Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes最新文献

{"title":"Short- and Long-Term Outcomes and Catheter Durability After Venting Percutaneous Transesophageal Gastrostomy in Palliative Malignant Bowel Obstruction.","authors":"Alfredo Páez-Carpio, Romman Nourzaie, Matthew Squire, Elizabeth David, Chris Dey, Robyn Pugash, Gilbert Maroun","doi":"10.1177/08465371261437627","DOIUrl":"10.1177/08465371261437627","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical effectiveness, safety, and catheter durability of venting percutaneous transesophageal gastrostomy (PTEG) in patients with malignant bowel obstruction (MBO) who were not candidates for percutaneous gastrostomy (PG).</p><p><strong>Materials and methods: </strong>This retrospective single-center study included 47 patients with MBO who underwent PTEG between 2018 and 2025. Outcomes included technical success, >72 hours clinical outcomes, paired pre-post analysis of nausea and vomiting severity, changes in antiemetic and opioid use, >72 hours catheter performance, and survival. Time-to-event analyses were performed using Kaplan-Meier estimates for overall survival and catheter event-free survival. Procedure-related adverse events were classified using the CIRSE system.</p><p><strong>Results: </strong>Technical success was achieved in all patients and clinical success within 72 hours occurred in 90.9%. Nausea and vomiting prevalence decreased from 87.2% to 8.5% and 4.3%, respectively (<i>P</i> < .001), with parallel reductions in antiemetic (87.2%-8.5%) and opioid use (53.2%-12.8%; <i>P</i> < .001). Catheter dysfunction occurred in 22.7% of patients. Median overall survival was 52.0 days (95% CI: 38.0-245.0), and median catheter event-free survival was 212 days (95% CI: 65-not reached). Mean overall survival was 136.2 days (95% CI: 75.5-196.8), while mean catheter event-free survival was 229.9 days (95% CI: 131.3-328.6). No major adverse events (CIRSE grade ≥3) were observed.</p><p><strong>Conclusion: </strong>Venting PTEG demonstrated favorable short- and long-term clinical outcomes in patients with MBO who were unsuitable for PG.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"765-774"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730825","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 Quality of Life in Terminal Patients With Malignant Bowel Obstruction: A Feasible, Safe and Successful Interventional Radiological Technique.","authors":"Adrian P Brady","doi":"10.1177/08465371261451136","DOIUrl":"10.1177/08465371261451136","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"625-626"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950230","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":"Contemporary Leadership in Radiology: Transitioning From Hierarchical Models to Distributive Servant Leadership.","authors":"Philippe Soyer, Marie-Pierre Revel","doi":"10.1177/08465371261451132","DOIUrl":"10.1177/08465371261451132","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"619-620"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950228","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":"CAR/CAIR Practice Guidelines: Periprocedural Management of Patient Bleeding Risk.","authors":"Kelly Harper, Casey Hurrell, Ashish Gupta, Rohan Parab, Louis-Martin Boucher, Menaka Pai, Rita Selby, Jeannie Callum, Alexandre Menard","doi":"10.1177/08465371261433905","DOIUrl":"10.1177/08465371261433905","url":null,"abstract":"<p><p>These practice guidelines, developed by the Canadian Association for Interventional Radiology (CAIR) and the Canadian Association of Radiologists (CAR) with input from hematology experts, provide evidence informed, practical recommendations for managing bleeding risk during image guided procedures. Building on the 2019 Society of Interventional Radiology guideline, they streamline decision making around anticoagulation, antiplatelet therapy, laboratory testing, and transfusion thresholds for use across Canadian radiology departments. A systematic review of post 2019 evidence and expert consensus-informed updates to procedural risk stratification and clarified INR and platelet thresholds. The guidance emphasizes that most radiologic procedures carry very low bleeding risk and generally do not require routine laboratory screening or interruption of anticoagulant or antiplatelet medications, while high risk procedures warrant targeted testing and standardized transfusion thresholds, including those tailored for chronic liver disease. Special sections address lumbar puncture, arterial access, and urgent or emergent procedures. Overall, the guideline highlights individualized clinical judgment, avoidance of unnecessary delays or consultations, and careful consideration of transfusion risks, with the goal of promoting streamlined, safe, and consistent care across Canadian imaging practices.