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

Background: Adherence of diagnostic accuracy imaging research to the STARD 2015 reporting guideline was assessed at baseline in 2016; on average, only 55% of 30 items were reported. Several knowledge translation strategies have since been implemented by the STARD group. Purpose: The purpose of this study was to evaluate the adherence of diagnostic accuracy studies recently published in imaging journals to STARD 2015, to assess for changes in the level of adherence relative to the baseline study. Methods: We performed an electronic search on MEDLINE for diagnostic accuracy studies, published between May and June of 2024, from a select group of imaging journals. The timespan was modulated to achieve a sample size of 100 to 150 included studies. Overall and item-specific adherence to STARD 2015 was evaluated, in addition to associations with journal of publication, imaging modality, study design, country of corresponding author, imaging subspecialty area, journal impact factor, and journal STARD adoption. Statistical comparison to the baseline study from 2016 was also performed. Poisson Regression and two-tailed student's tests were used to compare STARD adherence relative to variables included in subgroup analysis. Results: In the 126 included studies, average adherence to STARD 2015 was 61% (18.3/30 items; SD = 3.1), improved compared to the baseline study (55%; 16.6/30 items; SD = 2.2; P < .0001). Studies published in higher impact factor journals reported more items than those in lower impact factor journals (20.6 vs 18.4 items, P-value <.0001). There was no significant association between reporting completeness and journal of publication (P = .7), imaging modality (P = .21), country of corresponding author (P = .46), imaging subspecialty (P = .31), and journal STARD adoption status (P = .55). Conclusion: Recently published diagnostic accuracy studies reported more STARD 2015 items than studies published in 2016, but completeness of reporting is still not optimal.

Purpose: Breast arterial calcifications (BAC) are not routinely reported on mammography but are linked to coronary artery calcification (CAC) and cardiovascular disease (CVD) events. We sought to assess primary care provider (PCP) follow-up after BAC and CAC notification and the association between BAC on mammography and CAC on CT. Methods: Participants without known CVD undergoing mammography at a single centre were prospectively recruited over 18 months. BAC were qualitatively scored (none/mild/moderate/severe) by 2 breast radiologists. All participants had research cardiac CT for CAC within 6 months, scored using the Agatston method. Questionnaires collected baseline demographics, risk factors, and follow-up data. Results: 286 participants were included (median age 62 ± 10). Prevalence of BAC was 13% (38/286), 248 had none, 18 mild, 16 moderate, and 4 severe. For CAC: 180 had none, 70 had mild (CAC 1-99), 28 had moderate (CAC 100-399), and 8 had severe (CAC >400). For detecting CAC, BAC presence had 92% specificity (166/180), 23% sensitivity (24/106), and 67% negative predictive value (166/248). Most participants with BAC and CAC (71%, 17/24) were not on lipid-lowering therapy and 63% (15/24) did not believe they had elevated CVD risk. At follow-up (median 202 days), 46% (11/24) with BAC and CAC implemented lifestyle modifications, 92% (22/24) scheduled PCP follow-up, and 56% (10/18) underwent further CV risk assessment following their appointment. One participant with BAC and CAC had a stroke during follow-up. Conclusion: In a prospective cohort without known CVD undergoing mammography, notification of BAC and CAC status prompted high follow-up rates with PCPs and lifestyle modifications.

Ultrasound (US) is an invaluable tool for evaluating the neonatal spine, offering a non-invasive, cost-effective, and radiation-free imaging alternative. This article reviews the indications, techniques, and sonographic features of congenital and acquired spinal pathologies in neonates. Common indications include the evaluation of atypical sacral dimples, spinal anomalies such as tethered cord and syringomyelia, congenital tumours like sacrococcygeal teratomas, and post-traumatic conditions such as spinal hematomas. Detailed sonographic spine anatomy, variants, and ultrasound guidance for interventions like lumbar puncture are also discussed. By enabling early diagnosis, US is crucial in guiding clinical management, especially in pediatric populations with spinal disorders.

