Current problems in diagnostic radiology最新文献

{"title":"CT imaging of pulmonary artery aneurysms in the emergency department - What you need to know.","authors":"Mohammad Yasrab, Charles K Crawford, Elliot K Fishman, Satomi Kawamoto","doi":"10.1067/j.cpradiol.2025.05.004","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.05.004","url":null,"abstract":"<p><p>Pulmonary artery (PA) aneurysms are rare vascular abnormalities with potentially life-threatening complications such as rupture, massive hemoptysis, and pulmonary infarction. These conditions are often asymptomatic and incidentally detected but can present with nonspecific symptoms like cough, dyspnea, or hemoptysis in an emergency setting. Multidetector CT pulmonary angiography (CTPA) has outshone traditional angiography, supplemented by advanced 3D post-processing techniques such as maximum intensity projection (MIP), volumetric rendering (VR), and cinematic rendering (CR) techniques, playing a pivotal role in diagnosis and management of PA aneurysms. This pictorial essay reviews eight cases of PA aneurysms and pseudoaneurysms, exploring their diverse etiologies, imaging findings, and the application of 3D imaging to enhance diagnostic confidence and procedural planning. Through these cases, we highlight the critical role of advanced imaging and post-processing reconstructions in the timely identification and treatment of these rare but high-risk vascular entities in the emergency setting.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145131","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":"Impact of demographics on surveillance and survival in post-resection orthopedic Sarcoma patients.","authors":"Tristan Chari, Austin Leonard, Brian P Triana, Chad Cook, Elizabeth Sachs, Christian A Pean, Jon Martin, William Eward, Robert French","doi":"10.1067/j.cpradiol.2025.05.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.05.002","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to evaluate the impact of race, socioeconomic deprivation, and insurance status on adherence to imaging surveillance within five years following the diagnosis and resection of sarcoma of the bone. It also examines how these factors relate to cancer-related mortality.</p><p><strong>Patients and methods: </strong>A retrospective cohort study evaluated the relationship between demographics and surveillance imaging adherence among primary bone tumor (PBT) patients at a single institution. Out of 128 patients diagnosed with and surgically managed for a PBT between 2013 and 2018, 91 were chosen for analysis after excluding for metastatic disease at the time of resection and insufficient surveillance data. Surveillance data was collected from patients who were monitored for five years post-resection or until metastasis occurred, with adherence to surveillance imaging protocols and survival assessed over this period.</p><p><strong>Results: </strong>The cohort comprised 91 patients (56 % male, 44 % female; 71 % White, 24 % Black or African American). Under-represented minority (URM) status was associated with 0.19 odds of receiving optimal imaging adherence (95 % CI [0.05, 0.71], P = .01). Furthermore, URM patients had 3.20 odds of mortality compared to White patients during the five-year follow-up (95 % CI [1.18, 8.67], P = .02).</p><p><strong>Conclusion: </strong>At our institution, URM patients demonstrate significantly lower adherence to imaging surveillance and higher mortality rates following primary sarcoma resection. These findings highlight the necessity for targeted interventions to address societal and health system factors that contribute to disparities in imaging adherence and survival among URM patients.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096408","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":"Comparison of sagittal angle of trigeminal nerve at porus trigeminus between responders and non-responders to microvascular decompression surgery in patients with trigeminal neuralgia.","authors":"Shehbaz Ansari, Brian H Mu, Eric R Basappa, Melih Akyuz, Miral D Jhaveri, Santhosh Gaddikeri","doi":"10.1067/j.cpradiol.2025.05.003","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.05.003","url":null,"abstract":"<p><strong>Background and purpose: </strong>The sagittal angle of the trigeminal nerve at the porus trigeminus (SATNaPT) has been described as abnormally hyperacute in a subset of patients with trigeminal neuralgia and proposed as a potential marker for the likelihood of poor microvascular decompression (MVD) outcomes. The purpose of this study is to replicate these results and evaluate this hypothesized association by comparing the SATNaPT between MVD responders and non-responders.</p><p><strong>Materials and methods: </strong>At a single institution, 80 patients with a clinical diagnosis of trigeminal neuralgia, surgical intervention with MVD, and available adequate high-resolution T2 imaging were identified. SATNaPT was measured between the cisternal segment of the trigeminal nerve and its uppermost branch in the Meckel cave by a blinded observer. These data were evaluated for normality of distribution and compared between responders and non-responders to MVD as well as between affected and unaffected sides. Non-response to MVD was defined as persistent pain requiring continuous medication postoperatively or progression to secondary interventions.