{"title":"Bilateral internal carotid dissection: advocating for the use of the “googly eyes sign’’","authors":"Nikolaos-Achilleas Arkoudis MD, PhD , Georgios Velonakis MD, PhD","doi":"10.1067/j.cpradiol.2025.04.001","DOIUrl":"10.1067/j.cpradiol.2025.04.001","url":null,"abstract":"","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 4","pages":"Pages 526-527"},"PeriodicalIF":1.5,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite a decade of significant growth in economic conditions of South Asian countries, people continue to suffer from the pervading problem of malnutrition. High prevalence of child undernutrition despite unprecedented economic growth in these nations have a multifactorial etiology including fetal malnutrition and status of women, inadequate feeding practices in infant and young child, poor household sanitation and untargeted health schemes. The diagnosis and management of malnutrition and its various complications require a multidisciplinary approach and radiologists have a potentially important, albeit currently underutilized, role in early detection, identifying the other clinical mimics such as endocrinal and genetic disorders, and detection of key complications. In this review, we apprise the radiological aspects of PEM and micro-nutritional deficiency and their complications. We also provide a comprehensive structured evaluation scheme for evaluation of a suspected malnourished child.
{"title":"Radiological insights into pediatric undernutrition: Early detection, complications, and a structured evaluation approach","authors":"Ishan Kumar MBBS, MD, DNB , Ashish Verma MBBS, DNB, PhD , Priyanka Aggarwal MBBS, MD , Nidhi Yadav MBBS, MD , Karan Kukreja MBBS, MD , Pramod Kumar Singh MBBS, MD","doi":"10.1067/j.cpradiol.2025.03.002","DOIUrl":"10.1067/j.cpradiol.2025.03.002","url":null,"abstract":"<div><div>Despite a decade of significant growth in economic conditions of South Asian countries, people continue to suffer from the pervading problem of malnutrition. High prevalence of child undernutrition despite unprecedented economic growth in these nations have a multifactorial etiology including fetal malnutrition and status of women, inadequate feeding practices in infant and young child, poor household sanitation and untargeted health schemes. The diagnosis and management of malnutrition and its various complications require a multidisciplinary approach and radiologists have a potentially important, albeit currently underutilized, role in early detection, identifying the other clinical mimics such as endocrinal and genetic disorders, and detection of key complications. In this review, we apprise the radiological aspects of PEM and micro-nutritional deficiency and their complications. We also provide a comprehensive structured evaluation scheme for evaluation of a suspected malnourished child.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 5","pages":"Pages 616-626"},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-08DOI: 10.1067/j.cpradiol.2025.03.001
Negar Firoozeh MD , Sung Yoon Park MD , Yaw Nyame MD , Arash Mahdavi MD , Seyed Ali Nabipoorashrafi MD , Achille Mileto MD , Bahar Mansoori MD , Antonio C Westphalen MD, PhD
Objective
To compare Prostate Imaging Reporting and Data System (PI-RADS) scores derived from a standard multiparametric prostate MRI (mpMRI) protocol with those from a protocol consisting only of T2-weighted and dynamic contrast-enhanced images (T2+DCE MRI).
Methods
In this retrospective, single-center, cross-sectional study approved by the IRB and compliant with HIPAA, 492 MRI exams performed in 2022 were analyzed. PI-RADS scores from mpMRIs were extracted from medical records, and new scores were generated for T2+DCE MRI following PI-RADS guidelines. Score differences were evaluated using Wilcoxon signed-rank and McNemar's tests, stratified by lesion location (peripheral zone, PZ, and transition zone, TZ). Diagnostic accuracies of the two methods were compared using ROC curves, and logistic regression was employed to identify predictors of score changes.
Results
Notable differences in PI-RADS scores were observed were observed in the PZ (P = 0.03) and TZ (P < 0.001). 4.8 % of PZ and 4.0 % of TZ PI-RADS 3-5 lesions were misclassified as PI-RADS 1-2 on T2W+DCE MRI (PZ vs TZ, P = 0.64). However, ROC curve analyses revealed no significant difference in diagnostic accuracy between mpMRI (Az = 0.77) and T2+DCE MRI (Az = 0.75, P = 0.07). PSA density was identified as a predictor of score changes from PI-RADS 3-5 to 1-2, although the effect size was modest.
