Clinical Imaging最新文献

{"title":"Updates on the MR safety guidelines - Essentials for radiologists.","authors":"Ghazal Zandieh, Iman Yazdaninia, Shadi Afyouni, Ali Borhani, Takeshi Yokoo, Ihab R Kamel","doi":"10.1016/j.clinimag.2024.110394","DOIUrl":"10.1016/j.clinimag.2024.110394","url":null,"abstract":"<p><p>Magnetic Resonance Imaging (MRI) is a sophisticated diagnostic tool that utilizes the magnetic properties of biological tissue to generate detailed images of internal structures without the use of ionizing radiation. Despite its benefits in providing high-contrast images of soft tissues, the strong magnetic fields used in MRI present a unique safety challenge. Increasing MRI-related accidents and the prevalence of patients with metallic implants in recent years underscore the critical need for stringent MR safety protocols. This article reviews the latest 2024 updates in the MRI safety manual by the American College of Radiology (ACR), highlighting the comprehensive efforts to manage risks associated with MRI, including projectile and burn incidents, patients with medical devices, and emerging complex MRI environments. The manual emphasizes the importance of specialized training for healthcare professionals to navigate the complexities of MRI safety to ensure patient and staff safety. This review also touches on the dynamic landscape of MRI safety standards, driven by technological advances and evolving clinical practices, aiming to provide a thorough understanding of current best practices in MRI safety management. LIST OF UPDATES.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"118 ","pages":"110394"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing breast cancer screening through information-theoretic approaches and AI.","authors":"Sultan Alam","doi":"10.1016/j.clinimag.2024.110384","DOIUrl":"10.1016/j.clinimag.2024.110384","url":null,"abstract":"","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"118 ","pages":"110384"},"PeriodicalIF":1.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of renal cell carcinoma with ablation in comparison to nephrectomy: A 5-year analysis of inpatient procedural data to evaluate utilization disparities in the United States.","authors":"Tarig S Elhakim, Taha Lodhi, Wilton Fidelis, Allison Brea, Ana Mort, Maryam Mohagheghtabar, Azadeh Tabari, Samuel R Davis, Raul N Uppot, Ronald S Arellano, Michael Dezube, Dania Daye","doi":"10.1016/j.clinimag.2025.110412","DOIUrl":"https://doi.org/10.1016/j.clinimag.2025.110412","url":null,"abstract":"<p><strong>Purpose: </strong>To perform a nationwide analysis of ablation compared to partial and total nephrectomy for the management of renal cell carcinoma (RCC) to evaluate utilization trends and disparities in the USA.</p><p><strong>Materials and methods: </strong>The 2016-2020 National Inpatient Sample was analyzed. Using ICD-10, we identified the diagnosis of RCC then analyzed the utilization trends of ablation and nephrectomies (both partial and complete). To determine if any disparities exist, a multivariate logistic regression was performed to assess the influence of age, sex, race, income, payer, illness severity, geographical location, and hospital factors.</p><p><strong>Results: </strong>From the 183,885 inpatient encounters with RCC, 3045 (1.65 %) underwent ablation, 70,080 (38.1 %) underwent partial nephrectomy, and 110,760 (60.2 %) underwent total nephrectomy. There was no significant difference in the sex between all groups. There was a statistically significant difference in the mean age of those undergoing ablation (67.30, SD = 12.05) versus those undergoing partial nephrectomy (59.27, SD = 13.26) and total nephrectomy (62.22, SD = 14.42) (OR: 1.04, 95%CI: 1.03-1.05, P < 0.001). Compared to White patients, Hispanic and African Americans were more likely to undergo ablation versus nephrectomy (OR: 1.52, 95%CI: 1.16-1.98, P = 0.002 and OR: 1.65, 95%CI: 1.28-2.13, P < 0.001, respectively). Compared to patients on private insurance, those on Medicaid and Medicare were more likely to have ablation than nephrectomy (OR: 1.85, 95%CI: 1.31-2.61, P < 0.001, and OR: 1.62, 95%CI: 1.26-2.08, P < 0.001, respectively). Furthermore, patients were less likely to undergo ablation than nephrectomies in 2020 compared to 2016 (OR: 0.69, 95%CI: 0.53-0.90, P = 0.006).</p><p><strong>Conclusion: </strong>Since 2016, there has been a decreasing trend in the use of ablation for treating RCC in hospitalized patients. Those undergoing ablation tend to be older, African American, Hispanic, and insured by Medicare or Medicaid. Further research is needed to ensure equitable access for optimal treatment of RCC.