Current Problems in Diagnostic Radiology最新文献_第3页

Patient decision aids (PDA): An opportunity in radiology 病人决策辅助（PDA）：放射学的一个机会。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-27 DOI: 10.1067/j.cpradiol.2025.10.006

Nadja Kadom MD, FACR , Julia E. Goldberg MD, MBA , Matthew D. Cham MD , Robin E. Wyatt , Kerry L Thomas MD, FSAR , Karen E Gerlach MD. MS. MBA , Erin Gomez MD , Nina S. Vincoff MD

引用次数: 0

Integrating programmable mice to improve ergonomics and workflow in radiology residency: A quality improvement initiative 集成可编程鼠标以改善放射学住院医师的人体工程学和工作流程：一项质量改进计划。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-25 DOI: 10.1067/j.cpradiol.2025.10.009

Jay Yu MD MS, Jacob Elam MD, Alden Wyland MD, Ramandeep Singh MD, Theodore Donta MD PhD, Catherine Metz MD

Rationale and Objectives

Radiology residents spend prolonged hours at computer workstations, often leading to ergonomic strain and workflow inefficiency. Programmable mice, commonly used in high-performance computing, may enhance ergonomics and support learning. This study evaluated their perceived impact in graduate medical education.

Materials and Methods

As part of a quality-improvement initiative at a large academic radiology residency program, 16 residents (primarily PGY-2 and PGY-3, with one PGY-4) received programmable mice. Pre- and post-intervention surveys (September 2024, April 2025) assessed usage, adaptation, ergonomics, workflow, and perceived learning support. Institutional exam-volume data were reviewed to provide contextual information on resident workload during the study period.

Results

All residents completed both surveys (100 % follow-up). Nearly all (94 %) used the mouse daily and adapted within four weeks. Residents reported perceived improvements in ergonomics (88 %), workflow (88 %), and learning (88 %). Reported learning support significantly exceeded initial expectations (50 % vs. 88 %, p = 0.02). All participants preferred the programmable mouse over the standard model. Call-taking residents completed approximately 4.9 % more on-call exams than the prior-year cohort, indicating stable or modestly improved throughput during the intervention period.

Conclusion

Programmable mice were rapidly adopted and perceived to improve comfort, workflow, and learning support among radiology residents. These findings suggest that programmable mice represent a low-cost, scalable intervention to enhance ergonomics and support the educational transition in radiology training.

理由和目的：放射科住院医生长时间在计算机工作站工作，经常导致人体工程学压力和工作效率低下。可编程鼠标，通常用于高性能计算，可以提高人体工程学和支持学习。本研究评估了他们对研究生医学教育的感知影响。材料和方法：作为一个大型学术放射学住院医师项目质量改进计划的一部分，16名住院医师（主要是PGY-2和PGY-3，还有1名PGY-4）接受了可编程小鼠。干预前后调查（2024年9月、2025年4月）评估了使用情况、适应性、人体工程学、工作流程和感知学习支持。审查了机构考试量数据，以提供研究期间住院医师工作量的背景信息。结果：所有居民均完成了两项调查（100%随访）。几乎所有（94%）的人每天都使用老鼠，并在四周内适应。居民报告了在人体工程学（88%）、工作流程（88%）和学习（88%）方面的改善。报告的学习支持显著超过最初的预期（50%对88%，p = 0.02）。与标准模型相比，所有参与者都更喜欢可编程鼠标。与前一年的队列相比，接听电话的居民完成的随叫随到的检查大约多4.9%，表明在干预期间，吞吐量稳定或适度提高。结论：可编程小鼠被迅速采用，并被认为可以改善放射住院医师的舒适度、工作流程和学习支持。这些发现表明，可编程小鼠代表了一种低成本、可扩展的干预措施，可以增强人体工程学，并支持放射学培训中的教育转型。

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引用次数: 0

Can CT esophagogram replace fluoroscopic assessment of suspected esophageal leaks after hours without compromising patient safety? Our 6 year multicenter experience 在不影响患者安全的情况下，CT食管造影能否在数小时后取代透视评估疑似食管渗漏？我们6年的多中心经验。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-25 DOI: 10.1067/j.cpradiol.2025.10.010

Minal Jagtiani, Rajat Bhargava, Christopher Mejias, Charles Watt, Puneet Bhargava

Modality of choice for imaging diagnosis of esophageal leaks out of hours has been a dilemma with increasing backlogs and workflow logistics. We highlight our review of current institutional practice and describe the challenges encountered, assessing interchangeability of CT with fluoroscopy to accurately assess for esophageal perforation in recent times.

