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

{"title":"Outcomes of Multidetector Computed Tomography Pulmonary Angiography in Pregnant and Postpartum Women With Suspected Pulmonary Embolism.","authors":"Simon Sun,&nbsp;Marius Diaconescu,&nbsp;Tian Zhe,&nbsp;Benoit Mesurolle,&nbsp;Alexandre Semionov","doi":"10.1177/0846537119899552","DOIUrl":"https://doi.org/10.1177/0846537119899552","url":null,"abstract":"<p><strong>Purpose: </strong>Verify whether there is a difference in likelihood of developing pulmonary embolism (PE) between pregnant women, nonpregnant women of reproductive age, and postpartum (up to 6 weeks) women, by comparing their outcomes on computed tomography pulmonary angiography (CTPA) done for suspicion of PE.</p><p><strong>Materials and methods: </strong>Retrospective cohort study of 1463 CTPA done for suspicion of PE in females of reproductive age (18-40 years), nonpregnant, pregnant (antepartum), and postpartum, from 2 tertiary-care academic hospitals between October 2006 and September 2015. Primary outcome was diagnosis of PE on imaging. Additional assessment was made of technical adequacy of the studies and method of delivery for the postpartum cohort (vaginal vs caesarean birth). Twenty-nine technically nondiagnostic studies were excluded. The effect of any potential variable on PE status was tested using univariate logistic regression. Subgroup analysis was performed after excluding patients with independent risk factors for PE.</p><p><strong>Results: </strong>The rate of CTPA positive for PE was less among pregnant patients compared to early postpartum and nonpregnant women of similar age, 2.9% vs 11.5% and 10.3%, respectively. Pregnancy was associated with statistically significant decreased odds ratio of developing a PE on CTPA, 0.23 (0.09-0.89), <i>P</i> value = .004. After excluding patients with additional independent risk factors for PE, there was no statistically significant odds ratio association between presence of PE on CTPA and pregnancy 0.41 (0.13-1.34), <i>P</i> value = .14.</p><p><strong>Conclusion: </strong>Rate of CTPA positive for PE in pregnant women was lower than in nonpregnant and early postpartum women. Pregnancy was statistically significantly less likely to be associated with positive PE on a CTPA study. The common perception that pregnancy (antepartum state) is associated with an increased risk of PE may require a thorough critical reappraisal.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"512-518"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537119899552","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37654576","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":"An Evaluation of the Content of Canadian and American Nuclear Medicine Fellowship Websites.","authors":"Saira Hamid,&nbsp;Brian Gibney,&nbsp;Bonnie Niu,&nbsp;Rachel Phord-Toy,&nbsp;Nicolas Murray,&nbsp;Arvind Vijayasarathi,&nbsp;Savvas Nicolaou,&nbsp;Faisal Khosa","doi":"10.1177/0846537120913031","DOIUrl":"https://doi.org/10.1177/0846537120913031","url":null,"abstract":"<p><strong>Background: </strong>Radiology trainees frequently use the Internet to research potential fellowship programs across all subspecialties. For a field like nuclear medicine, which has multiple training pathways, program websites can be an essential resource for potential applicants. This study aimed to analyze the online content of Canadian and American Nuclear Medicine fellowship websites.</p><p><strong>Materials and methods: </strong>The content of all active Canadian and American Nuclear Medicine fellowship websites was evaluated using 26 criteria in the following subdivisions: application, recruitment, education, research, clinical work, and incentives. Fellowships without websites were excluded from the study. Scores were summed per program and compared by geographic region and ranking.</p><p><strong>Results: </strong>A total of 42 active Canadian and American Nuclear Medicine fellowship programs were identified, of which 39 fellowships had dedicated fellowship websites available for the analysis. On average, fellowship websites contained 34.4% (9 ± 3.3) of the 26 criteria. Programs did not score differently on the criteria by geographical distribution (<i>P</i> = .08) nor by ranking (<i>P</i> = .18).</p><p><strong>Conclusion: </strong>Most Canadian and American Nuclear Medicine fellowship websites are lacking content relevant to prospective fellows. Addressing inadequacies in online content may support programs to inform and recruit residents into fellowship programs.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"392-397"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120913031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37781495","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":"Female Authorship in Radiology: Trends in the Past Decade in CARJ.","authors":"Nicole Li,&nbsp;Mostafa Alabousi,&nbsp;Michael N Patlas","doi":"10.1177/0846537120946641","DOIUrl":"https://doi.org/10.1177/0846537120946641","url":null,"abstract":"<p><strong>Purpose: </strong>To identify trends in female authorship in the <i>Canadian Association of Radiologists Journal</i> (CARJ) from 2010 to 2019.