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Gangi-Burton A, Plumb AA, De Paepe KN, Godfrey EM, Halligan S, Higginson A, Khwaja S, Patel A, Taylor S. Paris classification of colonic polyps using CT colonography: prospective cohort study of interobserver variation. Eur Radiol 2024; 34:6877-6884. [PMID: 38488970 DOI: 10.1007/s00330-024-10631-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/18/2023] [Accepted: 01/16/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND The Paris classification categorises colorectal polyp morphology. Interobserver agreement for Paris classification has been assessed at optical colonoscopy (OC) but not CT colonography (CTC). We aimed to determine the following: (1) interobserver agreement for the Paris classification using CTC between radiologists; (2) if radiologist experience influenced classification, gross polyp morphology, or polyp size; and (3) the extent to which radiologist classifications agreed with (a) colonoscopy and (b) a combined reference standard. METHODS Following ethical approval for this non-randomised prospective cohort study, seven radiologists from three hospitals classified 52 colonic polyps using the Paris system. We calculated interobserver agreement using Fleiss kappa and mean pairwise agreement (MPA). Absolute agreement was calculated between radiologists; between CTC and OC; and between CTC and a combined reference standard using all available imaging, colonoscopic, and histopathological data. RESULTS Overall interobserver agreement between the seven readers was fair (Fleiss kappa 0.33; 95% CI 0.30-0.37; MPA 49.7%). Readers with < 1500 CTC experience had higher interobserver agreement (0.42 (95% CI 0.35-0.48) vs. 0.33 (95% CI 0.25-0.42)) and MPA (69.2% vs 50.6%) than readers with ≥ 1500 experience. There was substantial overall agreement for flat vs protuberant polyps (0.62 (95% CI 0.56-0.68)) with a MPA of 87.9%. Agreement between CTC and OC classifications was only 44%, and CTC agreement with the combined reference standard was 56%. CONCLUSION Radiologist agreement when using the Paris classification at CT colonography is low, and radiologist classification agrees poorly with colonoscopy. Using the full Paris classification in routine CTC reporting is of questionable value. CLINICAL RELEVANCE STATEMENT Interobserver agreement for radiologists using the Paris classification to categorise colorectal polyp morphology is only fair; routine use of the full Paris classification at CT colonography is questionable. KEY POINTS • Overall interobserver agreement for the Paris classification at CT colonography (CTC) was only fair, and lower than for colonoscopy. • Agreement was higher for radiologists with < 1500 CTC experience and for larger polyps. There was substantial agreement when classifying polyps as protuberant vs flat. • Agreement between CTC and colonoscopic polyp classification was low (44%).
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Ahmad Y, Gunderman RB. The Love for Radiology's Living Language. Acad Radiol 2024:S1076-6332(24)00600-7. [PMID: 39332988 DOI: 10.1016/j.acra.2024.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 08/17/2024] [Indexed: 09/29/2024]
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Waltz MJ, Gunderman RB. Enhancing Radiology Education for Regional Campus Medical Students. Acad Radiol 2024:S1076-6332(24)00565-8. [PMID: 39232911 DOI: 10.1016/j.acra.2024.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 09/06/2024]
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Lauar MCV, Lauar GCV, Barbisan CC, Mello ACO, Benetti CCTP, Albuquerque KS, Chamié LP. Social media for radiologists: opportunities and challenges. Abdom Radiol (NY) 2024:10.1007/s00261-024-04528-w. [PMID: 39172192 DOI: 10.1007/s00261-024-04528-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/03/2024] [Accepted: 08/10/2024] [Indexed: 08/23/2024]
Abstract
The use of social media in medicine offers unprecedented opportunities for social interaction. Activity on platforms such as X (formerly Twitter), Instagram, Facebook, and LinkedIn plays crucial roles in various medical services, particularly regarding patients' access to information and healthcare services, medical education, and professional networking. However, the integration of social media into healthcare is not challenge-free and has certain pitfalls. In this article, we address several critical issues that compromise the reliability and effectiveness of social media as a professional healthcare resource, particularly in the field of radiology. We discuss possible solutions and tips and tricks to facilitate the use of this valuable tool to our advantage and in a reliable manner.