Conclusions
Although T2+DCE MRI yields different PI-RADS scores compared to mpMRI, the clinical impact on diagnostic accuracy and decision-making is overall small. This supports the continued use of T2+DCE MRI, particularly when diffusion-weighted imaging is compromised.
{"title":"Diagnostic impact of DWI absence on prostate lesion assessment using PI-RADS 2.1","authors":"Negar Firoozeh MD , Sung Yoon Park MD , Yaw Nyame MD , Arash Mahdavi MD , Seyed Ali Nabipoorashrafi MD , Achille Mileto MD , Bahar Mansoori MD , Antonio C Westphalen MD, PhD","doi":"10.1067/j.cpradiol.2025.03.001","DOIUrl":"10.1067/j.cpradiol.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>To compare Prostate Imaging Reporting and Data System (PI-RADS) scores derived from a standard multiparametric prostate MRI (mpMRI) protocol with those from a protocol consisting only of T2-weighted and dynamic contrast-enhanced images (T2+DCE MRI).</div></div><div><h3>Methods</h3><div>In this retrospective, single-center, cross-sectional study approved by the IRB and compliant with HIPAA, 492 MRI exams performed in 2022 were analyzed. PI-RADS scores from mpMRIs were extracted from medical records, and new scores were generated for T2+DCE MRI following PI-RADS guidelines. Score differences were evaluated using Wilcoxon signed-rank and McNemar's tests, stratified by lesion location (peripheral zone, PZ, and transition zone, TZ). Diagnostic accuracies of the two methods were compared using ROC curves, and logistic regression was employed to identify predictors of score changes.</div></div><div><h3>Results</h3><div>Notable differences in PI-RADS scores were observed were observed in the PZ (<em>P</em> = 0.03) and TZ (<em>P</em> < 0.001). 4.8 % of PZ and 4.0 % of TZ PI-RADS 3-5 lesions were misclassified as PI-RADS 1-2 on T2W+DCE MRI (PZ vs TZ, <em>P</em> = 0.64). However, ROC curve analyses revealed no significant difference in diagnostic accuracy between mpMRI (Az = 0.77) and T2+DCE MRI (Az = 0.75, <em>P</em> = 0.07). PSA density was identified as a predictor of score changes from PI-RADS 3-5 to 1-2, although the effect size was modest.</div></div><div><h3>Conclusions</h3><div>Although T2+DCE MRI yields different PI-RADS scores compared to mpMRI, the clinical impact on diagnostic accuracy and decision-making is overall small. This supports the continued use of T2+DCE MRI, particularly when diffusion-weighted imaging is compromised.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 5","pages":"Pages 596-602"},"PeriodicalIF":1.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-18DOI: 10.1067/j.cpradiol.2025.02.002
Zier Zhou , Arsalan Rizwan , Nick Rogoza , Andrew D Chung , Benjamin YM Kwan
Purpose
Recent competency-based medical education (CBME) implementation within Canadian radiology programs has required faculty to conduct more assessments. The rise of narrative feedback in CBME, coinciding with the rise of large language models (LLMs), raises questions about the potential of these models to generate informative comments matching human experts and associated challenges. This study compares human-written feedback to GPT-3.5-generated feedback for radiology residents, and how well raters can differentiate between these sources.
Methods
Assessments were completed by 28 faculty members for 10 residents within a Canadian Diagnostic Radiology program (2019–2023). Comments were extracted from Elentra, de-identified, and parsed into sentences, of which 110 were randomly selected for analysis. 11 of these comments were entered into GPT-3.5, generating 110 synthetic comments that were mixed with actual comments. Two faculty raters and GPT-3.5 read each comment to predict whether it was human-written or GPT-generated.
