Journal of the American College of Radiology最新文献

{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Imaging After Breast Surgery","authors":"Elizabeth M. McGuire , Samantha L. Heller PhD, MD","doi":"10.1016/j.jacr.2024.09.012","DOIUrl":"10.1016/j.jacr.2024.09.012","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Page 145"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482488","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":"Ranking the Relative Importance of Image Quality Features in CT by Consensus Survey","authors":"Dustin A. Gress MS ,&nbsp;Ehsan Samei PhD ,&nbsp;Donald P. Frush MD ,&nbsp;Casey E. Pelzl MPH ,&nbsp;Joel G. Fletcher MD ,&nbsp;Mahadevappa Mahesh MS, PhD ,&nbsp;David B. Larson MD, MBA ,&nbsp;Mythreyi Bhargavan-Chatfield PhD","doi":"10.1016/j.jacr.2024.10.006","DOIUrl":"10.1016/j.jacr.2024.10.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study sought to determine consensus opinions from subspecialty radiologists and imaging physicists on the relative importance of image quality features in CT.</div></div><div><h3>Methods</h3><div>A prospective survey of subspecialty radiologists and medical physicists was conducted to collect consensus opinions on the relative importance of 10 image quality features: axial sharpness, blooming, contrast, longitudinal sharpness, low-contrast axial sharpness, metal artifact, motion, noise magnitude, noise texture, and streaking. The survey was first sent to subspecialty radiologists in volunteer leadership roles in the ACR and RSNA, thereafter relying on snowball sampling. Surveyed subspecialties were abdominal, cardiac, emergency, musculoskeletal, neuroradiology, pediatric, and thoracic radiology and medical physics. Individual respondents’ ratings were normalized for calculation of mean normalized ratings and priority rankings for each feature within subspecialties. Also calculated were intraclass correlation coefficients across image quality features within subspecialties and analysis of variance across subspecialties within each feature.</div></div><div><h3>Results</h3><div>Most subspecialties had moderate to excellent intraclass agreement. For every radiology subspecialty except musculoskeletal, motion was the most important image quality feature. There was agreement across subspecialties that axial sharpness and contrast are only moderately important. There was disagreement across subspecialties on the relative importance of noise magnitude. Blooming was highly important to cardiac radiologists, and noise texture was highly important to musculoskeletal radiologists.</div></div><div><h3>Conclusion</h3><div>Image quality preferences differ based on clinical tasks and challenges in each anatomical radiology subspecialty. CT image analysis and development of quantitative measures of quality and protocol optimization—and related policy initiatives—should be specific to radiology subspecialty.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Pages 66-75"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482493","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":"Demographic Differences in the Radiology Residency Match, 2022 to 2024","authors":"Taha Lodhi BS ,&nbsp;Francis Deng MD","doi":"10.1016/j.jacr.2024.10.016","DOIUrl":"10.1016/j.jacr.2024.10.016","url":null,"abstract":"<div><h3>Purpose</h3><div>Ranking preferences by residency programs in the Match could shape the diversity of selective specialties. We investigated demographic characteristics of applicants and matched residents in radiology and other specialties to identify changes in representation.</div></div><div><h3>Methods</h3><div>Survey data from the National Resident Matching Program were obtained for applicants to radiology (diagnostic radiology, interventional radiology, and combined diagnostic radiology and nuclear medicine) and nonradiology programs in the 2022 to 2024 Main Residency Matches. Demographics among applicants preferring a specialty and matched residents were compared using χ² tests.</div></div><div><h3>Results</h3><div>Radiology had a 73.9% match rate (3,486 of 4,718 applicants). Women represented 29.0% of radiology applicants compared with 52.0% in other specialties. In radiology, only US citizenship had higher representation among matched residents compared with applicants (+4.0%, 95% confidence interval [CI], 2.8%-5.3%) (<em>P</em> = .001). Other demographics were not significantly different between applicants and matched residents in radiology overall. A higher representation of women was observed in matched residents compared with applicants in diagnostic radiology (+2.4%, 95% CI, 0.2%-4.6%) (<em>P</em> = .031) but not interventional radiology (+0.2%, 95% CI, −5.1% to 5.5%) (<em>P</em> = .944). In nonradiology specialties, female sex, nonheterosexual orientation, White race, US citizenship, first-generation medical graduate, and nonurban childhood were associated with higher match rates.</div></div><div><h3>Conclusion</h3><div>US citizenship but not other demographic variables was associated with higher rates of matching into radiology. Women are underrepresented among radiology applicants and have slightly higher match rates in diagnostic radiology but not interventional radiology.