Journal of the American College of Radiology最新文献

{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Suspected and Known Heart Failure: 2025 Update","authors":"Sania Choudhary , Sonya Bhole MD","doi":"10.1016/j.jacr.2025.06.024","DOIUrl":"10.1016/j.jacr.2025.06.024","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Page 1254"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340766","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":"Effect of Fee Removal on the Use of Digital Breast Tomosynthesis to Minimize Health Care Disparities","authors":"Nina Capiro MD ,&nbsp;Prasidda Khadka MD ,&nbsp;James Sayre PhD ,&nbsp;Gelareh Sadigh MD ,&nbsp;Anne Hoyt MD","doi":"10.1016/j.jacr.2025.06.022","DOIUrl":"10.1016/j.jacr.2025.06.022","url":null,"abstract":"<div><h3>Background</h3><div>After FDA clearance of digital breast tomosynthesis (DBT) in 2011, many insurers were slow to adopt full coverage without cost sharing. Our institution implemented a $45 out-of-pocket fee for DBT, refunded upon insurance payment. This fee was eliminated in January 2021 after most insurers began covering DBT. We evaluated the effect of out-of-pocket fee removal on DBT versus digital mammography use across patient groups.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of screening mammograms scheduled at a multisite academic institution between March 2018 and August 2022. A difference-in-difference analysis was performed for women with screening mammography both before and after fee removal to assess the effect of fee removal across patient groups.</div></div><div><h3>Results</h3><div>Among 13,284 women (mean age, 61.5 ± 11.2 years), DBT utilization increased from 83.7% (11,123 of 13,284) pre-intervention to 91.5% (12,256 of 13,284) postintervention. Relative to White patients, the rise in DBT utilization was greater by 5.0 percentage points (pp) for Asian patients (95% confidence interval [CI] = 3.7-6.2), 6.2 pp for Black patients (95% CI = 5.0-7.3), and 6.2 pp for Hispanic patients (95% CI = 4.9-7.5). Non-English-speaking patients had a larger increase in DBT usage than English-speaking patients (7.1 pp; 95% CI = 6.1-8.1). Medicaid (6.7 pp; 95% CI = 4.8-8.5) and commercially insured (5.1 pp; 95% CI = 3.8-6.4) patients showed a greater rise in DBT usage than patients with Medicare. Patients from more socio-economically disadvantaged areas had a greater increase in DBT utilization compared with those from less disadvantaged areas (5.2 pp; 95% CI = 4.1-6.8).</div></div><div><h3>Conclusion</h3><div>Eliminating out-of-pocket cost for DBT improved overall utilization and narrowed disparities. However, persistent inequities suggest additional strategies are needed to ensure equitable access to DBT for all women undergoing screening mammography.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Pages 1193-1200"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340761","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":"Creating a Cyberattack Plan for Radiology Operations: A Practical Pediatric Perspective","authors":"Susan Sotardi MD, MSEng ,&nbsp;Colleen Flowers AS, RT(R)(MR) ,&nbsp;Ethan Larsen PhD ,&nbsp;Mario Sinti-Ycochea MD ,&nbsp;Ann M. Johnson MD ,&nbsp;Sudha Anupindi MD","doi":"10.1016/j.jacr.2025.07.017","DOIUrl":"10.1016/j.jacr.2025.07.017","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the development of a comprehensive plan for the initial radiology department in response to a cyberattack, aligned with enterprise-wide disaster preparedness in a pediatric hospital setting.</div></div><div><h3>Methods</h3><div>Our department participated in a coordinated, multidisciplinary enterprise effort to build a cyberattack protocol. We created a command center model to maintain radiology operations in the event of a complete network outage, which includes organizing staff, tracking equipment, archiving imaging studies, and communicating within and outside our department. This plan encompasses all imaging modalities and current interdepartmental dependencies.</div></div><div><h3>Results</h3><div>A radiology downtime strategy was created to address cyber-events, including command center setup, modality-based imaging workflows, secure communication, and equipment recovery, with a focus on paper-based tools, encrypted storage, teamwork across departments, streamlined approach to image acquisition and interpretation, and postevent follow-up.</div></div><div><h3>Conclusion</h3><div>This work highlights the need for radiology departments to proactively outline cyberattacks protocols. By sharing our process, we aim to support other institutions in building robust systems to sustain imaging services during network outages. To ensure readiness for potential future cyberattacks, it is important to maintain readiness, aligned with multidepartmental efforts.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Pages 1148-1156"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710116","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":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Acute Shoulder Pain: 2024 Update","authors":"Jonathan Burns ,&nbsp;Shari T. Jawetz MD","doi":"10.1016/j.jacr.2025.06.012","DOIUrl":"10.1016/j.jacr.2025.06.012","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Page 1252"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251178","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":"Addressing the Screening Care Gap by Removing Upfront Fees for Digital Breast Tomosynthesis","authors":"Matthew D. Phelps MD,&nbsp;Brian N. Dontchos MD","doi":"10.1016/j.jacr.2025.05.024","DOIUrl":"10.1016/j.jacr.2025.05.024","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Pages 1201-1202"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369626","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":"Sustainability Challenges in Radiology: A Call for Action","authors":"José David Cardona Ortegón MD,&nbsp;Laura Manuela Olarte Bermúdez MD (Research assistant),&nbsp;Valeria Noguera