选择的方式影像学诊断食管泄漏的时间已成为一个两难的积压和工作流程的后勤增加。我们重点回顾了当前的机构实践，并描述了所遇到的挑战，评估了CT与透视的互换性，以准确评估近期的食管穿孔。

引用次数: 0

Detection of small pancreatic ductal adenocarcinoma: The potential of cinematic rendering in earlier lesion detection 小胰腺导管腺癌的检测：电影渲染在早期病变检测中的潜力。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-25 DOI: 10.1067/j.cpradiol.2025.10.018

Hajra Arshad , Sebastian Krueger , Linda C. Chu , Elliot K. Fishman

Small pancreatic ductal adenocarcinomas (PDACs) generally have a more favorable prognosis; however, up to 40 % may be missed on CT scan. Cinematic rendering (CR) is a novel three-dimensional post-processing technique that accentuates subtle textural differences and holds the potential to improve detection of small tumors. It utilizes a complex global lighting model generating photorealistic images with enhanced visualization of shadows and texture based on volumetric scalar fields (Hounsfield units). While CR has been studied for pre-surgical planning and vascular anatomy assessment, its role in detecting small PDACs remains underexplored. This pictorial essay highlights the potential of CR in detecting small PDACs and differentiating surface textures, while also addressing its limitations and future directions.

小胰腺导管腺癌（pdac）通常有较好的预后；然而，高达40%可能在CT扫描中被遗漏。电影渲染（CR）是一种新颖的三维后处理技术，可以突出细微的纹理差异，并具有提高小肿瘤检测的潜力。它利用复杂的全局照明模型生成逼真的图像，增强了基于体积标量场（Hounsfield单位）的阴影和纹理的可视化。虽然CR已被研究用于术前计划和血管解剖评估，但其在检测小pdac中的作用仍未得到充分探讨。这篇图片文章强调了CR在检测小pdac和区分表面纹理方面的潜力，同时也指出了它的局限性和未来的方向。

引用次数: 0

Implementing peer learning in a pediatric division in a university-based health system: Review and illustration of case categories and related quality improvement 在以大学为基础的卫生系统的儿科部门实施同伴学习：病例类别的回顾和说明以及相关的质量改进。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-25 DOI: 10.1067/j.cpradiol.2025.10.013

Carolina V. Guimaraes, William W. Pryor, Marcelo Straus Takahashi, Selima Siala, Rebecca Hansen, Lynn A. Fordham, Lane F. Donnelly

Purpose

- To review 30-months of experience in converting from case-based peer review to peer learning in a pediatric radiology division within an academic university-based radiology department.

Materials & Methods

- Cases were identified by pediatric radiology faculty for a weekly peer learning conference. Cases were categorized as: System Issue, Great Call, Learning Opportunity, New Knowledge, Interesting Case, or Artifact / Quality Issue. Trends in the volume and types of cases reviewed were evaluated for the 30-month period (9/2022 – 2/2025). For all System Issue cases, the total number of executed improvement action plans was recorded and categorized.

Results

- 558 cases were submitted and reviewed for peer learning, for a rate of 18.6/month including the case types: System Issue 83 (15 %), Great Call 41 (7 %), Learning Opportunity 123 (22 %), New Knowledge 16 (3.0 %), Interesting Case 237 (42 %), and Artifact / Quality Issue 58 (10 %). Cases submission increased in each successive period: year 1 (13.3/month) year 2 (20.3/month), year 3 [6 months] (31/month). Of the 83 peer learning cases categorized as system issues, it was found that multiple cases often pointed to the same underlying problem. This allowed for the creation of 38 distinct improvement action plans, which successfully addressed 57 of the original cases. Examples of improvement plans included new imaging protocols, new standardized reports, new processes, minor equipment replacement, and other technical changes.

Conclusions

- Peer Learning was quickly adopted and proved an effective means of identifying and addressing pediatric system issues, fostering collaboration, driving process improvement, and enhancing operational efficiency in an adult-oriented university-based health system.

