Current problems in diagnostic radiology最新文献

{"title":"A stroke imaging protocol in patients with a history of contrast-induced anaphylaxis.","authors":"Gabriel M Virador, Rahul B Singh, Vivek Gupta, Dinesh Rao, Josephine F Huang, Leslie V Simon, Sukhwinder J S Sandhu","doi":"10.1067/j.cpradiol.2024.12.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.12.001","url":null,"abstract":"<p><p>The need for emergent, contrast-enhanced neuroimaging in stroke patients with a history of severe reaction to iodinated contrast represents a unique dilemma in emergency departments. There is currently a lack of evidence-based management protocols for these cases. We describe a protocol established at our institution, based off American College of Radiology (ACR) guidelines and institutional experience, to guide decision-making in these scenarios.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822866","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":"Mentors without Borders: Bridging global gaps in medical and radiological education.","authors":"Monica Pernia Marin, Vikas Burugu, Sofia M Tarchi, Reza Solemani, Mary Salvatore","doi":"10.1067/j.cpradiol.2024.12.005","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.12.005","url":null,"abstract":"<p><p>Pursuing medical careers like radiology is challenging even for those with high levels of commitment, discipline, and resilience. Many rely on the guidance and support from mentors whose experiences serve as the roadmap for new generations. Unfortunately, finding a mentor can be difficult in certain parts of the world or when physicians decide to live and practice medicine outside their country of origin. Within the United States, medical education in the United States is very competitive given the high demand of highly qualified aspirants and the lack of enough training positions to accept them all. Having good mentorship not only can help students enhance the skills required to succeed within their fields of interest during the residency and fellowship application processes, but it can also provide counseling as they navigate training and, ultimately, transition to the workplace. \"Mentors without Borders\" is a program founded by a radiologist to provide free mentorship to those interested in pursuing medical education and training to pursue radiology and other medical careers in and out of the United States. Its primary focus is on strengthening skills needed for academic writing and publication of scientific articles in radiology. This initiative has already benefited several students and physicians from all over the world and is aiming to become a fully structured program with a larger outreach.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901309","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":"Arachnoid granulations: Dynamic nature and review.","authors":"Andrew Wai Kei Ko, Ahmed Abdelmonem, M Reza Taheri","doi":"10.1067/j.cpradiol.2024.12.006","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.12.006","url":null,"abstract":"<p><p>Arachnoid granulations have been known for centuries yet remain incompletely understood. While traditionally associated with cerebrospinal fluid transport, the precise mechanism remains uncertain. This manuscript reviews the literature on the anatomy, histology, and imaging findings of arachnoid granulations and their mimickers and anomalous variations. We highlight variations in incidence, size, and characteristics of arachnoid granulations on imaging, and hypothesize that these variations may be explained by arachnoid granulations being dynamic secondary to varying functionality. We review the pathophysiologic role of arachnoid granulations in pathologies related to hydrocephalus, neurodegenerative disorders, and intracranial hypertension and hypotension. A further understanding of arachnoid granulations, their mechanism in cerebrospinal fluid transport, and change over time may provide a basis for future imaging markers and therapies.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831494","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":"Release of complex imaging reports to patients, do radiologists trust AI to help?","authors":"Kanhai S Amin, Melissa A Davis, Amir Naderi, Howard P Forman","doi":"10.1067/j.cpradiol.2024.12.008","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.12.008","url":null,"abstract":"<p><strong>Background: </strong>As a result of the 21st Century Cures Act, radiology reports are immediately released to patients. However, these reports are often too complex for the lay patient, potentially leading to stress and anxiety. While solutions such as patient portals or providing radiologist contact information have been proposed in the past, new generative artificial intelligence technologies like ChatGPT and Google Gemini may provide the most accessible and scalable method of simplifying radiology reports for patients. Here, we gather the opinions of radiologists regarding this possibility.</p><p><strong>Methods: </strong>An eight-question survey was sent out to all diagnostic/interventional radiology attendings and clinical fellows at our large academic medical center.</p><p><strong>Results: </strong>From our survey (N = 52), 52.8 % of respondents agreed/strongly agreed that patients should have immediate access to their radiology reports. Only 9.61 % agreed that radiology reports are understandable by the lay patient. Regarding potential avenues to improve patient comprehension of their radiology reports, using artificial intelligence to simplify reports with a manual check by radiologists garnered the most support/strong support (46.2 %). Support of artificial intelligence generated simplifications dropped to (23.1 %) without a manual check.