</p><p><strong>Methods: </strong>We retrieved papers published in the CARJ over a 10-year period, and retrospectively reviewed 602 articles. All articles except editorials and advertisements were included. We categorized the names of the first and last position authors as female or male and excluded articles that had at least one author of which gender was not known. We compared the trends in the first and last position authors of the articles from 2010 to 2019. For statistical analysis, logistic regression was performed with reported odds ratios (ORs), and a <i>P</i> value of <.05 was defined as statistically significant.</p><p><strong>Results: </strong>Five hundred thirteen articles met inclusion criteria. Among them, 23 articles with a single author were classified as having only a first author. 39.8% (204/513) of first authors were female and 26.9% (132/490) of last authors were female. There has been an overall temporal increase in the odds of both the first and last author being female in CARJ publications (OR: 1.11, <i>P</i> = .034). Similarly, the odds a CARJ publication's first author being female increased over time (OR: 1.07, <i>P</i> = .033). Female last author did not predict female first author (OR: 1.48, <i>P</i> = .056). There was no association identified between female last author and year of publication (OR: 1.04, <i>P</i> = .225).</p><p><strong>Conclusion: </strong>There has been an overall increase in engagement of female authorship in CARJ.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"388-391"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120946641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38264305","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":"Interventional Radiology's Evolution Into a Clinically Based Specialty.","authors":"Elizabeth Tai,&nbsp;Tara Graham,&nbsp;Jason Wong,&nbsp;Amol Mujoomdar","doi":"10.1177/0846537120975214","DOIUrl":"https://doi.org/10.1177/0846537120975214","url":null,"abstract":"Traditionally, interventional radiology (IR) was referred to as ‘‘angiography’’ or ‘‘special procedures’’ and interventional radiologists were solely viewed as technicians or ‘‘hired guns.’’ Clinical patient care outside of IR procedures was lacking. In a speech given at the 1968 American College of Surgery Meeting, Charles Dotter, the father of interventional radiology, insightfully stated: If my fellow angiographers prove unwilling or unable to accept or secure for their patients the clinical responsibilities attendant on transluminal angioplasty, they will become highpriced plumbers facing forfeiture of territorial rights based solely on imaging equipment others can obtain and skill still others can learn. Over time, the scope of IR increased beyond diagnostic imaging to include minimally invasive therapies involving a wide range of head-to-toe treatments including but not limited to oncology intervention, peripheral vascular disease, gastrointestinal and genitourinary conditions, embolization of hemorrhage, stroke and vascular malformations. With this expansion, modern interventional radiologists have increased their involvement in patient care, beyond the technical act of performing the procedure. In Canada, the developing field of IR is supported by the Canadian Association for Interventional Radiology (CAIR). The scope of and demand for IR procedures has grown with both the medical community and patient preference for minimally invasive procedures. The culmination of the CAIR’s effort has been the recognition of IR as a distinct subspecialty of Diagnostic Radiology by the Royal College of Physicians and Surgeons of Canada in 2016. This has been followed by development of a separate residency program and licensing examination. The future of IR lies in producing physicians with strong clinical, technical and imaging skills. In order to develop strong collaborative clinicians, the Royal College IR residency program has selectives in general surgery, hepatobiliary surgery, vascular surgery, critical care medicine, cardiology, medical oncology and urology. To obtain Royal College certification in IR, the program builds on skills developed in the diagnostic radiology residency and trains residents in periprocedural and intraprocedural care, clinical consultation, workup and management of IR clinical problems. Senior residents must actively participate in the longitudinal clinical care of IR patients. Based on results of Canadian surveys of interventional radiologists in 2015, 90% of respondents are involved in longitudinal patient care that includes pre-procedure consultations, clinical assessments and follow-up which increased compared to 42% in 2005. In 2015, the number of interventional radiologists with admitting privileges was 46%, also increased from 29% in 2005. The successful