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"637-650"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655425","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":"Predictors of Repeat Nondiagnostic Cytology in Thyroid Fine-Needle Aspiration.","authors":"Felipe Castillo, Monica Tafur, Chantelle Lin, Pascal Tyrrell, Paraskevi A Vlachou, Matias Callejas Canepa","doi":"10.1177/08465371261442120","DOIUrl":"10.1177/08465371261442120","url":null,"abstract":"<p><strong>Introduction: </strong>Nondiagnostic results after thyroid fine-needle aspiration (FNA) are common and may delay diagnosis.</p><p><strong>Purpose: </strong>To identify demographic and sonographic predictors of nondiagnostic cytology at repeat thyroid FNA and to report malignancy rates in this group.</p><p><strong>Materials and methods: </strong>Single-center retrospective cohort including consecutive adult patients who underwent repeat ultrasound-guided FNA of thyroid nodules with prior nondiagnostic cytology (Bethesda I) between 2015 and 2023. Nodule-level ultrasound features were extracted from structured reports. The primary outcome was nondiagnostic cytology at repeat FNA. Multivariable logistic regression with generalized estimating equations was used to account for clustering of nodules.</p><p><strong>Results: </strong>A total of 208 patients with 242 thyroid nodules were included. On repeat FNA, 77 of 242 nodules (31.8%) remained nondiagnostic. In multivariable analysis, older age (odds ratio [OR] per year, 1.03) and nodule composition were independently associated with a nondiagnostic result at repeat FNA. Solid nodules had lower odds of a nondiagnostic result than cystic or mixed cystic-solid nodules (OR, 0.30). Patient sex, maximum diameter, echogenicity, echogenic foci, calcifications, shape, and margins showed no significant association. Cytology suspicious for or diagnostic of malignancy (Bethesda V-VI) was found in 4 nodules (1.6%); however, this estimate may be affected by verification bias.</p><p><strong>Conclusion: </strong>Approximately one-third of nodules remained nondiagnostic at repeat FNA. Older age and cystic or mixed nodule composition were independently associated with a higher risk of repeat nondiagnostic cytology. Alternative diagnostic strategies (eg, rapid on-site evaluation, core-needle biopsy, or surveillance) can be considered early in the diagnostic workup of these nodules.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"727-733"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789771","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":"Geographic and Sex Distribution of LI-RADS Research Globally: A Cross-Sectional Meta-Research Study.","authors":"Hoda Osman, Eric Lam, Christian B van der Pol, Hala Talal Mahdi, Rawan Awad, Nabil Islam, Mostafa Alabousi, Jean-Paul Salameh, Mustafa R Bashir, Andreu F Costa, Haresh Naringrekar, Justin Presseau, An Tang, Matthew D F McInnes","doi":"10.1177/08465371261429344","DOIUrl":"10.1177/08465371261429344","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC) has an uneven global distribution and a higher incidence in males. The Liver Imaging Reporting and Data System (LI-RADS) is a standardized imaging framework for HCC diagnosis. It is unclear whether the evidence used to inform LI-RADS reflects the global burden of HCC.</p><p><strong>Purpose: </strong>To determine whether the geographic and sex distribution of studies assessing LI-RADS and those included in the LI-RADS individual participant data (IPD) database reflect the global burden of HCC.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional meta-research study comparing the country- and sex-specific HCC prevalence from GLOBOCAN 2022 with the distribution of studies eligible for and included in the LI-RADS IPD database. Studies were identified through a systematic search of 4 databases.</p><p><strong>Study protocol: </strong><u>OSF page</u>.</p><p><strong>Results: </strong>We identified 470 eligible studies including 98 014 patients; of these, 76 studies comprising 11 924 patients were included in the IPD database. Asian and African countries, excluding Republic of Korea, were underrepresented in both the eligible and the IPD dataset. North America was overrepresented. Female patients were under-represented in LI-RADS eligible studies (<i>Z</i> = -21.95, <i>P</i> < .0001) and in studies included in the IPD (<i>Z</i> = -9.02, <i>P</i> < .0001) compared to the global prevalence of HCC in females.</p><p><strong>Conclusion: </strong>LI-RADS research is disproportionately reported from some countries relative to HCC burden. Asia, Africa, and female patients remain underrepresented. This may affect the generalizability and diagnostic equity of the LI-RADS system and underscore the need for improved global inclusivity in LI-RADS research.