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Clinical Imaging Feb 2023A clinical internship is currently required by the American Board of Radiology prior to Radiology residency. The purpose of this investigation is to evaluate practicing...
BACKGROUND
A clinical internship is currently required by the American Board of Radiology prior to Radiology residency. The purpose of this investigation is to evaluate practicing radiologists' perspectives on the value of the internship and their recommendations for optimization.
METHODS
A five-minute online survey was distributed via email to practicing radiologist members of the American College of Radiology.
RESULTS
A total of 566 completed responses (11.3% response rate) were received. Most respondents agreed that their internship was essential for improving non-radiology clinical knowledge (84%) and affirming their decision to become a radiologist (74%). Most respondents (59%) disagree that the one-year internship before residency should be eliminated. Most (53%) of the radiologists in an academic practice agreed that internship should be integrated into Radiology residency. If radiologists were to redesign the internship ("PreRad Internship"), a majority of the respondents would include training in other medical specialties (71%), working along technologists (55%) and informatics/AI/computer science (54%). While the greatest proportion (50%) of interventional radiologists reported a Surgery internship would be the most beneficial for their primary subspecialty (50%), diagnostic radiologists most commonly (27%) reported the PreRad Internship would be the most beneficial. The greatest proportions of Abdominal-, Breast-, and Neuroradiology-trained respondents reported a PreRad Internship would be the most beneficial internship for their primary field of subspecialty Radiology practice (32%, 36%, and 33%, respectively).
CONCLUSION
The internship before Radiology residency offers some benefits but could be further optimized. There is support from practicing radiologists for a redesigned, more Radiology-specific PreRad Internship.
Topics: Humans; United States; Internship and Residency; Radiology; Radiography; Radiologists; Surveys and Questionnaires
PubMed: 36495850
DOI: 10.1016/j.clinimag.2022.11.023 -
Academic Radiology Dec 2021To describe and analyze the pediatric neuroradiology implicit curriculum for general-pediatric and neuro-pediatric radiology fellowship training in order to define...
RATIONALE AND OBJECTIVES
To describe and analyze the pediatric neuroradiology implicit curriculum for general-pediatric and neuro-pediatric radiology fellowship training in order to define specific trainee needs and inform an explicit pediatric neuroradiology curriculum.
MATERIALS AND METHODS
A focus group of pediatric radiologists, pediatric neuroradiologists and fellows was conducted to create a needs assessment questionnaire that focused on training experience, current job, and a list of essential competency items. The questionnaire was distributed to 175 members of the Society for Pediatric Radiology. Data were derived from categorical and continuous survey variables. Using an inductive approach, we analyzed and systematically inspected the data to derive themes regarding trainee needs and how they might inform an explicit curriculum.
RESULTS
Fifty-seven pediatric radiologists (response rate of 33%) responded to the survey. Sixty-three percent of respondents were fellowship trained in general pediatric radiology, 21% in pediatric neuroradiology, and 16% in both. In their current jobs, 75% of respondents were responsible for interpreting some pediatric neuroradiology. 50% or greater reported limited or no fellowship instruction in five areas of imaging interpretation: fetal neuroimaging; ear and/or nose and/or throat imaging; head and neck imaging; neuroembryology; neuro-spectroscopy and four areas of technical skills and/or image quality: reducing imaging time; choice of contrast agents; sedation; understanding clinical management pathways.
CONCLUSION
Trainees endorse inadequate training in certain aspects of imaging interpretation and technical skills which are known to remain a significant and vital aspect of pediatric neuroradiology practice, revealing an opportunity to emphasize these aspects in an explicit curriculum and dedicate educational resources towards this cause.
Topics: Child; Curriculum; Education, Medical, Graduate; Fellowships and Scholarships; Humans; Needs Assessment; Radiology; Surveys and Questionnaires
PubMed: 33618941
DOI: 10.1016/j.acra.2020.08.025 -
Current Oncology (Toronto, Ont.) Jun 2021Radiomics is an emerging translational field of medicine based on the extraction of high-dimensional data from radiological images, with the purpose to reach reliable... (Review)
Review
Radiomics is an emerging translational field of medicine based on the extraction of high-dimensional data from radiological images, with the purpose to reach reliable models to be applied into clinical practice for the purposes of diagnosis, prognosis and evaluation of disease response to treatment. We aim to provide the basic information on radiomics to radiologists and clinicians who are focused on breast cancer care, encouraging cooperation with scientists to mine data for a better application in clinical practice. We investigate the workflow and clinical application of radiomics in breast cancer care, as well as the outlook and challenges based on recent studies. Currently, radiomics has the potential ability to distinguish between benign and malignant breast lesions, to predict breast cancer's molecular subtypes, the response to neoadjuvant chemotherapy and the lymph node metastases. Even though radiomics has been used in tumor diagnosis and prognosis, it is still in the research phase and some challenges need to be faced to obtain a clinical translation. In this review, we discuss the current limitations and promises of radiomics for improvement in further research.