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"110412"},"PeriodicalIF":1.8,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"There is no \"I\" in team: Implications for academic radiology.","authors":"Steven P Rowe, Jennifer A Schroeder, Linda C Chu, Elliot K Fishman","doi":"10.1016/j.clinimag.2025.110411","DOIUrl":"https://doi.org/10.1016/j.clinimag.2025.110411","url":null,"abstract":"<p><p>All of us must find the right balance between team science and fostering leadership with dynamic colleagues. That dichotomy was well-encapsulated in a famous exchange between basketball players Shaquille O'Neal and Kobe Bryant regarding there \"being no 'I' in team\". In our view, there is nothing more satisfying than collaborating with a team of people and publishing impactful papers or making key discoveries. At the same time, there are innumerable instances of collaborations stumbling along and the team failing to gel in a meaningful way. Strong leaders may be very important to propagating the overall team approach. Those leaders may be acknowledging that the team is composed of individuals who all bring something to the table. In this way, a diversity of backgrounds of the individual teammates makes the team stronger. The key, of course, is to find the right team and build within that team a strong foundation. Ultimately, we need to emphasize the importance of both team science and individual excellence in our work. In this manuscript, we will emphasize that as scientific endeavor continues to become more complex, leveraging diverse teams will be increasingly important - but also that team success cannot come at the expense of the uniquely talented individual.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"110411"},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the ink: Marking the skin with henna through ultrasound gel.","authors":"Samuel Jang, Brooke E Willborg, Gina K Hesley, Nathan J Brinkman, Nho V Tran, Matthew W Urban, Christine U Lee","doi":"10.1016/j.clinimag.2025.110410","DOIUrl":"https://doi.org/10.1016/j.clinimag.2025.110410","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate henna as a durable skin marker on various skin tones for sonographic targeting and to identify the shortest duration of henna application needed for practical clinical workflow.</p><p><strong>Materials and methods: </strong>Prospective study applying seven henna lines through ultrasound (US) gel on the forearms of 15 healthy participants equally represented across the validated six-color bar tool. Color bar categories 1-2, 3-4, and 5-6 were designated low, moderate, and high-melanin groups, respectively. Each subsequent line was applied with staining wait-times ranging from 10 to 480 s. Serial photographs were obtained after scrubbing with chlorhexidine every 2-3 days with the number of clearly visible lines assessed by participants, by individual and consensus physician reads, and by band intensity quantification.</p><p><strong>Results: </strong>Henna could be applied through US gel and the markings were resistant to chlorhexidine scrubbing. Staining wait-times for 60, 120, and 240 s resulted in visible lines for 6, 8, and 10 days (low-melanin), 5, 6, and 8 days (moderate-melanin), and 2, 3, and 4 days (high-melanin). No lines were visible on day 13 for most participants in the low or moderate-melanin groups and on day 6 on most participants in the high-melanin group. The marking intensities decreased more quickly in the moderate-melanin group compared the low-melanin group.</p><p><strong>Conclusion: </strong>Henna is an effective skin marker that can be applied through US gel where short staining wait-times result in markings lasting several days. To achieve the same durability, staining wait-times are about double for high-melanin skin tones compared to low or moderate-melanin skin tones.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"110410"},"PeriodicalIF":1.8,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance and clinical outcomes of computed tomography colonography in a sick inpatient population.","authors":"Jessica T Lovett, Chenchan Huang, Vinay Prabhu","doi":"10.1016/j.clinimag.2025.110401","DOIUrl":"https://doi.org/10.1016/j.clinimag.2025.110401","url":null,"abstract":"<p><strong>Purpose: </strong>Though prior studies have proven CTC's efficacy in outpatients, its utility in the inpatient setting has not been studied. We evaluated the efficacy of a modified CTC protocol in the inpatient setting, primarily for patients awaiting organ transplantation.