Results
Actual comments from humans were often longer and more specific than synthetic comments, especially when describing clinical procedures and patient interactions. Source differentiation was more difficult when both feedback types were similarly vague. Low agreement (k=-0.237) between responses provided by GPT-3.5 and humans was observed. Human raters were also more accurate (80.5 %) at identifying actual and synthetic comments than GPT-3.5 (50 %).
Conclusion
Currently, GPT-3.5 cannot match human experts in delivering specific, nuanced feedback for radiology residents. Compared to humans, GPT-3.5 also performs worse in distinguishing between actual and synthetic comments. These insights could guide the development of more sophisticated algorithms to produce higher-quality feedback, supporting faculty development.
{"title":"Differentiating between GPT-generated and human-written feedback for radiology residents","authors":"Zier Zhou , Arsalan Rizwan , Nick Rogoza , Andrew D Chung , Benjamin YM Kwan","doi":"10.1067/j.cpradiol.2025.02.002","DOIUrl":"10.1067/j.cpradiol.2025.02.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Recent competency-based medical education (CBME) implementation within Canadian radiology programs has required faculty to conduct more assessments. The rise of narrative feedback in CBME, coinciding with the rise of large language models (LLMs), raises questions about the potential of these models to generate informative comments matching human experts and associated challenges. This study compares human-written feedback to GPT-3.5-generated feedback for radiology residents, and how well raters can differentiate between these sources.</div></div><div><h3>Methods</h3><div>Assessments were completed by 28 faculty members for 10 residents within a Canadian Diagnostic Radiology program (2019–2023). Comments were extracted from Elentra, de-identified, and parsed into sentences, of which 110 were randomly selected for analysis. 11 of these comments were entered into GPT-3.5, generating 110 synthetic comments that were mixed with actual comments. Two faculty raters and GPT-3.5 read each comment to predict whether it was human-written or GPT-generated.</div></div><div><h3>Results</h3><div>Actual comments from humans were often longer and more specific than synthetic comments, especially when describing clinical procedures and patient interactions. Source differentiation was more difficult when both feedback types were similarly vague. Low agreement (<em>k</em>=-0.237) between responses provided by GPT-3.5 and humans was observed. Human raters were also more accurate (80.5 %) at identifying actual and synthetic comments than GPT-3.5 (50 %).</div></div><div><h3>Conclusion</h3><div>Currently, GPT-3.5 cannot match human experts in delivering specific, nuanced feedback for radiology residents. Compared to humans, GPT-3.5 also performs worse in distinguishing between actual and synthetic comments. These insights could guide the development of more sophisticated algorithms to produce higher-quality feedback, supporting faculty development.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 5","pages":"Pages 574-578"},"PeriodicalIF":1.5,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-11DOI: 10.1067/j.cpradiol.2025.02.001
Michael Mathelier BS , Abheek Raviprasad MD , Kevin Pierre MD , Persis Desai BS , Olivia Scheuermann BS , Christopher Sistrom MD, PhD, MPH , Roberta Slater MD , Otgonbayar Batmunh MS , Linda Lanier MD , Anthony Mancuso MD , Dhanashree Rajderkar MD , Priya Sharma MD
Purpose
To assess radiology residents' diagnostic accuracy in interpreting thoracic emergency cases using the Wisdom in Diagnostic Imaging Simulation (WIDI SIM) platform and identify potential areas for educational improvement.
Methods
In this retrospective study, 761 radiology residents were assessed on five thoracic emergency cases using WIDI SIM over four years. Cases included bronchial disruption, septic emboli, ventricular perforation, pulmonary embolism, and a negative pulmonary CTA. Residents provided free-text interpretations, which were scored by faculty using a standardized point system. Scores and errors were analyzed using descriptive statistics and the Kruskal-Wallis test.
Results
Residents' performance varied across the five cases, with the highest average score on the negative pulmonary CTA (9.59) and the lowest on bronchial disruption (6.59). Observational errors were more common than interpretive errors. The Kruskal-Wallis test revealed significant differences in median scores across the cases (p < 0.0001), with pairwise comparisons showing significant differences in all but two comparisons.
Conclusion
This study reveals significant variability in radiology residents' diagnostic accuracy in interpreting thoracic emergency cases, with a high prevalence of observational errors. Our observations emphasize the need for targeted educational strategies to address specific areas of weakness and improve diagnostic accuracy in this critical area of radiology practice.
