Current problems in diagnostic radiology最新文献

{"title":"A breakdown of how diagnostic radiology residency became increasingly competitive for US doctors of osteopathic medicine (DOs) and international medical graduates (IMGs).","authors":"Sakina Divan, Hebatullah M Elsingergy, Arif Musa, Mohamed M Elsingergy, Brigitte Berryhill, Gulcin Altinok","doi":"10.1067/j.cpradiol.2025.04.007","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.007","url":null,"abstract":"<p><p>Diagnostic Radiology has emerged as an increasingly competitive specialty posing a significant challenge for aspirants, particularly for Doctors of Osteopathic Medicine (DOs) and International Medical Graduates (IMGs). This could be attributed to the field's dynamic nature, flexibility of career paths, and high job demand. This article delves into a decade's worth of matching trends in diagnostic radiology, underscoring the unique obstacles faced by DOs and IMGs including possible implicit biases, logistical hurdles, and the implications of the USMLE Step 1's transition to pass/fail scoring. It offers practical solutions to level the playing field, such as expanding clinical and research opportunities for applicants, encouraging residency programs to address implicit biases, increasing curriculum adaptability in osteopathic and foreign medical schools, and exploring accreditation reforms. Together, these recommendations aim to create a more equitable selection process and mitigate the systemic barriers DOs and IMGs face in securing highly sought-after radiology residency spots.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014892","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":"Theranostics: A primer for medical students and residents.","authors":"Ibrahim A Rehman, Richard B Gunderman","doi":"10.1067/j.cpradiol.2025.04.016","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.04.016","url":null,"abstract":"<p><p>A key component of the introduction of any medical innovation is education. Simply put, health professionals not involved in such an innovation's development need to learn about it, and such education needs to be tailored to the needs of different learning communities, including those who will someday incorporate it into the care of their patients and those who will receive queries about it from patients and colleagues. Among such key groups are medical students and residents, and one such promising innovation is theranostics, a burgeoning field whose name is a portmanteau of therapeutics and diagnostics that combines targeted therapeutics with molecular imaging to deliver individualized care. The field is sufficiently new that it is not included in the curricula of many medical schools and residency programs, yet physicians in training need a basic understanding of its current and projected future role in healthcare. This article serves as such an introduction.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054825","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":"Radiological insights into pediatric undernutrition: Early detection, complications, and a structured evaluation approach.","authors":"Ishan Kumar, Ashish Verma, Priyanka Aggarwal, Nidhi Yadav, Karan Kukreja, Pramod Kumar Singh","doi":"10.1067/j.cpradiol.2025.03.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.03.002","url":null,"abstract":"<p><p>Despite a decade of significant growth in economic conditions of South Asian countries, people continue to suffer from the pervading problem of malnutrition. High prevalence of child undernutrition despite unprecedented economic growth in these nations have a multifactorial etiology including fetal malnutrition and status of women, inadequate feeding practices in infant and young child, poor household sanitation and untargeted health schemes. The diagnosis and management of malnutrition and its various complications require a multidisciplinary approach and radiologists have a potentially important, albeit currently underutilized, role in early detection, identifying the other clinical mimics such as endocrinal and genetic disorders, and detection of key complications. In this review, we apprise the radiological aspects of PEM and micro-nutritional deficiency and their complications. We also provide a comprehensive structured evaluation scheme for evaluation of a suspected malnourished child.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702547","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 impact of DWI absence on prostate lesion assessment using PI-RADS 2.1.","authors":"Negar Firoozeh, Sung Yoon Park, Yaw Nyame, Arash Mahdavi, Seyed Ali Nabipoorashrafi, Achille Mileto, Bahar Mansoori, Antonio C Westphalen","doi":"10.1067/j.cpradiol.2025.03.