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Comparison of RECIST 1.1, mRECIST and PERCIST for assessment of peptide receptor radionuclide therapy treatment response in metastatic neuroendocrine tumors. 比较 RECIST 1.1、mRECIST 和 PERCIST 用于评估转移性神经内分泌肿瘤的肽受体放射性核素治疗反应。
Pub Date : 2024-10-04 DOI: 10.1067/j.cpradiol.2024.10.003
Jack Zhao, Kaustav Bera, Amr Mohamed, Qiubai Li, Nikhil Ramaiya, Sree Harsha Tirumani

Purpose: To compare RECIST 1.1, modified RECIST (mRECIST) and PERCIST for assessment of Peptide Receptor Radionuclide Therapy (PRRT) treatment response in metastatic neuroendocrine tumors.

Materials: In this IRB-approved, HIPAA compliant retrospective study, patients treated with PRRT between July 2019 and Dec 2022 were identified. Inclusion criteria were presence of at least one pre-and one post-treatment imaging (CT, MRI, Ga 68 or Cu64 DOTATATE PET/CT) within one year of the start and end of PRRT respectively. The imaging was reviewed independently by two radiologists using RECIST 1.1, modified RECIST (mRECIST) and PERCIST criteria. Response of first post treatment scan and presence of disease progression during follow-up were recorded along with the date of best response and disease progression. Statistical analysis was performed to determine inter-reader agreement and agreement between the various response criteria using kappa statistics.

Results: Best response by RECIST 1.1 was recorded in 26 patients (PR-7, SD- 13, PD- 6), by mRECIST in 22 patients (PR-7, SD- 10, PD- 5), by PERCIST in 14 patients (PR-4, SD- 3, PD- 7). Inter-reader agreement was highest for PERCIST (weighted kappa 0.921, standard error 0.078 95% CI 0.769 to 1.000) followed by RECIST 1.1 (weighted kappa 0.897, standard error 0.071 95% CI 0.758 to 1.000) and mRECIST (weighted kappa 0.883, standard error 0.079 95% CI 0.727 to 1.000).

目的:比较 RECIST 1.1、改良 RECIST(mRECIST)和 PERCIST 对转移性神经内分泌肿瘤的肽受体放射性核素疗法(PRRT)治疗反应的评估:在这项经 IRB 批准、符合 HIPAA 标准的回顾性研究中,确定了 2019 年 7 月至 2022 年 12 月期间接受 PRRT 治疗的患者。纳入标准是在 PRRT 开始和结束后一年内,分别至少有一次治疗前和一次治疗后影像学检查(CT、MRI、Ga 68 或 Cu64 DOTATATE PET/CT)。影像学检查由两名放射科医生根据 RECIST 1.1、改良 RECIST (mRECIST) 和 PERCIST 标准独立完成。记录治疗后首次扫描的反应和随访期间的疾病进展情况,以及最佳反应和疾病进展的日期。采用卡帕统计法进行了统计分析,以确定阅读者之间的一致性以及各种反应标准之间的一致性:结果:26 名患者(PR-7,SD- 13,PD- 6)记录了 RECIST 1.1 最佳反应,22 名患者(PR-7,SD- 10,PD- 5)记录了 mRECIST 最佳反应,14 名患者(PR-4,SD- 3,PD- 7)记录了 PERCIST 最佳反应。PERCIST(加权卡帕0.921,标准误差0.078,95% CI 0.769-1.000)的读数间一致性最高,其次是RECIST 1.1(加权卡帕0.897,标准误差0.071,95% CI 0.758-1.000)和mRECIST(加权卡帕0.883,标准误差0.079,95% CI 0.727-1.000)。
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引用次数: 0
Simulated learning environment for diagnosis of appendicitis and other causes of abdominal pain in pregnant patients using MRI. 利用磁共振成像诊断妊娠患者阑尾炎及其他腹痛原因的模拟学习环境。
Pub Date : 2024-10-04 DOI: 10.1067/j.cpradiol.2024.10.005
Daniel R Ludwig, Benjamin S Strnad, Anup S Shetty, Richard Tsai, Vincent M Mellnick

Objectives: Acute appendicitis is a common surgical condition which is usually diagnosed on CT in adult patients, though MRI is frequently used as a first-line diagnostic test in pregnant patients due to its lack of ionizing radiation and superior ability to visualize the appendix compared to ultrasound. Interpretation of abdominal MRI exams in pregnant patients with suspected appendicitis is an important skill in clinical practice, but one that is difficult to become proficient at due to its relative infrequence, even in a high-volume practice.