{"title":"Assessment of radiology residents' diagnostic accuracy in thoracic emergencies using the WIDI SIM platform","authors":"Michael Mathelier BS , Abheek Raviprasad MD , Kevin Pierre MD , Persis Desai BS , Olivia Scheuermann BS , Christopher Sistrom MD, PhD, MPH , Roberta Slater MD , Otgonbayar Batmunh MS , Linda Lanier MD , Anthony Mancuso MD , Dhanashree Rajderkar MD , Priya Sharma MD","doi":"10.1067/j.cpradiol.2025.02.001","DOIUrl":"10.1067/j.cpradiol.2025.02.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess radiology residents' diagnostic accuracy in interpreting thoracic emergency cases using the Wisdom in Diagnostic Imaging Simulation (WIDI SIM) platform and identify potential areas for educational improvement.</div></div><div><h3>Methods</h3><div>In this retrospective study, 761 radiology residents were assessed on five thoracic emergency cases using WIDI SIM over four years. Cases included bronchial disruption, septic emboli, ventricular perforation, pulmonary embolism, and a negative pulmonary CTA. Residents provided free-text interpretations, which were scored by faculty using a standardized point system. Scores and errors were analyzed using descriptive statistics and the Kruskal-Wallis test.</div></div><div><h3>Results</h3><div>Residents' performance varied across the five cases, with the highest average score on the negative pulmonary CTA (9.59) and the lowest on bronchial disruption (6.59). Observational errors were more common than interpretive errors. The Kruskal-Wallis test revealed significant differences in median scores across the cases (<em>p</em> < 0.0001), with pairwise comparisons showing significant differences in all but two comparisons.</div></div><div><h3>Conclusion</h3><div>This study reveals significant variability in radiology residents' diagnostic accuracy in interpreting thoracic emergency cases, with a high prevalence of observational errors. Our observations emphasize the need for targeted educational strategies to address specific areas of weakness and improve diagnostic accuracy in this critical area of radiology practice.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"55 1","pages":"Pages 105-110"},"PeriodicalIF":1.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-07DOI: 10.1067/j.cpradiol.2025.01.005
Cody R. Johnson MD, Syed Muhammad Awais Bukhari MD, Amit Gupta MD
Personnel wellness in professional environments is often perceived as a secondary concern wherein efficiency and productivity are prioritized. The Blue Zones philosophy challenges this traditional approach. We propose implementing consistent wellness practices that are based on the Blue Zones principles and believe that these will primarily benefit providers and organizations as a whole. By fostering an environment where all interactions and activities nurture the collective, we can reimagine wellness as an integral part of professional life.
{"title":"Personnel wellness: Creating the next blue zone in radiology","authors":"Cody R. Johnson MD, Syed Muhammad Awais Bukhari MD, Amit Gupta MD","doi":"10.1067/j.cpradiol.2025.01.005","DOIUrl":"10.1067/j.cpradiol.2025.01.005","url":null,"abstract":"<div><div>Personnel wellness in professional environments is often perceived as a secondary concern wherein efficiency and productivity are prioritized. The Blue Zones philosophy challenges this traditional approach. We propose implementing consistent wellness practices that are based on the Blue Zones principles and believe that these will primarily benefit providers and organizations as a whole. By fostering an environment where all interactions and activities nurture the collective, we can reimagine wellness as an integral part of professional life.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 4","pages":"Pages 440-442"},"PeriodicalIF":1.5,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-31DOI: 10.1067/j.cpradiol.2025.01.014
Isabella E. Amador MS , Abheek G. Raviprasad MD , Kevin Pierre MD , Nicholas Rodriguez-Zingg , Kerolus Anis , Roberta M. Slater MD , Christopher L. Sistrom MD, PhD , Ivan Davis MD , Anthony A. Mancuso MD , Dhanashree Rajderkar MD
Purpose
To evaluate radiology resident performance in diagnosing four non-traumatic musculoskeletal (MSK) pathologies that have historically yielded low scores on the Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM).
