Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes最新文献

{"title":"The Impact of Slice Thickness on Diagnostic Accuracy in Digital Breast Tomosynthesis.","authors":"Yen Zhi Tang,&nbsp;Amna Al-Arnawoot,&nbsp;Abdullah Alabousi","doi":"10.1177/08465371211068200","DOIUrl":"https://doi.org/10.1177/08465371211068200","url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the effect of slice thickness on diagnostic accuracy in Digital Breast Tomosynthesis (DBT). <b>Method:</b> Two readers retrospectively interpreted 150 DBT (125 normal and 25 pathology-proven cancer) cases scanned between October 2017-November 2020. The DBT studies were randomised and reviewed independently by the two readers. DBT studies were reviewed using a standard protocol (1 mm slices, no overlap and synthetic 2D-mammography (SM)) and an experimental protocol (10 mm slabs, 5 mm overlap and SM). Any abnormality and BIRADS scores were recorded by each reader. Sensitivity, specificity, interobserver and intraobserver agreement were calculated (Cohen's Kappa κ). For diagnostic accuracy, the reference standard was histopathology or a normal mammogram at 2 years. <b>Results:</b> The sensitivity and specificity for reader 1 and 2 for cancer detection was reader 1 (97% and 79% for the standard protocol, 97% and 76% for the experimental protocol) and reader 2 (97% and 74% for both protocols). Reader 1 had 97.6% intraobserver agreement (κ .95) and reader 2 had 96.4% intraobserver agreement (κ .92) when assessing the standard and experimental protocols. There was 90.5% agreement between the readers for the standard protocol (κ .80). There was 90.9% agreement between the readers for the experimental protocol (κ .81). Of the 25 DBT studies with pathology-proven cancer, one cancer was missed by both readers using both protocols. <b>Conclusion:</b> The diagnostic accuracy was similar between the standard and experimental DBT protocols, demonstrating excellent interobserver and intraobserver agreement. This suggests 10-mm thick slabs can potentially replace 1-mm thin slices in the interpretation of DBT.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"535-541"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39820033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrial Strain by Feature-Tracking Cardiac Magnetic Resonance Imaging in Takotsubo Cardiomyopathy. Features, Feasibility, and Reproducibility.","authors":"Riccardo Cau,&nbsp;Pierpaolo Bassareo,&nbsp;Gloria Caredda,&nbsp;Jasjit S Suri,&nbsp;Antonio Esposito,&nbsp;Luca Saba","doi":"10.1177/08465371211042497","DOIUrl":"https://doi.org/10.1177/08465371211042497","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to investigate whether there may be a bi-atrial dysfunction in Takotsubo syndrome (TS) during the transient course of the disease, using cardiac magnetic resonance imaging feature tracking (CMR-FT) in analyzing bi-atrial strain.</p><p><strong>Method: </strong>Eighteen TS patients and 13 healthy controls were studied. Reservoir, conduit, and booster bi-atrial functions were analyzed by CMR-FT. The correlation between LA and RA strain parameters was assessed. Intra- and inter-observer reproducibility was evaluated for all strain and strain rate (SR) parameters using intraclass correlation coefficients (ICCs) and Bland-Altman analysis.</p><p><strong>Results: </strong>Atrial strain were feasible in all patients and controls. Takotsubo patients showed an impaired LA Reservoir strain (∊_s), LA Reservoir strain rate (SRs), LA and RA Conduit strain(∊_e), LA and RA conduit strain rate (SRe) in comparison with controls (P < 0.001 for all of them), while no differences were found as to LA and RA booster deformation parameters (∊_a and SRa). Analysis of correlation showed that LA ∊_s, SRs, ∊_e, and SRe were positively correlated with corresponding RA strain measurements (P < 0.001, r = 0.61 and P = 0,03, r = 0,54, respectively). Reproducibility was good to excellent for all atrial strain and strain rate parameters (ICCs ranging from 0,50 to 0,96).</p><p><strong>Conclusion: </strong>Atrial strain analysis using CMR-FT may be a useful tool to reveal new pathophysiological insights in Takotsubo cardiomyopathy. Additional studies, with a larger number of patients, are needed to confirm the possible role of these advanced CMR tools in characterizing TS patients.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"573-580"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39493605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papilledema: A Review of the Pathophysiology, Imaging Findings, and Mimics.","authors":"Angela Guarnizo,&nbsp;Danah Albreiki,&nbsp;Juan Pablo Cruz,&nbsp;Laurent Létourneau-Guillon,&nbsp;Dana Iancu,&nbsp;Carlos Torres","doi":"10.1177/08465371211061660","DOIUrl":"https://doi.org/10.1177/08465371211061660","url":null,"abstract":"<p><p>Increased intracranial pressure is the most common cause of papilledema. Multiple etiologies such as cerebral edema, hydrocephalus, space occupying lesions, infection, and idiopathic intracranial hypertension among others should be considered. Imaging plays a critical role in the detection of pathologies that can cause papilledema. MRI with contrast and CE-MRV, in particular, are key for the diagnosis of idiopathic intracranial hypertension. This review will focus in common and infrequent causes of papilledema, the role of imaging in patients with papilledema as well as its potential mimickers.