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Miller A, Gunderman RB. Treatment Planning: A Key Component of Medical Student Education in Radiology. Acad Radiol 2024; 31:3471-3472. [PMID: 39060207 DOI: 10.1016/j.acra.2024.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024]
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Lee J, Yoon JH, Lee E, Lee HY, Jeong S, Park S, Jo YS, Kwak JY. Immune response and mesenchymal transition of papillary thyroid carcinoma reflected in ultrasonography features assessed by radiologists and deep learning. J Adv Res 2024; 62:219-228. [PMID: 37783270 PMCID: PMC11331164 DOI: 10.1016/j.jare.2023.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 09/07/2023] [Accepted: 09/29/2023] [Indexed: 10/04/2023] Open
Abstract
INTRODUCTION Ultrasonography (US) features of papillary thyroid cancers (PTCs) are used to select nodules for biopsy due to their association with tumor behavior. However, the molecular biological mechanisms that lead to the characteristic US features of PTCs are largely unknown. OBJECTIVES This study aimed to investigate the molecular biological mechanisms behind US features assessed by radiologists and three convolutional neural networks (CNN) through transcriptome analysis. METHODS Transcriptome data from 273 PTC tissue samples were generated and differentially expressed genes (DEGs) were identified according to US feature. Pathway enrichment analyses were also conducted by gene set enrichment analysis (GSEA) and ClusterProfiler according to assessments made by radiologists and three CNNs - CNN1 (ResNet50), CNN2 (ResNet101) and CNN3 (VGG16). Signature gene scores for PTCs were calculated by single-sample GSEA (ssGSEA). RESULTS Individual suspicious US features consistently suggested an upregulation of genes related to immune response and epithelial-mesenchymal transition (EMT). Likewise, PTCs assessed as positive by radiologists and three CNNs showed the coordinate enrichment of similar gene sets with abundant immune and stromal components. However, PTCs assessed as positive by radiologists had the highest number of DEGs, and those assessed as positive by CNN3 had more diverse DEGs and gene sets compared to CNN1 or CNN2. The percentage of PTCs assessed as positive or negative concordantly by radiologists and three CNNs was 85.6% (231/273) and 7.1% (3/273), respectively. CONCLUSION US features assessed by radiologists and CNNs revealed molecular biologic features and tumor microenvironment in PTCs.
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Shen MR, Shen SH, Wang LJ, Chiou HJ. Loading and Coverage Hours of Radiologists in Taiwan: Findings of a Small Survey in 2024. Korean J Radiol 2024; 25:691-694. [PMID: 39028014 PMCID: PMC11306007 DOI: 10.3348/kjr.2024.0487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 07/20/2024] Open
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Mathur D, Barnacle BD, Magera RW, Fazal Z, Zafar AM. System-based strategies for mitigating burnout in radiology. Emerg Radiol 2024:10.1007/s10140-024-02275-5. [PMID: 39073731 DOI: 10.1007/s10140-024-02275-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 07/17/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Burnout is a chronic problem prevalent in radiology, with a significant burden on individuals and healthcare systems. DISCUSSION A substantial portion of the literature on managing burnout has focused on individual-based remedies. We posit that burnout is a systemic problem and present an overview of some system-based strategies that could be employed to mitigate burnout in radiology. These include managing workload, optimizing work shifts, maximizing autonomy, limiting work-life conflicts, creating opportunities for professional fulfillment, utilizing user-friendly electronic medical records (EMR), deploying efficient picture archiving and communication systems (PACS), building system redundancy, leadership transparency, and fostering a healthy work environment. CONCLUSION: System-based strategies can help mitigate burnout.
