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

{"title":"Recommendations for the Management of Incidentally Detected Gallbladder Polyps: Update of the 2020 Canadian Association of Radiologists Recommendations for the Management of Incidental Hepatobiliary Findings in Adults.","authors":"Christopher I Fung, Aya Kamaya, Gary L Brahm, Jeffery R Bird, Iain D C Kirkpatrick","doi":"10.1177/08465371251346728","DOIUrl":"https://doi.org/10.1177/08465371251346728","url":null,"abstract":"<p><p>The Canadian Association of Radiologists (CAR) Incidental Findings Working Group has updated its guidance on the management of incidentally detected gallbladder polyps, originally published in 2020. Prompted by new evidence and recent international guidelines, the Working Group re-evaluated the literature and assessed both the 2022 Society of Radiologists in Ultrasound (SRU) Consensus Recommendations and the 2022 joint European guidelines. The updated guidance reflects a shift toward assessing polyp morphology and reduced surveillance and intervention for small polyps, endorsing the SRU's evidence-based, risk-stratified approach over the more conservative European recommendations. This update aims to minimize unnecessary imaging and surgery for benign polyps while maintaining patient safety.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251346728"},"PeriodicalIF":2.9,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250921","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":"Insights From a National Survey on Gaps and Opportunities for Curriculum Improvement in Breast Imaging Education in Canadian Radiology Residency Programs.","authors":"Kaitlin M Zaki-Metias, Sri Sannihita Vatturi, Aleena Malik, Hayley McKee, Silma Solorzano, Jean M Seely, Supriya Kulkarni, Zina Kellow, Raman Verma","doi":"10.1177/08465371251344246","DOIUrl":"https://doi.org/10.1177/08465371251344246","url":null,"abstract":"<p><p><b>Objective:</b> Radiology residents must demonstrate competence in breast imaging prior to entering practice. Breast imaging fellowship training programs have attracted fewer trainees, contributing to the ongoing shortage in the field. This survey aimed to evaluate the structure, supports, and barriers to breast imaging training in Canadian residency programs to help guide future curriculum development. <b>Methods:</b> Following ethical approval, a 45-question cross-sectional survey was distributed to all 16 diagnostic radiology program directors of Canadian residency programs via email using the online platform SurveyMonkey between March and May 2024. The questions covered program demographics, breast imaging and procedural experience, integration into multidisciplinary care, the impact of other learners, scheduling, and departmental leadership. <b>Results/Discussion:</b> Twelve (75%) program directors across 7 provinces responded. Responses revealed variability in program structures and resources. All programs provided the suggested 4 months of breast imaging training. Exposure to interpreting screening mammography was offered by 75% (9/12) of programs, however, 75% (9/12) of programs did not involve residents in multidisciplinary rounds, limiting collaborative care training. Simulation sessions for breast imaging procedures were offered in 33% (4/12) of programs. Assessment methods across programs lacked uniformity, with only 17% (2/12) of programs using post-rotation tests, and all relying on subjective evaluations. <b>Conclusion:</b> This study highlights the need to address disparities and enhance standardization to improve residents' breast imaging education. Establishing clear guidelines for integration of multimodality breast imaging exposure, increasing procedural training, and providing opportunities to participate in multidisciplinary care conferences are essential for developing a more uniform and comprehensive breast imaging curriculum nationally.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251344246"},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188534","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":"Biparametric Prostate MRI: A Practical Approach to Implementation and Comparative Analysis.","authors":"Olivia Muhn, Darya Kurowecki, Michael N Patlas, Abdullah Alabousi","doi":"10.1177/08465371251342706","DOIUrl":"https://doi.org/10.1177/08465371251342706","url":null,"abstract":"<p><p>Prostate cancer (PCa) remains a leading cause of cancer-related morbidity and mortality among men worldwide. Multiparametric MRI (mpMRI) is currently the gold standard for PCa detection, diagnosis, and active surveillance. However, its reliance on dynamic contrast-enhanced (DCE) imaging introduces safety concerns, higher costs, and longer scan times. Biparametric MRI (bpMRI), which omits DCE, has emerged as a streamlined alternative that retains T2-weighted and diffusion-weighted imaging. This review critically examines the technical considerations, diagnostic performance, clinical applications, and limitations of bpMRI compared to mpMRI. We evaluate bpMRI's sensitivity, specificity, and negative predictive value in detecting clinically significant prostate cancer (csPCa), highlighting its advantages in terms of patient safety, accessibility, and cost-effectiveness. Despite promising findings, the widespread clinical adoption of bpMRI is hindered by variability in imaging protocols, limited large-scale validation, and concerns over missed subtle lesions. Future directions include standardizing bpMRI protocols, integrating artificial intelligence and biomarkers, and conducting multi-centre trials to establish its role in PCa management. bpMRI holds significant potential as a reliable and efficient imaging tool that could complement or replace mpMRI in select clinical contexts.