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"557-567"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39831473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hope and Mentorship in the Time of COVID-19.","authors":"Juvel Lee","doi":"10.1177/08465371211063778","DOIUrl":"https://doi.org/10.1177/08465371211063778","url":null,"abstract":"Regardless of their current subspecialty or stage of practice, many radiologists still fondly recall their off-service PGY1 year. There was the thrill of finally being able to sign prescriptions, and the new pressure of making decisions alone overnight. There were moments of dismay when clinicians (half-jokingly) requested interpretations of high-resolution CTs or shoulder MRIs. But most of all, there was the anticipation of being mere months away from formal radiology training. For many, however, that excitement was tempered by several concerns. In particular, the prospect of research often weighs heavily on the minds of junior trainees. The scope of potential projects is nearly unlimited, and while this can be invigorating, it also presents a multitude of logistic questions. How does one find a willing mentor with suitable research interests and expertise? How does one collect and analyze radiology-specific data? And, given the plethora of publications already available, can one’s findings truly be novel or useful? The onset of the COVID-19 pandemic further complicated such concerns for new trainees such as myself. Social distancing policies and the provision of only essential patient services hindered extracurricular pursuits such as mentorship and research. Key learning opportunities like interprofessional rounds, clinical case conferences, and academic lectures were abruptly halted. Even when sessions resumed in an online format, IT issues and Zoom fatigue beleaguered successful implementation. Although we understood the necessity and context of these public health measures, the situation was nonetheless stressful. My conversations with other junior residents revealed a common theme of feeling disconnected from our seniors, attendings, and other teachers. Further, we still needed to achieve training milestones on a strict timeline despite the disruptions of COVID-19. Undertaking research projects, presenting at conferences, and choosing fellowships were commitments we all felt ill-equipped to pursue. The inaugural Resident Reviewers Mentorship Program started by the Canadian Association of Radiologists Journal (CARJ) in 2020 was an opportunity to address these unprecedented issues. Based on shared research interests, the CARJ matched mentees with staff radiologists who were experienced in manuscript review and resident education. This process alleviated the hesitance or intimidation that junior trainees often feel when approaching a busy attending for mentorship. Recognizing that my mentor volunteered for this program enabled me to feel comfortable discussingmy learning goals and limitations in knowledge. It was reassuring to know that my mentor and I had similar expectations and commitment to the program. Moreover, their professional skillset inspired confidence and motivated me to actively participate. The CARJ also provided clear objectives, directions and timelines for our endeavors. I appreciated this formal structure, which has been sh","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"452-453"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309585/pdf/10.1177_08465371211063778.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39664307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addition of CT to Improve the Diagnostic Confidence for the Detection of Sacroiliac Joint Erosions in Patients with Equivocal MRI Findings.","authors":"Ibrahim M Nadeem,&nbsp;Sohaib Munir,&nbsp;Vincent Leung,&nbsp;Euan Stubbs","doi":"10.1177/08465371211056552","DOIUrl":"https://doi.org/10.1177/08465371211056552","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if CT can improve the diagnostic confidence for the detection of sacroiliac joint (SIJ) erosions in patients with equivocal MRI findings.</p><p><strong>Methods: </strong>A retrospective analysis of adult patients who had an SIJ MRI and a subsequent SIJ CT within 12 months was conducted. Using a 5-point Likert scale, two reviewers evaluated the de-identified MRI and CT images in randomized order and in separate sessions to answer the question: \"Does the patient have SIJ erosions?\". A Fisher's exact test was used to analyze the difference in diagnostic confidence, and intraclass correlation coefficient (ICC) was used to determine interrater reliability.