Pub Date : 2025-02-01DOI: 10.1016/j.clinimag.2024.110394
Ghazal Zandieh , Iman Yazdaninia , Shadi Afyouni , Ali Borhani , Takeshi Yokoo , Ihab R. Kamel
<div><div>Magnetic Resonance Imaging (MRI) is a sophisticated diagnostic tool that utilizes the magnetic properties of biological tissue to generate detailed images of internal structures without the use of ionizing radiation. Despite its benefits in providing high-contrast images of soft tissues, the strong magnetic fields used in MRI present a unique safety challenge. Increasing MRI-related accidents and the prevalence of patients with metallic implants in recent years underscore the critical need for stringent MR safety protocols. This article reviews the latest 2024 updates in the MRI safety manual by the American College of Radiology (ACR), highlighting the comprehensive efforts to manage risks associated with MRI, including projectile and burn incidents, patients with medical devices, and emerging complex MRI environments. The manual emphasizes the importance of specialized training for healthcare professionals to navigate the complexities of MRI safety to ensure patient and staff safety. This review also touches on the dynamic landscape of MRI safety standards, driven by technological advances and evolving clinical practices, aiming to provide a thorough understanding of current best practices in MRI safety management.</div></div><div><h3>List of updates</h3><div><ul><li><span>1.</span><span><div>Reformatted introduction: Provides a basic overview of MR risks and safety concerns, setting the stage for comprehensive safety protocols.</div></span></li><li><span>2.</span><span><div>Management of MR Safety and Policies: Updates guidelines for creating, implementing, and maintaining MR safety policies, emphasizing new considerations for policy development.</div></span></li><li><span>3.</span><span><div>MR Environment: Updates the fringe field limit to 9 gauss, reflecting the latest safety standards by the International Electrotechnical Commission (IEC).</div></span></li><li><span>4.</span><span><div>MR Personnel: Enhances MR Safety Training with updated language, introduces a training checklist, provides new staffing guidance, and incorporates remote scanning protocols.</div></span></li><li><span>5.</span><span><div>MR Screening: Reorganizes and clarifies the process for screening staff, patients, and materials for MR safety, including risk identification and the use of MR Safe attire.</div></span></li><li><span>6.</span><span><div>Final Stop/Final Check: Introduces routine and augmented protocols, including the mandatory removal of hearing aids before entering Zone IV.</div></span></li><li><span>7.</span><span><div>Zone IV Exam Preparation and Completion: A new section that outlines specific procedures for preparing and completing exams in the high-risk Zone IV area.</div></span></li><li><span>8.</span><span><div>MRI Fields and Safety Concerns: Reorganizes critical information on RF Magnetic Fields and Magnetic Field Gradient concerns, addressing whole-body, focal, and resonant heating, as well as auditory impacts and nerve stimulation.</div><
{"title":"Updates on the MR safety guidelines – Essentials for radiologists","authors":"Ghazal Zandieh , Iman Yazdaninia , Shadi Afyouni , Ali Borhani , Takeshi Yokoo , Ihab R. Kamel","doi":"10.1016/j.clinimag.2024.110394","DOIUrl":"10.1016/j.clinimag.2024.110394","url":null,"abstract":"<div><div>Magnetic Resonance Imaging (MRI) is a sophisticated diagnostic tool that utilizes the magnetic properties of biological tissue to generate detailed images of internal structures without the use of ionizing radiation. Despite its benefits in providing high-contrast images of soft tissues, the strong magnetic fields used in MRI present a unique safety challenge. Increasing MRI-related accidents and the prevalence of patients with metallic implants in recent years underscore the critical need for stringent MR safety protocols. This article reviews the latest 2024 updates in the MRI safety manual by the American College of Radiology (ACR), highlighting the comprehensive efforts to manage risks associated with MRI, including projectile and burn incidents, patients with medical devices, and emerging complex MRI environments. The manual emphasizes the importance of specialized training for healthcare professionals to navigate the complexities of MRI safety to ensure patient and staff safety. This review also touches on the dynamic landscape of MRI safety standards, driven by technological advances and evolving clinical practices, aiming to provide a thorough understanding of current best practices in MRI safety management.</div></div><div><h3>List of updates</h3><div><ul><li><span>1.</span><span><div>Reformatted introduction: Provides a basic overview of MR risks and safety concerns, setting the stage for comprehensive safety protocols.</div></span></li><li><span>2.</span><span><div>Management of MR Safety and Policies: Updates guidelines for creating, implementing, and maintaining MR safety policies, emphasizing new considerations for policy development.</div></span></li><li><span>3.</span><span><div>MR Environment: Updates the fringe field limit to 9 gauss, reflecting the latest safety standards by the International Electrotechnical Commission (IEC).</div></span></li><li><span>4.