Interventional Radiology Suite: A Primer for Trainees

Visuo-motor transformations in the intraparietal sulcus mediate the acquisition of endovascular medical skill

Performing endovascular medical interventions safely and efficiently requires a diverse set of skills that need to be practised in dedicated training sessions. Here, we used multimodal magnetic resonance (MR) imaging to determine the structural and functional plasticity and core skills associated with skill acquisition. A training group learned to perform a simulator-based endovascular procedure, while a control group performed a simplified version of the task; multimodal MR images were acquired before and after training. Using a well-controlled interaction design, we found strong multimodal evidence for the role of the intraparietal sulcus (IPS) in endovascular skill acquisition that is in line with previous work implicating the structure in visuospatial transformations including simple visuo-motor and mental rotation tasks. Our results provide a unique window into the multimodal nature of rapid structural and functional plasticity of the human brain while learning a multifaceted and complex clinical skill. Further, our results provide a detailed description of the plasticity process associated with endovascular skill acquisition and highlight specific facets of skills that could enhance current medical pedagogy and be useful to explicitly target during clinical resident training.

A Contribution to the History of Japanese Education Systems for Radiological Technologists

Background

The evolution of radiological technology is one of the most remarkable events of modern medical technology. Radiological examination has resulted in non-invasive, individual diagnostic imaging, which has contributed significantly to successful medical treatment of patients.

Key Concepts

This review summarizes past and current Japanese educational systems for radiological technologists with a historical perspective focusing on three periods. The first period begins with Roentgen's discovery of X-rays (1895), the second period begins with the establishment of the Radiological X-ray Technologist Act (1951), and the third period begins with the launch of the first university course for radiological technologists (1987). It is conceivable that those periods are in accordance with the technological paradigm shifts, including the development of contrast radiography and the application of CT and MRI to clinical practice. To maintain awareness of the most recent available technologies and maximize safety, educational programs teaching the latest knowledge were offered during each period.

Conclusions

The advanced technologies require highly skilled radiological technologists and highly established educational systems. At present, over 70% of Japanese educational programs for radiological technologists are university courses leading to a bachelor's degree. The increasing globalization of radiological technology requires future radiological education systems to have a global perspective.

Iatrogenic vascular trauma and complications of vascular access in children

Vascular access is frequently a critical component of the diagnostic and therapeutic procedures required to manage childhood illnesses, including many emergent conditions and critical illnesses. Vascular access in the pediatric population presents unique challenges, and many clinical and technical factors must be considered to avoid complications that can occur with vascular access procedures. This article reviews various aspects of vascular access and associated iatrogenic trauma in children, including risk factors, management of complications, and preventive measures to avoid complications. It is only with a comprehensive understanding of the topic that vascular access in children can be performed safely, effectively, and efficiently.

CIRSE Standards of Practice on Percutaneous Transhepatic Cholangiography, Biliary Drainage and Stenting

This CIRSE Standards of Practice document is aimed at interventional radiologists and provides best practices for performing percutaneous transhepatic cholangiography, biliary drainage and stenting. It has been developed by an expert writing group established by the CIRSE Standards of Practice Committee.

Interventional radiology in gynecology and obstetric practice: Safety issues

Interventional radiology is continuing to reshape current practice in many specialties of clinical care and the fields of gynecology and obstetrics are no exception. Imaging skills, clinical knowledge as well as vascular and non-vascular interventional technical ability, are essential to practice interventional radiology effectively. Patient safety is of paramount importance in interventional radiology as in all branches of medicine. Potential failures occur throughout successful procedures and are attributed to a spectrum of errors, including equipment unavailability, planning errors, and communication errors. These are mainly preventable by improved preprocedural planning and teamwork. Of all the targeted and effective actions that can be undertaken to reduce adverse events, the use of safety checklists might have a prominent role. The advantage of a safety checklist for interventional radiology is that it guarantees that human error in terms of forgetting key steps in patient preparation, intraprocedural care, and postoperative care are not forgotten.