Journal of the American College of Radiology最新文献

{"title":"National Utilization Trends of Inpatient Procedures for Symptomatic Uterine Fibroids and Adenomyosis: A 10-Year Analysis","authors":"Matthew A. Patetta MD ,&nbsp;Kira N. Griffith BS ,&nbsp;Joshua A. Walker BS ,&nbsp;Maureen P. Kohi MD ,&nbsp;Sarah J. Nyante PhD ,&nbsp;Gloria Salazar MD ,&nbsp;Nicole A. Keefe MD","doi":"10.1016/j.jacr.2024.11.031","DOIUrl":"10.1016/j.jacr.2024.11.031","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to determine changes in procedural utilization for symptomatic uterine fibroids and adenomyosis from 2011 to 2020.</div></div><div><h3>Methods</h3><div>An institutional review board–exempt retrospective study of the National Inpatient Sample database from 2011 to 2020 was performed using International Classification of Diseases, Ninth Revision, and International Classification of Diseases, 10th Revision, diagnosis and procedural codes for uterine fibroids, adenomyosis, hysterectomy, myomectomy, uterine artery embolization (UAE), and endometrial ablation. Patients with endometriosis, uterine cancer, placenta accreta spectrum, pelvic inflammatory disease, and uterine prolapse were excluded. Data were analyzed using statistical process control and χ² testing.</div></div><div><h3>Results</h3><div>A total of 247,476 inpatient procedures were identified in women with fibroids and/or adenomyosis. Of those patients with only uterine fibroids (n = 212,532), 77.9% underwent hysterectomy, 18.9% underwent myomectomy, and 2.8% underwent UAE. The utilization of UAE remained stable over the decade, whereas an increased prevalence of myomectomy was offset by a decrease in hysterectomy (2011 versus 2020: hysterectomy, 81.4% versus 73.7%; myomectomy, 15.4% versus 24.0%; UAE, 2.9% versus 2.0%). Regarding adenomyosis only (n = 16,073), more women underwent hysterectomy (98.1%) compared with UAE (1.1%), with minimal change in these procedures across the decade. For combined fibroids and adenomyosis (n = 18,871), hysterectomy was the most utilized procedure, with its utilization declining from 92.0% to 85.2% during the time period.</div></div><div><h3>Conclusions</h3><div>The utilization of hysterectomy remains the dominant inpatient procedural intervention for the treatment of uterine fibroids and adenomyosis, but the proportion of myomectomy in the setting of fibroids is increasing. Utilization of UAE did not change from 2011 to 2020, and it remains relatively underutilized despite initiatives to increase utilization.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Pages 417-424"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the Gap: Evaluation of a Supplemental Surge Staffing Model to Maintain Radiology Turnaround Times Amid Labor Constraints","authors":"Khushboo Jhala MD, MBA ,&nbsp;Fionnuala McPeake ,&nbsp;Jennifer W. Uyeda MD ,&nbsp;Oleg S. Pianykh PhD ,&nbsp;Aaron D. Sodickson MD, PhD","doi":"10.1016/j.jacr.2024.11.004","DOIUrl":"10.1016/j.jacr.2024.11.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Many practices face staffing challenges stemming from expanding clinical volumes and recruitment difficulties. This study aims to evaluate the use of supplemental surge staffing along with scheduled shift redistribution as a bridge to needed staffing increases.</div></div><div><h3>Methods</h3><div>A tertiary care academic Emergency Radiology Division comprising 23 radiologists faced a labor shortage during the addition of a new hospital emergency department on June 30, 2023. Strategies to preserve turnaround times (TATs) included increasing daily scheduled shift hours and surge staffing. In surge staffing, scheduled radiologists initiate “surge” calls for assistance during high volumes, prompting available nonscheduled staff to read remotely, with compensation based on length and time of surge engagement. Staff could participate in one or both strategies. Data collected 60 days before and after the emergency room addition compared total relative value units (RVUs), median and 80th percentile TATs, RVUs per person hour, and individual staff surge engagement versus shift increase.</div></div><div><h3>Results</h3><div>Total RVUs increased by 15% in the post-addition period (38,746 versus 44,628, <em>P</em> &lt; .01), and median TATs (42 versus 44 min, <em>P</em> = .53), 80th percentile TATs (74 versus 73 min, <em>P</em> = .87), and average RVUs per person hour (8.2 versus 8.2, <em>P</em> = .52) did not change significantly. Only 70% (16 of 23) of baseline staff increased scheduled shift hours post-addition, and 96% (22 of 23) engaged in surge staffing. Surge timing and duration varied per individual.