Materials and Methods
This multi-institutional, retrospective study analyzed WIDI SIM data collected from 2015 to 2021. A total of 351 radiology residents (R1–R4) interpreted 65 de-identified imaging cases, four of which focused on septic arthritis/osteomyelitis of the shoulder, septic arthritis/osteomyelitis of the hip, acetabular neoplasm, and Legg-Calve-Perthes disease. Each case was scored using a standardized 10-point rubric (0–2 = critical error, 3–6 = problematic omissions, 7–10 = effective report). Scores were further categorized into observational (missed findings) and interpretive (incorrect conclusion despite correct identification) errors. The Kruskal-Wallis test with Dunn's multiple comparisons was used to assess performance differences across postgraduate years.
Results
Among these four MSK pathologies, only hip osteomyelitis demonstrated a statistically significant difference across training levels (p = 0.0063), although no specific pairwise comparisons were significant. Average scores remained relatively low across all cases, with observational errors surpassing interpretive errors in frequency.
Conclusion
Radiology residents struggled to accurately diagnose non-traumatic MSK pathologies in a simulated on-call setting, predominantly due to missed imaging findings. Implementation of enhanced training strategies, such as targeted case review, high-yield simulations, and systematic visual search protocols, may improve MSK diagnostic competency and reduce the risk of clinically significant oversights.
{"title":"Radiology resident competency in diagnosing non-traumatic musculoskeletal conditions: A simulation-based assessment using WIDI SIM","authors":"Isabella E. Amador MS , Abheek G. Raviprasad MD , Kevin Pierre MD , Nicholas Rodriguez-Zingg , Kerolus Anis , Roberta M. Slater MD , Christopher L. Sistrom MD, PhD , Ivan Davis MD , Anthony A. Mancuso MD , Dhanashree Rajderkar MD","doi":"10.1067/j.cpradiol.2025.01.014","DOIUrl":"10.1067/j.cpradiol.2025.01.014","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate radiology resident performance in diagnosing four non-traumatic musculoskeletal (MSK) pathologies that have historically yielded low scores on the Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM).</div></div><div><h3>Materials and Methods</h3><div>This multi-institutional, retrospective study analyzed WIDI SIM data collected from 2015 to 2021. A total of 351 radiology residents (R1–R4) interpreted 65 de-identified imaging cases, four of which focused on septic arthritis/osteomyelitis of the shoulder, septic arthritis/osteomyelitis of the hip, acetabular neoplasm, and Legg-Calve-Perthes disease. Each case was scored using a standardized 10-point rubric (0–2 = critical error, 3–6 = problematic omissions, 7–10 = effective report). Scores were further categorized into observational (missed findings) and interpretive (incorrect conclusion despite correct identification) errors. The Kruskal-Wallis test with Dunn's multiple comparisons was used to assess performance differences across postgraduate years.</div></div><div><h3>Results</h3><div>Among these four MSK pathologies, only hip osteomyelitis demonstrated a statistically significant difference across training levels (<em>p</em> = 0.0063), although no specific pairwise comparisons were significant. Average scores remained relatively low across all cases, with observational errors surpassing interpretive errors in frequency.</div></div><div><h3>Conclusion</h3><div>Radiology residents struggled to accurately diagnose non-traumatic MSK pathologies in a simulated on-call setting, predominantly due to missed imaging findings. Implementation of enhanced training strategies, such as targeted case review, high-yield simulations, and systematic visual search protocols, may improve MSK diagnostic competency and reduce the risk of clinically significant oversights.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"55 1","pages":"Pages 111-117"},"PeriodicalIF":1.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-30DOI: 10.1067/j.cpradiol.2025.01.002
Victor J. Seghers M.D.Ph.D. , Margaret A. Clement , Robert C. Orth M.D.Ph.D. , Marla B.K. Sammer M.D. , Andrew C. Sher M.D.