Topics: Breast Neoplasms; Female; Humans; Lymphatic Metastasis; Neoadjuvant Therapy; Prognosis; Radiology
PubMed: 34202321
DOI: 10.3390/curroncol28040217 -
Academic Radiology Jun 2024Radiomics uses advanced mathematical analysis of pixel-level information from radiologic images to extract existing information in traditional imaging algorithms. It is... (Review)
Review
Radiomics uses advanced mathematical analysis of pixel-level information from radiologic images to extract existing information in traditional imaging algorithms. It is intended to find imaging biomarkers related to the genomics of tumors or disease patterns that improve medical care by advanced detection of tumor response patterns in tumors and to assess prognosis. Radiomics expands the paradigm of medical imaging to help with diagnosis, management of diseases and prognostication, leveraging image features by extracting information that can be used as imaging biomarkers to predict prognosis and response to treatment. Radiogenomics is an emerging area in radiomics that investigates the association between imaging characteristics and gene expression profiles. There are an increasing number of research publications using different radiomics approaches without a clear consensus on which method works best. We aim to describe the workflow of radiomics along with a guide of what to expect when starting a radiomics-based research project.
Topics: Humans; Imaging Genomics; Neoplasms; Algorithms; Diagnostic Imaging; Genomics; Biomedical Research; Multiomics; Radiomics
PubMed: 38286723
DOI: 10.1016/j.acra.2024.01.024 -
Clinical Imaging Apr 2020Quality and patient safety are essential to the practice of radiology. "Quality is our image" is the slogan for the American College of Radiology (ACR), which has...
Quality and patient safety are essential to the practice of radiology. "Quality is our image" is the slogan for the American College of Radiology (ACR), which has embraced the quality and safety movement as a central tenet. The impact of advances in radiology on diagnosis and management of complex medical disorders cannot be understated. Nevertheless, these revolutionary technologies do come at a cost. Increasing utilization of advanced imaging in emergency departments throughout the country poses challenges both in terms of appropriate use and management of radiation dose. The indispensable place advanced imaging plays in diagnosis has necessitated guidelines and accountability to protect patients and radiology staff. In this series, we have created a concise discourse on what we have determined to be the essentials of the economics of quality and safety as it pertains to radiology. In this first article, we summarize the accreditation programs in radiology, their legislative background, and the associated financial and market responses that have subsequently resulted. We discuss the progression from historical predecessors to the passage of the Mammography Quality and Safety Act (MQSA), which served as a model for subsequent laws governing the quality and safety of other imaging modalities. These laws have had real economic implications for radiology practices seeking to meet new increasingly stringent guidelines. We also break down the costs of participation in the ACR accreditation and center of excellence programs.
Topics: Accreditation; Humans; Mammography; Radiology; United States
PubMed: 31812348
DOI: 10.1016/j.clinimag.2019.09.003 -
Current Problems in Diagnostic Radiology 2022Radiology departments around the world have been faced with the challenge to adapt, and recover to the COVID-19 pandemic. This study is part of a worldwide survey of...
PURPOSE
Radiology departments around the world have been faced with the challenge to adapt, and recover to the COVID-19 pandemic. This study is part of a worldwide survey of radiologists' responses to COVID-19 in 18 different countries in Africa, Asia, Europe, and Latin America. The purpose of this study is to analyze the changes made in international radiology departments and practices in response to the pandemic.
METHODS
The 18-item survey was sent via email from April to May 2020 to radiologists in Africa, Asia, Europe, and Latin America to assess their response to COVID-19. Our survey included questions regarding imaging, workforce adjustments, testing availability, staff and patient safety, research and education, and infrastructure availability.
RESULTS
Twenty-eight survey responses were reviewed. Of the 28 respondents, 42.9% have shortages of infrastructure and 78.6% responded that COVID-19 testing was available. Regarding the use of Chest CT in COVID-19 patients, 28.6% respondents used Chest CT as screening for COVID-19. For staff safety, interventions included encouraging use of masks in patient encounters, social distancing and PPE training. To cope with their education and research mission, radiology departments are doing online lectures, reducing the number of residents in rotations, and postponing any non-urgent activities.