</span><span><div>MR Personnel: Enhances MR Safety Training with updated language, introduces a training checklist, provides new staffing guidance, and incorporates remote scanning protocols.</div></span></li><li><span>5.</span><span><div>MR Screening: Reorganizes and clarifies the process for screening staff, patients, and materials for MR safety, including risk identification and the use of MR Safe attire.</div></span></li><li><span>6.</span><span><div>Final Stop/Final Check: Introduces routine and augmented protocols, including the mandatory removal of hearing aids before entering Zone IV.</div></span></li><li><span>7.</span><span><div>Zone IV Exam Preparation and Completion: A new section that outlines specific procedures for preparing and completing exams in the high-risk Zone IV area.</div></span></li><li><span>8.</span><span><div>MRI Fields and Safety Concerns: Reorganizes critical information on RF Magnetic Fields and Magnetic Field Gradient concerns, addressing whole-body, focal, and resonant heating, as well as auditory impacts and nerve stimulation.</div><","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"118 ","pages":"Article 110394"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.clinimag.2024.110391
Christine Lamoureux , Eric Rohren , Edward Callaway , Erin Vair-Grilley , Scott G. Baginski , Phil Ramis , Tarek N. Hanna
Rationale and objectives
To evaluate radiologists' perspectives regarding American Medical Association Category 1 Continuing Medical Education (Cat-1 CME) activities in private practice (PP) and teleradiology (TR), as well as American Board of Radiology Maintenance of Certification (ABR MOC) program participation status.
Materials and methods
An electronic survey informed by existing literature regarding physician Cat-1 CME use and opinions was distributed via email to a national radiology practice. The survey was open for seventeen days in 2023, with a single reminder. Statistical analysis was performed using Pearson Chi square hypothesis testing and logistic regression modeling.
Results
Response rate was 19.2 % (599/3112). Of the 588 ABR certified, 65.6 % (n = 386) of respondents participated in ABR MOC, 50.9 % (n = 299) were in TR and 43.4 % (n = 255) were in PP. PP was associated with a greater participation in the ABR MOC program than TR (p0.05). Format (42 %) and content/topic (35 %) were the most important reasons for CME selection. PP radiologists preferred live in person lectures 1.94 times over TR. ABR MOC participants were 1.82 times more likely to select “cost” as the most important reason for choosing a Cat-1 CME activity, had lower odds of agreeing that Cat-1 CME helped maintain and improve skills, and had lower odds of being satisfied with Cat-1 CME activities available.
Conclusion
TR and PP settings in addition to ABR MOC participation status are associated with differences in Cat-1 CME-related preferences and perspectives.
{"title":"CME preferences and perspectives among practicing radiologists","authors":"Christine Lamoureux , Eric Rohren , Edward Callaway , Erin Vair-Grilley , Scott G. Baginski , Phil Ramis , Tarek N. Hanna","doi":"10.1016/j.clinimag.2024.110391","DOIUrl":"10.1016/j.clinimag.2024.110391","url":null,"abstract":"<div><h3>Rationale and objectives</h3><div>To evaluate radiologists' perspectives regarding American Medical Association Category 1 Continuing Medical Education (Cat-1 CME) activities in private practice (PP) and teleradiology (TR), as well as American Board of Radiology Maintenance of Certification (ABR MOC) program participation status.</div></div><div><h3>Materials and methods</h3><div>An electronic survey informed by existing literature regarding physician Cat-1 CME use and opinions was distributed via email to a national radiology practice. The survey was open for seventeen days in 2023, with a single reminder. Statistical analysis was performed using Pearson Chi square hypothesis testing and logistic regression modeling.</div></div><div><h3>Results</h3><div>Response rate was 19.2 % (599/3112). Of the 588 ABR certified, 65.6 % (n = 386) of respondents participated in ABR MOC, 50.9 % (n = 299) were in TR and 43.4 % (n = 255) were in PP. PP was associated with a greater participation in the ABR MOC program than TR (p0.05). Format (42 %) and content/topic (35 %) were the most important reasons for CME selection. PP radiologists preferred live in person lectures 1.94 times over TR. ABR MOC participants were 1.82 times more likely to select “cost” as the most important reason for choosing a Cat-1 CME activity, had lower odds of agreeing that Cat-1 CME helped maintain and improve skills, and had lower odds of being satisfied with Cat-1 CME activities available.</div></div><div><h3>Conclusion</h3><div>TR and PP settings in addition to ABR MOC participation status are associated with differences in Cat-1 CME-related preferences and perspectives.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"118 ","pages":"Article 110391"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-31DOI: 10.1016/j.clinimag.2025.110419
Sarah Ciccarelli , Natalia Eugene , Zi Zhang
Purpose
Compare the reduction and recovery of breast cancer screening and diagnostic services in urban versus suburban communities during the COVID-19 pandemic to identify opportunities for advancing equitable breast cancer detection.
