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

{"title":"Part 1: CAR Metabolic Dysfunction-Associated Steatotic Liver Disease Working Group Guidance Statements for Detecting and Grading Hepatic Steatosis Using Ultrasound, CT, or MRI.","authors":"Mitchell P Wilson, An Tang, Gavin Low, Li Xin Zhang, Andreu F Costa, Emily Pang, Silvia Chang, Alexandra Medellin, Abdel-Aziz Shaheen, Jérémy Dana, Noam Millo, Ania Kielar, Mark Swain, Victoria Leung, Daisy Fung, Casey Hurrell, Christopher Fung","doi":"10.1177/08465371251357444","DOIUrl":"https://doi.org/10.1177/08465371251357444","url":null,"abstract":"<p><p>The Canadian Association of Radiologists (CAR) metabolic dysfunction-associated steatotic liver disease (MASLD) Working Group (WG) is a multidisciplinary working group composed of radiologists, hepatologists, and family physicians. In this 3-part series, we provide Delphi consensus-based guidance on clinical and imaging findings for patients with known or suspected MASLD (formerly termed non-alcoholic fatty liver disease or NAFLD). Part 1 focuses on the detection and grading of hepatic steatosis on imaging; Part 2 on risk-stratification of patients with MASLD, including a patient pathway that incorporates serological and imaging investigations; and Part 3 on the implementation of practice recommendations for quality assurance using shear wave elastography (SWE) and magnetic resonance elastography (MRE) for disease staging. In the first part of these guidelines, we provide 17 guidance statements for detection, grading, and surveillance of hepatic steatosis using ultrasound (US), CT, or MRI. In addition to conventional B-mode US, we review current evidence on semi-quantitative and quantitative US techniques and provide guidance for appropriate indications and recommended technique.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251357444"},"PeriodicalIF":3.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790737","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":"Deep Learning Reconstruction for T2 Weighted Turbo-Spin-Echo Imaging of the Pelvis: Prospective Comparison With Standard T2-Weighted TSE Imaging With Respect to Image Quality, Lesion Depiction, and Acquisition Time.","authors":"Marshall S Sussman, Lumeng Cui, Stephanie B M Tan, Shopnil Prasla, Tanya Wah-Kahn, Dominik Nickel, Kartik S Jhaveri","doi":"10.1177/08465371251357790","DOIUrl":"https://doi.org/10.1177/08465371251357790","url":null,"abstract":"<p><strong>Purpose: </strong>In pelvic MRI, Turbo Spin Echo (TSE) pulse sequences are used for T2-weighted imaging. However, its lengthy acquisition time increases the potential for artifacts. Deep learning (DL) reconstruction achieves reduced scan times without the degradation in image quality associated with other accelerated techniques. Unfortunately, a comprehensive assessment of DL-reconstruction in pelvic MRI has not been performed. The objective of this prospective study was to compare the performance of DL-TSE and conventional TSE pulse sequences in a broad spectrum of pelvic MRI indications.</p><p><strong>Methods: </strong>Fifty-five subjects (33 females and 22 males) were scanned at 3 T using DL-TSE and conventional TSE sequences in axial and/or oblique acquisition planes. Two radiologists independently assessed image quality in 6 categories: edge definition, vessel margin sharpness, T2 Contrast Dynamic Range, artifacts, overall image quality, and lesion features. The contrast ratio was calculated for quantitative assessment. A two-tailed sign test was used for assessment.</p><p><strong>Results: </strong>The 2 readers found DL-TSE to deliver equal or superior image quality than conventional TSE in most cases. There were only 3 instances out of 24 where conventional TSE was scored as providing better image quality. Readers agreed on DL-TSE superiority/inferiority/equivalence in 67% of categories in the axial plane and 75% in the oblique plane. DL-TSE also demonstrated a better contrast ratio in 75% of cases. DL-TSE reduced scan time by approximately 50%.</p><p><strong>Conclusion: </strong>DL-accelerated TSE sequences generally provide equal or better image quality in pelvic MRI than standard TSE with significantly reduced acquisition times.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251357790"},"PeriodicalIF":3.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776971","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 Patient Throughput in Limited Resource Environments.","authors":"Sian Chin, Aimee Langan, Richard Walker, Alison Harris, Gilles Soulez, Ania Kielar","doi":"10.1177/08465371251361082","DOIUrl":"https://doi.org/10.1177/08465371251361082","url":null,"abstract":"<p><p>Waiting times for medical imaging examinations in Canada are growing as the demand for these tests exceeds current capacity. This document summarizes strategies that may be employed to increase medical imaging patient throughput in an environment of limited resources. This document also advocates for provincial measures to optimize use of resources and national policies that support sustainable radiology services to meet growing demand now and in the future.