Journal of the American College of Radiology最新文献

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Patient-Friendly Summary of the ACR Appropriateness Criteria®: Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis, Crystalline Arthritis, or Erosive Osteoarthritis ACR适宜性标准的患者友好总结®：慢性四肢关节疼痛疑似炎性关节炎，结晶性关节炎或糜烂性骨关节炎。

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.2025.10.014

Jonathan Burns , Shari T. Jawetz MD

引用次数: 0

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Suspected Primary Bone Tumors: 2025 Update ACR适宜性标准的患者友好总结®：疑似原发性骨肿瘤：2025年更新。

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.2025.10.022

Jayden Lee BS, BA, Karen Chen MD

引用次数: 0

Facility-Level Variation Underlying Low Inferior Vena Cava Filter Retrieval in the United States 在美国，低下腔静脉过滤器检索的设施水平变化。

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.2025.08.005

Premal Trivedi MD, MS , Lei Wang MSPH , Evan Carey PhD, MS , Richard Lindrooth PhD , Maria Puello Baron MD , Jonathan Lindquist MD , P. Michael Ho MD, PhD

Objectives

Timely retrieval of inferior vena cava (IVC) filters is recommended to reduce complications and optimize outcomes. This study aims to quantify facility-level variation in risk-adjusted IVC filter retrieval across US hospitals and to identify patient- and hospital-level factors associated with nonretrieval.

Methods

Medicare beneficiaries undergoing IVC filter implantation were identified in the 100% claims files for years 2016 to 2020. Facility-level variation in device retrieval was quantified using Bayesian hospital profiling. Patient- and hospital-level factors associated with nonretrieval were assessed using logistic regression, adjusting for diagnostic indication, comorbidities, and implantation year.

Results

IVC filters were implanted in 119,613 Medicare beneficiaries across 2,485 facilities. Retrieval rates were low: median 6.2% within 3 months and 14.8% within 1 year. Excluding deaths within 3 months (30.2%), retrieval ranged from 0% to 100% across facilities. Among high-volume hospitals (top 25th percentile, implanting ≥13 filters per year), 1-year risk-adjusted retrieval ranged from 0% to 74.5%, mean 20% ± 14.2% (positive skew 0.95). Patient factors associated with IVC filter nonretrieval included age > 80 years (odds ratio 2.98, 95% confidence interval [2.73-3.24]), Black race (1.62, [1.51-1.72]), and Hispanic ethnicity (1.45, [1.16-1.80]). Among hospital factors, nonteaching (1.45 [1.37-1.53]), small bed size (1.37 [1.24-1.50]), and safety-net (1.42 [1.34-1.50]) facilities were strongly associated with IVC filter nonretrieval.

Discussion

High mortality within 3 months of IVC filter implantation suggests opportunity to improve patient selection and, potentially, device type choice. There is large facility-level variance underlying low aggregate IVC filter retrieval nationally; a focus on standardizing device surveillance and identifying best practices from high-performing facilities is warranted.

目的：建议及时取出下腔静脉（IVC）滤器，减少并发症，优化预后。本研究旨在量化美国各医院风险调整后IVC滤器回收的设施水平差异，并确定与非回收相关的患者和医院水平因素。方法：在2016-2020年100%的索赔档案中确定接受IVC过滤器植入的医疗保险受益人。使用贝叶斯医院分析量化设备检索的设施水平变化。采用逻辑回归方法评估患者和医院层面与不回收相关的因素，调整诊断指征、合并症和植入年份。结果：IVC过滤器植入119,613医疗保险受益人在2485个设施。检索率低：3个月内中位数为6.2%，1年内中位数为14.8%。不包括3个月内的死亡（30.2%），各设施的回收率从0-100%不等。在大容量医院（前25%，植入≥13个过滤器/年）中，1年风险校正检索范围为0-74.5%，平均值为20% +/- 14.2%（正偏度0.95）。与IVC滤镜未取回相关的患者因素包括：年龄100 - 80岁（OR 2.98, 95% CI[2.73-3.24]）、黑人（1.62,[1.51-1.72]）和西班牙裔（1.45,[1.16-1.80]）。在医院因素中，非教学设施（1.45[1.37-1.53]）、小床位（1.37[1.24-1.50]）和安全网（1.42[1.34-1.50]）设施与IVC滤器未取物密切相关。讨论：IVC过滤器植入3个月内的高死亡率提示有机会改善患者选择，并可能改善设备类型的选择。在全国范围内，总体IVC滤波检索较低的基础上存在较大的设施水平差异；将重点放在设备监控的标准化上，并从高性能设施中确定最佳实践是必要的。