Environmental sustainability in radiology has a growing role in health care as climate changes intensify. Quality Initiative/Improvement (QI) projects lead to improved patient care and safety as well as efficient use of limited health care resources. When designing a QI project, including an environmental lens increases awareness of sustainability in medicine. This document will focus specifically on sustainability in QI (SusQI) in the field of radiology, though similar principles may be applied in other medical fields. The sustainable QI model updates the value equation denominator from cost to the triple bottom line of environmental, social, and economic measures. Using this SusQI model can lead to a win (patient)-win (health care system)-win (environment). This article will also discuss the importance of the environment for human health and the link between quality initiatives and environmental sustainability in demonstrating the value of Radiology and improving the quality of patient care. It will provide some examples of sustainability applied to many quality initiatives in Radiology: For example, reduction in oral contrast use for many previously used indications, streamlined MRI protocols, as well as using ultrasound over CT or MRI for indications that are equally appropriate.

Lung cancer is the second-most diagnosed cancer and the leading cause of cancer-related death in Canada. The updated CAR/CSTR Practice Guideline on CT Screening for Lung Cancer reflects advancements in evidence since the 2016 guideline, including findings from the NELSON trial and preliminary data from multiple provincial lung cancer screening programs, and aims to support Canadian diagnostic imaging departments in implementing organized lung cancer screening programs. The guideline emphasizes screening with the use of low-dose CT (LDCT) to reduce lung cancer mortality in appropriately selected individuals with increased risk of lung cancer, using eligibility criteria based on risk prediction models such as the PLCO_m2012. It outlines training requirements for radiologists, standardized CT and reporting protocols, quality assurance measures, and the integration of AI tools for nodule risk stratification. The document also highlights emerging areas for investigation, including the potential for biennial screening and equitable access to programs across Canada.

Background: Report structures in radiology can be free-text or structured formats. There are currently no guidelines regarding optimal reporting structure for neuroradiological studies. Clear and efficient reports are essential to facilitating communication between healthcare providers. This project characterizes and compares preferred radiological reporting structures in neuroradiology among physicians. Methods: A REDCap survey including questions on practice environments, satisfaction with current reports, and preferences in report structures for 7 studies: MRI Lumbar Spine, MRI Sella, MRI Dementia, MRI Glioma, MRI Brain Metastases, CTA Head and Neck, and CT Unenhanced Brain was drafted and reviewed by radiologists. This anonymous survey collected responses from radiologists and physicians who read neuroradiology reports across the Greater Toronto Area. Results: The survey received 89 responses. Structured reports were preferred over free-text reports across all specialties for each study. Notably, a large proportion (37/44, 84.1%) preferred having structured reports for CTA head and neck. Preferences for MRI Brain Glioma were relatively mixed, with some respondents favouring free-text reports (8/24, 33.3%) and others preferring structured reports (13/24, 54.2%). Respondents preferring structured reports cited "ease in finding information" as the most common reason, while those favouring free-text reports chose "fewer unnecessary sections" most often. Conclusion: This study identifies opportunities to improve the organization and standardization of information in radiology reports. The consistent preference for structured reports highlights the need for guidelines to optimize radiological reporting and enhance communication between specialties.

Bariatric surgery is an effective approach to management of morbid obesity. Given its increasing popularity worldwide, post-operative imaging of patients following bariatric surgery is frequently encountered in clinical practice. In this article we review the physiological principles, normal post-operative anatomy, and imaging appearance of common bariatric procedures (Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and laparoscopic adjustable gastric banding) as well as less common bariatric procedures (including intragastric balloon and biliopancreatic diversion with duodenal switch). Technical considerations and imaging pearls for identifying perioperative and late complications following bariatric procedures will be illustrated through fluoroscopic upper GI studies and computed tomography case examples. Familiarity with expected anatomy and imaging appearances following bariatric procedures allows the radiologist to play a key role in early identification and management of postoperative complications.

Climate change, biodiversity loss, and pollution are disrupting earth's biophysical systems, with adverse effects on local and global human health. Planetary health describes the inextricable link between human health and the health of earth's biophysical systems. There is urgent need for a stronger focus on planetary health among healthcare systems and radiology departments. Medical imaging is a substantial contributor to climate change, responsible for 0.8% to 1% of global greenhouse gas emissions. As demands for medical imaging continue to grow, so will the need for radiologists to provide leadership in environmentally sustainable medical imaging. Mitigation strategies targeting overall reductions in environmental impact are pivotal including reducing the energy consumption of medical imaging equipment and establishing a circular supply chain to reduce unnecessary waste. In addition, radiology departments will need to focus on adaptative measures which build resiliency to the impacts of climate change, some of which will be unavoidable. This review aims to define planetary healthcare in the context of radiology and provide a framework within which to consider specific actions to reduce the environmental footprint of medically necessary medical imaging.