clinical practice of IR requires clinic time, clinic space and additional procedure time not required by diagnostic radiologists. In a clinical IR practice, interve","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"341-342"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120975214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38662942","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":"Combined Diagnosis of Whole-Lesion Histogram Analysis of T1- and T2-Weighted Imaging for Differentiating Adrenal Adenoma and Pheochromocytoma: A Support Vector Machine-Based Study.","authors":"Junhong Liu,&nbsp;Kangkang Xue,&nbsp;Shujian Li,&nbsp;Yong Zhang,&nbsp;Jingliang Cheng","doi":"10.1177/0846537120911736","DOIUrl":"https://doi.org/10.1177/0846537120911736","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine whether a combined diagnosis of whole-lesion histogram analysis of T1- and T2-weighted imaging based on support vector machine (SVM) can distinguish pheochromocytoma from adrenal adenoma.</p><p><strong>Methods: </strong>A pathology database was retrospectively appraised over a period of 7 years and we obtained 40 histopathologically proven adrenal adenomas and 20 pheochromocytomas with magnetic resonance images. The T1-weighted imaging (T₁WI, including both in phase and opposed phase) and T2-weighted imaging (T₂WI) images of each patients were analyzed using Mazda software. Nine parameters were selected as indicators of comparison: variance, skewness, kurtosis, mean, 1st percentile, 10th percentile, 50th percentile, 90th percentile, and 99th percentile. The parameters with differential-diagnosis significance were used to establish the combined diagnostic model of SVM.</p><p><strong>Results: </strong>Among the 9 parameters extracted using histogram analysis, the 1st percentile, 10th percentile, and 50th percentile of T₁WI (in phase) and the skewness of T₂WI and almost all parameters of T₁WI (opposed phase), except variance and 99th percentile, showed statistical significance between groups. Among the above parameters, the area under the curve (AUC) of 10th percentile of T₁WI (opposed phase) was the largest with the value of 0.909 (100.0% sensitivity and 80.0% specificity). After the analysis of combined diagnosis was performed, the AUC of SVM model in testing set showed the value of 0.917 (85.0% accuracy).</p><p><strong>Conclusions: </strong>Whole-lesion histogram analysis of T₁WI and T₂WI may help differentiate adrenal adenomas from pheochromocytomas. Furthermore, the combined diagnosis of T₁WI and T₂WI histogram based on SVM was more effective than most of individual histogram parameters.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"452-459"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120911736","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37767917","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":"Bone Mineral Densitometry Reporting: Pearls and Pitfalls.","authors":"Patrick Martineau,&nbsp;Sarah L Morgan,&nbsp;William D Leslie","doi":"10.1177/0846537120919627","DOIUrl":"https://doi.org/10.1177/0846537120919627","url":null,"abstract":"<p><p>Dual-energy X-ray absorptiometry (DXA) is the method of choice for assessing bone mineral density (BMD). Unfortunately, the performance and interpretation of DXA can be challenging and errors are common. In fact, it has been reported that up to 90% of BMD reports contain at least 1 error. Errors can be the result of technique or interpretative in nature or both and can result in inappropriate diagnosis and management. In this article, we review the various types of pitfalls frequently encountered by physicians interpreting DXA studies. Being aware of these pitfalls will help readers recognize and avoid them when encountered in clinical practice.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"490-504"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120919627","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37850913","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":"Appropriateness of Abdominal Aortic Aneurysm Screening With Ultrasound: Potential Cost Savings With Guideline Adherence and Review of Prior Imaging.","authors":"Matthew Murray,&nbsp;Andreu F Costa","doi":"10.1177/0846537120920866","DOIUrl":"https://doi.org/10.1177/0846537120920866","url":null,"abstract":"<p><strong>Objective: </strong>To assess the appropriateness of abdominal aortic aneurysm (AAA) screening with ultrasound (US) and potential cost savings by adhering to guidelines and reviewing prior imaging.</p><p><strong>Methods: </strong>Screening aortic US performed in Nova Scotia from January 1 to April 30, 2019, were reviewed. Patient sex, age, risk factors, and study result (negative, <2.5 cm; ectatic, 2.5-2.9 cm; positive for AAA, ≥3 cm) were recorded. Previous imaging tests were reviewed for the presence/absence of aortic ectasia or aneurysm. Appropriateness was based on the Canadian Task Force on Preventive Health Care (CTFPHC) and the Canadian Society of Vascular Surgery (CSVS) guidelines. The number of potentially averted US, subsequent missed positive findings, and cost savings (over the 4-month period) were calculated according to: 1) each guideline; and 2) each guideline combined with review of imaging done 0 to 5 years and 0 to 10 years previously.