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251361082"},"PeriodicalIF":3.7,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776972","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":"Large Language Model Agentic Workflows for Automated Opportunistic Screening of Incidental Coronary Artery Calcium on Chest CT Reports.","authors":"Aly Muhammad Ladak, Jaydeep Halankar, Elsie T Nguyen, Kate Hanneman, Yangqing Deng, Satheesh Krishna, Rajesh Bhayana","doi":"10.1177/08465371251358105","DOIUrl":"https://doi.org/10.1177/08465371251358105","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371251358105"},"PeriodicalIF":3.7,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765818","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/CSAR Practice Statement on Pelvic MRI for Endometriosis.","authors":"Emily Pang, Arvind Shergill, Silvia Chang, Priscila Crivellaro, Shauna Duigenan, Courtney R Green, Candyce Hamel, Signy Holmes, Ania Kielar, Iffat Rehman, Caroline Reinhold, Basma Al-Arnawoot","doi":"10.1177/08465371241306658","DOIUrl":"10.1177/08465371241306658","url":null,"abstract":"<p><p>The Canadian Association of Radiologists (CAR) Endometriosis Working Group was tasked with providing guidance and benchmarks to ensure the quality of technique and interpretation for advanced imaging modalities associated with diagnosing endometriosis. Advanced pelvic ultrasound is essential in diagnosing and mapping pelvic endometriosis, but pelvic MRI serves as an excellent imaging tool in instances where access to advanced ultrasound is limited, or an alternative imaging modality is required. Despite the known utility of MRI for endometriosis, there is no consensus on imaging protocol and patient preparation in Canada. To improve patient care and support excellence in imaging, the Working Group has developed recommendations for the use of pelvic MRI to assess for endometriosis with an aim to standardize MRI technique for use in both community and academic practices across Canada. The guidelines provide recommendations regarding imaging technique and patient preparation for pelvic MRI, along with suggestions for structured reporting of pelvic MRI for endometriosis.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"375-391"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958828","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":"Canadian Association of Radiologists Cancer Diagnostic Imaging Referral Guideline.","authors":"Candyce Hamel, Barb Avard, Howard Lim, Alex Mathieson, Alan Michaud, Kristoff Nelson, Devang Odedra, Jason Pantarotto, Anna Wilkinson, Karim Samji","doi":"10.1177/08465371241312087","DOIUrl":"10.1177/08465371241312087","url":null,"abstract":"<p><p>The Canadian Association of Radiologists (CAR) Cancer Expert Panel is made up of physicians from the disciplines of radiology, medical oncology, surgical oncology, radiation oncology, family medicine/general practitioner oncology, a patient advisor, and an epidemiologist/guideline methodologist. The Expert Panel developed a list of 29 clinical/diagnostic scenarios, of which 16 pointed to other CAR guidelines. A rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of the remaining 13 scenarios. Recommendations from 21 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop the recommendation for these scenarios. During recommendation formulation, one additional scenario was mapped to an existing CAR guideline scenario, leaving 12 scenarios with new recommendations. The guideline focuses on cancer diagnosis and does not cover cancer staging, follow-up, and surveillance. This guideline presents the methods of development and the referral recommendations for suspected pancreatic cancer, suspected liver cancer, incidental liver mass, incidental colon mass or suspected colon cancer, suspected anal cancer, suspected penile cancer, suspected cervical cancer, suspected endometrial/uterine cancer, suspected vulvar cancer, suspected vaginal cancer, suspected haematologic malignancies, and suspected skin cancer. The guideline also points to other CAR guidelines for suspected neck, thyroid, brain, lung, intracardiac/pericardial, esophageal/gastric, renal, adrenal, bladder, testicular, prostate and ovarian cancers, suspected soft tissue mass or tumour, suspected bone tumour, suspected bone tumour --myeloma, suspected spine tumours, and incidental lung cancer.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"427-434"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026115","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 Imaging of the Pancreas: A Review of Current Developments and Applications.","authors":"Maxime Barat, Joël Greffier, Salim Si-Mohamed, Anthony Dohan, Anna Pellat, Julien Frandon, Paul Calame, Philippe Soyer","doi":"10.1177/08465371251319965","DOIUrl":"10.1177/08465371251319965","url":null,"abstract":"<p><p>Pancreatic cancer continues to pose daily challenges to clinicians, radiologists, and researchers. These challenges are encountered at each stage of pancreatic cancer management, including early detection, definite characterization, accurate assessment of tumour burden, preoperative planning when surgical resection is possible, prediction of tumour aggressiveness, response to treatment, and detection of recurrence. CT imaging of the pancreas has made major advances in recent years through innovations in research and clinical practice. Technical advances in CT imaging, often in combination with imaging biomarkers, hold considerable promise in addressing such challenges. Ongoing research in dual-energy and spectral photon-counting computed tomography, new applications of artificial intelligence and image rendering have led to innovative implementations that allow now a more precise diagnosis of pancreatic cancer and other diseases affecting this organ. This article aims to explore the major research initiatives and technological advances that are shaping the landscape of CT imaging of the pancreas. By highlighting key contributions in diagnostic imaging, artificial intelligence, and image rendering, this article provides a comprehensive overview of how these innovations are enhancing diagnostic precision and improving outcome in patients with pancreatic diseases.