</p><p><strong>Methods: </strong>This retrospective study compared a group of inpatient CTCs from 2019 to 2021 and a randomly selected, age-matched 2:1 control group of outpatient CTCs. Both groups were assessed based on established criteria from literature.</p><p><strong>Results: </strong>10 % (63/652) of CTCs were performed in the inpatient setting, of which 29 were excluded, yielding 34 inpatient cases. 90 % (589/652) of CTCs were performed in the outpatient setting, from which 68 randomly selected, age-matched patients were selected as controls. Significantly more (24 %, 8/34) inpatients expired due to extracolonic causes (vs. 1 %, 1/68 outpatients, p < 0.05). 62 % (21/34) of inpatient CTCs were reported as diagnostic (vs. 74 %, 50/68 outpatient, p = 0.22). Significantly more inpatients (12 %, 4/34) than outpatients (1 %, 1/68) were unable to tolerate two imaging positions (p = 0.02). Subsequent colonoscopy was performed in 24 % (8/34) of inpatients, revealing pathologies including colonic polyps and non-bleeding ulcers. Inpatient CTCs had lower average quality scores, significant for one reviewer (p = 0.009-0.054). Inpatients had a larger number of segments with: >25 % residual fluid (1.22-1.28 inpatients vs. 0.60-0.73 outpatients, p = 0.003-0.026) and inadequate fluid tagging (1.10 inpatients vs. 0.49 outpatients, p = 0.046-0.0501). Distention was not significantly different between groups (p = 0.317-0.410).</p><p><strong>Conclusion: </strong>Quality of inpatient CTC was inferior to outpatient CTCs across several metrics. 24 % undergoing inpatient CTC died of extracolonic causes within 22 months, and most did not have findings warranting intervention, questioning the value of this difficult exam in this patient population. Routine CT may be sufficient to exclude large or metastatic colonic lesions precluding transplant.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"110401"},"PeriodicalIF":1.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"4D flow cardiac magnetic resonance in pediatric congenital heart disease: Insights from over four years of clinical practice.","authors":"Kerstin Lagerstrand, Pär-Arne Svensson, Linnea Andersson, Anna Nyström, Frida Dangardt, Charlotte de Lange","doi":"10.1016/j.clinimag.2024.110399","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110399","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart diseases (CHDs) are common birth defects. This work presents over four years of clinical experience of 4D flow cardiovascular magnetic resonance (CMR), highlighting its value for pediatric CHD.</p><p><strong>Methods: </strong>Children with various CHD diagnoses (n = 298) were examined on a 1.5 or 3 T scanner using 4D flow CMR in free breathing with respiratory compensation. The image volume was acquired in axial orientation, covering the entire heart and major vessels. Head-to-head comparisons with reference standards were systematically performed.</p><p><strong>Results: </strong>4D flow CMR provided more detailed insights into complex cardiovascular conditions while maintaining a comparable level of accuracy in peak velocity, Q and Qp/Qs (R = 0.9-1.0) compared to conventional 2D flow CMR. The advantages of 4D flow CMR were particularly evident for valve function, stenosis, and shunt assessments. However, our findings emphasize the need for additional corrections to address partial volume (up to 180 % error in perfusion ratio) and through-plane cardiac motion effects (up to 25/10 ml error in aortic/pulmonary regurgitation volume).</p><p><strong>Conclusion: </strong>Overall, 4D flow CMR proved to be a comprehensive diagnostic tool that enhanced the understanding and management of pediatric CHD, potentially changing the course of the treatment.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"110399"},"PeriodicalIF":1.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications related to radiofrequency ablation of lung tumors: CT findings and review.","authors":"José Guilherme Marranghello Maluf, José de Arimateia Batista Araujo-Filho, Guilherme Lopes Pinheiro Martins, Marcos Roberto Menezes, Tassia Regina Yamanari","doi":"10.1016/j.clinimag.2024.110396","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110396","url":null,"abstract":"<p><p>Radiofrequency ablation is a treatment option for primary and secondary lung tumors, particularly in non-surgical patients. Although it is considered a safe and effective procedure, various complications can occur. Most of these adverse events are self-limiting and can be treated conservatively; however, some may be severe and require intervention. Radiologists play a pivotal role in the diagnosis and follow-up of these conditions, aiding in their early identification and management in clinical practice. They must be familiar with the expected and unexpected imaging post-procedure features. This article reviews the main complications of radiofrequency ablation of lung tumors and their associated CT findings.