Radiology 2040

"A patient's doctor"- A high school freshman's reflection on the field of breast imaging

Despite an increasing focus on gender diversity in radiology the underrepresentation of women in radiology has not significantly improved over the last two decades, with women continuing to representing just a quarter of the radiology workforce since 2007 (AAMC, 20191). Although multifactorial, lack of perceived patient interaction in the field has been reported to be one of the main deterring factors in why women chose not to pursue radiology (Arleo et al., 2016; Fielding et al., 20072,3). With increasing advances and integration of medical imaging into medical care (Brink and Hricak, 20234), Radiology's impact on daily patient care will continue to increase and with it, the need for an expert and diverse radiologist workforce. Thus, exposure to the field and its patient-centered focus to younger women, especially those students who are already interested in STEM, presently is ever more important. Such early exposure can provide for longitudinal engagement with the field and its numerous career opportunities, dispel the many myths of the specialty as one of isolation and lack of patient contact, and popularize the field among young adults. Current investment in mentoring young women, prior to the cementing of rather pervasive misconceptions about Radiology during their undergraduate and medical education, can help support a more diverse future for our field. Below is one rising high-school freshman's reflection on the field of breast imaging after a 10-day summer shadowing experience with Department of Radiology.

Multimodality imaging in cardio-oncology: the added value of CMR and CCTA

During the last 30 years, we have assisted to a great implementation in anticancer treatment with a subsequent increase of cancer survivors and decreased mortality. This has led to an ongoing interest about the possible therapy-related side-effects and their management to better guide patients therapy and surveillance in the chronic and long-term setting. As a consequence cardio-oncology was born, involving several different specialties, among which radiology plays a relevant role. Till the end of August 2022, when European Society of Cardiology (ESC) developed the first guidelines on cardio-oncology, no general indications existed to guide diagnosis and treatment of cancer therapy-related cardiovascular toxicity (CTR-CVT). They defined multimodality imaging role in primary and secondary prevention strategies, cancer treatment surveillance and early CTR-CVT identification and management. Cardiac computed tomography angiography (CCTA) has acquired a central role in coronary assessment, as far as coronary artery disease (CAD) exclusion is concerned; but on the side of this well-known application, it also started to be considered in left ventricular function evaluation, interstitial fibrosis quantification and cardiac perfusion studies. Cardiac magnetic resonance (CMR), instead, has been acknowledged as the gold standard alternative to trans-thoracic echocardiography (TTE) poor acoustic window in quantification of heart function and strain modifications, as well as pre- and post-contrast tissue characterization by means of T1-T2 mapping, early Gadolinium enhancement (EGE), late Gadolinium enhancement (LGE) and extracellular volume (ECV) evaluation. Our review is intended to provide a focus on the actual role of CMR and CCTA in the setting of a better understanding of cardiotoxicity and to draw some possible future directions of cardiac imaging in this field, starting from the recently published ESC guidelines.