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251342706"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152876","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":"A Survey of After-Hours Interventional Radiology Availability in Ontario.","authors":"Blair E Warren, Alanna Supersad, Sebastian Mafeld, Arash Jaberi, George Oreopoulos","doi":"10.1177/08465371251340368","DOIUrl":"10.1177/08465371251340368","url":null,"abstract":"<p><p><b>Purpose:</b> A survey to determine the availability of after-hours IR on-call services at Ontario hospitals that have a radiology department. A secondary outcome is to determine potential barriers to the provision of IR after-hours on call services within the province. <b>Methods:</b> A survey was created and distributed to the radiology department heads across Ontario during a 6-week period in 2024. <b>Results:</b> The survey was sent to the department heads at 73 hospitals across the province of Ontario. Survey completion rate was 41% (30/73). Two thirds of the respondents had formal IR divisions (20/30, 66.7%). A total of 14 hospitals with IR departments offered on call services (70%, 14/20) and 2 of the hospitals without IR departments (2/10, 20%) offered on call services for non-vascular IR procedures (eg, abscess drainage). 92.9% of the groups offering IR call services stated year-over-year demand was increasing. The most common barrier to after-hours services were staffing resources. <b>Conclusion:</b> After-hours IR services have limited availability in the province of Ontario, and not all hospitals with IR departments currently provide after-hours access to IR procedures. The main barrier to provision of after-hours services is the lack of health human resources, in particular IR physicians.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251340368"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152873","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":"How to Become a Leader in Academic Radiology?","authors":"Philippe Soyer, Gilles Soulez","doi":"10.1177/08465371251343784","DOIUrl":"https://doi.org/10.1177/08465371251343784","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251343784"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152883","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":"Optimizing Musculoskeletal Imaging Referrals: Making Wise Choices a Knee-Jerk Reaction.","authors":"Natalia Gorelik, Courtney R Green, Candyce Hamel, Anne-Marie LeBlanc, Bheeshma Ravi, Danielle R Frost, Hugue Ouellette, Kuan-Chin Jean Chen, Lisa Y Liang, Nitai Gelber, Reza Mirza, Kawan S Rakhra","doi":"10.1177/08465371251339389","DOIUrl":"https://doi.org/10.1177/08465371251339389","url":null,"abstract":"<p><p><b>Purpose:</b> To develop Choosing Wisely Canada (CWC) recommendations for musculoskeletal (MSK) imaging indications, informed by the 2024 Canadian Association of Radiologists (CAR) Musculoskeletal System Diagnostic Imaging Referral Guideline. <b>Methods:</b> A Steering Committee comprising multidisciplinary MSK experts was convened to guide recommendation development. Using a two-round Delphi method, committee members selected the top 3 scenarios from the CAR MSK referral guidelines deemed most impactful for addressing overuse. Recommendations based on these scenarios were then drafted using the CWC format. <b>Results:</b> The 3 recommendations developed are: (1) Don't order MRI without first considering ultrasound for the assessment of rotator cuff pathology and bursitis; (2) Don't order MRI of the hip or knee when x-ray demonstrates greater than mild osteoarthritis, unless recommended by a musculoskeletal specialist; and (3) Don't order MRI of the hip just based on x-ray features of femoroacetabular impingement unless there are clinical signs and symptoms of joint impingement. <b>Conclusions:</b> This project represents a knowledge translation initiative to disseminate updated MSK imaging guideline recommendations. It strengthens the collaboration between CAR and CWC and establishes a reproducible structured consensus approach that can be applied to developing additional CWC imaging recommendations across the remaining 12 CAR referral guidelines in other subspecialties. This work supports value-based radiology, promoting optimized resource use.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251339389"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152888","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":"Computed Tomography Angiography Utilization in Lower Extremity Trauma: Insights From a Canadian Level I Trauma Centre.","authors":"Jacques du Plessis, Amos Kalu, Hayley McKee, Abdelazim Mohammed, Rayane Maroun, Ferco H Berger, Gilbert Maroun","doi":"10.1177/08465371251342064","DOIUrl":"10.1177/08465371251342064","url":null,"abstract":"<p><p><b>Introduction:</b> Computed tomography angiography (CTA) plays an important role in assessing patients with suspected lower extremity traumatic vascular injury. However, CTA overutilization has been reported in some centres, and improper use has been linked to increased healthcare costs and prolonged Emergency Department wait times. This study evaluated CTA utilization in a Canadian Level I trauma centre, determined the rate of positive CTA studies requiring intervention, and identified factors that may reduce unnecessary examinations. <b>Methods and Materials:</b> This retrospective study included