</p><p><strong>Results: </strong>54 patients were included in the analysis (average age, 43.9 years). The average time interval between initial SIJ MRI and subsequent CT was 14.4 weeks (range, 5.6-50.3 weeks). CT resulted in significantly more cases with definitive diagnostic confidence than cases with probable or equivocal confidence compared to MRI (<i>P</i> < .001). Amongst cases with equivocal findings on MRI, 73.2% of cases had definitive diagnoses on CT. There was moderate interrater agreement for MRI, with an ICC of .490 [95% CI, .258-.669], and excellent agreement for CT, with an ICC of .832 [95% CI, .728-.899].</p><p><strong>Conclusion: </strong>Overall, CT led to significantly increased diagnostic confidence and higher interrater reliability for the detection of SIJ erosions compared to MRI. Judicious use of CT may be useful in detecting SIJ erosions in patients with equivocal MRI findings.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"542-548"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39770417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications Associated With Totally Implanted Venous Access Devices in the Arm Versus the Chest: A Short-Term Retrospective Study.","authors":"Samuel Pike,&nbsp;Kiat Tan,&nbsp;Brent Burbridge","doi":"10.1177/08465371211040822","DOIUrl":"https://doi.org/10.1177/08465371211040822","url":null,"abstract":"<p><strong>Purpose: </strong>To retrospectively compare complications for totally implanted venous access devices (TIVADs or ports) in the arm vs. the chest. One participating institution implanted all TIVADs in the arm, whereas the other institution implanted them in the chest.</p><p><strong>Methods: </strong>Subjects were consecutive patients > 18 years with a device inserted between July 2017 and January 2019 at either Hospital A, where all devices were implanted in the arm, or at Hospital B, where all devices were implanted in the chest. Complications (rates/1,000 catheter-days and frequencies) were compared between the arm and chest locations.</p><p><strong>Results: </strong>201 arm devices (71% female, mean age 59.4 years) and 203 chest devices (66% female, mean age 61.5 years) were assessed. Overall complication rates did not differ between the arm and chest [arm: 30 complications per 56,938 catheter-days (0.530/1,000 catheter-days) vs. chest: 47 complications per 63,324 catheter-days (0.742/1,000 catheter-days), p-value 0.173]. Periprocedural complications and mechanical malfunction also did not differ. Although prophylactic antibiotic use was higher in the chest (79.3% vs. 1.50%, p-value < 0.0001), infection rates did not differ. Arm venous thrombosis was significantly higher in the arm cohort (0.205 vs. 0.017/1,000 catheter-days, p-value 0.003) and pulmonary thromboembolism in the chest cohort (0.269 vs 0.056/1,000 catheter-days, p-value 0.002).</p><p><strong>Conclusions: </strong>While arm venous thrombosis was higher in the arm and pulmonary thromboembolism in the chest cohort, other complications were similar. Antibiotic use was more frequent in the chest cohort, while infection rates remained similar in both cohorts.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"581-588"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39728064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender Distribution of Faculty Is Strongly Correlated With Resident Gender at Canadian Radiology Residency Programs.","authors":"Morgan Lawley,&nbsp;Jessica Dobson,&nbsp;Francine Heelan,&nbsp;Daria Manos","doi":"10.1177/08465371211069325","DOIUrl":"https://doi.org/10.1177/08465371211069325","url":null,"abstract":"<p><p><b>Objective:</b> Women are underrepresented in radiology overall, in radiology subspecialties, and in radiology leadership and academic positions. It is unclear why this disparity persists despite greater gender diversification in medicine. We sought to determine if a correlation exists between the proportion of female faculty at an institution, and the proportion of female residents in the associated residency program across Canada. <b>Methods:</b> Faculty gender for each Canadian Diagnostic Imaging Residency Program was obtained through publicly available sources (departmental websites and provincial physician registries) in the fall of 2020. Resident gender data was obtained through a survey emailed to programs following the April 2021 CaRMS match. Data was analyzed using Pearson's correlation coefficient. Research ethics approval was obtained. <b>Results:</b> Faculty information was available for 15 of the 16 Canadian radiology residency programs (94%) and resident information was obtained for 16 programs (100% response rate). Overall, women accounted for 31.4% of radiologist faculty and 31.9% of radiology residents, with a wide range between institutions (19.5-47.8% for faculty and 13.3%-47.1% for residents). There was a strong positive correlation between the proportion of female faculty and the proportion of female residents within individual programs (r=0.73; R2=0.54; p=0.002). <b>Conclusion:</b> Approximately one third of faculty and residents at Canadian Diagnostic Radiology residency programs were female but there was a wide range across the country with a strong correlation between faculty and resident gender distribution. Further exploration is warranted to determine causes of this correlation including the possible influence of role modeling, mentoring, female-friendly culture, and bias.