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Beatty M, Class J, Gunderman RB. Radiologists Who Lost Their Way: Nazi Eugenics. Acad Radiol 2024:S1076-6332(24)00456-2. [PMID: 39068093 DOI: 10.1016/j.acra.2024.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2024] [Revised: 07/13/2024] [Accepted: 07/14/2024] [Indexed: 07/30/2024]
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Davis L, D'Souza S. Private equity in radiology - Why aren't we more concerned? Curr Probl Diagn Radiol 2024; 53:449-451. [PMID: 38604880 DOI: 10.1067/j.cpradiol.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024]
Abstract
There has been recent scrutiny of private equity involvement in the healthcare market by federal and state governmental agencies who are concerned about the corporatization and financialization of healthcare in the United States. Data is emerging that patient costs increase, quality of healthcare decreases, physician autonomy decreases, and physician burnout and moral injury increases when corporate interests like private equity enter the medical market. Like other medical specialties, the field of radiology has been affected by corporatization and radiologists should understand how private equity interests may affect individual radiologists and the radiology workforce on a larger scale.
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Bhalla D, Sharma R, Jana M. Current status of pediatric radiology in India: a perspective. Pediatr Radiol 2024:10.1007/s00247-024-05961-1. [PMID: 38842616 DOI: 10.1007/s00247-024-05961-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
This review is a bird's eye view of the practice of pediatric radiology in India. The key focus of this article is training, certification and employment opportunities for radiologists aspiring to specialise in pediatric radiology. Further, we have traced the growth in academic and research opportunities over the past two decades, as well as given a peep into the future trajectory of this speciality. An understanding of these concepts is key to the expansion of pediatric radiologists not just within India, but across the globe.
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Pham ST, Sakai O, Andreu-Arasa VC. Imaging approach to ingested foreign bodies in the neck. Neuroradiology 2024; 66:867-881. [PMID: 38619570 DOI: 10.1007/s00234-024-03348-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024]
Abstract
Foreign body ingestion is a common clinical occurrence worldwide, with high morbidity in the pediatric population and in adult patients with intentional attempts. Coins and button battery ingestions are more common among children. Bone impaction and swallowed dentures are usually seen in older adults. While most ingested foreign bodies pass through the gastrointestinal tract spontaneously with no complications, some require endoscopic and/or surgical intervention. Complications such as pharyngoesophageal ulceration, perforation, stricture, and deep neck infection can develop without timely diagnosis and management. The purpose of this article is to familiarize radiologists with the imaging approach to assess for characteristics and impacted locations of ingested foreign bodies in the neck.
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Lemmenmeier S, Boehm IB. Injection of iodinated contrast media in lactating women: Shall we continue or stop breastfeeding? Eur J Radiol 2024; 175:111464. [PMID: 38636412 DOI: 10.1016/j.ejrad.2024.111464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/28/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
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Lamour RJ, Patel NN, Harris GB, England JS, Lesniak BP, Kaplan LD, Jose J. Comparing MRI and arthroscopic appearances of common knee pathologies: A pictorial review. J Clin Imaging Sci 2024; 14:15. [PMID: 38841313 PMCID: PMC11152552 DOI: 10.25259/jcis_98_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/23/2024] [Indexed: 06/07/2024] Open
Abstract
Knee pathology, including anterior cruciate ligament (ACL) tears, meniscal tears, articular cartilage lesions, and intra-articular masses or cysts are common clinical entities treated by orthopedic surgeons with arthroscopic surgery. Preoperatively, magnetic resonance imaging (MRI) is now standard in confirming knee pathology, particularly detecting pathology less evident with history and physical examination alone. The radiologist's MRI interpretation becomes essential in evaluating intra-articular knee structures. Typically, the radiologist that interprets the MRI does not have the opportunity to view the same pathology arthroscopically. Thus, the purpose of this article is to illustratively reconcile what the orthopedic surgeon sees arthroscopically with what the radiologist sees on magnetic resonance imaging when viewing the same pathology. Correlating virtual and actual images can help better understand pathology, resulting in more accurate MRI interpretations. In this article, we present and review a series of MR and correlating arthroscopic images of ACL tears, meniscal tears, chondral lesions, and intra-articular masses and cysts. Short teaching points are included to highlight the importance of radiological signs and pathological MRI appearance with significant clinical and arthroscopic findings.
