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

{"title":"Patient Size Estimation Methods for CMS Size-Adjusted Dose Reporting: Variability, Challenges, and Recommendations.","authors":"Gary Ge, Charles M Weaver, Alexander Alsalihi, Jie Zhang","doi":"10.1016/j.jacr.2025.07.021","DOIUrl":"10.1016/j.jacr.2025.07.021","url":null,"abstract":"<p><strong>Objective: </strong>The new CMS1074v3 measure assesses CT size-adjusted dose (SAD) and image quality as part of a reimbursement-linked quality measure. However, a key calculation, patient size estimation, is not strictly defined by CMS, introducing variability that may compromise consistency. This study evaluates five methods for calculating patient size and their impact on SAD and compliance.</p><p><strong>Methods: </strong>A retrospective analysis of 719 CT examinations across seven CT protocols was performed. These included five abdomen and two chest protocols covering various CT categories based on University of California San Francisco examples cited in the CMS measure. Five methods for calculating patient diameter were evaluated: Hounsfield unit (HU) Value Thresholding, Water-Equivalent Diameter (WED), Lateral (LAT) or anterior-posterior (AP) Conversion, LAT×AP, and (LAT + AP)/2. Statistical differences were assessed using Kruskal-Wallis and pairwise tests.</p><p><strong>Results: </strong>SAD values demonstrate significant variability between calculation methods. Attenuation-based methods (HU threshold, WED) overestimated SAD in chest examinations, and projection-based methods showed greater variability in abdominal examinations. This variability affects compliance with CMS-defined dose thresholds, with attenuation-based methods resulting in more failures in chest examinations and projection-based methods in abdominal examinations. The Urogram protocol had SAD values >30% below CMS thresholds despite its high-dose category, suggesting potential error in classification or threshold value. Statistically significant differences (P < .05) were found in Chest pulmonary embolism, Chest without, and Urogram protocols.</p><p><strong>Conclusions: </strong>Inconsistencies in SAD estimation methods and protocol mapping pose technical challenges that compromise the effectiveness of the metric. Standardized examination mapping and revisiting dose thresholds may improve alignment with clinical practice and enhance the reliability of the CMS measure.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769433","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":"Re: \"The Changing Landscape of Interventional Radiology: Growth in Nonprocedural Services and Market Dynamics\" by Hussain et al.","authors":"Luke R Wilkins, C Matthew Hawkins, Raymond Liu, Elizabeth Rula, Robert Lookstein","doi":"10.1016/j.jacr.2025.06.042","DOIUrl":"10.1016/j.jacr.2025.06.042","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765876","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":"Is the Sixth Edition of BI-RADS Lexicon Going to Be Stigmatization Free?","authors":"Halit Nahit Şendur, Aylin Billur Şendur","doi":"10.1016/j.jacr.2025.07.013","DOIUrl":"10.1016/j.jacr.2025.07.013","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719250","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":"Toward Pediatric Patient-Friendly Education Material Using Generative Artificial Intelligence.","authors":"Satvik Tripathi, Dana Alkhulaifat, Hansel J Otero, Tessa S Cook","doi":"10.1016/j.jacr.2025.07.009","DOIUrl":"10.1016/j.jacr.2025.07.009","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710118","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":"Patient Reminders and Self-Referrals via Online Patient Portals and Text Messaging to Improve Adherence to Screening Mammography: A Randomized Controlled Trial.","authors":"Patricia Balthazar, Ilana Graetz, Jeffrey M Switchenko, Olivia S Jung, Mohammed K Ali, Mary S Newell, Julie Hollberg, Nabile Safdar, Gelareh Sadigh","doi":"10.1016/j.jacr.2025.07.018","DOIUrl":"10.1016/j.jacr.2025.07.018","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710117","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":"Transforming Health Care Value at the Intersection of Technology, Data Science, and Patient Care.","authors":"Kurt Herzer, Elliot K Fishman, Linda C Chu, Steven P Rowe, Charles K Crawford","doi":"10.1016/j.jacr.2025.07.015","DOIUrl":"10.1016/j.jacr.2025.07.015","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710119","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":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Acute Spinal Trauma: 2025 Update.","authors":"Aatiqah Aziz, Lynne M Koweek","doi":"10.1016/j.jacr.2025.07.011","DOIUrl":"10.1016/j.jacr.2025.07.011","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700569","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":"Mammography Positioning Improvement Results and Unique Challenges in a Safety-Net Health System.","authors":"Firouzeh K Arjmandi, Havisha Munjal, Jody C Hayes, Lorie Thibodeaux, Jennifer Schopp, Kanwal Merchant, Tianshen Hu, Jessica H Porembka","doi":"10.1016/j.jacr.2025.07.007","DOIUrl":"10.1016/j.jacr.2025.07.007","url":null,"abstract":"<p><strong>Purpose: </strong>Poor mammography positioning can result in missed or delayed cancer diagnoses. The authors' safety-net breast imaging practice experienced an increase in technical repeats due to poor screening mammography quality, potentially worsening socioeconomic and racial disparities in breast cancer outcomes. The aim of this article is to share the authors' safety-net breast imaging practice challenges and the results of participating in a structured improvement program to improve screening mammography positioning.</p><p><strong>Methods: </strong>In collaboration with the ACR Learning Network, the authors' center joined cohort 3 of the ACR Mammography Positioning Improvement Collaborative. A project team was formed, and A3 thinking was applied to improve adherence to established positioning criteria. After conducting a current-state analysis and process mapping, root causes of poor image quality, key drivers for improvement, and interventions were identified. Throughout the program, positioning was assessed on 1,639 four-view screening mammograms, interventions were implemented, and changes in the percentage of screening mammograms meeting positioning criteria were tracked.</p><p><strong>Results: </strong>Root causes included variable technologist skill levels, inconsistent onboarding, high technologist turnover, understaffing, language barriers, challenging patient body habitus, and mobility issues. Interventions included daily positioning tips, one-on-one training for technologists, and a Spanish-language document for technologists. The percentage of screening mammograms meeting positioning criteria was significantly increased from 45% to 58% overall (P = .02), with an average weekly pass rate of 75% for the final 7 weeks of the project.</p><p><strong>Conclusions: </strong>Through a structured improvement program, the authors identified challenges to mammography positioning faced by a safety-net breast imaging practice and developed and implemented interventions to significantly improve overall image quality.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700568","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":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Male Breast Cancer Screening.","authors":"Jayden Lee, Sharon L D'Souza","doi":"10.1016/j.jacr.2025.07.012","DOIUrl":"10.1016/j.jacr.2025.07.012","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700581","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":"Letter to the Editor: Expanding on \"A Hitchhiker's Guide to Good Prompting Practices for Large Language Models in Radiology\".","authors":"Guilalume Fahrni, David C Rotzinger","doi":"10.1016/j.jacr.2025.07.010","DOIUrl":"10.1016/j.jacr.2025.07.010","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700567","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}