Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes最新文献

Radiology is experiencing rapid and interconnected change, including rising imaging volumes, expanding access demands, and the introduction of artificial intelligence into daily practice. However, many radiologists have limited exposure to structured approaches for leading change in complex clinical environments. Change management research provides a practical vocabulary and set of concepts that can help radiology leaders design and sequence change more effectively. Organizational readiness encompassing cognitive, operational, trust, and resource dimensions is consistently associated with successful transitions. Classic frameworks such as Lewin's change stages, Kotter's 8-step model for mobilizing teams, the ADKAR model for individual adoption, and Armenakis' evidence-based change-messaging principles offer radiology-specific value when planning workflow adjustments, introducing new processes, or shaping departmental culture. Attention to workflow reality, early engagement of key groups, understanding human responses to change, appropriate pacing, particularly during leadership transitions, and clarity of communication further support sustainable change. Applying contemporary change management concepts can help radiology departments and leaders navigate evolving demands while maintaining coherence, stability, and high-quality patient care.

Background: MRI often requires general anesthesia in children, which carries risks, increases costs, and prolongs scan wait times.

Purpose: Our study aimed to evaluate whether virtual reality (VR) simulations could familiarize children with the MRI experience to enable awake scans without anesthesia. Secondary objectives included assessing child anxiety and determining whether movement during the simulation correlated with scan quality.

Materials and methods: In this prospective study, 18 participants underwent a 10-minute VR simulation of an MRI procedure presented as an avatar-led game before their head MRI scan. Child and caregiver anxiety surveys were completed before the simulation and after the MRI. The VR software recorded head motion during the simulation, which was correlated with MRI scan quality.

Results: All participants (n = 18) successfully completed an awake MRI after the simulation session, aiding clinical diagnoses. The average participant age was 5.0 years (±1.3 years). MRI quality assessments indicated 44.4% excellent, 27.8% high-acceptable, 22.2% acceptable, and 5.6% low-acceptable scan quality. No statistically significant changes in anxiety levels were observed. 94.1% of legal guardians reported the VR simulation was effective at preparing their child for the MRI scan.

Conclusion: VR sessions were associated with a significant improvement in caregiver perceptions and enabled successful completion of MRI scans without the need for sedation in all children initially considered to require anesthesia. While no statistically significant reduction in anxiety was observed, the intervention resulted in diagnostic-quality imaging with minimal motion artifacts, supporting its utility as a strategy to facilitate pediatric MRI without anesthesia.

Background: Seizures are common neurological events in children, with neuroimaging playing a crucial role in evaluating new-onset seizures. While magnetic resonance imaging (MRI) is often preferred over computed tomography (CT) for pediatric seizure imaging due to higher sensitivity and lack of ionizing radiation, practices regarding imaging protocols and sedation use vary. Currently, there are no published Canada-wide guidelines describing the practices for workup of pediatric seizures.

Methods: A cross-sectional survey was conducted among radiologists at 16 Canadian tertiary pediatric centers to assess neuroimaging practices for children with new-onset seizures. The survey explored the presence and content of dedicated seizure MRI protocols, sedation use, and strategies to facilitate non-sedated MRI.

Results: Fifteen centers (94%) responded. Only 2 (13%) reported using dedicated new-onset seizure protocols, while 10 (67%) used epilepsy-specific MRI protocols, and the others used different approaches, including variations of routine brain MRI. MRI sequences varied across institutions. Sedation use also varied, with a median sedation age range of 3 months to 6 years. Non-sedated MRI techniques such as feed-and-swaddle (93%) and natural sleep (27%) were commonly used for infants. Video goggles (67%) and child life specialist support (53%) were often used for older children. Only 2 institutions (13%) had fast MRI protocols, and virtual reality preparation was uncommon (13%).

Conclusion: Considerable variability exists in MRI protocols and sedation practices across Canadian pediatric centers evaluating new-onset seizures. Our findings emphasize the need for national consensus guidelines to standardize imaging protocols, reduce sedation use, and optimize care for pediatric seizure patients.