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.03.001","url":null,"abstract":"<p><strong>Objective: </strong>To compare Prostate Imaging Reporting and Data System (PI-RADS) scores derived from a standard multiparametric prostate MRI (mpMRI) protocol with those from a protocol consisting only of T2-weighted and dynamic contrast-enhanced images (T2+DCE MRI).</p><p><strong>Methods: </strong>In this retrospective, single-center, cross-sectional study approved by the IRB and compliant with HIPAA, 492 MRI exams performed in 2022 were analyzed. PI-RADS scores from mpMRIs were extracted from medical records, and new scores were generated for T2+DCE MRI following PI-RADS guidelines. Score differences were evaluated using Wilcoxon signed-rank and McNemar's tests, stratified by lesion location (peripheral zone, PZ, and transition zone, TZ). Diagnostic accuracies of the two methods were compared using ROC curves, and logistic regression was employed to identify predictors of score changes.</p><p><strong>Results: </strong>Notable differences in PI-RADS scores were observed were observed in the PZ (P = 0.03) and TZ (P < 0.001). 4.8 % of PZ and 4.0 % of TZ PI-RADS 3-5 lesions were misclassified as PI-RADS 1-2 on T2W+DCE MRI (PZ vs TZ, P = 0.64). However, ROC curve analyses revealed no significant difference in diagnostic accuracy between mpMRI (Az = 0.77) and T2+DCE MRI (Az = 0.75, P = 0.07). PSA density was identified as a predictor of score changes from PI-RADS 3-5 to 1-2, although the effect size was modest.</p><p><strong>Conclusions: </strong>Although T2+DCE MRI yields different PI-RADS scores compared to mpMRI, the clinical impact on diagnostic accuracy and decision-making is overall small. This supports the continued use of T2+DCE MRI, particularly when diffusion-weighted imaging is compromised.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607567","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":"Differentiating between GPT-generated and human-written feedback for radiology residents.","authors":"Zier Zhou, Arsalan Rizwan, Nick Rogoza, Andrew D Chung, Benjamin Ym Kwan","doi":"10.1067/j.cpradiol.2025.02.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.02.002","url":null,"abstract":"<p><strong>Purpose: </strong>Recent competency-based medical education (CBME) implementation within Canadian radiology programs has required faculty to conduct more assessments. The rise of narrative feedback in CBME, coinciding with the rise of large language models (LLMs), raises questions about the potential of these models to generate informative comments matching human experts and associated challenges. This study compares human-written feedback to GPT-3.5-generated feedback for radiology residents, and how well raters can differentiate between these sources.</p><p><strong>Methods: </strong>Assessments were completed by 28 faculty members for 10 residents within a Canadian Diagnostic Radiology program (2019-2023). Comments were extracted from Elentra, de-identified, and parsed into sentences, of which 110 were randomly selected for analysis. 11 of these comments were entered into GPT-3.5, generating 110 synthetic comments that were mixed with actual comments. Two faculty raters and GPT-3.5 read each comment to predict whether it was human-written or GPT-generated.</p><p><strong>Results: </strong>Actual comments from humans were often longer and more specific than synthetic comments, especially when describing clinical procedures and patient interactions. Source differentiation was more difficult when both feedback types were similarly vague. Low agreement (k=-0.237) between responses provided by GPT-3.5 and humans was observed. Human raters were also more accurate (80.5 %) at identifying actual and synthetic comments than GPT-3.5 (50 %).</p><p><strong>Conclusion: </strong>Currently, GPT-3.5 cannot match human experts in delivering specific, nuanced feedback for radiology residents. Compared to humans, GPT-3.5 also performs worse in distinguishing between actual and synthetic comments. These insights could guide the development of more sophisticated algorithms to produce higher-quality feedback, supporting faculty development.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473241","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":"Assessment of radiology residents' diagnostic accuracy in thoracic emergencies using the WIDI SIM platform.","authors":"Michael Mathelier, Abheek Raviprasad, Kevin Pierre, Persis Desai, Olivia Scheuermann, Christopher Sistrom, Roberta Slater, Otgonbayar Batmunh, Linda Lanier, Anthony Mancuso, Dhanashree Rajderkar, Priya Sharma","doi":"10.1067/j.cpradiol.2025.02.