Medical knowledge and clinical productivity: independently correlated metrics during radiology residency

What Program Directors Think About Resident Education: Results of the 2023 Spring Survey of the Association of Program Directors in Radiology (APDR) Part II

RATIONALE AND OBJECTIVES

The Association of Program Directors in Radiology (APDR) administers an annual survey to assess issues and experiences related to residency program management and education. Response data from the 2023 survey provides insights on the impact of COVID-19 on resident recruitment (Part I) and education (Part II), which can be used to facilitate planning and resource allocation for the evolving needs of programs and their leadership.

MATERIALS AND METHODS

An observational, cross-sectional study of the APDR membership was performed using a web-based survey consisting of 45 questions, 12 of which pertain to resident education in the post-pandemic era and are discussed in Part II of a two-part survey analysis. All active APDR members (n = 393) were invited to participate in the survey.

RESULTS

The response rate was 32% (124 of 393). Results were tallied using Qualtrics software and qualitative responses were tabulated or summarized as comments.

CONCLUSIONS

The primary challenges to resident education are faculty burnout, rising case volumes, and remote instruction. However, most program leaders report that in-person readouts are much more common than remote readouts. The ability to offer both in-person and remote AIRP sessions is viewed positively. Most program leaders require Authorized User certification, although many do not think all residents need it. Assessment of procedural competence varies by the type of procedure and is similar to graduates' self-assessment of competence.

Prediction models for differentiating benign from malignant liver lesions based on multiparametric dual-energy non-contrast CT

OBJECTIVES

To create prediction models (PMs) for distinguishing between benign and malignant liver lesions using quantitative data from dual-energy CT (DECT) without contrast agents.

MATERIALS AND METHODS

This retrospective study included patients with liver lesions who underwent DECT, including non-contrast-enhanced scans. Benign lesions included hepatic hemangioma, whereas malignant lesions included hepatocellular carcinoma, metastatic liver cancer, and intrahepatic cholangiocellular carcinoma. Patients were divided into derivation and validation groups. In the derivation group, two radiologists calculated ten multiparametric data using univariate and multivariate logistic regression to generate PMs. In the validation group, two additional radiologists measured the parameters to assess the diagnostic performance of PMs.

RESULTS

The study included 121 consecutive patients (mean age 67.4 ± 13.8 years, 80 males), with 97 in the derivation group (25 benign and 72 malignant) and 24 in the validation group (7 benign and 17 malignant). Oversampling increased the benign lesion sample to 75, equalizing the malignant group for building PMs. All parameters were statistically significant in univariate analysis (all p < 0.05), leading to the creation of five PMs in multivariate analysis. The area under the curve for the five PMs of two observers was as follows: PM1 (slope K, blood) = 0.76, 0.74; PM2 (slope K, fat) = 0.55, 0.51; PM3 (effective-Z difference, blood) = 0.75, 0.72; PM4 (slope K, blood, fat) = 0.82, 0.78; and PM5 (slope K, effective-Z difference, blood) = 0.90, 0.87. PM5 yielded the best diagnostic performance.

CONCLUSION

Multiparametric non-contrast-enhanced DECT is a highly effective method for distinguishing between liver lesions.

CLINICAL RELEVANCE STATEMENT

The utilization of non-contrast-enhanced DECT is extremely useful for distinguishing between benign and malignant liver lesions. This approach enables physicians to plan better treatment strategies, alleviating concerns associated with contrast allergy, contrast-induced nephropathy, radiation exposure, and excessive medical expenses.

KEY POINTS

Distinguishing benign from malignant liver lesions with non-contrast-enhanced CT would be desirable. This model, incorporating slope K, effective Z, and blood quantification, distinguished benign from malignant liver lesions. Non-contrast-enhanced DECT has benefits, particularly in patients with an iodine allergy, renal failure, or asthma.

The integrated nuclear medicine and radiology residency program in the Netherlands: strengths and potential areas for improvement according to nuclear medicine physicians and radiologists

PURPOSE

To evaluate the Dutch integrated nuclear medicine and radiology residency program from the perspective of nuclear medicine physicians and radiologists.

METHODS

A survey was distributed among nuclear medicine physicians and radiologists in hospitals that participate in the Dutch integrated nuclear medicine and radiology training program.

RESULTS

A total of 139 completed questionnaires were included. Nuclear medicine physicians (n = 36) assigned a mean score of 5.7 ± 2.0, and radiologists (n = 103) assigned a mean score of 6.5 ± 2.8 (on a 1-10 scale) to the success of the integrated training program in their hospital. On multiple regression, female gender of the survey participant (B = 2.22, P = 0.034), musculoskeletal radiology as subspecialty of the survey participant (B = 3.36, P = 0.032), and the survey participant's expectancy of resident's ability to handle workload after completion of residency were significantly associated with perceived success of the integrated training program (B = 1.16, P = 0.023). Perceived strengths of the integrated training program included broadening of expertise, a better preparation of future imaging specialists for hybrid imaging, increased efficiency in training residents, and increased efficiency in multidisciplinary meetings. Perceived weaknesses of the integrated training program included reduced exposure to nuclear medicine, less time for research and innovation, and concerns about its international recognition.

CONCLUSION

This study provided insights into the experiences of nuclear medicine physicians and radiologists with the Dutch integrated nuclear medicine and radiology residency program, which may be helpful to improve the program and similar residency programs in other countries.