</div></div><div><h3>Conclusion</h3><div>A “just-in-time” supplemental surge staffing model, in combination with increasing scheduled shift hours, can be effectively used to maintain TATs during staffing shortages, aiding timely care delivery as a bridge to more permanent staffing solutions.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Pages 495-504"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building and Scaling a Platform Business in Health Care","authors":"Anurati Mathur BS ,&nbsp;Elliot K. Fishman MD ,&nbsp;Steven P. Rowe MD, PhD ,&nbsp;Linda C. Chu MD ,&nbsp;Ryan C. Rizk BS","doi":"10.1016/j.jacr.2024.11.033","DOIUrl":"10.1016/j.jacr.2024.11.033","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Pages 507-509"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Table of Content","authors":"","doi":"10.1016/S1546-1440(25)00094-8","DOIUrl":"10.1016/S1546-1440(25)00094-8","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Pages A1-A4"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Deep Learning-Based Computer-Aided Detection and Electronic Notification System for Pneumothorax on Time to Treatment: Clinical Implementation","authors":"Si Nae Oh MD ,&nbsp;Hyungkook Yang MD ,&nbsp;Chun Kyon Lee MD, PhD ,&nbsp;Sang-Hoon Park MD ,&nbsp;Chang Hoon Han MD, PhD ,&nbsp;Ho Heo MD, PhD ,&nbsp;Young Sung Kim MD","doi":"10.1016/j.jacr.2024.11.009","DOIUrl":"10.1016/j.jacr.2024.11.009","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether the implementation of deep learning (DL) computer-aided detection (CAD) that screens for suspected pneumothorax (PTX) on chest radiography (CXR) combined with an electronic notification system (ENS) that simultaneously alerts both the radiologist and the referring clinician would affect time to treatment (TTT) in a real-world clinical practice.</div></div><div><h3>Methods</h3><div>In May 2022, a commercial DL-based CAD and ENS was introduced for all CXRs at an 818-bed general hospital, with 33 attending doctors and their residents using ENS, while 155 others used only CAD. We used difference-in-differences estimates to compare TTT between the CAD and ENS group and the CAD-only group for the period from January 2018 to April 2022 and from May 2022 to April 2023.</div></div><div><h3>Results</h3><div>A total of 603,028 CXRs from 140,841 unique patients were included, with a PTX prevalence of 2.0%. There was a significant reduction in TTT for supplemental oxygen therapy for the CAD and ENS group compared with the CAD-only group in the postimplementation period (−143.8 min; 95% confidence interval [CI], −277.8 to −9.9; <em>P</em> = .035). However, there was no significant difference in TTT for other treatments, including aspiration or tube thoracostomy (14.4 min; 95% CI, −35.0 to 63.9) and consultation with the thoracic and cardiovascular surgery department (86.3 min; 95% CI, −175.1 to 347.6).</div></div><div><h3>Conclusion</h3><div>The introduction of a DL-based CAD and ENS reduced the time to initiate oxygen supplementation for patients with PTX.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Pages 471-477"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluating Endometrial Thickness in Symptomatic Postmenopausal Patients for Excluding Cancer: Systematic Review and Meta-Analysis","authors":"Ryan K.W. Chee MD, PhD ,&nbsp;Reshma M. Koshy MBChB, BMedSci ,&nbsp;Jordan Haidey PhD ,&nbsp;Mohammad H. Murad MD ,&nbsp;Gavin Low MBChB, MPhil, MRCS ,&nbsp;Mitchell P. Wilson MD","doi":"10.1016/j.jacr.2024.11.008","DOIUrl":"10.1016/j.jacr.2024.11.008","url":null,"abstract":"<div><h3>Purpose</h3><div>The current ACR and American College of Obstetricians and Gynecologists guidelines recommend a ≤4-mm endometrial thickness threshold for excluding endometrial cancer in symptomatic postmenopausal patients. This systematic review and meta-analysis aims to re-evaluate the optimal endometrial thickness threshold on imaging for excluding cancer in symptomatic postmenopausal patients.</div></div><div><h3>Materials and methods</h3><div>A systematic search of MEDLINE, EMBASE, Cochrane Library, and Scopus from inception to October 2023 was performed in addition to a gray literature search. Studies were included if they evaluated the diagnostic imaging accuracy of endometrial thickness thresholds for detecting endometrial cancer in symptomatic postmenopausal patients. The reference standard was histopathology. Full-text review and data extraction were performed independently by two reviewers. Risk of bias and applicability were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Meta-analysis was performed using a bivariate mixed-effects regression model.