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"477-488"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477150","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":"Sustainability in radiology: Position paper and call to action from ACR, AOSR, ASR, CAR, CIR, ESR, ESRNM, ISR, IS3R, RANZCR, and RSNA.","authors":"Andrea G Rockall, Bibb Allen, Maura J Brown, Tarek El-Diasty, Jan Fletcher, Rachel F Gerson, Stacy Goergen, Amanda P Marrero González, Thomas M Grist, Kate Hanneman, Christopher P Hess, Evelyn Lai Ming Ho, Dina H Salama, Julia Schoen, Sarah Sheard","doi":"10.1177/08465371251321390","DOIUrl":"10.1177/08465371251321390","url":null,"abstract":"<p><p>The urgency for climate action is recognised by international government and healthcare organisations, including the United Nations (UN) and World Health Organisation (WHO). Climate change, biodiversity loss, and pollution negatively impact all life on earth. All populations are impacted but not equally; the most vulnerable are at highest risk, an inequity further exacerbated by differences in access to healthcare globally.The delivery of healthcare exacerbates the planetary health crisis through greenhouse gas emissions, largely due to combustion of fossil fuels for medical equipment production and operation, creation of medical and non-medical waste, and contamination of water supplies.As representatives of radiology societies from across the globe who work closely with industry, and both governmental and non-governmental leaders in multiple capacities, we advocate together for urgent, impactful, and measurable changes to the way we deliver care by further engaging our members, policymakers, industry partners, and our patients. Simultaneous challenges including global health disparities, resource allocation, and access to care must inform these efforts.Climate literacy should be increasingly added to radiology training programmes. More research is required to understand and measure the environmental impact of radiological services and inform mitigation, adaptation and monitoring efforts. Deeper collaboration with industry partners is necessary to support innovations in the supply chain, energy utilization, and circular economy. Many solutions have been proposed and are already available, but we must understand and address barriers to implementation of current and future sustainable innovations. Finally, there is a compelling need to partner with patients, to ensure that trust in the excellence of clinical care is maintained during the transition to sustainable radiology.By fostering a culture of global cooperation and rapid sharing of solutions amongst the broader imaging community, we can transform radiological practice to mitigate its environmental impact, adapt and develop resilience to current and future climate and environmental threats, and simultaneously improve access to care.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"444-453"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506233","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":"Pediatric Neurosonography: Comprehensive Review and Systematic Approach.","authors":"Neetika Gupta, Shivaprakash B Hiremath, Isabelle Gauthier, Nagwa Wilson, Elka Miller","doi":"10.1177/08465371241308849","DOIUrl":"10.1177/08465371241308849","url":null,"abstract":"<p><p>Neurosonography (NSG) is pivotal for rapid, point-of-care neonatal brain assessment. This review elucidates the comprehensive applications of NSG in pediatric care, emphasizing its role in early diagnosis and management of pathologies affecting the pediatric head-such as scalp lesions, misshapen calvarium, ventricular distortions, and cerebrovascular abnormalities, and its specific role in conditions like hypoxic-ischaemic encephalopathy (HIE) across different neonatal gestational ages. We explore its diagnostic advantage in critical care settings, particularly for infants with stroke risk in sickle cell disease, ECMO-related complications, screening for therapeutic hypothermia, and routine neonatal intensive care unit monitoring. This review discusses the recommendations based on the timing of brain injury (preterm and term) and describes technical considerations that enhance diagnostic accuracy. Ultimately, this article advocates for its incorporation into routine neonatal screening to improve neurodevelopmental outcomes, underscoring its importance in clinical decision-making and long-term management of pediatric brain disorders.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"519-533"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904067","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/CSACI Practice Guidance for Contrast Media Hypersensitivity.","authors":"Adam Byrne, D Blair Macdonald, Iain D C Kirkpatrick, Magali Pham, Courtney R Green, Ana Maria Copaescu, Matthew D F McInnes, Ling Ling, Anne Ellis, Andreu F Costa","doi":"10.1177/08465371241311253","DOIUrl":"10.1177/08465371241311253","url":null,"abstract":"<p><p>Contrast media, including iodinated contrast media and gadolinium-based contrast agents, are commonly administered pharmaceuticals with excellent safety profiles. However, a minority of the population may experience a hypersensitivity reaction following intravenous administration. Hypersensitivity reactions can be immediate or delayed, and range from mild, such as urticaria, to severe, including anaphylaxis. There is emerging evidence that longstanding pretreatment protocols, such as diphenhydramine and corticosteroids, are ineffective and have the potential for side effects and other harms. Moreover, the evidence for efficacy on which this practice is based is weak and outdated. A joint collaborative working group of representatives from the Canadian Association of Radiologists and the Canadian Society of Allergy and Clinical Immunology was assembled to inform medical professionals and hospital policies regarding hypersensitivity reactions to contrast media. The objectives of the working group were to provide an overview of the epidemiology, physiology, risk factors, and types of hypersensitivity reactions; to synthesize the evidence for pretreatment strategies that minimize the risk of a breakthrough reaction for both iodinated contrast media and gadolinium-based contrast agents; to review the allergy investigations used to evaluate patients with a history of severe hypersensitivity reaction; and to provide an overview of existing guidelines. Following appraisal of the evidence, the working group established recommendations based on consensus in this practice guidance.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"400-416"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967250","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}