trauma patients who underwent lower extremity CTA between January 2020 and September 2024. Data regarding patient demographics, mechanism of injury, physical exam and computed tomography findings, ankle-brachial index value, and interventions were collected and evaluated. Statistical analysis included descriptive statistics and chi-square or Fisher's exact tests for categorical associations. <b>Results:</b> Six hundred twelve patients (82% male, median age 32 years) were included. Forty-six percent had a normal physical exam, and CTA was positive in 27% of cases. Eight percent of patients required an intervention, all of whom had at least one hard sign of vascular injury. A statistically significant association was identified between hard signs of a vascular injury and positive CTA findings (<i>P</i> < .001) and major vascular injuries (<i>P</i> < .01). No patients with a normal physical exam and a positive CTA required intervention. <b>Conclusion:</b> Nearly half of the CTA studies were performed on patients with a normal physical exam, none requiring intervention. Our findings suggest that implementing institution-specific appropriate criteria may reduce unnecessary CTA studies.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251342064"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152879","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":"Sustainable Radiology: Health Equity and Quality Improvement.","authors":"Lima Awad El-Karim, Ania Kielar, Satheesh Krishna, Zeyad F Elias, Hayley Panet, Maura Brown","doi":"10.1177/08465371251340243","DOIUrl":"10.1177/08465371251340243","url":null,"abstract":"<p><p>Environmental sustainability in radiology has a growing role in health care as climate changes intensify. Quality Initiative/Improvement (QI) projects lead to improved patient care and safety as well as efficient use of limited health care resources. When designing a QI project, including an environmental lens increases awareness of sustainability in medicine. This document will focus specifically on sustainability in QI (SusQI) in the field of Radiology, though similar principles may be applied in other medical fields. The sustainable QI model updates the value equation denominator from cost to the triple bottom line of environmental, social, and economic measures. Using this SusQI model can lead to a win (patient)-win (health care system)-win (environment). This article will also discuss the importance of the environment for human health and the link between quality initiatives and environmental sustainability in demonstrating the value of radiology and improving the quality of patient care. It will provide some examples of sustainability applied to many quality initiatives in radiology: For example, reduction in oral contrast use for many previously used indications, streamlined MRI protocols, as well as using ultrasound over CT or MRI for indications that are equally appropriate.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251340243"},"PeriodicalIF":2.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152891","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":"Theranostic: A Primer for Radiologists.","authors":"Seyed Ali Mirshahvalad, Mohsen Beheshti, Ur Metser, Di Maria Jiang, Rebecca Wong, Ibrahim Alrekhais, Patrick Veit-Haibach","doi":"10.1177/08465371251338032","DOIUrl":"https://doi.org/10.1177/08465371251338032","url":null,"abstract":"<p><p>Theranostic represents a transformative approach in precision medicine, integrating diagnostic imaging with targeted radiopharmaceutical therapy to enhance individualized disease management. Rooted in nuclear medicine, this approach uses molecular targeting agents labelled with diagnostic radioisotopes for imaging and therapeutic radioisotopes for treatment, ensuring a seamless transition from diagnosis to therapy. The field has evolved significantly in the last decade, with prostate-specific membrane antigen (PSMA)-targeted radioligand therapy transforming prostate cancer patient management and somatostatin receptor (SSTR)-targeted agents revolutionizing neuroendocrine tumour (NET) treatment. Considering its interdisciplinary nature, collaboration between nuclear medicine specialists, oncologists, radiologists, and other healthcare professionals is critical to refining clinical applications and improving patient outcomes. As prominent members of the theranostic team, radiologists play a pivotal role, from patient selection and imaging-based eligibility assessment to response evaluation and long-term monitoring. In this regard, advanced imaging modalities facilitate the precise evaluation of disease characteristics, guiding treatment decisions. Hence, as theranostics becomes increasingly integrated into patient management, radiologists face the need to be well-versed in both the technical aspects and clinical implications. In this review, we aimed to provide a primer for radiologists to gain a general insight into the theranostic field and its basic principles.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251338032"},"PeriodicalIF":2.9,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129645","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":"Chronic Pelvic Pain Due to Venous Disease: An Under-Recognized Condition.","authors":"Adrian P Brady","doi":"10.1177/08465371251342710","DOIUrl":"https://doi.org/10.1177/08465371251342710","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251342710"},"PeriodicalIF":2.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103254","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}