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

{"title":"Cancers Detected on Supplemental Breast Ultrasound in Women With Dense Breasts: Update From a Canadian Centre.","authors":"Paula B Gordon, Linda J Warren, Jean M Seely","doi":"10.1177/08465371251318578","DOIUrl":"10.1177/08465371251318578","url":null,"abstract":"<p><p><b>Objective:</b> Breast ultrasound is one of several tools proposed for supplemental screening of women with dense breasts but is not widely available in Canada. <b>Methods:</b> An IRB-approved, evaluation of ultrasound-guided breast biopsies prompted by screening breast ultrasound performed from August 1, 2021, to December 31, 2022, offered to asymptomatic women with category C and D breast tissue density after normal screening mammography (2D) in the provincial organized screening program, or surveillance diagnostic mammography after breast cancer. Risk factors, stage (AJCC 8th ed), incremental cancer detection rate (ICDR), biopsy rates, and positive predictive values for biopsy (PPV3) were evaluated. <b>Results:</b> 5257 women were screened, yielding 247 women (ages 34-82, median age of 56) who underwent biopsies (281 masses), 32 of whom were diagnosed with breast cancer, 27 invasive and 5 DCIS for PPV3 13.0% (32/247), and ICDR 6.1/1000. Ductal cancers found were stage 0 in 5/32 (15.6%), stage 1A in 18/32 (56.3%), and stage 1B in 2/32 (6.3%), 1 ductal/lobular cancer was stage 3B (3.1%), 5 lobular cancers (16.6%) were stage 1A (1), 1B (2), and 2B (2) and 1 adenoid cystic carcinoma was stage 2A (3.1%); 3 cancers were found on incident and 29 on prevalent screens, 27 (84.4%) in category c and 20 (62.5%) in women with no personal or first-degree family history of breast cancer. <b>Conclusion:</b> A high ICDR for screening breast ultrasound of 6.1/1000 was found. <b>Clinical Relevance Statement:</b> In women with dense breasts screened with 2D mammography where access to supplemental screening with MRI and contrast mammography is limited, supplemental screening ultrasound can play a significant role in cancer detection with a high ICDR in women in both category c and d densities that is higher than in jurisdictions offering annual screening mammography, or where MRI is used for surveillance after cancer.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"497-507"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470010","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 Friend in Need is a Friend Indeed: FDG PET/CT Prior to CT-Guided Transthoracic Core Needle Biopsy.","authors":"Patrik Rogalla, Jonatas Favero Prietto Dos Santos, Felipe A Sanchez Tijmes, Farah Cadour","doi":"10.1177/08465371251317468","DOIUrl":"10.1177/08465371251317468","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"373-374"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374996","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 Practice Guideline on Bone Mineral Densitometry Reporting: 2024 Update.","authors":"Steven Burrell, Melanie Desaulniers, Ho Jen, Conor Maguire, Moira Stilwell","doi":"10.1177/08465371241307524","DOIUrl":"10.1177/08465371241307524","url":null,"abstract":"<p><p>This practice guideline serves as an update to the Canadian Association of Radiologists' 2013 Technical Standards for Bone Mineral Densitometry Reporting. It aims to align bone mineral density testing and reporting practices in Canada with current clinical best practices, including guidelines from Osteoporosis Canada and the International Society for Clinical Densitometry. Key updates include the endorsement of both FRAX and CAROC tools for evaluating fracture risk, guidance for analyzing male patients and transgender patients, and provision of clinical management guidance of relevance to BMD reporting harmonized with that of Osteoporosis Canada. The document emphasizes the importance of accurate data collection in fracture risk assessment and provides recommendations for reporting fracture risk, T-scores, and clinical management strategies. Additionally, it outlines indications for baseline BMD testing and reassessment timelines, aiming to facilitate appropriate patient management and enhance bone health outcomes. This guideline is intended to complement existing standards and support healthcare professionals in delivering optimal care for patients undergoing BMD testing in Canada.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"417-426"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142966734","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":"Equity in Radiology Research Is Essential for Improving Diversity and Inclusivity in Clinical Data, Reducing Bias and Increasing Artificial Intelligence Accuracy.","authors":"Sonali Sharma, Cornelia Laule, Michael N Patlas, Charlotte J Yong-Hing","doi":"10.1177/08465371251322365","DOIUrl":"10.1177/08465371251322365","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"365-366"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460876","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":"Influence of BI-RADS Breast Density Scores on the Implementation of Supplemental Imaging Modalities in Those With Average Risk and Negative Mammogram by Primary Care Providers in British Columbia.","authors":"Jacqueline Bovard, Tammie Frysch, Nora Tong, Sonali Sharma, Charlotte J Yong-Hing","doi":"10.1177/08465371241306737","DOIUrl":"10.1177/08465371241306737","url":null,"abstract":"<p><p><b>Introduction:</b> Breast Imaging-Reporting and Data System (BI-RADS) density scores have been included in screening mammography reports in BC since 2018. Despite these density scores being present in screening mammography reports for numerous years, there remains insufficient evidence to guide supplemental testing for patients with dense breasts. <b>Objective:</b> The primary objective of this study was to evaluate how primary care providers in Canada utilize BI-RADS density scores reported on normal screening mammograms of average risk, asymptomatic patients in their clinical practice. The secondary objective of this study was to determine if there are any patterns related to primary care provider demographics and practice settings in BC that could be linked to differences in screening practices for patients based on BI-RADS density scores. <b>Methods:</b> A cross-sectional survey was conducted with family physicians (FPs) and nurse practitioners (NPs) practicing in BC. Descriptive statistics were calculated using percentages and further stratified by participant demographics. <i>P</i> values were derived from Fisher's exact test and results were regarded as statistically significant at <i>P</i> < .05. <b>Results:</b> Ninety-eight participants (85 FPs, 13 