Journal of the American College of Radiology最新文献

{"title":"Diagnostic Accuracy of Cone-Beam CT for Acute Intracranial Hemorrhage: A Systematic Review and Meta-Analysis","authors":"Nicholas G. Ferrone ,&nbsp;Maria X. Sanmartin PhD ,&nbsp;Joseph O’Hara ,&nbsp;Jean Jimenez ,&nbsp;Sophia R. Ferrone ,&nbsp;Zachary Lodato DO ,&nbsp;Gregory Lacher MD ,&nbsp;Sanjana Bandi MD ,&nbsp;Alicia Convey ,&nbsp;Mehrad Bastani PhD ,&nbsp;Un Jung Lee PhD ,&nbsp;Jaclyn Morales Vialet ,&nbsp;Timothy White MD ,&nbsp;Jason J. Wang PhD ,&nbsp;Jeffrey M. Katz MD ,&nbsp;Pina C. Sanelli MD, MPH","doi":"10.1016/j.jacr.2024.07.026","DOIUrl":"10.1016/j.jacr.2024.07.026","url":null,"abstract":"<div><h3>Objective</h3><div>Our purpose was to synthesize evidence in the literature to determine the diagnostic accuracy of cone-beam CT (CBCT) for the detection of intracranial hemorrhage (ICH) and hemorrhage types, including intraparenchymal hemorrhage (IPH), subarachnoid hemorrhage (SAH), and intraventricular hemorrhage (IVH).</div></div><div><h3>Methods</h3><div>We performed a meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Our protocol was registered with International Prospective Register of Systematic Reviews (PROSPERO-CRD42021261915). Systematic searches were last performed on April 30, 2024, in EMBASE, PubMed, Web-of-Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases. Inclusion criteria were (1) studies reporting diagnostic metrics of CBCT for ICH and (2) studies using a reference standard to determine ICH. Exclusion criteria were (1) case reports, abstracts, reviews and (2) studies without patient-level data. Pooled estimates and 95% confidence intervals (CIs) were calculated for diagnostic odds ratios (DORs), sensitivity, and specificity using random-effects and common-effects models. Mixed methods appraisal tool was used to evaluate risk of bias.</div></div><div><h3>Results</h3><div>Seven studies were included in the meta-analysis yielding 466 patients. Mean or median age ranged from 54 to 75 years. Female patients represented 51.4% (222 of 432) in reported studies. Multidetector CT was the reference standard in all studies. DOR, pooled sensitivity, and pooled specificity for ICH were 5.28 (95% CI: 4.11-6.46), 0.88 (95% CI: 0.79-0.97), and 0.99 (95% CI: 0.98-1.0). Pooled sensitivity for IPH, SAH, and IVH was 0.98 (95% CI: 0.95-1.0), 0.82 (95% CI: 0.57-1.0), and 0.78 (95% CI: 0.55-1.0). Pooled specificity for IPH, SAH, and IVH was 0.99 (95% CI: 0.98-1.0), 0.99 (95% CI: 0.97-1.0), and 1.0 (95% CI: 0.98-1.0).</div></div><div><h3>Discussion</h3><div>CBCT had moderate DOR and high pooled specificity for ICH and hemorrhage types. However, pooled sensitivity varied by hemorrhage type, with the highest sensitivity for IPH, followed by SAH and IVH.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Pages 1841-1850"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989666","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":"CT Pulmonary Angiogram Clinical Pretest Probability Tool: Impact on Emergency Department Utilization","authors":"Rachel P. Rosovsky MD, MPH ,&nbsp;Mark Isabelle BA ,&nbsp;Nooshin Abbasi MD, MPH ,&nbsp;Nicole Vetrano MHA ,&nbsp;Sanjay Saini MD ,&nbsp;Sayon Dutta MD, MPH ,&nbsp;David Lucier MD ,&nbsp;Amita Sharma MD ,&nbsp;Andetta Hunsaker MD ,&nbsp;Stanley Hochberg MD ,&nbsp;Ali S. Raja MD, MPH, MBA ,&nbsp;Ramin Khorasani MD, MPH ,&nbsp;Ronilda Lacson MD, PhD","doi":"10.1016/j.jacr.2024.07.024","DOIUrl":"10.1016/j.jacr.2024.07.024","url":null,"abstract":"<div><h3>Objective</h3><div>Currently, CT pulmonary angiogram (CTPA) for evaluating acute pulmonary embolism (PE) in emergency departments (EDs) is overused and with low yields. The goal of this study is to assess the impact of an evidence-based clinical decision support (CDS) tool, aimed at optimizing appropriate use of CTPA for evaluating PE.</div></div><div><h3>Methods</h3><div>The study was performed at EDs in a large health care system and included nine academic and community hospitals. The primary outcome was the percent difference in utilization (number of CTPAs performed per number of ED visits) and secondary outcome was yield (percentage of CTPAs positive for acute PE), comparing 12 months before (June 1, 2021, to May 31, 2022) versus 12 months after (June 1, 2022, to May 31, 2023) a systemwide implementation of the CDS. Univariate and multivariable analyses using logistic regression were performed to assess factors associated with diagnosis of acute PE. Statistical process control charts were used to assess monthly trends in utilization and yield.