</p><p><strong>Results: </strong>There were 17 (4.6%) of 369 ectatic aortas and 18 (4.9%) of 369 AAAs. The number of potentially averted examinations, missed ectatic aortas, missed AAAs, and cost savings were as follows, respectively: CTFPHC, 222 (60.2%) of 369, 8, 7, and CAD$20 501.70; CSVS, 117 (31.7%) of 369, 4, 2, and CAD$10 804.95. The model that would yield the greatest cost savings and fewest missed positive findings was the combination of CSVS guidelines with review of prior imaging within 5 years; this would avert 189 (51.2%) of 369 examinations, save CAD$17 454.15 over 4 months, and miss only 2 AAAs and 2 ectatic aortas.</p><p><strong>Conclusion: </strong>Over half of aortic US screening tests can be safely averted by adhering to CSVS guidelines and reviewing imaging performed within 5 years.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"398-403"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120920866","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37897525","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":"Factors Impacting Performance and Reproducibility of PI-RADS.","authors":"Baris Turkbey,&nbsp;Aytekin Oto","doi":"10.1177/0846537120943886","DOIUrl":"https://doi.org/10.1177/0846537120943886","url":null,"abstract":"Prostate cancer (PCa) is the most common noncutaneous cancer type among American men. In the last decade, prostate magnetic resonance imaging (MRI) and MRI-guided biopsies have been documented to increase the diagnostic yield of clinically significant PCa, which is generally defined as Gleason Grade &gt;1. With the increased use of prostate MRI, a need for standardization of its acquisition, interpretation, and reporting had emerged, and to address this, American College of Radiology and European Society of Genitourinary Radiology had released prostate imaging and reporting system version 2 (PI-RADSv2) in late 2014. Upon its release, PI-RADSv2 was commonly adopted by practicing radiologists and urologists. Moreover, its prospective use to guide prostate biopsies was proven to increase cancer detection yield in level 1A evidence series. While PI-RADSv2 was documented to bring an improvement in standardization for prostate MRIs, its reproducibility and cancer detection rate performance consistency have been reported to be widely variable. Several factors can impact the variable performance and reproducibility of PIRADS. Among the key factors are quality of prostate MRIs, experience level of the practicing radiologists, subjective aspects of PI-RADS categories which currently do not implement quantitative measures, quality of MRI-guided prostate biopsies, and variation in interpretation of prostate biopsy specimens. In this editorial, we are briefly covering the pressure points related to prostate MRI acquisition and interpretation. Quality of prostate MRI: As it applies to every imaging modality, prostate MRI requires high quality for optimum results for cancer detection. The PI-RADS document aims to achieve the quality assurance by implementing pre-image acquisition patient preparation maneuvers such as applying bowel preparation using enema, use of antispasmodic medicine, or removal of rectal gas via catheters. The use of these methods has shown variable results on image quality in the literature, and currently, the ideal one to achieve a good quality MRI is still unknown. In addition to that, the PI-RADS document provides minimum technical requirements for image acquisition. The adherence level to these minimum standards is again variable, and recently, it is shown that having good quality prostate MRIs is not always associated with strictly following them. There is currently an ongoing discussion on further extending these minimum standards and some research groups are trying to utilize artificial intelligence (AI) for the evaluation of prostate MRI quality and alert the technologists and radiologists on time about this. Experience of practicing radiologists: it is apparent that for each radiologist who wants to read prostate MRIs, a certain learning curve should be covered. However, the exact number of studies to cover this learning period is yet to be determined. Additionally, certification based on stringent criteria and performance metrics is ","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"337-338"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120943886","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38184556","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":"Use of Multiphase CT Protocols in 18 Countries: Appropriateness and Radiation Doses.","authors":"Shivam Rastogi,&nbsp;Ramandeep Singh,&nbsp;Riddhi Borse,&nbsp;Petra Valkovic Zujic,&nbsp;Doris Segota,&nbsp;Ana Diklic,&nbsp;Slaven Jurkovic,&nbsp;Antar Ali,&nbsp;Hassan Mohammed Kharita,&nbsp;Huda M Al-Naemi,&nbsp;Jokha Alkalbani,&nbsp;Amaal Al-Rasbi,&nbsp;Vesna Gershan,&nbsp;Stipe Galic,&nbsp;Mohammad Yusuf,&nbsp;Simona Avramova-Cholakova,&nbsp;Ili Majidah Binti Hj Zulkipli,&nbsp;Nilar Shein,&nbsp;Seife Teferi,&nbsp;Madan M Rehani,&nbsp;Jenia Vassileva,&nbsp;Mannudeep K Kalra","doi":"10.1177/0846537119888390","DOIUrl":"https://doi.org/10.1177/0846537119888390","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the frequency, appropriateness, and radiation doses associated with multiphase computed tomography (CT) protocols for routine chest and abdomen-pelvis examinations in 18 countries.