Current problems in diagnostic radiology最新文献

Objective: The primary outcome of this investigation was to describe the frequency and types of ultimate frisbee-related injuries at a single institution over an 11-year period. The secondary outcomes were to report rates of radiographic utilization and surgical intervention.

Materials and methods: TriNetX was utilized to identify patients with ultimate-frisbee related injuries from 2010 to 2021 at a single institution. Injured body parts were recorded and further classified by type of injury. Imaging utilization, including plain radiograph, computed tomography (CT), and magnetic resonance imaging (MRI) were recorded. Rate of subsequent surgery was also recorded.

Results: A total of 187 distinct injury encounters were identified. The most common anatomic regions injured were the knee (23.5 %), shoulder (14.8 %), and ankle (12.2 %). Among knee injuries, anterior cruciate ligament (ACL) tear was the most common type of injury (20.5 %). Sprains were the most common type of injury to the shoulder (34.5 %) and the ankle (64 %). 71.1 % of patients were imaged with radiographs, 16.6 % were imaged with MRI, and 3.7 % of patients were imaged with CT. Additionally, 14.4 % of patients required surgery due to their ultimate frisbee-related injury.

Conclusion: As ultimate frisbee increases in popularity among the general population so does the incidence of ultimate-related injuries. Although these injuries have many similarities with those associated with other non-contact team sports, knowledge of the gameplay and commonly associated injury patterns is integral to initiating effective treatment and management of these injuries.

Background: The sedentary work environment experienced by radiologists makes them highly susceptible to ergonomic challenges. These issues may not only affect work efficiency and productivity but also their overall health and well-being.

Objective: This review explores work-related musculoskeletal disorders (WMSDs) affecting the lower back, hips, knees, and legs in radiologists. Additionally, this paper examines potential prophylactic exercises and treatments for the injuries discussed.

Methods: A comprehensive literature review was conducted on lower-body WMSDs among radiologists by analyzing studies related to ergonomic challenges experienced by sedentary office workers, who share similar risk factors. Topics were categorized into four groups: lower back, hips, legs, and knees. A variety of publications were also reviewed to suggest a broad range of possible interventions, including ergonomic modifications, specific exercises, and prophylactic and therapeutic regimens.

Results: Lumbar spine stiffness and disk herniation were found to be the most common lower back WMSDs due to prolonged sitting. Limited passive hip extension may also contribute to the gradual development of hip osteoarthritis. Additionally, sedentary behavior has been associated with a higher prevalence of deep vein thrombosis and knee osteoarthritis. A wide range of therapeutic interventions, including effective ergonomic practices, stretching, resistance exercises, and aerobic workouts, may help prevent the development of these disorders or, at the very least, manage their symptoms.

Conclusion: Diagnostic radiologists face a significant risk of lower-body ergonomic challenges due to their predominantly sedentary work habits. Addressing these issues through evidence-based interventions can enhance not only their comfort and productivity but also their long-term health.

Background: Breast lesions are a common but often missed incidental finding. We evaluated whether artificial intelligence (AI) algorithms can efficiently detect radiologically significant incidental breast lesions (RSIBLs) missed by original interpreting radiologists (OIRs) on chest CT examinations.

Methods: This retrospective multi-institutional study analyzed chest CT examinations performed in June 2017 by a national teleradiology practice. Visual classifier (VC) and natural language processing (NLP) algorithms flagged potential RSIBLs, which were reviewed independently by two primary readers; disagreements were adjudicated by a third reader. Sizes and margins of confirmed RSIBLs were evaluated similarly. Differences in size and margin obscuration between RSIBLs missed versus identified by OIRs were statistically assessed (alpha, 0.05). A workflow efficiency analysis was performed.

Results: 3279 of 3541 examinations (92.6 %) were marked negative by both algorithms (i.e., VC-/NLP-) and not reviewed. The two primary readers assessed 262 examinations for RSIBLs, with substantial agreement (kappa, 0.77). After adjudication, 76 RSIBLs were confirmed (73 females, 3 males). Compared with the OIRs, the VC algorithm identified more RSIBLs (90.8 % [69/76] vs 39.5 % [30/76]) though with more false positives (67.9 % [178/262] vs. 3.4 % [9/262]). Among the OIRs, missed RSIBLs had smaller diameters than identified RSIBLs (1.4 cm vs. 3.0 cm; P < 0.001). Our reader workflow reduced the number of images viewed by 97.3 % relative to a hypothetical full double-read approach.

