Journal of the American College of Radiology : JACR最新文献

{"title":"Cancer Screening in Incarcerated Populations: Challenges and Opportunities.","authors":"Farah Acher Kaiksow, Rob Striker, Noelle K LoConte","doi":"10.1016/j.jacr.2025.04.016","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.016","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Changing Landscape of Interventional Radiology: Growth in Nonprocedural Services and Market Dynamics.","authors":"Zain S Hussain, Yusuf Zaidi, Eric Walser","doi":"10.1016/j.jacr.2025.04.014","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.014","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the evolution of interventional radiology (IR) practice patterns from 2013 to 2022, focusing on longitudinal growth in evaluation and management (E&M) services among actively practicing IR physicians.</p><p><strong>Methods: </strong>Using the Medicare Physician and Other Supplier Public Use File, we retrospectively identified \"actively practicing IR physicians\" based on a minimum 10% threshold of annual procedural and clinical work relative value units derived from IR-specific procedural codes. For each calendar year, we tallied the number of actively practicing IR physicians, total E&M claims, and mean E&M claims per IR physician. A two-step decomposition was then performed to quantify how much of the change in total E&M services was attributable to fluctuations in physician count versus changes in per-physician E&M billing.</p><p><strong>Results: </strong>From 2013 to 2022, total E&M claims rose from 149,481 to 201,825 (+52,344, +35.0%, P < .05). The number of IR physicians billing ≥11 E&M claims per annum rose 12.9% from 1,347 in 2013 to 1,522 in 2022. Mean E&M claims per clinically active IR physician increased 19.8% from 111 to 133 (P < .05). The number of actively practicing IR physicians declined from 12,483 in 2013 to 11,585 in 2022 (-7.2%). Decomposition analysis revealed that, absent the drop in IR physician count, E&M claims would have been higher by 10,776. However, an additional 62,559 E&M services stemming from increased per-physician billing offset this effect, yielding a net growth of approximately 52,000 E&M claims.</p><p><strong>Conclusion: </strong>IR physicians markedly expanded their E&M activities during the past decade. This growth is primarily driven by a rising fraction of \"active-clinical\" IRs who are growing in number and intensifying their clinical workload. These findings underscore IR's accelerating transition toward comprehensive patient care, with significant implications for training, practice management, and the specialty's role within the broader health care landscape.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Challenges in Estimating the Pediatric Radiology Workforce and Access to Pediatric Radiology Care in the United States.","authors":"Tatiana Morales-Tisnés, Casey E Pelzl, Sarah S Milla, Hansel J Otero","doi":"10.1016/j.jacr.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.03.002","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT Bone Density Assessed Using Thoracic Vertebrae Are Well Validated.","authors":"Matthew J Budoff, Suvasini Lakshmanan","doi":"10.1016/j.jacr.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.012","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability in Radiology: Challenges and Strategies in a Low- and Middle-Income Country.","authors":"Ana M Rendón-Garavito, Laura Manuela Olarte Bermúdez, José David Cardona Ortegón, David Fernando Torres Cortes","doi":"10.1016/j.jacr.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.03.008","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic management pathways for workup of abnormal screening with digital mammography versus digital breast tomosynthesis.","authors":"Louise M Henderson, Weiwei Zhu, Tracy Onega, Karla Kerlikowske, Diana L Miglioretti, Erin J Aiello Bowles, Brian L Sprague, Donald L Weaver, Anna N A Tosteson ScD, Christoph I Lee","doi":"10.1016/j.jacr.2025.04.008","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.008","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the transition from digital mammography (DM) to digital breast tomosynthesis (DBT) screening, we compared diagnostic work-up type and frequency, work-up pathways, and time to resolution of abnormal screening DBT versus DM.</p><p><strong>Methods: </strong>This cohort study includes screening exams with an abnormal result from 2011-2020 at 107 facilities across six Breast Cancer Surveillance Consortium registries. Diagnostic work-up included diagnostic DM, diagnostic DBT, ultrasound, magnetic resonance imaging, and biopsy within 90 days of the abnormal screening mammogram. We compared work-up modalities and number of work-up procedures using differences in proportion and 95% confidence intervals (95%CI). Time to diagnostic resolution between DBT and DM was compared with a log-rank test.</p><p><strong>Results: </strong>Among 77,123 abnormal DBT and 197,589 abnormal DM screening examinations, the number of imaging modalities in the diagnostic pathway was similar. The first work-up procedure was more often ultrasound following abnormal DBT compared to abnormal DM (21.1% vs. 4.7%). Biopsy rates were higher for DBT versus DM (16.2% vs. 14.0%, difference in proportions=2.27 95%CI:1.97-2.58) with biopsies following DM versus DBT more likely surgical versus FNA/core (5.8% vs.3.2%, difference in proportions=2.6, 95%CI:2.19-3.01), resulting in a rate of excision biopsy per 1000 abnormal screens of 5.1 for DBT and 8.0 for DM. Time to diagnostic resolution was similar (median=10 days).</p><p><strong>Conclusions: </strong>We found differences in the type of diagnostic work-up pathways following an abnormal screening DBT versus DM. While the biopsy rate was higher after abnormal DBT, the biopsy type may be more invasive (surgical excision) after abnormal DM screening.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Health-Related Social Needs and Associated Missed Imaging Appointments Among Patients With Cancer.","authors":"Angellica O Gordon, Ali Rashidi, Jeremy P Harris, Laila A Gharzai, Gelareh Sadigh","doi":"10.1016/j.jacr.