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"110396"},"PeriodicalIF":1.8,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing patient viewership of complex imaging reports: The paradox of the Cures Act.","authors":"Kanhai S Amin, Melissa A Davis, Amir Naderi, Howard P Forman","doi":"10.1016/j.clinimag.2024.110398","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110398","url":null,"abstract":"<p><strong>Background: </strong>As a result of the 21st Century Cures Act, radiology reports are immediately released to patients. We determine if readers of radiology reports, via electronic health records (EHRs), and radiology report complexity have changed post the implementation of the 21st Century Cures Act.</p><p><strong>Methods: </strong>A retrospective observational study was used to analyze 10,000 radiology reports (equal split of CT, mammogram, MRI, X-ray, and ultrasound modalities) per year between 2013 and 2023. Readability was calculated through reading grade level indices.</p><p><strong>Results: </strong>Patient viewership of their radiology reports via EHRs increased from 3.3 % (95 % CI: 3.0 %-3.7 %) in 2013 to 58.2 % (95 % CI: 57.3 %-59.2 %) in 2023. Once the 21st Century Cures Act's Information Blocking Provision went into effect, there was a significant increase in viewing probability with patients having 1.71 times higher odds of viewing their reports (OR = 1.71, 95 % CI: 1.27-2.32, p < 0.001). This increase in patient viewership held for all modalities tested except CT (P < 0.01). Despite increased viewership, the reading grade level of radiologist dictated radiology reports was greater than the recommended level for health information across all years and modalities tested.</p><p><strong>Conclusions and relevance: </strong>Patients are increasingly engaging with their radiology reports, but reports may be too complex for the typical patient. Solutions will be required to improve patient experience with their radiology reports.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"110398"},"PeriodicalIF":1.8,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between price transparency and patient decision to complete outpatient imaging.","authors":"Ali Rashidi, Thao Pham, Aldo Arce, Diya Garg, Gelareh Sadigh","doi":"10.1016/j.clinimag.2024.110397","DOIUrl":"https://doi.org/10.1016/j.clinimag.2024.110397","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of price transparency on patients' decisions to receive the recommended care is unclear. This study aimed to assess the utilization rate of hospital price estimator tools for outpatient imaging appointments, and the association between price estimator utilization and subsequent imaging completion.</p><p><strong>Methods: </strong>In this retrospective, cross-sectional study, adult patients with scheduled outpatient radiology examinations between August 2022 and 2023 at a single tertiary academic health system were included. Data regarding whether an out-of-pocket cost (OOPC) estimate was generated for the scheduled imaging exam, the estimate generation date, amount, generator (patient vs. staff), the date of first view by patients, appointment status (completed vs. missed appointment), and demographics were extracted. The association between price estimator use and imaging completion was assessed using generalized estimation equation multivariable regression models.</p><p><strong>Results: </strong>A total of 470,422 imaging encounters (mean age: 55.6 ± 19.1; 57.5 % female; 56.3 % white) were included. Overall, 70,437 (15.0 %) OOPC estimates were generated (99.9 % by hospital staff and 0.1 % by patients). There was a higher number of self-pay patients among those with self-generated (55.8 %) vs. staff-generated (8.9 %) estimates (P < 0.001). The odds of imaging appointment completion were significantly higher when an OOPC estimate was generated (OR,1.91; 95 % CI, 1.87, 1.95), and significantly lower when the estimate was self-generated (OR,0.29; 95%CI, 0.17, 0.51).</p><p><strong>Conclusion: </strong>Price-aware patients with staff-generated cost estimates were more likely to complete imaging. Self-pay patients were more likely to self-generate estimates, which was associated with lower likelihood of completing imaging.</p>","PeriodicalId":50680,"journal":{"name":"Clinical Imaging","volume":"119 ","pages":"110397"},"PeriodicalIF":1.8,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}