Journal of the American College of Radiology最新文献

{"title":"Variability Among Radiologists in Interpreting Low-Dose CT Lung Cancer Screens","authors":"Paul F. Pinsky PhD,&nbsp;Ella Kazerooni MD,&nbsp;Gerard Silvestri MD,&nbsp;Raymond U. Osarogiagbon MD,&nbsp;Farhood Farjah MD,&nbsp;Eric Miller PhD,&nbsp;Lindsey Enewold PhD,&nbsp;Louise Henderson PhD,&nbsp;Danielle Durham PhD,&nbsp;Robert A. Smith PhD,&nbsp;Philip Connor BA,&nbsp;Andrew Ward PhD,&nbsp;V. Paul Doria-Rose PhD","doi":"10.1016/j.jacr.2026.08.006","DOIUrl":"10.1016/j.jacr.2026.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer screening (LCS) with low-dose CT (LDCT) reduces lung cancer mortality, but false-positive tests remain a concern. Radiologist variability in interpreting LDCT scans may contribute to higher false-positive rates (FPRs).</div></div><div><h3>Methods</h3><div>Radiologists were identified from the LCS registry maintained by the ACR. Registry data were merged with Medicare files to create an LCS registry-Medicare database. Radiologists with ≥50 baseline or ≥50 postbaseline LDCT screens in the database were included in the analysis. The sensitivity and FPR were defined as the proportion of positive (Lung CT Screening Reporting and Data System 3-4) screens among those with and without a lung cancer diagnosis, respectively. Distributions, including median and interquartile range, of radiologists’ FPRs were evaluated based on observed data and mixed-effects models, in which the radiologist was the random effect. Sensitivity was computed on an aggregate level based on radiologists’ FPR quartiles.</div></div><div><h3>Results</h3><div>In all, 1,130 radiologists read ≥50 baseline screens, and 935 read ≥50 postbaseline screens. Median (interquartile range) FPR for baseline screens was 15.9% (11.3%-21.8%) and 16.3% (11.8%-21.8%) based on observed data and the mixed-effects model, respectively. Corresponding values for postbaseline screens were 8.5% (5.7%-12.8%) and 8.8% (6.3%-11.8%). Sensitivity increased significantly with radiologist FPR quartile for baseline and postbaseline screens. For baseline screens, radiologists in the lower two FPR quartiles had aggregate FPR and sensitivity of 10.9% and 89.6%, respectively, versus 24.1% and 94.4% for radiologists in the upper two quartiles.</div></div><div><h3>Conclusions</h3><div>Variability in radiologists’ FPRs with LDCT screening was high. Higher FPRs were associated with increased sensitivity rates.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Pages 1915-1923"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708870","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":"Strategies Associated With High Inferior Vena Cava Filter Retrieval: A Positive Deviance Study","authors":"Premal Trivedi MD, MS,&nbsp;Juliana G. Barnard MA,&nbsp;Dennis Gurfinkel MPH,&nbsp;Maria Puello Baron MD,&nbsp;Jonathan Lindquist MD,&nbsp;Harrison Bai MD,&nbsp;P. Michael Ho MD, PhD","doi":"10.1016/j.jacr.2026.07.002","DOIUrl":"10.1016/j.jacr.2026.07.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Inferior vena cava (IVC) filter retrieval is recommended once mechanical protection against pulmonary embolism is no longer needed, ideally within 3 months of implantation. Building on prior work demonstrating low aggregate retrieval and substantial interfacility variation in the United States, this qualitative study aimed to describe barriers to timely IVC filter retrieval and surveillance processes and implementation strategies associated with exceptionally high (&gt;95th percentile) retrieval rates.</div></div><div><h3>Methods</h3><div>This qualitative analysis was embedded within a mixed-methods positive deviance study. After risk-adjusted 1-year IVC filter retrieval rates were estimated for US hospitals serving Medicare beneficiaries, we examined four high-performing (retrieval rates 40%-74%) and three intermediate-performing (retrieval rates 7%-40%) hospitals. Semistructured interviews with surveillance personnel were analyzed using team-based rapid qualitative analysis focused on barriers to timely retrieval and high-retrieval surveillance processes.</div></div><div><h3>Results</h3><div>Barriers to timely retrieval were similar across sites and included dependence on individual clinicians to recognize implanted filters, labor-intensive tracking, difficulty obtaining provider input, challenges contacting patients, and competing clinical obligations. High-retrieval hospitals converged on several implementation strategies: an empowered nonphysician champion, protocolized surveillance, presumptive rather than open-ended communication regarding retrieval eligibility with involved clinicians, and reserving additional imaging or clinic evaluation for medically complex patients. Electronic medical record dashboards facilitated workflow but did not differentiate high- from intermediate-retrieval hospitals.