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"486-490"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39726750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons Learned from a Cyberattack on the Healthcare System of Newfoundland and Labrador: A Radiology Perspective.","authors":"Hilary Strong,&nbsp;Angela Pickles,&nbsp;Angus Hartery","doi":"10.1177/08465371221081549","DOIUrl":"https://doi.org/10.1177/08465371221081549","url":null,"abstract":"","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"601-602"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39811283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAR Peer Learning Guide.","authors":"Felipe Soares Torres,&nbsp;Andreu F Costa,&nbsp;Yoan K Kagoma,&nbsp;Martin Arrigan,&nbsp;Malcolm Scott,&nbsp;Brian Yemen,&nbsp;Casey Hurrell,&nbsp;Ania Kielar","doi":"10.1177/08465371211065454","DOIUrl":"https://doi.org/10.1177/08465371211065454","url":null,"abstract":"<p><p>Peer learning is a quality initiative used to identify potential areas of practice improvement, both on a patient level and on a systemic level. Opportunities for peer learning include review of prior imaging studies, evaluation of cases from multidisciplinary case conferences, and review of radiology trainees' call cases. Peer learning is non-punitive and focuses on promoting life-long learning. It seeks to identify and disseminate learning opportunities and areas for systems improvement compared to traditional peer review. Learning opportunities arise from peer learning through both individual communication of cases reviewed for routine work, as well as through anonymous presentation of aggregate cases in an educational format. In conjunction with other tools such as root cause analysis, peer learning can be used to guide future practice improvement opportunities. This guide provides definitions of terms and a synthetic evidence review regarding peer review and peer learning, as well as medicolegal and jurisdictional considerations. Important aspects of what makes an effective peer learning program and best practices for implementing such a program are presented. The guide is intended to be a living document that will be updated regularly as new data emerges and peer learning continues to evolve in radiology practices.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"491-498"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39858161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Oral Contrast Beneficial for Visualization of the Appendix in Low-Weight Children?","authors":"Gali Shapira-Zaltsberg,&nbsp;Maria Dien Esquivel,&nbsp;Nicholas Mitsakakis,&nbsp;Lamia Hayawi,&nbsp;Elka Miller","doi":"10.1177/08465371211064315","DOIUrl":"https://doi.org/10.1177/08465371211064315","url":null,"abstract":"<p><p><b>Purpose:</b> It has been shown that oral contrast does not improve the diagnostic accuracy of Computed Tomography (CT) for appendicitis in pediatric patients; however, the cohorts in these studies were not stratified by weight or body mass index. The purpose of this study is to assess the benefit of oral contrast administration for identifying the appendix in younger children in the lower weight quartile. <b>Materials and Methods:</b> This retrospective study comprised 100 patients (2-10 years) in lower weight quartile who had intravenous contrast-enhanced CT of the abdomen and pelvis, 37 of which with oral contrast, and 63 without. A pediatric radiologist and a pediatric radiology fellow independently assessed whether the appendix was visualized or not. In case of discrepancy, an additional pediatric radiologist was the \"tie-breaker.\" Chi-squared test was used to compare the proportion of visualized appendix between the groups (with and without oral contrast). Inter-rater reliability was determined using Cohen's Kappa coefficient. <b>Results:</b> There was no significant difference in the visualization of the appendix between the group with oral contrast and without (<i>P</i> = 1). The Cohen Kappa coefficients were .33 (.05, .62) and .91 (.73, 1.00) for the \"no oral\" and \"oral\" groups, respectively, yielding evidence of a difference (<i>P</i> = .007). <b>Conclusions:</b> There was no significant difference in the visualization of the appendix using CT with or without oral contrast in low-weight pediatric patients. The inter-rater reliability, however, was significantly higher in the group given oral contrast. Additional studies assessing the value of oral contrast for the sole indication of appendicitis may provide clearer results.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"568-572"},"PeriodicalIF":3.1,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39650289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}