There are increasing requests and benefits of providing formal written reports for second opinions of outside imaging in part due to medical legal concerns supporting appropriate documentation and concerns that misunderstandings from verbal curbside consults on the part of the requesting physician may lead to suboptimal patient care and potential liability for the radiologist and hospital. Verbal communication of findings on outside imaging is thus often considered insufficient with recommendations from undocumented consultations less likely to be acted upon. The increased work associated with performance of second-opinion interpretations may be substantial, raising concern that if curbside consults are not properly compensated, some second opinion interpretations may be performed more expeditiously than primary interpretations due to their more direct impact upon the daily work load, income, and relative value units. Since 2016, our quaternary-care academic pediatric hospital system has provided and billed for formal second-opinion imaging interpretations upon request for MRI, CT, and Nuclear Medicine exams, and disallowed the process of informal curbside consultations on such studies. This study aims to offer insight into our second opinion interpretation workflows and our experience in obtaining reimbursement for pediatric second opinion interpretations. Our findings indicate a formal second-opinion interpretation program can be financially viable and may help offset the additional resources required, and can serve as a guide to inform other departments attempting to establish a similar process.
{"title":"Reimbursement for outside second opinion imaging interpretation: Experience at a quaternary care academic pediatric health system","authors":"Victor J. Seghers M.D.Ph.D. , Margaret A. Clement , Robert C. Orth M.D.Ph.D. , Marla B.K. Sammer M.D. , Andrew C. Sher M.D.","doi":"10.1067/j.cpradiol.2025.01.002","DOIUrl":"10.1067/j.cpradiol.2025.01.002","url":null,"abstract":"<div><div>There are increasing requests and benefits of providing formal written reports for second opinions of outside imaging in part due to medical legal concerns supporting appropriate documentation and concerns that misunderstandings from verbal curbside consults on the part of the requesting physician may lead to suboptimal patient care and potential liability for the radiologist and hospital. Verbal communication of findings on outside imaging is thus often considered insufficient with recommendations from undocumented consultations less likely to be acted upon. The increased work associated with performance of second-opinion interpretations may be substantial, raising concern that if curbside consults are not properly compensated, some second opinion interpretations may be performed more expeditiously than primary interpretations due to their more direct impact upon the daily work load, income, and relative value units. Since 2016, our quaternary-care academic pediatric hospital system has provided and billed for formal second-opinion imaging interpretations upon request for MRI, CT, and Nuclear Medicine exams, and disallowed the process of informal curbside consultations on such studies. This study aims to offer insight into our second opinion interpretation workflows and our experience in obtaining reimbursement for pediatric second opinion interpretations. Our findings indicate a formal second-opinion interpretation program can be financially viable and may help offset the additional resources required, and can serve as a guide to inform other departments attempting to establish a similar process.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 5","pages":"Pages 590-595"},"PeriodicalIF":1.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-28DOI: 10.1067/j.cpradiol.2025.01.011
Samantha Pfiffner B.S. , Michael Burcescu M.D. , Arif Musa M.D. , Hamed Kordbacheh M.D. , Alhassan Alhasson M.D. , Gulcin Altinok M.D. , Lisa Dillon Ph.D. , Ali Harb M.D.
The evolving landscape of graduate medical education (GME) necessitates innovative approaches to residency program evaluation and improvement. At Detroit Medical Center/Wayne State University, a novel resident-led Program Improvement Committee (PIC) was established in June 2022 within the Diagnostic Radiology Residency Program. The PIC serves as a flexible, resident-driven structure designed to enhance engagement, provide continuous feedback, and implement actionable solutions in collaboration with residency leadership. Unlike traditional Program Evaluation Committees (PECs) and Clinical Competency Committees (CCCs), the PIC promotes a more democratized approach, empowering residents to take ownership of their training. By convening monthly and fostering fluid subcommittees, the PIC has successfully driven initiatives including increased research engagement, mentorship programs, social media enhancement, and system-level improvements such as the establishment of a dedicated WiFi network for hospital employees. The PIC represents a paradigm shift in residency enhancement, offering a responsive, adaptable mechanism for fostering innovation, inclusivity, and collaboration. Further research is needed to evaluate its broader impact, but the PIC has the potential to revolutionize residency training and improve medical education.