</div></div><div><h3>Conclusions</h3><div>High IVC filter retrieval seemed less dependent on a specific surveillance model than on how programs operationalized follow-up into routine care. Scalable interventions should prioritize accountable nonphysician ownership, risk-stratified escalation, protocolized reassessment, and streamlined clinician decision making, rather than registries or dashboards alone.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Pages 1946-1954"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474566","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":"A Road Map for Addressing Incidental Findings in Pediatric Radiology","authors":"Marla B.K. Sammer MD, MHA,&nbsp;Aparna Joshi MD,&nbsp;Angela J. Beavers MD,&nbsp;Michael J. Callahan MD,&nbsp;Sarah M. Desoky,&nbsp;Jonathan R. Dillman MD, MSc,&nbsp;Richard Jones MD,&nbsp;Viet T. Le MD,&nbsp;Ezekiel Maloney MD, MSc,&nbsp;Cara Morin MD, PhD,&nbsp;Narendra S. Shet MD,&nbsp;Jeffrey J. Tutman MD,&nbsp;Steve J. Stephen MBA,&nbsp;Stella K. Kang MD, MSc","doi":"10.1016/j.jacr.2026.06.019","DOIUrl":"10.1016/j.jacr.2026.06.019","url":null,"abstract":"<div><div>Incidental findings on pediatric imaging studies can adversely impact patients and their families when inappropriately managed. However, there is limited literature on management of these findings in the pediatric population, and guidelines for similar findings in adult patients may not be suitable. Here, examples of incidental findings in children are illustrated to give readers a practical understanding of how pediatric incidental findings may differ from those in adults. The ACR’s planned approach to developing pediatric-specific guidance for incidental findings is outlined, and a strategy for managing pediatric incidental findings in the absence of specific pediatric guidance is also provided.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Pages 1895-1903"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868068","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":"Enhancing Patient Understanding of Radiology Reports Through Large Language Model–Generated Summaries, Clickable Terms, and Artificial Intelligence Videos","authors":"Hanzhou Li MD,&nbsp;John T. Moon MD,&nbsp;Patricia Balthazar MD, MPH,&nbsp;Oanh Nguyen BS,&nbsp;Emily Patel BS,&nbsp;Ekaa Kasetty BS,&nbsp;Shriya Veluri MD, MPH,&nbsp;Zachary Bercu MD,&nbsp;Janice Newsome MD,&nbsp;Elizabeth Krupinski PhD,&nbsp;Judy Gichoya MD,&nbsp;Hari Trivedi MD","doi":"10.1016/j.jacr.2026.06.001","DOIUrl":"10.1016/j.jacr.2026.06.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate how a custom web application integrating clinician-edited large language model (LLM)–generated summaries, clickable definitions, and artificial intelligence (AI)-generated videos affects radiology report comprehension, feature preferences, and overall sentiment toward AI-assisted report summaries.</div></div><div><h3>Materials and methods</h3><div>This prospective study recruited participants between May and July 2025 at a hospital-based outpatient imaging floor before their scheduled examinations at a tertiary university hospital. After examination completion and report publication, patient-friendly AI summaries were generated and reviewed by a radiologist for accuracy. Participants were then shown a web application containing their own de-identified, AI-augmented reports featuring clinician-edited LLM-generated summaries with clickable terms and AI videos. Participants were surveyed on comprehension, feature usefulness, and attitudes toward LLM summaries.</div></div><div><h3>Results</h3><div>Participants (n = 101, 40 male and 61 female, racially diverse subjects) ranged from 20 to 82 (mean 58 ± 15) years old. Overall comprehension improved significantly (median before using the web application: 4.00, median after: 5.00, <em>P</em> &lt; .001), with 47.52% (n = 48) identifying LLM summaries as most helpful. However, LLM-summaries required manual clinician edits (average per summary: 24.75 words removed; 0.13 words added, lexical similarity = 84.63%; semantic similarity = 98.25%). When asked if they were comfortable with LLM summaries without clinician edits, most participants reported being only somewhat comfortable (27.72%) or very uncomfortable (25.74%).</div></div><div><h3>Conclusion</h3><div>This prospective study demonstrates that interactive, LLM-driven applications can significantly improve self-reported patient comprehension of complex radiology reports, emphasizing their potential to enhance patient-centered communication. However, patients had reservations about clinician-edited LLM-generated summaries, indicating that successful integration is contingent on professional oversight—an added workload that may limit scalable real-world implementation.