Current problems in diagnostic radiology最新文献

{"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":"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":"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":"Musculoskeletal imaging fellowship program directors: A study of educational paths, and scholarly engagement in the United States.","authors":"Mili Rohilla, Shruti Kumar, Parv Mehta, Samruddhi Jain, Abhigyan Bindal, George Vilanilam, Tarun Pandey","doi":"10.1067/j.cpradiol.2024.10.007","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.10.007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The overall aim of the study is to analyze and provide a comprehensive understanding of the demographics, educational backgrounds, and scholarly activities of musculoskeletal imaging fellowship program directors across the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A list of all members of the Society of Skeletal Radiology was obtained and musculoskeletal imaging fellowship program directors across the US were included. Publicly available online sources were used to gather demographic and educational information about each musculoskeletal imaging fellowship program director, which included the online curriculum vitae from the program websites, Health Grades, Doximity, and Elsevier's Scopus database. Demographic and educational data including age, gender, educational background (medical school, residency, fellowship), additional degrees, academic rank, prior leadership positions, and metrics of scholarly activity were recorded. Fellowships in diagnostic musculoskeletal radiology along with additional degrees were recorded. A two-tailed unpaired t-test was used to calculate the difference between means of scholarly activity between male and female PDs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In this study encompassing 92 programs across the United States, the majority (88) were dedicated to pure Musculoskeletal (MSK) Imaging Fellowship, while one each offered combined training in MSK and Body Imaging, MSK, and Emergency Imaging, MSK Sports, and Interventional Spine, and Pediatric MSK Imaging. Program directors were identified for 90 out of 92 programs, revealing a regional distribution of 29 in the South (31.5 %), 24 in the North East (26.1 %), 20 in the Midwest (21.74 %) and 19 in the West (20.65 %). Gender analysis unveiled a predominantly male representation, with 71 male directors compared to 17 female directors, while age ranged from 30 to 70 years, with a mean age of 47.17 ± 7.4 years. Medical school backgrounds predominantly featured MD degrees (80), followed by IMG (7) and DO (4) degrees, with the most common IMG source being India. Faculty positions were mainly distributed among Assistant Professors (35), Associate Professors (32), and Professors (11). Research output metrics showcased a mean of 41.943 publications and an h-index of 10.625. Extra degrees were obtained by 31 directors, with common additions being other fellowships, MBAs, MS degrees, and PhDs. Notably, some directors held previous or current leadership positions, while a few had completed residencies outside of Radiology or pursued fellowships beyond MSK Imaging.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Musculoskeletal imaging fellowship program directors across the United States are predominantly male, with approximately 8 % having graduated from international medical schools. The most common training pathway for these directors is completing a diagnostic radiology residency followed by a musculoskeletal radiology fellowship. This study highlighted the ge","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483994","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":"Thoracic MRI in pleural infection - a feasibility study from patients' and radiographers' perspectives.","authors":"Pia Iben Pietersen, Tobias Stæhr Jakobsen, Stefan Markus Walbom Harders, Jürgen Biederer, Stefan Møller Luef, Morten Bendixen, Jesper Rømhild Davidsen, Christian B Laursen","doi":"10.1067/j.cpradiol.2024.10.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.10.001","url":null,"abstract":"<p><strong>Background: </strong>Pleural infections present significant clinical challenges, particularly in elderly or immunosuppressed patients, leading to prolonged hospital stay, high morbidity and high mortality. While CT and X-ray are standard imaging modalities, MRI's potential remain unexplored due to historical limitations in scan duration and patient discomfort. Advances in MRI technology, however, may enable its broader use in thoracic imaging. The study aimed to explore the feasibility of thoracic MRI from the radiographers' and patients' perspectives.</p><p><strong>Methods: </strong>A prospective feasibility study was conducted involving thirteen patients with pleural infections who underwent thoracic MRI as an add-on within 48 h of the conventional contrast-enhanced chest CT. Feasibility was assessed on technical success, and scan duration. Patients and radiographers experiences were evaluated through questionnaires and qualitative comments.</p><p><strong>Results: </strong>Technical success was high as all thirteen patients completed the scans. The mean in-room time was 30.7±5.5 minutes and the mean scan time was 23 ± 5.4 minutes. Radiographers reported the MRI scans as feasible with few patients requiring breaks or assistance. Most patients found the MRI experience manageable though two reported difficulties with breath-hold instructions. No patients were challenged by lying in supine position and no patients felt very anxious. No significant movement- or breathing artefacts were identified on MRI.</p><p><strong>Conclusion: </strong>Thoracic MRI is feasible with high technical success, acceptable scan time, and good patient experience in patients with pleural infections offering potential as a radiation-free imaging modality. Furthermore, compared to CT, the use of MRI showed potential advantages in identifying pleural effusion septations.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396234","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":"Qualitative interviews for hospitalists addressing lung cancer screening.","authors":"Brett C Bade, Alex Makhnevich, Katherine L Dauber-Decker, Jeffrey Solomon, Elizabeth Cohn, Jesse Chusid, Suhail Raoof, Gerard Silvestri, Stuart L Cohen","doi":"10.1067/j.cpradiol.2024.08.011","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.08.011","url":null,"abstract":"<p><p>Novel strategies are needed to improve low rates of lung cancer screening (LCS) in the US. Seeking to determine hospitalists' perspectives on leveraging hospitalizations to identify patients eligible for LCS, we performed qualitative interviews with eight hospitalists from two hospitals within a large integrated healthcare system. The interviews used semi-structured questions to assess (1) knowledge and practice of general screening and LCS guidelines from the United States Preventive Services Task Force (USPSTF), (2) identification of smoking history, and (3) hospitalists' views on how data obtained during hospitalization may be utilized to improve general screening and LCS post hospitalization. We ultimately reached the conclusion that hospitalists would support a dedicated program to identify hospitalized patients eligible for LCS and facilitate testing after discharge. Efforts to identify patients and arrange subsequent screening should be performed by team members outside the inpatient team.