Journal of the American College of Radiology最新文献

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Wait—They Had Another Miss? 等等——他们又失误了？？

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.08.050

Jennifer Nathan MD , Frank Lexa MD

引用次数: 0

Preoperative Breast MRI: Striving for Precision and Equity in Surgical Planning 术前乳房MRI：在手术计划中力求精确和公平。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.10.002

Derek L. Nguyen MD

引用次数: 0

Association of Interventional Radiologist Clinical Evaluation and Management Services and Procedural Complexity 介入放射科医师临床评估和管理服务及程序复杂性协会。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.08.048

Eric W. Christensen PhD , Alexandra R. Drake MPH , Luke R. Wilkins MD , Minhajuddin Khaja MD , Nicole A. Lamparello MD , Richard Duszak Jr. MD , Elizabeth Y. Rula PhD

Purpose

Clinical evaluation and management (E&M) services performed by interventional radiologists may be undervalued by radiology practices compared with higher work relative value unit (wRVU) interventional radiology (IR) procedural services. The aim of this study was to assess whether higher E&M provision is associated with higher IR procedural complexity and the contribution of nonphysician practitioners (NPPs) in delivering IR services.

Methods

Using claims data from a 5% sample of Medicare beneficiaries (2022), the proportion of IR-related work (invasive procedures and E&M) for radiologists and NPPs was determined. Associations of E&M services and procedural complexity were assessed by each radiologist’s proportion of IR-related work. In radiology-only practices, NPPs’ IR-related work was assessed relative to the practice’s IR focus.

Results

A total of 30,467 radiologists met the selection criteria, collectively with 168,029 procedure and 18,051 E&M claims. Of these, 51.9% and 4.5% provided >0% and >90% IR-related work, respectively. Comparing radiologists with >0% to 10% versus >90% to 100% IR-related work, average wRVUs were 1.52 (95% confidence interval [CI], 1.50-1.54) versus 3.08 (95% CI, 3.01-3.16) per procedure and 1.42 (95% CI, 1.29-1.55) versus 1.72 (95% CI, 1.68-1.77) per E&M visit. Likewise, E&M claims per procedure were 0.01 (95% CI, 0.00-0.01) versus 0.66 (95% CI, 0.06-1.25), respectively. NPPs’ IR-related work shifted from majority (84.5%) procedural at practices without IRs to majority (86.0%) E&M at majority-IR practices.

Conclusions

Radiologists with higher proportions of IR-related work billed more E&M claims per procedure and had higher average procedural complexity. These observed associations indicate that practice leaders should not consider the contribution of procedural and E&M services in isolation but recognize their interdependence with high-level IR practice.

目的：与较高工作相对价值单位（wRVU）介入放射学（IR）程序服务相比，介入放射科医师的临床评估和管理（E&M）服务可能被放射学实践低估。本研究的目的是评估更高的E&M提供是否与更高的IR程序复杂性和非医师从业人员（NPPs）在提供IR服务方面的贡献有关。方法：使用5%的医疗保险受益人样本（2022年）的索赔数据，确定放射科医生和npp的ir相关工作（侵入性手术和E&M）的比例。通过每位放射科医生在红外相关工作中所占的比例来评估E&M服务和程序复杂性的关联。在只有放射学的实践中，核电站的红外相关工作是相对于实践的红外焦点进行评估的。结果：共有30,467名放射科医生符合选择标准，共计168,029项手术和18,051项E&M索赔。其中，51.9%和4.5%分别提供了50%和90%的ir相关工作。对比放射科医生的ir相关工作为>0% - 10%和>90% - 100%，每次手术的平均wRVUs分别为1.52（95%置信区间[CI]， 1.50-1.54）和3.08 (95% CI, 3.01-3.16)，每次E&M就诊的平均wRVUs分别为1.42 （95% CI, 1.29-1.55）和1.72 （95% CI, 1.68-1.77）。同样，每个手术的E&M索赔分别为0.01 （95% CI, 0.00-0.01）和0.66 （95% CI, 0.06-1.25）。核电厂的内部审计相关工作从大多数（84.5%）无内部审计的程序性工作转变为大多数（86.0%）有内部审计的机电工作。结论：从事ir相关工作比例较高的放射科医师每次手术的E&M索赔金额较高，且平均程序复杂性较高。这些观察到的关联表明，实践领导者不应孤立地考虑程序和机电服务的贡献，而应认识到它们与高水平IR实践的相互依存关系。