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引用次数: 0

Performance of Artificial Intelligence Models in Predicting Responsiveness of Hepatocellular Carcinoma to Transarterial Chemoembolization (TACE): A Systematic Review and Meta-Analysis 人工智能模型在预测肝细胞癌对经动脉化疗栓塞（TACE）反应性方面的表现：一项系统综述和荟萃分析。

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.2025.08.028

Iman Kiani , Iman Razeghian , Parya Valizadeh , Yasmin Esmaeilian , Payam Jannatdoust , Bardia Khosravi MD, MPH, MHPE

Background

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related mortality worldwide. Handcrafted radiomics (HCR) and deep learning (DL) models have emerged as promising predictive tools extracting granular insights from images.

Objective

This systematic review and meta-analysis aims to evaluate the predictive performance of these artificial intelligence models in predicting treatment efficacy in patients with HCC who are undergoing transarterial chemoembolization (TACE).

Methods

A comprehensive search was conducted on PubMed, Embase, Web of Science, and Cochrane Library databases up to June 15, 2024. Inclusion criteria encompassed studies involving patients with confirmed HCC undergoing TACE. Random-effects diagnostic test accuracy meta-analyses were performed using bivariate modeling. Methodological quality was assessed using the Prediction model Risk of Bias Assessment Tool.

Results

Twenty-seven studies were included in this review. The overall meta-analysis of models for TACE treatment response included 11 studies. The pooled area under the receiver operating characteristic curve was 0.89 (95% confidence interval: 0.81-0.93) for internal validation and 0.81 (95% confidence interval: 0.80-0.92) for external validation, with no significant differences (P = .66). Moreover, no significant differences were found between DL and HCR models (P = .21) or between models with and without clinical data (P = .78).

Conclusion

Artificial intelligence models, including DL and HCR, show potential for predicting treatment outcomes in patients with HCC who are undergoing TACE. However, the observed heterogeneity stresses the need for further research.

背景：肝细胞癌（HCC）仍然是世界范围内癌症相关死亡的主要原因。手工制作放射组学（HCR）和深度学习（DL）模型已经成为从图像中提取颗粒洞察的有前途的预测工具。目的：本系统综述和荟萃分析旨在评估这些AI模型在预测HCC患者经动脉化疗栓塞（TACE）治疗效果方面的预测性能。方法：综合检索PubMed、Embase、Web of Science和Cochrane Library数据库，检索时间截止到2024年6月15日。纳入标准包括确诊HCC患者接受TACE治疗的研究。采用双变量模型进行随机效应诊断测试准确性meta分析。采用预测模型偏倚风险评估工具（PROBAST）评估方法学质量。结果：本综述纳入了27项研究。TACE治疗反应模型的整体荟萃分析包括11项研究。内部验证的合并AUROC为0.89 (95% CI: 0.81 - 0.93)，外部验证的合并AUROC为0.81 (95% CI: 0.80 - 0.92)，两者无显著差异（p = 0.66）。此外，DL和HCR模型之间无显著差异（p = 0.21），有和没有临床资料的模型之间无显著差异（p = 0.78）。结论：AI模型，包括DL和HCR，显示出预测肝癌患者接受TACE治疗结果的潜力。然而，观察到的异质性强调了进一步研究的必要性。