</p><p><strong>Results: </strong>There were 43 (52.5 %) responders and 39 (47.5 %) non-responders to MVD. Two patients had bilateral disease for 82 affected sides and 78 unaffected sides. The mean SATNaPT among responders was 150.5° (SD: ±10.6°), which was not significantly different (p = 0.21) from the 153.1° (SD: ±8.0°) mean angle in non-responders. Mean SATNaPT was not significantly different (p = 0.10) between the affected (mean: 151.7°, SD: ±9.5°) and the unaffected (mean: 153.1°, SD: ±10.0°) sides.</p><p><strong>Conclusions: </strong>Our study did not replicate the bimodal distribution of the SATNaPT in cTN patients. No statistically significant difference was noted in the SATNaPT between responders and non-responders to MVD or between symptomatic and asymptomatic sides.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096405","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":"Optimizing contrast enhanced mammography: A comprehensive review of artefacts, causes, and remedies.","authors":"Dr Veenu Singla, Dr Dollphy Garg, Bhavith","doi":"10.1067/j.cpradiol.2025.05.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.05.001","url":null,"abstract":"<p><p>Contrast enhanced mammography (CEM) is a promising imaging technique in breast imaging, combining efficiency and cost-effectiveness with the ability to provide structural as well as functional information. However, like all imaging modalities, CEM is prone to artifacts that can occur at various stages of the process, including patient preparation, image acquisition, equipment calibration, and digital subtraction. Recognising and rectifying these artifacts is essential for achieving optimal image quality and accurate diagnosis. The purpose of this article is to familiarise the readers with common artifacts encountered during CEM and minimise their impact on image interpretation, with a focus on strategies for optimising CEM imaging. We have also described a few previously uncharted CEM-specific artifacts observed in our clinical experience. Additionally, this review highlights major pitfalls encountered during CEM reporting and measures to improve diagnostic accuracy.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027750","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":"Perceived wellness through the online lens: assessment of wellness resources in interventional radiology residency websites.","authors":"Matthew D Viveiros, Abigail Buckley, Mina S Makary","doi":"10.1067/j.cpradiol.2025.04.012","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.012","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate wellness across interventional radiology residency programs within the US through their online presence and to highlight areas of success and further improvement.</p><p><strong>Materials and methods: </strong>A systematic review was conducted of the websites specific to Interventional Radiology and Graduate Medical Education (GME) for all ACGME-accredited IR residency programs listed in the 2023-2024 ERAS. Data collection was based on 39 predetermined wellness criteria across five categories: general program characteristics, financial, work, personal, and social, which were evaluated for their presence or absence on each website.</p><p><strong>Results: </strong>Out of 169 total IR residency programs, 165 websites were analyzed. Key findings included a predominant male-to-female ratio, variable financial support offerings, and inconsistent representation of work and personal wellness features across websites. The most frequently included wellness aspects were city life, vacation days, insurance coverage, moonlighting, and mental health resources, while <50 % of programs adequately provided information on social events and elective opportunities.</p><p><strong>Conclusion: </strong>This study represents the first comprehensive online evaluation of wellness resources in IR residency programs, identifying significant variability and gaps in how programs present wellness-related information. While some areas demonstrate success, there is a crucial need for enhanced transparency and consistency across websites. Future research should develop standardized reporting and evaluation methods to better support the well-being and career development of residents, thereby improving the alignment between program offerings and the wellness needs of IR trainees. This foundational work sets the stage for ongoing improvements in the way residency programs communicate key aspects of wellness to prospective residents.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055563","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":"Coronary computed tomography angiography without ECG leads; A feasibility study.","authors":"Brian Thomsen, Ali Nabipoor, Sanaz Asadian, Ingrid Reiser, Juan Cotella, Darin Okerlund, Melissa Challman, Luis Landeras, Hamid Chalian","doi":"10.1067/j.cpradiol.2025.04.019","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.019","url":null,"abstract":"<p><strong>Background: </strong>Modern CT scanners with wide coverage and high temporal resolution have enabled robust coronary CT angiography (CCTA) with automated phase selection and motion correction algorithms, even at high heart rates and arrhythmia. We hypothesized that these advanced technologies may make it feasible to perform a CCTA without triggering from a patient's ECG signal.