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Gray BR, Gunderman RB. Gratitude, Humility, and the Impulse to Make a Mark. Acad Radiol 2024; 31:1714-1715. [PMID: 38245455 DOI: 10.1016/j.acra.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 12/31/2023] [Accepted: 01/03/2024] [Indexed: 01/22/2024]
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Han PL, Jiang L, Cheng JL, Shi K, Huang S, Jiang Y, Jiang L, Xia Q, Li YY, Zhu M, Li K, Yang ZG. Artificial intelligence-assisted diagnosis of congenital heart disease and associated pulmonary arterial hypertension from chest radiographs: A multi-reader multi-case study. Eur J Radiol 2024; 171:111277. [PMID: 38160541 DOI: 10.1016/j.ejrad.2023.111277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/10/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVES To explore the possibility of automatic diagnosis of congenital heart disease (CHD) and pulmonary arterial hypertension associated with CHD (PAH-CHD) from chest radiographs using artificial intelligence (AI) technology and to evaluate whether AI assistance could improve clinical diagnostic accuracy. MATERIALS AND METHODS A total of 3255 frontal preoperative chest radiographs (1174 CHD of any type and 2081 non-CHD) were retrospectively obtained. In this study, we adopted ResNet18 pretrained with the ImageNet database to establish diagnostic models. Radiologists diagnosed CHD/PAH-CHD from 330/165 chest radiographs twice: the first time, 50% of the images were accompanied by AI-based classification; after a month, the remaining 50% were accompanied by AI-based classification. Diagnostic results were compared between the radiologists and AI models, and between radiologists with and without AI assistance. RESULTS The AI model achieved an average area under the receiver operating characteristic curve (AUC) of 0.948 (sensitivity: 0.970, specificity: 0.982) for CHD diagnoses and an AUC of 0.778 (sensitivity: 0.632, specificity: 0.925) for identifying PAH-CHD. In the 330 balanced (165 CHD and 165 non-CHD) testing set, AI achieved higher AUCs than all 5 radiologists in the identification of CHD (0.670-0.858) and PAH-CHD (0.610-0.688). With AI assistance, the mean ± standard error AUC of radiologists was significantly improved for CHD (ΔAUC + 0.096, 95 % CI: 0.001-0.190; P = 0.048) and PAH-CHD (ΔAUC + 0.066, 95 % CI: 0.010-0.122; P = 0.031) diagnosis. CONCLUSION Chest radiograph-based AI models can detect CHD and PAH-CHD automatically. AI assistance improved radiologists' diagnostic accuracy, which may facilitate a timely initial diagnosis of CHD and PAH-CHD.
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Hassankhani A, Amoukhteh M, Valizadeh P, Jannatdoust P, Sabeghi P, Gholamrezanezhad A. Radiology as a Specialty in the Era of Artificial Intelligence: A Systematic Review and Meta-analysis on Medical Students, Radiology Trainees, and Radiologists. Acad Radiol 2024; 31:306-321. [PMID: 37349157 DOI: 10.1016/j.acra.2023.05.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/20/2023] [Accepted: 05/21/2023] [Indexed: 06/24/2023]
Abstract
RATIONALE AND OBJECTIVES Artificial intelligence (AI) is changing radiology by automating tasks and assisting in abnormality detection and understanding perceptions of medical students, radiology trainees, and radiologists is vital for preparing them for AI integration in radiology. MATERIALS AND METHODS A systematic review and meta-analysis were conducted following established guidelines. PubMed, Scopus, and Web of Science were searched up to March 5, 2023. Eligible studies reporting outcomes of interest were included, and relevant data were extracted and analyzed using STATA software version 17.0. RESULTS A meta-analysis of 21 studies revealed that 22.36% of individuals were less likely to choose radiology as a career due to concerns about advances in AI. Medical students showed higher rates of concern (31.94%) compared to radiology trainees and radiologists (9.16%) (P < .01). Radiology trainees and radiologists also demonstrated higher basic AI knowledge (71.84% vs 35.38%). Medical students had higher rates of belief that AI poses a threat to the radiology job market (42.66% vs 6.25%, P < .02). The pooled rate of respondents who believed that "AI will revolutionize radiology in the future" was 79.48%, with no significant differences based on participants' positions. The pooled rate of responders who believed in the integration of AI in medical curricula was 81.75% among radiology trainees and radiologists and 70.23% among medical students. CONCLUSION The study revealed growing concerns regarding the impact of AI in radiology, particularly among medical students, which can be addressed by revamping education, providing direct AI experience, addressing limitations, and emphasizing medico-legal issues to prepare for AI integration in radiology.
