. RESULTS Eighty per cent of the SRs were fully complete without any missing key features whereas only 45% of the NRs were fully complete (p < 0.001). The extraction of information was regarded to be easy in 92% of the SRs and 63% of the NRs. The overall quality of the SRs was rated better than that of the NRs (p < 0.001). CONCLUSIONS Structured reporting of shoulder MRI improves the readability as well as the linguistic quality of radiological reports, and potentially leads to a higher satisfaction of referring physicians. KEY POINTS • Structured MRI reports of the shoulder improve readability. • Structured reporting facilitates information extraction. • Referring physicians prefer structured reports to narrative free text reports. • Structured MRI reports of the shoulder can reduce radiologist re-consultations.
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Affiliation(s)
- Sebastian Gassenmaier
- Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany.
| | - Marco Armbruster
- Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Florian Haasters
- Department of Knee, Hip and Shoulder Surgery, Schön Klinik München Harlaching, Munich, Germany
- Department of General, Trauma and Reconstructive Surgery, Ludwig-Maximilians-University (LMU), Campus Innenstadt, Munich, Germany
| | - Tobias Helfen
- Department of General, Trauma and Reconstructive Surgery, Ludwig-Maximilians-University (LMU), Campus Innenstadt, Munich, Germany
| | - Thomas Henzler
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim - Heidelberg University, Heidelberg, Germany
| | - Sedat Alibek
- Ambulatory Health Care Center Radiology & Nuclear Medicine, Fürth, Germany
- Department of Diagnostic Radiology, Friedrich-Alexander University, Erlangen-Nuremberg, Germany
| | - Dominik Pförringer
- Department of Trauma Surgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wieland H Sommer
- Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
| | - Nora N Sommer
- Department of Clinical Radiology, Ludwig-Maximilians-University (LMU), Campus Großhadern, Marchioninistraße 15, 81377, Munich, Germany
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Yang H, Schaffer K, Liu L, Mahesh M, Yousem DM. Benchmarking Lumbar Puncture Fluoroscopy Time during Fellowship Training. AJNR Am J Neuroradiol 2017; 38:656-658. [PMID: 27908868 DOI: 10.3174/ajnr.a5031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 10/08/2016] [Indexed: 11/07/2022]
Abstract
We sought to establish a guide for identifying fellowship competency in performing fluoroscopically guided lumbar punctures. With a linear mixed-effects model, we compared the fluoroscopy time between the first and last 3 months of neuroradiology training. During 7 years, 55 fellows performed 1142 and 861 lumbar punctures in the first and last quarters of training. A target fluoroscopy time of 0.26 minutes, the upper 95% confidence interval, can serve as a fellowship benchmark for successfully achieving competence in fluoroscopically guided lumbar punctures.
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Affiliation(s)
- H Yang
- From the Division of Neuroradiology (H.Y., K.S., L.L., M.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
- Shandong Medical Imaging Research Institute (H.Y.), Shandong University, Jinan, Shandong, China
| | - K Schaffer
- From the Division of Neuroradiology (H.Y., K.S., L.L., M.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - L Liu
- From the Division of Neuroradiology (H.Y., K.S., L.L., M.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - M Mahesh
- From the Division of Neuroradiology (H.Y., K.S., L.L., M.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - D M Yousem
- From the Division of Neuroradiology (H.Y., K.S., L.L., M.M., D.M.Y.), The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
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Aspelin P, Nordenström J. [Value-based radiology - from efficiency to benefit]. Lakartidningen 2017; 114:EEYL. [PMID: 28195627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Peter Aspelin
- Dept of Radiology - Stockholm, Sweden Dept of Radiology - Stockholm, Sweden
| | - Jörgen Nordenström
- Karolinska Institutet - Department of Molecular Medicine and Surgery Stockholm, Sweden Karolinska Institutet - Department of Molecular Medicine and Surgery Stockholm, Sweden
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47
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Interpretation of mammography screenings. Clin Privil White Pap 2017;:1-16. [PMID: 28165211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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48
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Muszyńska-Graca M, Dąbkowska B, Brewczyński PZ. [Guidelines for the use of the International Classification of Radiographs of Pneumoconioses of the International Labour Office (ILO): Substantial changes in the currrent edition]. Med Pr 2016; 67:833-837. [PMID: 28005090 DOI: 10.13075/mp.5893.00493] [Citation(s) in RCA: 8] [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] [Indexed: 10/20/2022] Open
Abstract
The International Classification of Radiographs of Pneumoconioses is the scheme worked out by the International Labour Office in Geneva (ILO), to register radiographic chest abnormalities in a well-ordered, reproducible and comparable way. It is used for diagnosing abnormalities caused by dust exposure. Guidelines for the use of the ILO International Classification of Radiographs of Pneumoconioses contain detailed information and recommendations on how to use the classification, as well as how the chest X-ray examination should be performed and recorded. To facilitate the diagnosis of observed abnormalities the classification is completed by the set of standard radiograms illustrating typical irregularities referring to lungs and pleura, included in the classification. The article presents the key information on classification and the most important amendments adopted in the 2000 and 2011 ILO guidelines revisions. These changes refer to radiographs quality assessment, the way of presenting abnormalities registered in standard radiographs (QUAD set, digital images) and registration of failures not related to dust exposure. Particularly important complements result from the development of radiological imaging techniques. They are concerned about the classification of radiographic images of the chest recorded digitally. Med Pr 2016;67(6):833-837.