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引用次数: 0

Limited Added Value of Pelvic Ultrasound After Negative CT Abdomen Pelvis for Emergent Gynecologic Pathology 骨盆CT阴性后盆腔超声对急诊妇科病理的价值有限。

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.2025.08.016

Tamanna Hossin MD , Rohit B. Sangal MD, MBA , Joseph Cavallo MD, MBA , Terri Q. Huynh MD, MSCR , R. Andrew Taylor MD, MHS , Arjun K. Venkatesh MD, MBA, MHS

引用次数: 0

Closing the Loop: 9-Year Outcomes of an Electronic Medical Record–Based Protocol for Reporting Incidental Imaging Findings 闭合循环：报告偶发影像学发现的基于电子病历协议的9年结果

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.2025.08.047

Rohan M. Shah BS , Aniket Dehadrai BS , Ariz Keshwani MPH , Brenda Schmitz RN , James C. Carr MD

Purpose

Incidental findings in radiology are common, especially with rising imaging volumes. Early disease recognition can greatly improve clinical outcomes, but in low-risk cases, incidental findings often lead to overdiagnosis and overtreatment, causing harm. Robust systems are critical to promote early identification without overburdening patients or health care systems.

Methods

The authors conducted a retrospective analysis of incidental findings reported through a novel electronic notification system from January 1, 2015, to December 31, 2023. Adults undergoing CT, MRI, radiography, or ultrasound were included. The protocol involved radiologists’ submitting findings using a button in the electronic medical record, triggering a nursing-led follow-up algorithm that varied according to clinical setting (emergency department, inpatient, outpatient) and finding type (eg, lung, kidney). Primary outcomes were use (total cases, compounded growth) and case resolution. Secondary outcomes included stratification by imaging modality and type of incidental finding. Descriptive statistics were used for analysis.

Results

A total of 25,175 incidental findings were reported, averaging 2,797 cases per year and 233 per month, with an overall compounded annual growth rate of 21.44%. Resolution rates remained consistently >99% after initial tracking began, with only 2 months lower than this threshold. From 2019 to 2023, among 17,205 available cases, lung findings were the most common (19.31%), followed by brain (7.29%) and kidney (7.17%) findings. CT was the most frequent modality (53.99%), followed by MRI (20.34%), radiography (18.17%), and ultrasound (7.49%).

Conclusions

The authors successfully implemented an incidental findings reporting protocol with strong provider uptake and case resolution. As imaging volumes continue to rise, structured follow-up systems are increasingly critical for hospitals.

简介：放射学中的意外发现是常见的，特别是随着成像体积的增加。疾病的早期识别可以极大地改善临床结果，但在低风险病例中，偶然发现往往导致过度诊断和过度治疗，造成伤害。健全的系统对于促进早期识别而不使患者或卫生保健系统负担过重至关重要。方法：对2015年1月1日至2023年12月31日通过新型电子通报系统报告的意外发现进行回顾性分析。接受CT、MRI、x线摄影或超声检查的成年人也包括在内。该方案涉及放射科医生通过电子病历按钮提交检查结果，触发护理主导的随访算法，该算法根据临床环境（急诊科、住院、门诊）和发现类型（如肺、肾）而变化。主要结果是使用率（总病例数，复合增长率）和病例解决率。次要结果包括影像学方式分层和偶然发现类型。采用描述性统计进行分析。结果：共报告意外发现25175例，平均每年2797例，每月233例，年复合增长率为21.44%。在最初的跟踪开始后，分辨率一直保持在99%左右，只有两个月低于这个阈值。2019-2023年，在17205例可用病例中，肺部最常见（19.31%），其次是脑部（7.29%）和肾脏（7.17%）。CT影像学检查最多（53.99%），其次为MRI（20.34%）、x线片（18.17%）和超声（7.49%）。结论：我们成功地实施了意外发现报告协议，具有强大的提供者吸收和病例解决方案。随着影像量的不断增加，结构化的随访系统对医院来说越来越重要。