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引用次数: 0

Radiologist Interaction with Artificial Intelligence-Generated Preliminary Reports: A Longitudinal Multireader Study 放射科医生与人工智能生成的初步报告的互动：一项纵向多读者研究。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.09.015

Eun Kyoung Hong MD, PhD , Chong Hyun Suh MD, PhD , Monika Nukala MD , Azadehsadat Esfahani MD , Andro Licaros MD , Rachna Madan MD , Andetta Hunsaker MD , Mark Hammer MD

Objectives

To investigate the integration of multimodal AI-generated reports into radiology workflow over time, focusing on their impact on efficiency, acceptability, and report quality.

Methods

A multicase, multireader study involved 756 publicly available chest radiographs interpreted by five radiologists using preliminary reports generated by a radiology-specific multimodal AI model, divided into 7 sequential batches of 108 radiographs each. Two thoracic radiologists assessed the final reports using RADPEER criteria for agreement and 5-point Likert scale for quality. Reading times, rate of acceptance without modification, agreement, and quality scores were measured, with statistical analyses evaluating trends across seven sequential batches.

Results

Radiologists’ reading times for chest radiographs decreased from 25.8 seconds in batch 1 to 19.3 seconds in batch 7 (P < .001). Acceptability increased from 54.6% to 60.2% (P < .001), with normal chest radiographs demonstrating high rates (68.9%) compared with abnormal chest radiographs (52.6%; P < .001). Median agreement and quality scores remained stable for normal chest radiographs but varied significantly for abnormal chest radiographs (all P < .05).

Discussion

The introduction of AI-generated reports improved efficiency of chest radiograph interpretation, and acceptability increased over time. However, agreement and quality scores showed variability, particularly in abnormal cases, emphasizing the need for oversight in the interpretation of complex chest radiographs.

目的：研究多模式人工智能生成的报告随时间整合到放射学工作流程中，重点关注其对效率、可接受性和报告质量的影响。方法：一项多病例、多解读研究涉及756张公开的胸部x线片，由5名放射科医生使用放射学特异性多模态AI模型生成的初步报告进行解读，分为7个连续批次，每个批次108张x线片。两名胸科放射科医生使用RADPEER标准评估最终报告的一致性和5点李克特量表评估质量。通过统计分析评估七个连续批次的趋势，测量阅读时间、未修改接受率、一致性和质量分数。结果：放射科医师的胸片阅读时间从第1批的25.8秒下降到第7批的19.3秒（p < 0.001）。可接受度从54.6%增加到60.2% (p < 0.001)，正常胸片的可接受度（68.9%）高于异常胸片（52.6%,p < 0.001）。正常胸片的中位一致性和质量评分保持稳定，但异常胸片的中位一致性和质量评分差异显著（ps < 0.05）。讨论：人工智能生成报告的引入提高了胸片解释的效率，可接受性随着时间的推移而增加。然而，一致性和质量评分表现出可变性，特别是在异常病例中，强调在解释复杂胸片时需要监督。

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引用次数: 0

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Imaging After Total Hip Arthroplasty ACR适宜性标准的患者友好总结®：全髋关节置换术后影像学。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.11.012

Yash Sachin Saboo , Saadiya Sehareen DO

引用次数: 0

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Pulmonary Arteriovenous Malformation (PAVM) 患者友好ACR适宜性标准总结：肺动静脉畸形（PAVM）。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.11.015

Yash Sachin Saboo , Lynne Koweek MD

引用次数: 0

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Chronic Shoulder Pain 对患者友好的ACR适宜性标准总结：慢性肩痛。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.11.020

Yash Sachin Saboo , Luke Ledbetter MD

引用次数: 0

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Management of Acute Pulmonary Embolism ACR适宜性标准的患者友好总结：急性肺栓塞的管理。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.11.010

Jonathan Burns , Alexander Lam MD

引用次数: 0

Association of Child Opportunity Index 3.0 With Imaging Missed Care Opportunities in Ambulatory Pediatric Nuclear Medicine Examinations 儿童机会指数3.0与儿童核医学门诊检查影像遗漏护理机会的关系。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-02-01 DOI: 10.1016/j.jacr.2025.11.013

