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

The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family physicians. In this 3-part series, we provide Delphi consensus-based guidance on clinical and imaging findings for patients with known or suspected MASLD (formerly termed nonalcoholic fatty liver disease or NAFLD). Part 1 focuses on the detection and grading of hepatic steatosis on imaging; Part 2 on risk-stratification of patients with MASLD, including a patient pathway using serological and imaging investigations; and Part 3 on the implementation of practice recommendations for quality assurance using shear wave elastography (SWE) and magnetic resonance elastography (MRE) programs. In Part 2 of these guidelines, the WG provides 14 recommendations for risk stratifying MASLD patients into low and high risk for advanced hepatic fibrosis (F ≥ 3) using a combination of serological and imaging investigations. Population screening and risk stratification of MASLD patients using a clinical and serological investigation (FIB-4) followed by imaging pathway is recommended. Clinical, technical, and grading recommendations for point shear wave elastography (pSWE), 2-dimensional SWE (2D-SWE), and MRE are discussed.

Purpose: The precentral cortex normally demonstrates lower signal intensity compared to remainder of the neocortex on 2D fluid attenuated inversion recovery (FLAIR) images. Loss of this normal hypointensity bilaterally can be seen in patients with adult hypoxic-ischemic brain injury (HIBI). We have named this the 'FLAIR motor' sign (FMS). The performance of this sign for detection of HIBI is evaluated in this case-control study.

Methods: MRI studies of 74 consecutive patients with clinical evidence of HIBI following cardiac arrest formed the 'case' group. Controls comprised of normal MRI studies of an equal number of age and gender matched patients. Two fellowship-trained neuro-radiologists reviewed the MRI studies in a blinded randomized fashion and recorded the presence or absence of 'FLAIR motor' sign.

Results: Average time from cardiac arrest to MRI was 7.12 days (range: 1-25 days). The average sensitivity and specificity of 'FLAIR motor' sign for HIBI was 86.49% and 100% respectively. The sign demonstrated excellent inter-reader agreement (kappa >0.8).

Conclusion: The loss of the normal hypointensity in bilateral pre-central cortex on 2D-FLAIR images is a specific and reliable MRI sign of HIBI in the subacute phase following cardiac arrest in adults.

Rationale and Objectives: Artificial intelligence (AI) tools, particularly generative models, are increasingly used to depict clinical roles in healthcare. This study evaluates whether generative AI systems accurately differentiate between radiologists and medical radiation technologists (MRTs), 2 roles often confused by patients and providers. Materials and Methods: We assessed 1380 images and videos generated by 8 text-to-image/video AI models. Five raters evaluated task-role accuracy, attire, equipment, lighting, isolation, and demographics. Statistical tests compared differences across models and roles. Results: MRTs were depicted accurately in 82.0% of outputs, while only 56.2% of radiologist images/videos were role-appropriate. Among inaccurate radiologist depictions, 79.1% misrepresented MRTs tasks. Radiologists were more often male (73.8%) and White (79.7%), while MRTs were more diverse. Stethoscope misuse, lack of disability/religious markers, and overuse of business attire for radiologists further reflected bias. Conclusion: Generative AI frequently misrepresents radiologist roles and demographics, reinforcing stereotypes and public confusion. Greater oversight and inclusion standards are needed to ensure equitable AI-generated healthcare content.

The Canadian Association of Radiologists (CAR) Incidental Findings Working Group has updated its guidance on the management of incidentally detected gallbladder polyps, originally published in 2020. Prompted by new evidence and recent international guidelines, the Working Group re-evaluated the literature and assessed both the 2022 Society of Radiologists in Ultrasound (SRU) Consensus Recommendations and the 2022 joint European guidelines. The updated guidance reflects a shift toward assessing polyp morphology and reduced surveillance and intervention for small polyps, endorsing the SRU's evidence-based, risk-stratified approach over the more conservative European recommendations. This update aims to minimize unnecessary imaging and surgery for benign polyps while maintaining patient safety.

The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family physicians. In this 3-part series, we provide Delphi consensus-based guidance on clinical and imaging findings for patients with known or suspected MASLD (formerly termed non-alcoholic fatty liver disease or NAFLD). Part 1 focuses on the detection and grading of hepatic steatosis on imaging; Part 2 on risk-stratification of patients with MASLD, including a patient pathway that incorporates serological and imaging investigations; and Part 3 on the implementation of practice recommendations for quality assurance using shear wave elastography (SWE) and magnetic resonance elastography (MRE) for disease staging. In the first part of these guidelines, we provide 17 guidance statements for detection, grading, and surveillance of hepatic steatosis using ultrasound (US), CT, or MRI. In addition to conventional B-mode US, we review current evidence on semi-quantitative and quantitative US techniques and provide guidance for appropriate indications and recommended technique.