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引用次数: 0

The Challenges and Promises of Artificial Intelligence Triage Systems in Practice 人工智能分类系统在实践中的挑战和前景。

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.2025.08.026

Sarah J. Ricklan MD, MPhil , Tessa S. Cook MD, PhD

引用次数: 0

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Screening, Locoregional Assessment, and Surveillance of Pancreatic Ductal Adenocarcinoma ACR适宜性标准总结：胰腺导管腺癌的筛查、局部评估和监测。

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.2025.10.016

Jayden S. Lee BS, BA , David H. Kim MD

引用次数: 0

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Osteonecrosis 患者友好ACR适宜性标准总结®：骨坏死。

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.2025.10.021

Yash Sachin Saboo , Kristen Coffey MD

引用次数: 0

Leveraging High Mammography Screening Prevalence to Increase Lung Cancer Screening Among Women—a Geospatial Perspective 利用高乳房x线摄影筛查率增加女性肺癌筛查-地理空间视角。

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

Journal of the American College of Radiology

Pub Date : 2025-12-01 DOI: 10.1016/j.jacr.2025.05.019

Vanhvilai L. Douangchai Wills MSc , Liora Sahar PhD , Lauren Rosenthal MPH , Ella A. Kazerooni MD, MS , Kim Lori Sandler MD , Carey Thomson MD, MPH , Robert A. Smith PhD

Purpose

Lung cancer (LC) is the leading cause of cancer death in women, yet LC screening (LCS) rates remain low. Identifying women eligible for LCS who are undergoing screening mammography has been shown to increase LCS in this population. We aim to evaluate the proximity of mammography facilities to LCS facilities to further leverage screening mammography on a national level to increase LCS uptake among women.

Methods

A geospatial approach was used to assess the proximity of mammography and LCS facilities at graduated short distances of 0, 0.5, and 1 mile. Public data were used to calculate the estimated women aged 50 to 74, women who have undergone mammography, and the estimated women eligible for LCS within these distances. Bivariate maps were created to highlight potential areas for intervention.

Results

Almost 40% of mammography facilities are within 1 mile of LCS facilities, and many of these facilities (59.5%) are “nearby facilities” (0 miles or share an address) that are mostly in more urban areas, presenting a disparity in access between rural and urban areas. Although <25% of all mammography facilities are within 0 miles of LCS facilities, they are in counties in which most of the women eligible for LCS and most of the women who have undergone mammography reside.

Conclusion

High mammography prevalence coupled with the alignment of the distribution of facilities, women eligible for LCS, and women who have undergone mammography provide an opportunity to reach women at risk for LC to assess eligibility and offer convenient screening near the time of their mammograms.

目的：肺癌（LC）是女性癌症死亡的主要原因，但肺癌筛查（LCS）率仍然很低。通过筛查乳房x光检查确定符合LCS条件的妇女可增加这一人群的LCS。我们的目标是评估乳房x光检查设施与LCS设施的接近程度，以进一步在国家层面上利用筛查乳房x光检查（SM）来增加女性对LCS的吸收。方法：采用地理空间方法评估乳房x光检查和LCS设施在0、0.5和1英里短距离内的接近程度。使用公共数据计算50-74岁的估计妇女，接受乳房x光检查的妇女，以及这些距离内估计的LCS合格妇女。创建双变量图以突出潜在的干预区域。结果：近40%的乳房x光检查设施位于LCS设施的1英里范围内，其中许多设施（59.5%）是“附近设施”（0英里/共享地址），这些设施大多位于城市地区，在农村和城市地区之间存在差异。结论：乳房x光检查的高患病率，加上设施分布的一致性，符合lcs条件的妇女，以及接受过乳房x光检查的妇女，为有LC风险的妇女提供了机会，以评估其资格，并在乳房x光检查时提供方便的筛查。

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