Methods
This retrospective cohort study used the Montage™ data mining system to analyze percent change in the number of screening and diagnostic mammograms, breast biopsies, and breast cancer diagnoses at a single mid-Atlantic institution with urban and suburban sites centered in and around Philadelphia, Pennsylvania from 1/1/2019 to 12/31/2022, with urban-suburban subset comparison from 1/1/2019 to 12/31/2021.
Results
In 2020, screening mammogram volume dropped 23.9 % at urban sites and 1.6 % at suburban sites while diagnostic mammogram volume decreased 26.4 % at urban and 21.4 % at suburban sites. In 2021, screening volume at urban and suburban sites was 2.6 % and 31.0 % greater than pre-pandemic levels, and diagnostic volume was 28.5 % and 16.9 % below pre-pandemic levels. That same year, the proportion of invasive ductal carcinoma at urban sites increased by 26.2 %. In 2022, screening volume at all sites surpassed pre-pandemic levels by 19.5 % while diagnostic volume remained 21.7 % less than pre-pandemic levels.
Conclusion
The COVID-19 pandemic disproportionately reduced breast cancer screening and diagnostic services in urban communities, who experienced slower recovery and increased invasive breast cancer in the subsequent year. Throughout our institution, screening mammograms surpassed pre-pandemic levels in 2021 and 2022 while diagnostic services remained below pre-pandemic levels through 2022. Considering these findings, we must improve access to breast cancer screening and diagnosis to mitigate the long-term consequences of the pandemic.
{"title":"Disparities in breast cancer screening and diagnosis: Urban-suburban contrasts in the wake of the COVID-19 pandemic","authors":"Sarah Ciccarelli , Natalia Eugene , Zi Zhang","doi":"10.1016/j.clinimag.2025.110419","DOIUrl":"10.1016/j.clinimag.2025.110419","url":null,"abstract":"<div><h3>Purpose</h3><div>Compare the reduction and recovery of breast cancer screening and diagnostic services in urban versus suburban communities during the COVID-19 pandemic to identify opportunities for advancing equitable breast cancer detection.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used the Montage™ data mining system to analyze percent change in the number of screening and diagnostic mammograms, breast biopsies, and breast cancer diagnoses at a single mid-Atlantic institution with urban and suburban sites centered in and around Philadelphia, Pennsylvania from 1/1/2019 to 12/31/2022, with urban-suburban subset comparison from 1/1/2019 to 12/31/2021.</div></div><div><h3>Results</h3><div>In 2020, screening mammogram volume dropped 23.9 % at urban sites and 1.6 % at suburban sites while diagnostic mammogram volume decreased 26.4 % at urban and 21.4 % at suburban sites. In 2021, screening volume at urban and suburban sites was 2.6 % and 31.0 % greater than pre-pandemic levels, and diagnostic volume was 28.5 % and 16.9 % below pre-pandemic levels. That same year, the proportion of invasive ductal carcinoma at urban sites increased by 26.2 %. In 2022, screening volume at all sites surpassed pre-pandemic levels by 19.5 % while diagnostic volume remained 21.7 % less than pre-pandemic levels.</div></div><div><h3>Conclusion</h3><div>The COVID-19 pandemic disproportionately reduced breast cancer screening and diagnostic services in urban communities, who experienced slower recovery and increased invasive breast cancer in the subsequent year. Throughout our institution, screening mammograms surpassed pre-pandemic levels in 2021 and 2022 while diagnostic services remained below pre-pandemic levels through 2022. Considering these findings, we must improve access to breast cancer screening and diagnosis to mitigate the long-term consequences of the pandemic.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110419"},"PeriodicalIF":1.8,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-29DOI: 10.1016/j.clinimag.2025.110418
Amanda L. Pomeroy , Kara Romano
{"title":"Dr. Eleanor Montague - Advancing the care of patients with breast cancer","authors":"Amanda L. Pomeroy , Kara Romano","doi":"10.1016/j.clinimag.2025.110418","DOIUrl":"10.1016/j.clinimag.2025.110418","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"Article 110418"},"PeriodicalIF":1.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143071163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-28DOI: 10.1016/j.clinimag.2025.110416
Xinjie Yu , Dengfa Yang , Gang Xu , Fengjuan Tian , Hengfeng Shi , Zongyu Xie , Zhenyu Cao , Jian Wang
Objectives
To establish a model for prediction of recurrence of non-small cell lung cancer (NSCLC) based on clinical data and computed tomography (CT) imaging characteristics.