Methods: We created a simulation-based platform built on an online radiology viewing platform (Pacsbin) for training residents and abdominal imaging fellows to interpret pregnant appendicitis MRI exams, which we made publicly available for use by trainees at any institution (forms.office.com/r/FYyq06rw0v). This platform was used to train our 2024-2025 abdominal imaging fellows (N=8), and we collected pre- and post-intervention survey data which included level of confidence (Likert scale,1-5) in approaching these studies.

Results: We discuss and illustrate the content of our case set, including various teaching points we emphasize throughout the exercise. Among our eight body imaging fellows, the level of confidence in approaching pregnant appendicitis MRI studies after the intervention increased from 2.4 ± 0.7 (range 1-3) to 3.6 ± 0.5 (range 3-4; p = 0.01).

Conclusion: Simulation-based training sets such as this have the potential to supplement traditional approaches in radiology education across a broad range of radiology subspecialities and imaging modalities.

目的:急性阑尾炎是一种常见的外科疾病,成年患者通常通过 CT 诊断,但由于核磁共振成像不含电离辐射,且与超声波相比能更好地观察阑尾,因此经常被用作孕妇的一线诊断检查。对疑似阑尾炎的孕妇进行腹部核磁共振成像检查是临床实践中的一项重要技能,但由于这种检查相对较少,即使在工作量较大的临床实践中也很难熟练掌握:我们在在线放射学浏览平台(Pacsbin)上创建了一个模拟平台,用于培训住院医师和腹部影像学研究员解释妊娠阑尾炎核磁共振检查,并将其公开,供任何机构的受训人员使用(forms.office.com/r/FYyq06rw0v)。我们利用该平台培训了2024-2025年的腹部成像学员(8人),并收集了干预前后的调查数据,其中包括对这些研究的信心程度(李克特量表,1-5):我们讨论并说明了病例集的内容,包括我们在整个练习过程中强调的各种教学要点。我们的八名人体成像研究员在接受干预后,对妊娠阑尾炎 MRI 研究的信心水平从 2.4 ± 0.7(范围 1-3)提高到 3.6 ± 0.5(范围 3-4;P = 0.01):结论:像这样以模拟为基础的培训有可能补充传统放射学教育方法的不足,适用于广泛的放射学亚专业和成像模式。
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引用次数: 0
What can radiologists learn from the AI evolution in dentistry? 放射科医生能从牙科人工智能的发展中学到什么?
Pub Date : 2024-10-03 DOI: 10.1067/j.cpradiol.2024.10.008
Ophir Tanz, Ryan C Rizk, Steven P Rowe, Elliot K Fishman, Linda C Chu
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引用次数: 0
Improving access to outpatient computed tomography. 改善门诊计算机断层扫描的可及性。
Pub Date : 2024-10-03 DOI: 10.1067/j.cpradiol.2024.10.009
Denes Szekeres, Michael Lechner, Susan Moody, Melody Musso, Eric Weinberg, Thomas Murray, Ben Wandtke

Demand for diagnostic imaging services in the United States continues to rise, posing challenges for health systems to maintain efficient scheduling processes. This study documents a quality improvement initiative undertaken at our institution in response to a surge in demand for outpatient imaging during 2022, which led to a notable scheduling backlog. By October 2022, the average scheduling interval, defined as the time from order placement to scheduled examination date, had increased from 2 weeks to 6 weeks. The objective of this initiative was to reduce the scheduling interval from 6 weeks to 10 days by January 2023. Utilizing feedback from schedulers, technologists, and radiologists, several interventions were implemented. The impact of each intervention was monitored with a control chart with weekly appointment delays tracked as a balancing measure. Initially, examination slots were double-booked for a period of 4 weeks to address the backlog, resulting in a reduction of the scheduling interval to 12 days (72 % decrease). Subsequently, examination slot duration was shorted from 20 to 15 min and contrast protocols were standardized across all sites. These adjustments further decreased the interval to 7 days (41 % reduction) over the following 9 weeks. While staffing shift adjustments had no impact on the scheduling interval, the introduction of an extra CT scanner reduced the interval to 3 days (57 % decrease). These interventions resulted in a notable increase in examination volume, from a weekly average of 722 to 860 examinations (19 % increase), approximately an additional $1,612,000 in annual revenue. Importantly, there was no change in the average appointment delay, which remained at 15 min over the study period. These improvements were sustained across the subsequent months and received favorable subjective feedback from staff. While the initiative successfully addressed scheduling inefficiencies across our health system, the rise in examination volumes has led to an increased turnaround time for completed reports. Future directions for enhancing the outpatient scheduling process include expanding online scheduling platforms, implementing systems to assess imaging appropriateness, and developing urgency stratification to prioritize time-sensitive examinations.

