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Pham ST, Sakai O, Andreu-Arasa VC. Imaging approach to ingested foreign bodies in the neck. Neuroradiology 2024:10.1007/s00234-024-03348-5. [PMID: 38619570 DOI: 10.1007/s00234-024-03348-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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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Affiliation(s)
- Serena T Pham
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, Boston, MA, USA
| | - Osamu Sakai
- Division of Neuroradiology, Department of Radiology, Harvard Medical School/Massachusetts General Hospital, Boston, MA, USA
| | - V Carlota Andreu-Arasa
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine/Boston Medical Center, Boston, MA, USA.
- Division of Neuroradiology, Department of Radiology, VA Boston Healthcare System, Boston, MA, USA.
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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] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/28/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
Affiliation(s)
- Sina Lemmenmeier
- Department of Anaesthesiology, Spital of Buelach, Buelach, Switzerland
| | - Ingrid B Boehm
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, University of Bern, Bern, Switzerland.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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]
Affiliation(s)
- Benjamin R Gray
- Department of Radiology, Indiana University School of Medicine, 702 North Barnhill Drive, Room 1053, Indianapolis, Indiana, 46202, USA
| | - Richard B Gunderman
- Department of Radiology, Indiana University School of Medicine, 702 North Barnhill Drive, Room 1053, Indianapolis, Indiana, 46202, USA.
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Davis L, D'Souza S. Private equity in radiology - Why aren't we more concerned? Curr Probl Diagn Radiol 2024:S0363-0188(24)00056-2. [PMID: 38604880 DOI: 10.1067/j.cpradiol.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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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Affiliation(s)
- Leah Davis
- Grand Traverse Radiologists, PC, 10850 Traverse Highway, Suite 1175, Traverse City, Michigan 49684, United States.
| | - Sharon D'Souza
- Tulsa Radiology Associates, 4111 S Darlington Ave Ste 700, Tulsa, OK 74135, United States
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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 2024:10.1007/s00330-024-10631-9. [PMID: 38488970 DOI: 10.1007/s00330-024-10631-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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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Affiliation(s)
| | - Andrew A Plumb
- University College London Hospitals NHS Foundation Trust, London, UK.
| | - Katja N De Paepe
- Addenbrooke's Hospital, Cambridge, UK
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | | | - Steve Halligan
- Centre for Medical Imaging, University College London, London, UK
| | | | | | - Anisha Patel
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Stuart Taylor
- Centre for Medical Imaging, University College London, London, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Pei-Lun Han
- Department of Radiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Jiang
- College of Computer Science, Sichuan University, Chengdu, China
| | - Jun-Long Cheng
- College of Computer Science, Sichuan University, Chengdu, China
| | - Ke Shi
- Department of Radiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Shan Huang
- Department of Radiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Jiang
- Department of Radiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Li Jiang
- Department of Radiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Xia
- SenseTime Research, Beijing, China
| | - Yi-Yue Li
- Department of Radiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Min Zhu
- College of Computer Science, Sichuan University, Chengdu, China
| | - Kang Li
- Department of Radiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China; Med-X Center for Informatics, Sichuan University, Chengdu, China; Shanghai Artificial Intelligence Laboratory, Shanghai, China
| | - Zhi-Gang Yang
- Department of Radiology and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Amir Hassankhani
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), 1441 Eastlake Avenue Ste 2315, Los Angeles, CA 90089 (A.H., M.A., P.V., P.J., P.S., A.G.); Department of Radiology, Mayo Clinic, Rochester, Minnesota (A.H., M.A.).
| | - Melika Amoukhteh
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), 1441 Eastlake Avenue Ste 2315, Los Angeles, CA 90089 (A.H., M.A., P.V., P.J., P.S., A.G.); Department of Radiology, Mayo Clinic, Rochester, Minnesota (A.H., M.A.)
| | - Parya Valizadeh
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), 1441 Eastlake Avenue Ste 2315, Los Angeles, CA 90089 (A.H., M.A., P.V., P.J., P.S., A.G.)
| | - Payam Jannatdoust
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), 1441 Eastlake Avenue Ste 2315, Los Angeles, CA 90089 (A.H., M.A., P.V., P.J., P.S., A.G.)
| | - Paniz Sabeghi
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), 1441 Eastlake Avenue Ste 2315, Los Angeles, CA 90089 (A.H., M.A., P.V., P.J., P.S., A.G.)
| | - Ali Gholamrezanezhad
- Department of Radiology, Keck School of Medicine, University of Southern California (USC), 1441 Eastlake Avenue Ste 2315, Los Angeles, CA 90089 (A.H., M.A., P.V., P.J., P.S., A.G.)
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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] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 09/10/2023]
Affiliation(s)
- Clare Gallagher
- Department of Radiology, Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN, 46202
| | - Richard B Gunderman
- Department of Radiology, Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN, 46202.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Umber Shafique
- Indiana University School of Medicine, Indianapolis, IN, USA.
| | | | - Alexander J Towbin
- Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Eleni Michalopoulou
- University of Nottingham, School of Medicine, Clinical Sciences Building, City Hospital Campus, Hucknall Road, NG5 1PB, Nottingham, UK.
| | - Paola Clauser
- Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Medical University of Vienna, 1090, Vienna, Austria
| | - Fiona J Gilbert
- Department of Radiology, Clinical School, Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Ruud M Pijnappel
- University Medical Centre Utrecht, Utrecht University, Heidelberglaan 100, 3584, Utrecht, CX, The Netherlands
- Dutch Expert Centre for Screening, Wijchenseweg 101, 6538, Nijmegen, SW, The Netherlands
| | - Ritse M Mann
- Department of Medical Imaging, Radboud University Medical Centre, 6525, Nijmegen, The Netherlands
- Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Pascal A T Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Allgemeines Krankenhaus, Medical University of Vienna, 1090, Vienna, Austria
| | - Yan Chen
- University of Nottingham, School of Medicine, Clinical Sciences Building, City Hospital Campus, Hucknall Road, NG5 1PB, Nottingham, UK
| | - Eva Maria Fallenberg
- Department of Diagnostic and Interventional Radiology, School of Medicine & Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675, München, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Sérgio Miravent
- Department of Radiology, University of Algarve, Algarve Regional Health Administration (ARS Algarve), Portugal
| | | | | | - Manuel Duarte Lobo
- Local Health Unit of Northeast, Polytechnic Institute of Castelo Branco, Portugal
| | - Gualter Cruz
- National Institute of medical Emergency, Portugal
| | - Rui Pedro Almeida
- Department of Radiology, University of Algarve, Comprehensive Health Research Center (CHRC), Portugal
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Seungsoo Lee
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu,Gyeonggi-do 16995, Yongin-si, South Korea
| | - Eun-Kyung Kim
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu,Gyeonggi-do 16995, Yongin-si, South Korea
| | - Soo Yoon Chung
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu,Gyeonggi-do 16995, Yongin-si, South Korea
| | - Hyun Joo Shin
- Department of Radiology, Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yongin Severance Hospital, Yonsei University College of Medicine, 363, Dongbaekjukjeon-daero, Giheung-gu,Gyeonggi-do 16995, Yongin-si, South Korea.
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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 2023:S2090-1232(23)00292-8. [PMID: 37783270 DOI: 10.1016/j.jare.2023.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [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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Affiliation(s)
- Jandee Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Jung Hyun Yoon
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul 03722, South Korea
| | - Eunjung Lee
- School of Mathematics and Computing (Computational Science and Engineering), Yonsei University, Seoul 03722, South Korea
| | - Hwa Young Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Yonsei Cancer Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Seonhyang Jeong
- Department of Internal Medicine, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Sunmi Park
- Department of Internal Medicine, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul 03722, South Korea
| | - Young Suk Jo
- Department of Internal Medicine, Open NBI Convergence Technology Research Laboratory, Yonsei University College of Medicine, Seoul 03722, South Korea.
| | - Jin Young Kwak
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul 03722, South Korea.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
| | - Marc J Gollub
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David H Kim
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Reshel Budhu
- Durban University of Technology, Faculty of Health Science; Department of Radiography, Ritson Campus; Durban, 4000 KwaZulu Natal, South Africa.
| | - Busisiwe Pauline Nkosi
- Durban University of Technology, Faculty of Health Science; Department of Radiography, Ritson Campus; Durban, 4000 KwaZulu Natal, South Africa
| | - Thandokuhle Emmanuel Khoza
- Durban University of Technology, Faculty of Health Science; Department of Radiography, Ritson Campus; Durban, 4000 KwaZulu Natal, South Africa
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Khethiwe Margaret Sethole
- Department of Radiography, Faculty of Health Sciences, University of Pretoria, Hatfield, South Africa.