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.002","url":null,"abstract":"<p><strong>Purpose: </strong>Health-related social needs (HRSNs) lead to health disparities and impact cancer care, but their link with missed imaging appointments in patients with cancer is unclear. We assessed screen rate and prevalance of HRSNs and their association with missed imaging appointments among patients with cancer.</p><p><strong>Methods: </strong>Patients aged ≥18 years with cancer who completed an oncology wellness form as part of usual care between January 1, 2022, and September 30, 2023, who had an imaging examination scheduled at the same health system within 3 months after form completion were included. The form assessed HRSNs (financial, transportation, and housing) and patients' preference for written or verbal information about HRSNs services. Multivariable regression models evaluated the association between HRSNs and missed imaging appointments.</p><p><strong>Results: </strong>In all, 3,495 (16.6%) of patients had a completed oncology wellness form during 3,964 (4.3%) encounters; of those, 2,890 had imaging scheduled in the next 3 months and were included (mean age: 61.6 ± 15.9 years; 50.2% female; 20.1% Asian, 2.8% Black, 57% White, 20.6% Hispanic). HRSNs were reported during 22.9% of encounters, with 82.9%, 40.2%, and 37.5% of reported HRSNs being due to financial hardship, transportation, and housing issues. Only 6.5% and 4.4% of encounters positive for HRSNs reported a desire for written information or to speak with someone about their HRSNs, respectively. At least one imaging encounter was missed by 70% in the subsequent 3 months. Adjusting for sociodemographic factors, patients reporting HRSNs were more likely to miss their imaging appointment (odds ratio, 1.29; 95% confidence interval, 1.03-1.61).</p><p><strong>Conclusion: </strong>Patients with cancer with self-reported HRSNs tend to have higher missed imaging appointments.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia Diagnosis Trends and Opportunistic Use of Abdominal CT Among Medicare Beneficiaries.","authors":"Eric W Christensen, Alexandra R Drake, Leon Lenchik, Robert D Boutin","doi":"10.1016/j.jacr.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.03.001","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the share of the Medicare fee-for-service population with sarcopenia compared with osteoporosis, an associated age-related disease, using claims data and to assess abdominal CT use in the diagnosis of sarcopenia compared with dual-energy x-ray absorptiometry for the diagnosis of osteoporosis.</p><p><strong>Methods: </strong>This retrospective study used a nationally representative 5% sample of Medicare fee-for-service beneficiaries from CMS (2017-2022). Diagnostic trends for sarcopenia and osteoporosis were compared. Nonlinear regression was used to assess the temporal association of the number of beneficiaries with an abdominal CT and a sarcopenia diagnosis (compared with dual-energy x-ray absorptiometry and osteoporosis diagnosis). Multivariable logistic regression models controlling for gender, age, race or ethnicity, urbanicity, area deprivation, and comorbidities assessed the likelihood of imaging associated with the diagnosis.</p><p><strong>Results: </strong>For 11,801,012 beneficiary years, there were 2,849,547 unique beneficiaries (53.2% female). Beneficiaries diagnosed with sarcopenia increased 480% from 0.01% in 2017 to 0.07% in 2022. From 90 days before the diagnosis date, the number of beneficiaries with an abdominal CT scan increased from the baseline rate at an exponential rate. After the diagnosis, the number of beneficiaries with abdominal CT scans was also elevated and returned to the baseline rate by 90 days after the diagnosis. These nonlinear patterns are statistically different from the null hypothesis of a flat line, which is indicative of no temporal association.</p><p><strong>Conclusion: </strong>Although the diagnostic rate for sarcopenia increased nearly 5-fold from 2017 to 2022, it remains underdiagnosed. The results provide evidence that abdominal CT (used opportunistically or intentionally) may contribute to diagnosing sarcopenia.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability Challenges in Radiology: A Call for Action.","authors":"José David Cardona Ortegón, Laura Manuela Olarte Bermúdez, Valeria Noguera, Juan Andres Mejia","doi":"10.1016/j.jacr.2025.04.013","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.013","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the Socio-Ecological Model to Address Recruitment, Promotion, and Leadership Development of Women in Radiology.","authors":"Shiva D Yagobian, Franklin Iheanacho, Amy Patel, Efren J Flores, Toma S Omofoye, Megha Garg, Randy C Miles","doi":"10.1016/j.jacr.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.011","url":null,"abstract":"<p><p>Women, who represent nearly 50% of medical school graduates, consistently comprise approximately 25% of radiology residency spots. Recruitment, promotion, and leadership development of radiologists from diverse backgrounds is important for continued growth of the field. Despite major radiological societies and journals championing this cause across all practice levels, efforts to improve diversity in the field have been limited. The socio-ecological model has been used to address challenges in health care by evaluating the interplay between individuals and their environment. In this article, we build on prior literature describing challenges faced by women in recruitment, promotion, and leadership development by applying the socio-ecological model to systematically understand and address barriers to the advancement of qualified women in radiology. We evaluate challenges women face in terms of recruitment, promotion, and leadership development at each level of the socio-ecological model and propose evidence-based solutions aimed at addressing barriers to the advancement of women in the field.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}