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.02.001","url":null,"abstract":"<p><strong>Purpose: </strong>To assess radiology residents' diagnostic accuracy in interpreting thoracic emergency cases using the Wisdom in Diagnostic Imaging Simulation (WIDI SIM) platform and identify potential areas for educational improvement.</p><p><strong>Methods: </strong>In this retrospective study, 761 radiology residents were assessed on five thoracic emergency cases using WIDI SIM over four years. Cases included bronchial disruption, septic emboli, ventricular perforation, pulmonary embolism, and a negative pulmonary CTA. Residents provided free-text interpretations, which were scored by faculty using a standardized point system. Scores and errors were analyzed using descriptive statistics and the Kruskal-Wallis test.</p><p><strong>Results: </strong>Residents' performance varied across the five cases, with the highest average score on the negative pulmonary CTA (9.59) and the lowest on bronchial disruption (6.59). Observational errors were more common than interpretive errors. The Kruskal-Wallis test revealed significant differences in median scores across the cases (p < 0.0001), with pairwise comparisons showing significant differences in all but two comparisons.</p><p><strong>Conclusion: </strong>This study reveals significant variability in radiology residents' diagnostic accuracy in interpreting thoracic emergency cases, with a high prevalence of observational errors. Our observations emphasize the need for targeted educational strategies to address specific areas of weakness and improve diagnostic accuracy in this critical area of radiology practice.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477002","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 resident competency in diagnosing non-traumatic musculoskeletal conditions: A simulation-based assessment using WIDI SIM.","authors":"Isabella E Amador, Abheek G Raviprasad, Kevin Pierre, Nicholas Rodriguez-Zingg, Kerolus Anis, Roberta M Slater, Christopher L Sistrom, Ivan Davis, Anthony A Mancuso, Dhanashree Rajderkar","doi":"10.1067/j.cpradiol.2025.01.014","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.01.014","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate radiology resident performance in diagnosing four non-traumatic musculoskeletal (MSK) pathologies that have historically yielded low scores on the Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM).</p><p><strong>Materials and methods: </strong>This multi-institutional, retrospective study analyzed WIDI SIM data collected from 2015 to 2021. A total of 351 radiology residents (R1-R4) interpreted 65 de-identified imaging cases, four of which focused on septic arthritis/osteomyelitis of the shoulder, septic arthritis/osteomyelitis of the hip, acetabular neoplasm, and Legg-Calve-Perthes disease. Each case was scored using a standardized 10-point rubric (0-2 = critical error, 3-6 = problematic omissions, 7-10 = effective report). Scores were further categorized into observational (missed findings) and interpretive (incorrect conclusion despite correct identification) errors. The Kruskal-Wallis test with Dunn's multiple comparisons was used to assess performance differences across postgraduate years.</p><p><strong>Results: </strong>Among these four MSK pathologies, only hip osteomyelitis demonstrated a statistically significant difference across training levels (p = 0.0063), although no specific pairwise comparisons were significant. Average scores remained relatively low across all cases, with observational errors surpassing interpretive errors in frequency.</p><p><strong>Conclusion: </strong>Radiology residents struggled to accurately diagnose non-traumatic MSK pathologies in a simulated on-call setting, predominantly due to missed imaging findings. Implementation of enhanced training strategies, such as targeted case review, high-yield simulations, and systematic visual search protocols, may improve MSK diagnostic competency and reduce the risk of clinically significant oversights.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191543","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":"Reimbursement for outside second opinion imaging interpretation: Experience at a quaternary care academic pediatric health system.","authors":"Victor J Seghers, Margaret A Clement, Robert C Orth, Marla B K Sammer, Andrew C Sher","doi":"10.1067/j.cpradiol.2025.01.002","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.01.002","url":null,"abstract":"<p><p>There are increasing requests and benefits of providing formal written reports for second opinions of outside imaging in part due to medical legal concerns supporting appropriate documentation and concerns that misunderstandings from verbal curbside consults on the part of the requesting physician may lead