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Gallagher C, Gunderman RB. Effect on Radiology of Innovation in Other Medical Fields: Intensive Care. Acad Radiol 2023; 30:3147-3149. [PMID: 37684181 DOI: 10.1016/j.acra.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 09/10/2023]
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Shafique U, Chaudhry US, Towbin AJ. Are the Pilots Onboard? Equipping Radiologists for Clinical Implementation of AI. J Digit Imaging 2023; 36:2329-2334. [PMID: 37556028 PMCID: PMC10584741 DOI: 10.1007/s10278-023-00892-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/10/2023] Open
Abstract
The incorporation of artificial intelligence into radiological clinical workflow is on the verge of being realized. To ensure that these tools are effective, measures must be taken to educate radiologists on tool performance and failure modes. Additionally, radiology systems should be designed to avoid automation bias and the potential decline in radiologist performance. Designed solutions should cater to every level of expertise so that patient care can be enhanced and risks reduced. Ultimately, the radiology community must provide education so that radiologists can learn about algorithms, their inputs and outputs, and potential ways they may fail. This manuscript will present suggestions on how to train radiologists to use these new digital systems, how to detect AI errors, and how to maintain underlying diagnostic competency when the algorithm fails.
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Michalopoulou E, Clauser P, Gilbert FJ, Pijnappel RM, Mann RM, Baltzer PAT, Chen Y, Fallenberg EM. A survey by the European Society of Breast Imaging on radiologists' preferences regarding quality assurance measures of image interpretation in screening and diagnostic mammography. Eur Radiol 2023; 33:8103-8111. [PMID: 37481690 PMCID: PMC10598074 DOI: 10.1007/s00330-023-09973-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
OBJECTIVES Quality assurance (QA) of image interpretation plays a key role in screening and diagnostic mammography, maintaining minimum standards and supporting continuous improvement in interpreting images. However, the QA structure across Europe shows considerable variation. The European Society of Breast Imaging (EUSOBI) conducted a survey among the members to collect information on radiologists' preferences regarding QA measures in mammography. MATERIALS AND METHODS An anonymous online survey consisting of 25 questions was distributed to all EUSOBI members and national breast radiology bodies in Europe. The questions were designed to collect demographic characteristics, information on responders' mammography workload and data about QA measures currently used in their country. Data was analysed using descriptive statistical analysis, the χ2 test, linear regression, and Durbin-Watson statistic test. RESULTS In total, 251 breast radiologists from 34 countries completed the survey. Most respondents were providing both screening and symptomatic services (137/251, 54.6%), working in an academic hospital (85/251, 33.9%) and reading 1000-4999 cases per year (109/251, 43.4%). More than half of them (133/251, 53%) had established QA measures in their workplace. Although less than one-third (71/251, 28.3%) had to participate in regular performance testing, the vast majority (190/251, 75.7%) agreed that a mandatory test would be helpful to improve their skills. CONCLUSION QA measures were in place for more than half of the respondents working in screening and diagnostic mammography to evaluate their breast imaging performance. Although there were substantial differences between countries, the importance of having QA in the workplace and implemented was widely acknowledged by radiologists. CLINICAL RELEVANCE STATEMENT Although several quality assurance (QA) measures of image interpretation are recommended by European bodies or national organisations, the QA in mammography is quite heterogenous between countries and reporting settings, and not always actively implemented across Europe. KEY POINTS The first survey that presents radiologists' preferences regarding QA measures of image interpretation in mammography. Quality assurance measures in the workplace are better-established for breast screening compared to diagnostic mammography. Radiologists consider that performance tests would help to improve their mammography interpretation skills.