| | - Nombeko Mshunqane
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Hatfield, South Africa
| | - Mable Kekana
- Department of Radiography, Faculty of Health Sciences, University of Pretoria, Hatfield, South Africa
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Molwitz I, Kemper C, Stahlmann K, Oechtering TH, Sieren MM, Afat S, Gerwing M, Bucher AM, Storz C, Langenbach MC, Reim M, Lotz J, Zagrosek-Regitz V, Can E, Köhler D, Yamamura J, Adam G, Hamm B, Keller S. Work expectations, their fulfillment, and exhaustion among radiologists of all career levels: what can be learned from the example of Germany. Eur Radiol 2023; 33:5664-5674. [PMID: 36897346 PMCID: PMC9999063 DOI: 10.1007/s00330-023-09510-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/21/2023] [Accepted: 02/07/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES To evaluate work expectations of radiologists at different career levels, their fulfillment, prevalence of exhaustion, and exhaustion-associated factors. METHODS A standardized digital questionnaire was distributed internationally to radiologists of all career levels in the hospital and in ambulatory care via radiological societies and sent manually to 4500 radiologists of the largest German hospitals between December 2020 and April 2021. Statistics were based on age- and gender-adjusted regression analyses of respondents working in Germany (510 out of 594 total respondents). RESULTS The most frequent expectations were "joy at work" (97%) and a "good working atmosphere" (97%), which were considered fulfilled by at least 78%. The expectation of a "structured residency within the regular time interval" (79%) was more frequently judged fulfilled by senior physicians (83%, odds ratio (OR) 4.31 [95% confidence interval (95% CI) 1.95-9.52]), chief physicians (85%, 6.81 [95% CI 1.91-24.29]), and radiologists outside the hospital (88%, 7.59 [95% CI 2.40-24.03]) than by residents (68%). Exhaustion was most common among residents (physical exhaustion: 38%; emotional exhaustion: 36%), in-hospital specialists (29%; 38%), and senior physicians (30%; 29%). In contrast to paid extra hours, unpaid extra hours were associated with physical exhaustion (5-10 extra hours: OR 2.54 [95% CI 1.54-4.19]). Fewer opportunities to shape the work environment were related to a higher probability of physical (2.03 [95% CI 1.32-3.13]) and emotional (2.15 [95% CI 1.39-3.33]) exhaustion. CONCLUSIONS While most radiologists enjoy their work, residents wish for more training structure. Ensuring payment of extra hours and employee empowerment may help preventing burnout in high-risk groups. KEY POINTS • Most important work expectations of radiologists who work in Germany are "joy at work," a "good working atmosphere," "support for further qualification," and a "structured residency within the regular time interval," with the latter containing potential for improvement according to residents. • Physical and emotional exhaustion are common at all career levels except for chief physicians and for radiologists who work outside the hospital in ambulatory care. • Exhaustion as a major burnout criterion is associated with unpaid extra hours and reduced opportunities to shape the work environment.
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Affiliation(s)
- Isabel Molwitz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christoph Kemper
- Department of Radiology, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Katharina Stahlmann
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thekla Helene Oechtering
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
- Department of Radiology, University of Wisconsin, Madison, WI, USA
| | - Malte Maria Sieren
- Department of Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein Campus Lübeck, Lübeck, Germany
| | - Saif Afat
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls University, Tübingen, Germany
| | - Mirjam Gerwing
- Clinic of Radiology, Medical Faculty, University of Münster, Münster, Germany
| | - Andreas Michael Bucher
- Institute for Diagnostic and Interventional Radiology, Goethe University Frankfurt, Frankfurt Am Main, Germany
| | - Corinna Storz
- Department of Neuroradiology, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marcel C Langenbach
- Institute for Diagnostic and Interventional Radiology, University Hospital Cologne, Cologne, Germany
- Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Martin Reim
- Department of Radiology and Interventional Radiology, Tartu University Hospital, University of Tartu, Tartu, Estonia
| | - Joachim Lotz
- Institute for Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
| | - Vera Zagrosek-Regitz
- Institute for Gender in Medicine, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Cardiology, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Elif Can
- Department of Radiology, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Daniel Köhler
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jin Yamamura
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- evidia Group, Berlin, Germany
| | - Gerhard Adam
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Hamm
- Department of Radiology, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sarah Keller
- Department of Radiology, Charité Universitaetsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Oprisan A, Baettig-Arriagada E, Baeza-Delgado C, Martí-Bonmatí L. Prevalence of burnout syndrome in Spanish radiologists. Radiologia (Engl Ed) 2023; 65:307-314. [PMID: 37516484 DOI: 10.1016/j.rxeng.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 09/07/2021] [Indexed: 07/31/2023]
Abstract
BACKGROUND AND AIMS The primary objective was to analyze the prevalence and degree of professional burnout in radiologists in Spain. Secondary objectives were to identify possible factors that increase or decrease the risk of burnout to enable preventive and corrective measures, decrease the stress associated with this condition, and thereby increase radiologists' performance and satisfaction at work. MATERIAL AND METHODS This cross-sectional observational study used a voluntary, anonymous online survey of attending radiologists and residents through Google Forms®. The survey was structured into three sections: a qualitative assessment of the degree of professional burnout with the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a series of sociodemographic and work-related questions, and a final section centered on possible causes of stress and improvements to the working environment. The results of the survey were analyzed statistically to determine which variables were associated with burnout syndrome as well as to identify possible risk factors and protective factors. RESULTS After disseminating the survey through social networks and email contacts, we received a total of 226 responses (175 from attending radiologists and 51 from residents; 52% men; mean age, 41 ± 11 years; age range, 25-68). The prevalence of the syndrome was 33%, without significant differences between attending radiologists and residents. No risk factors associated with burnout were identified. Teaching in the workplace was the only protective factor. CONCLUSIONS One-third of the respondents had burnout syndrome. Because the consequences of this syndrome can affect professionals' personal life and their ability to do their jobs, early detection and intervention should be prioritized.
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Affiliation(s)
- A Oprisan
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | - E Baettig-Arriagada
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - C Baeza-Delgado
- Grupo de Investigación Biomédica en Imagen (GIBI230), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - L Martí-Bonmatí
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Grupo de Investigación Biomédica en Imagen (GIBI230), Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Académico de Número de la Real Academia Nacional de Medicina de España, Spain
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Alelyani M, Gameraddin M, Khushayl AMA, Altowaijri AM, Qashqari MI, Alzahrani FAA, Gareeballah A. Work-related musculoskeletal symptoms among Saudi radiologists: a cross-sectional multi-centre study. BMC Musculoskelet Disord 2023; 24:468. [PMID: 37286979 DOI: 10.1186/s12891-023-06596-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 06/01/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND Musculoskeletal disorders are common health problems worldwide. Several factors cause these symptoms, including ergonomics and other individual considerations. Computer users are prone to repetitive strain injuries that increase the risk of developing musculoskeletal symptoms (MSS). Radiologists are susceptible to developing MSS because they work long hours analysing medical images on computers in an increasingly digitalised field. This study aimed to identify the prevalence of MSS among Saudi radiologists and the associated risk factors. METHODS This study was a cross-sectional, non-interventional, self-administered online survey. The study was conducted on 814 Saudi radiologists from various regions in Saudi Arabia. The study's outcome was the presence of MSS in any body region that limited participation in routine activities over the previous 12 months. The results were descriptively examined using binary logistic regression analysis to estimate the odds ratio (OR) of participants who had disabling MSS in the previous 12 months. All university, public, and private radiologists received an online survey containing questions about work surroundings, workload (e.g., spent at a computer workstation), and demographic characteristics. RESULTS The prevalence of MSS among the radiologists was 87.7%. Most of the participants (82%) were younger than 40 years of age. Radiography and computed tomography were the most common imaging modalities that caused MSS (53.4% and 26.8%, respectively). The most common symptoms were neck pain (59.3%) and lower back pain (57.1%). After adjustment, age, years of experience, and part-time employment were significantly associated with increased MSS (OR = .219, 95% CI = .057-.836; OR = .235, 95% CI = 087-.634; and OR = 2.673, 95% CI = 1.434-4.981, respectively). Women were more likely to report MSS than males (OR = 2.12, 95% CI = 1.327-3.377). CONCLUSIONS MSS are common among Saudi radiologists, with neck pain and lower back pain being the most frequently reported symptoms. Gender, age, years of experience, type of imaging modality, and employment status were the most common associated risk factors for developing MSS. These findings are vital for the development of interventional plans to reduce the prevalence of musculoskeletal complaints in clinical radiologists.
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Affiliation(s)
- Magbool Alelyani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 62529, Saudi Arabia.
| | - Moawia Gameraddin
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah, Saudi Arabia
- Department of Diagnostic Radiology, Faculty of Radiological Sciences and Medical Imaging, Alzaiem Alazhari University, Khartoum, Sudan
| | | | | | | | | | - Awadia Gareeballah
- Department of Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah, Saudi Arabia
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Bai M, Gao L, Ji M, Ge J, Huang L, Qiao H, Xiao J, Chen X, Yang B, Sun Y, Zhang M, Zhang W, Luo F, Yang H, Mei H, Qiao Z. The uncovered biases and errors in clinical determination of bone age by using deep learning models. Eur Radiol 2023; 33:3544-3556. [PMID: 36538072 DOI: 10.1007/s00330-022-09330-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 10/13/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate AI biases and errors in estimating bone age (BA) by comparing AI and radiologists' clinical determinations of BA. METHODS We established three deep learning models from a Chinese private dataset (CHNm), an American public dataset (USAm), and a joint dataset combining the above two datasets (JOIm). The test data CHNt (n = 1246) were labeled by ten senior pediatric radiologists. The effects of data site differences, interpretation bias, and interobserver variability on BA assessment were evaluated. The differences between the AI models' and radiologists' clinical determinations of BA (normal, advanced, and delayed BA groups by using the Brush data) were evaluated by the chi-square test and Kappa values. The heatmaps of CHNm-CHNt were generated by using Grad-CAM. RESULTS We obtained an MAD value of 0.42 years on CHNm-CHNt; this result indicated an appropriate accuracy for the whole group but did not indicate an accurate estimation of individual BA because with a kappa value of 0.714, the agreement between AI and human clinical determinations of BA was significantly different. The features of the heatmaps were not fully consistent with the human vision on the X-ray films. Variable performance in BA estimation by different AI models and the disagreement between AI and radiologists' clinical determinations of BA may be caused by data biases, including patients' sex and age, institutions, and radiologists. CONCLUSIONS The deep learning models outperform external validation in predicting BA on both internal and joint datasets. However, the biases and errors in the models' clinical determinations of child development should be carefully considered. KEY POINTS • With a kappa value of 0.714, clinical determinations of bone age by using AI did not accord well with clinical determinations by radiologists. • Several biases, including patients' sex and age, institutions, and radiologists, may cause variable performance by AI bone age models and disagreement between AI and radiologists' clinical determinations of bone age. • AI heatmaps of bone age were not fully consistent with human vision on X-ray films.