</div></div><div><h3>Results</h3><div>Thirty-five studies with 6,302 patients met inclusion criteria. Mean age range was 51 to 68 years. The sensitivities and specificities with 95% confidence intervals for the 2- to 7-mm thresholds are 95% (84%-98%) and 22% (8%-49%) for ≤2 mm, 94% (82%-98%) and 35% (24%-47%) for ≤3 mm, 95% (86%-98%) and 45% (34%-56%) for ≤4 mm, 88% (75%-95%) and 56% (42%-68%) for ≤5 mm, 84% (63%-94%) and 60% (43%-74%) for ≤6 mm, and 85% (56%-96%) and 62% (49%-73%) for ≤7 mm. Studies were deemed predominantly low risk for bias across domains.</div></div><div><h3>Conclusion</h3><div>This comprehensive meta-analysis supports the ≤4-mm endometrial thickness threshold for excluding endometrial cancer in symptomatic postmenopausal patients.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Pages 425-435"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Acute Pancreatitis","authors":"Jeshwanth Mohan ,&nbsp;Saadiya Sehareen DO","doi":"10.1016/j.jacr.2024.11.015","DOIUrl":"10.1016/j.jacr.2024.11.015","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Page 517"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Physician Agreement With Radiologist-Recommended Follow-up Imaging","authors":"Moses Flash MD ,&nbsp;Elyse A. Lynch MPH ,&nbsp;Ronilda Lacson MD, PhD ,&nbsp;Jeffrey P. Guenette MD, MPH ,&nbsp;Sonali Desai MD, MPH ,&nbsp;Neena Kapoor MD","doi":"10.1016/j.jacr.2024.11.006","DOIUrl":"10.1016/j.jacr.2024.11.006","url":null,"abstract":"<div><h3>Objective</h3><div>Although recommendations for additional imaging are common in radiology reports, completion of follow-up imaging does not always occur, which could reflect disagreement between radiologist and referring provider. We assessed how frequently referring providers agree with radiologists’ follow-up recommendations, reasons for disagreement, and factors associated with radiologist-referring provider agreement.</div></div><div><h3>Methods</h3><div>This institutional review board-exempt, retrospective study was performed at a large academic center. A PACS-integrated tool allowed radiologists to send follow-up imaging recommendations to referring providers, who used the tool to document agreement or disagreement with recommendations. The study included recommendations sent for outpatients between October 21, 2019, and October 31, 2022. Multivariable logistic regression analysis was performed to identify patient, radiologist, and imaging examination factors associated with radiologist-referring provider agreement.</div></div><div><h3>Results</h3><div>Of the 9,406 recommendations meeting inclusion criteria, 8,331 (88.6%) resulted in agreement. The most common reason for disagreement was that the recommendation was considered not clinically relevant (44.5%, 478 of 1,075). The following factors were associated with low rates of agreement: referring provider being a surgeon (odds ratio [OR] 0.73, <em>P</em> &lt; .001) or recommendation for follow-up nuclear imaging (OR 0.64, <em>P</em> = .012). The odds of agreement were higher for recommendations made by thoracic radiologists (OR 1.41, <em>P</em> = .002) and for recommendations with longer follow-up time frames (weeks) (OR 1.03, <em>P</em> &lt; .001). Patient race, ethnicity, insurance type, and living in a socio-economically disadvantaged neighborhood were not significantly associated with radiologist-referring provider agreement.</div></div><div><h3>Discussion</h3><div>Referring providers frequently agree with follow-up imaging recommendations made by radiologists for outpatients, and patient demographics and socio-economic factors do not seem to significantly impact radiologist-referring provider agreement.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Pages 407-416"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in Using Large Language Models for Simplifying Radiology Reports","authors":"Yaara Artsi BMedSC,&nbsp;Vera Sorin MD,&nbsp;Eyal Klang MD","doi":"10.1016/j.jacr.2024.08.031","DOIUrl":"10.1016/j.jacr.2024.08.031","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Page 405"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Affecting Adherence to Fine Needle Aspiration Recommendations of TI-RADS 4 Thyroid Nodules","authors":"Jean Lee MB BChir ,&nbsp;Melissa Shuhui Lee MBBS ,&nbsp;Richard Wiggins MD ,&nbsp;Amani Jridi MS ,&nbsp;Yoshimi Anzai MD","doi":"10.1016/j.jacr.2024.10.013","DOIUrl":"10.1016/j.jacr.2024.10.013","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 4","pages":"Pages 444-448"},"PeriodicalIF":4.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}