</p><p><strong>Conclusion: </strong>Patients are increasingly gaining access to their radiology reports, but reports may be too complex for the lay patient. Eventually, artificial intelligence systems may help simplify radiology reports for patients, but there is currently limited support from radiologists.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831497","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":"Large language models as an academic resource for radiologists stepping into artificial intelligence research.","authors":"Satvik Tripathi, Jay Patel, Liam Mutter, Felix J Dorfner, Christopher P Bridge, Dania Daye","doi":"10.1067/j.cpradiol.2024.12.004","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.12.004","url":null,"abstract":"<p><strong>Background: </strong>Radiologists increasingly use artificial intelligence (AI) to enhance diagnostic accuracy and optimize workflows. However, many lack the technical skills to effectively apply machine learning (ML) and deep learning (DL) algorithms, limiting the accessibility of these methods to radiology researchers who could otherwise benefit from them. Large language models (LLMs), such as GPT-4o, may serve as virtual advisors, offering tailored algorithm recommendations for specific research needs. This study evaluates GPT-4o's effectiveness as a recommender system to enhance radiologists' understanding and implementation of AI in research.</p><p><strong>Intervention: </strong>GPT-4o was used to recommend ML and DL algorithms based on specific details provided by researchers, including dataset characteristics, modality types, data sizes, and research objectives. The model acted as a virtual advisor, guiding researchers in selecting the most appropriate models for their studies.</p><p><strong>Methods: </strong>The study systematically evaluated GPT-4o's recommendations for clarity, task alignment, model diversity, and baseline selection. Responses were graded to assess the model's ability to meet the needs of radiology researchers.</p><p><strong>Results: </strong>GPT-4o effectively recommended appropriate ML and DL algorithms for various radiology tasks, including segmentation, classification, and regression in medical imaging. The model suggested a diverse range of established and innovative algorithms, such as U-Net, Random Forest, Attention U-Net, and EfficientNet, aligning well with accepted practices.</p><p><strong>Conclusion: </strong>GPT-4o shows promise as a valuable tool for radiologists and early career researchers by providing clear and relevant AI and ML algorithm recommendations. Its ability to bridge the knowledge gap in AI implementation could democratize access to advanced technologies, fostering innovation and improving radiology research quality. Further studies should explore integrating LLMs into routine workflows and their role in ongoing professional development.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822867","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":"Tumor mutational burden as a marker for radiologic response to immune checkpoint inhibitors.","authors":"Dheeman Futela, Sree Harsha Tirumani, Ezgi Guler, Brandon Declouette, Christopher Hoimes, Nikhil H Ramaiya","doi":"10.1067/j.cpradiol.2024.12.010","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.12.010","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the utility of tumor mutational burden (TMB) as a marker for radiologic response to immune checkpoint inhibitor (ICI) therapy at a single tertiary cancer center.</p><p><strong>Materials and methods: </strong>In this retrospective study, out of 1044 patients treated with ICIs between January 2010 and November 2018, 75 patients (38 males and 37 females) with a mean age of 62 (range 22-87) years, who had information about TMB and adequate imaging, were included. Imaging response was determined according to iRECIST criteria. Predictors of objective response were analysed using non-parametric tests, and progression-free survival and overall survival were analysed using log-rank test.</p><p><strong>Results: </strong>Median TMB was 7.2 mutations/mb [interquartile range: 4-13.5]. The objective radiologic response rate according to iRECIST was 26.7 % (20 patients) and the median time to best response was 61 days [IQR: 47-88 days]. Median TMB in responders (12.5 [IQR: 5-18] muts/mb) was significantly higher than in non-responders (6 [IQR: 3-12] muts/mb) (p = 0.0293). Median TMB was higher in responders in the subgroup of patients treated with Nivolumab (20 vs 4 muts/mb, P = .0043), but not significantly in those treated with Pembrolizumab (9 vs 6 muts/mb, P = .211). There was no difference in PFS (p = 0.37, Log-Rank) or OS (p = 0.053, Log-Rank) between TMB low and high groups.</p><p><strong>Conclusion: </strong>Higher TMB was associated with objective response to ICI, however, TMB was an imperfect biomarker for PFS and OS in our study.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831438","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":"Mimics of pancreatic neoplasms at cross-sectional imaging: Pearls for characterization and diagnostic work-up.","authors":"David Salgado, Jessie Kang, Andreu F Costa","doi":"10.1067/j.cpradiol.2024.12.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.12.002","url":null,"abstract":"<p><p>Interpreting imaging examinations of the pancreas can be a challenge. Several different entities can mimic or mask pancreatic neoplasms, including normal anatomic variants, non-pancreatic lesions, and both acute and chronic pancreatitis. It is important to distinguish these entities from pancreatic neoplasms, as the management and prognosis of a pancreatic neoplasm, particularly adenocarcinoma, have considerable impact on patients. Normal pancreatic variants that mimic a focal lesion include focal fatty atrophy, annular pancreas, and ectopic pancreas. Extra-pancreatic lesions that can mimic a primary pancreatic neoplasm include vascular lesions, such as arteriovenous malformations and pseudoaneurysms, duodenal diverticula, and intra-pancreatic accessory spleen. Both acute and chronic pancreatitis can mimic or mask a pancreatic neoplasm and are also associated with pancreatic ductal adenocarcinoma. Awareness of these entities and their imaging features will enable the radiologist to narrow the differential diagnosis, provide recommendations that expedite diagnosis and avoid unnecessary work-up or delays in patient care.