</div></div><div><h3>Results</h3><div>Among 931,677 visits to EDs, 28,101 CTPAs were performed on 24,675 patients. In all, 14,825 CTPAs were performed among 455,038 visits (3.26%) pre-intervention and 13,276 among 476,639 visits (2.79%) postintervention, a 14.51% relative decrease in CTPA utilization (χ², <em>P</em> &lt; .001). CTPA yield remained unchanged (1,371 of 14,825 = 9.25% pre- versus 1,184 of 13,276 = 8.92% postintervention; χ², <em>P</em> = .34). Patients with coronavirus disease of 2019 diagnosis before CTPA had higher probability of acute PE. Statistical process control charts demonstrated seasonal variation in utilization (Friedman test, <em>P</em> = .047).</div></div><div><h3>Discussion</h3><div>Implementing a CDS based on validated decision rules was associated with a significant reduction in CTPA utilization. The change was immediate and sustained for 12 months postintervention.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Pages 1851-1861"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972417","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":"Reinvesting in the Next Generation of Physician Scientists and Educators in Radiology","authors":"Priscilla J. Slanetz MD, MPH ,&nbsp;Steven J. Cajamarca MD, PhD ,&nbsp;Ana P. Lourenco MD ,&nbsp;Neil M. Rofsky MD, MHA","doi":"10.1016/j.jacr.2024.08.004","DOIUrl":"10.1016/j.jacr.2024.08.004","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Pages 1904-1906"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001514","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®: Evaluation of the Symptomatic Male Breast","authors":"Avani Shinde MD ,&nbsp;Saadiya Sehareen DO","doi":"10.1016/j.jacr.2024.04.020","DOIUrl":"10.1016/j.jacr.2024.04.020","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Page e101"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917640","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":"The Potential of Large Language Models for Radiology Report Simplification and Translations","authors":"Satvik Tripathi ,&nbsp;Farouk Dako MD, MPH","doi":"10.1016/j.jacr.2024.06.004","DOIUrl":"10.1016/j.jacr.2024.06.004","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Pages 1896-1897"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332687","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":"Improving Efficiencies While Also Delivering Better Health Care Outcomes: A Role for Large Language Models","authors":"Shivdev K. Rao MD ,&nbsp;Elliot K. Fishman MD ,&nbsp;Ryan C. Rizk BS ,&nbsp;Linda C. Chu MD ,&nbsp;Steven P. Rowe MD, PhD","doi":"10.1016/j.jacr.2024.01.003","DOIUrl":"10.1016/j.jacr.2024.01.003","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Pages 1913-1915"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139460589","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":"The Importance of Experiential Learning in Inspiring and Preparing the Next Generation","authors":"Nick Bayer BS ,&nbsp;Elliot K. Fishman MD ,&nbsp;Steven P. Rowe MD, PhD ,&nbsp;Linda C. Chu MD ,&nbsp;Elias Lugo-Fagundo BS","doi":"10.1016/j.jacr.2023.12.019","DOIUrl":"10.1016/j.jacr.2023.12.019","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Pages 1916-1918"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139072125","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":"Radiology Readiness for Monkeypox: Correspondence","authors":"Rujittika Mungmunpuntipantip PhD,&nbsp;Viroj Wiwanitkit MD","doi":"10.1016/j.jacr.2022.12.025","DOIUrl":"10.1016/j.jacr.2022.12.025","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Page 1837"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139669601","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":"Improving Workflow Efficiency at an Outpatient MRI Imaging Facility: A Case Study","authors":"Min Lang MD, MSc ,&nbsp;Wei-Ching Lo PhD ,&nbsp;Andrew Sharp MS ,&nbsp;Sean P. Hartmann MS ,&nbsp;Oleg S. Pianykh PhD ,&nbsp;Lauren M. Melski MHA ,&nbsp;Jeremy A. Herrington MHA ,&nbsp;Robert Sellers BS ,&nbsp;Vibhas Deshpande PhD ,&nbsp;Bryan Clifford PhD ,&nbsp;James A. Brink MD ,&nbsp;Jad S. Husseini MD ,&nbsp;Mukesh G. Harisinghani MD ,&nbsp;Susie Y. Huang MD, PhD","doi":"10.1016/j.jacr.2024.06.007","DOIUrl":"10.1016/j.jacr.2024.06.007","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Pages 1875-1879"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441204","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":"Social Constructionism in Radiology: An Introduction","authors":"Subha Ghosh MD, MBA ,&nbsp;James Stoller MD, MS","doi":"10.1016/j.jacr.2024.07.006","DOIUrl":"10.1016/j.jacr.2024.07.006","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 12","pages":"Pages 1910-1912"},"PeriodicalIF":4.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735901","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}