CONCLUSION
In conclusion, there are disparities in infrastructure, research, and educational initiatives during COVID-19 which also provides opportunity for the global radiology community to work together on these issues.
Topics: COVID-19; COVID-19 Testing; Humans; Pandemics; Radiology; SARS-CoV-2; Surveys and Questionnaires
PubMed: 33994227
DOI: 10.1067/j.cpradiol.2021.03.017 -
Radiography (London, England : 1995) May 2023Paediatric patients differ from adult patients with respect to anatomy, examination factors, behaviour, and intellectual development, requiring dedicated specialised...
INTRODUCTION
Paediatric patients differ from adult patients with respect to anatomy, examination factors, behaviour, and intellectual development, requiring dedicated specialised knowledge and expertise. In the absence of a formal dedicated paediatric medical imaging subspecialty, this study undertook to understand student radiographers' experiences and perspectives on paediatric medical imaging.
METHODS
The study entailed a descriptive cross-sectional survey design entailed a 51-item closed and open-ended response questionnaire using a total sampling method. Data were collected from both under- and postgraduate student radiographers who undertook clinical placement. Data interpretation and analysis involved statistical analysis of close-ended questions and thematic analysis of open-ended questions.
RESULTS
The overall response rate was 70%. Most participants acknowledged the importance of dedicated paediatric content as well as the theory content covered. The shortcoming in pre-placement practical component was overcome through varied approaches like observations and attempting through supervision whilst experiencing uncertainty, anxiety and felt unfair to risk the patient. As reported in literature like their qualified counterparts expressed similar challenges in technique adaptation, styles of interactions in gaining cooperation from both the children and parents. They also felt paediatric content and the practicals should be embedded throughout the course offering to not compromise the day-to-day service delivery.
CONCLUSIONS
The study findings iterate the importance paediatric imaging in the service delivery context. The importance of undertaking these examinations reliant on experiential learning is insufficient to bridge the gap of preparation prior to placement.
IMPLICATIONS FOR PRACTICE
Collaborative academic and clinical radiography education will ensure that radiography students' dedicated specialised paediatric imaging knowledge and experience are enhanced.
Topics: Child; Humans; Australia; Cross-Sectional Studies; Radiography; Radiology; Students, Medical
PubMed: 37075490
DOI: 10.1016/j.radi.2023.03.013 -
Canadian Association of Radiologists... May 2023Prior studies on Canadian physicians' income have demonstrated a gender pay gap (GPG); however, there is a paucity of data in the Radiology specialty. A cross-sectional...
Prior studies on Canadian physicians' income have demonstrated a gender pay gap (GPG); however, there is a paucity of data in the Radiology specialty. A cross-sectional study was conducted to determine if practicing Canadian radiologists' self-reported income is related to gender, controlling for demographic and work variables. English and French online surveys were distributed by email and social media to radiologists and trainees (May-July 2021). The association between Gender (controlling for Ethnicity variables, Region, having Children, Full-/Part-Time work, and Academic position) and Self-Reported Income was examined using chi-square tests. Pearson correlations examined relationships between opinion variables. Analyses were conducted using SPSS V28.0. A priori significance was < .05. Study had ethics approval. Four hundred and fifty-four practicing Canadian radiologists responded. Majority were women (51.2%, n = 227), a non-visible Minority (71.7%, n = 317), and from Western Provinces (67.8%, n = 308). Significant relationship was established between Self-Reported Income and Gender (χ2 = 10.44, df = 2, < .05). More men (70.6%, n = 120) than women (56.4%, n = 110), reported income "greater than $500 000"; fewer men (20.6%, n = 35) than women (35.9%, n = 70) reported "$300 000-$500 000"; a similar percent of men (8.8%, n = 15) and women (7.7%, n = 15) reported "less than $300 000." No relationship was found between self-reported income and gender for ethnicity variables, those without children, part-time, or non-academic radiologists. The opinion "Addressing the GPG is important" correlated to "Canadian Association of Radiologists should collect demographic data" (r = 0.63). Responses were low for ethnic minorities and non-western provinces. Our results suggest a GPG exists in Canadian radiology and is an important first step for future studies.