Methods
A total of 695 patients with surgically resected NSCLC confirmed by pathology at three centers were retrospectively investigated. 626 patients from center 1 were randomly divided into two sets in a ratio of 7:3 (training set, n = 438; testing set, n = 188), 69 patients from center 2 and 3 were assigned in the external validation set. Univariate and binary logistic regression analyses of clinical and CT imaging features determined the independent risk factors used to construct the model. The receiver-operating characteristic curve nomogram and decision curves analysis were used to evaluate the predictive ability of the model.
Results
The mean patient age was 63.3 ± 10.1 years, and 44.7 % (311/695) were male. The univariate and binary logistic regression analyses identified four independent risk factors (age, tumor markers, consolidation/tumor ratio, and pleural effusion), which were used to construct the prediction model. In the training set, the model had an area under the curve of 0.857, an accuracy of 71.7 %, a sensitivity of 88.1 %, and a specificity of 70.0 %; in the testing set, the respective values were 0.867, 75.5 %, 94.4 %, and 73.5 %; in the external validation set, the respective values were 0.852, 79.7 %, 83.3 %, 78.9 %.
Conclusion
A prediction model based on clinical data and CT imaging characteristics showed excellent efficiency in prediction of recurrence of NSCLC. Clinical use of this model could be useful for selection of appropriate treatment options.
{"title":"A model for prediction of recurrence of non-small cell lung cancer based on clinical data and CT imaging characteristics","authors":"Xinjie Yu , Dengfa Yang , Gang Xu , Fengjuan Tian , Hengfeng Shi , Zongyu Xie , Zhenyu Cao , Jian Wang","doi":"10.1016/j.clinimag.2025.110416","DOIUrl":"10.1016/j.clinimag.2025.110416","url":null,"abstract":"<div><h3>Objectives</h3><div>To establish a model for prediction of recurrence of non-small cell lung cancer (NSCLC) based on clinical data and computed tomography (CT) imaging characteristics.</div></div><div><h3>Methods</h3><div>A total of 695 patients with surgically resected NSCLC confirmed by pathology at three centers were retrospectively investigated. 626 patients from center 1 were randomly divided into two sets in a ratio of 7:3 (training set, <em>n</em> = 438; testing set, <em>n</em> = 188), 69 patients from center 2 and 3 were assigned in the external validation set. Univariate and binary logistic regression analyses of clinical and CT imaging features determined the independent risk factors used to construct the model. The receiver-operating characteristic curve nomogram and decision curves analysis were used to evaluate the predictive ability of the model.</div></div><div><h3>Results</h3><div>The mean patient age was 63.3 ± 10.1 years, and 44.7 % (311/695) were male. The univariate and binary logistic regression analyses identified four independent risk factors (age, tumor markers, consolidation/tumor ratio, and pleural effusion), which were used to construct the prediction model. In the training set, the model had an area under the curve of 0.857, an accuracy of 71.7 %, a sensitivity of 88.1 %, and a specificity of 70.0 %; in the testing set, the respective values were 0.867, 75.5 %, 94.4 %, and 73.5 %; in the external validation set, the respective values were 0.852, 79.7 %, 83.3 %, 78.9 %.</div></div><div><h3>Conclusion</h3><div>A prediction model based on clinical data and CT imaging characteristics showed excellent efficiency in prediction of recurrence of NSCLC. Clinical use of this model could be useful for selection of appropriate treatment options.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"120 ","pages":"Article 110416"},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.clinimag.2025.110417
Denise J. van der Reijd , Ezgi A. Soykan , Birthe C. Heeres , Doenja M.J. Lambregts , Marieke A. Vollebergh , Koert F.D. Kuhlmann , Niels F.M. Kok , Petur Snaebjornsson , Regina G.H. Beets-Tan , Monique Maas , Elisabeth G. Klompenhouwer
Purpose
To determine to what extent colorectal liver metastases (CRLM) display typical imaging characteristics on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and what changes after chemotherapy.