目的：-回顾30个月的经验，从案例为基础的同行评审转化为同行学习在儿科放射科的学术大学为基础的放射科。材料与方法：病例由儿科放射科教师在每周一次的同行学习会议上确定。案例被分类为：系统问题，伟大的号召，学习机会，新知识，有趣的案例，或工件/质量问题。评估了30个月期间（2022年9月至2025年2月）所审查病例的数量和类型的趋势。对于所有的系统问题案例，已执行的改进行动计划的总数被记录和分类。结果：558个案例被提交并评审，以18.6个/月的速度进行同行学习，包括案例类型：系统问题83(15%)，伟大的呼叫41(7%)，学习机会123(22%)，新知识16(3.0%)，有趣的案例237（42%）和工件/质量问题58（10%）。报告病例数逐年增加：第一年（13.3例/月），第二年（20.3例/月），第三年[6个月]（31例/月）。在83个被归类为系统问题的同伴学习案例中，我们发现多个案例往往指向相同的潜在问题。这允许创建38个不同的改进行动计划，成功地解决了57个原始案例。改进计划的例子包括新的成像协议、新的标准化报告、新的流程、小型设备更换和其他技术变更。结论：在以成人为导向的大学卫生系统中，同伴学习被迅速采用，并被证明是识别和解决儿科系统问题、促进协作、推动流程改进和提高运营效率的有效手段。

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引用次数: 0

A cross-sectional review on the demographics and characteristics of interventional radiology residency program directors in the United States 美国介入放射学住院医师项目主任的人口统计和特征的横断面回顾。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-24 DOI: 10.1067/j.cpradiol.2025.10.015

John Cacciatore , Levi Travis , Emilio Roig , Stephanie Gonzalez , Lindsay Thornton , Shree Venkat

Program directors (PDs) oversee training and generously provide their time to mentorship. Cultural competency and diverse mentorship may better prepare doctors while increasing student interest. This study examines PD demographic data in IR, noting changes from 2020 to 2023. A list of IR PDs for IR programs was obtained from the ACGME. Duplicates were removed. Public websites were searched to collect age, sex, ethnicity, training, and research metrics (RM). Descriptive statistics were made for demographic data and analyzed. There were 114 unique IR PDs. By sex, 18.4 % were female. Mean age was 42.7. Of the 114, 79 had ethnic data, the most common being non-Hispanic white (54.5 %) and the least common were Hispanic (2.5 %) and Black (3.5 %). Only 2.6 % held DO degrees. In 2020, 12 % of PDs were female. In 2019, 17.8 % of trainees were female and 11.3 % were ethnicities under-represented in medicine (3.1 % Black, 8.2 % Hispanic). From 2020 to 2023, the proportion of women PDs increased by 6.4 % surpassing 2019′s 17.8 % of female trainees. Strictly comparing URM, the 7.7 % PDs has not yet met 2019′s 11.3 % of URM IR trainees. However, diversity has increased as Asian and Middle Eastern PDs account for 37.2 %, a greater than 10 % increase from 2019′s trainees. PD diversity may reflect trends in overall IR diversity. The increase in diverse PDs thus far is promising. Increased PD diversity may garner diverse student interest and provide better trained physicians.

项目主管（pd）监督培训，并慷慨地提供他们的时间指导。文化能力和多样化的导师可以更好地培养医生，同时提高学生的兴趣。本研究检查了IR的PD人口统计数据，注意到2020年至2023年的变化。从ACGME获得了IR项目的IR pd列表。删除了重复项。检索公共网站以收集年龄、性别、种族、培训和研究指标（RM）。对人口统计数据进行描述性统计分析。有114个独特的IR pd。按性别划分，18.4%为女性。平均年龄为42.7岁。在114例中，79例有种族数据，最常见的是非西班牙裔白人（54.5%），最不常见的是西班牙裔（2.5%）和黑人（3.5%）。只有2.6%的人拥有职业教育学位。2020年，12%的pd是女性。2019年，17.8%的学员是女性，11.3%的学员是医学领域代表性不足的种族（黑人3.1%，西班牙裔8.2%）。从2020年到2023年，女性博士的比例比2019年的17.8%增长了6.4%。严格比较URM， 7.7%的pd尚未达到2019年URM 11.3%的IR学员。然而，多样性有所增加，亚洲和中东的pd占37.2%，比2019年的培训生增加了10%以上。PD多样性可能反映了整体IR多样性的趋势。到目前为止，各种pd的增加是有希望的。增加PD的多样性可以吸引不同的学生的兴趣，并提供更好的训练有素的医生。

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引用次数: 0

Clinical Correlation: A Defense 临床相关性：一种防御。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-24 DOI: 10.1067/j.cpradiol.2025.10.011

Albab Uddin BS, Rupa Radhakrishnan M.D., Richard B. Gunderman M.D., PhD

The phrase “correlate clinically” has long been a target of satire and criticism in radiology, often dismissed as vague, defensive, or meaningless. At the same time, it reflects a deeper reality -- that imaging alone can rarely tell the whole story. This article examines the historical critique of the phrase, illustrates its pitfalls, and defends its value when reframed as part of a sound clinical discussion.