MD (Associated author),&nbsp;Juan Andres Mejia MD (Associated researcher)","doi":"10.1016/j.jacr.2025.04.013","DOIUrl":"10.1016/j.jacr.2025.04.013","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Page 1109"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060692","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":"Consensus, Frameworks, and Best Practices in A Review of Cybersecurity and Privacy Standards in Medical Imaging","authors":"Po-Hao Chen MD, MBA ,&nbsp;Christoph Wald MD, PhD, MBA","doi":"10.1016/j.jacr.2025.06.033","DOIUrl":"10.1016/j.jacr.2025.06.033","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Pages 1124-1131"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512902","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":"Interventional Radiology and Health Equity: Disparities in Uterine Artery Embolization Based on Insurance Status","authors":"Brijesh Sathian PhD,&nbsp;Syed Muhammad Ali MBBS,&nbsp;Javed Iqbal RN, MHA,&nbsp;Ayesha Parvaiz Malik MBBS","doi":"10.1016/j.jacr.2025.06.034","DOIUrl":"10.1016/j.jacr.2025.06.034","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Pages 1115-1116"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531485","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":"Remote Arbitrage in Radiology: Multiple Affiliations as a Specialty Specific Adaptation to Changing Practice Demands","authors":"Curtis L. Simmons MD, MBA ,&nbsp;Laura K. Harper MD ,&nbsp;Luis F. Goncalves MD ,&nbsp;Richard E. Sharpe MD, MBA","doi":"10.1016/j.jacr.2025.06.041","DOIUrl":"10.1016/j.jacr.2025.06.041","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze trends from 2017 to 2024 in the number of group and state affiliations among Medicare-serving physicians, with emphasis on diagnostic radiologists.</div></div><div><h3>Methods</h3><div>Affiliation data were obtained from the CMS Physician and Other Supplier Public Use File (2017-2024). Group and state affiliations per physician were analyzed across specialties and compared between diagnostic radiologists and nonradiologist physicians. Statistical analyses included descriptive measures, compound annual growth rates, <em>t</em> tests, correlation, mixed-effect models, and regression models. Subgroup and generational analyses were also conducted.</div></div><div><h3>Results</h3><div>From 2017 to 2024, 635,961 unique physicians were included in this analysis. All physicians had an average of 1.19 group and 1.06 state affiliations. Among physician specialties, diagnostic radiologists had the highest average number of affiliations, with 2.03 groups and 1.31 states on average. This is 1.7 and 1.2 times as many affiliations, respectively, compared with all nonradiologist physicians. From 2017 to 2024, the compound annual growth rates of affiliations per nonradiologist physician was −0.12% for groups and +0.14% for states, whereas for diagnostic radiologists it was +2.23% for groups and +1.63% for states.</div></div><div><h3>Conclusions</h3><div>Compared with all other types of physicians, diagnostic radiologists are much more likely to expand the reach of their services through use of multiple group and state affiliations. Despite recent technological and policy advances with the potential to expand access to care through use of affiliations across groups and states, there has only been modest use of these strategies among other physician types.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Pages 1217-1226"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577148","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":"Association of Changes in Missouri Law for Breast Cancer Screening, Screening Rates, and Use of Digital Breast Tomosynthesis","authors":"Amy K. Patel MD ,&nbsp;Alexandra R. Drake MPH ,&nbsp;Eugenia Brandt MM ,&nbsp;Eric W. Christensen PhD","doi":"10.1016/j.jacr.2025.06.037","DOIUrl":"10.1016/j.jacr.2025.06.037","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the association of Missouri law changes expanding mammography coverage to include annual screening from age 40 (previously biennial from age 50), digital breast tomosynthesis (DBT) on overall screening rates, and use of DBT.</div></div><div><h3>Methods</h3><div>This retrospective study (2015-2022) used a national claims database (Inovalon Insights, LLC). A difference-in-differences approach was used in logistic regression models to assess the association of changes in Missouri law with women’s likelihood of screening, and for those screened, the likelihood of receiving DBT. Within-Missouri models compared Medicaid and commercial patients to beneficiaries of federally regulated Medicare Advantage (MA) plans. The association was further tested via a comparison of Missouri patients to their counterparts in Missouri border states without a coverage change.</div></div><div><h3>Results</h3><div>There were 1,008,881 unique women (41.4% [417,835] in Missouri). After the Missouri law change, women with Medicaid (odds ratio [OR]: 1.45; 95% confidence interval [CI]: 1.36-1.55) and commercial insurance (OR: 1.05; 95% CI: 1.01-1.10) had a greater increase in likelihood of screening mammography compared to MA women whose coverage is based on federal law. Medicaid women with mammography had a higher likelihood of DBT for both within-Missouri (OR: 2.31; 95% CI: 2.01-2.66) and border-state (OR: 1.24; 95% CI: 1.22-1.27) comparisons. Commercially insured women likewise had a relative increase in likelihood of receiving DBT.</div></div><div><h3>Conclusion</h3><div>Changes in Missouri law expanding breast cancer screening coverage were strongly associated with increased screening rates among Medicaid patients as well as increased likelihood of DBT among screened patients, for both Medicaid and commercially insured patients.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 10","pages":"Pages 1207-1214"},"PeriodicalIF":5.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700565","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}