美国对影像诊断服务的需求持续上升,这给医疗系统保持高效的排班流程带来了挑战。本研究记录了我院为应对 2022 年期间门诊影像需求激增而采取的质量改进措施,该措施导致了明显的排期积压。到 2022 年 10 月,平均排期间隔(定义为从下单到预定检查日期的时间)从 2 周增加到 6 周。这一举措的目标是在 2023 年 1 月前将排期间隔从 6 周缩短至 10 天。利用排期人员、技术人员和放射科医生的反馈意见,实施了多项干预措施。每项干预措施的影响都通过控制图进行监控,每周跟踪预约延迟情况作为平衡措施。起初,为了解决积压问题,在 4 周内对检查时段进行了双预约,从而将排期间隔缩短至 12 天(减少了 72%)。随后,检查时段的持续时间从 20 分钟缩短至 15 分钟,并在所有站点统一了对比方案。在随后的 9 周内,这些调整进一步将间隔时间缩短至 7 天(减少了 41%)。虽然人员轮班调整对排班间隔没有影响,但额外引进的 CT 扫描仪却将间隔缩短至 3 天(缩短了 57%)。这些干预措施使检查量显著增加,从每周平均 722 次增加到 860 次(增加 19%),年收入约增加 161.2 万美元。重要的是,平均预约延迟时间没有变化,在研究期间保持在 15 分钟。这些改进在随后的几个月中得以持续,并得到了员工的积极反馈。虽然这一举措成功解决了整个医疗系统排班效率低下的问题,但检查量的增加也导致完成报告的周转时间延长。改进门诊排期流程的未来方向包括扩大在线排期平台、实施系统以评估成像的适当性,以及开发紧迫性分层以优先安排时间紧迫的检查。
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引用次数: 0
Differentiating primary from metastatic ovarian tumors of gastrointestinal origin by CT. 通过 CT 鉴别胃肠道来源的原发性和转移性卵巢肿瘤。
Pub Date : 2024-10-03 DOI: 10.1067/j.cpradiol.2024.10.011
Olivia Li, Aya Hamadeh, Ali Pourvaziri, Sarah Mercaldo, Jeffrey Clark, Katherine McLay, Mukesh Harisinghani

Purpose: To determine differentiating CT imaging features of primary ovarian cancers from ovarian metastases of gastrointestinal origin.

Methods: Retrospective study of 50 patients with new ovarian lesions on CT, half were primary ovarian cancers and half gastrointestinal metastases. Two blinded independent readers described tumor characteristics on CT (size, laterality, margin, etc.) and ancillary features (ascites, peritoneal seeding, lymphadenopathy, etc.). Patient age, sex, cancer history, and tumor marker levels for CA-125 and CEA were collected. Wilcoxon test and Pearson's chi-squared test were used for statistical analysis.

Results: 50 patients with mean age of 62.1 years were included. Ovarian metastases were more likely to be cystic/mainly cystic (p=0.013), have smooth margins (p=0.011), and have no/mild enhancement (p<0.001). Primary ovarian lesions were associated with moderate to large volume of ascites (p=0.047) and more commonly seen with lymphadenopathy (p=0.008). Laterality was not significantly different between the two groups. CA-125 level was more commonly elevated in primary ovarian lesions (87% vs 50%, p=0.018), and with much higher values (1076.5 vs 155.1, p=0.013). CEA level was more commonly elevated in metastatic ovarian lesions (83.3% vs 15.4%, p<0.001), and with higher values (72.4 vs 2.1, p<0.001).