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Affiliation(s)
- Maja Muszyńska-Graca
- Instytut Medycyny Pracy i Zdrowia Środowiskowego / Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland (Zakład Zdrowia Środowiskowego i Epidemiologii / Department of Environmental Health and Epidemiology).
| | - Beata Dąbkowska
- Instytut Medycyny Pracy i Zdrowia Środowiskowego / Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland (Zakład Zdrowia Środowiskowego i Epidemiologii / Department of Environmental Health and Epidemiology).
| | - Piotr Z Brewczyński
- Instytut Medycyny Pracy i Zdrowia Środowiskowego / Institute of Occupational Medicine and Environmental Health, Sosnowiec, Poland (Zakład Szkodliwości Biologicznych i Immunoalergologii / Department of Biohazard and Immunoallergology).
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49
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Alcaraz M, Velasco F, Olivares A, Velasco E, Canteras M. DOSE REFERENCE LEVELS IN SPANISH INTRAORAL DENTAL RADIOLOGY: STABILISATION OF THE INCORPORATION OF DIGITAL SYSTEMS IN DENTAL CLINICAL PRACTICES. Radiat Prot Dosimetry 2016; 172:422-427. [PMID: 26705354 DOI: 10.1093/rpd/ncv508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 10/20/2015] [Accepted: 11/11/2015] [Indexed: 06/05/2023]
Abstract
A total of 34 044 official quality assurance reports in dental radiodiagnostic surgery from 16 regions of Spain, compiled from 2002 to 2014, were studied in order to determine the progress of diagnostic reference levels (DRLs) for obtaining diagnostic images under normal conditions for clinical practice in Spanish dental clinics. A DRL of 2.8 mGy was set in 2014, which represents a 41.7 % decrease compared with that of 2002 (4.8 mGy). Over the same time period, the mean dose fell by 55.2 %. However, over the last 3 y, the stabilisation of the mean dose administered to patients has been observed with only a 6.7 % reduction in DRLs, which corresponds to the stabilisation of dental radiodiagnostic surgery on replacing the use of radiographic film with digital imaging systems.
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Affiliation(s)
- M Alcaraz
- Department of Radiology and Physical Medicine, Faculty of Medicine/Dentistry, University of Murcia, Campus Espinardo, Murcia 30100, Spain
| | - F Velasco
- Department of Radiology and Physical Medicine, Faculty of Medicine/Dentistry, University of Murcia, Campus Espinardo, Murcia 30100, Spain
| | - A Olivares
- Department of Radiology and Physical Medicine, Faculty of Medicine/Dentistry, University of Murcia, Campus Espinardo, Murcia 30100, Spain
| | - E Velasco
- Department of Radiology and Physical Medicine, Faculty of Medicine/Dentistry, University of Murcia, Campus Espinardo, Murcia 30100, Spain
| | - M Canteras
- Department of Biostatistics, Faculty of Medicine/Dentistry, University of Murcia, Campus Espinardo, Murcia 30100, Spain
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Lim H, Linet MS, Van Dyke ME, Miller DL, Simon SL, Sigurdson AJ, Kitahara CM. Changing Patterns in the Performance of Fluoroscopically Guided Interventional Procedures and Adherence to Radiation Safety Practices in a U.S. Cohort of Radiologic Technologists. AJR Am J Roentgenol 2016; 207:1350-1359. [PMID: 27575031 PMCID: PMC8190773 DOI: 10.2214/ajr.15.15979] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Information is limited on changes over time in the types of fluoroscopically guided interventional procedures performed and associated radiation safety practices used by radiologic technologists. MATERIALS AND METHODS Our study included 12,571 U.S. radiologic technologists who were certified for at least 2 years in 1926-1982 and who reported in a 2012-2013 survey that they ever performed or assisted with fluoroscopically guided interventional procedures. They completed a mailed questionnaire in 2013-2014 describing their detailed work practices for 21 fluoroscopically guided interventional procedures and associated radiation safety practices from the 1950s through 2009. RESULTS Overall, the proportion of technologists who reported working with therapeutic fluoroscopically guided interventional procedures, including percutaneous coronary interventions, increased over time, whereas the proportion of technologists who worked with diagnostic fluoroscopically guided interventional procedures, including diagnostic cardiovascular catheterization and neuroangiographic procedures, decreased. We also observed substantial increases in the median number of times per month that technologists worked with diagnostic cardiovascular catheterizations and percutaneous coronary interventions. In each time period, most technologists reported consistently (≥ 75% of work time) wearing radiation monitoring badges and lead aprons during fluoroscopically guided interventional procedures. However, fewer than 50% of the technologists reported consistent use of thyroid shields, lead glasses, and room shields during fluoroscopically guided interventional procedures, even in more recent time periods. CONCLUSION This study provides a detailed historical assessment of fluoroscopically guided interventional procedures performed and radiation safety practices used by radiologic technologists from the 1950s through 2009. Results can be used in conjunction with badge dose data to estimate organ radiation dose for studies of radiation-related health risks in radiologic technologists who have worked with fluoroscopically guided interventional procedures.
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Affiliation(s)
- Hyeyeun Lim
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Miriam E. Van Dyke
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Donald L. Miller
- Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD
| | - Steven L. Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Alice J. Sigurdson
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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