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Pages 25-32"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549388","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":"Office-Based Diagnostic Imaging Interpreted by Nonphysician Practitioners: Characteristics, Recent Trends, and State Variation","authors":"Eric W. Christensen PhD ,&nbsp;Clinton T. Case BS ,&nbsp;Robert W. Morris MD ,&nbsp;Casey E. Pelzl MPH ,&nbsp;Elizabeth Y. Rula PhD ,&nbsp;Richard Duszak Jr. MD","doi":"10.1016/j.jacr.2024.10.008","DOIUrl":"10.1016/j.jacr.2024.10.008","url":null,"abstract":"<div><h3>Purpose</h3><div>Diagnostic imaging interpretations by nonphysician practitioners (NPPs) are increasing. With hospital-based imaging overwhelmingly interpreted by radiologists, we studied office-based interpretations by NPPs by their physician employer specialty.</div></div><div><h3>Methods</h3><div>Linking Medicare claims and provider datasets, we identified imaging interpretation claims submitted by nurse practitioners and physician assistants (together NPPs) in office settings, mapping NPPs to physician employer specialties, and assessed NPP characteristics and practice patterns.</div></div><div><h3>Results</h3><div>Between 2013 and 2022, the share of office-based imaging interpretations by NPPs increased 9.0% annually (from 2.52% to 5.47%) overall and by the following modalities: radiography (8.9%; 4.30%-9.23%), ultrasound (9.4%; 0.52%-1.18%), CT (9.4%; 0.13%-0.28%), MR (9.9%, 0.19%-0.44%), and nuclear medicine (7.2%; 0.07%-0.12%). Just 5.55% of NPPs rendered interpretations. NPPs employed by primary care physicians (PCPs) and orthopedists interpreted the largest shares of NPP imaging (39.5% and 34.1%, respectively). By modality, the largest shares by employer specialties were PCPs and orthopedists for radiography (39.7%, 37.4%), PCPs and practices without physicians for ultrasound (44.7%, 12.7%), PCPs and otolaryngologists for CT (58.2%, 17.1%), orthopedists and PCPs for MR (60.3%, 24.0%), and PCPs and cardiologists for nuclear medicine (40.4%, 25.9%). Younger NPPs (&lt;35 years) interpreted imaging more frequently than older counterparts (≥65) (odds ratio 1.42 [95% confidence interval: 1.37-1.48]) and male NPPs interpreted imaging more frequently than female NPPs (odds ratio 1.61 [95% confidence interval: 1.58-1.63]). Overall interpretation shares ranged from 13.16% in Alaska to 0.29% in Washington, DC.</div></div><div><h3>Conclusion</h3><div>In Medicare, the share of office-based imaging interpretations performed by NPPs is increasing, varying considerably by state. Interpretations are performed by relatively few NPPs, particularly those younger, male, and employed by PCPs and orthopedists.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Pages 56-65"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683744","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®: Imaging After Mastectomy and Breast Reconstruction","authors":"Sania Choudhary ,&nbsp;Nina S. Vincoff MD","doi":"10.1016/j.jacr.2024.09.011","DOIUrl":"10.1016/j.jacr.2024.09.011","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Page 146"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482489","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":"Utilization of CT for Extremity Cellulitis: A Retrospective Single-Center Analysis","authors":"Cynthia E. Burke BS ,&nbsp;Owen R. Maley MD ,&nbsp;Benjamin Mancini BS ,&nbsp;SaraPettey Sandifer BS ,&nbsp;Sahil Sardesai BS ,&nbsp;Tonya S. King PhD ,&nbsp;Donald J. Flemming MD","doi":"10.1016/j.jacr.2024.10.011","DOIUrl":"10.1016/j.jacr.2024.10.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Routine imaging of soft tissue infection is not recommended and represents a potential area of CT overuse. The utility of CT in patients with superficial soft tissue infection of the extremities is unknown. The purpose of this study is to evaluate the utilization and clinical impact of CT ordered in the setting of extremity cellulitis.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients with extremity cellulitis examined with CT between 2012 and 2021 at a single center. We collected patient history, diagnostic imaging characteristics, and subsequent surgery decision. We hypothesized that yield of CT for deep infection was significantly lower than 10% and that yield was decreasing over time. These hypotheses were evaluated with Rao-Scott χ² tests and repeated measures logistic regression.</div></div><div><h3>Results</h3><div>There were 496 eligible encounters among 463 patients. Yield of positive CT among lower extremity patients was 5.5% (95% confidence interval 3.33-7.75), significantly less than our hypothesis of 10% (<em>P</em> = .003). In 71.8% of encounters, patients underwent diagnostic imaging studies in addition to CT. Utilization rose from 0.08% per hospital visit in 2012 to 2013 to 0.14% in 2020 to 2021, with differences in yield between time periods not reaching statistical significance (<em>P</em> = .059). Among 496 encounters, 62 received surgery (12.1%), with 21 of these cases preceded by a positive CT for deep infection.