Current problems in diagnostic radiology最新文献

Background: Disparities in research grant funding have been documented across various fields of medicine; yet gender inequities within radiology remain underexplored.

Objective: To evaluate gender-based differences in NIH radiology grant funding, focusing on the number of grants awarded and average funding amounts received by principal investigators (PIs) from 2009 to 2023.

Methods: A retrospective cross-sectional analysis was conducted using publicly available NIH RePORTER data. Grants awarded to PIs affiliated with radiology departments from 2009 to 2023 were included. Gender was inferred using Genderize.io and verified manually. Extracted data included number of grants, average and total funding amounts, and PI gender. Analyses included descriptive statistics, t-tests for comparing means, and linear regression to evaluate temporal trends.

Results: A total of 9,378 NIH-funded radiology grants were analyzed. Of these, 75.2% (n=7,056) went to men and 24.8% (n=2,322) to women. Men received significantly higher average funding per grant than women ($704.2 K vs $535.5 K; p < 0.0001) and were more likely to be repeat recipients (p < 0.05), revealing a persistent funding gap between genders. Total funding to men PIs was $5.0 B versus $1.3 B for women PIs. While the men-to-women ratio narrowed (7:1 in 2009 to 2.8:1 in 2023), men consistently received higher grant volume and funding annually.

Conclusion: Despite incremental progress in women's representation, these findings underscore ongoing gender disparities in radiology funding. This imbalance may hinder innovation and limit the range of perspectives driving future research. Evidence-informed strategies may help address inequities, promote diversity and innovation, and ensure equitable, high-quality patient care.

Introduction: Recent advancements in Artificial Intelligence (AI)-driven algorithms have improved patient alignment in Computed Tomography (CT) imaging. However, studies mainly focus on single scanners or specific body areas, indicating a need for broader evaluations. Our study uses a Dose Monitoring System (DMS) to compare vertical shifts in CT exams from two scanners, one AI-based and one manually operated.

Methods: We analysed 6983 CT scans from 3000 patients on two scanners operated by the same radiology team using the GE DoseWatch (GE Healthcare, Milwaukee, USA) platform. Statistical analysis included tests for normality and distribution comparison (p<0.05). Parameter estimation used an iterative bootstrap method. We also evaluated how many scans have vertical displacement greater than 20 mm.

Results: Our results showed non-Gaussian vertical shift distributions for both scanners (p <0.01) and significant differences between them (p < 0.01). Notably, 23% of Ascend exams had vertical shifts beyond ±20 mm, compared to 43% for Lightspeed, indicating substantial improvement with AI-assisted positioning.

Conclusion: These findings demonstrate that DMSs can measure alignment accuracy, allowing for the comparison of positioning protocols. However, 23% of AI-assisted examinations showed misalignment, highlighting the need for ongoing training and oversight for technical staff, especially in complex cases. Limitations include reliance on specific software and the absence of image quality and radiation dose comparisons. Future studies should analyse the longterm performance of AI in various clinical settings.

Implications for practice: This study highlights the importance of continuous data analysis for monitoring system performance and identifying training needs. Better positioning accuracy enhances patient care. The study suggests that while AI-based positioning systems provide substantial benefits, their practical use depends on careful integration into clinical workflows and ongoing training of technical staff.

Early hands-on training in image-guided procedures is limited during radiology training. We described our institutional experience implementing cadaveric simulation for CT- and ultrasound (US)-guided procedures to address limited procedural exposure and trainee anxiety early in fellowship. A single-day cadaveric simulation program was implemented for incoming abdominal and musculoskeletal imaging fellows, providing supervised hands-on practice in multiple CT- and US-guided procedures using clinical equipment. Cadaveric simulation was feasible and associated with significant reductions in trainee-reported anxiety and significant improvements in procedural familiarity and confidence across all assessed domains (all p < 0.05). Cadaveric simulation may serve as a valuable adjunct to early procedural training, with future work needed to evaluate objective clinical performance outcomes.

The American Board of Radiology Oral Certifying Exam will return in 2028, prompting a need to update radiology education. Residency programs differ in size, faculty, resources, and educational support, but they all share a key challenge: creating and maintaining a successful oral boards curriculum. The authors suggest using SWOT analysis as a helpful tool for all programs to create, assess, and implement a new oral boards curriculum. This article reviews the internal strengths and weaknesses, as well as the external opportunities and threats related to developing an oral boards curriculum. From their detailed review through SWOT analysis, the authors present an Oral Boards Curriculum Readiness Checklist. The checklist serves as a guide for residency programs to design, evaluate, and improve their oral boards curriculum initiatives. Important domains such as faculty expertise, curriculum integration, case volume and variety, multidisciplinary involvement, structured mock oral exams, simulation methods, technology use, and peer teaching are turned into clear metrics that can help assess readiness, spot gaps, and prioritize necessary changes. Through this checklist, the authors offer an adaptable tool to provide clarity and consistency for programs when establishing new oral board educational efforts and preparing residents for future success on the new exam.