{"title":"Take your PIC (Program Improvement Committee): The benefits of a resident-run initiative to improve graduate medical education","authors":"Samantha Pfiffner B.S. , Michael Burcescu M.D. , Arif Musa M.D. , Hamed Kordbacheh M.D. , Alhassan Alhasson M.D. , Gulcin Altinok M.D. , Lisa Dillon Ph.D. , Ali Harb M.D.","doi":"10.1067/j.cpradiol.2025.01.011","DOIUrl":"10.1067/j.cpradiol.2025.01.011","url":null,"abstract":"<div><div>The evolving landscape of graduate medical education (GME) necessitates innovative approaches to residency program evaluation and improvement. At Detroit Medical Center/Wayne State University, a novel resident-led Program Improvement Committee (PIC) was established in June 2022 within the Diagnostic Radiology Residency Program. The PIC serves as a flexible, resident-driven structure designed to enhance engagement, provide continuous feedback, and implement actionable solutions in collaboration with residency leadership. Unlike traditional Program Evaluation Committees (PECs) and Clinical Competency Committees (CCCs), the PIC promotes a more democratized approach, empowering residents to take ownership of their training. By convening monthly and fostering fluid subcommittees, the PIC has successfully driven initiatives including increased research engagement, mentorship programs, social media enhancement, and system-level improvements such as the establishment of a dedicated WiFi network for hospital employees. The PIC represents a paradigm shift in residency enhancement, offering a responsive, adaptable mechanism for fostering innovation, inclusivity, and collaboration. Further research is needed to evaluate its broader impact, but the PIC has the potential to revolutionize residency training and improve medical education.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 5","pages":"Pages 546-549"},"PeriodicalIF":1.5,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vascular anomalies arise during embryologic development due to errors in vasculogenesis. They are associated with sporadic or inherited mutations in receptors, growth factors or enzymes within various vasculogenic pathways such as mTOR, VEGF, and PI3K. Vascular anomalies have the capability to cause significant symptoms and disability, especially when located in the distal extremities. These symptoms often include local pain, swelling, and decreased range of motion and functionality of the affected area.
This article intends to provide a concise overview of vascular anomalies in the distal extremities and their treatment options. The categorization of the vascular anomalies, key clinical features, diagnostic approaches, and potential significance of when they occur in the extremities and how that makes them unique are discussed. An overview of the six major management options used to treat vascular anomalies in general is reviewed in the context of vascular anomalies in the extremities, including observation, pharmacotherapy, sclerotherapy, embolization, cryoablation, and surgery. Each section discusses the role of the treatment approach and associated benefits and risks.
{"title":"Management options for vascular anomalies in the distal extremities","authors":"Chase Mahler BS , Emily Gullette MD , Jake DiFatta BS , Rachel Oser MD FSIR , Junaid Raja MD MSPH FACP","doi":"10.1067/j.cpradiol.2025.01.013","DOIUrl":"10.1067/j.cpradiol.2025.01.013","url":null,"abstract":"<div><div>Vascular anomalies arise during embryologic development due to errors in vasculogenesis. They are associated with sporadic or inherited mutations in receptors, growth factors or enzymes within various vasculogenic pathways such as mTOR, VEGF, and PI3K. Vascular anomalies have the capability to cause significant symptoms and disability, especially when located in the distal extremities. These symptoms often include local pain, swelling, and decreased range of motion and functionality of the affected area.</div><div>This article intends to provide a concise overview of vascular anomalies in the distal extremities and their treatment options. The categorization of the vascular anomalies, key clinical features, diagnostic approaches, and potential significance of when they occur in the extremities and how that makes them unique are discussed. An overview of the six major management options used to treat vascular anomalies in general is reviewed in the context of vascular anomalies in the extremities, including observation, pharmacotherapy, sclerotherapy, embolization, cryoablation, and surgery. Each section discusses the role of the treatment approach and associated benefits and risks.</div></div>","PeriodicalId":51617,"journal":{"name":"Current Problems in Diagnostic Radiology","volume":"54 4","pages":"Pages 506-512"},"PeriodicalIF":1.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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