“临床相关”一词长期以来一直是放射学中讽刺和批评的对象，经常被认为是模糊的、防御性的或无意义的。与此同时，它反映了一个更深层次的现实——仅凭图像很难说明整个故事。本文考察了这一短语的历史批判，说明了它的陷阱，并捍卫了它的价值，当重新定义为一个健全的临床讨论的一部分。

引用次数: 0

Exploring the feasibility and effectiveness of simulated root cause analysis for radiology training 探讨模拟根本原因分析在放射学培训中的可行性和有效性。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-24 DOI: 10.1067/j.cpradiol.2025.10.008

Meredith H. Fishleder , Cathy L. Hannafin MBA/HCM, RN, CPHQ , Lisa M. Ponce MS, RT(R) , Chloe Reyes , Jonathan A. Flug MD, MBA , Logan P. Haug MD , Nelly Tan MD

The Accreditation Council for Graduate Medical Education (ACGME) requires radiology residents to engage in an annual safety event that leads to actionable changes in residency programs. Root cause analysis (RCA) is frequently used to fulfill this requirement. Because actual RCA is rare, simulations are a suitable alternative. We evaluated the feasibility and effectiveness of using simulated RCA curriculum to meet the ACGME safety requirement. During the 2023-2024 academic year, quality improvement staff in the radiology department developed a simulated RCA and invited radiology residents to participate in the training event. Four allied health radiology staff were present to ensure realism. The case scenario involved a computed tomography–guided lung biopsy that resulted in a pneumothorax. During a 1 h session, residents analyzed the scenario, identified root causes, proposed actions, and created an action plan. Before and after the event, participants were asked to complete surveys regarding their knowledge, attitudes, and behaviors related to RCA events by using a 5-point Likert scale, and top box scores were compared. Of 18 residents, 11 (61%) attended. Comparison of presurvey and postsurvey top box scores showed that comfort with RCA event participation significantly increased from 6% to 44% (P = .04). Furthermore, knowledge of what to expect from an RCA event significantly increased from 6% to 56% (P = .01). The ability to identify system issues also significantly increased from 6% to 44% (P = .04). Simulated RCA events are effective for meeting ACGME safety improvement requirements and enhance resident soft skills essential for patient care.

研究生医学教育认证委员会（ACGME）要求放射科住院医师每年参加一次安全活动，从而对住院医师计划进行可操作的改变。根本原因分析（RCA）经常用于满足这一需求。因为实际的RCA很少，所以模拟是一个合适的替代方案。我们评估了使用模拟RCA课程来满足ACGME安全要求的可行性和有效性。在2023-2024学年，放射科质量改进人员开发了模拟RCA，并邀请放射科住院医师参加培训活动。4名专职保健放射学工作人员在场，以确保现实。病例场景涉及计算机断层扫描引导下的肺活检，导致气胸。在1小时的会议中，住院医生分析了情况，确定了根本原因，提出了行动建议，并制定了行动计划。在活动前后，参与者被要求用5分李克特量表完成关于他们与RCA事件相关的知识、态度和行为的调查，并比较顶框得分。在18名居民中，有11人（61%）出席。比较调查前和调查后的顶框得分显示，参与RCA活动的舒适度从6%显著增加到44% （P = .04）。此外，对RCA事件的预期知识从6%显著增加到56% （P = 0.01）。识别系统问题的能力也显著地从6%增加到44% （P = .04）。模拟RCA事件对于满足ACGME安全改进要求和提高住院医生的软技能是有效的。

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引用次数: 0

Understanding the significant underrepresentation of women in radiology 了解女性在放射学中的代表性明显不足。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-10-01 DOI: 10.1067/j.cpradiol.2025.09.018

Veena Peraka B.S., Karuna Raj M.D., Julie Champine M.D., Bersu Ozcan M.D., Basak Dogan M.D.

The aim of this systematic review is to highlight the reasons for a significant underrepresentation of women in radiology. We systematically examined the gender disparity within radiology across career stages, including medical school, residency training, and faculty positions. A comprehensive literature analysis was conducted to identify the determinants influencing female medical students' and physicians' pursuit of radiology.

Despite women making up approximately half of medical school graduates, their representation in radiology remains disproportionately low. Contributing factors include a scarcity of female mentors and insufficient exposure to radiology during medical training, leading to persistent misconceptions about the specialty. Additionally, female radiology faculty members encounter challenges, including gender bias and difficulty advancing in leadership positions, which contribute to professional dissatisfaction. Strategies like the formation of Women in Radiology groups and institutional initiatives have been established to increase mentorship for female trainees and progression of faculty in their careers.