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010159","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":"Long-term quality improvement in radiology specialty training at a tertiary cardiothoracic centre.","authors":"Monika Radikė, Marousa Ntouskou","doi":"10.1067/j.cpradiol.2024.08.010","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2024.08.010","url":null,"abstract":"<p><strong>Objectives: </strong>This quality improvement project (QIP) aimed to foster radiology training at a regional tertiary cardiothoracic centre that had very low trainee satisfaction rankings.</p><p><strong>Methods: </strong>To study the problem and intervene timely, multiple methods were applied, including a local feedback survey, placement reorganisation, consultant encouragement to train as accredited supervisors, followed by departmental education portal creation and start of externally funded Visiting Fellowships and salaried Clinical Fellowships. The regional rating was monitored. The local feedback survey was distributed and analysed using descriptive statistics. Alongside the QIP, service expansion occurred.</p><p><strong>Results: </strong>The site regionally ranked 9/19 in 2 years. Local survey responses (53) showed continuous improvement; cardiothoracic subspecialty interest (+39%) and audit/academic involvement (+36%) increased. Multiple Fellowships were completed; internationally reputable placements were agreed upon. Most consultants trained as supervisors. Per increased demand, compulsory deanery posts were changed to motivation-based, and an additional salaried position was offered. Five fellows stayed in the region as subspecialist consultants. Unexpected challenges included space and workstation loss with service expansion, lack of regional surveys since 2019, and the global pandemic. Regardless, the results were positive with subspecialty interest and projected reputational effect increase. Local long-term survey provided sustainable data in detecting improvement areas.</p><p><strong>Conclusions: </strong>Given the national radiologist shortage, this quality improvement project shows a possible positive impact of similar interventions, including workforce retention/recruitment and thus improving patient care.</p><p><strong>Advances in knowledge: </strong>Continuous feedback and quality improvement maintenance are valuable to enhance training quality locally and beyond.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057634","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":"Play in the reading room: Utilizing soft modeling compound to teach musculoskeletal anatomy and pathology.","authors":"Osvaldo Velez-Martinez,&nbsp;Grant L Hom,&nbsp;Samantha Jayasinghe,&nbsp;Vijaya Kosaraju,&nbsp;Navid Faraji,&nbsp;Jennifer Nicholas,&nbsp;Richard Barger","doi":"10.1067/j.cpradiol.2023.10.009","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2023.10.009","url":null,"abstract":"<p><strong>Problem description: </strong>Musculoskeletal (MSK) anatomy and pathology from a radiology perspective can be difficult to conceptualize and understand due to the challenge of visualizing 3D structures in stacks of 2D imaging. Consequently, trainees may benefit from inexpensive methods that can help trainees better visualize MSK anatomy and pathology. The purpose of this study is to provide proof of concept for inexpensive methodology to help learners such as radiology residents quickly and inexpensively understand musculoskeletal anatomy and pathology. This can help trainees become better at applying musculoskeletal knowledge to clinical practice.</p><p><strong>Institutional methodology: </strong>Soft-modeling compounds such as Play-Doh® was utilized in a variety of colors with pottery tools to recreate 3D models of challenging MSK anatomy and pathology for trainees. Qualitative feedback from the residents was collected.</p><p><strong>Results: </strong>Eighteen different pathological conditions across six major bone structures were modeled with a soft modeling compound. Residents qualitatively identified the experience as educational in terms of helping them better understand MSK pathology and positive in terms of making learning fun, less stressful, and memorable due to uniqueness of the learning modality. Residents report challenges modeling complex anatomical features and pathology via this methodology.</p><p><strong>Conclusion: </strong>Radiology residents and other learners can enhance their knowledge of musculoskeletal anatomy and pathology via utilization of inexpensive soft modeling compounds. This may offer a cheaper and more time sensitive alternative to current 3-dimensional hardware and software technologies being developed for educational purposes. Additional work needs to be done to examine the utility of this methodology across larger and diverse groups of learners.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61567060","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 Reading Room for the Future: Harnessing the Power of Large Language Models Like ChatGPT.","authors":"Charit Tippareddy,&nbsp;Sirui Jiang,&nbsp;Kaustav Bera,&nbsp;Nikhil Ramaiya","doi":"10.1067/j.cpradiol.2023.08.018","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2023.08.018","url":null,"abstract":"<p><p>Radiology has usually been the field of medicine that has been at the forefront of technological advances, often being the first to wholeheartedly embrace them. Whether it's from digitization to cloud side architecture, radiology has led the way for adopting the latest advances. With the advent of large language models (LLMs), especially with the unprecedented explosion of freely available ChatGPT, time is ripe for radiology and radiologists to find novel ways to use the technology to improve their workflow. Towards this, we believe these LLMs have a key role in the radiology reading room not only to expedite processes, simplify mundane and archaic tasks, but also to increase the radiologist's and radiologist trainee's knowledge base at a far faster pace. In this article, we discuss some of the ways we believe ChatGPT, and the likes can be harnessed in the reading room.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41143008","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}