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Miravent S, Figueiredo T, Donchenko I, Duarte Lobo M, Cruz G, Pedro Almeida R. Discrepancies between Screening Sonography and Ultrasound in Emergency Department - A Case Report. Curr Med Imaging 2023; 20:CMIR-EPUB-135481. [PMID: 37904564 DOI: 10.2174/0115734056249805231003052141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/18/2023] [Accepted: 08/31/2023] [Indexed: 11/01/2023]
Abstract
INTRODUCTION This case report presents a discrepancy in sonographic findings between a screening sonography performed by a Sonographer in the Basic Emergency Service (BES) and a subsequent ultrasound performed by a Radiologist physician in a Referral Hospital (RH). The aim of this report is to discuss the possible reasons for the discrepancy and its implications for patient care. CASE PRESENTATION A patient with a history of epigastric pain and vomiting underwent screening sonography in a BES, which suggested Intrahepatic Biliary Dilatation Duct (IHBD) and main pancreatic duct dilatation. The patient was subsequently referred to the RH for further evaluation. However, the Radiologist in the RH did not confirm any of the initial suspicions from BES through a normal ultrasound procedure. The discrepancy raises questions regarding the quality of the screening ultrasound, misinterpretation of the BES images, or the potential for ambiguity in the point of care ultrasound (POCUS) exam. CONCLUSION The differences in sonographic findings between BES and RH, in this case, suggest that the improvement of the patient's clinical condition and therapeutic interventions may have contributed to the discrepancy. Further investigation and standardization of POCUS training and interpretation may improve diagnostic accuracy and patient outcomes.
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Lee S, Kim EK, Chung SY, Shin HJ. Efficient Collaboration Between Radiologists Using the PACS-Integrated Refer Function to Reduce Communication Times. J Digit Imaging 2023; 36:1995-2002. [PMID: 37407844 PMCID: PMC10501968 DOI: 10.1007/s10278-023-00876-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023] Open
Abstract
The purpose of this study was to assess the utility of a picture archiving and communication systems (PACS)-integrated refer function for improving collaboration between radiologists and radiographers during daily reading sessions. Retrospective analysis was conducted on refers sent by radiologists using a PACS-integrated refer system from March 2020 to December 2021. Refers were categorized according to receiver: radiologists in the same division (intra-division), radiologists in a different division (inter-division), and radiographers. The proportions of answered refers, content of refers, and timing of refer posts were evaluated. Additionally, time intervals in minutes from initial refer post to refer response were assessed to assess the efficiency of the refer system and compared according to receivers using the Mann-Whitney U test. Among a total of 691 refers posted by radiologists, 579 (83.8%) were answered directly using the refer function in PACS. Of the answered refers, 346 refers (59.8%) were made between radiologists, and 173 (50%) were intra-division refers. About the content of refers, about 82.6% of radiologists' refers were about imaging interpretation consultation, and about 98.9% of refers from radiologists to radiographers were for image quality control. The median time interval until refer response was 9 min, and this response time did not differ between intra-division and inter-division refers (p = 0.998). Of the refers that got responses, 74.3% (257/346) were sent among radiologists before official reports were made, and the median time until refer response was 9-10 min. The proportion of refers answered by radiographers was 85.7% (233/272). The median time interval until refer response by radiographers was 87 min for all refers, and 63% were made within 6 h. Therefore, the PACS-integrated refer function can facilitate communication between radiologists for image interpretation and quality control.
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Korngold EK, Gollub MJ, Kim DH, Moreno CC, de Prisco G, Harisinghani M, Khatri G. Update on The National Accreditation Program for Rectal Cancer (NAPRC): the radiologist's role. Abdom Radiol (NY) 2023; 48:2814-2824. [PMID: 37160474 DOI: 10.1007/s00261-023-03919-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
The National Accreditation Program for Rectal Cancer (NAPRC) was established by the American College of Surgeons with the goal of standardizing care of rectal cancer patients in order to improve outcomes. NAPRC accreditation requires compliance with an established set of standards, many of which are directly related to radiology participation in multidisciplinary conference, rectal MR image acquisition, interpretation and reporting, and radiologist education. This paper outlines the pertinent standards/requirements for radiologists as part of the Rectal Cancer Multidisciplinary Team in the NAPRC guidelines, with proposed methods and tips for implementation of these standards from the perspective of the radiologist.