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Affiliation(s)
- Mei Bai
- Department of Radiology, Children's Hospital of Fudan University, No 399, Wan Yuan Road, Minhang District, Shanghai, 201102, China
| | | | - Min Ji
- Department of Radiology, Children's Hospital of Fudan University, No 399, Wan Yuan Road, Minhang District, Shanghai, 201102, China.
| | | | | | - HaoChen Qiao
- School of Public Health, Yale University, New Haven, USA
| | | | - Xiaotian Chen
- Department of Clinical epidemiology, Children's Hospital of Fudan University, Shanghai, China
| | - Bin Yang
- Department of Radiology, Children's Hospital of Fudan University, No 399, Wan Yuan Road, Minhang District, Shanghai, 201102, China
| | - Yingqi Sun
- Department of Radiology, Children's Hospital of Fudan University, No 399, Wan Yuan Road, Minhang District, Shanghai, 201102, China
| | - Minjie Zhang
- Department of Radiology, Children's Hospital of Fudan University, No 399, Wan Yuan Road, Minhang District, Shanghai, 201102, China
| | - Wenjie Zhang
- Information Technology Center, Children's Hospital of Fudan University, Shanghai, China
| | - Feihong Luo
- Department of Endocrinology, Children's Hospital of Fudan University, Shanghai, China
| | - Haowei Yang
- Department of Radiology, Children's Hospital of Fudan University, No 399, Wan Yuan Road, Minhang District, Shanghai, 201102, China
| | - Haibing Mei
- Department of Radiology, Ningbo Women and Children's Hospital, Ningbo, China
| | - Zhongwei Qiao
- Department of Radiology, Children's Hospital of Fudan University, No 399, Wan Yuan Road, Minhang District, Shanghai, 201102, China.
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Kaewlai R, Chatpuwaphat J, Maitriwong W, Wongwaisayawan S, Shin CI, Lee CW. Radiologic Imaging of Traumatic Bowel and Mesenteric Injuries: A Comprehensive Up-to-Date Review. Korean J Radiol 2023; 24:406-423. [PMID: 37133211 PMCID: PMC10157329 DOI: 10.3348/kjr.2022.0998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/15/2023] [Accepted: 03/29/2023] [Indexed: 05/04/2023] Open
Abstract
Diagnosing bowel and mesenteric trauma poses a significant challenge to radiologists. Although these injuries are relatively rare, immediate laparotomy may be indicated when they occur. Delayed diagnosis and treatment are associated with increased morbidity and mortality; therefore, timely and accurate management is essential. Additionally, employing strategies to differentiate between major injuries requiring surgical intervention and minor injuries considered manageable via non-operative management is important. Bowel and mesenteric injuries are among the most frequently overlooked injuries on trauma abdominal computed tomography (CT), with up to 40% of confirmed surgical bowel and mesenteric injuries not reported prior to operative treatment. This high percentage of falsely negative preoperative diagnoses may be due to several factors, including the relative rarity of these injuries, subtle and non-specific appearances on CT, and limited awareness of the injuries among radiologists. To improve the awareness and diagnosis of bowel and mesenteric injuries, this article provides an overview of the injuries most often encountered, imaging evaluation, CT appearances, and diagnostic pearls and pitfalls. Enhanced diagnostic imaging awareness will improve the preoperative diagnostic yield, which will save time, money, and lives.
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Affiliation(s)
- Rathachai Kaewlai
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Jitti Chatpuwaphat
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Worapat Maitriwong
- Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sirote Wongwaisayawan
- Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Cheong-Il Shin
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Choong Wook Lee
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Jain S, Chhabra A. Improving personal growth and sustaining mental and physical health of radiologists: essential quotients to embrace. Eur Radiol 2023:10.1007/s00330-023-09469-4. [PMID: 37083743 PMCID: PMC10120506 DOI: 10.1007/s00330-023-09469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 11/11/2022] [Accepted: 01/22/2023] [Indexed: 04/22/2023]
Abstract
This special report provides a viewpoint on attaining knowledge of essential traits also known as quotients (Q) that can improve the mental, physical, and spiritual satisfaction and health of radiologists. While intelligence Q is generally above-average for most doctors and radiologists, other Qs needed for wholesome personal growth include emotional Q, spiritual Q, cultural Q, and more importantly, the meaning Q. Self-reflection and embracing such elements can aid in personal development, enhanced mental peace, and improved systems-based practice in the context of integrated healthcare organizations. KEY POINT: • Emotional, spiritual, cultural, and meaning quotients can be embraced by radiologists for better self-development and improved systems-based practice in the context of integrated healthcare organizations.
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Affiliation(s)
- Suyash Jain
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA
| | - Avneesh Chhabra
- Department of Radiology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA.
- Department of Orthopedic Surgery, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9178, USA.
- Johns Hopkins University, Baltimore, MD, USA.
- Walton Centre for Neuroscience, Liverpool, UK.
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23
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Gunderman RB. Gemeinschaft and Gesellschaft. Acad Radiol 2023; 30:771-772. [PMID: 36658039 DOI: 10.1016/j.acra.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/01/2023] [Accepted: 01/01/2023] [Indexed: 01/20/2023]
Affiliation(s)
- Richard B Gunderman
- Department of Radiology, Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202.
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24
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Wang Y, Xu L, Lu W, Kong X, Shi K, Wang L, Kong D. Clinical evaluation of malignancy diagnosis of rare thyroid carcinomas by an artificial intelligent automatic diagnosis system. Endocrine 2023; 80:93-99. [PMID: 36462146 DOI: 10.1007/s12020-022-03269-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/18/2022] [Indexed: 12/04/2022]
Abstract
PURPOSE To evaluate the application value of a generally trained artificial intelligence (AI) automatic diagnosis system in the malignancy diagnosis of rare thyroid carcinomas, such as follicular thyroid carcinoma, medullary thyroid carcinoma, primary thyroid lymphoma and anaplastic thyroid carcinoma and compare the diagnostic performance with radiologists of different experience levels. METHODS We retrospectively studied 342 patients with 378 thyroid nodules that included 196 rare malignant nodules by using postoperative pathology as the gold standard, and compared the diagnostic performances of three radiologists (one junior, one mid-level, one senior) and that of AI automatic diagnosis system. RESULTS The accuracy of the AI system in malignancy diagnosis was 0.825, which was significantly higher than that of all three radiologists and higher than the best radiologist in this study by a margin of 0.097 with P-value of 2.252 × 10-16. The mid-level radiologist and senior radiologist had higher sensitivity (0.857 and 0.959) than that of the AI system (0.847) at the cost of having much lower specificity (0.533, 0.478 versus 0.802). The junior radiologist showed relatively balanced sensitivity and specificity (0.816 and 0.549) but both were lower than that of the AI system. CONCLUSIONS The generally trained AI automatic diagnosis system showed high accuracy in the differential diagnosis of begin nodules and rare malignancy nodules. It may assist radiologists for screening of rare malignancy nodules that even senior radiologists are not acquainted with.
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Affiliation(s)
- Yuan Wang
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China
| | - Lei Xu
- Zhejiang Qiushi Institute for Mathematical Medicine, Hangzhou, China
- South and North Lake Institute for Medical Artificial Intelligence, Haiyan, China
- Zhejiang Society for Mathematical Medicine, Hangzhou, China
| | - Wenliang Lu
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China
| | - Xiangkai Kong
- Department of Ultrasonography, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou, China
| | - Kaiyuan Shi
- Department of Ultrasonography, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou, China
| | - Liping Wang
- Zhejiang Society for Mathematical Medicine, Hangzhou, China.
- Department of Ultrasonography, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou, China.
| | - Dexing Kong
- School of Mathematical Sciences, Zhejiang University, Hangzhou, China.
- Zhejiang Qiushi Institute for Mathematical Medicine, Hangzhou, China.
- South and North Lake Institute for Medical Artificial Intelligence, Haiyan, China.
- Zhejiang Society for Mathematical Medicine, Hangzhou, China.
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25
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Gunderman DJ, Gunderman RB. Putting Workers Before Work. Acad Radiol 2023; 30:1220-1222. [PMID: 36804170 DOI: 10.1016/j.acra.2023.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 02/21/2023]
Affiliation(s)
- David J Gunderman
- Department of Radiology, Indiana University School of Medicine, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202
| | - Richard B Gunderman
- Department of Radiology, Indiana University School of Medicine, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202.
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Cereser L, Passarotti E, Tullio A, Patruno V, Monterubbiano L, Apa P, Zuiani C, Girometti R. Can a chest HRCT-based crash course on COVID-19 cases make inexperienced thoracic radiologists readily available to face the next pandemic? Clin Imaging 2023; 94:1-8. [PMID: 36434939 PMCID: PMC9678839 DOI: 10.1016/j.clinimag.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/01/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To test the inter-reader agreement in assessing lung disease extent, HRCT signs, and Radiological Society of North America (RSNA) categorization between a chest-devoted radiologist (CR) and two HRCT-naïve radiology residents (RR1 and RR2) after the latter attended a COVID-19-based chest high-resolution computed tomography (HRCT) "crash course". METHODS The course was built by retrospective inclusion of 150 patients who underwent HRCT for COVID-19 pneumonia between November 2020 and January 2021. During a first 10-days-long "training phase", RR1 and RR2 read a pool of 100/150 HRCTs, receiving day-by-day access to CR reports as feedback. In the subsequent 2-days-long "test phase", they were asked to report 50/150 HRCTs with no feedback. Test phase reports of RR1/RR2 were then compared with CR using unweighted or linearly-weighted Cohen's kappa (k) statistic and intraclass correlation coefficient (ICC). RESULTS We observed almost perfect agreement in assessing disease extent between RR1-CR (k = 0.83, p < 0.001) and RR2-CR (k = 0.88, p < 0.001). The agreement between RR1-CR and RR2-CR on consolidation, crazy paving pattern, organizing pneumonia (OP) pattern, and pulmonary artery (PA) diameter was substantial (k = 0.65 and k = 0.68), moderate (k = 0.42 and k = 0.51), slight (k = 0.10 and k = 0.20), and good-to-excellent (ICC = 0.87 and ICC = 0.91), respectively. The agreement in providing RSNA categorization was moderate for R1 versus CR (k = 0.56) and substantial for R2 versus CR (k = 0.67). CONCLUSION HRCT-naïve readers showed an acceptable overall agreement with CR, supporting the hypothesis that a crash course can be a tool to readily make non-subspecialty radiologists available to cooperate in reading high burden of HRCT examinations during a pandemic/epidemic.