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"651-660"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAR/BRC Recommendations for Management of Axillary Lymphadenopathy Following COVID-19 Vaccination.","authors":"Carolyn Flegg, Aleksandra Barczak, Samantha Fienberg, Rachel Fleming, Connie Hapgood, Rakhshan Kamran, Wade Koberstein, Saly Zahra, Michelle Zhang","doi":"10.1177/08465371261450192","DOIUrl":"10.1177/08465371261450192","url":null,"abstract":"<p><p>Axillary lymphadenopathy following vaccination has long been recognized as a benign, self-limited immune response, but its increased frequency during the COVID 19 vaccination campaign created diagnostic uncertainty and contributed to delays in breast imaging and unnecessary follow-up. Early conservative guidance, issued in the context of limited evidence, led to postponed screening examinations and increased patient anxiety. Since then, robust prospective and longitudinal data have demonstrated an extremely low, near-zero risk of malignancy in asymptomatic patients with isolated ipsilateral axillary lymphadenopathy following recent COVID 19 vaccination and no suspicious breast imaging findings, even when lymphadenopathy persists for many months. In response to this evolving evidence base, the Canadian Association of Radiologists (CAR) and Breast Radiologists of Canada (BRC) have developed updated, evidence-based recommendations for the management of axillary lymphadenopathy following COVID 19 vaccination. These recommendations emphasize that breast imaging examinations should not be delayed because of vaccination, outline the importance of documenting vaccination history, and provide clear guidance for classifying and managing ipsilateral, contralateral, palpable, and persistent lymphadenopathy across breast imaging modalities. Special considerations for patients with a personal history of breast cancer or other malignancies are also addressed. Adoption of these recommendations is intended to promote consistent national practice, reduce unnecessary imaging and biopsy, support patient reassurance, and maintain the effectiveness of breast cancer screening programs.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"670-673"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148007624","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 Radiology Workforce Crisis Through Early Exposure.","authors":"Charlotte J Yong-Hing, Tremayne Peart, Michael N Patlas, Jeffrey Hu","doi":"10.1177/08465371261436267","DOIUrl":"10.1177/08465371261436267","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"613-614"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147534605","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":"Building Purpose-Driven Radiology Departments: Distributive and Servant Leadership in Action.","authors":"Rakhshan Kamran, Michael N Patlas, Matthew Cecere, Andrea S Doria","doi":"10.1177/08465371261437071","DOIUrl":"10.1177/08465371261437071","url":null,"abstract":"<p><p>Radiology is increasingly defined by interdependence: imaging value is created through tightly coupled relationships among radiologists, technologists, nurses, physicists, administrators, and referring clinicians, under escalating expectations for access, safety, quality, and timeliness. In this context, leadership is a department-wide capability that must be deliberately designed, taught, and sustained. Drawing on distributive leadership and servant leadership literatures, we propose a radiology-specific synthesis, that decentralizes problem-solving while maintaining accountability, and positions leaders as multipliers who build others' competence, agency, and voice. We review why \"heroic\" leadership models predictably fail in complex adaptive clinical environments; summarize the empirical foundations of distributive and servant leadership; and translate these concepts into operational practices for radiology departments. This includes decision-rights design, meeting architecture, psychological safety, inclusive leadership, mentorship and sponsorship systems, and leadership development pathways for trainees and early-career faculty. We then examine 2 contemporary leadership stress tests: workforce sustainability (burnout, boreout, moral distress, hybrid work) and digital transformation (AI governance), arguing that both are best understood as organizational design challenges rather than individual resilience deficits or technology procurement exercises. Finally, we outline pragmatic metrics and evaluation approaches that align leadership behaviours with departmental outcomes (quality, access, safety culture, retention, and patient-centred value). A distributive servant leadership model offers a coherent, evidence-informed approach to building radiology departments that are adaptable, humane, and performance-oriented.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"627-636"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624642","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":"After Hours, After Thought? Rethinking CT Stewardship in Pediatric Head Trauma.","authors":"Caroline Rutten, Suzanne Beno, Birgit Ertl-Wagner","doi":"10.1177/08465371261449678","DOIUrl":"10.1177/08465371261449678","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"623-624"},"PeriodicalIF":4.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977479","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}