Methods
We retrospectively identified 258 patients with a gadoxetic acid-enhanced MRI between 2015 and 2021 and pathologically proven non-mucinous adenocarcinoma CRLM. 722 unique CRLMs were analyzed: 378 CRLM in only the chemotherapy-naïve analysis; 217 in post-chemotherapy analysis; and 127 CRLM were analyzed both pre- and post-chemotherapy. The following six characteristics were defined as typical; “hypovascular”, “unenhanced T1-weighted (UE-T1W) hypointensity”, “arterial rim enhancement”, “non-enhancing during hepatobiliary phase”, “T2-weighted (T2W) mild hyperintensity”, and “diffusion restriction”.
Results
All six typical characteristics were found in 249/505 chemotherapy-naïve CRLM (49 %) and 87/344 post-chemotherapy CRLM (25 %). The occurrence of some typical characteristics decreased post-chemotherapy: UE-T1W hypointensity 485/505 (96 %) versus 311/336 (93 %), arterial rim enhancement 291/498 (58 %) versus 154/301 (51 %), T2W mild hyperintensity 478/505 (95 %) versus 269/338 (79 %), and diffusion restriction 435/497 (87 %) versus 200/306 (65 %). Almost all metastases showed a hypovascular appearance, both in the chemotherapy-naïve (495/504, 98 %) and post-chemotherapy group (330/331, 100 %). Additionally, all CRLM appeared non-enhancing compared to the liver in the hepatobiliary phase (100 %).
Conclusion
Most CRLM show various combinations of at least five typical characteristics on gadoxetic acid-enhanced MRI. Arterial rim enhancement is the least prevalent characteristic both in chemotherapy-naïve and post-chemotherapy patients. Post-chemotherapy the occurrence of typical MRI characteristics decreases, especially mild T2W hyperintensity and the presence of diffusion restriction.
{"title":"Colorectal liver metastases on gadoxetic acid-enhanced MRI: Typical characteristics decrease after chemotherapy","authors":"Denise J. van der Reijd , Ezgi A. Soykan , Birthe C. Heeres , Doenja M.J. Lambregts , Marieke A. Vollebergh , Koert F.D. Kuhlmann , Niels F.M. Kok , Petur Snaebjornsson , Regina G.H. Beets-Tan , Monique Maas , Elisabeth G. Klompenhouwer","doi":"10.1016/j.clinimag.2025.110417","DOIUrl":"10.1016/j.clinimag.2025.110417","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine to what extent colorectal liver metastases (CRLM) display typical imaging characteristics on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and what changes after chemotherapy.</div></div><div><h3>Methods</h3><div>We retrospectively identified 258 patients with a gadoxetic acid-enhanced MRI between 2015 and 2021 and pathologically proven non-mucinous adenocarcinoma CRLM. 722 unique CRLMs were analyzed: 378 CRLM in only the chemotherapy-naïve analysis; 217 in post-chemotherapy analysis; and 127 CRLM were analyzed both pre- and post-chemotherapy. The following six characteristics were defined as typical; “hypovascular”, “unenhanced T1-weighted (UE-T1W) hypointensity”, “arterial rim enhancement”, “non-enhancing during hepatobiliary phase”, “T2-weighted (T2W) mild hyperintensity”, and “diffusion restriction”.</div></div><div><h3>Results</h3><div>All six typical characteristics were found in 249/505 chemotherapy-naïve CRLM (49 %) and 87/344 post-chemotherapy CRLM (25 %). The occurrence of some typical characteristics decreased post-chemotherapy: UE-T1W hypointensity 485/505 (96 %) versus 311/336 (93 %), arterial rim enhancement 291/498 (58 %) versus 154/301 (51 %), T2W mild hyperintensity 478/505 (95 %) versus 269/338 (79 %), and diffusion restriction 435/497 (87 %) versus 200/306 (65 %). Almost all metastases showed a hypovascular appearance, both in the chemotherapy-naïve (495/504, 98 %) and post-chemotherapy group (330/331, 100 %). Additionally, all CRLM appeared non-enhancing compared to the liver in the hepatobiliary phase (100 %).</div></div><div><h3>Conclusion</h3><div>Most CRLM show various combinations of at least five typical characteristics on gadoxetic acid-enhanced MRI. Arterial rim enhancement is the least prevalent characteristic both in chemotherapy-naïve and post-chemotherapy patients. Post-chemotherapy the occurrence of typical MRI characteristics decreases, especially mild T2W hyperintensity and the presence of diffusion restriction.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"Article 110417"},"PeriodicalIF":1.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-25DOI: 10.1016/j.clinimag.2025.110414