Conclusion: Ovarian metastases were more frequently smooth-margined and cystic with little enhancement. Primary ovarian lesions were more commonly associated with lymphadenopathy and larger volume of ascites. Tumor markers CEA and CA-125 were more frequently elevated in metastatic and primary lesions, respectively. Cancer history was the only variable that increased the odds of metastasis and therefore it is important to always correlate with history of cancer.

目的:确定原发性卵巢癌与胃肠道源性卵巢转移瘤的 CT 成像特征:回顾性研究:50 例 CT 检查发现卵巢新病变的患者,其中一半为原发性卵巢癌,一半为胃肠道转移瘤。两名独立的盲人阅片员描述 CT 上的肿瘤特征(大小、侧位、边缘等)和辅助特征(腹水、腹膜播散、淋巴结病等)。收集了患者的年龄、性别、癌症病史以及 CA-125 和 CEA 的肿瘤标志物水平。统计分析采用 Wilcoxon 检验和皮尔逊卡方检验:结果:共纳入 50 名患者,平均年龄为 62.1 岁。卵巢转移灶更倾向于囊性/主要为囊性(P=0.013)、边缘光滑(P=0.011)、无/轻度强化(P结论:卵巢转移灶更倾向于囊性/主要为囊性(P=0.013)、边缘光滑(P=0.011)、无/轻度强化(P=0.011):卵巢转移瘤多为边缘光滑、囊性且几乎无强化。原发性卵巢病变多伴有淋巴结病和较大的腹水。肿瘤标志物CEA和CA-125分别在转移灶和原发灶中更常升高。癌症史是增加转移几率的唯一变量,因此必须始终与癌症史相关联。
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引用次数: 0
Peer review protection: Pish-Posh or pivotal policy? 同行评审保护:小儿科还是关键政策?
Pub Date : 2024-10-03 DOI: 10.1067/j.cpradiol.2024.10.002
Mohammed Al Tarhuni, Richard Duszak, Robert Optican

The Healthcare Quality Improvement Act (HCQIA) of 1986 is a pivotal federal mandate designed to enhance medical care quality through effective professional peer review. Importantly, it offers legal immunity to reviewers under specified conditions and mandates the reporting of adverse actions to the National Practitioner Data Bank (NPDB). This article explores the implementation of peer review processes in hospitals and the potentially severe ramifications of failure to report, using the scenario of a diagnostic radiologist performing high-end vascular interventional procedures, whose performance came under scrutiny, highlighting the intersection of federal and state laws, accreditation standards, hospital policies, and physician professionalism standards and reporting duties.

1986 年的《医疗质量改进法案》(HCQIA)是一项重要的联邦授权,旨在通过有效的专业同行评审提高医疗质量。重要的是,该法案在特定条件下为评审者提供了法律豁免权,并规定必须向国家执业医师数据库(NPDB)报告不良行为。本文以一名从事高端血管介入手术的放射诊断医师的工作表现受到审查为例,探讨了同行评审程序在医院的实施情况以及未报告可能造成的严重后果,突出强调了联邦和州法律、评审标准、医院政策、医师职业标准和报告职责之间的交叉。
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引用次数: 0
Frequency and impact of incorrect data when assessing MR safety for patients with active implants. 评估活动性植入物患者磁共振安全性时出现错误数据的频率和影响。
Pub Date : 2024-10-03 DOI: 10.1067/j.cpradiol.2024.10.010
Samuel J Fahrenholtz, Yuxiang Zhou, William F Sensakovic

Problem: An active implant is a medical device that includes a power source and provides diverse therapies to patients. Active implants are a source of risk to patients undergoing magnetic resonance (MR) imaging. Institutions develop workflows to ensure devices are assessed for MR safety and scanned using acceptable acquisition parameters. Low data integrity can result in incorrect assessments and increased patient risk.

Approach and intervention: The rate of data integrity issues and their causes were not known at our institution. Between March 2020 and April 2023, a survey was distributed for each MR implant case recording the information used to assess MR safety of the implanted device. The leading cause of data integrity loss was incorrect vendor manual for the implant. A list of links to implant vendor manual repositories was added to our workflow in December of 2021 with instructions to always find the most recent version of the device manual.