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Budhu R, Nkosi BP, Khoza TE. Radiologists' perceptions of knowledge and training required by radiographers in the interpretation of radiographic images: An explorative study in KwaZulu-Natal province, South Africa. J Med Imaging Radiat Sci 2023; 54:457-464. [PMID: 37385913 DOI: 10.1016/j.jmir.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION The health sector of South Africa is burdened by the shortage of radiologists leading to the under-reporting of radiographic images and ultimately mismanagement of patients. Previous studies have recommended training of radiographers in radiographic image interpretation in order to improve the reporting. There is paucity of information regarding the knowledge and training required by radiographers to interpret radiographic images. The purpose of this study was therefore to explore the knowledge and training required by diagnostic radiographers, according to radiologists, for the interpretation of radiographs. METHOD A qualitative descriptive study employing criterion sampling to select qualified radiologists practicing in the eThekwini district of the KwaZulu Natal province, was conducted. One-on-one and in-depth, semi-structured interviews were used to collect data from three participants. The interviews were not carried out face to face as a result of the Covid 19 pandemic and the regulation of social distancing. This did not permit engagement with research communities. The data from the interviews were analysed using Tesch's eight steps for analysing qualitative data. RESULTS Findings revealed that radiologists supported the interpretation of radiographic images by radiographers in rural settings, and for the radiographer's scope of practice to be restructured to include the reporting of chest and the musculoskeletal system images. The themes that emerged from the analysis included knowledge, training, clinical competencies and medico-legal responsibilities required by radiographers in the interpretation of radiographic images. CONCLUSION Although the radiologists support the training of radiographers in the interpretation of radiographic images, radiologists think that the scope of practice should be limited to the interpretation of the chest and musculoskeletal systems in rural areas only.
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Sethole KM, Mshunqane N, Kekana M. Checklists for interpreting chest radiographs: a scoping review protocol. Syst Rev 2023; 12:152. [PMID: 37649115 PMCID: PMC10466731 DOI: 10.1186/s13643-023-02327-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 08/18/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION What is known about checklists for interpreting chest radiographs? The question will guide the development of the inclusion criteria for the scoping review. Breaking down the scoping review question will allow the evaluation of inclusion and exclusion criteria for the protocol. The eligibility of the proposed research question will be assessed using the Population or Participants, Concept and Context (PCC) framework. BACKGROUND X-ray reporting can be standardised using checklists. Checklists may reduce the time needed to produce a comprehensive X-ray report and improve the quality and consistency of detecting abnormalities on chest radiographs. This scoping review aims to map the available literature on what is known about checklists for interpreting chest radiographs. METHODS We will follow the methodological framework for scoping reviews originally described by Arksey and O'Malley. The scoping review will include articles that describe checklists for reducing diagnostic errors, checklists for analysing chest radiographs, checklists for identifying abnormalities on chest radiographs and checklists for reporting chest radiographs in all settings. Search terms are chest radiographs, checklists, and chest X-rays. We will search for peer-reviewed articles and grey literature including dissertations and theses. We will search online databases including Ovid Medline and Ebscohost, to identify articles published in English from 1994 to 2022. The searched articles will undergo two levels of screening, first the title and abstract screening, then a full-text screening by two reviewers. Data from the selected articles will be extracted, using a tested extraction form and charted using the Joanna Briggs Institute guidelines. RESULTS The results will be collated, summarised and discussed including any limitations of the included articles. The articles will be summarised in a table, as well as narratively. The distribution of studies will be summarised quantitatively and the numerical analysis will provide an overview and identify knowledge gaps. Content analysis will map different checklists available for chest interpretation. DISCUSSION The results of the scoping review will be used to develop a checklist that will be used by medical doctors in collaboration with radiographers working in settings where there are no radiologists on-site, for interpreting chest radiographs. SYSTEMATIC REVIEW REGISTRATION Scoping review protocol registered with Open Science Framework on 27 July 2022. Registration https://doi.org/10.17605/OSF.IO/JS5PQ.
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