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

{"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":"8465371241307524"},"PeriodicalIF":2.9,"publicationDate":"2025-01-11","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":"Fracture Risk Assessment in the 2023 Osteoporosis Canada Guideline.","authors":"William D Leslie, Steven Burrell, Suzanne N Morin","doi":"10.1177/08465371241307945","DOIUrl":"https://doi.org/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":"8465371241307945"},"PeriodicalIF":2.9,"publicationDate":"2025-01-11","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":"Increasing Female Representation at Canadian Association of Radiologists Annual Scientific Meetings.","authors":"Chen Abitbol, Rajesh Bhayana, Ciara O'Brien, Zara A Shaikh, Candyce Hamel, Carissa Piercey, Kate Hanneman, Ania Kielar, Satheesh Krishna","doi":"10.1177/08465371241312567","DOIUrl":"https://doi.org/10.1177/08465371241312567","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371241312567"},"PeriodicalIF":2.9,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967316","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":"Implementation of O-RADS Ultrasound Reporting System: A Quality Improvement Initiative.","authors":"Genevieve Bouchard-Fortier, Phyllis Glanc, Sarah E Ferguson, Debbie Elman, Rachel Kupets, Leslie Po, Sarah Taleghani, Lisha Lo, Kalesha Hack","doi":"10.1177/08465371241301335","DOIUrl":"https://doi.org/10.1177/08465371241301335","url":null,"abstract":"<p><p><b>Objectives:</b> To determine the feasibility of implementing Ovarian-Adnexal Reporting & Data System (O-RADS) ultrasound (US) for reporting of adnexal masses at our institution, with a specific goal of increasing the use of O-RADS from a baseline of <5% to at least 75% over a 16-month period. <b>Methods:</b> A prospective interrupted time series quality improvement study was undertaken over a 16-month period. Plan, do, study, act cycles included: (1) Engagement of interested parties, (2) Targeted educational sessions, (3) Development of reporting templates, (4) Weekly audit-feedback. Inter-reader variability assessment was performed on 70% of O-RADS risk-category 2 to 5. The primary outcome was the reporting of an O-RADS risk category. <b>Results:</b> A total of 635 female pelvic US were performed at our centre between July 2022 and April 2023. An O-RADS risk category was provided on the final radiology report by the radiologist for 489/635 (77%) US. From November 2022 to April 2023, the weekly rate of O-RADS risk category reporting reached 88%. The O-RADS score was concordant between readers for 83/103 (81%) of US reports with kappa score of 0.69 corresponding to good agreement. <b>Conclusions:</b> The reporting of O-RADS risk category increased from <5% to 88% over a 16-month period with a high level of agreement among readers in assigning O-RADS risk category. Implementation of a standardizing reporting ultrasound system at a tertiary cancer centre is feasible with rapid learning and uptake curves.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371241301335"},"PeriodicalIF":2.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958831","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, Ania Kielar, Signy Holmes, 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":"8465371241306658"},"PeriodicalIF":2.9,"publicationDate":"2025-01-07","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":"Pediatric Neurosonography: Comprehensive Review and Systematic Approach.","authors":"Neetika Gupta, Shivaprakash B Hiremath, Isabelle Gauthier, Nagwa Wilson, Elka Miller","doi":"10.1177/08465371241308849","DOIUrl":"https://doi.org/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":"8465371241308849"},"PeriodicalIF":2.9,"publicationDate":"2024-12-29","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":"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":"https://doi.org/10.1177/08465371241309821","url":null,"abstract":"","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371241309821"},"PeriodicalIF":2.9,"publicationDate":"2024-12-29","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":"Do Risk Factors for HCC Impact the Association of CT/MRI LIRADS Major Features With HCC? An Individual Participant Data Meta-Analysis.","authors":"Robert G Adamo, Eric Lam, Jean-Paul Salameh, Christian B van der Pol, Stacy M Goins, Haben Dawit, Andreu F Costa, Brooke Levis, Amit G Singal, Victoria Chernyak, Claude B Sirlin, Mustafa R Bashir, An Tang, Ayman Alhasan, Brian C Allen, Caecilia S Reiner, Christopher Clarke, Daniel R Ludwig, Milena Cerny, Jin Wang, Sang Hyun Choi, Tyler J Fraum, Bin Song, Ijin Joo, So Yeon Kim, Heejin Kwon, Hanyu Jiang, Hyo-Jin Kang, Andrea S Kierans, Yeun-Yoon Kim, Maxime Ronot, Joanna Podgórska, Grzegorz Rosiak, Ji Soo Song, Matthew D F McInnes","doi":"10.1177/08465371241306297","DOIUrl":"https://doi.org/10.1177/08465371241306297","url":null,"abstract":"<p><p><b>Background:</b> Guidelines suggest the Liver Imaging Reporting and Data System (LI-RADS) may not be applicable for some populations at risk for hepatocellular carcinoma (HCC). However, data assessing the association of HCC risk factors with LI-RADS major features are lacking. <b>Purpose:</b> To evaluate whether the association between HCC risk factors and each CT/MRI LI-RADS major feature differs among individuals at-risk for HCC. <b>Methods:</b> Databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scopus) were searched from 2014 to 2022. Individual participant data (IPD) were extracted from studies evaluating HCC diagnosis using CT/MRI LI-RADS and reporting HCC risk factors. IPD from studies were pooled and modelled with one-stage meta-regressions. Interactions were assessed between major features and HCC risk factors, including age, sex, cirrhosis, chronic hepatitis B virus (HBV), and study location. A mixed effects model that included the major features, as well as separate models that included interactions between each risk factor and each major feature, were fit. Differences in interactions across levels of each risk factor were calculated using adjusted odds-ratios (ORs), 95% confidence-intervals (CI), and <i>z</i>-tests. Risk of bias was assessed using QUADAS-2. (Protocol: https://osf.io/tdv7j/). <b>Results:</b> Across 23 studies (2958 patients and 3553 observations), the associations between LI-RADS major features and HCC were consistent across several HCC risk factors (<i>P</i>-value range: .09-.99). A sensitivity analysis among the 4 studies with a low risk of bias did not differ from the primary analysis. <b>Conclusion:</b> The association between CT/MRI LI-RADS major features and HCC risk factors do not significantly differ in individuals at-risk for HCC. These findings suggest that CT/MR LI-RADS should be applied to all patients considered at risk by LI-RADS without modification or exclusions, regardless of the presence or absence of the risk factors evaluated in this study.</p>","PeriodicalId":55290,"journal":{"name":"Canadian Association of Radiologists Journal-Journal De L Association Canadienne Des Radiologistes","volume":" ","pages":"8465371241306297"},"PeriodicalIF":2.9,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904059","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":"https://doi.org/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":"8465371241306737"},"PeriodicalIF":2.9,"publicationDate":"2024-12-21","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":"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":"8465371241306731"},"PeriodicalIF":2.9,"publicationDate":"2024-12-18","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}