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Affiliation(s)
- Lorenzo Cereser
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital “S. Maria della Misericordia”, p.le S. Maria della Misericordia, 15, 33100 Udine, Italy,Corresponding author
| | - Emanuele Passarotti
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital “S. Maria della Misericordia”, p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Annarita Tullio
- Institute of Hygiene and Clinical Epidemiology, University Hospital “S. Maria della Misericordia”, p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Vincenzo Patruno
- Pulmonology Department, “S. Maria della Misericordia” University Hospital, p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Leonardo Monterubbiano
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital “S. Maria della Misericordia”, p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Pierpaolo Apa
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital “S. Maria della Misericordia”, p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Chiara Zuiani
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital “S. Maria della Misericordia”, p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
| | - Rossano Girometti
- Institute of Radiology, Department of Medicine, University of Udine, University Hospital “S. Maria della Misericordia”, p.le S. Maria della Misericordia, 15, 33100 Udine, Italy
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Affiliation(s)
- Richard B Gunderman
- Department of Radiology, Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202.
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28
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Bonanno N, Cioni D, Caruso D, Cyran CC, Dinkel J, Fournier L, Gourtsoyianni S, Hoffmann RT, Laghi A, Martincich L, Mayerhoefer ME, Zamboni GA, Sala E, Schlemmer HP, Neri E, D’Anastasi M. Attitudes and perceptions of radiologists towards online (virtual) oncologic multidisciplinary team meetings during the COVID-19 pandemic-a survey of the European Society of Oncologic Imaging (ESOI). Eur Radiol 2023; 33:1194-1204. [PMID: 35986772 PMCID: PMC9391636 DOI: 10.1007/s00330-022-09083-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/03/2022] [Accepted: 08/04/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To explore radiologists' opinions regarding the shift from in-person oncologic multidisciplinary team meetings (MDTMs) to online MDTMs. To assess the perceived impact of online MDTMs, and to evaluate clinical and technical aspects of online meetings. METHODS An online questionnaire including 24 questions was e-mailed to all European Society of Oncologic Imaging (ESOI) members. Questions targeted the structure and efficacy of online MDTMs, including benefits and limitations. RESULTS A total of 204 radiologists responded to the survey. Responses were evaluated using descriptive statistical analysis. The majority (157/204; 77%) reported a shift to online MDTMs at the start of the pandemic. For the most part, this transition had a positive effect on maintaining and improving attendance. The majority of participants reported that online MDTMs provide the same clinical standard as in-person meetings, and that interdisciplinary discussion and review of imaging data were not hindered. Seventy three of 204 (35.8%) participants favour reverting to in-person MDTs, once safe to do so, while 7/204 (3.4%) prefer a continuation of online MDTMs. The majority (124/204, 60.8%) prefer a combination of physical and online MDTMs. CONCLUSIONS Online MDTMs are a viable alternative to in-person meetings enabling continued timely high-quality provision of care with maintained coordination between specialties. They were accepted by the majority of surveyed radiologists who also favoured their continuation after the pandemic, preferably in combination with in-person meetings. An awareness of communication issues particular to online meetings is important. Training, improved software, and availability of support are essential to overcome technical and IT difficulties reported by participants. KEY POINTS • Majority of surveyed radiologists reported shift from in-person to online oncologic MDT meetings during the COVID-19 pandemic. • The shift to online MDTMs was feasible and generally accepted by the radiologists surveyed with the majority reporting that online MDTMs provide the same clinical standard as in-person meetings. • Most would favour the return to in-person MDTMs but would also accept the continued use of online MDTMs following the end of the current pandemic.
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Affiliation(s)
- Nathania Bonanno
- Medical Imaging Department, Mater Dei Hospital, University of Malta, Msida, MSD 2090 Malta
| | - Dania Cioni
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | - Damiano Caruso
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
| | - Clemens C. Cyran
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Julien Dinkel
- Department of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377 Munich, Germany
| | - Laure Fournier
- Radiology Department, Hôpital Européen Georges Pompidou, AP-HP, Université de Paris, 20 Rue Leblanc, F-75015 Paris, France
| | - Sofia Gourtsoyianni
- 1st Department of Radiology, School of Medicine, Areteion Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Ralf-Thorsten Hoffmann
- Diagnostische und Interventionelle Radiologie Universitätsklinikum Dresden, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Andrea Laghi
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant’Andrea University Hospital, Via di Grottarossa, 1035-1039, 00189 Rome, Italy
| | - Laura Martincich
- Ospedale Cardinal Massaia Asti, Unit of Radiology, Corso Dante Alighieri, 202, 14100, Asti, Italy
| | - Marius E. Mayerhoefer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, A-1090 Vienna, Austria ,Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065 USA
| | - Giulia A. Zamboni
- Department of Diagnostics and Public Health, Institute of Radiology, University of Verona, Policlinico GB Rossi, P.le LA Scuro 10, 37134 Verona, Italy
| | - Evis Sala
- Department of Radiology Box 218, Cambridge Biomedical Campus Cambridge, Cambridge, CB2 0QQ UK
| | - Heinz-Peter Schlemmer
- Department of Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, Via Roma 67, 56126 Pisa, Italy
| | - Melvin D’Anastasi
- Medical Imaging Department, Mater Dei Hospital, University of Malta, Msida, MSD 2090 Malta
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Jungmann F, Ziegelmayer S, Lohoefer FK, Metz S, Müller-Leisse C, Englmaier M, Makowski MR, Kaissis GA, Braren RF. Algorithmic transparency and interpretability measures improve radiologists' performance in BI-RADS 4 classification. Eur Radiol 2023; 33:1844-1851. [PMID: 36282311 PMCID: PMC9935738 DOI: 10.1007/s00330-022-09165-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To evaluate the perception of different types of AI-based assistance and the interaction of radiologists with the algorithm's predictions and certainty measures. METHODS In this retrospective observer study, four radiologists were asked to classify Breast Imaging-Reporting and Data System 4 (BI-RADS4) lesions (n = 101 benign, n = 99 malignant). The effect of different types of AI-based assistance (occlusion-based interpretability map, classification, and certainty) on the radiologists' performance (sensitivity, specificity, questionnaire) were measured. The influence of the Big Five personality traits was analyzed using the Pearson correlation. RESULTS Diagnostic accuracy was significantly improved by AI-based assistance (an increase of 2.8% ± 2.3%, 95 %-CI 1.5 to 4.0 %, p = 0.045) and trust in the algorithm was generated primarily by the certainty of the prediction (100% of participants). Different human-AI interactions were observed ranging from nearly no interaction to humanization of the algorithm. High scores in neuroticism were correlated with higher persuasibility (Pearson's r = 0.98, p = 0.02), while higher consciousness and change of accuracy showed an inverse correlation (Pearson's r = -0.96, p = 0.04). CONCLUSION Trust in the algorithm's performance was mostly dependent on the certainty of the predictions in combination with a plausible heatmap. Human-AI interaction varied widely and was influenced by personality traits. KEY POINTS • AI-based assistance significantly improved the diagnostic accuracy of radiologists in classifying BI-RADS 4 mammography lesions. • Trust in the algorithm's performance was mostly dependent on the certainty of the prediction in combination with a reasonable heatmap. • Personality traits seem to influence human-AI collaboration. Radiologists with specific personality traits were more likely to change their classification according to the algorithm's prediction than others.
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Affiliation(s)
- Friederike Jungmann
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Sebastian Ziegelmayer
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Fabian K. Lohoefer
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Stephan Metz
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Christina Müller-Leisse
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Maximilian Englmaier
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Marcus R. Makowski
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany
| | - Georgios A. Kaissis
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany ,grid.7445.20000 0001 2113 8111Department of Computing, Faculty of Engineering, Imperial College of Science, Technology and Medicine, London, SW7 2AZ UK ,grid.6936.a0000000123222966Institute for Artificial Intelligence in Medicine and Healthcare, School of Medicine and Faculty of Informatics, Technical University of Munich, 81675 Munich, Germany
| | - Rickmer F. Braren
- grid.6936.a0000000123222966Institute of Diagnostic and Interventional Radiology, School of Medicine, Technical University of Munich, 81675 Munich, Germany ,grid.7497.d0000 0004 0492 0584German Cancer Consortium (DKTK) Partner Site Munich, 69120 Heidelberg, Germany
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Meng F, Kottlors J, Shahzad R, Liu H, Fervers P, Jin Y, Rinneburger M, Le D, Weisthoff M, Liu W, Ni M, Sun Y, An L, Huai X, Móré D, Giannakis A, Kaltenborn I, Bucher A, Maintz D, Zhang L, Thiele F, Li M, Perkuhn M, Zhang H, Persigehl T. AI support for accurate and fast radiological diagnosis of COVID-19: an international multicenter, multivendor CT study. Eur Radiol 2022; 33:4280-4291. [PMID: 36525088 PMCID: PMC9755771 DOI: 10.1007/s00330-022-09335-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Differentiation between COVID-19 and community-acquired pneumonia (CAP) in computed tomography (CT) is a task that can be performed by human radiologists and artificial intelligence (AI). The present study aims to (1) develop an AI algorithm for differentiating COVID-19 from CAP and (2) evaluate its performance. (3) Evaluate the benefit of using the AI result as assistance for radiological diagnosis and the impact on relevant parameters such as accuracy of the diagnosis, diagnostic time, and confidence. METHODS We included n = 1591 multicenter, multivendor chest CT scans and divided them into AI training and validation datasets to develop an AI algorithm (n = 991 CT scans; n = 462 COVID-19, and n = 529 CAP) from three centers in China. An independent Chinese and German test dataset of n = 600 CT scans from six centers (COVID-19 / CAP; n = 300 each) was used to test the performance of eight blinded radiologists and the AI algorithm. A subtest dataset (180 CT scans; n = 90 each) was used to evaluate the radiologists' performance without and with AI assistance to quantify changes in diagnostic accuracy, reporting time, and diagnostic confidence. RESULTS The diagnostic accuracy of the AI algorithm in the Chinese-German test dataset was 76.5%. Without AI assistance, the eight radiologists' diagnostic accuracy was 79.1% and increased with AI assistance to 81.5%, going along with significantly shorter decision times and higher confidence scores. CONCLUSION This large multicenter study demonstrates that AI assistance in CT-based differentiation of COVID-19 and CAP increases radiological performance with higher accuracy and specificity, faster diagnostic time, and improved diagnostic confidence. KEY POINTS • AI can help radiologists to get higher diagnostic accuracy, make faster decisions, and improve diagnostic confidence. • The China-German multicenter study demonstrates the advantages of a human-machine interaction using AI in clinical radiology for diagnostic differentiation between COVID-19 and CAP in CT scans.