to suboptimal patient care and potential liability for the radiologist and hospital. Verbal communication of findings on outside imaging is thus often considered insufficient with recommendations from undocumented consultations less likely to be acted upon. The increased work associated with performance of second-opinion interpretations may be substantial, raising concern that if curbside consults are not properly compensated, some second opinion interpretations may be performed more expeditiously than primary interpretations due to their more direct impact upon the daily work load, income, and relative value units. Since 2016, our quaternary-care academic pediatric hospital system has provided and billed for formal second-opinion imaging interpretations upon request for MRI, CT, and Nuclear Medicine exams, and disallowed the process of informal curbside consultations on such studies. This study aims to offer insight into our second opinion interpretation workflows and our experience in obtaining reimbursement for pediatric second opinion interpretations. Our findings indicate a formal second-opinion interpretation program can be financially viable and may help offset the additional resources required, and can serve as a guide to inform other departments attempting to establish a similar process.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367063","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":"Take your PIC (Program Improvement Committee): The benefits of a resident-run initiative to improve graduate medical education.","authors":"Samantha Pfiffner, Michael Burcescu, Arif Musa, Hamed Kordbacheh, Alhassan Alhasson, Gulcin Altinok, Lisa Dillon, Ali Harb","doi":"10.1067/j.cpradiol.2025.01.011","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.01.011","url":null,"abstract":"<p><p>The evolving landscape of graduate medical education (GME) necessitates innovative approaches to residency program evaluation and improvement. At Detroit Medical Center/Wayne State University, a novel resident-led Program Improvement Committee (PIC) was established in June 2022 within the Diagnostic Radiology Residency Program. The PIC serves as a flexible, resident-driven structure designed to enhance engagement, provide continuous feedback, and implement actionable solutions in collaboration with residency leadership. Unlike traditional Program Evaluation Committees (PECs) and Clinical Competency Committees (CCCs), the PIC promotes a more democratized approach, empowering residents to take ownership of their training. By convening monthly and fostering fluid subcommittees, the PIC has successfully driven initiatives including increased research engagement, mentorship programs, social media enhancement, and system-level improvements such as the establishment of a dedicated WiFi network for hospital employees. The PIC represents a paradigm shift in residency enhancement, offering a responsive, adaptable mechanism for fostering innovation, inclusivity, and collaboration. Further research is needed to evaluate its broader impact, but the PIC has the potential to revolutionize residency training and improve medical education.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061663","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":"Responding to daily volume surges in real time in an academic setting: the \"Ad Hoc\" shift.","authors":"Dana Alkhulaifat, Ethan Larsen, Cassie Solomon, David M Biko, Sudha A Anupindi, Hansel Otero","doi":"10.1067/j.cpradiol.2025.01.008","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.01.008","url":null,"abstract":"<p><p>Staffing shortages and increased radiology study volumes have led to higher workloads and increased rates of burnout among pediatric radiologists. These conditions are exacerbated by daily fluctuations in study volumes which can occur due to a plethora of reasons and can often be unpredictable. Current solutions involve increasing staffing numbers and offsetting certain specialized studies to other subspecialties. However, these solutions can be costly and impractical. Therefore, we devised a dynamic, flexible two-hour shift called the Ad Hoc shift in which a designated pediatric radiologist dubbed as the \"maestro\" assesses the body division workflow in real-time and decides whether to recruit additional radiologists during high study volumes. In this paper, we discuss the protocol of the proposed Ad Hoc shift, along with preliminary results from our institution after a year of implementation. Additionally, we discuss its advantages and address some considerations that may arise during the implementation process.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076718","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}