</p><p><strong>Methods: </strong>Forty-three subjects undergoing clinically indicated CCTA were prospectively enrolled. ECG-less CCTA data was acquired for approximately the whole cardiac cycle using a wide-coverage scanner with fast gantry rotation (Revolution Apex, GE HealthCare). Images were generated using seven sub-ranges of the acquired data and evaluated for motion artifact using a 6-point Likert scale by three experts.</p><p><strong>Results: </strong>The mean age of the study population was 62.0 ± 12.0 years; 51.2 % were male. The mean heart rate (HR) was 65.3 ± 9.0 beats per minute (bpm). Overall image quality (IQ) was higher with motion correction vs standard reconstruction (4.6 ± 0.66 vs 4.0 ± 0.95, p < 0.01). At HR ≤ 60 bpm, 61-70 bpm, ≥ 71 bpm, IQ scores were 4.9 ± 0.31, 4.5 ± 0.66, 4.4 ± 0.78, respectively. IQ from sub-ranges was similar to the reference of the study, reconstructed images from full-phase data, except in the cases where 1/4 of the scanned data was considered in HR ≤ 60 bpm and ≥ 71 bpm (4.3 ± 0.83, 4.6 ± 0.67 and 4.1 ± 0.96 respectively).</p><p><strong>Conclusion: </strong>CCTA without ECG leads on an advanced CT scanner is feasible. This approach could improve patient comfort, workflow efficiency, and access to CCTA.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045216","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":"Quantitative and qualitative imaging in marijuana users and smokers.","authors":"Aparna Singh, Ozgu Alcali, Andetta R Hunsaker, Mark M Hammer","doi":"10.1067/j.cpradiol.2025.04.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of marijuana use compared to cigarette smoking on imaging findings in the lungs.</p><p><strong>Methods: </strong>By searching the electronic medical record, we identified patients who were marijuana users who never smoked; current smokers; and non-marijuana never smokers, who underwent chest CT in our healthcare system in 2019. We generated a random sample of 100 marijuana users as well as 100 each age- and sex-matched controls from the current smoker and never-smoker groups. Patients with extensive airspace disease on CT were excluded. Quantitative CT analysis was performed to measure total lung volume (TLV). A thoracic radiologist reviewed chest CTs in a blinded fashion for the presence of emphysema, centrilobular ground glass opacities, mosaic attenuation, bronchial wall thickening, and coronary calcification.</p><p><strong>Results: </strong>Our study included 285 participants, comprising 89 non-smokers, 97 smokers, and 99 marijuana users. Despite propensity score matching, the marijuana user group was slightly younger than the smokers and non-smokers (mean age 59 versus 62 and 64 years, respectively, p = 0.04), with similar sex distribution across all groups. TLV was higher in smokers than marijuana users and non-smokers (p<.01 for both). By visual analysis, 62 % of smokers had emphysema versus 4 % of marijuana users (p<.001). Additionally, centrilobular ground glass opacities were more prevalent in smokers (15 %) than in marijuana users (2 %) (p = 0.0008). No significant difference was noted in the occurrence of mosaic attenuation between smokers and marijuana users. In terms of coronary artery calcification, more smokers had moderate to severe coronary artery calcifications compared to marijuana users (43 % versus 25 %, p = 0.01).</p><p><strong>Conclusion: </strong>While emphysema and hyperinflation were common in smokers, they were rare in marijuana users.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059973","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":"Impact of turnaround time in radiology: The good, the bad, and the ugly.","authors":"Brandon Ritchie, Lesley Summerville, Max Sheng, Monica Choi, Sree Tirumani, Nikhil Ramaiya","doi":"10.1067/j.cpradiol.2025.04.018","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.018","url":null,"abstract":"<p><p>Turnaround time (TAT) has evolved into a complex metric in the current era of diagnostic radiology. Initially monitoring a radiologist's ability to efficiently generate a report, there is now a hierarchy of stakeholders who are affected by its modern-day interpretation and use. This article explores \"more than the metric\" and reviews the multi-faceted use and implementation of TAT through the lens of a large academic hospital network. The authors highlight \"The Good\" of turnaround time as a useful quality metric that guides patient outcomes, organizational performance, and revenue generation, and they discuss how it has been implemented at their institution to positively influence workflow and guide departmental staffing. The \"bad\" implications of TAT are discussed, which can strain radiology departmental workflows and propagate issues such as delays in finalizing reports for