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Affiliation(s)
- Fanyang Meng
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China
| | - Jonathan Kottlors
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Rahil Shahzad
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Innovative Technology, Philips Healthcare, Aachen, Germany
| | - Haifeng Liu
- Department of Radiology, Wuhan No. 1 Hospital, Wuhan, China
| | - Philipp Fervers
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Yinhua Jin
- Department of Radiology, Ningbo Hwamei Hospital, University of Chinese Academy of Sciences, Wuhan, China
| | - Miriam Rinneburger
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Dou Le
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China
| | - Mathilda Weisthoff
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Wenyun Liu
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China
| | - Mengzhe Ni
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China
| | - Ye Sun
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China
| | - Liying An
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China
| | | | - Dorottya Móré
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Athanasios Giannakis
- Department of Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Isabel Kaltenborn
- Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt, Germany
| | - Andreas Bucher
- Institute for Diagnostic and Interventional Radiology, Frankfurt University Hospital, Frankfurt, Germany
| | - David Maintz
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lei Zhang
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China
| | - Frank Thiele
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Innovative Technology, Philips Healthcare, Aachen, Germany
| | - Mingyang Li
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China
| | - Michael Perkuhn
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Innovative Technology, Philips Healthcare, Aachen, Germany
| | - Huimao Zhang
- Department of Radiology, The First Hospital of Ji Lin University, No. 1 Xinmin Street, Changchun, 130012, China.
| | - Thorsten Persigehl
- Institute for Diagnostic and Interventional Radiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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Alzahrani NM, Paddock M, Jeanes A, Shuweihdi F, Offiah AC. Professional practice and awareness of child abuse among radiologists and radiologic technologists: results from Saudi Arabia. Pediatr Radiol 2022; 53:832-843. [PMID: 36517574 PMCID: PMC10156848 DOI: 10.1007/s00247-022-05561-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/02/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND The knowledge, awareness and professionalism of health care providers in the field of child protection are crucial in identifying and reporting suspected child abuse. Radiologic technologists and radiologists play a vital role in the diagnosis of suspected physical child abuse. OBJECTIVE To assess current practice, knowledge and awareness of child abuse among radiologic technologists and radiologists in Saudi Arabia. MATERIALS AND METHODS We distributed an internet-based questionnaire to radiologic technologists and radiologists working in Saudi Arabia via national radiology societies and social media channels over a 6-week period (27 October to 8 December 2021). Survey questions covered knowledge regarding child abuse, professional practice in radiology departments in Saudi Arabia in cases of suspected physical abuse (SPA), and knowledge of the national legislation and reporting and acting procedures in child abuse. RESULTS A total of 315 respondents (224 radiologic technologists and 91 radiologists) participated in this study. The median score for knowledge of abuse was higher amongst radiologists (4.8) than radiologic technologists (4.0); P < 0.001. In total, 210 (93.8%) radiologic technologists and 61 (67.0%) radiologists reported that there was no protocol (i.e. skeletal survey) at their hospital for imaging children with SPA. Most radiologic technologists had no training in paediatric radiology (165/224, 73.7%) and most radiologists had received no training in evaluating imaging performed for SPA (73/91, 80.2%). More than half of respondents - 131 (58.5%) radiologic technologists and 44 (48.4%) radiologists - were not familiar with the reporting and acting procedures at their hospitals in cases of child abuse. CONCLUSION Although radiologic technologists and radiologists in Saudi Arabia have good knowledge and awareness of child abuse in general, they lack specific knowledge of the reporting and acting procedures at their hospitals in cases of suspected child abuse. National imaging guidelines and training courses are needed to develop appropriate skills in the recognition, imaging and reporting of SPA in infants and young children in Saudi Arabia.
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Affiliation(s)
- Nasser M Alzahrani
- Department of Oncology and Metabolism, University of Sheffield, Damer Street Building, Western Bank, Sheffield, S10 2TH, United Kingdom.
- Diagnostic Radiology Department, College of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Michael Paddock
- Department of Oncology and Metabolism, University of Sheffield, Damer Street Building, Western Bank, Sheffield, S10 2TH, United Kingdom
- Medical Imaging Department, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Annmarie Jeanes
- Department of Paediatric Radiology, Leeds Children's Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | - Farag Shuweihdi
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Amaka C Offiah
- Department of Oncology and Metabolism, University of Sheffield, Damer Street Building, Western Bank, Sheffield, S10 2TH, United Kingdom
- Department of Radiology, Sheffield Children's NHS Foundation Trust, Western Bank, Sheffield, United Kingdom
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Abuzaid MM, Elshami W, Kadhom M, McConnell J, Mc Fadden S. The changing concept of radiographer's role in UAE: An analysis of radiologists' opinions and acceptance. Radiography (Lond) 2022; 28:1042-1049. [PMID: 35969941 DOI: 10.1016/j.radi.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The role of radiographers in the United Arab Emirates (UAE) is currently focused on image acquisition. However, many advances have been made in different countries in recent years whereby radiographers who receive appropriate education and training, can provide image interpretation/reports. When implemented, this role development has enabled a more cost effective and efficient service delivery whilst relieving the burden off radiologists, allowing them to concentrate on more complex imaging examinations. This role development is commonplace in many countries but not in the UAE. AIM This study aims to investigate the radiologists' opinions, perceptions, and willingness to accept the advanced practice role of reporting radiographers in the UAE and determine their level of support for implementing these roles. METHODS Data was collected utilizing a mixed-methods study design that included a survey and focus group discussions (FGD). Study participants included radiologists who currently work in UAE public and private health organizations. The survey link was emailed directly to the radiologists, together with a covering letter and participants' information sheet outlining the study's aim. Participants indicated on the survey if they wanted to participate in FGD. Two online FGD were conducted using Zoom software (Zoom Video Communications Inc., San Jose, California, United States) and aimed to explore possible reasons for participant's opinions. Ethical approval was obtained from the Ministry of Health, and all methods were performed as per study protocol. RESULTS A total of 69 radiologists participated in the survey, 48 males and 21 females aged between 41 and 60 years and with between 11 and 16 years of experience. Most participants (n = 54, 78.2%) believe that radiographers should only perform advanced tasks in image interpretation after obtaining adequate training and under the supervision of a radiologist. According to 55% of radiologists, the development of the radiographer role could draw more UAE nationals to the field. Six participants were recruited to FGD and declared mixed opinions that emphasized the need to improve the radiographers knowledge and experience to enable role development. CONCLUSION Radiologists' worries about radiographer engagement in image interpretation may be alleviated if they participate in education and training for new responsibilities. In addition, this could boost the confidence of radiologists and improve trust in radiographer competency and training. IMPLICATIONS FOR PRACTICE Guidelines and work standards must be developed jointly by radiologists and radiographers to ensure the governance and acceptability of new radiographer reporting roles. Some radiologists perceive that radiographer reporting is possible in UAE when radiographers are trained to set guidelines and with supervision from radiologists. Change is taking place, and many radiologists express optimism for the future, though the rate of change will be determined by a willingness to change attitudes and perceptions.
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Affiliation(s)
- M M Abuzaid
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - W Elshami
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - M Kadhom
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - J McConnell
- Radiology Department, NHS Greater Glasgow and Clyde, Scotland, UK
| | - S Mc Fadden
- Diagnostic Radiography and Imaging, School of Health Sciences, University of Ulster, Ireland
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Affiliation(s)
- Richard B Gunderman
- Department of Radiology, Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, Indiana 46202
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Roson N, Antolin A, Mast R, Sanchéz-Tirado C, Griñón J, Andreu J, Perez Lafuente M, Tomasello A, Escobar M. Experience and results after the implementation of a radiology day unit in a reference hospital. Insights Imaging 2022; 13:109. [PMID: 35767122 PMCID: PMC9243205 DOI: 10.1186/s13244-022-01251-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 06/09/2022] [Indexed: 11/30/2022] Open
Abstract
Background Interventional radiological procedures have significantly increased in recent years. Most of them are minimally invasive and require a short hospitalization, mainly done in other non-radiological units nowadays. Limited bed availability and high occupancy rates in these units create longer waiting lists and cancellations. The aim of this retrospective study is to assess the creation and functioning of a Radiology Day Unit (RDU) and evaluating its outcomes. For this purpose, data about interventional procedures and its complications, incidents, patient safety, quality and satisfaction rates were collected from May 2018 to December 2020, and posteriorly analyzed to evaluate its implementation. Results During the assessed period, 3841 patients were admitted into the RDU, with a net increase of 13% and 26% in the second and third year, respectively. Procedures performed by the Abdominal Radiology section were the most frequent (76–85%) followed by Interventional Vascular Radiology and Thoracic Radiology. Complication rates were low (1.5%) and most of them were self-limited and managed in the own department. Waiting lists were significantly reduced, from 2 months to 1 week in case of procedures performed by the Abdominal Radiology section. Patient satisfaction was higher than 80% in all the items evaluated with a global satisfaction of 93%. Conclusion The RDU in our hospital has become a vital section for the management and post-procedure caring of patients undergoing interventional procedures in the Radiology Service with low complication rates and overall high levels of quality and patient safety, allowing the reduction of waiting lists and occupancy rates.