Ankush Ankush
VoxRad is an open-source application designed to enhance radiology reporting by leveraging generative AI. Utilizing locally hosted Automatic Speech Recognition (ASR) and Large Language Models (LLM), VoxRad enables continuous dictation, transcribing reports into standardized formats with high accuracy, efficiency, and data security. The modular design allows flexible integration of user-selected ASR and LLM models via OpenAI-compatible APIs, ensuring HIPAA compliance with secure local storage of data. Customizable template guided prompting using Chain-of-Thought like systematic processing, and specialized dictionaries further optimize report generation. VoxRad's future aims include healthcare system integration and community-driven template libraries, enhancing its utility for the medical community.
{"title":"VoxRad: Building an open-source locally-hosted radiology reporting system","authors":"Ankush Ankush","doi":"10.1016/j.clinimag.2025.110414","DOIUrl":"10.1016/j.clinimag.2025.110414","url":null,"abstract":"<div><div>VoxRad is an open-source application designed to enhance radiology reporting by leveraging generative AI. Utilizing locally hosted Automatic Speech Recognition (ASR) and Large Language Models (LLM), VoxRad enables continuous dictation, transcribing reports into standardized formats with high accuracy, efficiency, and data security. The modular design allows flexible integration of user-selected ASR and LLM models via OpenAI-compatible APIs, ensuring HIPAA compliance with secure local storage of data. Customizable template guided prompting using Chain-of-Thought like systematic processing, and specialized dictionaries further optimize report generation. VoxRad's future aims include healthcare system integration and community-driven template libraries, enhancing its utility for the medical community.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"Article 110414"},"PeriodicalIF":1.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-25DOI: 10.1016/j.clinimag.2025.110413
Shatha Jamal Almushayt
Injectable dermal fillers have seen a remarkable rise in popularity in recent years for aesthetic enhancements, such as facial contouring and rejuvenation. Hyaluronic acid (HA)-based fillers are especially favored due to their tolerability, minimal invasiveness, and effectiveness. This review examines the applications of ultrasound in HA dermal filler procedures. A literature search was conducted from February 25 to 26, 2024, using Medline and Google Scholar to identify relevant studies on the use of ultrasound for facial HA dermal fillers. Inclusion criteria included peer-reviewed English language studies from the last decade and involving living human subjects. Eleven studies met these criteria. The findings indicate that ultrasound significantly enhances the accuracy and safety of HA filler procedures by enabling precise vascular mapping, filler detection, and complication detection and identification. By presenting evidence of reduced risks and improved outcomes, this review underscores the potential for ultrasound to become a standard tool in HA filler applications, representing an innovation and a new application for ultrasound in the field of aesthetic dermatology.
