Zeyad Elias, Usman Tarique, Patrick Veit-Haibach, Ania Z. Kielar
{"title":"Standardizing Multidisciplinary Case Conferences and Improving Communication Between Referring Physicians and Radiologists: A Quality Improvement Initiative","authors":"Zeyad Elias, Usman Tarique, Patrick Veit-Haibach, Ania Z. Kielar","doi":"10.1177/08465371241281055","DOIUrl":"https://doi.org/10.1177/08465371241281055","url":null,"abstract":"Purpose: Assess the effectiveness of standardizing multidisciplinary case conferences (MDCs). Methods: Anonymous electronic surveys gauged opinions of abdominal radiologists engaged in recurring MDCs. A standardized Excel template, following Cancer Care Ontario guidelines and relevant literature, was distributed to MDC managers. Physicians were instructed to send cases 36 hours prior to MDC. Template adherence was assessed at 1.5 and 8 months. A follow-up survey at 4 months evaluated the intervention’s effectiveness. Results: 27/34 abdominal radiologists provided 47 baseline responses, and 12 delegated radiologists provided 23 follow-up responses. “Often/always” being provided the image’s location increased from 36% (17/47) at baseline to 70% (16/23) at follow-up. Non-adherence to the 36-hour cut-off decreased from 36% (16/45) to 17% (4/23). 72% disagreed that uploading remote imaging to hospital servers is easy (33/46), similar to follow-up (18/23, 78%). In assessing the intervention, 41% noted improved standardization (9/22), another 41% considered MDCs already standardized (9/22), and 18% reported no change (4/22). Those reporting no change experienced a higher frequency of non-adherence to the 36-hour cut-off (3/4, 75%) than others (1/18, 6%), and less frequent “often/always” ratings for image location being provided (3/4, 75%) than others (2/18, 11%). 89% (25/28) of MDCs adhered to the template. Issues regarding last-minute add-on cases may be mitigated through EPIC force functions. Artificial intelligence advancements may assist in retrieving external images and patient information. Conclusion: Adherence to MDC standardization was high, allowing for more efficient preparation, potentially reducing radiologist administrative burdens. Future force functions and artificial intelligence integration into electronic patient records may further augment this.","PeriodicalId":517406,"journal":{"name":"Canadian Association of Radiologists Journal","volume":"20 1","pages":"8465371241281055"},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patrick W. O’Regan, James A. O’Regan, Michael M. Maher, David J. Ryan
{"title":"The Emerging Role and Clinical Applications of Morphomics in Diagnostic Imaging","authors":"Patrick W. O’Regan, James A. O’Regan, Michael M. Maher, David J. Ryan","doi":"10.1177/08465371241242763","DOIUrl":"https://doi.org/10.1177/08465371241242763","url":null,"abstract":"Analytic morphomics refers to the accurate measurement of specific biological markers of human body composition in diagnostic medical imaging. The increasing prevalence of disease processes that alter body composition including obesity, cachexia, and sarcopenia has generated interest in specific targeted measurement of these metrics to possibly prevent or reduce negative health outcomes. Typical morphomic measurements include the area and density of muscle, bone, vascular calcification, visceral fat, and subcutaneous fat on a specific validated axial level in the patient’s cross-sectional diagnostic imaging. A distinct advantage of these measurements is that they can be made retrospectively and opportunistically with pre-existing datasets. We provide a narrative review of the current state of art in morphomics, but also consider some potential future directions for this exciting field. Imaging based quantitative assessment of body composition has enormous potential across the breadth and scope of modern clinical practice. From risk stratification to treatment planning, and outcome assessment, all can be enhanced with the use of analytic morphomics. Moreover, it is likely that many new opportunities for personalized medicine will emerge as the field evolves. As radiologists, embracing analytic morphomics will enable us to contribute added value in the care of every patient.","PeriodicalId":517406,"journal":{"name":"Canadian Association of Radiologists Journal","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140613891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cinematic Rendering: A New Look at Pancreatic Neuroendocrine Tumour Imaging","authors":"Philippe Soyer","doi":"10.1177/08465371241247800","DOIUrl":"https://doi.org/10.1177/08465371241247800","url":null,"abstract":"","PeriodicalId":517406,"journal":{"name":"Canadian Association of Radiologists Journal","volume":"299 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140595687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sylvain Bodard, Sylvain Guinebert, Elena N. Petre, Erica Alexander, Brett Marinelli, Debkumar Sarkar, Francois H. Cornelis