Topics: Child; Humans; Male; Female; Canada; Cross-Sectional Studies; Radiology; Radiography; Radiologists
PubMed: 36223428
DOI: 10.1177/08465371221132465 -
Radiology. Cardiothoracic Imaging Feb 2024While idiopathic pulmonary fibrosis (IPF) is the most common type of fibrotic lung disease, there are numerous other causes of pulmonary fibrosis that are often... (Review)
Review
While idiopathic pulmonary fibrosis (IPF) is the most common type of fibrotic lung disease, there are numerous other causes of pulmonary fibrosis that are often characterized by lung injury and inflammation. Although often gradually progressive and responsive to immune modulation, some cases may progress rapidly with reduced survival rates (similar to IPF) and with imaging features that overlap with IPF, including usual interstitial pneumonia (UIP)-pattern disease characterized by peripheral and basilar predominant reticulation, honeycombing, and traction bronchiectasis or bronchiolectasis. Recently, the term has been used to describe non-IPF lung disease that over the course of a year demonstrates clinical, physiologic, and/or radiologic progression and may be treated with antifibrotic therapy. As such, appropriate categorization of the patient with fibrosis has implications for therapy and prognosis and may be facilitated by considering the following categories: () radiologic UIP pattern and IPF diagnosis, () radiologic UIP pattern and non-IPF diagnosis, and () radiologic non-UIP pattern and non-IPF diagnosis. By noting increasing fibrosis, the radiologist contributes to the selection of patients in which therapy with antifibrotics can improve survival. As the radiologist may be first to identify developing fibrosis and overall progression, this article reviews imaging features of pulmonary fibrosis and their significance in non-IPF-pattern fibrosis, progressive pulmonary fibrosis, and implications for therapy. Idiopathic Pulmonary Fibrosis, Progressive Pulmonary Fibrosis, Thin-Section CT, Usual Interstitial Pneumonia © RSNA, 2024.
Topics: Humans; Idiopathic Pulmonary Fibrosis; Inflammation; Radiology; Bronchiectasis; Tomography, X-Ray Computed
PubMed: 38358328
DOI: 10.1148/ryct.230135 -
Canadian Association of Radiologists... Nov 2015Cancer remains a leading cause of death in Canada and worldwide. Whilst advances in anatomical imaging to detect and monitor malignant disease have continued over the... (Review)
Review
Cancer remains a leading cause of death in Canada and worldwide. Whilst advances in anatomical imaging to detect and monitor malignant disease have continued over the last few decades, limitations remain. Functional imaging, such as positron emission tomography (PET), has improved the sensitivity and specificity in detecting malignant disease. In combination with computed tomography (CT), PET is now commonly used in the oncology setting and is an integral part of many cancer patients' pathways. Although initially the CT component of the study was purely for attenuation of the PET imaging and to provide anatomical coregistration, many centers now combine the PET study with a diagnostic quality contrast enhanced CT to provide one stop staging, thus refining the patient's pathway. The commonest tracer used in everyday practice is FDG (F18-fluorodeoxyglucose). There are many more tracers in routine clinical practice and those with emerging roles, such as 11C-choline, useful in the imaging of prostate cancer; 11C-methionine, useful in imaging brain tumours; C11-acetate, used in imaging hepatocellular carcinomas; 18F-FLT, which can be used as a marker of cellular proliferation in various malignancies; and F18-DOPA and various 68Ga-somatostatin analogues, used in patients with neuroendocrine tumours. In this article we concentrate on FDG PETCT as this is the most commonly available and widely utilised tracer now used to routinely stage a number of cancers. PETCT alters the stage in approximately one-third of patients compared to anatomical imaging alone. Increasingly, PETCT is being used to assess early metabolic response to treatment. Metabolic response can be seen much earlier than a change in the size/volume of the disease which is measured by standard CT imaging. This can aid treatment decisions in both in terms of modifying therapy and in addition to providing important prognostic information. Furthermore, it is helpful in patients with distorted anatomy from surgery or radiotherapy when there is suspicion of recurrent or residual disease. FDG PETCT is not specific for malignancy and can also be used for diagnosing and monitoring a number of inflammatory and infectious conditions that can be difficult to diagnose on anatomical imaging, some of which carry significant morbidity. FDG PETCT is increasingly used in patients with pyrexia of unknown origin and in patients with metastatic malignancies of unidentified primary on conventional imaging. This article reviews the uses of PETCT including an overview of the more common incidental lesions and conditions. It also provides guidance of how to approach a PETCT as a nonradionuclide radiologist and how to interpret a study in the multidisciplinary team setting.
Topics: Education, Medical, Continuing; Fluorodeoxyglucose F18; Humans; Multimodal Imaging; Neoplasm Staging; Neoplasms; Positron-Emission Tomography; Radiology; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 26277234
DOI: 10.1016/j.carj.2015.02.003