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866841","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":"Adipose tissue around the knee; A pictorial review of normal anatomy and common pathologies.","authors":"Mohammad Reza Rouhezamin, Arash Azhideh, Sara Haseli, Atefe Pooyan, Nastaran Hosseini, Majid Chalian","doi":"10.1067/j.cpradiol.2024.11.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.11.001","url":null,"abstract":"<p><p>The periarticular adipose tissues play a crucial role in knee biomechanics, yet they are often overlooked in daily radiology practice. As the primary mechanical shock absorbers of the knee, intra-articular fat pads reduce the friction between intra-articular structures during joint movement. They also contribute to inflammatory regulation, endocrine secretion, and pain detection. Periarticular fat pads are susceptible to a spectrum of traumatic, degenerative, inflammatory, and neoplastic changes. MRI enables radiologists to assess the anatomy of periarticular fat pads and their related pathologies to make accurate diagnoses and to guide appropriate management. The MRI presentation of these pathologies can be categorized into three groups: (a) signal change and thickening of synovial lining, (b) edema-like change in fat pads, and (c) mass-like lesions. While degeneration and impingement appear as high signal edema-like intensity on fluid-sensitive sequences, inflammatory or infectious synovitis, hemosiderin deposition, and lipoma arborescens can change the signal intensity of the synovial lining. A mass-like lesion arising from these structures could be a true neoplastic lesion, or a variety of non-neoplastic pathologies. A comprehensive understanding of adipose tissues and their pathologies is fundamental for accurate diagnosis and interpretation. In this review, we aim to provide an in-depth assessment of the anatomy and common pathologies of these adipose tissues.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775860","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":"Radiology quick cash? Kickbacks, compliance, and consequences.","authors":"Robert Optican, Richard Duszak","doi":"10.1067/j.cpradiol.2024.05.020","DOIUrl":"10.1067/j.cpradiol.2024.05.020","url":null,"abstract":"<p><p>The Anti-Kickback Statute was passed by Congress in the 1970s to reduce the overuse of government-reimbursed medical services. It attempts to eliminate fraud, abuse, and waste of medical services by outlawing the incentive of personal gain when referring patients for government-funded services. Although safe harbors were written into the law to maintain transactions beneficial to society, they require strict adherence. Anti-Kickback Statute violations are subject to the whistleblower provision of the False Claims Act, and violations can yield significant civil and criminal penalties.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":"677-678"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961173","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":"Online radiology teaching for doctors in a university setting: an Australian experience.","authors":"Dr Sally L Ayesa, Adjunct Prof Annette G Katelaris, Prof Patrick Brennan, Prof Stuart M Grieve","doi":"10.1067/j.cpradiol.2024.10.038","DOIUrl":"10.1067/j.cpradiol.2024.10.038","url":null,"abstract":"<p><strong>Background: </strong>Imaging Surgical Patients (ISP) and Essential Imaging for Clinicians (EIC) are online medical imaging units of study for non-radiologist medical practitioners within the Master of Surgery and Master of Medicine programs at the University of Sydney. This paper presents the findings of evaluations of the coursework associated with these units.</p><p><strong>Methods: </strong>ISP and EIC were reviewed after successful delivery of 8 and 4 semesters, respectively. Reflection and analyses were drawn from the educational team's experiences, formal student feedback, and cohort demographic data in the context of changes made to the units' structure, content, and assessment activities.</p><p><strong>Results: </strong>From 2016 to 2022, 568 students completed ISP, and 108 completed EIC from 2019-2022. For ISP, course revisions were progressively made to prioritise imaging skills and clinically significant knowledge, to balance the course load against the busy clinical lives of the students, and to offer a flexible learning experience that could be tailored to clinical interests. The design and delivery of EIC were informed by experiences delivering ISP, including the importance of clear learning outcomes and stakeholder consultation. Student and faculty engagement in an online learning environment presents an ongoing challenge. Both units continue to attract strong enrolments within their respective programs.</p><p><strong>Conclusions: </strong>ISP and EIC are unique Master-level units of study for medical practitioners in the Australian tertiary setting, given that their sole focus is improving non-radiologist clinicians' medical imaging knowledge and skills. By prioritising high-yield and clinically relevant learning experiences, the educational team hopes that engagement with radiology as a specialty will benefit from these units' continued delivery and refinement.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666742","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}