{"title":"Percutaneous Lung Biopsies With Robotic Systems: A Systematic Review of Available Clinical Solutions","authors":"Sylvain Bodard, Sylvain Guinebert, Elena N. Petre, Erica Alexander, Brett Marinelli, Debkumar Sarkar, Francois H. Cornelis","doi":"10.1177/08465371241242758","DOIUrl":"https://doi.org/10.1177/08465371241242758","url":null,"abstract":"Objectives: This systematic review aims to assess existing research concerning the use of robotic systems to execute percutaneous lung biopsy. Methods: A systematic review was performed and identified 4 studies involving robotic systems used for lung biopsy. Outcomes assessed were operation time, radiation dose to patients and operators, technical success rate, diagnostic yield, and complication rate. Results: One hundred and thirteen robot-guided percutaneous lung biopsies were included. Technical success and diagnostic yield were close to 100%, comparable to manual procedures. Technical accuracy, illustrated by needle positioning, showed less frequent needle adjustments in robotic guidance than in manual guidance ( P < .001): 2.7 ± 2.6 (range 1-4) versus 6 ± 4 (range 2-12). Procedure time ranged from comparable to reduced by 35% on average (20.1 ± 11.3 minutes vs 31.4 ± 10.2 minutes, P = .001) compared to manual procedures. Patient irradiation ranged from comparable to reduced by an average of 40% (324 ± 114.5 mGy vs 541.2 ± 446.8 mGy, P = .001). There was no significant difference in reported complications between manual biopsy and biopsies that utilized robotic guidance. Conclusion: Robotic systems demonstrate promising results for percutaneous lung biopsy. These devices provide adequate accuracy in probe placement and could both reduce procedural duration and mitigate radiation exposure to patients and practitioners. However, this review underscores the need for larger, controlled trials to validate and extend these findings.","PeriodicalId":517406,"journal":{"name":"Canadian Association of Radiologists Journal","volume":"299 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140595858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sclerotherapy in the Treatment of Hydroceles: A Comprehensive Review of the Efficacy, Types of Sclerosants, and Comparative Outcomes Against Hydrocelectomy","authors":"Sana Rashid, Ajit Kishore, Basil Ahmad, Lorraine Min-Shan Liang, Oleg Mironov, Syed Umair Mahmood","doi":"10.1177/08465371241243271","DOIUrl":"https://doi.org/10.1177/08465371241243271","url":null,"abstract":"While hydrocelectomy is the gold-standard for treating hydroceles, it poses an increased risk to patients and a greater burden to the healthcare system. Sclerotherapy is an alternative treatment for hydroceles that involves injecting a sclerosant into the hydrocele under ultrasound guidance. This literature review aimed to assess the types of sclerosants used and how sclerotherapy compares to hydrocelectomy. A literature search was conducted of MEDLINE and EMBASE using the terms “sclerotherapy” and “hydrocelectomy,” which yielded 1058 studies, of which 29 met the inclusion criteria. Only studies published after 2000 were included to ensure the most recent information was reviewed. The results showed hydrocele sclerotherapy is done using a variety of sclerosants. The most used agents are polidocanol, phenol, and STS. Of these, phenol had the highest clinical success rate of 96.5%. There was evidence for the use of atypical agents, such as tetracycline antibiotics, which yielded cure rates up to 93%, and alcohol, which was found to be especially useful for treating multiseptated hydroceles. The results comparing sclerotherapy to hydrocelectomy indicated hydrocelectomy to be a more effective method in completely curing hydroceles. However, this came at the cost of more complications. Additionally, sclerotherapy was found to be more advantageous for secondary outcomes, such as healthcare costs and burden to patients. In conclusion, this review shows that while hydrocelectomy is more effective, sclerotherapy is a valuable alternative for treating hydroceles. Due to the lack of standardization among studies, a definitive conclusion cannot be made regarding which sclerosant is best to use.","PeriodicalId":517406,"journal":{"name":"Canadian Association of Radiologists Journal","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140595685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hana L. Haver, Manisha Bahl, Florence X. Doo, Peter I. Kamel, Vishwa S. Parekh, Jean Jeudy, Paul H. Yi