Outcomes: 749 patient records were reviewed by MR safety experts. Data integrity issues, i.e., a lack of complete and/or correct patient and implant information, occurred in 16% of cases and could impact MR safety (assessment or scanning) in 47% of those cases. A missing or incorrect manual was the leading cause of data integrity loss (78%). The incorrect manual problem initially worsened between October 2021 and March 2022 due to increased surveillance leading to more incorrect manuals being detected. The rate improved by August 2022 and remained high through March of 2023. Reducing the difficulty of finding implant vendor manuals by providing a list of links to vendor manual repositories along with guidance to pull the most recent manual version is an effective strategy to improve data integrity in MR safety workflows.

问题:有源植入物是一种医疗设备,包括电源并为患者提供多种治疗。有源植入物对接受磁共振 (MR) 成像的患者来说是一个风险源。医疗机构需要制定工作流程,确保对设备进行磁共振安全性评估,并使用可接受的采集参数进行扫描。数据完整性低会导致评估错误,增加患者风险:我们机构的数据完整性问题发生率及其原因尚不清楚。在 2020 年 3 月至 2023 年 4 月期间,我们对每个磁共振植入病例进行了调查,记录了用于评估植入设备磁共振安全性的信息。数据完整性丢失的主要原因是植入物的供应商手册不正确。2021 年 12 月,我们在工作流程中添加了植入物供应商手册库的链接列表,并指示始终查找最新版本的设备手册:MR 安全专家审查了 749 份患者记录。16%的病例存在数据完整性问题,即缺乏完整和/或正确的患者和植入物信息,47%的病例可能会影响磁共振安全(评估或扫描)。手册缺失或错误是导致数据完整性丢失的主要原因(78%)。在 2021 年 10 月至 2022 年 3 月期间,由于加强监控导致发现更多错误手册,错误手册问题最初有所恶化。到 2022 年 8 月,这一比率有所改善,直到 2023 年 3 月仍居高不下。通过提供供应商手册库的链接列表以及调取最新手册版本的指导,降低查找植入物供应商手册的难度,是提高 MR 安全工作流程数据完整性的有效策略。
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引用次数: 0
Enhancing radiology training with GPT-4: Pilot analysis of automated feedback in trainee preliminary reports. 利用 GPT-4 加强放射学培训:对学员初步报告中的自动反馈进行试点分析。
Pub Date : 2024-08-15 DOI: 10.1067/j.cpradiol.2024.08.003
Wasif Bala, Hanzhou Li, John Moon, Hari Trivedi, Judy Gichoya, Patricia Balthazar

Rationale and objectives: Radiology residents often receive limited feedback on preliminary reports issued during independent call. This study aimed to determine if Large Language Models (LLMs) can supplement traditional feedback by identifying missed diagnoses in radiology residents' preliminary reports.

Materials & methods: A randomly selected subset of 500 (250 train/250 validation) paired preliminary and final reports between 12/17/2022 and 5/22/2023 were extracted and de-identified from our institutional database. The prompts and report text were input into the GPT-4 language model via the GPT-4 API (gpt-4-0314 model version). Iterative prompt tuning was used on a subset of the training/validation sets to direct the model to identify important findings in the final report that were absent in preliminary reports. For testing, a subset of 10 reports with confirmed diagnostic errors were randomly selected. Fourteen residents with on-call experience assessed the LLM-generated discrepancies and completed a survey on their experience using a 5-point Likert scale.

Results: The model identified 24 unique missed diagnoses across 10 test reports with i% model prediction accuracy as rated by 14 residents. Five additional diagnoses were identified by users, resulting in a model sensitivity of 79.2 %. Post-evaluation surveys showed a mean satisfaction rating of 3.50 and perceived accuracy rating of 3.64 out of 5 for LLM-generated feedback. Most respondents (71.4 %) favored a combination of LLM-generated and traditional feedback.

Conclusion: This pilot study on the use of LLM-generated feedback for radiology resident preliminary reports demonstrated notable accuracy in identifying missed diagnoses and was positively received, highlighting LLMs' potential role in supplementing conventional feedback methods.