Neha Kwatra MBBS, MD , Patrice Melvin MPH , Samantha G. Harrington MD , Stephanie Connors MBA , Melicia Y. Whitley MM , Valentina Ferrer Valencia MD , Valerie L. Ward MD, MPH

Objectives

There is a paucity of data on missed imaging appointments, also known as imaging missed care opportunities (IMCOs), in pediatric nuclear medicine (NM) and related sociodemographic factors, specifically, Child Opportunity Index (COI), a composite measure of US neighborhood resources linked to healthy child development. COI levels group neighborhoods into quintiles: very low, low, moderate, high, and very high opportunity. The primary aim was to examine association of COI with IMCOs for ambulatory pediatric NM examinations and secondarily assess other sociodemographic factors affecting IMCOs.

Methods

Retrospective single-center cross-sectional review was performed of outpatient pediatric NM examinations (patient age ≤ 21 years) from 2017 to 2022, after institutional review board approval. The primary outcome was IMCOs (patient nonarrival; incomplete appointment upon arrival; or non-provider-driven cancellation ≤ 1 day before the appointment). The primary exposure was COI 3.0 level. Covariates included patient (age, gender, race or ethnicity, language, insurance, and residency type) and appointment factors (imaging group, year, season, and wait days). Univariate and multivariable analyses were performed, with P < .05 considered statistically significant.

Results

Seven thousand six hundred twenty patients (12,864 appointments) met inclusion criteria. Median age (interquartile range) was 8 years (3-15), and 920 (7.2%) appointments resulted in IMCOs. There were 66% higher odds of IMCOs for patient appointments from zip codes with very low or low compared with very high COI levels (P < .001). Other predictors of IMCOs were age (P = .020), race or ethnicity (P = .026), insurance (P < .001), season (P < .001), and imaging group (P < .001).

Conclusions

COI was significantly associated with IMCOs for pediatric NM examinations. Interventions are needed to reduce imaging inequities and IMCOs from lower-opportunity neighborhoods.

目的：关于儿童核医学（NM）中错过的影像预约，即成像错过的护理机会（IMCO），以及相关的社会人口因素，特别是儿童机会指数（COI）的数据缺乏，儿童机会指数是一种与儿童健康发展相关的美国社区资源的综合衡量标准。COI水平将社区划分为五分之一：非常低、低、中等、高和非常高的机会。本研究的主要目的是通过儿科NM门诊检查检查COI与IMCO的关系，其次评估影响IMCO的其他社会人口因素。方法：经机构审查委员会批准，对2017-2022年门诊儿科NM检查（患者年龄≤21岁）进行回顾性单中心横断面评价。主要终点是IMCO（患者未到达；到达时未完成预约；或预约前≤1天非提供者驱动的取消预约）。初次暴露为coi3.0水平。协变量包括患者（年龄、性别、种族/民族、语言、保险和住院类型）和预约因素（影像学组、年份、季节和等待天数）。进行单因素和多因素分析，p< 0.05认为有统计学意义。结果：7620例患者（12864次预约）符合纳入标准。中位年龄（IQR）为8岁（3-15岁），920例（7.2%）就诊导致IMCO。与非常高的COI水平相比，来自邮政编码非常低/低的患者预约IMCO的几率高出66% （p< 0.001）。其他预测IMCO的因素有年龄（p = 0.020）、种族/民族（p = 0.026）、保险（p< 0.001）、季节（p< 0.001）和影像学组（p< 0.001）。结论：COI与儿童NM检查的IMCO显著相关。需要采取干预措施，以减少低机会社区的成像不平等/IMCO。

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引用次数: 0

Bridging Radiologic Disparities Through Federally Qualified Health Center-Academic Partnerships: A Call for Rural Inclusion and Outcome-Oriented Approaches 通过fqhc -学术伙伴关系弥合放射学差异：呼吁农村包容和以结果为导向的方法。

IF 5.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2026-01-01 DOI: 10.1016/j.jacr.2025.07.032

Javed Iqbal RN, MHA, Ayesha Parvaiz Malik MBBS, Ghulam Hussain PhD, Somayeh Hormaty PhD, Sumaira Khowaja-Punjwani BSN

引用次数: 0

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Journal of the American College of Radiology

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