{"title":"The role of ultrasound in facial hyaluronic acid dermal filler injections – A review article","authors":"Shatha Jamal Almushayt","doi":"10.1016/j.clinimag.2025.110413","DOIUrl":"10.1016/j.clinimag.2025.110413","url":null,"abstract":"<div><div>Injectable dermal fillers have seen a remarkable rise in popularity in recent years for aesthetic enhancements, such as facial contouring and rejuvenation. Hyaluronic acid (HA)-based fillers are especially favored due to their tolerability, minimal invasiveness, and effectiveness. This review examines the applications of ultrasound in HA dermal filler procedures. A literature search was conducted from February 25 to 26, 2024, using Medline and Google Scholar to identify relevant studies on the use of ultrasound for facial HA dermal fillers. Inclusion criteria included peer-reviewed English language studies from the last decade and involving living human subjects. Eleven studies met these criteria. The findings indicate that ultrasound significantly enhances the accuracy and safety of HA filler procedures by enabling precise vascular mapping, filler detection, and complication detection and identification. By presenting evidence of reduced risks and improved outcomes, this review underscores the potential for ultrasound to become a standard tool in HA filler applications, representing an innovation and a new application for ultrasound in the field of aesthetic dermatology.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"Article 110413"},"PeriodicalIF":1.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-22DOI: 10.1016/j.clinimag.2025.110412
Tarig S. Elhakim , Taha Lodhi , Wilton Fidelis , Allison Brea , Ana Mort , Maryam Mohagheghtabar , Azadeh Tabari , Samuel R. Davis , Raul N. Uppot , Ronald S. Arellano , Michael Dezube , Dania Daye
Purpose
To perform a nationwide analysis of ablation compared to partial and total nephrectomy for the management of renal cell carcinoma (RCC) to evaluate utilization trends and disparities in the USA.
Materials and methods
The 2016–2020 National Inpatient Sample was analyzed. Using ICD-10, we identified the diagnosis of RCC then analyzed the utilization trends of ablation and nephrectomies (both partial and complete). To determine if any disparities exist, a multivariate logistic regression was performed to assess the influence of age, sex, race, income, payer, illness severity, geographical location, and hospital factors.
Results
From the 183,885 inpatient encounters with RCC, 3045 (1.65 %) underwent ablation, 70,080 (38.1 %) underwent partial nephrectomy, and 110,760 (60.2 %) underwent total nephrectomy. There was no significant difference in the sex between all groups. There was a statistically significant difference in the mean age of those undergoing ablation (67.30, SD = 12.05) versus those undergoing partial nephrectomy (59.27, SD = 13.26) and total nephrectomy (62.22, SD = 14.42) (OR: 1.04, 95%CI: 1.03–1.05, P < 0.001). Compared to White patients, Hispanic and African Americans were more likely to undergo ablation versus nephrectomy (OR: 1.52, 95%CI: 1.16–1.98, P = 0.002 and OR: 1.65, 95%CI: 1.28–2.13, P < 0.001, respectively). Compared to patients on private insurance, those on Medicaid and Medicare were more likely to have ablation than nephrectomy (OR: 1.85, 95%CI: 1.31–2.61, P < 0.001, and OR: 1.62, 95%CI: 1.26–2.08, P < 0.001, respectively). Furthermore, patients were less likely to undergo ablation than nephrectomies in 2020 compared to 2016 (OR: 0.69, 95%CI: 0.53–0.90, P = 0.006).
Conclusion
Since 2016, there has been a decreasing trend in the use of ablation for treating RCC in hospitalized patients. Those undergoing ablation tend to be older, African American, Hispanic, and insured by Medicare or Medicaid. Further research is needed to ensure equitable access for optimal treatment of RCC.