The growing use of biomarker testing for personalized oncologic care has increased the demand for complex and repeated percutaneous biopsies in abdominal and interventional radiology practices. Challenging biopsies can be daunting, requiring a careful assessment of feasibility, safety, and risk tolerance. Several strategies can help optimize the chances of achieving success. Such strategies include leveraging the advantages of the modality chosen for image guidance, ensuring patient comfort, and the use of special techniques, such as IV contrast, navigational tols, and biopsy needle modifications. This review outlines practical tips and tricks for radiologists performing challenging percutaneous biopsies.

Contrast-enhanced ultrasound (CEUS) has gained widespread acceptance in recent years. The addition of ultrasound contrast overcomes the primary limitation of conventional sonography by providing real-time visualization of perfusion characteristics within the target structure. Various publications have described the utility of CEUS in characterising visceral focal lesions. However, in practice, CEUS is used more as a problem-solving modality to obviate the need for CT / MRI or where the latter are indeterminate. We aim to highlight the niche indications where intravascular CEUS may be preferred as the investigation of choice, based on its ease of use and the likelihood of resolving the clinical dilemma. The article is organized with a brief description of the basic principle and advantages of CEUS, followed by an illustration of the specific niche applications. Routine indications like evaluation of focal liver lesions in cirrhosis, demonstrating typical enhancement patterns in hemangioma and focal nodular hyperplasia, and differentiating neuroendocrine tumors from hypovascular tumors (like pancreatic ductal carcinoma) are beyond the purview of this article.

Meckels diverticulum (MD) is the commonest among the omphalomesenteric duct anomaly spectrum with an overall incidence of 2-3% . It is a true diverticulum arising on the antimesenteric side of distal ileum approximately 2 feet from the ileocecal junction. Heterotopic gastric and pancreatic mucosa are commonly found within the diverticulum predisposing to bleeding and inflammation. Complications are more common in male and the type of complication differs based on the age of occurrence and include hemorrhage, inflammation, obstruction, ischemia and tumor formation. Due to overlapping clinical presentation, imaging plays a vital role in the diagnosis of complications. Commonly used imaging modalities include Ultrasonography (USG), Computed Tomography (CT) and Nuclear medicine. This pictorial essay aims at providing the spectrum of Meckels diverticulum related complications, key embyrological concepts, role of imaging in the diagnosis and current guidelines on the management of incidentally picked MD.

Mammography is traditionally regarded as a domain confined to the detection of breast malignancies; however, it can also serve as a mirror for diverse systemic, haematological, autoimmune, infectious, and metabolic diseases. Imaging manifestations may reveal distinctive pathognomonic features that directly suggest an underlying systemic disorder or provide subtle indirect clues that prompt timely multidisciplinary evaluation, thereby sparing patients from unnecessary procedures. In this comprehensive review, we present one of the most diverse compilations of extramammary and systemic disorders manifesting within the breast. Through multimodality imaging and clinico-pathological correlation, we illustrate entities ranging from tubercular mastitis, IgG4-related mastitis, breast lymphoma, breast metastases, to vasculitis, amyloidosis, diabetic mastopathy, and systemic failure states, including cardiac and renal disease. Mammography provides an underutilised opportunity to assess overall patient health, guide systemic illness workup, and aid in risk stratification for conditions such as cardiovascular disease or syndromic malignancy predisposition, in addition to cancer detection. By consolidating these entities into a single resource, this article aims to expand the interpretive lens of breast radiologists, improving diagnostic precision and enabling them to contribute decisively to multidisciplinary patient care.

Background: The practice of paying referral fees, in which radiology service providers offer a percentage of the cost of radiology tests to referring clinicians, is known to exist in India; however, the extent of this practice is not well documented. This study aims to explore how common is this practice and how it affects the cost and quality of radiology services. The study also investigates if this practice varies between the private hospitals and diagnostic centers.

Method: An anonymous online survey was distributed between November 2024 and January 2025 to radiologists currently practicing in India. Total 440 responses were received and the survey data were analyzed using descriptive and comparative statistics.

Results: 85.88% radiologists have witnessed referral fee payment and 80.6% of radiologists believe that at least 20% of cost of any radiology investigation is paid as commission. 58.55% radiologists are of view that referral fee incentivizes clinicians to order unnecessary radiology investigations. Majority of radiologists think that kickback both increases the cost of radiology services for patients and reduces the net radiology revenue per test, which in turn compels them to perform more investigations in shorter timeframe. 75.28% radiologists believe that referral fee reduces the quality of radiology services. Referral fee is more common in diagnostic centres in comparison to the hospitals.

Conclusion: As per perception of practicing radiologists, referral fee payment for diagnostic radiology tests is very common practice in India, which prompts clinicians to order unnecessary radiology tests, increases costs for patients, adds to burnout of radiologists, ultimately negatively impacting the quality of radiology services.

Establishing a Fair and Just Culture (FJC) in healthcare is foundational for enhancing reporting of patient safety events and human errors, driving quality outcomes, and establishing shared accountability among healthcare professionals. Accordingly, we developed and implemented an engaging 3-hour in-person training on FJC that was customized to radiology practice. In the inaugural year, we trained 118 physicians, staff, and operations leaders in radiology and demonstrated that the program results in increased knowledge, skills and attitude ratings collectively by 67.1%. We are sustaining this training program to date and plan to expand it based on participant feedback and interest from stakeholders outside of radiology at our academic institution.