The underrepresentation of women is a concern that warrants attention due to the unique collaborative and empathetic dimensions that women contribute to patient care and education. Throughout their careers, women encounter numerous obstacles that affect their exposure to, involvement in, and satisfaction with the field. Addressing these barriers is crucial for enhancing the presence and influence of women in radiology.

本系统综述的目的是强调妇女在放射学中代表性明显不足的原因。我们系统地研究了放射学在不同职业阶段的性别差异，包括医学院、住院医师培训和教师职位。通过文献分析，探讨影响女医学生和女医师选择放射学的因素。尽管妇女约占医学院毕业生的一半，但她们在放射学领域的比例仍然低得不成比例。造成这种情况的因素包括缺乏女性导师和在医学培训期间接触放射学的机会不足，导致对该专业的误解持续存在。此外，女性放射科教师面临挑战，包括性别偏见和在领导职位上的晋升困难，这导致了职业不满。已经制定了诸如组建妇女放射学小组和机构倡议等战略，以增加对女性受训人员的指导和教师在职业生涯中的发展。妇女代表性不足是一个值得关注的问题，因为妇女对病人护理和教育作出了独特的合作和同情方面的贡献。在她们的职业生涯中，女性会遇到许多障碍，这些障碍会影响她们对该领域的接触、参与和满意度。解决这些障碍对于提高妇女在放射学中的存在和影响至关重要。

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引用次数: 0

The effect of primary operator specialty on diagnostic yield and bleeding complications following percutaneous native renal parenchymal biopsy 主要手术医师专业对经皮原生肾实质活检术后诊断率及出血并发症的影响。

IF 1.5 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Current Problems in Diagnostic Radiology

Pub Date : 2025-09-24 DOI: 10.1067/j.cpradiol.2025.09.012

Agatha Stanek MD , Cyrus T. Thomas MD , Matthew P. Schenker MD , Zhou Lan PhD , Daniel I. Glazer MD

Objectives

To evaluate the safety and efficacy of image-guided percutaneous native renal parenchymal biopsy when performed by abdominal radiologists and nephrologists.

Methods

This IRB-approved single institution retrospective study included all patients undergoing percutaneous native renal parenchymal biopsies performed by abdominal radiologists and nephrologists 1/1/22-12/31/23. Basic demographic data (age, sex, weight), guidance modality, needle gauge, biopsy technique, number of core samples, adverse events, and number of glomeruli obtained were all collected from the electronic health record. Adverse events were graded according to Common Terminology of Adverse Events criteria. Categorical variables were compared with a Fisher exact test and continuous variables were compared with a t-test. Multivariable regression analysis was performed to assess variables that were predictive of adverse events.

Results

A total of 375 biopsies were performed during the study period, 109 by radiologists and 266 by nephrologists. Diagnostic rate was 100% [109/109] for radiologists and 99.2% [264/266] for nephrologists (p=1.0). Mean number of glomeruli (36.7 vs. 30.9; p<0.001) was higher for biopsies performed by radiologists. Patients undergoing radiologist-performed biopsies were heavier (mean weight 95.8 kg vs 75.1 kg, p<0.001). The incidence of grade 3 or 4 adverse events was similar for radiologists compared to nephrologists (0.9% [1/109] vs 1.1% [3/266]; p=1.0).

Conclusion

Percutaneous renal parenchymal biopsies performed by both specialties achieved nearly universal diagnostic success and had low rates of major complications. Slightly more glomeruli were obtained with radiologist-performed biopsies.

目的：评价影像引导下经皮肾实质活检由腹部放射科医师和肾脏科医师进行的安全性和有效性。方法：这项经irb批准的单机构回顾性研究纳入了所有由腹部放射科医生和肾脏科医生于1月1日至12月31日进行经皮肾实质活检的患者。基本人口统计数据（年龄、性别、体重）、引导方式、针规、活检技术、核心样本数量、不良事件和肾小球数量均从电子健康记录中收集。根据不良事件通用术语标准对不良事件进行分级。分类变量比较采用Fisher精确检验，连续变量比较采用t检验。进行多变量回归分析以评估预测不良事件的变量。结果：在研究期间共进行了375次活检，其中放射科医生109次，肾病科医生266次。放射科诊断率为100%[109/109]，肾病科诊断率为99.2% [264/266]（p=1.0）。结论：两个专科的经皮肾实质活检几乎获得了普遍的诊断成功率，并且主要并发症的发生率很低。放射学活检获得的肾小球略多。

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引用次数: 0