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Affiliation(s)
- Nuria Roson
- Department of Radiology, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Andreu Antolin
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
| | - Richard Mast
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Cristina Sanchéz-Tirado
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Jesús Griñón
- Department of Radiology, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Jordi Andreu
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Mercedes Perez Lafuente
- Department of Radiology, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Alejandro Tomasello
- Department of Radiology, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Manuel Escobar
- Department of Radiology, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain
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Yoon J, Lee HS, Kim MJ, Park VY, Kim EK, Yoon JH. AI-CAD for differentiating lesions presenting as calcifications only on mammography: outcome analysis incorporating the ACR BI-RADS descriptors for calcifications. Eur Radiol 2022. [PMID: 35748900 DOI: 10.1007/s00330-022-08961-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To evaluate how AI-CAD triages calcifications and to compare its performance to an experienced breast radiologist. METHODS Among routine mammography performed between June 2016 and May 2018, 535 lesions detected as calcifications only on mammography in 500 women (mean age, 48.8 years) that were additionally interpreted with additional magnification views were included in this study. One dedicated breast radiologist retrospectively reviewed the magnification mammograms to assess morphology, distribution, and final assessment category according to ACR BI-RADS. AI-CAD analyzed routine mammograms providing AI-CAD marks and corresponding AI-CAD scores (ranging from 0 to 100%), for which values ≥ 10% were considered positive. Ground truth in terms of malignancy or benignity was confirmed with a histopathologic diagnosis or at least 1 year of imaging follow - up. RESULTS Of the 535 calcifications, 215 (40.2%) were malignant. Calcifications with positive AI-CAD scores showed significantly higher PPVs compared to calcifications with negative scores for all morphology (all p < 0.05). PPVs were significantly higher in calcifications with positive AI-CAD scores compared to those with negative scores for BI-RADS 3, 4a, or 4b assessments (all p < 0.05). AI-CAD and the experienced radiologist did not show significant difference in diagnostic performance; sensitivity 92.1% vs 95.4% (p = 0.125), specificity 71.9% vs 72.5% (p = 0.842), and accuracy 80.0% vs 81.7% (p = 0.413). CONCLUSION Among calcifications with same morphology or BI-RADS assessment, those with positive AI-CAD scores had significantly higher PPVs. AI-CAD showed similar diagnostic performances to the experienced radiologist for calcifications detected on mammography. KEY POINTS • Among calcifications with same morphology or BI-RADS assessment, those with positive AI-CAD scores had significantly higher PPVs. • AI-CAD showed similar diagnostic performance to an experienced radiologist in assessing lesions detected as calcifications only on mammography. • Among malignant calcifications, calcifications with positive AI-CAD scores showed higher rates of invasive cancers than calcifications with negative scores (all p > 0.05).
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Gunderman RB. Making the Most of Retirement. Acad Radiol 2022; 29:1282-1283. [PMID: 35752574 DOI: 10.1016/j.acra.2022.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Richard B Gunderman
- Department of Radiology, Indiana University School of Medicine, 702 North Barnhill Drive, Room 1053, Indianapolis, Indiana.
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The role of radiologist in the changing world of healthcare: a White Paper of the European Society of Radiology (ESR). Insights Imaging 2022; 13:100. [PMID: 35662384 PMCID: PMC9167391 DOI: 10.1186/s13244-022-01241-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Radiology as a specialty has been enormously successful since its beginnings, moving over time from an adjunct to clinical decision-making to a crucial component of multidisciplinary patient care. However, this increased centrality of radiology and reliance on our services carries within it dangers, prominent among them being the danger of our being viewed as deliverers of a commodity, and the risk of our becoming overwhelmed by increasing workload, unable to interact sufficiently with patients and referrers due to pressure of work. With this White Paper, the Board of Directors of the European Society of Radiology (ESR) seeks to briefly explain the position of the radiologist in the modern healthcare environment, considering our duties and contributions as doctors, protectors, communicators, innovators, scientists and teachers. This statement is intended to serve as a summary of the breadth of our responsibilities and roles, and to assist radiologists in countering misunderstanding of who we are and what we do.
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Bonday R, Wu I, Gunderman RB. Numbers in Educational Excellence. Acad Radiol 2022; 29:786-787. [PMID: 35272952 DOI: 10.1016/j.acra.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Rida Bonday
- Department of Radiology (R.B., I.W., R.B.G.), Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202
| | - Isaac Wu
- Department of Radiology (R.B., I.W., R.B.G.), Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202
| | - Richard B Gunderman
- Department of Radiology (R.B., I.W., R.B.G.), Indiana University, 702 North Barnhill Drive, Room 1053, Indianapolis, IN 46202.
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Gandomkar Z, Khong PL, Punch A, Lewis S. Using Occlusion-Based Saliency Maps to Explain an Artificial Intelligence Tool in Lung Cancer Screening: Agreement Between Radiologists, Labels, and Visual Prompts. J Digit Imaging 2022; 35:1164-1175. [PMID: 35484439 PMCID: PMC9582174 DOI: 10.1007/s10278-022-00631-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 03/03/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022] Open
Abstract
Occlusion-based saliency maps (OBSMs) are one of the approaches for interpreting decision-making process of an artificial intelligence (AI) system. This study explores the agreement among text responses from a cohort of radiologists to describe diagnostically relevant areas on low-dose CT (LDCT) images. It also explores if radiologists’ descriptions of cases misclassified by the AI provide a rationale for ruling out the AI’s output. The OBSM indicating the importance of different pixels on the final decision made by an AI were generated for 10 benign cases (3 misclassified by the AI tool as malignant) and 10 malignant cases (2 misclassified by the AI tool as benign). Thirty-six radiologists were asked to use radiological vocabulary, typical to reporting LDCT scans, to describe the mapped regions of interest (ROI). The radiologists’ annotations were then grouped by using a clustering-based technique. Topics were extracted from the annotations and for each ROI, a percentage of annotations containing each topic were found. Radiologists annotated 17 and 24 unique ROIs on benign and malignant cases, respectively. Agreement on the main label (e.g., “vessel,” “nodule”) by radiologists was only seen in only in 12% of all areas (5/41 ROI). Topic analyses identified six descriptors which are commonly associated with a lower malignancy likelihood. Eight common topics related to a higher malignancy likelihood were also determined. Occlusion-based saliency maps were used to explain an AI decision-making process to radiologists, who in turn have provided insight into the level of agreement between the AI’s decision and radiological lexicon.
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Affiliation(s)
- Ziba Gandomkar
- Discipline of Medical Imaging Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Pek Lan Khong
- Clinical Imaging Research Center (CIRC), Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amanda Punch
- Discipline of Medical Imaging Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Sarah Lewis
- Discipline of Medical Imaging Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
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Zhang T, Dong M, Wang H, Jia R, Li F, Ni X, Jin C. Visual expertise modulates baseline brain activity: a preliminary resting-state fMRI study using expertise model of radiologists. BMC Neurosci 2022; 23:24. [PMID: 35413843 PMCID: PMC9003981 DOI: 10.1186/s12868-022-00707-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/25/2022] [Indexed: 01/27/2023] Open
Abstract
Background visual expertise and experience modulate evoked brain activity in response to training-related stimuli. However, few studies have considered how the visual experience is represented in the resting state brain activity. This study tried to investigate the way visual experience, i.e., visual recognition expertise, modulates baseline brain neuronal activity in the resting state using the model of radiologists. Methods The amplitude of low-frequency (< 0.08 Hz) fluctuation (ALFF) was used as the metric of baseline brain activity and a visual expertise model of radiologists to investigated this question. The visual recognition skill enables them to accurately identify pathological information in medical images. After the behavior measurement, a cohort group of radiology interns (n = 22) and a group of matched layperson (n = 22) were selected for inclusion in the study. The resting state functional magnetic resonance imaging (fMRI) scans were performed for all of the subjects. Results Higher ALFF in the right fusiform gyrus and the left orbitofrontal cortex were observed, and the ALFF in the fusiform gyrus was correlated with the intern radiologists’ behavioral expertise(all results corrected for multiple comparisons). Conclusions Visual experience modulates the baseline brain activity in both high-level visual cortex and high-order cognitive cortex, indicating the engagement of both top-down and bottom-up facilitation. We provide a novel perspective to how visual experience modulated cortical brain activity by introducing the resting state changes. Also, we propose that our current study may provide novel ideas for the development of new training protocols in medical school.
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Affiliation(s)
- Ting Zhang
- School of Humanities and Social Science, Xi'an Jiaotong University, Xi'an, China.,College of Tourism & Landscape Architecture, Guilin University of Technology, Guilin, China
| | - Minghao Dong
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Xi'an Key Laboratory of Intelligent Sensing and Regulation of Trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, 710126, Shaanxi, China
| | - Hongmei Wang
- Department of Medical Imaging, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Rui Jia
- College Students Mental Health Education Center, Xi'an University of Technology, Xi'an, China
| | - Fu Li
- Key Laboratory of Intelligent Perception and Image Understanding of Ministry of Education, School of Artificial Intelligence, Xidian University, Xi'an, China
| | - Xiaoli Ni
- School of Humanities and Social Science, Xi'an Jiaotong University, Xi'an, China.
| | - Chenwang Jin
- Department of Medical Imaging, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China.