</div></div><div><h3>Conclusions</h3><div>Our 10-year single-center analysis of CT use for extremity cellulitis demonstrated a low yield of positive CT findings for deep infection and limited impact of CT on surgical management. A high incidence of patients undergoing multiple radiologic examinations suggests uncertainty in selecting appropriate imaging modalities in this clinical scenario.</div></div><div><h3>Summary</h3><div>This single-center retrospective analysis found that CT examination of patients with clinically diagnosed cellulitis of the extremities has significantly low yield for deep infection in the lower extremities.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Pages 76-83"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570534","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":"Shaping the Future of Radiology Through Medical Student Education","authors":"Anastacia Wahl MS ,&nbsp;Francis Deng MD","doi":"10.1016/j.jacr.2024.12.001","DOIUrl":"10.1016/j.jacr.2024.12.001","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Pages 7-9"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792895","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":"Large Language Model Use in Radiology Residency Applications: Unwelcomed but Inevitable","authors":"Emile B. Gordon MD ,&nbsp;Charles M. Maxfield MD ,&nbsp;Robert French MD, MBA ,&nbsp;Laura J. Fish MD ,&nbsp;Jacob Romm MD ,&nbsp;Emily Barre MPH, BSE ,&nbsp;Erica Kinne MD ,&nbsp;Ryan Peterson MD ,&nbsp;Lars J. Grimm MD, MHS","doi":"10.1016/j.jacr.2024.08.027","DOIUrl":"10.1016/j.jacr.2024.08.027","url":null,"abstract":"<div><h3>Objective</h3><div>This study explores radiology program directors’ perspectives on the impact of large language model (LLM) use among residency applicants to craft personal statements.</div></div><div><h3>Methods</h3><div>Eight program directors from the Radiology Residency Education Research Alliance participated in a mixed-methods study, which included a survey regarding impressions of artificial intelligence (AI)-generated personal statements and focus group discussions (July 2023). Each director reviewed four personal statement variations for five applicants, anonymized to author type: the original and three Chat Generative Pre-trained Transformer-4.0 (GPT) versions generated with varying prompts, aggregated for analysis. A 5-point Likert scale surveyed the writing quality, including voice, clarity, engagement, organization, and perceived origin of each statement. An experienced qualitative researcher facilitated focus group discussions. Data analysis was performed using a rapid analytic approach with a coding template capturing key areas related to residency applications.</div></div><div><h3>Results</h3><div>GPT-generated statement ratings were more often average or worse in quality (56%, 268 of 475) than ratings of human-authored statements (29%, 45 of 160). Although reviewers were not confident in their ability to distinguish the origin of personal statements, they did so reliably and consistently, identifying the human-authored personal statements at 95% (38 of 40) as probably or definitely original. Focus group discussions highlighted the inevitable use of AI in crafting personal statements and concerns about its impact on the authenticity and the value of the personal statement in residency selections. Program directors were divided on the appropriate use and regulation of AI.</div></div><div><h3>Discussion</h3><div>Radiology residency program directors rated LLM-generated personal statements as lower in quality and expressed concern about the loss of the applicant’s voice but acknowledged the inevitability of increased AI use in the generation of application statements.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Pages 33-40"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302711","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":"Seven Challenges in Radiology Practice: From Declining Reimbursement to Inadequate Labor Force: Summary of the 2023 ACR Intersociety Meeting","authors":"Bettina Siewert MD ,&nbsp;Michael A. Bruno MD ,&nbsp;J. Daniel Bourland PhD ,&nbsp;Priscilla J. Slanetz MD, MPH ,&nbsp;Paul Guillerman MD ,&nbsp;Erin S. Schwartz MD ,&nbsp;Harriet J. Paltiel MD ,&nbsp;Ronald Hublall MD ,&nbsp;Olga R. Brook MD ,&nbsp;Mary H. Scanlon MD ,&nbsp;Frank J. Lexa MD, MBA","doi":"10.1016/j.jacr.2024.08.030","DOIUrl":"10.1016/j.jacr.2024.08.030","url":null,"abstract":"<div><div>This summary of the proceedings of the 2023 ACR Intersociety Meeting discusses the seven most important challenges facing radiology today: declining reimbursement, corporatization and consolidation, inadequate labor force, imaging appropriateness, burnout, turf wars with nonphysicians, and workflow efficiency. Participants in the Intersociety Summer Conference-2023 focused their effort on identifying potential solutions given how critical these topics are to the sustainability of the profession.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Pages 129-138"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549390","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":"Editors' Note","authors":"","doi":"10.1016/j.jacr.2024.10.012","DOIUrl":"10.1016/j.jacr.2024.10.012","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 1","pages":"Page 6"},"PeriodicalIF":4.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634225","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}