</p><p><strong>Materials and methods: </strong>In collaboration with the International Atomic Energy Agency, multi-institutional data on clinical indications, number of scan phases, scan parameters, and radiation dose descriptors (CT dose-index volume; dose-length product [DLP]) were collected for routine chest (n = 1706 patients) and abdomen-pelvis (n = 426 patients) CT from 18 institutions in Asia, Africa, and Europe. Two radiologists scored the need for each phase based on clinical indications (1 = not indicated, 2 = probably indicated, 3 = indicated). We surveyed 11 institutions for their practice regarding single-phase and multiphase CT examinations. Data were analyzed with the Student <i>t</i> test.</p><p><strong>Results: </strong>Most institutions use multiphase protocols for routine chest (10/18 institutions) and routine abdomen-pelvis (10/11 institutions that supplied data for abdomen-pelvis) CT examinations. Most institutions (10/11) do not modify scan parameters between different scan phases. Respective total DLP for 1-, 2-, and 3-phase routine chest CT was 272, 518, and 820 mGy·cm, respectively. Corresponding values for 1- to 5-phase routine abdomen-pelvis CT were 400, 726, 1218, 1214, and 1458 mGy cm, respectively. For multiphase CT protocols, there were no differences in scan parameters and radiation doses between different phases for either chest or abdomen-pelvis CT (<i>P</i> = 0.40-0.99). Multiphase CT examinations were unnecessary in 100% of routine chest CT and in 63% of routine abdomen-pelvis CT examinations.</p><p><strong>Conclusions: </strong>Multiphase scan protocols for the routine chest and abdomen-pelvis CT examinations are unnecessary, and their use increases radiation dose.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"381-387"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537119888390","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37647805","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":"Controversies Surrounding the BMD Reporting Standard for the Determination of 10-Year Absolute Fracture Risk: A Canadian Perspective.","authors":"Kerry Siminoski,&nbsp;Margaret O'Keeffe,&nbsp;Cigdem Akincioglu,&nbsp;S Nimu Ganguli,&nbsp;Jacques Levesque,&nbsp;Peter Raaphorst,&nbsp;Giuseppe Tarulli,&nbsp;Wendy Thurston,&nbsp;David Lyons","doi":"10.1177/0846537120907655","DOIUrl":"https://doi.org/10.1177/0846537120907655","url":null,"abstract":"<p><p>The Canadian Association of Radiologists and Osteoporosis Canada currently endorse a fracture risk prediction tool called CAROC. It has been used in Canada since 2005 with an update in 2010. It is an integral part of bone mineral densitometry reporting across the country. New osteoporosis guidelines from Osteoporosis Canada (OC) are expected in the near future. There has been pressure on radiologists to report fracture risk using an alternative fracture risk prediction platform called FRAX. In addition, OC collaborated in the development of the Canadian FRAX model and has been copromoting both FRAX and CAROC, raising the prospect that new guidelines may seek to replace CAROC with FRAX for fracture risk determination. A number of concerns have been raised about FRAX, including: (1) FRAX has not released its algorithms to the public domain with the consequence that it is impossible to verify results for an individual patient; (2) FRAX has incorrectly claimed that it was developed by the World Health Organization (WHO) and has used this affiliation to promote itself until recently ordered by the WHO to desist; (3) FRAX requires collection of additional clinical information beyond that needed for CAROC, and this patient-reported medical data is prone to substantial error; and (4) despite claims to the contrary, there are no valid studies comparing FRAX to CAROC. We believe it is important that radiologists be aware of these issues in order to provide input into future Technical Standards for Bone Mineral Densitometry Reporting of the Canadian Association of Radiologists.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"483-489"},"PeriodicalIF":3.1,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/0846537120907655","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37729385","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}