Conclusion: An AI-based approach enhanced RSIBL detection rates. Although the AI-based approach also increased the number of false positives, our targeted review process allowed for efficient detection of missed RSIBLs.

Purpose: This study aims to evaluate the impact of race, socioeconomic deprivation, and insurance status on adherence to imaging surveillance within five years following the diagnosis and resection of sarcoma of the bone. It also examines how these factors relate to cancer-related mortality.

Patients and methods: A retrospective cohort study evaluated the relationship between demographics and surveillance imaging adherence among primary bone tumor (PBT) patients at a single institution. Out of 128 patients diagnosed with and surgically managed for a PBT between 2013 and 2018, 91 were chosen for analysis after excluding for metastatic disease at the time of resection and insufficient surveillance data. Surveillance data was collected from patients who were monitored for five years post-resection or until metastasis occurred, with adherence to surveillance imaging protocols and survival assessed over this period.

Results: The cohort comprised 91 patients (56 % male, 44 % female; 71 % White, 24 % Black or African American). Under-represented minority (URM) status was associated with 0.19 odds of receiving optimal imaging adherence (95 % CI [0.05, 0.71], P = .01). Furthermore, URM patients had 3.20 odds of mortality compared to White patients during the five-year follow-up (95 % CI [1.18, 8.67], P = .02).

Conclusion: At our institution, URM patients demonstrate significantly lower adherence to imaging surveillance and higher mortality rates following primary sarcoma resection. These findings highlight the necessity for targeted interventions to address societal and health system factors that contribute to disparities in imaging adherence and survival among URM patients.

Background: Modern CT scanners with wide coverage and high temporal resolution have enabled robust coronary CT angiography (CCTA) with automated phase selection and motion correction algorithms, even at high heart rates and arrhythmia. We hypothesized that these advanced technologies may make it feasible to perform a CCTA without triggering from a patient's ECG signal.

Methods: Forty-three subjects undergoing clinically indicated CCTA were prospectively enrolled. ECG-less CCTA data was acquired for approximately the whole cardiac cycle using a wide-coverage scanner with fast gantry rotation (Revolution Apex, GE HealthCare). Images were generated using seven sub-ranges of the acquired data and evaluated for motion artifact using a 6-point Likert scale by three experts.

Results: The mean age of the study population was 62.0 ± 12.0 years; 51.2 % were male. The mean heart rate (HR) was 65.3 ± 9.0 beats per minute (bpm). Overall image quality (IQ) was higher with motion correction vs standard reconstruction (4.6 ± 0.66 vs 4.0 ± 0.95, p < 0.01). At HR ≤ 60 bpm, 61-70 bpm, ≥ 71 bpm, IQ scores were 4.9 ± 0.31, 4.5 ± 0.66, 4.4 ± 0.78, respectively. IQ from sub-ranges was similar to the reference of the study, reconstructed images from full-phase data, except in the cases where 1/4 of the scanned data was considered in HR ≤ 60 bpm and ≥ 71 bpm (4.3 ± 0.83, 4.6 ± 0.67 and 4.1 ± 0.96 respectively).

Conclusion: CCTA without ECG leads on an advanced CT scanner is feasible. This approach could improve patient comfort, workflow efficiency, and access to CCTA.

Though few feel adequately prepared, the increasing complexity of healthcare systems highlights a need for physicians to develop management skills. Some training programs for residents exist, including Physician Management Pathway. Such programs are inaccessible for radiology residents, underscoring the need for tailored, accessible management training fitting into the standard 4-year radiology residency. The James H. Thrall Management and Leadership Training (MLT) program at Massachusetts General Hospital was designed to address this gap with a tailored, comprehensive curriculum integrating didactics, practical experience, mentorship, and scholarly projects, integrated into the standard four-year radiology residency. The MLT program is comprised of five key components: a structured didactic curriculum, practical administrative experience, mentorship, a scholarly project, and a capstone in health policy and management or quality and patient safety. This manuscript outlines the design, implementation,a nd preliminary outcomes of the MLT program and serves as a model for developing future physician-leaders prepared to navigate the complexities of healthcare.

The Anti-Kickback Statute was passed by Congress in the 1970s to reduce the overuse of government-reimbursed medical services. It attempts to eliminate fraud, abuse, and waste of medical services by outlawing the incentive of personal gain when referring patients for government-funded services. Although safe harbors were written into the law to maintain transactions beneficial to society, they require strict adherence. Anti-Kickback Statute violations are subject to the whistleblower provision of the False Claims Act, and violations can yield significant civil and criminal penalties.