理由和目标:放射科住院医师在独立调用期间发布的初步报告中收到的反馈通常很有限。本研究旨在确定大语言模型(LLMs)能否通过识别放射科住院医师初步报告中的漏诊来补充传统反馈:从我们的机构数据库中随机抽取了500份(250份训练/250份验证)成对的初步报告和最终报告,时间跨度为2022年12月17日到2023年5月22日。通过 GPT-4 API(gpt-4-0314 模型版本)将提示和报告文本输入 GPT-4 语言模型。对训练/验证集的一个子集进行了迭代提示调整,以指导模型在最终报告中识别初步报告中没有的重要发现。为进行测试,随机选取了 10 份确诊诊断错误的报告子集。14 名有值班经验的住院医师评估了 LLM 生成的差异,并使用 5 点李克特量表完成了他们的经验调查:结果:根据 14 位住院医师的评价,该模型在 10 份测试报告中识别出了 24 个独特的漏诊,模型预测准确率为 i%。用户还发现了另外 5 项诊断,模型灵敏度达到 79.2%。评估后调查显示,LLM 生成反馈的平均满意度为 3.50,感知准确度为 3.64(满分为 5 分)。大多数受访者(71.4%)赞成将 LLM 生成的反馈与传统反馈相结合:这项针对放射科住院医师初步报告使用由实验室管理员生成反馈意见的试点研究在识别漏诊方面表现出了显著的准确性,并获得了积极的反响,凸显了实验室管理员在补充传统反馈方法方面的潜在作用。
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引用次数: 0
Instagram reels versus image posts in radiology education. Instagram 卷轴与放射学教育中的图片帖子。
Pub Date : 2024-08-14 DOI: 10.1067/j.cpradiol.2024.08.005
Lilly Kauffman, Felipe Lopez-Ramirez, Edmund M Weisberg, Elliot K Fishman

Objective: In January 2016, we created an Instagram page for radiology education. Numerous publications in different fields have reported that Instagram "reels," introduced in 2020 as a short-form video feature, are more popular than image posts. These findings and our familiarity with Instagram prompted us to analyze our own data to better understand how image posts compared with reels when used in the context of radiology education.

Materials and methods: For each post category, metric values were extracted from the Instagram platform and analyzed as continuous variables, reported as medians with interquartile ranges (IQR). Metrics were compared between image categories using the Kruskal-Wallis test, with resulting p-values adjusted for multiple comparisons using the Bonferroni correction. Corrected p-values of less than 0.05 were considered statistically significant.

Results: We included 128 images and 96 reels in the analysis. Images generally reached a larger audience, with a median of 18,745 [IQR: 13,478-27,243] impressions vs. 11,972 [IQR: 9,310.0-13,844.5] for reels (p < 0.01). Images also tended to be shared more frequently (median 19 vs. 20, p < 0.01), liked more often (median 480 vs. 296, p < 0.01), and saved more by users (median 138 vs. 84, p < 0.01) than reels, respectively. Both images and reels received a similar number of comments, with a median of 3 comments for both (p > 0.99). We also explored the performance differences of image post subcategories. Within images, our "You Make the Call!" (YMTC) questions (n = 23) displayed higher performance metrics across the board than the three other types of image posts combined (n = 105). When compared, the median number of impressions for YMTC images was 36,735 [IQR: 31,343-40,742] vs. 15,992 [IQR:12,774-21,873] for other types of images (p < 0.01). YMTC images were shared more often (median 25 vs. 17, p < 0.01), received more likes (median 809 vs. 445, p < 0.01) and saves (median 206 vs. 119, p < 0.01) than non-YMTC images, respectively. User engagement showed slightly different trends with YMTC reels being the most liked, while quiz reels receiving the most comments and talking clips being the most saved.

Conclusion: Our findings on the use of Instagram in radiology education suggest that static images perform much better than reels. Consequently, we recommend to radiology educators seeking to establish an Instagram presence that using static image posts is an appropriate approach for reaching a radiology audience, particularly with image posts that engage an audience with participatory opportunities such as answering quiz-like questions aimed at making a diagnosis.