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Pages 1965-1977"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148213746","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":"Comment on “Evaluating Generative Artificial Intelligence as an Educational Tool for Radiology Resident Report Drafting”","authors":"Maajid Mohi Ud Din Malik PhD","doi":"10.1016/j.jacr.2026.06.021","DOIUrl":"10.1016/j.jacr.2026.06.021","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Page 1887"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407374","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":"Comparison of Supplemental Breast Cancer Screening Outcomes for Automated Versus Handheld Ultrasound","authors":"Garth H. Rauscher PhD,&nbsp;Nila Alsheik MD,&nbsp;Joanna Eavey MSPH,&nbsp;Laura Ichikawa MS,&nbsp;Hannah Perry MD,&nbsp;Kathryn Lowry MD,&nbsp;Karla Kerlikowske MD,&nbsp;Brian L. Sprague PhD","doi":"10.1016/j.jacr.2026.06.018","DOIUrl":"10.1016/j.jacr.2026.06.018","url":null,"abstract":"<div><h3>Objective</h3><div>Supplemental ultrasound as an adjuvant to screening mammography has expanded due in part to the implementation of state laws mandating breast density notification. Automated breast ultrasound (ABUS) is an emerging modality that can potentially improve reproducibility and reduce operator dependency associated with handheld ultrasound (HHUS) in appropriately selected patients. The goals of these analyses were to compare the performance of ABUS versus HHUS for women with dense breasts.</div></div><div><h3>Methods</h3><div>We used observational data from 21,110 HHUS and 4,218 ABUS examinations among women with dense breasts conducted during 2017-2020 at 27 radiology facilities within three Breast Cancer Surveillance Consortium registries. Differences in abnormal interpretation rate, short-interval follow-up recommendation rate, biopsy recommendation rate, and cancer detection rate, as well as the false-positive initial assessment rate, false-positive biopsy recommendation rate, and positive predictive values for initial assessment and biopsy recommendation were compared.</div></div><div><h3>Results</h3><div>ABUS was associated with a lower abnormal interpretation rate (14.9% versus 19.2%, <em>P</em> &lt; .0001), a lower short-interval follow-up recommendation rate (3.0% versus 14.6%, <em>P</em> &lt; .0001), and a lower false-positive initial assessment rate (14.6 versus 19.1; <em>P</em> &lt; .0001) compared with HHUS. There were no apparent differences in biopsy recommendation or false-positive biopsy recommendation rate, positive predictive value, or cancer detection rate for ABUS versus HHUS.</div></div><div><h3>Conclusion</h3><div>Compared with HHUS, ABUS was associated with fewer abnormal interpretations and fewer short-interval follow-up recommendations and with a similar cancer detection rate. ABUS should be considered by health care providers as an effective alternative to handheld ultrasound for screening of certain women with dense breasts.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Pages 1936-1945"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383314","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":"Comment on “Pediatric MRI Safety: Frequency, Types, and Severity of Zone IV MRI Safety Events at Five US Children’s Hospitals”","authors":"Deepti M. Sati MPharma,&nbsp;Vanashri Dhananjay Shinde MD,&nbsp;Chhaya Agarwal PhD","doi":"10.1016/j.jacr.2026.06.022","DOIUrl":"10.1016/j.jacr.2026.06.022","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Pages 1888-1889"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498437","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":"Medicare Graduate Medical Education Funding and Radiology Residency Growth: Trends and Implications for Workforce Policy","authors":"Keervani Kandala MS,&nbsp;Dheeman Futela MBBS,&nbsp;Seyedmehdi Payabvash MD,&nbsp;Dhairya A. Lakhani MD,&nbsp;Dheeraj Gandhi MD,&nbsp;Richard Duszak MD,&nbsp;Ajay Malhotra MD, MMM","doi":"10.1016/j.jacr.2026.07.008","DOIUrl":"10.1016/j.jacr.2026.07.008","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Pages 1995-1998"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563969","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":"Screening Mammography Completion Among Women Enrolled in a Lung Cancer Screening Program","authors":"Meghan H. Maceyko MD,&nbsp;Christine Shusted MPH,&nbsp;Saba Daneshpooy MD,&nbsp;Jacob Woodroof MD,&nbsp;Khaled Noueihed MD,&nbsp;Alliric I. Willis MD, MSPH,&nbsp;Julie Barta MD","doi":"10.1016/j.jacr.2026.06.017","DOIUrl":"10.1016/j.jacr.2026.06.017","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Pages 1955-1959"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148383359","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®: Staging and Follow-Up of Gastric Cancer","authors":"Maya Doyle BA,&nbsp;David H. Kim MD","doi":"10.1016/j.jacr.2026.07.006","DOIUrl":"10.1016/j.jacr.2026.07.006","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"23 10","pages":"Page 2040"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551541","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}