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Calame P, Weck M, Busse-Cote A, Brumpt E, Richou C, Turco C, Doussot A, Bresson-Hadni S, Delabrousse E. Role of the radiologist in the diagnosis and management of the two forms of hepatic echinococcosis. Insights Imaging 2022; 13:68. [PMID: 35394226 PMCID: PMC8994011 DOI: 10.1186/s13244-022-01190-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
Echinococcosis is a parasitic disease caused by two zoonotic tapeworms (cestodes) of the Echinocococcus genus. It can be classified as either alveolar or cystic echinococcosis. Although the two forms differ significantly in terms of imaging findings, they share similarities in terms of management and treatment. In parallel to medical treatment with albendazole (ABZ), and surgery, historically used in these diseases, various imaging-guided interventional procedures have recently emerged (drainage, stenting, or Puncture, aspiration, injection, and reaspiration (PAIR)). These options open up a new range of therapeutic options. As in oncology, multidisciplinary consultation meetings now play a major role in adapted management and patient care in hepatic echinococcosis. Consequently, diagnostic imaging and interventional expertise have brought radiologists to the fore as important members of these multidisciplinary team. The radiologist will need to evaluate parasite activity in both forms of the disease, to guide the choice of the appropriate therapy from among medical treatment, interventional radiology procedures and/or surgical treatment. Knowledge of the specific complications of the two forms of echinococcosis will also help radiologists to discuss the appropriate treatment and management. The aim of this review is to describe the core knowledge that what a radiologist should possess to actively participate in multidisciplinary meetings about hepatic echinococcosis. We discuss the role of imaging, from diagnosis to treatment, in alveolar (AE) and cystic echinococcosis (CE), respectively.
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Affiliation(s)
- Paul Calame
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France. .,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France.
| | - Mathieu Weck
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Andreas Busse-Cote
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Eleonore Brumpt
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France
| | - Carine Richou
- Department of Hepatology, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Celia Turco
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Alexandre Doussot
- Department of Digestive Surgery, University of Bourgogne Franche-Comté, University Hospital Besançon, 25030, Besançon, France
| | - Solange Bresson-Hadni
- Laboratoire de Parasitologie-Mycologie, University Hospital Besançon, 25030, Besançon, France.,Centre National de Référence Echinococcoses, University Hospital Besançon, 25030, Besançon, France
| | - Eric Delabrousse
- Department of Radiology, University of Bourgogne Franche-Comté, University Hospital Besançon, 3 Boulevard Fleming, 25030, Besançon, France.,EA 4662 Nanomedicine Lab, Imagery and Therapeutics, University of Bourgogne Franche-Comté, Besançon, France
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What radiologists need to know about patients' expectations: P.A.T.I.E.N.T.S C.A.R.E.R.S A.I.M.S. Insights Imaging 2022; 13:53. [PMID: 35316426 PMCID: PMC8938634 DOI: 10.1186/s13244-022-01184-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
The Patient Advisory Group (PAG) of the European Society of Radiology aims to highlight, in this short paper, patients’ expectations from the radiological community and support workers, throughout the patient’s medical imaging journey for completion of diagnostic or interventional examinations. In order to maintain constant awareness of patients’ expectations, key expectations have been summarised in an easy-to-remember mnemonic: PATIENTS CARERS AIMS. Due to disparate healthcare systems and medical imaging services in Europe, not all patient expectations can be systematically met, but healthcare providers should be mindful, when setting up new operational procedures, of the need to focus on patient-centred needs and care. At times when new or improved technology is being introduced, such as artificial intelligence applications, telemedicine, robotisation of interventional procedures and digitised records, the impact on radiologist–patient communication and interactions should be considered.
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Glazer DI, Budiawan E, Burk KS, Shinagare AB, Lacson R, Boland GW, Khorasani R. Adoption of a diagnostic certainty scale in abdominal imaging: 2-year experience at an academic institution. Abdom Radiol (NY) 2022; 47:1187-95. [PMID: 34985634 DOI: 10.1007/s00261-021-03391-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE Assess use of a diagnostic certainty scale (CS) for abdominal imaging reports and identify factors associated with greater adoption. METHODS This retrospective, Institutional Review Board-exempt study was conducted at an academic health system. Abdominal radiology reports containing diagnostic certainty phrases (DCPs) generated 4/1/2019-3/31/2021 were identified by a natural language processing tool. Reports containing DCPs were subdivided into those with/without a CS inserted at the end. Primary outcome was monthly CS use rate in reports containing DCPs. Secondary outcomes were assessment of factors associated with CS use, and usage of recommended DCPs over time. Chi-square test was used to compare proportions; univariable and multivariable regression assessed impact of other variables. RESULTS DCPs were used in 81,281/124,501 reports (65.3%). One-month post-implementation, 82/2310 (3.6%) of reports with DCPs contained the CS, increasing to 1862/4644 (40.1%) by study completion (p < 0.001). Multivariable analysis demonstrated reports containing recommended DCPs were more likely to have the CS (Odds Ratio [OR] 4.5; p < 0.001). Using CT as a reference, CS use was lower for ultrasound (OR 0.73; p < 0.001) and X-ray (OR 0.38; p < 0.001). There was substantial inter-radiologist variation in CS use (OR 0.01-26.3, multiple p values). CONCLUSION DCPs are very common in abdominal imaging reports and can be further clarified with CS use. Although voluntary CS adoption increased 13-fold over 2 years, > 50% of reports with DCPs lacked the CS at study's end. More stringent interventions, including embedding the scale in report templates, are likely needed to reduce inter-radiologist variation and decrease ambiguity in conveying diagnostic certainty to referring providers and patients.
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Dybvik JA, Fasmer KE, Ytre-Hauge S, Husby JHA, Salvesen ØO, Stefansson IM, Krakstad C, Trovik J, Haldorsen IS. MRI-assessed tumor-free distance to serosa predicts deep myometrial invasion and poor outcome in endometrial cancer. Insights Imaging 2022; 13:1. [PMID: 35000020 PMCID: PMC8742796 DOI: 10.1186/s13244-021-01133-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To explore the diagnostic accuracy of preoperative magnetic resonance imaging (MRI)-derived tumor measurements for the prediction of histopathological deep (≥ 50%) myometrial invasion (pDMI) and prognostication in endometrial cancer (EC). METHODS Preoperative pelvic MRI of 357 included patients with histologically confirmed EC were read independently by three radiologists blinded to clinical information. The radiologists recorded imaging findings (T1 post-contrast sequence) suggesting deep (≥ 50%) myometrial invasion (iDMI) and measured anteroposterior tumor diameter (APD), depth of myometrial tumor invasion (DOI) and tumor-free distance to serosa (iTFD). Receiver operating characteristic (ROC) curves for the prediction of pDMI were plotted for the different MRI measurements. The predictive and prognostic value of the MRI measurements was analyzed using logistic regression and Cox proportional hazard model. RESULTS iTFD yielded highest area under the ROC curve (AUC) for the prediction of pDMI with an AUC of 0.82, whereas DOI, APD and iDMI yielded AUCs of 0.74, 0.81 and 0.74, respectively. Multivariate analysis for predicting pDMI yielded highest predictive value of iTFD < 6 mm with OR of 5.8 (p < 0.001) and lower figures for DOI ≥ 5 mm (OR = 2.8, p = 0.01), APD ≥ 17 mm (OR = 2.8, p < 0.001) and iDMI (OR = 1.1, p = 0.82). Patients with iTFD < 6 mm also had significantly reduced progression-free survival with hazard ratio of 2.4 (p < 0.001). CONCLUSION For predicting pDMI, iTFD yielded best diagnostic performance and iTFD < 6 mm outperformed other cutoff-based imaging markers and conventional subjective assessment of deep myometrial invasion (iDMI) for diagnosing pDMI. Thus, iTFD at MRI represents a promising preoperative imaging biomarker that may aid in predicting pDMI and high-risk disease in EC.
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Affiliation(s)
- Julie Andrea Dybvik
- Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway. .,Section for Radiology, Department of Clinical Medicine, University of Bergen, Jonas Lies vei 87, 5021, Bergen, Norway.