目标:2016 年 1 月,我们创建了放射学教育 Instagram 页面。不同领域的许多出版物都报道说,Instagram 在 2020 年推出的短视频功能 "reels "比图片帖子更受欢迎。这些发现以及我们对 Instagram 的熟悉促使我们对自己的数据进行分析,以便更好地了解在放射学教育背景下,图片帖子与短片的对比情况:我们从 Instagram 平台提取了每个帖子类别的指标值,并将其作为连续变量进行分析,以中位数和四分位数间距 (IQR) 的形式进行报告。使用 Kruskal-Wallis 检验对不同图片类别的指标进行比较,并使用 Bonferroni 校正对得出的 p 值进行多重比较调整。校正后的 p 值小于 0.05 即为具有统计学意义:我们分析了 128 幅图像和 96 个卷轴。图片的受众普遍较多,中位数为 18,745 [IQR:13,478-27,243],而卷轴的中位数为 11,972 [IQR:9,310.0-13,844.5](P < 0.01)。图片的分享频率(中位数 19 vs. 20,p < 0.01)、被喜欢的频率(中位数 480 vs. 296,p < 0.01)和被保存的频率(中位数 138 vs. 84,p < 0.01)也分别高于短片。图片和卷轴收到的评论数量相似,中位数均为 3 条(p > 0.99)。我们还探讨了图片帖子子类别的表现差异。在图片中,我们的 "你说了算!"(YMTC) 问题(n = 23)的性能指标全面高于其他三类图片帖子的总和(n = 105)。相比之下,YMTC 图片的印象数中位数为 36,735 [IQR:31,343-40,742],而其他类型图片的印象数中位数为 15,992 [IQR:12,774-21,873](P < 0.01)。与非 YMTC 图片相比,YMTC 图片的分享频率更高(中位数为 25 vs. 17,p < 0.01),获得的点赞数(中位数为 809 vs. 445,p < 0.01)和保存数(中位数为 206 vs. 119,p < 0.01)也更多。用户参与呈现出略微不同的趋势,YMTC 卷轴最受喜欢,而问答卷轴收到的评论最多,谈话剪辑被保存的最多:我们关于在放射学教育中使用 Instagram 的研究结果表明,静态图片的表现要比视频短片好得多。因此,我们建议寻求在 Instagram 上建立影响力的放射学教育工作者,使用静态图片帖子是接触放射学受众的合适方法,尤其是那些让受众有参与机会的图片帖子,如回答旨在做出诊断的类似问答的问题。
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引用次数: 0
Qualitative interviews for hospitalists addressing lung cancer screening. 针对医院医生的肺癌筛查定性访谈。
Pub Date : 2024-08-14 DOI: 10.1067/j.cpradiol.2024.08.011
Brett C Bade, Alex Makhnevich, Katherine L Dauber-Decker, Jeffrey Solomon, Elizabeth Cohn, Jesse Chusid, Suhail Raoof, Gerard Silvestri, Stuart L Cohen

Novel strategies are needed to improve low rates of lung cancer screening (LCS) in the US. Seeking to determine hospitalists' perspectives on leveraging hospitalizations to identify patients eligible for LCS, we performed qualitative interviews with eight hospitalists from two hospitals within a large integrated healthcare system. The interviews used semi-structured questions to assess (1) knowledge and practice of general screening and LCS guidelines from the United States Preventive Services Task Force (USPSTF), (2) identification of smoking history, and (3) hospitalists' views on how data obtained during hospitalization may be utilized to improve general screening and LCS post hospitalization. We ultimately reached the conclusion that hospitalists would support a dedicated program to identify hospitalized patients eligible for LCS and facilitate testing after discharge. Efforts to identify patients and arrange subsequent screening should be performed by team members outside the inpatient team.

美国需要新的策略来改善肺癌筛查(LCS)率低的问题。为了了解医院医生对利用住院治疗来识别符合肺癌筛查条件的患者的看法,我们对一家大型综合医疗系统内两家医院的八名医院医生进行了定性访谈。访谈使用了半结构化问题,以评估(1)对美国预防服务工作组(USPSTF)提供的一般筛查和低碳碳治疗指南的了解和实践,(2)对吸烟史的识别,以及(3)住院医生对如何利用住院期间获得的数据改善一般筛查和住院后低碳碳治疗的看法。我们最终得出的结论是,住院医生将支持一项专门计划,以识别符合 LCS 条件的住院患者,并为出院后的检测提供便利。识别患者和安排后续筛查的工作应由住院团队以外的团队成员执行。
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Current problems in diagnostic radiology
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