{"title":"Evaluation of Multimodal ChatGPT (GPT-4V) in Describing Mammography Image Features","authors":"Hana L. Haver, Manisha Bahl, Florence X. Doo, Peter I. Kamel, Vishwa S. Parekh, Jean Jeudy, Paul H. Yi","doi":"10.1177/08465371241247043","DOIUrl":"https://doi.org/10.1177/08465371241247043","url":null,"abstract":"","PeriodicalId":517406,"journal":{"name":"Canadian Association of Radiologists Journal","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140595985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical Assessment of Magnetic Resonance Spectroscopy and Diffusion-Weighted Imaging in Diffuse Glioma: Insights Into Histological Grading and IDH Classification","authors":"Han-Wen Zhang, Hong-Bo Zhang, Xiao-Lei Liu, Hua-Zhen Deng, Yu-Zhe Zhang, Xu-Mei Tang, Fan Lin, Biao Huang","doi":"10.1177/08465371241238917","DOIUrl":"https://doi.org/10.1177/08465371241238917","url":null,"abstract":"Purpose:To assess the diagnostic utility of clinical magnetic resonance spectroscopy (MRS) and diffusion-weighted imaging (DWI) in distinguishing between histological grading and isocitrate dehydrogenase ( IDH) classification in adult diffuse gliomas.Methods:A retrospective analysis was conducted on 247 patients diagnosed with adult diffuse glioma. Experienced radiologists evaluated DWI and MRS images. The Kruskal-Wallis test examined differences in DWI and MRS-related parameters across histological grades, while the Mann–Whitney U test assessed molecular classification. Receiver Operating Characteristic (ROC) curves evaluated parameter effectiveness. Survival curves, stratified by histological grade and IDH classification, were constructed using the Kaplan–Meier test.Results:The cohort comprised 141 males and 106 females, with ages ranging from 19 to 85 years. The Kruskal-Wallis test revealed significant differences in ADC mean, Cho/NAA, and Cho/Cr concerning glioma histological grade ( P < .01). Subsequent application of Dunn’s test showed significant differences in ADC mean among each histological grade ( P < .01). Notably, Cho/NAA exhibited a marked distinction between grade 2 and grade 3/4 gliomas ( P < .01). The Mann–Whitney U test indicated that only ADC mean showed statistical significance for IDH molecular classification ( P < .01). ROC curves were constructed to demonstrate the effectiveness of the specified parameters. Survival curves were also delineated to portray survival outcomes categorized by histological grade and IDH classification. Conclusions: Clinical MRS demonstrates efficacy in glioma histological grading but faces challenges in IDH classification. Clinical DWI’s ADC mean parameter shows significant distinctions in both histological grade and IDH classification.","PeriodicalId":517406,"journal":{"name":"Canadian Association of Radiologists Journal","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140595861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ulysse Puel, Michael Eliezer, Fatma Boubaker, Nicolas Villani, Bouchra Assabah, Gabriela Hossu, Pedro Augusto Gondim Teixeira, Alain Blum, Cécile Parietti-Winkler, Romain Gillet
{"title":"Effect of Matrix Size and Acquisition Mode on Image Quality and Radiation Dose of Ultra-High-Resolution CT of the Temporal Bone: An Anatomical Study","authors":"Ulysse Puel, Michael Eliezer, Fatma Boubaker, Nicolas Villani, Bouchra Assabah, Gabriela Hossu, Pedro Augusto Gondim Teixeira, Alain Blum, Cécile Parietti-Winkler, Romain Gillet","doi":"10.1177/08465371241234795","DOIUrl":"https://doi.org/10.1177/08465371241234795","url":null,"abstract":"Purpose: To compare image quality and radiation exposure between super- and ultra-high-resolution helical and super-high-resolution volumetric CT of the temporal bone. Methods: Six cadaveric temporal bone specimens were used to evaluate key temporal bone structures using the following CT reconstruction and acquisition modes: helical and single-volume acquisition modes in super-high resolution (0.25-mm slice thickness, 1024<jats:sup>2</jats:sup> matrix), and helical mode in ultra-high resolution (0.25-mm slice thickness, 2048<jats:sup>2</jats:sup> matrix). Two observers performed 5 previously described preoperative measurements, measured noise and signal-to-noise ratios for air, and noise for bone, and rated the visualization of 5 anatomical structures on a 4-point scale, for each reconstruction mode. Radiation dose exposure was recorded for each examination. Results: There was no significant difference between any of the quantitative or qualitative measurements in any of the reconstruction and acquisition modes. There was a slight increase in noise and a decrease in signal-to-noise ratio in the air using the single-volume mode (115 ± 13.1 HU and 8.37 ± 0.91, respectively) compared to the helicoidal super-high-resolution (92.4 ± 11.8 HU and 10.8 ± 1.26, respectively) and helicoidal ultra-high-resolution (91.1 ± 10.7 HU and 10.9 ± 1.39, respectively) modes ( P < .002). The volumic CT dose index was 50.9 mGy with helical acquisition and 29.8 mGy with single-volume acquisition mode ( P < .0001). Conclusion: The single-volume super-high-resolution acquisition mode allows a reduction in radiation dose exposure without compromising image quality compared to helical scanning, but with a slightly lower signal-to-noise ratio in air with the single-volume mode, while there was no difference in image quality between the helical super- and ultra-high-resolution modes.","PeriodicalId":517406,"journal":{"name":"Canadian Association of Radiologists Journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140026653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}