| | - Kristine E Fasmer
- Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.,Section for Radiology, Department of Clinical Medicine, University of Bergen, Jonas Lies vei 87, 5021, Bergen, Norway
| | - Sigmund Ytre-Hauge
- Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway
| | - Jenny Hild Aase Husby
- Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway
| | - Øyvind O Salvesen
- Unit for Applied Clinical Research, Department of Public Health and Nursing, Norwegian University of Science and Technology, Post Office Box 8905, 7491, Trondheim, Norway
| | - Ingunn Marie Stefansson
- Department of Pathology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Medicine, University of Bergen, Jonas Lies vei 87, 5021, Bergen, Norway
| | - Camilla Krakstad
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Post Office Box 7804, 5020, Bergen, Norway
| | - Jone Trovik
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.,Centre for Cancer Biomarkers, Department of Clinical Science, University of Bergen, Post Office Box 7804, 5020, Bergen, Norway
| | - Ingfrid S Haldorsen
- Mohn Medical Imaging and Visualization Centre (MMIV), Department of Radiology, Haukeland University Hospital, Post Office Box 1400, 5021, Bergen, Norway.,Section for Radiology, Department of Clinical Medicine, University of Bergen, Jonas Lies vei 87, 5021, Bergen, Norway
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Elsingergy MM, Carlsson T, Andronikou S. Evaluation of quality of renal tract ultrasound scans and reports performed in children with first urinary tract infection. J Med Imaging Radiat Sci 2021; 53:65-74. [PMID: 34893454 DOI: 10.1016/j.jmir.2021.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the quality of renal tract ultrasound (US) imaging records performed in children for evaluation of urinary tract infection (UTI) by multiple professionals with different levels of experience in a dedicated academic children's hospital. METHODS Retrospective analysis of US images and reports for children ≤ 13-years with first presentation of a UTI. 9 Operators (6 consultant radiologists and 3 sonographers) were anonymised and the adequacy of their US images and reports were evaluated for the following categories; Image acquisition, Image labelling, Metric labelling, and Final reporting. The frequency of the reporting quality of the elements assessed was compared between radiologists and sonographers using Chi-square or fisher exact test. RESULTS Renal tract US studies for 100 children (20 males, 80 females) with first UTI episode were assessed. Mean age was 4.5 ± 3.4 years. 54% of the studies were performed by sonographers and 46% by radiologists. Kidneys and pre-micturition bladder scans were acquired in more than 96% of exams by both sonographers and radiologists. Kidney image and metric labelling was adequate in almost all exams (98-100%) with the exception of plane labelling which was not routinely done by US operators (less than 3%). Sonographers performed consistently better than radiologists in post-micturition bladder scanning, pre- and post-micturition bladder labelling and renal length reporting (p<0.05). Least to be recorded by US operators (both radiologists and sonographers) were doppler scan acquisitions (less than 3%), bladder wall thickness labelling (less than 3%), and renal calculi reporting (less than 1%). CONCLUSION The inconsistency of the reporting quality between the different elements assessed highlights the difference in US training and experience received by sonographers and radiologists. A pro-forma structured reporting template may ensure US operators provide consistent, thorough and good quality ultrasound images and reports.
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Affiliation(s)
- Mohamed M Elsingergy
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
| | - Tarryn Carlsson
- Department of Radiology, Bristol Royal Hospital for Children, University Hospitals Bristol, Bristol, United States
| | - Savvas Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Department of Radiology, Bristol Royal Hospital for Children, University Hospitals Bristol, Bristol, United States; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States
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Alhasan AS, Aalam WA. Magnitude and Determinants of Computer Vision Syndrome Among Radiologists in Saudi Arabia: A National Survey. Acad Radiol 2021; 29:e197-e204. [PMID: 34836777 DOI: 10.1016/j.acra.2021.10.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/26/2022]
Abstract
RATIONALE AND OBJECTIVES To assess the magnitude and determinants of computer vision syndrome (CVS) among radiologists in Saudi Arabia using a reliable and validated survey instrument. MATERIALS AND METHODS This nationwide cross-sectional web-based survey took place in April 2021 and included all radiologists and radiology residents residing practicing in Saudi Arabia. We used the reliable and validated CVS questionnaire. Univariate and multivariate analyses were carried out using nonparametric methods. The CVS score was correlated with different demographic- and health-related variables. The Mann-Whitney U test and Kruskal-Wallis test were used to determine if there was a statistically significant difference between subgroups. RESULTS The survey was completed by 416 participants. The prevalence of CVS was 65.4% (95% CI: 60.8-70.0). The median CVS score was 7.5 (interquartile range: 4.0; 12.0). Mild CVS was observed in 188 participants (69.1%), moderate CVS was observed in 69 (25.4%), and severe CVS was observed in 15 (5.5%). The most common symptoms perceived by participants were headache (72.1%), dryness (70.7%), burning (63.7%), blurred vision (56.3%), and increased sensitivity to light (55.5%). Multinomial regression analysis suggested that female sex (p < 0.001), work as a general radiologist (p = 0.05), and the use of eyeglasses (p = 0.001) were significant predictors of CVS. CONCLUSION The prevalence of CVS among radiologists in our study was high. Local and international societies need to establish and implement legislative and preventive measures to ensure the safety and ocular and visual health of radiologists.
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Muhanna AM, Brown PN, Pratt S. An investigation of radiographers' and radiologists' perceptions and attitudes in Kuwait towards extending radiographers' role in mammography. Radiography (Lond) 2021; 28:325-332. [PMID: 34782216 DOI: 10.1016/j.radi.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/11/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Kuwait has a shortage of radiologists, especially in mammography, resulting in increased workload and longer waiting times for women receiving imaging investigations. This study looked at how radiographers and radiologists perceived radiographers' role extension (RE) in mammography, and whether this could reduce radiologist workload, thereby improving patient service and waiting times. METHODS A single case study design with 10 radiographers (mammographers) and 10 radiologists was undertaken across multiple sites: hospitals, screening clinics and specialist centres in Kuwait. Data included individual semi-structured interviews, documentary analysis and field notes. Perceptions were examined under a theoretical framework, Abbotts' System of Professions. RESULTS Two main themes were identified, firstly in examining the current role of radiographers in mammography and areas of interest for extending role, this highlighted insufficient knowledge of the concept. The second focused on in-depth understanding of drivers and barriers to RE in mammography, both groups opposed radiographers performing extended tasks without radiologist supervision. CONCLUSION Radiologists and radiographers' attitudes were influenced by concepts of professional identity and professional identity formation. Insufficient professional knowledge negatively affected the radiographers' readiness to undertake RE in mammography. Radiologists are reluctant to blur boundaries, enabling them to maintain and control jurisdiction of their own profession and that of radiographers, thereby, as discussed in Abbott's theory, limiting impact on workload or waiting times. IMPLICATIONS FOR PRACTICE Whilst RE is limited, to improve workload and patient waiting times, setting up an educational programme for radiographers specialising in mammography would be an important step to extending the radiographers' role. The study highlighted a need to educate radiographers to undertake breast ultrasound and amend policy to introduce training programmes for radiographers. Radiographer rotation across the various radiographic modalities negatively affected radiographers' performance, placing well-trained radiographers permanently within the mammography department should improve experience and overall skills.
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Affiliation(s)
- A M Muhanna
- Cardiff University, Ty Dewi Sant, Heath Campus, CF14 4XN, UK.
| | - P N Brown
- Cardiff University, Ty Dewi Sant, Heath Campus, CF14 4XN, UK
| | - S Pratt
- Cardiff University, Ty Dewi Sant, Heath Campus, CF14 4XN, UK
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Abstract
Disparities exist in access to a multitude of screening and diagnostic imaging examinations and procedures. To address these disparities within radiology, emphasis so far has been placed upon diversifying the workforce and formally educating trainees on healthcare disparities. Currently, there is no organized and nationally accepted educational program or content for practicing radiologists specific to diversity and healthcare disparity. This void can be addressed by providing an educational curriculum framework for practicing radiologists based on three key factors: individual efforts, calling for institutional change, and national collaboration. Individual efforts should focus on acknowledging the existence of disparities, understanding the contribution of one's implicit bias in perpetuating disparities, understanding and highlighting issues related to insurance coverage of radiology examinations, and participating in radiology political action committees. These efforts can be facilitated by a consolidated web-based training program for practicing radiologists. To pave the way for meaningful systemic change, the implementation of institutional change like that initiated by the Culture of Safety movement in 2002 is needed. A national collaborative effort initiated by radiology organizations to empower radiologists and recognize positive changes would further provide support. SUMMARY: A three-pronged educational framework combining individual radiologist education, institutional change, and national collaboration will enable radiologists to play a role in addressing imaging-related disparities in healthcare.
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Affiliation(s)
- Miral M Patel
- Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Jay R Parikh
- Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Froc A, Crocker C, Abdolell M, Costa AF. Diagnostic performance of US for suspected appendicitis: Does multi-categorical reporting provide better estimates of disease in adults, and what factors are associated with false or indeterminate results? Eur J Radiol 2021; 144:109992. [PMID: 34634535 DOI: 10.1016/j.ejrad.2021.109992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/03/2021] [Accepted: 09/29/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To identify factors associated with false or indeterminate US result for suspected appendicitis, and assess whether multi-categorical reporting of US yields more precise estimates regarding the probability of appendicitis. METHODS 562 US examinations for suspected appendicitis between May 2013-April 2015 were categorized as true (77/562 true positives or true negatives) or false/indeterminate (485/562 false negatives, false positives or indeterminates) based on results from a prior study. Of 541 examinations with images available retrospectively, a category of A-E was assigned as follows: non-visualized appendix with secondary findings (A) absent or (B) present; appendix visualized and considered (C) negative, (D) equivocal, or (E) positive for appendicitis. The following factors were recorded: age; sex; scan time (daytime vs. off-hours); resident/fellow involvement; abdominal subspecialty radiologist; radiologist experience (>5 years or not); and tenderness on interrogation. Associations between factors and US result were assessed (t-tests, Fisher's exact test and multivariate logistic regression). RESULTS The true group had proportionally more males (18/77 (23.4%) vs. 66/485 (13.6%), p = 0.04) and patients with sonographic tenderness (43/77 (55.8%) vs. 132/353 (27.3%), p < 0.0001). There was no significant difference or association with other factors. On multivariate logistic regression, false/indeterminate results were 1.9 times (95% CIs 1.0-3.5) more likely among females and 3.8 times more likely in the absence of tenderness (95% CIs 2.3-6.4). The proportion of patients with appendicitis in categories A-E was 34/410 (8.3%), 24/44 (54.5%), 0/18 (0%), 0/3 (0%) and 61/66 (92.4%), respectively. CONCLUSIONS Females and absence of tenderness were associated with a false/indeterminate US. Categorical reporting provides more granular estimates of the post-test probability of appendicitis.
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Abstract
With current conflicting and confusing screening mammography guidelines between major medical organizations, radiologists have an opportunity to educate and advocate for patients using the power of social media. The authors provide a brief overview on the impact of social media in radiology, in particular Facebook, as well as challenges encountered by radiologists as they establish an online presence, and how to effectively use Facebook Live to advocate for screening mammography.
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Affiliation(s)
- Hilda H Tso
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., CPB5.3208, Houston, TX, 77030, USA.
| | - Jay R Parikh
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., CPB5.3208, Houston, TX, 77030, USA
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