{"title":"Management of renal cell carcinoma with ablation in comparison to nephrectomy: A 5-year analysis of inpatient procedural data to evaluate utilization disparities in the United States","authors":"Tarig S. Elhakim , Taha Lodhi , Wilton Fidelis , Allison Brea , Ana Mort , Maryam Mohagheghtabar , Azadeh Tabari , Samuel R. Davis , Raul N. Uppot , Ronald S. Arellano , Michael Dezube , Dania Daye","doi":"10.1016/j.clinimag.2025.110412","DOIUrl":"10.1016/j.clinimag.2025.110412","url":null,"abstract":"<div><h3>Purpose</h3><div>To perform a nationwide analysis of ablation compared to partial and total nephrectomy for the management of renal cell carcinoma (RCC) to evaluate utilization trends and disparities in the USA.</div></div><div><h3>Materials and methods</h3><div>The 2016–2020 National Inpatient Sample was analyzed. Using ICD-10, we identified the diagnosis of RCC then analyzed the utilization trends of ablation and nephrectomies (both partial and complete). To determine if any disparities exist, a multivariate logistic regression was performed to assess the influence of age, sex, race, income, payer, illness severity, geographical location, and hospital factors.</div></div><div><h3>Results</h3><div>From the 183,885 inpatient encounters with RCC, 3045 (1.65 %) underwent ablation, 70,080 (38.1 %) underwent partial nephrectomy, and 110,760 (60.2 %) underwent total nephrectomy. There was no significant difference in the sex between all groups. There was a statistically significant difference in the mean age of those undergoing ablation (67.30, SD = 12.05) versus those undergoing partial nephrectomy (59.27, SD = 13.26) and total nephrectomy (62.22, SD = 14.42) (OR: 1.04, 95%CI: 1.03–1.05, <em>P</em> < 0.001). Compared to White patients, Hispanic and African Americans were more likely to undergo ablation versus nephrectomy (OR: 1.52, 95%CI: 1.16–1.98, <em>P</em> = 0.002 and OR: 1.65, 95%CI: 1.28–2.13, <em>P</em> < 0.001, respectively). Compared to patients on private insurance, those on Medicaid and Medicare were more likely to have ablation than nephrectomy (OR: 1.85, 95%CI: 1.31–2.61, <em>P</em> < 0.001, and OR: 1.62, 95%CI: 1.26–2.08, <em>P</em> < 0.001, respectively). Furthermore, patients were less likely to undergo ablation than nephrectomies in 2020 compared to 2016 (OR: 0.69, 95%CI: 0.53–0.90, <em>P</em> = 0.006).</div></div><div><h3>Conclusion</h3><div>Since 2016, there has been a decreasing trend in the use of ablation for treating RCC in hospitalized patients. Those undergoing ablation tend to be older, African American, Hispanic, and insured by Medicare or Medicaid. Further research is needed to ensure equitable access for optimal treatment of RCC.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"Article 110412"},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1016/j.clinimag.2025.110411
Steven P. Rowe , Jennifer A. Schroeder , Linda C. Chu , Elliot K. Fishman
All of us must find the right balance between team science and fostering leadership with dynamic colleagues. That dichotomy was well-encapsulated in a famous exchange between basketball players Shaquille O'Neal and Kobe Bryant regarding there “being no ‘I’ in team”. In our view, there is nothing more satisfying than collaborating with a team of people and publishing impactful papers or making key discoveries. At the same time, there are innumerable instances of collaborations stumbling along and the team failing to gel in a meaningful way. Strong leaders may be very important to propagating the overall team approach. Those leaders may be acknowledging that the team is composed of individuals who all bring something to the table. In this way, a diversity of backgrounds of the individual teammates makes the team stronger. The key, of course, is to find the right team and build within that team a strong foundation. Ultimately, we need to emphasize the importance of both team science and individual excellence in our work. In this manuscript, we will emphasize that as scientific endeavor continues to become more complex, leveraging diverse teams will be increasingly important – but also that team success cannot come at the expense of the uniquely talented individual.
{"title":"There is no “I” in team: Implications for academic radiology","authors":"Steven P. Rowe , Jennifer A. Schroeder , Linda C. Chu , Elliot K. Fishman","doi":"10.1016/j.clinimag.2025.110411","DOIUrl":"10.1016/j.clinimag.2025.110411","url":null,"abstract":"<div><div>All of us must find the right balance between team science and fostering leadership with dynamic colleagues. That dichotomy was well-encapsulated in a famous exchange between basketball players Shaquille O'Neal and Kobe Bryant regarding there “being no ‘I’ in team”. In our view, there is nothing more satisfying than collaborating with a team of people and publishing impactful papers or making key discoveries. At the same time, there are innumerable instances of collaborations stumbling along and the team failing to gel in a meaningful way. Strong leaders may be very important to propagating the overall team approach. Those leaders may be acknowledging that the team is composed of individuals who all bring something to the table. In this way, a diversity of backgrounds of the individual teammates makes the team stronger. The key, of course, is to find the right team and build within that team a strong foundation. Ultimately, we need to emphasize the importance of both team science and individual excellence in our work. In this manuscript, we will emphasize that as scientific endeavor continues to become more complex, leveraging diverse teams will be increasingly important – but also that team success cannot come at the expense of the uniquely talented individual.</div></div>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"Article 110411"},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：