NPs) responded to the survey. The percentage of participants who ordered supplemental testing based on BI-RADS density scores alone was 8% for BI-RADS score D, 37% for BI-RADS scores C or D, and 2% for BI-RADS scores B, C, or D. Forty-eight percent of female participants and 45% of male participants would order supplemental testing based on BI-RADS density scores alone (<i>P</i> = 1). Forty-nine percent of FPs and 39% of NPs would order supplemental testing based on BI-RADS density scores (<i>P</i> = .56). Fifty-three percent of participants who had been in practice for more than 10 years, 50% of those who had been in practice for 6 to 10 years, and 36% of those in practice for 5 years or less would order supplemental testing (<i>P</i> = .34). Fifty-seven percent of those practicing in large urban centres, 43% of those practicing in medium-sized communities, and 32% of those in rural or remote communities would order testing (<i>P</i> = .17). Fifty-seven percent of participants were aware of the increased risk of breast cancer with higher breast density. <b>Conclusion:</b> Variations exist in how primary care providers in BC utilize the BI-RADS density scores reported on normal screening mammography of average risk, asymptomatic patients in their clinical practice. Further research in this area is needed to establish clearer clinical guidelines to educate and inform primary care providers on the need for supplemental testing for patients with dense breasts and to improve resources for breast cancer screening in BC.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"489-496"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873461","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":"Role of Supplemental Screening Ultrasound in Women With Dense Breasts.","authors":"Mostafa Alabousi, Michael N Patlas","doi":"10.1177/08465371251331438","DOIUrl":"10.1177/08465371251331438","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"367-368"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765874","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":"Fracture Risk Assessment in the 2023 Osteoporosis Canada Guideline.","authors":"William D Leslie, Steven Burrell, Suzanne N Morin","doi":"10.1177/08465371241307945","DOIUrl":"10.1177/08465371241307945","url":null,"abstract":"<p><p>Radiologists and other diagnostic imaging specialists play a pivotal role in the management of osteoporosis, a highly prevalent condition of reduced bone strength and increased fracture risk. Bone mineral density (BMD) measurement with dual-energy X-ray absorptiometry (DXA) is a critical component of identifying individuals at high risk for fracture. Strategies to prevent fractures are consolidated in the Osteoporosis Canada clinical practice guideline which was updated in 2023. In this guideline, treatment recommendations are based upon a consideration of fracture history, 10-year major osteoporotic fracture (MOF) risk, and BMD T-score in conjunction with age. The current review aims to familiarize radiologists and other diagnostic imaging specialists with the reporting requirements needed to support implementation of this guideline using the FRAX™ risk calculation tool. Fortunately, for specialists already familiar with the Canadian Association of Radiologists and Osteoporosis Canada (CAROC) tool, the transition to FRAX-based reporting is readily accommodated in a radiology workflow.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"508-518"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967242","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":"FDG PET/CT Performed Prior to CT-Guided Percutaneous Biopsy of Lung Masses is Associated With an Increased Diagnostic Rate and Often Identifies Alternate Safer Sites to Biopsy.","authors":"Jordan Haidey, Jonathan T Abele","doi":"10.1177/08465371241306731","DOIUrl":"10.1177/08465371241306731","url":null,"abstract":"<p><p><b>Purpose:</b> To determine the benefit of a FDG PET/CT scan prior to CT-guided lung biopsy on the rate of diagnosis, rate of complication, and the identification of potentially safer biopsy sites. <b>Methods:</b> This retrospective observational cross-sectional study evaluated consecutive adult patients who underwent CT-guided lung biopsy in 2020 or 2021 at 2 Canadian tertiary care hospitals. These patients were grouped into those that had PET/CT performed within 8 weeks prior to biopsy, within 8 weeks after biopsy, or no PET/CT scan within this time frame. Biopsy complication rates and pathology diagnostic rates were compared. The PET/CT images of those performed after biopsy were reviewed to determine if alternate safer biopsy sites could be identified. Categorical variables were compared using Pearson chi square test (<i>P</i> < .05 significant). <b>Results:</b> 547 patients who had CT-guided lung biopsy were included. Patients with lung masses (≥3 cm) who had a PET/CT scan prior to biopsy had a higher diagnostic rate (90.8%) compared to those that did not (80.2%). The overall post-biopsy pneumothorax rate was 43.3% with 11.3% overall requiring chest tube insertion and 13.9% requiring hospitalization. There was no difference in complication rate for those who had PET/CT prior to biopsy and those that did not. 28.9% to 42.1% of patients who had PET/CT after biopsy had safer sites amenable to biopsy identified retrospectively outside of the lungs. <b>Conclusion:</b> PET/CT prior to CT-guided lung biopsy improves the diagnostic rate in 10.6% of patients with lung masses (≥3 cm) and identifies alternate safer sites to biopsy in 28.9% to 42.1% of patients (any size lesion).</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"534-540"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848541","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":"Excess Greenhouse Gas Emissions From Medical Imaging Related to Environmental Exposures.","authors":"Omar Taboun, Michael N Patlas, Anish Kirpalani, Birgit Ertl-Wagner, Julien Aguet, Heidi Schmidt, Ania Kielar, Maura J Brown, Kate Hanneman","doi":"10.1177/08465371241309821","DOIUrl":"10.1177/08465371241309821","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"541-543"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904060","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 Innovation in Pancreatic Imaging: A Bright Future, But Are We There Yet?","authors":"Moran Drucker Iarovich, Maria Gladkikh, Christian B van der Pol","doi":"10.1177/08465371251331381","DOIUrl":"10.1177/08465371251331381","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"369-370"},"PeriodicalIF":2.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755723","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}