inpatient and outpatient worklists in the setting of rapidly growing imaging volumes. Broader systemic issues of TAT are discussed within \"The Ugly\" section of this review, which highlights TAT's negative impact on resident education, physician burnout, and its creation of \"New School\" and \"Old School\" radiologist practices. The article provides further discussion of existing strategies and future directions that can mitigate the negative impacts of TAT, including various staffing models, approaches to optimize workflow systems, and methods for re-prioritizing STAT cases using artificial intelligence. The authors conclude with a call for balanced, continued implementation of TAT as a metric but not at the expense of sacrificing the quality of work performed by radiologists and trainees.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003651","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":"Nationwide survey of benefits provided to radiology residents in the United States.","authors":"Muhammad Y Hameed, Surbhi Raichandani, Andrew Baker, Evan D Hicks, Paula K Roberson, Roopa Ram","doi":"10.1067/j.cpradiol.2025.04.009","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.009","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to comprehensively evaluate key benefits offered by various diagnostic radiology residency programs in the United States, focusing on stipends, research support, educational resources, time-off policies, mini-fellowships, and additional perks. The goal is to offer insights into the diverse landscape of resident compensation, as well as the variety and type of benefits.</p><p><strong>Methods: </strong>Data collection utilized an anonymous survey of diagnostic radiology residency programs, addressing stipends, research support, educational resources, time-off policies, mini-fellowships, and additional benefits. A structured questionnaire facilitated responses from program representatives which were collected during March-April 2023. The survey employed quantitative and qualitative questions to gather comprehensive information. Descriptive statistics and correlations were subsequently performed to analyze the responses.</p><p><strong>Results: </strong>Analysis of stipends revealed significant geographic and program-related variations, impacting resident compensation. Analysis of post pandemic era stipends showed that R1 stipends ranged from less than $45,000 to over $65,000, with statistically significant differences across geographic regions (p = 0.01). R1 stipends varied significantly across different Cost-of-Living Index (COLI) groups (p < 0.01). While most programs provide support for educational and research activities, such as conference leave and funding for specialized courses, there was considerable variability in the type and extent of benefits offered, reflecting a lack of standardization among residency programs.</p><p><strong>Discussion: </strong>The study outcomes prompt actionable considerations for optimizing benefits provided by radiology residency programs. Geographic and program-specific stipend variations underscore the importance of establishing stipend compensation at par with cost-of-living expenses. Comprehensive knowledge of the trends and variation in residency benefits could guide program enhancements, with the overarching goal of supplementing current stipends to enhance resident satisfaction and well-being.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050143","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":"Preparing the next generation of healthcare leaders through a longitudinal management and leadership training program for radiology residents.","authors":"Krishnaveni Parvataneni, Regina Tamposi, Theresa C McLoud, Michael S Gee, James A Brink, Dania Daye","doi":"10.1067/j.cpradiol.2025.04.013","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.013","url":null,"abstract":"<p><p>Though few feel adequately prepared, the increasing complexity of healthcare systems highlights a need for physicians to develop management skills. Some training programs for residents exist, including Physician Management Pathway. Such programs are inaccessible for radiology residents, underscoring the need for tailored, accessible management training fitting into the standard 4-year radiology residency. The James H. Thrall Management and Leadership Training (MLT) program at Massachusetts General Hospital was designed to address this gap with a tailored, comprehensive curriculum integrating didactics, practical experience, mentorship, and scholarly projects, integrated into the standard four-year radiology residency. The MLT program is comprised of five key components: a structured didactic curriculum, practical administrative experience, mentorship, a scholarly project, and a capstone in health policy and management or quality and patient safety. This manuscript outlines the design, implementation,a nd preliminary outcomes of the MLT program and serves as a model for developing future physician-leaders prepared to navigate the complexities of healthcare.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027763","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}